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At least 145 records · Page 8Linked to original sources
PubMed2001

Sun protection practices in preadolescents and adolescents: a school-based survey of almost 25,000 Connecticut schoolchildren.

Sun protection practices in children and adolescents fall well below national recommendations. We present the results of a survey of sun protection use and other health-related behaviors in a sample of Connecticut Caucasian students aged 9 through 18 years (N = 24,645). Our objectives were to estimate the prevalence of sun protection use and to evaluate the relationship between sun protection use and health-risk behaviors and attitudes about appearance. We present data from 1988 through 1995 from the Connecticut Health Check, a health risk appraisal survey sponsored by the Connecticut Department of Public Health. Students enrolled in public and private elementary junior as well as senior high schools took the self-administered anonymous survey, which included multiple-choice questions about use of sun protection, cigarettes, and alcohol and about body image and self-esteem. We report prevalence proportions for use of sun protection by demographic features. We compared the proportion of students in 3 categories of outcome (always, sometimes, and never use sun protection) who reported various health-risk behaviors. Twenty percent of the sample reported always using sun protection; this is well below national goals set forth in the Healthy People 2000 recommendations. Sun protection use was inversely related to age and was higher among girls than boys at all ages. At all ages, students who did not use sun protection were more likely than those who did to report other health risk behaviors, such as use of cigarettes and alcohol. The data suggested that use of sun protection is associated with positive attitudes about appearance and self-image. Use of sun protection may be one component of an overall mode of health awareness and behavior. Programs promoting safe sun practices should target boys and be integrated into an overall campaign aimed at other risk-taking behaviors.

Adolescent↗
PubMed1994

Comparison of mortality rates for open and closed cholecystectomy in the elderly: Connecticut statewide survey.

The objective was to determine the safety of laparoscopic cholecystectomy for patients 65 years of age and older with symptomatic uncomplicated chronic gallbladder disease by comparing the mortality rate with open cholecystectomy. Connecticut Hospital Information Management Exchange and the Connecticut Society of American Board of Surgeons established a Connecticut Laparoscopic Registry made up of 33 acute care hospitals. A cohort longitudinal retrospective statewide registry collected data mortality rates on all 2865 elderly patients undergoing open (OC) or closed (LC) cholecystectomy for uncomplicated chronic cholecystitis. A database was established and continuously monitored from October 1, 1988, to December 31, 1992. Seven hundred sixty-one patients over 65 years of age underwent open cholecystectomy for uncomplicated chronic cholecystectomy during fiscal year 1989, with a mortality rate of 1.4%. The mortality rate of a similar cohort of patients who underwent laparoscopic cholecystectomy during fiscal years 1991 and 1992 was 0.3% and 0.6%, respectively. The mortality rate was further broken down into age subsets 65-69, 70-79, and 80+. The prelaparoscopic era (FY 1989) age subsets were compared with those of the laparoscopic era (FY 1991 and 1992). A statistically significant reduction (p = 0.01) in mortality rate was noted in the 70-79 age group following laparoscopic surgery. Laparoscopic cholecystectomy in the elderly for the treatment of symptomatic, uncomplicated chronic cholecystitis is as safe if not safer than open cholecystectomy as measured by mortality rate.

Aged↗
PubMed2002

Bioterrorism-related anthrax surveillance, Connecticut, September-December, 2001.

On November 19, 2001, a case of inhalational anthrax was identified in a 94-year-old Connecticut woman, who later died. We conducted intensive surveillance for additional anthrax cases, which included collecting data from hospitals, emergency departments, private practitioners, death certificates, postal facilities, veterinarians, and the state medical examiner. No additional cases of anthrax were identified. The absence of additional anthrax cases argued against an intentional environmental release of Bacillus anthracis in Connecticut and suggested that, if the source of anthrax had been cross-contaminated mail, the risk for anthrax in this setting was very low. This surveillance system provides a model that can be adapted for use in similar emergency settings.

Absenteeism↗
PubMed1992

Ten-year follow-up of breast carcinoma in situ in Connecticut.

Statistics from the Connecticut Tumor Registry from 1979 to 1988 were examined, and individual medical records from 1979 to 1983 were also reviewed. Three hundred nineteen medical records were available for review, documenting 220 cases of ductal carcinoma in situ and 102 cases of lobular carcinoma in situ. In 1979, there were 33 new cases of ductal carcinoma in situ reported to the Connecticut Tumor Registry, representing 1.8% of all breast cancers. There has been a yearly increase in ductal carcinoma in situ, with 200 new cases, or 7.4% of all breast cancers, reported in 1988. Forty-eight (22%) of 217 patients with ductal carcinoma in situ had bilateral breast involvement with ductal carcinoma in situ or an invasive breast cancer. Ten (83%) of 12 mastectomy specimens from patients with ductal carcinoma in situ who presented with nipple discharge demonstrated residual tumor, suggesting a more diffuse involvement. Two of the three reported recurrences involved nipple discharge. Thirty-seven (16.8%) of the 220 patients with ductal carcinoma in situ and six (5.9%) of the 102 patients with lobular carcinoma in situ were diagnosed as having another unrelated cancer. Ongoing clinical trials will direct optimum therapy for patients increasingly diagnosed as having ductal carcinoma in situ.

Breast Neoplasms↗
PubMed1996

Bile duct injuries, 1989-1993. A statewide experience. Connecticut Laparoscopic Cholecystectomy Registry.

OBJECTIVE: To review the incidence of major bile duct injuries (MBDI) during the shift from open (OC) to laparoscopic cholecystectomy (LC). DESIGN: Cohort analysis; minimum 15-month patient follow-up. SETTING: Acute care Connecticut hospitals. PATIENTS: Medical records of 30211 patients with cholecystectomy (OC or LC) reviewed; 47 cases of MBDI confirmed. MAIN OUTCOME MEASURE: Rate of MBDI. RESULTS: The incidence of MBDI in Connecticut hospitals rose from 0.04% in 1989 to 0.24% in 1991, then decreased to 0.11% in 1993. The increase was due to increased numbers of cholecystectomies and the initial increased risk of injury with LC. The 1990-through-1993 trend of decreasing incidence of LC MBDI was statistically significant (P=.02). By 1993, the difference between LC and OC was no longer significant (P=.81). Acute cholecystitis (odds ratio, 3.3) and gallstone pancreatitis (odds ratio, 3.6) increased the risk of MBDI during LC (P<.001). The LC MBDI more commonly were ductal excision or transections and often were not diagnosed intraoperatively. Intraoperative cholangiography facilitated intraoperative recognition and repair. Most patients (89%) underwent definitive management of the MBDI at the hospital of origin; of those, 5% required further interventions. CONCLUSIONS: Surgeries for acute cholecystitis and gallstone pancreatitis are associated with an increased risk for MBDI. Ductal anatomy, the timing of recognition of injury, and the method of repair dictate patient outcomes. Most patients are successfully managed at the hospital of origin, with good long-term results. Late bile duct strictures appear rare.

Acute Disease↗
PubMed1996

Continuing increase in incidence of germ-cell testis cancer in young adults: experience from Connecticut, USA, 1935-1992.

The current study is designed to examine long-term trends by histologic types of testis cancer in Connecticut. A regression model was used to identify age, period, or cohort as determinants of the time-trend on histologic types of testis cancer. The results from this descriptive epidemiologic study show that the overall age-adjusted incidence rate of testis cancer has increased 3.5-fold in Connecticut during the past nearly 60 years of cancer registration. The rates for seminoma and non-seminoma have been increasing since the mid-1950s and increase in a similar manner for those aged 15 to 49. The largest increase was observed in the age groups 20 to 44 for seminoma and 15 to 34 for non-seminoma. The observed increase was limited to whites. The results from age-period-cohort modeling suggest that the observed increase in seminoma before 1950s could be largely attributable to a period effect, while the increase for cohorts born after about 1910 both for seminoma and for non-seminoma are mainly explained by a strong birth-cohort effect. Therefore, the observed increase in germ-cell testis cancer in this population is likely to continue in the coming years. Thus far, the proposed hypotheses, such as exposure to DES in utero, earlier lifetime exposure to viruses, trauma or unusual amounts of heat to the testis, cannot adequately explain the observed incidence patterns of testis cancer. Analytical epidemiologic studies with large sample size are urgently needed to examine the risk factors responsible for the increase.

Adolescent↗
PubMed1996

A model for the effect of cigarette smoking on lung cancer incidence in Connecticut.

Population based data on smoking history derived from NCHS surveys were used to develop a model for lung cancer incidence in Connecticut. Trends in smoking prevalence suggest that, while the prevalence in men increased earlier than women, more male smokers have quit than their female counterparts. These trends in smoking prevalence suggest striking gender differences in a period effect for the smoking prevalence. Estimates of the proportion of current smokers, ex-smokers, and the mean duration of smoking were used in a model for the lung cancer incidence rates. The form for the relationship between smoking history and the incidence rate for these subgroups was based on information from cohort studies. The models represented a mixture of the smoking subgroups where the effect of smoking was considered to be either a multiplicative effect on the underlying age distribution, or a separate effect in which the level of exposure was the sole contribution to risk among smokers. The multiplicative model explained more than 80 per cent of the deviance for the period and cohort effects, while the non-multiplicative model could only account for trends in females. Hence, these results suggest that a sizeable portion of the period and cohort contributions to the lung cancer incidence trends in Connecticut can be attributed to the multiplicative model that utilizes this smoking information, although the lack of more detailed information is a limiting factor in developing the model.

Adult↗
PubMed1977

A comparison of Hodgkin's disease in Alameda County, California, and Connecticut: histologic subtype and age distribution.

A comparison of the histologic patterns of Hodgkin's disease in Alameda County, California and Connecticut was made in relation to age. All Hodgkin's disease cases from the Alameda County Cancer Registry diagnosed between 1960 and 1969 for which adequate material was available for evaluation were reviewed and histologically subtyped according to the Rye classification (159 cases). The age-specific relative frequencies and incidence rates for the histologic subtypes of Hodgkin's disease in Alameda County were estimated and compared to those estimated for Hodgkin's disease in Connecticut. The morphologic ex pression of Hodgkin's disease in both areas was similar and characteristic of economically developed regions with high living standards. The comparison supports the hypothesis that the host immune capacity, influenced by socioeconomic factors, has a strong and measurable effect on the pathogenesis of Hodgkin's disease.

Adolescent↗
PubMed1987

Time and age trends for sinonasal cancer in Connecticut incidence and US mortality rates.

Population-based rates for sinonasal cancer are examined in US mortality data among whites and in Connecticut incidence data. The observed rates are fitted to a log-linear model in order to examine the effect of each of the three variables, age, period and cohort, simultaneously for each sex. For Connecticut incidence, there is little evidence of either an increase or decrease from 1865 to 1955 birth cohorts. For the US mortality rates, from the 1875 to 1950 birth cohorts, there is a decline by more than twofold in men and more than threefold in women. Monitoring of those trends is discussed with respect to increases in exposure to cigarette smoking and formaldehyde. Regarding the age distribution, both incidence and mortality data are consistent: men show a linear increase of the log (rate) with log (age) in a fashion characteristic of other epithelial nongynecologic malignancies; for women, in contrast, there is a downward curvature around age 50 followed by an upward curvature in the 55 to 70 age range. The rate in most postmenopausal age groups is 20% to 67% of the rate expected on the basis of a linear increase of the log (rate) with log (age). The age patterns in women are similar to "Clemmesen's hook" observed for female breast cancer. There is evidence that the pattern in female subjects differs significantly from that for male subjects. The female age pattern requires confirmation in other populations. An etiologic role for sex hormones is hypothesized in view of that age distribution and in view of physiologic and laboratory observations.

Age Factors↗
PubMed1990

Increasing incidence of cecal and sigmoid carcinoma. Data from the Connecticut Tumor Registry.

We have studied both the distribution and incidence of colorectal cancer using The Connecticut Tumor Registry, the oldest tumor registry in the United States. During the time period 1973 to 1985, left-sided colon cancers accounted for 63% of the cancers, right-sided cancers 33%, and cancers with unspecified sites 4%. Indeed, this pattern of distribution has remained constant for 25 years. For the period 1935 to 1985, we calculated the sex-specific, age-adjusted (normalized to the 1970 U.S. Census) incidence. Age-adjusted incidence of rectal cancer has remained stable for 50 years: for men, 22.8 cases/100,000/year, and for women, 13.9 cases/100,000/year. During these 50 years, the age-adjusted incidence of cecal carcinoma for men has increased from 3.6 to 16.7 cases/100,000/year, while for women, it has increased from 4.9 to 14.2 cases/100,000/year. Sigmoid carcinoma for men has increased from 8.8 to 18.7 cases/100,000/year, and for women, it has increased from 7.7 to 12.8 cases/100,000/year. The incidence of colon cancer at each site has been and continues to be increasing at a constant rate. Age-adjusted incidence for all colorectal cancers has increased from 35.2 to 70.2 cases/100,000/year for men and from 32.1 to 49.2 cases/100,000/year for women. Thus, distribution of colorectal cancers by site in Connecticut has remained stable for 25 years. More importantly, however, the age-adjusted incidence of colon cancer has continued to increase for 50 years, whereas that of rectal cancer has remained relatively stable.

Cecal Neoplasms↗
PubMed1992

Black versus white racial differences in clinical stage at diagnosis and treatment of prostatic cancer in Connecticut.

BACKGROUND: There are few published data on stage-specific prostate cancer incidence rates in United States black patients versus white patients, and there are no data comparing treatment received by black versus white patients with prostate cancer. METHODS: Using data from a population-based cancer registry, the proportion of prostate cancers diagnosed in Connecticut from 1985-1988 at each clinical stage was examined for blacks and whites, along with stage-specific incidence rates. First course of treatment was also examined by clinical stage. RESULTS: The proportion of cases diagnosed at the metastatic stage was higher for black patients (35.4%) than for white patients (22.1%), and age-specific incidence rates for metastatic cancer were 1.5-3.3 times higher for black patients. Among localized-stage cases, the distribution of histologic grade (or degree of differentiation) did not differ in blacks versus whites, suggesting no difference in tumor aggressiveness or potential response to treatment. For localized (or A and B)-stage cancers, significantly lower use of prostatectomy in blacks versus whites younger than 70 years of age was the only important black-white difference, which requires confirmation in other studies. Frequency of use of hormonal therapy including endocrine surgery (orchiectomy) did not differ between black and white patients with pelvic metastases or disseminated disease. Comparisons were also made with data on treatment (all races combined) reported from the American College of Surgeons' national survey of prostate cancer cases diagnosed in 1983. CONCLUSIONS: Earlier detection of prostate cancer in blacks is needed to reduce black-white differences in stage at diagnosis and thereby reduce overall differences in survival rates. There was little evidence for inequities in treatment of prostate cancer for black patients versus white patients in Connecticut.

Black or African American↗
PubMed1993

Estimating cervical cancer incidence in the Hispanic population of Connecticut by use of surnames.

BACKGROUND: The problem of estimating cancer incidence in the growing population of Hispanic women in the Northeastern United States has received little attention. METHODS: Age-specific incidence rates (1980-1988) for invasive and in situ cervical cancer for Hispanic women were estimated by matching individual surnames in the population-based Connecticut Tumor Registry with the 1980 census list of Spanish surnames. Maiden names, obtained from death records of women previously receiving diagnoses of invasive cervical cancer, also were matched with the Spanish-surname list. RESULTS: Estimated age-specific invasive cervical cancer rates for Hispanic women, based on matching individual surnames in the registry with the Spanish-surname list, were higher than rates for all white women in all age groups and at least as high as those for all black women in most age groups. Comparison of maiden names with individual surnames for deceased women, however, suggested that use of individual surnames resulted in some misclassification of Hispanic ethnicity. CONCLUSIONS: The findings indicated that the estimation of cancer rates for Hispanic women in Connecticut could be improved by obtaining maiden names of all women receiving cancer diagnoses.

Adolescent↗
PubMed1994

Trends in cancer incidence in Connecticut, 1935-1991.

BACKGROUND: This study used data from the population-based Connecticut Tumor Registry, a unique resource for examining secular trends in cancer incidence rates since 1935. METHODS: Trends in average annual age-standardized incidence rates (ASRs) for invasive cancers in Connecticut residents were examined from 1935-1939 to 1990-1991. RESULTS: Trends in ASRs were complex, with some sites showing large increases but others only small changes since 1935-1939. Declines were evident for stomach and cervical since 1935-1939 and for colorectal cancer after 1980-1984. Since 1965-1969, when 2% or less of cancers were ascertained only by death certificates, exclusion of cancers of the breast and prostate (strongly affected by increased screening), smoking-related cancers, and cancers of other sites with identified causes (melanoma and human immunodeficiency virus-related cancers), resulted in little or no increase in the ASRs for all other sites combined. For young (20-44-year-old) adults, unexplained increases since 1965-1969 were limited to testicular cancer and Hodgkin's disease. CONCLUSIONS: Reducing cancer incidence rates will require expanded primary prevention efforts (mainly involving behavioral changes) and more etiologic research on common cancers whose causes are poorly understood (e.g., breast and prostate cancer) and rarer cancers showing unexplained recent increases (i.e., testicular cancer and Hodgkin's disease).

Connecticut↗
PubMed2001

Capture-recapture estimation of unreported work-related musculoskeletal disorders in Connecticut.

BACKGROUND: Estimates of the extent of musculoskeletal disorders (MSD) are usually based upon workers' compensation reports, although recent reports indicate that there may be widespread under-reporting of MSD. METHODS: An estimate of the incidence of arm and hand work-related MSD was made using capture-recapture analysis of the overlap between state workers' compensation reports and physician reports in Connecticut for 1995. The resulting estimate was compared to a population-based survey of MSD. RESULTS: There was very small overlap between the two state injury reporting systems: 6.7% of 793 reported workers' compensation cases, or 8% of 661 physician's reports. The estimate for MSD not captured by either system was 13,285, resulting in 14,686 (95% CI: 9,733-18,453) total reported and non-reported cases. This compares to an estimate of 13,775 cases (95% CI: 8,800-18,800) based on a phone survey. CONCLUSIONS: This analysis points to substantial under-reporting of MSD in Connecticut: estimates of unreported cases exceed those officially reported by a factor of 11:1. The findings have an important bearing on injury prevention programs and policy making.

Connecticut↗
PubMedDate not supplied

Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities.

An epidemic form of arthritis has been occurring in eastern Connecticut at least since 1972, with the peak incidence of new cases in the summer and early fall. Its identification has been possible because of tight geographic clustering in some areas, and because of a characteristic preceding skin lesion in some patients. The authors studied 51 residents of three contiguous Connecticut communities -- 39 children and 12 adults -- who developed an illness characterized by recurrent attacks of asymmetric swelling and pain in a few large joints, especially the knee. Attacks were usually short (median: 1 week) with much longer intervening periods of complete remission (median: 2.5 months), but some attacks lasted for months. To date the typical patient has had three recurrences, but 16 patients have had none. A median of 4 weeks (range: 1-24) before the onset of arthritis, 13 patients (25%) noted an erythematous papule that developed into an expanding, red, annular lesion, as much as 50 cm in diameter. Only 2 of 159 family members of patients had such a lesion and did not develop arthritis (P less than 0.000001). The overalll prevalence of the arthritis was 4.3 cases per 1,000 residents, but the prevalence among children living on four roads was 1 in 10. Six families had more than 1 affected member. Nine of 20 symptomatic patients had low serum C3 levels, compared to none of 31 asymptomatic patients (P less than 0.005); no patient had iridocyclitis or a positive test for antinuclear antibodies. Neither cultures of synovium and synovial fluid nor serologic tests were positive for agents known to cause arthritis. "Lynne arthritis" is thought to be a previously unrecognized clinical entity, the epidemiology of which suggests transmission by an arthropod vector.

Adult↗
PubMed1993

Age-period-cohort modelling of large-bowel-cancer incidence by anatomic sub-site and sex in Connecticut.

In order to investigate etiologic distinctions among the anatomic sub-sites of the large bowel by sex, the relationship between large-bowel-cancer incidence and age at diagnosis, time period at diagnosis, and birth cohort was analyzed by anatomic sub-site and by sex, using data from the Connecticut Tumor Registry. Included in the study were all incident large-bowel-cancer cases occurring between 1950 and 1984 among Connecticut residents aged 40 to 79. Cancers of the large bowel were classified into 5 anatomic sub-sites: ascending colon (including cecum), transverse colon (including flexures), descending colon, sigmoid colon, and rectum (including rectosigmoid junction, anal canal, and anus). The data were fitted to log-linear age-period-cohort models. For each of the sub-sites, the age-period-cohort patterns for males and females differed. Within each sex, sub-site groupings with common patterns were indicated. Among males, the age-period-cohort patterns for the colon sub-sites were fairly similar; but the pattern for the rectum differed markedly from that for the colon sub-sites. There were secondary differences among the colon sub-sites that pointed to a secondary distinction between the right and the left colons. Among females, the age-period-cohort patterns for the left colon sub-sites and the rectum were fairly similar. The pattern for the transverse colon differed moderately from that of the left colon, and differed substantially from that of the rectum and the ascending colon. The ascending colon differed markedly from each of the other sub-sites. It is possible that these differences in age-period-cohort patterns reflect etiologic distinctions among sub-site groupings and between the sexes.

Adult↗
PubMed1995

Time trend in pancreatic cancer incidence in Connecticut, 1935-1990.

A total of 13,246 incident pancreatic cancer cases, reported to the Connecticut Tumor Registry between 1935 and 1990, were included in our study. Results indicate that the overall age-adjusted incidence rate of pancreatic cancer increased between 1935 and 1964 in males, and leveled off thereafter. Since 1975, the incidence rate has in fact been decreasing, from 12.04/100,000 in 1975-79 to 10.44/100,000 in 1985-90. In females, the overall age-adjusted incidence rate also increased between 1935 and 1974. Since then, however, it has remained relatively stable. Age-specific incidence rates also show no signs of an increase in rate from any age group, or from either sex for recent birth cohorts. There is also no clear increase in the incidence of pancreatic cancer in any of the ethnic/gender categories since the early 1970s. Age-period-cohort modeling shows that the increasing birth cohort trend peaked among those born around 1920-1925 and, for recent birth cohort, a slightly decreasing trend was observed in both males and females. Our study reveals no signs of an increase in the immediate future in pancreatic cancer incidence rate in any of the sex, ethnic and age groups in Connecticut.

Adult↗
PubMed1988

Trends in the incidence of childhood and adolescent cancer in Connecticut, 1935-1979.

Trends in the incidence of childhood cancer in Connecticut are reported and analyzed for the period 1935-1979 by 5-year age groups (0-4, 5-9, 10-14, 15-19 years), using a log linear model method. A threefold increase (P less than .001) in the incidence of ALL in males 0-4 years of age was observed, with significant increases of smaller magnitude seen in males aged 5-9 and 15-19 and females aged 0-4 and 5-9. The incidence of central nervous system cancers also increased in several age groups for both sexes with the largest increase seen in males 0-4 years old. Significant increases in incidence of large magnitude were also observed for Hodgkin's disease, in males aged 15-19 years and females aged 10-19 years, for neuroblastoma in both sexes at ages 0-4 years, and for testis and ovarian cancer at ages 15-19 years. This study of trends in incidence of childhood cancers by 5-year age groups has revealed significant changes, which would not have been as apparent if broader age groups had been used. These results provide relevant data for investigating the etiology of cancer during infancy, childhood, and adolescence. Trends in Connecticut are compared with findings from other registries in the United States and other countries.

Adolescent↗