National Cancer Institute monograph最新文献

Fusui County in the Guangxi Autonomous Region of China is a high-risk area for hepatocellular carcinoma (HCC). In 1971-73, the average annual standardized (world population) mortality rate of HCC in Fusui was 20.09 and 111.75/100,000 person-years for females and males, respectively. Epidemiologic and pathologic studies of HCC have been conducted in Fusui since 1959. This paper describes some of the studies relating to the hepatitis B virus infection and aflatoxin contamination of foodstuffs.

Various issues pertaining to the design of a nutrition intervention trial in Linxian, a county in North Central China where esophageal cancer rates are extraordinarily high among a population with chronic deficiencies of multiple nutrients, are addressed. Two target populations are identified: One is a group of patients diagnosed with severe esophageal dysplasia, the other is the general population of the high-risk area. Interventions involving the supplementation of each group with vitamins and minerals are described, and a rationale is provided for the selection of nutrients and choice of dose levels. Several potential statistical designs are evaluated, with particular emphasis on the balancing of gains in specificity afforded by full and fractional factorial designs against their potential loss in sensitivity compared with the simplest design involving a placebo versus a multiple vitamin and mineral supplement.

Cancers of the buccal cavity and the pharynx are not only anatomically related but, except for the nasopharynx, also have risk factors in common. Multifocal occurrence of cancers in the buccal cavity and pharynx must be kept in mind when one is interpreting findings on multiple tumors. However, susceptibility to common risk factors, predominantly alcohol and tobacco, seem to be in operation among males, inasmuch as excess lung cancer followed cancers of the tongue [relative risk (RR) = 2.2], other parts of the mouth (RR = 2.2), and pharynx (RR = 2.0). Among females, lung cancer was in excess after cancers of the tongue (RR = 3.7) and mouth (RR = 3.6). Among males, esophageal cancer was elevated after cancers of the mouth (RR = 4.7) and tongue (RR = 5.7). Other combinations of tobacco-related cancers among males include those of the bladder (RR = 2.5) after cancer of the tongue and larynx (RR = 5.4) after pharyngeal cancer. Common etiologic factors or the multifocal nature of tumors of the buccal cavity might also account for the increases of cancer of the mouth (RR = 2.6) following lip cancer and cancer of the tongue (RR = 14) following mouth cancers among males. Among females, cancer of the mouth (RR = 17) was elevated after tongue, tongue (RR = 31) after mouth, and tongue (RR = 10) after salivary gland tumors. The excess of pharyngeal cancers in women (RR = 19) following cancer of the lip may be explained by common risk factors. Observed deficits of colon cancer following cancer of the lip in males and after tongue and salivary gland tumors in females could reflect low socioeconomic status, although a deficit of stomach cancer among males (RR = 0.1) also followed cancer of the salivary glands.

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.

To evaluate occupational cancer mortality in British Columbia, we calculated the age-standardized proportional mortality ratios (PMR) and proportional cancer mortality ratios (PCMR) for 4,091 woodworkers, 5,457 loggers, 2,020 fishermen, 4,066 farmers, and 1,912 miners. Woodworkers 20-65 years old had significantly elevated risks of death from stomach cancer (PCMR = 128, P less than .01) and non-Hodgkin's lymphoma (PCMR = 140, P less than .05). Loggers appear to have an elevated risk of death from nasal sinus tumors (PCMR = 364, P less than .05). Fishermen had an elevated risk of stomach cancer (PCMR = 168, P less than .01). Farmers in British Columbia appeared to have excess risks of stomach (PCMR = 136, P less than .01) and liver cancer (PCMR = 173, P less than .05), but decreased risk from lung cancer (PCMR = 76, P less than .01). Miners had an elevated risk of death from lung cancer (PCMR = 127, P less than .05) and primary eye tumors (PCMR = 569, P less than .05).

The age-standardized mortality rates for cancers of the nose, middle ear, and maxillary sinuses in Japan were calculated for 1970 and compared with those for 1975 and 1980. Japan shows a downward trend of these rates in both sexes in recent years. Demographic correlation analyses revealed that only the proportion of persons engaged in the lumber industry was positively correlated with the male maxillary sinus cancer mortality rate. A matched-pair case-control study was performed in Hokkaido in 1982; we collected data by questionnaires mailed to 41 male patients with maxillary sinus cancer and their age-, sex-, and residence-matched community controls and 82 males with laryngeal cancer and their community controls. Family, educational, and past histories of chronic sinusitis were not correlated with either maxillary sinus or laryngeal cancer. A cluster of occupations comprised of workers exposed to some chemical substances, coal miners, and tailors showed a significant elevated risk for maxillary sinus cancer but not for laryngeal cancer.