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A I Neugut

Publications and source records attributed to A I Neugut.

At least 73 records · Page 4Linked to original sources
PubMed1996

Incidence of adenomas after curative resection for colorectal cancer.

OBJECTIVE: The benefits of periodic colonoscopic surveillance after curative resection for colon cancer are controversial. We investigated the incidence, size, and time interval to the detection of recurrent adenomatous polyps in patients who have undergone resection of a colorectal cancer. METHODS: In this retrospective study, the records of 351 patients who underwent curative resection for colorectal carcinoma between 1967 and 1991 were reviewed. Sixty-one patients were excluded because of incomplete data. RESULTS: Eighty-seven patients (30%) were found to have had at least one adenoma. Twelve patients had more than five adenomas. The median time to diagnosis was 24 months. Forty-six patients of the 87 (52.9%) had polyp recurrences within 2 yr after cancer resection. CONCLUSION: This group of patients is at increased risk for the development of adenomatous polyps. Surveillance colonoscopy and polypectomy may reduce the incidence of metachronous colon cancer.

Adenomatous Polyps↗
PubMed1995

Pancreas cancer as a second primary malignancy. A population-based study.

BACKGROUND: The study of second primary malignancies may give clues to the etiology of various cancers. Little is known about risk factors for pancreatic carcinoma; therefore, its occurrence as a second primary malignancy was investigated. METHODS: Data from the Surveillance, Epidemiology, and End-Results (SEER) program were used for the period from January 1, 1973 through December 31, 1990. Person-years of follow-up for various cancer sites were calculated, excluding the initial 6 months after diagnosis, and were multiplied times the age- and sex-specific incidence rates for pancreas cancer to calculate the expected number of second primary pancreas cancer cases. The observed number of cases was divided by the expected number to estimate the relative risk (RR) of pancreas cancer as a second primary cancer, and 95% confidence limits were calculated. RESULTS: The risk of second primary cancer was elevated after lung cancer for men (RR 1.3, 95% CI 1.0-1.6) and women (RR 2.5, 95% CI 1.9-3.2). An elevation in risk also was found after head and neck cancer in women (RR 1.8, 95% CI 1.2-2.5) and bladder cancer in women (RR 1.5, 95% CI 1.1-2.0), but not in men. Other significant elevations were found after prostate cancer (RR 1.2, 95% CI 1.1-1.3), and a decreased risk was found after lymphoma in men (RR 0.2, 95% CI 0.0-0.8). CONCLUSIONS: Second primary pancreas cancer is increased after tobacco-related malignancies, particularly in females, supporting the role of cigarette smoking as a risk factor for pancreas cancer and suggesting a stronger effect of cigarette smoking for women. The elevation in risk after prostate cancer and the decreased risk after lymphoma in males need to be confirmed in other data sets.

Databases, Factual↗
PubMed1995

Levels of p53 antigen in the plasma of patients with adenomas and carcinomas of the colon.

Plasma levels of p53 protein were examined by an enzyme linked immunosorbent assay in 184 patients enrolled in a colonoscopy study. The mean levels among 47 individuals with normal colonoscopic examinations and no prior history of colonic neoplasia (0.12 ng/ml) and among 61 individuals with normal colonoscopic examinations and a prior history of colonic neoplasia (0.09 ng/ml) were similar. However, the mean levels among 54 individuals with newly diagnosed colonic adenomas (0.44 ng/ml) and 22 individuals with newly diagnosed colonic carcinomas (0.55 ng/ml) were statistically significantly elevated compared to the normal controls (P < 0.02). Among these tumor patients, the plasma levels tended to increase with increasing adenoma size and with increasing carcinoma stage, although these trends were not statistically significant. Defining a significant positive plasma level as any value greater than ten times background, the percentage of positive samples increased from 4% in the controls to 20% in the adenoma cases to 32% in the carcinoma cases. These results demonstrate that plasma p53 protein levels are elevated in a subgroup of individuals with colonic neoplasia.

Adenoma↗
PubMed1995

Clinical characteristics of metachronous colorectal tumors.

A cancer-registry-based study was conducted to investigate the survival patterns associated with metachronous colorectal tumors and to compare the survival of patients with single and metachronous colorectal tumors. The study included all 1,396 White patients with metachronous colorectal tumors diagnosed among 143,283 patients with primary colorectal tumors reported between 1973-1986 to the SEER program. The influence on survival of age at diagnosis, site of tumor and stage was evaluated by means of multivariate survival analysis, using Cox Proportional Hazards Models. Metachronous tumors developed more often following left-colon tumors. Stage distribution of the second tumors was better than that of single 47% of the second tumors were discovered in regionally-advanced or distant-metastatic stages. Survival from the second tumor diagnosed in the rectum was worse than that of a single tumor in the same stage and site. Only the stage of the second tumor was found to influence survival from metachronous tumors. The relatively high rate of diagnosis of advanced second colorectal tumors may reflect either improper follow-up after the diagnosis of the first tumor, or more aggressive biological characteristics of the second tumors.

Aged↗
PubMed1995

Reproductive risk factors for colorectal adenomatous polyps (New York City, NY, United States).

Events of reproductive life, such as parity and age at menarche, have been found in some but not all studies to be associated with risk for colorectal cancer in females. Because adenomatous polyps (adenomas) are precursors of colorectal cancer, we investigated whether reproductive variables were associated with colorectal adenomas. We conducted a case-control study among patients examined in three colonoscopy practices in New York City (NY, United States) from 1986 to 1988. Adenoma cases (n = 128) were defined as women who had an adenoma detected at the index colonoscopy with no history of inflammatory bowel disease, adenomas, or cancer. Controls (n = 283) were women with a normal index colonoscopy and no history of inflammatory bowel disease, adenomas, or cancer. The adjusted odds ratio (OR) for the association of early menarche (age less than 13 years) with adenomas was 0.6 (95 percent confidence interval = 0.4-0.9). Parity, history of spontaneous or induced abortion, infertility, type of menopause, age at menopause, use of oral contraceptives, and use of menopausal hormone replacement therapy were not associated statistically significantly with adenoma risk, although some possible trends were observed. Our findings do not implicate reproductive events, nulliparity, or overexposure to estrogens or to menstrual cycles as mechanisms of increased risk for colorectal neoplasia.

Abortion, Spontaneous↗
PubMed1995

Coronary artery disease and colorectal neoplasia.

PURPOSE: This study was designed to determine whether patients with coronary artery disease are at elevated risk for colorectal neoplasia. METHODS: A case-control study was conducted among consecutive patients in three colonoscopy practices in New York City from 1986 to 1988. All study participants completed an interview questionnaire covering demographics, diet, environmental and behavioral exposures, family and personal medical history, and other variables. For the present study, 298 newly diagnosed colorectal adenoma cases and 107 incident cancer cases were compared with 507 colonoscoped controls without colorectal neoplasia or other significant findings on colonoscopy. Data on history of coronary artery disease (angina and/or heart attack) were obtained solely from the study participants' questionnaire responses. RESULTS: No association was observed between angina, heart attack, or either and colorectal adenomas in males. However, prior coronary artery disease was found to be associated with colorectal cancer in males more than 60 years of age and with colorectal adenomas in females aged 50 years or younger. CONCLUSION: Men with coronary artery disease may be at elevated risk for subsequent colorectal cancer. Young women with coronary artery disease also may be at elevated risk for colorectal neoplasia.

Adenomatous Polyps↗
PubMed1995

Incidence and recurrence rates of colorectal adenomas: a prospective study.

BACKGROUND/AIMS: The frequency of colorectal adenomas, the precursor lesions for most cases of colorectal carcinoma, has been generally measured as prevalence rates of adenomas at autopsy or colonoscopy. The aim of this study was to estimate the incidence rate of adenomas and compare it with the adenoma recurrence rate. METHODS: Data on colonoscopies performed in three New York City practices were collected prospectively. The cumulative rate of adenoma diagnosis on repeat colonoscopy was calculated for patients with no abnormalities on index colonoscopy ("incidence" rate) and for patients with adenomas on the index colonoscopy ("recurrence" rate). RESULTS: The cumulative incidence rate of adenomas at 36 months was 16%, and the cumulative recurrence rate at 36 months was 42% (P < 0.004). The recurrence rate was higher in patients with multiple adenomas than in those with a single adenoma on index colonoscopy, although the increase was not statistically significant. CONCLUSIONS: Although the recurrence rate has always been assumed to be elevated, this study is the first to compare the recurrence rate of adenomas with the incidence rate directly and to show that the recurrence rate is indeed elevated.

Adenoma↗
PubMed1995

Reproducibility of food intake in a food frequency questionnaire used in a general population.

This study evaluates the reproducibility of food intake reports in a 45-item self-administered food frequency questionnaire (FFQ) used for a diet study in a large cohort in New York State. The first FFQ was mailed in 1980, and a followup version containing 75 food items was mailed in 1988 to the eligible original participants. Reproducibility was evaluated by comparing the subjects' 1988 responses with their original 1980 responses. Spearman's correlations ranged from 0.27 (nuts other than peanuts) to 0.56 (summer squash) in men and from 0.25 (tomatoes) to 0.51 (summer squash) in women. Analyses stratified by age, education, marital status, body mass index, cigarette smoking, alcohol drinking, and special diet revealed few substantial differences in correlations. The moderate reproducibility of foods in this questionnaire indicates that brief FFQs may be a useful tool to study food intake and chronic disease relationships in this population.

Adolescent↗
PubMed1995

Trends in incidence of primary malignant brain tumors in USA, 1981-1990.

BACKGROUND: There has been considerable controversy regarding whether a recent observed rise in brain tumor incidence is real and so suggestive of increasing exposure to environmental carcinogens, or whether it is largely explainable by changes in diagnostic technology, particularly the introduction of computerized axial tomography (CT) scans in the 1970s. We analysed data from the US Surveillance, Epidemiology, and End Results (SEER) Program to investigate whether there was a rise of brain tumor incidence during 1981-1990, the period after CT scans became extensively available, and if so, the rates of which specific histologic subtypes have risen. METHODS: Age- and sex-specific, as well as age-adjusted incidence rates were calculated for each brain tumor histologic subtype. Regression analysis was used to estimate age-adjusted incidence rate ratios (RR) for different periods and to examine time trends. RESULTS: For all histologic subtypes, the incidence rates increased with age. Regarding time trends, lymphomas in men increased in all age groups during the study period with the age-adjusted rate ratio reaching 5.6 (95% CI: 3.7-8.3) for 1989-1990 as compared to 1981-1982. Lymphoma in women and glioblastoma multiforme in both sexes also appear to have increased, particularly in the elderly. Other histologies did not show any time trends in the age-specific or age-adjusted analyses. CONCLUSION: Our histology-specific analysis is not suggestive of any significant increase in the incidence of brain tumors during 1980-1990, except for lymphomas in men.

Adult↗
PubMed1995

Association of malignant brain tumors and cancers of other sites.

PURPOSE: We conducted an exploratory study of brain tumors that occurred as a second primary malignancy to identify potential risk factors for brain tumors. METHODS: Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we calculated the sex-specific standardized incidence ratio (SIR), adjusted to age and time period, as an estimate of the relative risk (RR) of developing a second primary brain tumor following other cancers. RESULTS: We found an elevated RR of brain tumors after bladder cancer in both men (RR, 1.7; 95% confidence interval [CI], 1.2 to 2.3) and women (RR, 1.7; 95% CI, 0.8 to 3.2); this effect was present for both astrocytoma and glioblastoma multiforme. Elevated RRs of brain tumors were also found after sarcoma (RR, 4.4; 95% CI, 1.8 to 9.0) and leukemia (RR, 2.9; 95% CI, 1.6 to 4.8) in men, and after colorectal cancer (RR, 1.8; 95% CI, 1.3 to 2.4) and endometrial cancer (RR, 1.4; 95% CI, 1.0 to 1.9) in women. The highest RR observed in this study was for CNS lymphoma following any first primary malignancy in men (RR, 7.9; 95% CI, 5.5 to 11.0). CONCLUSION: The associations of brain tumors with bladder, colorectal, and endometrial cancers in women, and an increased occurrence of CNS lymphoma as a second malignancy in men, are new findings that have not been described previously.

Adult↗
PubMed1995

The limitations of breast cancer screening for first-degree relatives of breast cancer patients.

Bitter controversy surrounds the recommendation of mammographic breast-cancer screening for women aged 40 and 49 years of average risk. This paper considers the case for screening women in their 40s with higher risk, specifically women who have one or more first-degree relatives with breast cancer. A review of the literature and of current knowledge suggests that screening such women is more cost-effective, in the sense of having a higher yield per mammogram and better predictive value, than screening women of average risk in this age group. However, there is no evidence that screening is more efficacious in reducing mortality in this subgroup than in other women in their 40s.

Adult↗
PubMed1995

Clinical characteristics of patients with a second primary tumor in the endometrium or ovary.

The clinical characteristics of patients with second primary tumors in the ovary and endometrium were compared to those with single primary tumors treated at our Center during the same period of time. Despite the fact that the patients were under medical surveillance for the first primary tumor, most second tumors were diagnosed following patient symptoms and complaints, and not at a routine follow-up appointment. Patients with a second primary endometrial cancer had a more advanced stage of disease at diagnosis as compared to those with single endometrial cancer. This was not found to be true for patients with second ovarian cancer. Patients with primary breast cancer and colon cancer, lymphoma or melanoma were found to be at higher risk for developing a second primary tumor in the endometrium or ovary as compared to those with a primary tumor at other sites. Although there are no proven means for the early detection of these gynecologic malignancies, it seems prudent to draw the attention of medical practitioners to the need for a better gynecologic evaluation for women with cancer at other sites during their follow-up visits. Studies on the efficacy of currently available diagnostic techniques should be carried out to evaluate their yield in this high risk group.

Breast Neoplasms↗
PubMed1995

Diagnostic and management issues in gallbladder carcinoma.

Carcinoma of the gallbladder is a rare malignancy, with an incidence rate in the United States of 2.2 to 4.4 per 100,000 persons. Its clinical presentation is nonspecific, and the majority of patients have advanced disease at presentation. The diagnosis is rarely made preoperatively. About 90% of gallbladder cancers are adenocarcinomas. Surgical treatment is curative for lesions localized to the mucosa and submucosa, but these represent only about 16% of all gallbladder carcinomas. The role of radical surgery with node dissection and liver resection is controversial. Chemotherapy and radiation therapy do not have a major role in the treatment of gallbladder carcinoma. The prognosis is very poor, with a 5-year survival rate of less than 5%.

Adenocarcinoma↗