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A J van Loon

Publications and source records attributed to A J van Loon.

30 records · Page 2Linked to original sources
PubMed1995

Socioeconomic status and colon cancer incidence: a prospective cohort study.

The association between socioeconomic status and colon cancer was investigated in a prospective cohort study that started in 1986 in The Netherlands among 120,852 men and women aged 55-69 years. At baseline, data on socioeconomic status, alcohol consumption and other dietary and non-dietary covariates were collected by means of a self-administered questionnaire. For data analysis a case-cohort approach was used, in which the person-years at risk were estimated using a randomly selected subcohort (1688 men and 1812 women). After 3.3 years of follow-up, 312 incident colon cancer cases were detected: 157 men and 155 women. After adjustment for age, we found a positive association between colon cancer risk and highest level of education (trend P = 0.13) and social standing (trend P = 0.008) for men. Also, male, upper white-collar workers had a higher colon cancer risk than blue-collar workers (RR = 1.42, 95% CI 0.95-2.11). Only the significant association between social standing and colon cancer risk persisted after additional adjustment for other risk factors for colon cancer (trend P = 0.005), but the higher risk was only found in the highest social standing category (RR highest/lowest social standing = 2.60, 95% CI 1.31-5.14). In women, there were no clear associations between the socioeconomic status indicators and colon cancer.

Cohort Studies↗
PubMed1995

Lung cancer: is there an association with socioeconomic status in The Netherlands?

STUDY OBJECTIVE: To evaluate if there are differences in lung cancer incidence between socioeconomic groups in the Netherlands and if so, if smoking habits and other lifestyle characteristics could explain these differences. DESIGN: Prospective cohort study. Baseline measurement included information on socioeconomic status, smoking habits, and other covariates by means of a self-administered questionnaire. Follow up was established by computerised record linkage to cancer registries and a pathology register. SETTING: Population originating from 204 municipalities in The Netherlands. PARTICIPANTS: 58,279 men aged 55-69 years in September 1986. After 3.3 years of follow up 490 microscopically confirmed incident lung cancer cases were detected. MAIN RESULTS: An inverse association between lung cancer risk and highest level of education was found, which persisted after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol (rate ratio (RR) highest/lowest level of education = 0.52, 95% CI 0.33, 0.82, trend p < 0.001). Men with a lower white collar profession had a significantly lower relative rate of lung cancer compared with blue collar workers (RR = 0.66, 95% CI 0.47, 0.96), but after adjustment for smoking habits this difference was reduced (RR = 0.73, 95% CI 0.51, 1.08). CONCLUSIONS: There is an inverse association between highest level of education and lung cancer, which is still apparent after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol. The significantly lower lung cancer risk of lower white collar workers compared with the risk of blue collar workers could be partially explained by smoking habits.

Age Factors↗
PubMed1995

Differences in cancer incidence and mortality among socio-economic groups.

OBJECTIVES: In this article studies on the association between socioeconomic status (SES) and risk for cancer at different sites are reviewed. METHODS: The review is restricted to studies conducted in affluent societies, after 1970. Only studies using income, education and/or occupation as SES indicators are included. RESULTS: A more or less consistent positive association between SES and cancer risk was found for colon and breast cancer. More or less consistent inverse associations were found for lung, stomach, oropharyngeal and esophageal cancer. Inconsistent associations were reported for cancer of the rectum and pancreas. Possible explanations for SES differences in cancer risk are discussed with special emphasis on lifestyle variables related to cancer risk. CONCLUSIONS: It is concluded that it is still unclear whether the reported associations can be (partially) attributed to lifestyle related risk factors for cancer such as smoking, nutritional habits, drinking habits and reproductive factors.

Breast Neoplasms↗
PubMed1994

Effect of extent of anterior resection and sex on disease-free survival and local recurrence in patients with rectal cancer.

Results are presented following 119 curative resections for rectal cancer performed on 47 women and 72 men. Throughout the study it was policy to remove part of the female genital tract when the rectal tumour impinged on the uterus and/or the posterior vaginal wall. After a median follow-up of 7.5 years, local recurrence occurred in three of 46 women and 15 of 71 men (P = 0.03). The survival rates at 5 years were 71 per cent for women (95 per cent confidence interval 56-83 per cent) and 60 per cent for men (95 per cent confidence interval 50-71 per cent) (P < 0.05). The risk for distant metastasis was comparable, suggesting an influence of local recurrence on survival. Reduction of the local recurrence rate coincides with the higher proportion of anterior extensions of surgery in women (19 of 47) than in men (two of 72).

Adult↗
PubMed1993

Non-immune hydrops fetalis and bilateral pulmonary hypoplasia in a newborn infant with extralobar pulmonary sequestration.

Extralobar pulmonary sequestration was found in a newborn premature infant that presented with non-immune hydrops fetalis, massive bilateral hydrothorax and polyhydramnios in utero. The baby died of severe respiratory insufficiency 15 h after birth. Postmortem examination revealed distended lymphatic vessels in the sequestered lung tissue probably due to impeded lymph drainage. We suggest that not extralobar pulmonary sequestration itself but a subsequent massive unilateral hydrothorax due to severe obstruction of lymph drainage was the cause of the non-immune hydrops fetalis, pulmonary hypoplasia and polyhydramnios. If these symptoms are diagnosed before delivery, a search for extralobar pulmonary sequestration is indicated.

Adult↗
PubMed1992

[2 patients with brain metastases who became pregnant during phenytoin administration].

Two young women taking phenytoin because of symptomatic brain metastases are described. Both patients, one with end-stage lung cancer and the other in complete remission after intensive chemotherapeutic treatment of a choriocarcinoma, became pregnant while using oral contraceptives in combination with phenytoin. One patient had the child, but died a year after the metastases became apparent, in the other the pregnancy was terminated. When prescribing phenytoin, attention should be paid to fertility--even in patients with end-stage cancer or after intensive, possibly sterilising, chemotherapeutic treatment.

Abortion, Therapeutic↗
PubMed1990

Pelvimetry by magnetic resonance imaging in breech presentation.

Evaluation of the pelvis by pelvimetry plays an important role in selecting patients with term breech presentation for possible vaginal delivery. X-ray pelvimetry involves the disadvantage of fetal exposure to ionizing radiation. Computed tomography reduces the amount of radiation markedly, but there is still a risk. Ten patients with breech presentation at term underwent antepartum pelvimetry with magnetic resonance imaging, following by postpartum magnetic resonance pelvimetry and x-ray pelvimetry. Measurements with magnetic resonance imaging are as reliable as those obtained with x-ray pelvimetry and the contrast of the magnetic resonance images is even better. The advantages of magnetic resonance pelvimetry are clear: no ionizing radiation and reliable pelvimetry results in cases of term breech presentation in which a normal pelvis is a prerequisite for safe vaginal delivery.

Breech Presentation↗
PubMed1990

Cross-sectional versus longitudinal investigations of the diet-cancer relation.

Within a prospective cohort study on diet and cancer, information was collected on cancer prevalence and baseline meat consumption. A nested case-control study on meat and cancer was conducted with 656 prevalent colorectal cases, 1,894 breast cancer cases, and 4,701 controls. When analyzed cross-sectionally, prevalence odds ratios for eating meat rarely versus regularly were 2.08 for female colorectal and 1.75 for breast cancer. In the longitudinal analysis, cases who started consuming meat rarely after diagnosis were excluded, resulting in odds ratios of 0.51 for female colorectal and 1.17 for breast cancer. These opposite findings highlight the problem of cross-sectional designs.

Aged↗
PubMedDate not supplied

Randomised controlled trial of magnetic-resonance pelvimetry in breech presentation at term.

BACKGROUND: Pelvimetry is widely used in women with breech presentation at term to select those for whom planned vaginal delivery is appropriate. However, its clinical value has never been established. We evaluated pelvimetry in a randomised controlled trial. The main outcome measures were the elective and emergency caesarean-section rates and the early condition of the neonate. METHODS: Magnetic-resonance (MR) pelvimetry was done on 235 women. The women were then randomly assigned to two groups--for the study group (n = 118), the pelvimetry results were reported to the responsible obstetricians, who used them as the basis for decisions on whether to schedule elective caesarean or trial of labour; for the control group (n = 117), the pelvimetry results were not disclosed until 8 weeks post partum, and decisions about obstetric management were made on the basis of clinical factors only. FINDINGS: 35 women (15 [13%] study group, 20 [17%] control group) had abnormalities on pelvimetry. The overall caesarean-section rates did not differ significantly between the study and control groups (50 [42%] vs 59 [50%], p = 0.24) but the emergency caesarean-section rate was significantly lower in the study group than in the control group (22 [19%] vs 41 [35%], p = 0.0052). The mean 1 min Apgar scores in the study and control groups were 8.1 and 8.0 (p = 0.93) and the mean 3 min scores 9.5 and 9.4, respectively (p = 0.28). There were no significant differences in the early neonatal outcome for infants born vaginally, by emergency caesarean section, or by elective caesarean section in the two groups, except for a significantly lower Apgar score in the six infants born vaginally to control-group women who had pelvic abnormalities. INTERPRETATION: The use of MR pelvimetry in breech presentation at term did not significantly reduce the overall caesarean-section rate. However, it allowed better selection of the delivery route, with a significantly lower emergency caesarean-section rate. Neonatal outcome was not compromised by use of the pelvimetry data.

Apgar Score↗