Biomedical subjects

Colleen C McLaughlin

Publications and source records attributed to Colleen C McLaughlin.

5 recordsLinked to original sources

PubMed2006

Maternal and infant birth characteristics and hepatoblastoma.

Hepatoblastoma is a rare embryonal tumor with unknown etiology. The authors conducted a case-cohort study using public health surveillance data sets to examine perinatal risk factors for hepatoblastoma. Hepatoblastoma cases (n = 58) diagnosed between 1985 and 2001 were identified from the New York State Cancer Registry and were matched to electronic birth records for 1985-2001 from New York State, excluding New York City. Controls (n = 6,056) were selected from the birth cohorts for the same years. Having a birth weight less than 1,000 g was associated with a strongly increased risk of hepatoblastoma (relative risk (RR) = 56.9, 95% confidence interval (CI): 24.0, 130.7). After adjustment for birth weight, a moderately increased risk of hepatoblastoma was found for younger maternal age (<20 years vs. 20-29 years: RR = 2.5, 95% CI: 1.0, 5.5), presumptive use of infertility treatment (RR = 9.2, 95% CI: 2.1, 31.5), maternal smoking (RR = 2.1, 95% CI: 1.0, 4.2), and higher maternal prepregnancy body mass index (body mass index of 25-29 vs. 20-24: RR = 2.9, 95% CI: 1.2, 7.6).

Adult↗

PubMed2006

Effects of randomization methods on statistical inference in disease cluster detection.

Monte Carlo methods are commonly used to assess the statistical significance of disease clusters. This usually involves permuting the observed outcome measure, such as the rate of disease, across the geographic units within the study area. When the variance of the disease rates is heterogeneous, however, randomizing the disease rate across the geographic units results in over-estimating the p-values in areas of low variance and under-estimating the p-values in areas of high variance. This bias results in under-ascertainment of clusters in urban areas and over-ascertainment of clusters in rural areas. As an alternative, randomizing the number of cases of disease or deaths proportional to the population at risk preserves the variance structure of the study area, therefore resulting in unbiased statistical inference. We compare results from randomizing rates with those from randomizing case counts, using county-level prostate cancer mortality data for the United States and ZIP-Code level prostate cancer incidence data for New York State, using the local Moran's I statistic.

Bias↗

PubMed2005

Incidence of noncutaneous melanomas in the U.S.

BACKGROUND: Description of the epidemiology of noncutaneous melanoma has been hampered by its rarity. The current report was the largest in-depth descriptive analysis of incidence of noncutaneous melanoma in the United States, using data from the North American Association of Central Cancer Registries. METHODS: Pooled data from 27 states and one metropolitan area were used to examine the incidence of noncutaneous melanoma by anatomic subsite, gender, age, race, and geography (northern/southern and coastal/noncoastal) for cases diagnosed between 1996 and 2000. Percent distribution by stage of disease at diagnosis and histology were also examined. RESULTS: Between 1996 and 2000, 6691 cases of noncutaneous melanoma (4885 ocular and 1806 mucosal) were diagnosed among 851 million person-years at risk. Ocular melanoma was more common among men compared with women (6.8 cases per million men compared with 5.3 cases per million women, age-adjusted to the 2000 U.S. population standard), whereas mucosal melanoma was more common among women (2.8 cases per million women compared with 1.5 cases per million men). Rates of ocular melanoma among whites were greater than eight times higher than among blacks. Rates of mucosal melanoma were approximately two times higher among whites compared with blacks. CONCLUSIONS: In contrast to cutaneous melanoma, there was no apparent pattern of increased noncutaneous melanoma among residents of southern or coastal states, with the exception of melanoma of the ciliary body and iris. Despite their shared cellular origins, both ocular and mucosal melanomas differ from cutaneous melanoma in terms of incidence by gender, race, and geographic area.

Adolescent↗

PubMed2005

Cancer incidence patterns among adolescents and young adults in the United States.

OBJECTIVE: The purpose of this study was to examine age-specific cancer incidence patterns among adolescents and young adults (ages 15--49). METHOD: Cancer incidence data for 1995--1999 from 22 population-based central cancer registries, covering about 47% of the US population, were used. Relative frequencies and average annual age-specific incidence rates per 100,000 person-year were computed for the five-year age groups from age 15--19 years through 45--49 years. Tests of significance for comparison were at a level of p<0.05. RESULTS: The age at crossover from a predominance of non-epithelial cancers to a predominance of epithelial cancers during adolescence and young adulthood varied by gender and race. Epithelial cancer became the predominant type of tumor after age 40 years among males while it was the predominant type after age 25 years among females. There was also a shift in the top five cancer types with increasing age, which varied by race and gender. Epithelial cancers of the thyroid, breast, ovary, and cervix uteri started to increase sharply among young women in their 20s while among males epithelial cancers rarely occurred until the early 30s (ages 30--34). Cancers of the female breast, colon and rectum, and lung began to occur at an earlier age and increased more sharply among blacks than among whites. However, the incidence rates of epithelial thyroid and ovarian cancers rose more quickly among whites than blacks. Non-Hodgkin lymphoma and soft tissue sarcoma (excluded Kaposi's sarcoma) increased with age among both whites and blacks but the rates were significantly higher among blacks than among whites. Both Kaposi's sarcoma and testicular cancer incidence increased with age and peaked in the early 30s (ages 30--34). The former was significantly higher among blacks than whites while the latter was significantly higher among whites than blacks. Cervical cancer incidence leveled off when white women reached their 30s, but for black women the rate continued to rise with advancing age. Cutaneous melanoma rates were significantly higher among females than among males between the ages of 15 and 39. Conclusion Cancer incidence patterns among adolescents and young adults are distinctive. Specific cancer prevention and control strategies should be targeted accordingly and tailored to their specific needs.

Adolescent↗

PubMed2005

Geographic patterns of prostate cancer mortality and variations in access to medical care in the United States.

BACKGROUND: Striking geographic variation in prostate cancer death rates have been observed in the United States since at least the 1950s; reasons for these variations are unknown. Here we examine the association between geographic variations in prostate cancer mortality and regional variations in access to medical care, as reflected by the incidence of late-stage disease, prostate-specific antigen (PSA) utilization, and residence in rural counties. METHODS: We analyzed mortality data from the National Center for Health Statistics, 1996 to 2000, and incidence data from 30 population-based central cancer registries from the North American Association of Central Cancer Registries, 1995 to 2000. Ecological data on the rate of PSA screening by registry area were obtained from the 2001 Behavioral Risk Factor Surveillance System. Counties were grouped into metro and nonmetro areas according to Beale codes from the Department of Agriculture. Pearson correlation analyses were used to examine associations. RESULTS: Significant correlations were observed between the incidence of late-stage prostate cancer and death rates for Whites (r = 0.38, P = 0.04) and Blacks (r = 0.53, P = 0.03). The variation in late-stage disease corresponded to about 14% of the variation in prostate cancer death rates in White men and 28% in Black men. PSA screening rate was positively associated with total prostate cancer incidence (r = 0.42, P = 0.02) but inversely associated with the incidence of late-stage disease (r = -0.58, P = 0.009) among White men. Nonmetro counties generally had higher death rates and incidence of late-stage disease and lower prevalence of PSA screening (53%) than metro areas (58%), despite lower overall incidence rates. CONCLUSION: These ecological data suggest that 10% to 30% of the geographic variation in mortality rates may relate to variations in access to medical care.

Adult↗