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Biomedical subjects

D Schottenfeld

Publications and source records attributed to D Schottenfeld.

At least 73 records · Page 4Linked to original sources
PubMed1984

Noncontraceptive estrogen use and the risk of breast cancer.

The relation between the risk of breast cancer and the use of noncontraceptive estrogens was investigated in a hospital-based study of 1,610 women with breast cancer and 1,606 with other conditions. The overall relative risk estimate for conjugated estrogens first taken at least 18 months before admission, compared with never-use of any noncontraceptive estrogens, was 0.9 (95% confidence interval, 0.7 to 1.1). For other estrogens first taken at least 18 months before admission, the estimate was 0.8 (0.6 to 1.1). The results were similar when known risk factors for breast cancer were taken into account. Among postmenopausal women, conjugated estrogens did not appear to increase the risk of breast cancer, even when taken for many years or in the distant past. There was no evidence of an increased risk due to conjugated estrogen use among subgroups of women defined according to various risk factors for breast cancer. The results of this study suggest that noncontraceptive estrogens do not increase the risk of breast cancer.

Adult↗
PubMed1984

Breast cancer and cigarette smoking.

It has been suggested that cigarette smoking may reduce the incidence of breast cancer, perhaps by as much as 20 per cent. To evaluate the relation between breast-cancer risk and smoking, we studied 2160 women with breast cancer and 717 controls who had been admitted to the hospital for cancer of the ovary, cancer of the colon or rectum, malignant melanoma, or lymphoreticular cancers. As compared with women who had never smoked, the estimated relative risk of breast cancer was 1.1 for current smokers of any amount (95 per cent confidence interval, 0.9 to 1.3), and 1.0 (0.8 to 1.3) for heavy smokers (15 or more cigarettes per day). Allowance for all identified potential confounding factors did not materially alter the results. There was no indication that age at commencement of smoking was related to the risk, nor was there evidence of an effect of smoking within the categories of age at first pregnancy or age at menopause. The data provide evidence against the hypothesis that smoking may reduce the incidence of breast cancer by 20 per cent.

Adult↗
PubMed1984

Risk of breast cancer in relation to the use of rauwolfia alkaloids.

In a case-control study of 1881 women with breast cancer and 1523 controls with benign conditions, 65 cases (3.5%) and 64 controls (4.2%) reported having used a drug that contained rauwolfia, giving a rate ratio estimate of 0.8 (95% confidence interval, 0.5-1.1). Use that ended more than a year previously was negatively associated with breast cancer (rate ratio, 0.5; 95% confidence interval, 0.2-0.9). The risk of breast cancer did not vary significantly according to duration of use. Nor did it vary within strata of varying base-line risk, such as age at first pregnancy. The data suggest that rauwolfia alkaloids do not increase the risk of breast cancer.

Adult↗
PubMed1984

Breast cancer and oral contraceptive use.

The risk of breast cancer in relation to oral contraceptive use was evaluated in a case-control study of 1191 patients with breast cancer and 5026 control patients. For ever-use compared with never-use, the estimated relative risk of breast cancer was 1.0 (95% confidence interval 0.9-1.2). Use of oral contraceptives for five or more years was not associated with breast cancer, regardless of whether use had ended as much as 10 or more years previously, or more recently. Within categories of women whose baseline risk was elevated, including nulligravidae, premenopausal women, and those with benign breast disease or history of breast cancer in first-degree relatives, the relative risk estimates for five or more years of oral contraceptive use approximated 1.0. For any use before first pregnancy, the relative risk estimate was 1.3, and for use lasting three or more years it was 0.9. These data suggest that long-term oral contraceptive use does not increase the risk of breast cancer even after a latent interval in excess of one decade; nor do oral contraceptives appear to increase the risk within categories of women at relatively high baseline risk.

Adult↗
PubMed1984

Leukemia following treatment of germ cell tumors in men.

We investigated the incidence of leukemia occurring subsequent to the treatment of germ cell tumors in men at our institution over a 30-year interval and found four patients with acute nonlymphocytic leukemia (ANLL) and one patient with chronic myelomonocytic leukemia. The relative risk (observed/expected cases) estimates for the development of leukemia ranged from 13.7 (P = .0005) in the total population to 50.1 (P = .0001) in the group treated with cytotoxic agents alone. All three patients with ANLL treated with contemporary antileukemic therapy had complete responses, with survivals of 7, 29, and 133 + months. In a review of the literature, 14 additional cases of germ cell tumors were found in which the men subsequently developed leukemia. It is concluded that leukemia following germ cell tumors is increased in incidence and is likely to be treatment induced. Complete responses and long-term survival are possible in secondary leukemia and aggressive antileukemic therapy should be given.

Adult↗
PubMed1984

Second primary cancers following treatment of Hodgkin's disease.

A cohort study designed to evaluate the carcinogenicity of treatment for Hodgkin's disease (HD) was conducted. This report describes 2,591 patients with HD diagnosed in 1940-75 and presents an analysis of follow-up findings through 1978. Seventy-four second primary cancers (excluding basal cell and squamous cell cancers of the skin and in situ carcinomas of the cervix uteri) were observed 1 year or more after diagnosis of HD, including 21 leukemias. Twenty leukemias occurred after chemotherapy. The relative risk (RR) of leukemia after intensive chemotherapy with or without radiotherapy was 136 relative to general population incidence rates. In the subgroup with both intensive chemotherapy and intensive radiotherapy, the RR of leukemia was 125. Both RR estimates differed significantly from unity. The RR of cancers other than leukemia 10 years or more after intensive radiotherapy relative to no intensive therapy was 19.5 (95% confidence limits: 4.8-80).

Adolescent↗
PubMed1984

Lack of an elevated risk of malignant melanoma in relation to oral contraceptive use.

Epidemiologic and laboratory data suggest an effect of oral contraceptives (OC) on the risk of malignant melanoma. This relationship was explored in a hospital-based case-control study of 160 women with malignant melanoma and 640 matched controls, all of whom were white and 20-59 years of age. A total of 63 cases (39%) had used OC compared with 270 controls (42%), yielding a relative risk estimate of 0.9 (95% confidence interval: 0.6-1.3). When a number of potential confounding factors were simultaneously controlled, the relative risk estimate was 0.8 (0.5-1.3). For use that lasted 5 or more years the estimate was 0.9 (0.5-1.6). The level of tumor invasion was not related to OC use. The evidence from this study suggests that OC, even when used for 5 or more years, do not increase the risk of malignant melanoma.

Canada↗
PubMed1983

Risk factors for breast cancer.

Since 1976, data were collected to evaluate risk factors for breast cancer in a hospital-based case-control study of 1185 women with breast cancer and 3227 controls. The risk of breast cancer increased with increasing age at first birth; this effect was not accounted for by parity. An early age at first birth appeared to reduce the risk relative to no pregnancy, whereas a late age at first birth was associated with a higher risk than not having a full-term pregnancy. High parity was associated with a reduction in the risk that was independent of that of age at first birth: for parity greater than or equal to 5, compared with parity 1-2, the relative risk estimate was 0.7 (95% confidence interval, 0.5-1.0). Late age at menarche was associated with a lower risk among premenopausal women but not among postmenopausal women. The relative risk decreased with increasing obesity among premenopausal women. Among postmenopausal women, the risk was higher among those who were obese, but there was no evidence of a trend with increasing body mass index. Risk did not vary materially according to history of abortion when gravidity was controlled. Risk was lower among postmenopausal women than among premenopausal women of the same age and increased with increasing age at menopause; bilateral oophorectomy reduced the risk more than hysterectomy alone. A positive history of benign breast disease, a positive family history of breast cancer, Jewish religion, and 12 or more years of education were each independently associated with an increased risk of breast cancer.

Adult↗
PubMed1982

Epithelial ovarian cancer and combination oral contraceptives.

The risk of epithelial ovarian cancer in relation to the use of combination oral contraceptives was evaluated in a case-control study of women younger than 60 years. Combination oral contraceptives were used by 35 (26%) of 136 cases and 187 (35%) of 539 controls. The relative risk estimate for combination oral contraceptive use was 0.6 (95% confidence interval, 0.4 to 0.9). The reduction in risk appeared to persist for as long as ten years after use had ceased and to be greater for longer durations of use, but these results were not statistically significant. The findings were not explained by parity or by other identified potential confounding factors. The results suggest that the use of combination oral contraceptives protects against epithelial ovarian cancer.

Adult↗
PubMed1982

Diazepam and the risk of breast cancer.

The relation of breast cancer to diazepam use was evaluated in a case-control study of 1236 women with breast cancer and 728 control subjects with other malignancies. Compared to women who never used diazepam, the relative risk for women who used the drug at least 4 days per week for at least 6 months was estimated to be 0.9, with 95% confidence limits of 0.5 and 1.6. There was no apparent association for recent use, or for use in the distant past, although confidence intervals were fairly wide in these categories. The results were not explained by various potential confounding factors, including the major risk factors for breast cancer. The findings suggest that regular diazepam use does not increase the risk of breast cancer relative to other cancers.

Adult↗
PubMed1982

Breast cancer and alcoholic-beverage consumption.

The relation between breast cancer and alcoholic-beverage consumption was evaluated in a case-control study of 1152 women with breast cancer and two groups of control women-519 with endometrial or ovarian cancer, and 2702 with non-malignant disorders. The relative-risk estimate of breast cancer, with allowance for all potential distorting factors, for women who had ever drunk alcoholic beverages relative to those who had never drunk was 1.4 (95% confidence interval, 1.0-2.0) when the comparison group was the group with endometrial or ovarian cancer and 1.9 (1.5-2.4) when the controls who had non-malignant disorders were the comparison group. The association was evident for beer, wine, and spirits. The association was not explained by any of the major known risk factors for breast cancer, but we had no information on dietary factors. The findings support the hypothesis that alcohol consumption, or related dietary factors, increases the risk of breast cancer.

Adult↗
PubMed1982

Carotid body tumors in humans: genetics and epidemiology.

Genetic factors in the etiology of carotid body tumors (CBT) were sought in a medical record review of 222 histologically diagnosed cases at 12 U.S. medical centers. Patients in the series, which had a marked female predominance (146 females:76 males), usually developed tumors between the fourth and seventh decades of life (mean, 44.7 yr). In 16 patients who also had other extra-adrenal paragangliomas, suggesting a multiple primary tumor syndrome, CBT were diagnosed significantly earlier (mean, 35.4 yr; P less than 0.01). The occurrence of thyroid cancer in 5 other patients appeared to be excessive. Familial CBT was recognized in 16 patients from 13 affected families, including 9 newly ascertained kindreds. Compared with non-familial lesions, familial CBT tended to develop bilaterally (38% vs. 8% unilaterally) and at slightly earlier ages (41.6 vs. 44.9 yr). CBT was reported to occur in an autosomal dominant pattern in some families and within sibships in others; relatives were not examined for confirmation. The familial findings are generally consistent with a two-step mutation model of the development of hereditary and nonhereditary CBT; apparent deviations from the model might be clarified with additional data on this rare neoplasm.

Adolescent↗
PubMed1981

The epidemiology of cancer: an overview.

The contribution of cancer epidemiology to cancer prevention is in identifying risk factors, providing clues for understanding etiologic mechanisms, and in developing the scientific rationale for the effective application of preventive measures. Cancer mortality, incidence, and survival trends over 25 years (1950-1974) in the United States are reviewed for 12 selected sites in adult men and women. If both incidence and mortality for a specific cancer site remain unchanged or change proportionately over a period of years, no major change in survival should be anticipated. The patterns of occurrence and their etiologic implications are reviewed separately in American blacks and in children and young adults. The studies of geographic pathology and of various migrant populations have provided observational "experiments of nature" that have facilitated our understanding of cancer etiology by stimulating important paths of research.

Adolescent↗