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Biomedical subjects

F F Holmes

Publications and source records attributed to F F Holmes.

At least 19 recordsLinked to original sources
PubMed1992

Meningiomas are not significantly associated with breast cancer.

We studied 283 meningiomas seen at the University of Kansas, Kansas City, from 1948 through 1984, identifying all additional nonmeningeal malignancies and primary brain tumors in these patients and calculating the expected number of additional tumors by the use of a person-year method from age and sex-matched cancer incidence data. We determined expected numbers of total neoplasms in our meningioma population as well as the expected numbers in each major organ system for the sexes independently and together. We then calculated standard morbidity ratios and 95% confidence intervals for each tumor type. The number of breast cancers did not reach statistical significance. We found a significantly increased number of second primary brain tumors in women (standard morbidity ratio, 8.0; 95% confidence interval, 2.2 to 20.4) and an increased number of thyroid cancers in both sexes (standard morbidity ratio, 7.5; 95% confidence interval, 1.5 to 21.9).

Adult↗
PubMed1992

Smoking habits in survivors of childhood and adolescent cancer.

Because of their increased risk for second cancers, childhood cancer survivors are people who really should not smoke, but available evidence suggests that they do. We studied the smoking habits of long-term childhood cancer survivors in data collected from 1289 adult survivors of childhood cancer and 1930 of their sibling controls. Survivors were diagnosed with cancer between 1945 and 1974 when they were less than 20 years old. Using matched analyses that controlled for the influence of family, survivors were 8% less likely than controls to be current smokers, 13% less likely to be ever-smokers, but 12% less likely to have quit smoking; these differences were not statistically significant. In a logistic regression analysis there was a significant difference by year of diagnosis for current smoking rate ratios (RR); survivors were less likely to be current smokers if diagnosed in recent years (RR = 0.76; 95% confidence intervals = 0.58-0.98, between 1965-74) and quite similar to controls if diagnosed in earlier years (RR = 1.05 between 1945 and 1954). In our group of long-term cancer survivors, the reduction in current smoking came about because survivors were more inclined never to start smoking than controls. Once addicted to tobacco, they were less likely to quit. While the fact that survivors are less likely to start smoking is encouraging, the persistence of smoking habits strongly suggests the need for continuing efforts to prevent smoking in this most vulnerable group.

Adolescent↗
PubMed1992

Early menopause in long-term survivors of cancer during adolescence.

OBJECTIVE: We attempted to investigate the risk of early menopause after treatment for cancer during childhood or adolescence. STUDY DESIGN: We interviewed 1067 women in whom cancer was diagnosed before age 20, who were at least 5-year survivors, and who were still menstruating at age 21. Self-reported menopause status in survivors was compared with that in 1599 control women. RESULTS: Cancer survivors, with disease diagnosed between ages 13 and 19, had a risk of menopause four times greater than that of controls during the ages 21 to 25; the risk relative to controls declined thereafter. Significantly increased relative risks of menopause during the early 20s occurred after treatment with either radiotherapy alone (relative risk 3.7) or alkylating agents alone (relative risk 9.2). During ages 21 to 25 the risk of menopause increased 27-fold for women treated with both radiation below the diaphragm and alkylating agent chemotherapy. By age 31, 42% of these women had reached menopause compared with 5% for controls. CONCLUSION: Treatment for cancer during adolescence carries a substantial risk for early menopause among women still menstruating at age 21. Increasing use of radiation and chemotherapy, together with the continued trend toward delayed childbearing, suggests that these women should be made aware of their smaller window of fertility so that they can plan their families accordingly.

Adult↗
PubMed1991

Biology of cancer and aging.

The greatest risk factor for cancer is aging. Human cancer incidence increases exponentially with advancing age. Cancer growth rate and potential for metastatic spread may be influenced by age-specific change in host response. Because cancer and aging are, thus, inextricably linked, the American Cancer Society should encourage submission of research proposals that address the mechanisms of aging and how aging alters cancer development.

Age Factors↗
PubMed1991

Gender influences subsite of origin of laryngeal carcinoma.

The relationship of gender to laryngeal cancer is not well understood. We analyzed 688 laryngeal cancers diagnosed in Kansas from 1980 through 1989 for sex differences in subsite distribution (glottis, supraglottis, subglottis, and laryngeal cartilage) as well as survival, histologic grade, and age at diagnosis. The ratio of glottic to supraglottic tumors was 22.12:1 in men and 0.56:1 in women, a highly significant difference. Survival in glottic tumors was significantly better than in supraglottic tumors, but survival was not significantly better for women than it was for men. Glottic tumors were significantly more likely than were supraglottic tumors to be of low-grade malignancy for all subjects and for male subjects alone, but not for female subjects alone. Women were younger at time of diagnosis than were men, but not significantly so. Gender is an important factor in the genesis of laryngeal cancer.

Aged↗
PubMed1990

Analysis of bladder carcinoma by subsite. Cystoscopic location may have prognostic value.

Nine hundred fourteen cases of carcinoma of the urinary bladder registered from 1977 to 1988 with the Kansas state tumor registry were evaluated by subsite for differences in grade, histology, sex, age at diagnosis, and survival. Only initial occurrences of carcinoma were included. Carcinoma of the lateral walls accounted for 37.1%; the posterior wall, 17.9%; the trigone, 12.6%; the neck, 11.1%; the ureteric orifices, 9.8%; the dome, 7.7%; and the anterior wall, 3.8%. Malignant neoplasms occurring in the neck of the bladder had a significantly poorer prognosis by survival analysis (P less than 0.05). Malignancies of the dome were found to present as higher grade lesions (P = 0.00003), and carcinoma of the ureteric orifices and lateral walls tended to be of lower grade (P = 0.02 and P = 0.05, respectively). Carcinomas of the anterior wall and dome occurred in a more elderly population (mean ages, 75.6 and 73.9 years, respectively), and carcinomas of the trigone and ureteric orifices occurred in a younger group (mean ages, 68.3 and 67.5 years, respectively). On histologic evaluation the trigone gave rise to more squamous cell carcinoma than expected (P = 0.001, 325% of expected). No distribution difference was noted among subsites with respect to sex. These data show significant differences among subsites of the urinary bladder with regard to survival, grade, histology, and age at diagnosis.

Adenocarcinoma↗
PubMed1990

Childhood cancer survivors: attained adult heights. Compared with sibling controls.

As part of a large collaborative study, the authors administered a pretested questionnaire to 62 childhood and adolescent cancer survivors and 62 same-sex sibling controls. The authors requested information regarding attained adult height on the questionnaire. Mean adult height of survivors (172.2 cm) was less than that of controls (174.1 cm), at a borderline significant difference of p = 0.0757. Multivariate analysis examined four potential, independent variables as possible predictors of this difference. The presence of brain tumor (vs. nonbrain tumor) (p less than .0001) and diagnosis at an early age (less than or equal to 8 years vs. 9-15 years) (p = .05) were factors significantly related to the differential; sex of patient and type of therapy were not. Our findings thus identify malignancy site and age at diagnosis as important predictors of adult height in childhood and adolescent cancer survivors.

Adolescent↗
PubMed1990

Survival in acute non-lymphocytic leukaemia following breast cancer.

Acute non-lymphocytic leukaemia (ANLL) occurs with increased frequency in women with previously diagnosed breast cancer. Adjuvant radiotherapy and chemotherapy are related to this increase. We studied the interrelationships among age at breast cancer diagnosis, interval to ANLL diagnosis, and survival in 54 women of whom 11 were from Kansas and 43 were from two other published series. Median age at breast cancer diagnosis was 50.5 years, median interval to ANLL diagnosis was 4.8 years, and median survival after ANLL diagnosis was 2.2 months. Increasing age was associated with a decrease of the interval to ANLL diagnosis just short of statistical significance (P = 0.0591). There was no association of survival with either age or the interval to ANLL diagnosis. With an increase in the use of adjuvant therapy in breast cancer there is a need to identify women at greatest risk of subsequently developing ANLL, at present not possible.

Adult↗
PubMed1989

Marriage and divorce after childhood and adolescent cancer.

As part of a study of long-term survivors of childhood and adolescent cancer, we interviewed 2170 survivors and 3138 sibling control subjects about their marital histories. In a proportional hazards analysis, both male and female survivors were less likely to be ever married than control subjects (rate ratio [RR] for males, 0.87; 99% confidence interval, 0.76 to 0.99; RR for females, 0.86; 99% confidence interval, 0.76 to 0.97). Survivors of brain and central nervous system tumors accounted for most of the marriage deficit, which was greater in men than in women (RRs, 0.48 and 0.73, respectively). Survivors married at the same average age as control subjects, except for survivors of central nervous system tumors, who married slightly later. The average length of first marriages was shorter in survivors than in control subjects. Men who had survived central nervous system tumors diagnosed before 10 years of age and male survivors of retinoblastoma had higher divorce rates than male control subjects (RRs, 2.9 and 1.9, respectively). In this cohort (which received less intense therapy than given in current practice), altered marriage practices are substantial only among survivors of central nervous system tumors.

Adolescent↗
PubMed1989

A case-control study of soft-tissue sarcoma.

The roles of nonagricultural occupations, tobacco use, beverage consumption, medical history, and other factors in the development of soft-tissue sarcoma were examined in a population-based case-control study in Kansas. Based on 133 cases diagnosed between 1976-1982 and 948 controls, there were significant excesses associated with use of the drug chloramphenicol (odds ratio (OR) = 5.4, 95% confidence interval (Cl) 1.2-23.9) and chewing tobacco or snuff (OR = 1.8, 95% Cl 1.1-2.9). The risk associated with smokeless tobacco varied with the location of the tumors; greater risks were observed for tumors of the upper gastrointestinal tract (OR = 3.3), the lung, pleura, and thorax (OR = 3.1), and the head, neck, and face region (OR = 2.4) than other regions of the body (OR = 1.4). A nonsignificant excess was seen with the use of cholesterol-lowering drugs, such as clofibrate (OR = 1.7). Four cases reported histories of prior radiation treatment to the same area of their bodies as their tumors. Soft-tissue sarcoma was also associated with employment in woodworking occupations (OR = 1.7, 95% Cl 0.9-3.2) and risk increased with increasing duration of employment. Persons with first-degree blood relatives with a history of Hodgkin's disease, lymphoma, or cancers of the pancreas, prostate, brain, or skin were at increased risk. Many of the associations observed in this study, notably the risk of soft-tissue sarcoma with smokeless tobacco and medications such as chloramphenicol, deserve further evaluation.

Adult↗
PubMed1989

Accuracy of diagnosis of pancreatic cancer decreases with increasing age.

Pancreatic cancer is common in the elderly and often is diagnosed clinically without pathologic confirmation. We compared age distribution and survival of 240 elderly patients with clinically diagnosed pancreatic cancer and 712 elderly patients with pathologically confirmed adeno- and ductal pancreatic carcinoma. All patients were registered by the Kansas state cancer registry from 1975-1984. The percentage of clinical diagnoses increased significantly from 12% in those aged in their 60s to 59% for those in their 90s (P less than .005). Observed 5-year survival for all of the clinically diagnosed patients was 8.4% compared with 0.6% for those pathologically confirmed. When locally confined disease only was considered, 5-year survival was 27% for patients clinically diagnosed and 4% for those pathologically confirmed. Given the fact that long survival from pancreatic carcinoma is a rare event, these findings suggest that in many elderly patients clinical diagnoses of pancreatic cancer are wrong. The findings have implications for the statistics on increasing incidence of pancreatic cancer (particularly in the elderly) and in discussion of prognosis with elderly patients diagnosed with pancreatic cancer without pathologic confirmation.

Adenocarcinoma↗
PubMed1988

Reproductive problems and birth defects in survivors of Wilms' tumor and their relatives.

In a retrospective cohort study of 47 Wilms' tumor survivors and their 77 sibling controls, female survivors had a fourfold excess risk (risk ratio, 4.1; 95% confidence interval, 1.7-10.1) for any adverse livebirth outcome, including birth defects, compared with their sibling controls. Wives of male survivors had no apparent excess risk for problem pregnancies. The families had a number of severe reproductive problems and major birth defects, such as primary amenorrhea in two survivors, bicornuate uterus in two survivors and one control, and mental retardation in one male survivor and a male control. The son of a female survivor died after bilateral Wilms' tumors. Birth defects in the offspring of female survivors are compatible either with intrauterine constraint, possibly due to radiation-induced fibrosis or with the complex of malformations associated with Wilms' tumor. Female survivors of Wilms' tumor appear to be at increased risk for a variety of reproductive problems, from sterility to fetal loss, early delivery, and birth defects in offspring. Furthermore, relatives of survivors of Wilms' tumor may be at risk of having associated birth defects, with clinically significant consequences.

Adolescent↗
PubMed1988

A case-referent study of soft-tissue sarcoma and Hodgkin's disease. Farming and insecticide use.

A population-based case-referent study in Kansas examined the relationship between exposure to insecticides and the development of soft-tissue sarcoma (STS) and Hodgkin's disease (HD). Data from telephone interviews for 133 STS cases, 121 HD cases, and 948 referents indicated that STS was associated with use of insecticides on animals, but not on crops. HD was not significantly associated with either use. STS risk was higher among the farmers who themselves mixed or applied insecticides to animals than among farmers who did not. Farmers who failed to use any protective equipment to reduce insecticide exposure were at a significantly elevated risk of STS. Risk rose with early calendar year of first use. The excess risk appeared to be primarily among fibrous and myomatous sarcomas with little association seen for lipomatous or other STS neoplasms. Myomatous sarcomas increased significantly with duration and time since first use of insecticides on animals. If the reported association between STS and insecticides is causal, the data suggest that exposure to the agent(s) responsible may have been reduced in the mid-1950s or the agent(s) have an average latency period for STS of at least 20 years.

Aged↗
PubMed1987

Cancer in offspring of long-term survivors of childhood and adolescent cancer.

A multicentre retrospective cohort study of long-term survivors of childhood and adolescent cancer identified 7 cases of cancer among 2308 offspring (0.30%) of 2283 case-survivors and 11 cases among 4719 offspring (0.23%) of 3604 controls. Overall, the observed numbers of cases were not significantly different from those expected in the general population. Among offspring of case-survivors observed for the first 5 years of life, the group with the most person-years of follow-up, 5 cancers were reported (3 confirmed), compared with 1.7 expected, a significant excess due mostly to boys whose mothers survived cancer. Some offspring with cancer had known single-gene traits; others resembled previously recognised patterns of family cancer. The remainder may represent chance occurrences or new cancer family syndromes, such as an association with malignant melanoma. The study had an overall 79% power to detect a 3-fold excess of cancer among offspring of case-survivors, but no excess was observed. The number person-years of follow-up in the second decade of life, when most cases of cancer developed, was small.

Adolescent↗
PubMed1987

Lung carcinoma in the elderly population. Influence of histology on the inverse relationship of stage to age.

Unlike most cancers, lung carcinoma is more likely to be localized at the time of diagnosis in older age groups when compared to those who are middle-aged. In an attempt to explain this inverse age-stage relationship we studied 9062 histologically confirmed cases of lung carcinoma occurring from 1975 to 1984 obtained from the regional cancer registry for Kansas and western Missouri. They were analyzed according to histologic type, age, sex, and stage at diagnosis. The data suggest that the proportion of squamous cell carcinoma rises and that of adenocarcinoma and small cell undifferentiated carcinoma falls with increasing age. The proportion of staged lung carcinoma with local disease at the time of diagnosis increases with age. In males this trend occurred in all cell types except large cell undifferentiated carcinoma but was most significant for squamous cell carcinoma. Squamous cell carcinoma was the only group to show a significant trend among females. The rise in squamous cell and fall in small cell carcinoma may partially explain the increased prevalence of local stage disease with advancing age.

Adenocarcinoma↗