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Biomedical subjects

G J Macfarlane

Publications and source records attributed to G J Macfarlane.

At least 91 records · Page 5Linked to original sources
PubMed1995

Second cancers occurring after cancers of the mouth and pharynx: data from three population-based registries in Australia, Scotland and Slovenia.

Data over at least 20 years from three large population-based registries in Europe and Australasia have been used to assess the risk of second primary tumours occurring after a cancer of the mouth or pharynx. These patients have previously been shown in clinical series to be at a particularly high risk of subsequent tumours, while data from cancer registries have shown conflicting results on the magnitude of the risk. In this study, patients were found to have between a 2-fold (Scotland and New South Wales) and 4-fold (Slovenia) increase in risk of a subsequent tumour over that in the population, although the actual risk in each centre was similar (between 2.8 and 3.1 per 100 person years). The risk remained for 10 years after diagnosis of the original tumour and was primarily in the upper aerodigestive tract. The most elevated risks (approximately 10-fold) were for tumours in the oral cavity and oesophagus. These data provide higher estimates of risk than previously reported from European cancer registries for second primary tumours and emphasize the need for close follow-up of patients who may represent an appropriate population in which to assess possible new chemopreventive agents.

Digestive System Neoplasms↗
PubMed1995

Oesophageal and gastric cancer in Scotland 1960-90.

In Scotland over the last 31 years the incidence of gastric cancer has significantly declined by 0.6% per annum in males and 1.1% in females. In contrast, for oesophageal cancer, incidence rates have risen significantly by 3.0% and 2.0% per annum in males and females respectively. Increasing incidence of both adenocarcinomas and squamous carcinomas of the oesophagus in men and squamous and recently adenocarcinomas in women has been observed. This cannot be entirely accounted for by a growth in the proportion of histologically verified (HV) tumours over time. The incidence of adenocarcinoma of the stomach increased over the study period, most likely because of increasing proportions of HV tumours and improved diagnostic precision. Areas with high levels of deprivation in Scotland are strongly associated with high rates of oesophageal cancer in men, and of gastric cancer in both men and women. All these observations are discussed in the context of current knowledge of risk factors for these diseases.

Adenocarcinoma↗
PubMed1995

Determinants of treatment-seeking behaviour for urinary symptoms in older men.

OBJECTIVE: To determine the factors associated with seeking treatment for urinary symptoms among older men in a European population. SUBJECTS AND METHODS: A community survey involving a representative nationwide sample of 2011 French men aged between 50 and 80 years was performed and information collected using an interviewer-administered questionnaire. RESULTS: Visiting a doctor for urinary symptoms was associated with the perceived bothersomeness of urinary symptoms, in addition to and independently of the level of symptom severity. It was also associated with higher socio-economic class. Many partners of men with urinary symptoms were unaware of their condition. CONCLUSIONS: This study emphasizes the importance of including the perception of bother associated with urinary symptoms in addition to urinary severity and provides information useful for inclusion in education programmes on urinary symptoms.

Aged↗
PubMed1994

Oral and pharyngeal cancer incidence in Slovakia 1968-1989.

Slovakia currently has one of the highest incidence rates of oral cancer in Europe. Incidence data from the Slovakian Cancer Registry relating to oropharyngeal cancer are analyzed for the period 1968-1989 to examine trends in the incidence of these malignancies, representing the first such reported time-series from Central Europe. Over this period, rates in males have increased from 4.5 per 100,000 in 1968-1970 to 17.9 per 100,000 in 1987-1989, with more marked increases noted amongst middle-aged males (35 to 64 years), among whom rates have increased from 6.8 to 47.9 per 100,000 over the same period. Rates in women have been relatively low and stable. Changes in rates in men follow a period during the 1950s and 1960s when there was a marked increase in alcohol and tobacco consumption. The magnitude of the increases have resulted in oropharyngeal cancer becoming an important public health problem in Slovakia and emphasizes the importance of measures to prevent further increases in the consumption of tobacco and alcohol.

Adult↗
PubMed1994

Trends of oral cancer mortality among females worldwide.

Oral cancer incidence and/or mortality has been reported to be currently increasing in several countries, particularly those of central and eastern Europe. Most of these reports pertain to men, although increases in incidence among women also have been found. In this report, data from twenty-four countries in the World Health Organization's mortality database are analyzed. The widespread increase observed in oral cancer mortality among men is not occurring in women. Nevertheless, increases have occurred in several countries in Europe, and oral-cancer death rates--especially in central and eastern Europe--are likely to increase further if tobacco smoking, in particular, becomes more popular among younger women.

Adult↗
PubMed1994

Rising trends of oral cancer mortality among males worldwide: the return of an old public health problem.

Oral cancer is considered widely to be a form of cancer whose etiology is well understood and which is becoming relatively rare in developed countries. There have been, however, a series of recent reports indicating that after many years of declining risk, the rates may be rising again in men. To investigate the extent of such changes, national time-series of oral-cancer mortality data available in the World Health Organization's mortality database have been analyzed. Age-period-cohort modeling was used to establish the extent and nature of these changes and to allow comparisons among countries. Nineteen out of 24 national datasets demonstrate a similar pattern of recent increasing cohort-effects for oral cancer in men. The largest increases have occurred in countries of central and eastern Europe where rates have increased by a factor of from three to 10 within a generation. The cohort-based nature of the changes observed in men suggest that there will be a continuing increase in the absolute numbers of cases of oral cancer to be treated in the coming decades.

Adult↗
PubMed1994

Epidemiological features of gastric and oesophageal cancers in Slovakia.

Data from Slovakia were analysed to determine whether, in accordance with observations made in western Europe and the United States, there is an increasing occurrence of tumours around the oesophagogastric junction. However, the increase in oesophageal cancers in this area was found to be attributable to squamous cell carcinomas. This is in keeping with observations made in central and eastern Europe of an increase in the incidence of tobacco- and alcohol-related cancers.

Adenocarcinoma↗
PubMed1994

Some statistical considerations in the analysis of case-control studies when the exposure variables are continuous measurements.

This paper focuses on some statistical considerations in the estimation of dose-response in case-control studies when the exposure variables are continuous measurements. The first point is that the effects of differential variability in the exposure distributions over cases and controls cannot be differentiated from a true quadratic risk model. The second point is that when dealing with variables where zero denotes no exposure, it is important to treat the unexposed subjects separately from those who were exposed. Failure to do so can lead to differential variability among cases and controls and the resulting confounding with a quadratic risk model. Both of these points are illustrated by an example.

Case-Control Studies↗
PubMed1994

Physical activity and colon cancer.

Heart disease and cancer, the major causes of mortality and morbidity in Western countries, have common risk factors. Exercise appears to reduce the risk of cardiovascular disease, but its role with respect to primary prevention of cancer has not been emphasized. Here we evaluate the epidemiological studies dealing with exercise and colon cancer. Despite the fact that different methods of assessing the amount of typical exercise of individuals and the different types of physical activity measured (occupational and recreational), there is remarkably consistent evidence that people who are highly physically active could be at a reduced risk of cancer of the colon. An analysis of case-control and cohort studies suggests that exercise might reduce the risk, at least in men, by up to one-third. We conclude that exercise has been overlooked as a potentially useful, effective, and acceptable method for reducing the risk of colon cancer.

Case-Control Studies↗
PubMed1994

Patterns of oral and pharyngeal cancer incidence in New South Wales, Australia.

Incidence and mortality rates for oral and pharyngeal cancers have been reported to be increasing in Europe and the United States, with particularly large increases in mortality in central and eastern Europe. Such increases have been noted to be birth cohort-based, primarily affecting young and middle-aged men. In this report oral and pharyngeal cancer incidence data from New South Wales, Australia has been analysed for the period 1972-90. Although an increase in the incidence of oral and pharyngeal cancer occurred during the mid-1970s and early 1980s, it did not continue. This pattern is consistent with Australian trends in per capita consumption of tobacco, alcohol, fruit and vegetables. Individual regions within metropolitan Sydney showed substantial geographical variation with age-specific rates of oral and pharyngeal cancers (combined) in middle-aged men being at least three times higher in the city of Sydney than in New South Wales as a whole. Given the preventable nature of the disease, such high rates need not occur.

Adult↗
PubMed1994

Thyroid cancer in Slovakia, 1968-1990: incidence, mortality and histological types.

Data on thyroid cancer incidence and mortality from the national cancer registry in Slovakia have been analysed for 1968-90, representing one of the first such descriptive epidemiological studies from Eastern Europe. The incidence of thyroid cancer has increased over this period, particularly among women, from approximately 1.5 to 2.5 per 100,000. These increases occurred primarily in papillary carcinomas, and to a lesser extent follicular carcinomas; the greatest proportional increase was in the younger age groups. In contrast to data reported from other areas, mortality also increased over the same period. The reasons for such increases are not evident, but the increases in mortality certainly indicate the potential for improvements in the treatment of thyroid cancer in Slovakia, as well as further study on the aetiological factors involved in the disease.

Adenocarcinoma, Follicular↗
PubMed1993

Epidemiological aspects of lip cancer in Scotland.

The purpose of this paper is to present the descriptive epidemiology of lip cancer in Scotland. The incidence and mortality of lip cancer are found to be higher in men than in women and to have fallen remarkably among men. This decline has been the result of cohort effects indicating that the risk of lip cancer is decreasing among successively younger people.

Adult↗
PubMed1992

Oral cancer in Scotland: changing incidence and mortality.

OBJECTIVES: To determine the incidence of oral cancer in Scotland between 1960 and 1989 and oral cancer mortality from 1911 to 1989. SETTING: Data were obtained on oral cancer incidence from the information and statistics division of the Common Services Agency of the Scottish Health Service and mortality data from the office of the registrar general for Scotland. RESULTS: Mortality from intraoral cancers in Scotland substantially declined throughout this century until the mid-1970s. This trend, however, was then reversed, and fourfold increases in incidence were observed in younger age groups after 1960. Death rates in these younger age groups increased to levels previously recorded in the 1940s. These increases seemed to be cohort based and may therefore continue into the future. CONCLUSIONS: Reasons for increasing rates among younger age groups are speculative and rely on combining knowledge about risk factors and available ecological data. Though increases in incidence at younger ages do not result in a large change in the number of cases diagnosed, possible similar increases continuing into older ages, when oral cancer is more common, will correspond to a much larger increase in the actual number of cases. Given that such a large attributable risk is associated with tobacco and alcohol, however, these increases may be preventable.

Adolescent↗
PubMed1992

Recent advances in epidemiology of head and neck cancer.

Cancer of the oral cavity is an important contributor to the overall international cancer burden, especially in the developing countries. Smoking cessation, moderation of alcohol consumption, and increased consumption of fruits, and probably vegetables, have been identified by epidemiologic studies as three actions that could lead to the prevention of approximately three fourths of cases in Western countries. Similar effects could be brought about in developing countries through cessation of cigarette smoking and, where appropriate, betel quid chewing and increased consumption of fruits and vegetables. Since this disease is increasing in frequency in many countries, it is important to implement these health education messages. A similar situation holds true for larynx cancer. Clearly many head and neck cancers are preventable and it is worth repeating that prevention should become an epidemiologic priority. There are exciting prospects of effective chemoprevention opportunities in head and neck cancer, with a number of compounds having activity. Further developments in this important area are awaited.

Alcohol Drinking↗
PubMed1992

The roles of general and geriatric medicine in the provision of acute medical care for elderly patients.

To determine whether there are differences between elderly patients admitted acutely to general medicine and those admitted to geriatric medical wards, and whether the patients are appropriately referred, a prospective survey of 426 consecutive patients aged 65 years or over admitted acutely to general medical and geriatric wards over a three month period was performed. A total of 286 patients were admitted to general medicine (GM) and 140 to the geriatric unit (GER). GER patients were older (81.0 v. 75.8 years) and had greater pre-morbid functional impairment and incontinence. Fewer GER patients presented with readily apparent organ specific diagnoses (56% v. 94%). Median length of stay was longer in GER patients (23 days v. 9 days). Variables independently predictive of GER admission were increasing age, increasing duration of illness, poor pre-morbid functional status and prior reliance on a carer. Length of stay was not associated with unit of admission allowing for the variables described above. GER patients are a different population. They have more chronic illness and functional impairment, and are more likely to require multidisciplinary assessment and rehabilitation in addition to treatment of presenting illness. Elderly patients are appropriately referred by General Practitioners (GPs) without a formal admissions policy.

Aged↗