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H Møller

Publications and source records attributed to H Møller.

At least 91 records · Page 5Linked to original sources

DNA content and expression of tumour markers in germ cells adjacent to germ cell tumours in childhood: probably a different origin for infantile and adolescent germ cell tumours.

The origin of testicular germ cell tumours occurring during childhood is poorly understood. In adults, the classical seminomas and non-seminomas originate from carcinoma in situ of the testis, which can usually also be detected in seminiferous tubules adjacent to the tumours. In order to contribute with information regarding a possible association between carcinoma in situ and the childhood group of germ cell tumours, we investigated seminiferous tubules adjacent to 13 infantile yolk sac tumours, five infantile teratomas, and six adolescent germ cell tumours of various types, using morphological evaluation, immunohistochemical staining with markers for carcinoma in situ cells, and densitometric DNA measurement of the germ cells. We detected clear differences between the germ cell populations adjacent to adolescent and infantile germ cell tumours. The former were associated with both normal germ cells and carcinoma in situ cells, like germ cell tumours occurring in adult men. Although we were in doubt in two cases, the infantile cell germ cell tumours were in general not associated with carcinoma in situ cells. The aetiology of infantile yolk sac tumours and teratomas may therefore be fundamentally different from that of adolescent and adult germ cell tumours. The origin of yolk sac tumours and teratomas remains to be elucidated.

Adolescent↗

Risk of testicular cancer after vasectomy: cohort study of over 73,000 men.

OBJECTIVE: To confirm or refute reports that vasectomy may increase the risk of cancers of the testis and prostate. DESIGN: Computerised record linkage study of cohort of men with vasectomy and comparison of cancer rates with those in the whole Danish population; manual check of all records of patients with testicular and prostate cancer diagnosed within the first year of follow up. SETTING: Denmark 1977-89. SUBJECTS: Cohort of 73,917 men identified in hospital discharge and pathology registers as having had a vasectomy for any reason during 1977-89. MAIN OUTCOME MEASURES: Observed incidences of testicular, prostate, and other cancers up to the end of 1989. RESULTS: The overall pattern of cancer incidence in the study cohort was similar to that expected nationally. No increased incidence in testicular cancer was observed (70 cases; standardised morbidity ratio 1.01 (95% confidence interval 0.79 to 1.28)). The incidence during the first year of follow up was also close to that expected (nine cases; standardised morbidity ratio 0.80 (0.36 to 1.51)). The incidence of prostate cancer was not increased (165 cases; standardised morbidity ratio 0.98 (0.84 to 1.14)). CONCLUSIONS: The incidence of testicular cancer in men with vasectomy is no higher than in other men. Vasectomy does not cause testicular cancer and does not accelerate the growth or diagnosis of pre-existing testicular neoplasms. Data concerning a causal relation between vasectomy and prostate cancer were inconclusive.

Adult↗

[Increased incidence of sarcoma in patients treated for seminoma].

In a nationwide cancer registry analysis of second primary malignancies in 6187 men with testicular cancer in the period 1943-1987, 13 sarcomas were found, yielding a 4-fold increase of the relative risk (RR). The majority of sarcomas occurred in men with seminoma, and the increased incidence was seen irrespective of time since the diagnosis of testicular cancer. The interval between the testicular cancer and the sarcoma varied from five to 34 years. After investigation of the hospital records and re-examination of the histological specimens, three patients were excluded. In spite of this, the RR was still considerably increased (at least three-fold). Seven of the 10 sarcomas were found to be located within the field of the radiation treatment administered and three at the periphery. The histological type of sarcomas varied, with leiomyosarcoma as the most frequent (three cases), followed by malignant fibrous histiocytoma (two cases) and fibrosarcoma (two cases). Since none of these patients had received chemotherapy and did not harbour sarcomatous components within the primary testis cancer, the sarcomas were probably caused by the radiation treatment. The absolute number of these secondary sarcomas is low, but the risk of developing such neoplasms and other malignancies should, even so, be kept in mind in the follow-up of testicular cancer patients.

Adolescent↗

Testicular germ cell tumours of childhood in Denmark, 1943-1989: incidence and evaluation of histology using immunohistochemical techniques.

In the Danish Cancer Registry, 72 testicular tumours in boys younger than 15 years of age were recorded during the period 1943-1989 and material from 34 of these was retrieved from Danish departments of pathology. The histological types were evaluated and the role of immunohistochemical staining was analysed. The survival of the patients was correlated with the histological diagnoses, and changes in the incidence of testicular cancers in childhood were analysed. Twenty-nine of the 34 patients had germ cell tumours, which fell into two groups (infantile and pubertal) with distinct differences. The tumours of infancy usually presented before the age of 3 years and were either pure yolk sac tumours or teratomas. The tumours of puberty showed no morphological or immunohistochemical differences from adult germ cell tumours. In the infantile group, immunohistochemical staining confirmed the morphological evaluation but was not necessary for diagnosis. Patients in the infantile group seemed to have a better prognosis than adult patients, only one patient dying from his disease, whereas the pubertal patients seemed to have a prognosis similar to that of adult patients. The incidence of infantile testicular cancer in Denmark appears to have increased at almost the same rate as that observed in adult men, but due to the small numbers in infancy, this cannot be statistically substantiated. We conclude that the testicular germ cell tumours of infancy and puberty may arise from different precursor cells, but both groups seem to arise prenatally.

Adolescent↗

The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group.

BACKGROUND/AIMS: Low serum levels of pepsinogen A are indicative of chronic atrophy, a risk factor for gastric cancer. This study investigated the relationships between low pepsinogen A levels, Helicobacter pylori seropositivity, and gastric cancer rates in 17 populations worldwide. METHODS: In each center, about 200 randomly selected subjects (50 male and 50 female, aged 25-34 and 55-64 years) provided serum samples for pepsinogen analysis and H. pylori serology. RESULTS: Cumulative gastric cancer rates were associated with the prevalence of low pepsinogen A levels in men (coefficient, 0.15 [P = 0.06] for mortality; coefficient, 0.36 [P = 0.01] for incidence) but not women. The prevalence of low pepsinogen A levels was also correlated with H. pylori seropositivity in the older age group (r = 0.55; P = 0.02). Low pepsinogen A levels were significantly more common in the older group (7.5% vs. 2.1% in the younger group; P < 0.001), among women (5.5% vs. 4.1% in men; P = 0.04), and among nonsmokers (5.8% vs. 2.9% in current smokers; P = 0.001). CONCLUSIONS: Low pepsinogen A levels are more common in areas with a high seroprevalence of H. pylori and in men in areas with high rates of gastric cancer. The prevalence of low pepsinogen A levels increases with age, but the excess in women and nonsmokers could reflect factors other than gastric pathology.

Adult↗

Obesity and cancer risk: a Danish record-linkage study.

A cohort of 43,965 obese persons was accrued on the basis of discharge registrations from Danish hospitals, and incidence of cancer in the cohort was compared to that in the Danish population as a whole using indirect standardisation for age and period. Increased incidence was observed for cancer of the uterine corpus independently of age [114 cases, relative risk (RR) = 2.0, confidence interval 1.6-2.4], and for breast cancer in women above the age of 70 (133 cases, RR = 1.2). These findings are consistent with previous studies. In younger women, breast cancer occurred less frequently and ovarian cancer occurred more frequently than expected. Increased incidence was observed for cancers of the oesophagus (26 cases, RR = 1.9) and the liver (58 cases, RR = 1.9), probably reflecting an increased prevalence of excessive alcohol consumption in the cohort. Increased incidence was furthermore observed for cancers of the pancreas (101 cases, RR = 1.7), the prostate (96 cases, RR = 1.3) and the colon (195 cases, RR = 1.2), which may indicate the existence of risk factors which are common to obesity and to these cancers, for example, dietary habits. Kidney cancer was increased in women only. Overall, the incidence of cancer was increased by 16% in the cohort. The results were essentially unchanged by restriction to the subcohort of 8207 persons in whom obesity was the primary discharge diagnosis, and were also similar in the first year of follow-up after hospital discharge. Selection bias is, therefore, not likely to have influenced the results.

Adolescent↗

Examination for intratubular germ cell neoplasia at operation for undescended testis in boys.

A total of 843 consecutive boys (median age 12.7 years) who had undergone testicular biopsy at operation for undescended testis was followed into adulthood (median age 25.2 years) to examine for testicular germ cell neoplasia. Five cases of testicular germ cell neoplasia were identified, including 1 nonseminoma of the contralateral testis, which had been treated before surgery for an undescended testis, 1 nonseminoma found at followup, 1 seminoma and 2 intratubular germ cell neoplasms. Of the later 3 patients 1 had a 45,X/46,XY karyotype and 2 had abnormal external genitalia. Previous testicular biopsy from the patient in whom nonseminoma was noted at followup showed Sertoli cells only. We recommend that testicular biopsy be performed at operation for undescended testis in boys with abnormal sex chromosomes, particularly 45,X/46,XY karyotype, and in those with abnormal external genitalia. The pattern of Sertoli cells only in biopsies from boys does not preclude the occurrence of testicular cancer in adulthood.

Biopsy↗

Cancer morbidity in alcohol abusers.

Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared with that of the total Danish population. On average the 15,214 men were observed for 12.9 years and the 3,093 women for 9.4 years. The overall morbidity of cancer was increased significantly. Of the men, 1,441 developed cancer [relative risk (RR) = 1.6; 95% confidence interval (CI) = 1.5-1.7], while 182 women did (RR = 1.5; 95% CI 1.3-1.8). Significantly increased incidences were found of cancer in the tongue, mouth, pharynx, oesophagus, liver, larynx, lung and pleura and secondary cancer. The women had significantly increased risk of cervical cancer (RR = 2.0; 95% CI 1.2-3.0). The men developed prostatic cancer significantly more frequently than expected (RR = 1.4; 95% CI 1.2-1.8). The risk of melanomas (RR = 0.5; 95% CI 0.2-0.8) was significantly lower than expected. The relative risks of cancer of the stomach, pancreas, kidney and endocrine system were only slightly increased. The study group did not develop more colonic (RR = 1.0; 95% CI 0.8-1.3) or rectal cancer (RR = 1.0; CI 0.7-1.3) than expected. The risk of breast cancer in women was slightly increased (RR = 1.3; 95% CI 0.9-1.7), but not statistically significant. Thus, the associations between alcohol and cancer of the upper digestive and respiratory tract and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers.

Adult↗

Indications for cesarean section in singleton pregnancies in two Danish counties with different cesarean section rates.

OBJECTIVE: To compare the clinical indications for delivery by cesarean section (CS) in singleton pregnancies in two Danish counties with different CS rates, and to describe the relation between CS in the two counties and parity, mother's age, type of delivery department, gestational age at birth, and birthweight. DESIGN: A population-based, follow-up study based on antecedent data. SETTING: Two Danish counties, where women deliver in obstetric as well as surgical departments, with a CS rate of 8.3% and 15.2%, respectively. SUBJECTS: All pregnant women in the two counties who delivered in 1989. MAIN OUTCOME MEASURES: Comparison of the rates of CS in the two counties carried out for five well-defined clinical indications: Previous cesarean section, breech presentation, dystocia, fetal distress, and other. SECONDARY MEASURES: Neonatal and maternal outcomes. RESULTS: In the county with the higher frequency of CS, all indications for CS were used significantly more often, except from 'fetal distress' in primiparous women. In this county 'breech presentation' was the commonest indication among primiparous women, whereas 'fetal distress' was the most common in the county with the lower CS rate. For multiparous women the highest CS rates in both counties were found among women who had had a previous CS. The major difference between the two counties was the threefold greater risk of CS indicated by 'dystocia' among multiparous women in the county with the higher CS rate. CONCLUSION: The regional differences in CS could not be explained by differences between the two populations or by an increased rate of a single indication, but could be due to differences in obstetric practice or expectations or demands from the pregnant women.

Adolescent↗

Testicular cancer.

Testicular cancer is a disease that predominantly affects young and middle aged men. Our data show that incidence rates have recently increased in men aged 15-54 years in all 13 populations examined, irrespective of whether the populations were at high, moderate or low underlying risk. The annual percentage increase in this age group between 1970 and 1985 varied from 1.9% in the West Midlands, UK, to 6.6% in Miyagi, Japan, with a median of 2.7%. Analysis of the data in two separate age bands, 15-34 and 35-54 years, shows that increases are occurring in both subgroups. This, together with analyses by histological category in Denmark and the West Midlands, UK, indicates that both teratomas and seminomas are increasing in incidence. In contrast to the pattern for incidence rates, testicular cancer mortality rates are now declining in all the nine national populations examined. The time from which mortality rates started to decline varies between populations, and in Poland, a reduction was not observed until the 1980-1985 period. This reflects delay in the uptake of effective chemotherapy for the treatment of teratomas. The decline in mortality, against a background of rapidly increasing incidence in most populations, emphasizes the appreciable improvements in prognosis associated with testicular cancer in recent decades. Although the epidemiology of testicular cancer strongly suggests the presence of environmental risk factors that may be controllable, our ignorance about the nature of these factors precludes any strategy of prevention. Early diagnosis and improved treatment will therefore remain a major focus for the control of this cancer. Our ability to treat testicular cancer is thus a major and necessary achievement given the increase in incidence.

Adolescent↗

The choice of approach in surgery for acoustic neuromas (vestibular schwannomas).

The advantages and disadvantages of the different surgical approaches for surgery of vestibular schwannomas are described, as well as the problems in evaluating the outcome of the treatment, regarding especially the evaluation of facial nerve function and hearing capacity. The eclectic Copenhagen treatment algorithm is outlined: 1) All tumors measuring 25 mm or more on MRI are operated via the translabyrinthine approach. 2) All patients with PTA poorer than 30 dB, and SDS poorer than 70% are operated via the translabyrinthine approach. 3) Tumors less than 10mm extrameatally, and PTA better than 30 dB and SDS better than 70% are removed via the middle fossa route. 4) Tumors measuring 10-25 mm and PTA better than 30 dB and SDS better than 70% are operated via the suboccipital route. Finally some consequences of postponing surgical treatment is described, demonstrating that 74% of 127 tumors continued to grow with a mean of 3.4 mm increased tumor diameter per year, and that 75% of patients, who were candidates for hearing preservation surgery lost the candidature in the observation period.

Algorithms↗

[Psoriasis and cancer].

This study reports the cancer incidence among 6910 individuals in Denmark discharged from hospital over the period 1977-1987 with a diagnosis of psoriasis. Patients were identified in the National Hospital Discharge Register and information on cases of cancer was obtained through the files of the Danish Cancer Registry. A 2,5-fold increased risk was observed for nonmelanoma skin cancer in men and women, with no preponderance of any specific histologic subtype of cancer. The incidence of non-cutaneous cancers at all sites combined was significantly increased in the study group, owing mainly to excesses of lung cancer in men (relative risk (RR) = 1.4) and women (RR = 1.6), of cancer of the larynx and pharynx in men (RR = 2.8 and 3.9), and of colon and kidney cancer in women (RR = 1.6 and 2.3). The effect of cigarette smoking on the risk for non-cutaneous cancer could not be assessed in this study; however, antipsoriatic treatment such as ionizing radiation and oral arsenicals must be considered as a possible cause, particularly in relation to colon cancer which has been observed in excess in two other studies of psoriatic patients, but also in relation to kidney and lung cancer.

Denmark↗

Trends in incidence of anal cancer in Denmark.

OBJECTIVE: To study long term trends in incidence of anal cancer in a well monitored, unselected population. DESIGN: Descriptive epidemiological study based on data from the Danish Cancer Registry. SETTING: Denmark, 1943-87. MAIN OUTCOME MEASURES: Time related changes in anal cancer incidence according to sex, age, birth cohort, urban or rural residence, and marital status. RESULTS: The incidence of anal cancer remained fairly constant in the period 1943-57 and was similar for men and women, but it increased 1.5-fold among men and nearly tripled among women thereafter. Among men the incidence increased from 0.25 per 100,000 population (world standardised) in 1958-62 to 0.38 in 1983-7 (p = 0.01) and among women from 0.28 to 0.74 (p < 0.01). The greatest increase was among residents of the capital (Copenhagen). During 1943-87 age specific trends increased in young and middle aged men and in all age groups among women. Men with anal cancer were significantly more likely throughout the study period to be unmarried than were patients with cancer of the colon (adjusted odds ratio 2.7; 95% confidence interval 2.0 to 3.6) and stomach (2.1; 1.5 to 2.8), but no association with marital status was found among women. CONCLUSIONS: The distribution and incidence of anal cancer have changed appreciably since around 1960, especially among women, which indicates important aetiological changes. Changes in sexual behaviour may have facilitated the spread of a transmittable agent of aetiological importance. It has recently been suggested that cigarette smoking promotes anal cancer, and this finds indirect support in the synchronism between changes in anal cancer incidence and heavy smoking behaviour. Factors associated with homosexuality are likely to explain some of the cases among men.

Adult↗