Vasectomy and testicular cancer: epidemiological evidence of association.
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Adult↗
Biomedical subjects
H Møller
Publications and source records attributed to H Møller.
Increased incidence of sarcoma in patients treated for testicular 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 irrespectively of time since the diagnosis of testicular cancer. The interval between the testicular cancer and the sarcoma varied from 5-34 years. After investigation of the hospital records and re-examination of the histological specimens, 3 patients were excluded. In spite of this, the RR was still considerably increased (at least 3-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 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.
Adult↗
Incidence of second primary cancer following testicular cancer.
The incidence of second primary cancers was investigated in 6187 Danish men diagnosed with testicular cancer in the period 1943-1987. During the course of 59,000 person years, 459 subsequent primary cancers occurred. The relative risks were significantly increased for leukaemia, gastric cancer, pancreatic cancer, bladder cancer, non-melanoma skin cancer and kidney cancer. Increased incidence was furthermore suggested for cancer of the rectum, prostate and lung. The increased incidence of leukaemia appeared in the first 10 years after testicular cancer diagnosis. The excess incidence for gastric cancer, pancreatic cancer, rectal cancer and lung cancer was strongest 10-19 years after testicular cancer, while the relative risk of non-melanoma skin cancer and prostate cancer increased throughout the period of follow-up. The increased incidence of cancer in this cohort is most likely an effect of radiotherapy used for testicular cancer. It is proposed that the different incidence patterns over time after testicular cancer diagnosis reflect differences in the growth rate of tumours originating in different tissues.
Adult↗
Observer variations in the evaluation of facial nerve function after acoustic neuroma surgery.
This investigation was performed in order to evaluate the observer variations in facial nerve function after surgery for an acoustic neuroma. From 1976-90, 507 patients were operated on by the same surgical team (M.T. and J.T.) using a translabyrinthine approach. One hundred and forty-four patients living in Copenhagen City and County were invited for interview and objective examination. Only 128 patients attended the interview and examination which were carried out by the same ENT physician. Data concerning observation of the facial nerve function only is presented. Its function was clinically evaluated (using the House and Brackmann (1985) grading scale) by two different observers i.e. the ENT physician and one of the surgeons. The patients were asked face-to-face with the ENT physician to estimate the degree of facial nerve function according to a 0-100 per cent scale. Comparing normal and abolished facial nerve function the judgments of the ENT physician and the surgeon agreed with the patient's own evaluation.
Adult↗
Occurrence of carcinogens in the external environment: epidemiological investigations.
The variation in cancer incidence between European populations indicates that at least 50% of the cancer incidence in Denmark may be attributable to environmental factors, including factors related to living conditions and lifestyle, and, hence, in principle are avoidable. Based on data from epidemiological studies of cancer causes, it is estimated that 30-40% of the total cancer burden in Denmark could be prevented by application of already available knowledge. Epidemiological studies of cancer occurrence in relation to arsenic in drinking-water, chlorination of drinking-water, nitrates in drinking-water and ambient air pollution are briefly reviewed. Although the causal associations between these factors and cancer in humans are hypothetical and unproven, the available data allow a rough calculation of the maximum proportion of cancer cases which possibly can be caused by these factors. At most, a few percent of the total cancer incidence is attributable to these external environmental factors.
Air Pollution↗
Clues to the aetiology of testicular germ cell tumours from descriptive epidemiology.
The descriptive epidemiology of testicular cancer in Denmark shows that the incidence of both seminoma and non-seminoma has increased gradually since the 1940s to the present. The age-incidence pattern has remained unchanged, and is the same in the Nordic countries despite variation in the overall incidence level. Men born during the early 1940s have a lower risk in all age groups than expected from the overall trend in incidence. These observations support the idea that the occurrence of testicular cancer (both seminoma and non-seminoma) is determined early in life, and most probably before birth. Once the carcinogenic process is established, the age of occurrence of cancer or the histological type of the cancer does not seem to depend upon external factors.
Adolescent↗
Survival of Danish cancer patients 1943-1987. Male genital organs.
This chapter describes the survival of men with the two commonest cancers of the genital organs--cancer of the prostate and cancer of the testis. Prostatic cancer is largely a disease of old age and occurs at a rate of about 1400 new cases per year in Denmark. Testicular cancer is a rare disease, usually affecting men in their 20s and 30s. About 250 new cases occur annually in Denmark. Both prostatic and testicular cancer have been increasing in incidence over the period of cancer registration in Denmark. Relative survival of prostatic cancer patients improved over the period of study, with an increase in one-year survival from 52% around 1945 to 80% around 1985. The corresponding change in five-year survival was from 22 to 39%. The survival of testicular cancer patients increased in response to improvements in therapy: relative one-year survival increased from 70% around 1945 to 95% around 1985. The increase was particularly strong for non-seminomas, for which one-year survival increased from 53 to 94%. Excess mortality after a diagnosis of testicular cancer was most pronounced in the first few years after diagnosis; for prostatic cancer, mortality relative to that of the general population was about two fold, even 10 years after diagnosis.
Age Factors↗
[Lateral cervical cysts as primary manifestation of tonsillar cancer].
Of 59 patients with tonsillar carcinoma, eight presented with a cervical cyst which was judged to be a branchial cyst clinically and after fine needle aspiration. In all cases, the cyst was removed and microscopic examination revealed malignancy. The correct diagnosis, carcinoma of the tonsil with cystic lymph node metastasis, was revealed during the primary operation in two cases, in four cases the diagnosis was made at a second operation where ipsilateral tonsillectomy was performed and in two cases the diagnosis was first made several years later. It is concluded that, in patients who are over the age of 40 years, the diagnosis of branchial cyst should not be accepted primarily even if fine needle aspiration does not give any suspicion of malignancy.
Adult↗
Nitrate and N-nitrosoproline excretion in two Italian regions with contrasting rates of gastric cancer: the role of nitrate and other factors in endogenous nitrosation.
Exposure to nitrate and propensity for endogenous nitrosation were examined in 80 healthy males, aged 25-40 years, residing in areas of Italy with long-standing high (Florence) and low (Cagliari) rates of gastric cancer. Nitrate exposure was assessed by measurement of urinary nitrate excretion over 12 hr, and endogenous nitrosation was assessed using the N-nitrosoproline test (NPRO-test). Our hypothesis was whether the geographic variation in cancer rate correlated with nitrate exposure or nitrosating ability. Exposure to background sources of NPRO was significantly higher in the high-risk subjects (phi = 0.04) whereas no differences were found in exposure to nitrate or in urinary NPRO levels after L-proline loading (test NPRO levels). The regional difference in test NPRO was almost completely accounted for by background NPRO exposure. Examination of individual rather than grouped data revealed that exposure to nitrate was a major factor in NPRO formation. No other factors studied (age, dietary-questionnaire-assessed intake of anti-oxidant vitamins) had a significant effect. Geographical variation in gastric cancer risk did not, therefore, correlate with either nitrate exposure or propensity for endogenous nitrosation of L-proline.
Adult↗
Prostate cancer incidence in cimetidine users.
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Adult↗
Some aspects of life quality after surgery for acoustic neuroma.
This investigation was performed to describe some aspects of the quality of life in subjects after translabyrinthine removal of an acoustic neuroma, resulting in unilateral total deafness. Two hundred ninety-three subjects who had been operated on during 1976 through 1990 and who were living outside the Copenhagen (Denmark) City and County received a postal questionnaire, to which 93% (n = 273) responded: 118 men and 155 women with a median age of 58 years (range, 18 to 81 years). The median observation period from surgery to the questionnaire was 6 years (range, 6 months to 14 years), and the median age at operation was 52 years (range, 15 to 76 years). Among the subjects, 22% had received postoperative hearing rehabilitation with various types of hearing aids in the ear not operated on. In 62%, tinnitus was experienced in the ear with tumor before surgery, and at the time of the questionnaire, 49% experienced tinnitus in the ear operated on. Half a year after surgery, 56% still experienced dizziness. Sixty-four percent reported damage to the facial nerve in relationship to the operation. At the time of the questionnaire, 12% indicated a total loss of facial nerve function. No vocational consequences were found in 74% after surgery. Information concerning different symptoms related to surgery was insufficient in 29%, while the quality of information in relation to surgery was more satisfying. In conclusion, the study demonstrates that deafness, dysequilibrium, and reduced facial nerve function caused the most severe problems. Improved information to patients before surgery may reduce the frequency of negative experiences.
Adolescent↗
Diuretics may increase risk of renal cell carcinoma.
The risk for kidney cancer was examined in a Danish cohort of 192,133 people on a hospital discharge register who had been given a diagnosis of hypertension, heart failure, or edema, and were presumed to be probable users of diuretics. The subjects were identified from 1977 to 1987 and followed-up for cancer through 1987. A total of 10,630 cancers was observed. While the risk for all cancers was increased slightly (standard mortality ratio [SMR] = 122, 95 percent confidence interval [CI] = 120-124), the risk for renal cell carcinoma was more than doubled (SMR(men) = 221, CI = 192-253; SMR(women) = 246, CI = 213-283). Increased risks were found in all age groups, and, although surveillance bias was present initially, the risk increased consistently in the years following discharge. Risk estimates for individuals discharged with hypertension were similar to those for the total cohort. Use of diuretics was validated in a random sample of 100 individuals. More than 70 percent were taking diuretics at the time of discharge. The increased risk for renal cell carcinoma in this cohort may indicate either that diuretics are involved in the etiology of renal cell carcinoma or that the risk can be attributed to confounders, including smoking, which affect risk for both the discharge diagnosis and renal cell carcinoma.
Aged↗
Malignant tumors in patients with psoriasis.
BACKGROUND: There is strong epidemiologic evidence that psoriasis treatments may cause nonmelanoma skin cancer and possibly other types of cancer. OBJECTIVE: This study from Denmark reports the cancer incidence in 6910 patients with psoriasis discharged from the hospital from 1977 through 1987. METHODS: 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; observed figures were compared with those expected on the basis of cancer incidence rates for the national population. RESULTS: 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. In addition, excesses were seen 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). CONCLUSION: The effect of cigarette smoking on the risk for noncutaneous 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 of colon cancer, which has been observed in excess in two other studies of psoriatic patients.
Adult↗
Risk of kidney cancer in analgesics users.
The risk of kidney cancer was examined in a cohort of people discharged from Danish hospitals from 1977-1987 with a diagnosis of rheumatoid arthritis, osteoarthrosis or backpain. These individuals are presumably more or less regular users of mild analgesics. A total of 155,554 people were identified. The risk of cancer of the urinary tract was slightly increased [relative risk (RR) = 1.31], almost exclusively because of an increased risk of renal cell carcinoma (RR = 1.40). The relative risk was higher in individuals with rheumatoid arthritis than among individuals with osteoarthrosis or backpain, and higher among women than men. Although this study lacks information on the actual analgesics consumption of the individual, and various biases may be present, these findings offer little support to the concern that increased analgesics use raises the risk of kidney cancer.
Adult↗
Incidence of cancer of oesophagus, cardia and stomach in Denmark.
Subtypes of oesophageal and gastric cancer in Denmark are compared with respect to their occurrence in men and in women, and in the Danish capital, Copenhagen, versus the rest of Denmark. Three categories of tumours can be distinguished epidemiologically: oesophageal squamous carcinoma, oesophageal and cardial adenocarcinoma, and distal gastric cancer. Comparison of information reported to the Danish Cancer Registry and cause of death as indicated on death certificates suggests that considerable misclassification between subtypes of tumours occurs. The Danish experience supports the findings from other populations of increasing incidence of oesophageal and cardial adenocarcinoma, but because of possible changes in diagnoses over time and of misclassification of subtypes, the data must be interpreted with caution.
Adenocarcinoma↗
Use of cimetidine and other peptic ulcer drugs in Denmark 1977-1990 with analysis of the risk of gastric cancer among cimetidine users.
The prevalence of use of peptic ulcer drugs in the Danish population is described at two points in time using registrations of applications for reimbursement. In 1977-81, the prevalence of use of cimetidine was 0.4% in men and 0.2% in women. In 1989-90, the prevalence of use of peptic ulcer drugs was 1.3% in men and 1.2% in women. The increase in prevalence was apparent in all age groups, but most pronounced at relatively old age. The median age of users increased from 55 years in 1977-81 to 63 years in 1989-90. The data indicated that a third of those who used peptic ulcer drugs in 1977-81 also used these drugs in 1989-90, conditional on surviving this period. The probability of becoming a long term user was highest for those who were 50-69 years in 1977-81. The incidence of gastric cancer was investigated in the cohort of persons who used cimetidine in 1977-81. An excess risk of gastric cancer was apparent in the first years after start of cimetidine use. This is thought to reflect a selection bias. Significantly increased incidence was also observed in women seven years or longer after start of cimetidine use (RR = 4.7; 95% CI: 1.7-10.3). This estimate was, however, based on only six cases, and a similar pattern was not observed in men.
Adult↗
Daily impedance audiometric screening of children. Validity of impedance tympanoscope ZS331 compared with impedance audiometer AZ7.
The purpose of the present study was to test a fully automated screening impedance tympanoscope against a clinical impedance audiometer. Previous studies have indicated a relatively high incidence of type B tympanograms when using the tympanoscope and in addition shown a surprisingly large number of type B curves of one day's duration. The present study was based on 51 otherwise healthy children attending kindergartens (100 ears) who underwent daily tympanometric screening with both the impedance tympanoscope ZS331 and the impedance audiometer AZ7. The tympanoscope indicated a significantly larger number of type B tympanograms, and in 16 cases the type B curves could be demonstrated on only one day, resulting in significantly higher point and period prevalences of type B tympanograms. The difference is mainly attributable to the different ways in which a type B tympanogram is defined by the two instruments. On the basis of the present study we conclude that the impedance tympanoscope is not well suited for this type of study.
Acoustic Impedance Tests↗
Mucosal immunity to Pseudomonas aeruginosa alginate in cystic fibrosis.
Patients with cystic fibrosis commonly acquire chronic pulmonary infection with alginate-producing Pseudomonas aeruginosa. The infection remains localized at the mucosal surfaces of the airways. Using enzyme-linked immunosorbent assays immunoglobulin concentrations and titers of specific antibodies to purified P. aeruginosa alginate and to P. aeruginosa sonicated antigens were measured in tears, saliva, sputum and serum. CF patients had significantly higher concentrations of IgG, IgA and SIgA in serum and saliva than controls. They also had significantly higher levels of specific antibodies to alginate and sonicated antigen in secretions and serum. Local production of IgA, IgG and IgM antibodies to P. aeruginosa was demonstrated. Only a minor proportion of specific IgA antibodies were present as secretory IgA in tears, saliva and sputum. The ratio of alginate-specific SIgA to specific monomeric IgA in sputum was significantly lower than the similar ratio in saliva, whereas the same ratio for specific P. aeruginosa sonicate antigens was found in saliva and sputum.
Adolescent↗