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Biomedical subjects

J Berkel

Publications and source records attributed to J Berkel.

At least 19 recordsLinked to original sources
PubMed1999

Do insulin-like growth factors mediate the effect of alcohol on breast cancer risk?

Despite a large number of epidemiologic studies demonstrating an increased risk of breast cancer in association with alcohol consumption, a causal relationship between alcohol intake and breast cancer risk remains to be determined. Several biological mechanisms have been proposed, but none of them explains well the features of the association, i.e. a modest increase in risk, a limited range of dose-response relationship and no further increase in risk among heavy drinkers. A new mechanism underlying a possible biological role of alcohol in breast cancer is proposed in this paper. Moderate consumption of alcohol increases the production of insulin-like growth factors (IGFs) by the liver and elevated IGFs via circulation stimulate or promote the development and/or growth of breast cancer. The effect of alcohol on IGF production declines among heavy drinkers as alcohol-caused liver-function damage results in no further increase in IGF production. Therefore, compared to moderate drinkers, heavy alcohol users do not have a higher risk of breast cancer.

Alcohol Drinking↗
PubMed1993

Small bowel cancer in western Canada.

Based on incident cases of small intestinal cancers in the four western Canadian provinces reported in the population-based cancer registries of British Columbia, Alberta, Saskatchewan and Manitoba we evaluated the descriptive epidemiological characteristics such as age, sex and subsite distribution of adenocarcinomas, carcinoids, lymphomas and sarcomas for the period 1975-1989. The distribution of adenocarcinomas, carcinoids and lymphomas presented a clear trend along the length of the small bowel. Most of the adenocarcinomas (54.7%) occurred in the duodenum and their relative frequency decreased in aboral direction: 29.9% in the jejunum and 16.0% in the ileum. The carcinoids showed an opposite trend, an increasing relative frequency in aboral direction: 3.9% in the duodenum, 9.2% in the jejunum and 86.7% in the ileum. Lymphomas were more frequent in the ileum (49.5%) compared to jejunum (29.4%) and duodenum (21.0%). Most sarcomas occurred along the jejunum (46.7%). The mean and median ages of lymphoma and sarcoma patients were significantly lower compared to adenocarcinoma and carcinoid cases. There was no difference in mean and median age by gender in the adenocarcinoma and carcinoid categories, but in the lymphoma and sarcoma groups males were significantly younger than females.

Adenocarcinoma↗
PubMed1992

Patterns and risks of cancer in farmers in Alberta.

Data on occupations and life styles of patients with cancer have been collected since 1983. To investigate cancer patterns and risks in farmers in Alberta, all farmers were abstracted and compared with nonfarmers in the data base, using case-control analysis. Controls were patients with cancer at any site except the index site. Significantly elevated odds ratio (OR), adjusted for age and smoking, were found among the farmers for cancers of the lip (OR = 3.22, 95% confidence interval [CI] = 2.14 to 4.84) and prostate (OR = 1.31, 95% CI = 1.11 to 1.55). Crude risk for lung cancer was significantly lower in farmers, but statistical significance disappeared when risk was adjusted for smoking (OR = 0.81, 95% CI = 0.65 to 1.02). Farmers were at considerably lower risk of malignant melanoma of the skin, compared with nonfarmers (OR = 0.57, 95% CI = 0.36 to 0.91).

Adult↗
PubMed1992

Meta-analysis of progestin and estrogen receptors in human meningiomas.

Among 301 human meningiomas published in the literature, 69% were progestin receptor (PgR)-positive. Estrogen receptors (ER) were detected in only 13% of the samples. The PgR levels were also elevated (p < 0.001) compared to the ER concentration. No association with sex, age, menstrual status or tumor location was found. Meningiomas with typical histology (75/171), were PgR-positive in significantly greater proportion than the atypical (12/171) or transitional (27/171) tumors. The PgR levels in the typical meningiomas were also increased (p = 0.005) compared to the atypical or transitional meningiomas. The ER levels did not differ by histology. The association of PgR levels with different histologic types is not well documented in the literature. Such an association is important for the understanding of the natural history of this disease as well as in the design and evaluation of therapeutic trials.

Adult↗
PubMed1990

General practitioners and completeness of cancer registry.

STUDY OBJECTIVE: The aim of the study was to evaluate the role of the general practitioner as a source of information for a cancer registry. DESIGN: The study involved a random sample of respondents to a letter inviting participation which was sent to all general practitioners in a specific area. Participating doctors were visited to maximise cooperation. Data collection consisted of setting up a retrospective (prevalence) registry of cancer patients diagnosed over a 20 month period, and a prospective (incidence) register over a subsequent 12 month period. The general practitioner cancer file was then linked to the total cancer registry data base to estimate missed cases. SETTING: The study took place in the catchment area of the Comprehensive Cancer Centre Middle-Netherlands (IKMN). PARTICIPANTS: Of 448 general practitioners in the IKMN region, 152 were willing to participate and of these 52 were randomly selected to take part (11% of all general practitioners in the region). MEASUREMENTS AND MAIN RESULTS: A total of 1637 tumours were identified from the general practitioners, of which 252 (15.4%) were not included in the cancer registry. Of these, only 22 (1.3%) were not included in the registry because they had tumours diagnosed clinically in outpatients and therefore had been omitted from the usual sources of information available to the cancer registry (pathology reports, hospital discharge letters). The missed cases were mostly older patients with digestive tract tumours. CONCLUSIONS: On cost-benefit grounds it was not considered feasible to initiate an active cancer registration system among general practitioners, provided that notification of pathological examinations to the registry is complete. Limited under-registration will occur when death certificates cannot be used as an additional source of information.

Catchment Area, Health↗
PubMed1990

Cholecystectomy and colon cancer.

A hospital-based case-control study on the possible relationship between cholecystectomy and colon cancer is described. In all, 569 cases and 1,129 controls were included in the study. Controls were patients who had been admitted either with another malignant disease (lung cancer or breast cancer), or because of benign gastrointestinal diseases. No differences with regard to colon cancer risk were observed between the two control groups. The crude odds ratio (OR) after cholecystectomy for colon cancer was 2.1 [95% CL (confidence limits) = 1.5; 2.9]. No significant difference in risk between males (OR = 2.0; 95% CL = 1.1; 3.6) and females (OR = 2.1; 95% CL = 1.4; 3.2) was found. A significant inverse relationship was found between the relative risk for colon cancer and sublocalization of the colon cancer, the highest relative risk (RR) found proximal in the colon. A decreasing risk with increasing interval between cholecystectomy and date of diagnosis of colon cancer was found. It is hypothesized that the apparent association between cholecystectomy and colon cancer does not reflect a necessary cause-effect relationship, but is rather an epiphenomenon representing a diminished exposure level to other etiologic factors.

Adult↗
PubMed1989

[Completeness of the cancer registry].

In 1985 the regional cancer registry in the IKMN area started. Pathology reports are used as the primary source of information for the registry. In order to evaluate the completeness of the registry, the registry database was compared with the discharge diagnosis register of the participating hospitals (LMR). In 1986 a total of 3546 tumours were registered by the registry, using the pathology reports as the primary source. The comparison with the LMR revealed that 616 patients were included in the cancer registry but not in the LMR. On the other hand 376 patients, in 180 of whom the diagnosis was confirmed by pathological examination while in 196 the diagnosis was based on clinical grounds only, were missing in the registry. Specifically, tumours of the central nervous system, liver, gallbladder, bile ducts and pancreas were missed in a high percentage. It is concluded that--even with an optimal pathology notification system--the LMR check is necessary to avoid underregistration. Omitting this check results in a 5% underregistration.

Cancer Care Facilities↗
PubMed1989

Second primary lung cancer: importance of long term follow up.

Review of histopathological and clinical data showed that 153 patients at one hospital developed a second primary lung cancer during 1980-6, 10% of all those with lung carcinoma. There were 64 synchronous tumours (interval less than one year) and 89 metachronous tumours (interval over one year). The average interval between metachronous tumours was 6.1 years. The criteria for diagnosing a second primary lung cancer were any of the following: (1) different histological type; (2) different lobe; (3) interval between the two tumours of at least three years. The incidence of second primary tumours increases with survival, and close follow up is required for their early detection.

Adult↗
PubMed1985

Effect of iron on neonatal gut flora during the first week of life.

Faecal specimens from 23 infants during the first week of life were compared. Ten infants received breast milk, six received cow-milk preparation supplemented with iron (+/- 5 mg/l) and seven unfortified cow-milk preparation (iron concentration less than 0.5 mg/l). Those on breast milk had low faecal pH, high counts of bifidobacteria and low counts of Enterobacteriaceae, bacteroides and clostridia. Infants receiving fortified cow-milk preparation had a high faecal pH and high counts of Enterobacteriaceae and putrefactive bacteria such as bacteroides and clostridia. Counts of bifidobacteria were also high. In those on unfortified cow-milk preparation a slow rise was observed in counts of Enterobacteriaceae followed by an increase in counts and isolation frequency of bifidobacteria: the latter was still rising on day 7. It is concluded that a low iron content in standard preparations of cow's milk enhances resistance of the neonatal gut to colonization.

Bacteria↗
PubMed1985

Religion and cancer in Los Angeles County.

The patterns of cancer risk by religion in the large multidenominational population of Los Angeles County were examined with the method of proportional incidence. Risk estimates for individual cancers by religion were screened and those extreme but stable estimates found were reexamined in light of relative socioeconomic class, nativity, and ethnicity. Within Protestant denominations, gradients which can still best be attributed to religious preference were observed for leukemia, stomach, and cervix cancer. Roman Catholics tend to have high risks of stomach and gallbladder and a low risk of prostate cancer, whereas Eastern Orthodox women trade high risk of stomach cancer for low risk of endometrial and lung cancer. The most extreme pattern of risk, that for Jews, is comprised of lowered risk for cervical cancer and for most sites usually associated with smoking, plus consistently higher risk for lymphomas, thyroid cancer, and bladder cancer among males. Like Jews, Seventh-Day Adventists experience high risk for lymphoma and low risk for cervical and respiratory cancers. Risk to Mormons in Los Angeles differs from that of the standard Protestant population in only minor and inconsistent ways. Neither Mormons nor Adventists showed the previously reported deficits of colorectal or breast cancer. Although the method of proportional incidence may be partly responsible for our failure to confirm previous findings, nonreligious cultural or methodologic factors in the original investigations also provide plausible explanations. More generally, associations of the modest magnitude observed between cancer risk and religion in American populations should probably not be attributed to religious life-style, unless extraordinary circumstances permit the exclusion of other determinants.

California↗
PubMed1983

Mortality pattern and life expectancy of Seventh-Day Adventists in the Netherlands.

The mortality pattern of Seventh-Day Adventists (SDAs) in the Netherlands was assessed during a ten-year study period, 1968-1977. Of 522 deceased SDAs the causes of death of 482 could be ascertained. Standardized Mortality Ratios (SMR) for total mortality (SMR = 0,45), cancer (SMR = 0,50) and cardiovascular diseases (SMR = 0,41) as well as for various subgroups differed significantly from the total Dutch population. Mean age at death as well as life-expectation at baptism were significantly higher in SDAs, both in males and females, as compared with Dutch males and females. A health survey among a sample of the total SDA population and a group of 'friend' controls' was done in order to try to explain the differences in mortality pattern and life expectancy. It is concluded that evidence was found for the thesis that abstinence from cigarette smoking is the main factor explaining the low mortality from ischaemic heart diseases among SDAs, while presumably an appropriate (prudent) diet confers additional benefit for example on colon cancer mortality.

Adolescent↗
PubMed1983

Relationship between the fatty acid composition of the diet and that of the subcutaneous adipose tissue in individual human subjects.

The fatty acid composition of the diet, measured by means of a two-day record, was compared with the fatty acid composition of subcutaneous body fat in 321 free-living adults. In spite of the known imprecision of dietary survey methods, highly significant correlations (r = 0.5) were found between the polyunsaturated fatty acid content or the polyunsaturated-to-saturated fatty acid ratio of the adipose tissue and the corresponding variable in the diet. It was estimated that complete elimination of the noise inherent in the measurement of an individual's fatty acid intake might have resulted in correlation coefficients of the order of 0.8. Analysis of subcutaneous fat biopsies merits consideration as a simple and reproducible measure of the dietary fatty acid composition of free-living individuals.

Adipose Tissue↗