Biomedical subjects

J M Liff

Publications and source records attributed to J M Liff.

At least 37 records · Page 2Linked to original sources

PubMed1994

Multiple myeloma among blacks and whites in the United States: the role of chronic antigenic stimulation.

Multiple myeloma (MM) is twice as common among Blacks than Whites in the United States. The reasons for this racial disparity are unknown, and the etiology of this cancer, in general, is poorly understood. Repeated or chronic antigenic stimulation (CAS) of the immune system has been suggested as a risk factor. Previous case-control studies have reported inconsistent CAS associations based on evaluations of individual and biologic categories of medical conditions. Interview data from 573 cases and 2,131 population-based controls were used to investigate further the CAS hypothesis using an immunologically based approach, and to determine whether CAS accounts for the excess of myeloma among Blacks. Over 50 medical conditions were grouped into biologically and immunologically related categories, and B-cell- and T-cell-mediated response groups. Except for urinary tract infections among Black men (odds ratio [OR] = 2.0), no significantly increased risks of MM were observed. However, there was a suggestion of increased risk among Blacks with an increased exposure to anaphylactic conditions. Analysis by immunoglobulin type revealed significantly elevated risks of IgG myeloma with eczema (OR = 2.1), the biologic category 'allergic conditions' (OR = 1.6), and the immunologic category 'anaphylaxis response' (OR = 1.6) among Whites, with Blacks having slightly lower risks. Our findings do not support a causal relationship between CAS and MM, nor do they explain the higher incidence among Blacks.

Adult↗

PubMed1994

Second cancers following oral and pharyngeal cancer: patients' characteristics and survival patterns.

A survey was made of second primary cancers among patients who were enrolled in a large case-control investigation of oral and pharyngeal cancer, hereafter called oral cancer, during 1984-1985 in four areas of the United States. Among the original 1090 patients with oral cancer (nearly all squamous cell carcinomas), 107 developed a second cancer (one-half of them squamous cell) by the end of follow-up in June 1989 (average follow-up 2.6 years), with 69% occurring in the oral cavity, pharynx, oesophagus, larynx or lung. Rates of second tumours varied by age and socioeconomic status, but not sex or race, and were higher among those whose initial cancer was localised, even after adjusting for their longer survival. Long-term survival was lower among those with second cancers. Conditional on surviving for 2 years, the survival at 5 years was under 50% and nearly 70%, respectively, for those with versus those without a second cancer in the first 2 years. These findings confirm the exceptionally high rate of second cancers (especially of the aerodigestive tract) following oral cancer, describe the clinical and pathological features of patients with multiple cancers and indicate the importance of preventive measures.

Adenocarcinoma↗

PubMed1994

Dietary factors and second primary cancers: a follow-up of oral and pharyngeal cancer patients.

To investigate the possible relationship between dietary factors and the development of multiple primary cancer, a nested case-control study was carried out within a cohort of 1,090 oral and pharyngeal cancer patients. This patient group, enrolled in 1984-1985 in a population-based case-control study conducted in four areas of the United States, was followed up through June 1989 for the occurrence of second primary cancer. Information on a number of risk factors, including diet, ascertained from interviews conducted at baseline (1984-1985) and at follow-up were compared between 80 patients with histologically confirmed second primary cancers (39% in the upper aerodigestive tract, 32% in the lung, 29% elsewhere) and 189 sex- and survival-matched control patients free of second cancers. Although few significant trends emerged, the results were suggestive of a protective effect provided by higher intake of vegetables. Risk of second primary cancers was 40-60% lower among those with the highest levels of intake for total vegetables and most vegetable subgroups, including dark yellow, cruciferous, and green leafy vegetables and legumes. Risks were also nonsignificantly lower among those with high consumption of vitamin C and carotenoids, with the adverse effects of alcohol being most evident among heavy drinkers with low vitamin C or carotenoid intake. There was also some evidence of an interaction between smoking and vitamin C consumption, but numbers of nonsmokers were small. Among other dietary factors considered, positive associations were found with increasing consumption of meats, liver, and retinol. The findings suggest that dietary factors contribute along with alcohol and smoking to the excess risks of second primary cancers among patients with oral and pharyngeal cancers.

Aged↗

PubMed1993

Breast cancer among black and white women in the 1980s. Changing patterns in the United States by race, age, and extent of disease.

BACKGROUND: This national study of breast cancer incidence and mortality was conducted to determine whether patterns of change differ for black and white women, to evaluate patterns by extent of disease, and to determine whether recent patterns of breast cancer are consistent with results that one would expect due to increases in use of screening examinations by women. METHODS: The study included 104,351 cases of in situ or invasive breast cancer diagnosed between 1983 and 1989 among women from the nine geographic areas participating in the National Cancer Institute Surveillance, Epidemiology, and End Results program. Breast cancer incidence patterns were examined by extent of disease for black and white women and by age at diagnosis. RESULTS: Significant increases occurred in the incidence of all early-stage breast cancers. Concomitantly, significant decreases occurred in the incidence of the most advanced-stage breast cancers. Although both white and black women experienced significant increases in early-stage breast cancer, black women have substantially lower rates of the least extensive breast cancers. CONCLUSIONS: These results strongly suggest that a major explanation for the increase in breast cancer incidence in the 1980s may well be the increased prevalence of breast cancer screening among women in the United States. They also suggest a consistent benefit of screening across all age groups from 40 to 49 years through 70 years and older.

Adult↗

PubMed1993

The search for human infection with simian type D retroviruses.

Evidence has recently been presented for an infection with a simian type D retrovirus in a patient with AIDS and lymphoma. We tested for simian type D infection in three groups of subjects: 375 patients with lymphoproliferative diseases (255 non-Hodgkin's, 88 Hodgkin's, and 32 chronic lymphoproliferative disease), of whom 75 were human immunodeficiency virus (HIV)-1 infected; seven persons with unexplained low CD4 lymphocyte counts with clinical conditions; and 45 blood donors, of whom 37 were human T-lymphocyte virus (HTLV)-I/II seroindeterminate and eight were HTLV-I/II and HIV-1 seronegative. Serum samples were screened for antibodies against simian type D retroviruses by an enzyme immunoassay, and reactive samples were analyzed by Western blotting. None of the samples were seropositive, but eight (five from non-Hodgkin's and three from Hodgkin's lymphoma patients) were seroindeterminate. Polymerase chain reaction analysis of genomic DNA from peripheral blood lymphocytes of all eight of these patients was carried out using simian type D gag generic primers with generic internal oligoprobing. All samples were negative. We conclude that simian type D infection is rare among HIV-infected and noninfected lymphoma patients, persons with unexplained low CD4 counts, and persons with HTLV-seroindeterminate test results.

Adult↗

PubMed1991

Incidence of histologic types of uterine sarcoma in relation to menstrual and reproductive history.

To determine whether the occurrence of one or more histologic types of uterine sarcoma is related to events in a woman's reproductive life, a population-based case-control study was conducted. One-hundred sixty-seven women newly diagnosed with uterine sarcoma among residents of 6 geographic regions were compared to 208 women selected at random from the same populations with regard to histories of menstruation, pregnancy and childbearing, and breast feeding, as reported during a telephone interview. Compared to women whose menstrual periods began at age 13, women whose menses began earlier were at increased risk of leiomyosarcoma (OR = 2.0, 95% CI 0.9, 4.3); other histologic types were less strongly associated with early age at menarche. Women with leiomyosarcoma and endometrial stromal sarcoma, but not malignant mixed Müllerian tumors, tended to have ceased menstruating 2-3 years later than controls. None of the histologic types was clearly related to parity or to age at first live birth, but each was inversely related to age at last live birth. Associations were observed between leiomyosarcoma and histories of an induced abortion (OR = 4.2, 95% CI 1.2, 14.2) and of breast feeding after a live birth (OR = 0.5, 95% CI 0.3, 1.0); these relationships were not observed for other morphologic variants. These results suggest possible similarities and differences in menstrual and reproductive risk factors among histologic types of uterine sarcoma, and between these malignancies and the more common breast, endometrial and ovarian carcinomas.

Adult↗

PubMed1991

Rural-urban differences in stage at diagnosis. Possible relationship to cancer screening.

Stage at diagnosis was examined for various malignancies identifiable through screening to determine whether rural-urban differences exist in Georgia. Data were obtained from a population-based cancer registry which registers all incident cancers among residents of metropolitan Atlanta and ten neighboring rural counties. Black and white patients with a first primary invasive malignancy newly diagnosed between 1978 and 1985 were included in this study. Residents of the rural area were twice as likely to have unstaged cancers (18.3%) as were urban residents (9.6%). Among patients with known stage at diagnosis, rural patients tended to have more advanced disease than urban patients. The relative excess of nonlocalized malignancies in rural Georgia was 21% for whites and 37% for blacks. The rural excess of nonlocalized prostate cancer among blacks was especially pronounced. Differences in access to or utilization of early detection methods may contribute to the rural-urban differential in the extent of disease at diagnosis.

Black or African American↗

PubMed1991

Adenocarcinomas of the colon and rectum in persons under 40 years old. A population-based study.

Data collected by nine population-based tumor registries participating in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute were analyzed to characterize the epidemiology of noncarcinoid adenocarcinomas of the colon and rectum in young adults. Tumors diagnosed in persons under 40 years old between 1973 and 1984 (n = 1736) were compared with those in persons 40 years and older (n = 106,760). This first large U.S. population-based study of colorectal adenocarcinomas in the young shows a higher incidence in blacks than whites and later detection in black males. It also shows a higher proportion of tumors of mucinous and signet ring histological type than in older age groups. Among the younger group, the average annual age-adjusted incidence rate was 34% higher in black males than in white males (12.6 vs. 9.4 per million persons) and 46% higher in black females than in white females (13.0 vs 8.9 per million persons). The proportion of tumors that were right-sided varied by age: 0-29 years, 30%; 30-39 years, 26%; 40-49 years, 22%; 50-59 years, 21%; 60-69 years, 24%; 70-79 years, 30%; and 80+ years, 35%. Males under age 40 were less likely to present with localized disease (whites, 27%; blacks, 21%) than were those aged 40 and older (whites, 39%; blacks, 36%). The proportion of tumors classified as mucinous decreased with age, from 28% among those aged 0-19 years to 5% among those 40 years and older. A similar trend was observed for signet ring tumors. Although this latter type accounted for 10% of large-bowel tumors among subjects aged 0-19 years, this proportion decreased with age to 0.2% in those 40 years and older.

Adenocarcinoma↗

PubMed1991

The relation of socioeconomic status to oral and pharyngeal cancer.

We assessed the relation between socioeconomic status and risk of oropharyngeal cancer in a population-based interview study of 762 male cases and 837 male controls in four areas of the United States. Three primary indicators of socioeconomic status were evaluated: education, occupational status, and percentage of potential working life spent in employment. With adjustment for the effects of established risk factors, such as use of tobacco products, alcohol consumption, and poor dentition, a relatively low percentage of years worked was also a risk factor. Educational attainment and occupational status were not independently related to risk of oropharyngeal cancer. These results are consistent with the hypothesis that behaviors that lead to social instability, and/or social instability itself, are linked to an increased risk of oral and pharyngeal cancers.

Adult↗

PubMed1991

Does increased detection account for the rising incidence of breast cancer?

BACKGROUND: The incidence of breast cancer has been increasing over time in the United States. METHODS: To determine the role of screening in this increase, trends in the incidence of in situ and invasive carcinoma of the breast were evaluated using records of the metropolitan Atlanta SEER program between 1979 and 1986. From a sample of records, evidence of symptoms and mammographic screening prior to diagnosis was recorded. RESULTS: The average annual age-adjusted incidence of invasive disease rose 29 percent among Whites and 41 percent among Blacks. Incidence increased in all age groups. A trend towards earlier detection of invasive disease was found. Asymptomatic tumors accounted for only 40 percent of the increased incidence among whites and 25 percent of the increased incidence among blacks, with mammography as the principal contributing procedure. CONCLUSIONS: These data suggest that increased detection accounts for some but not all of the rising incidence of breast cancer in the United States.

Adult↗

PubMed1990

Plantar melanoma: is the incidence of melanoma of the sole of the foot really higher in blacks than whites?

The overall incidence of malignant melanoma in black populations is considerably lower than that in whites. There have been repeated suggestions in the literature that black persons may have an increased incidence of melanoma of the sole, relative to whites, because among blacks with melanoma there is a high proportion with tumors of the sole of the foot. Whether this observed difference in site distribution represents a difference in incidence rates has never been demonstrated. Data on cancer incidence from 2 areas, western Washington State (1974-1983) and metropolitan Atlanta (1975-1984), were analyzed to examine this question. The annual area- and age-adjusted incidence of plantar melanoma was 1.7 per million per year for blacks and 2.0 per million per year for whites (relative risk for blacks as compared with whites = 0.88, 95% confidence interval = 0.36-2.11). These data argue that in North America there is little difference between blacks and whites in the incidence of plantar melanoma, and that the well known proportional difference appears to be due instead to the decreased incidence in blacks of melanoma on skin surfaces other than the soles of the feet.

Adult↗

PubMed1989

A comparison of acquired immunodeficiency syndrome and Kaposi's sarcoma incidence rates, Atlanta, 1983-86.

Recent temporal trends in incidence rates for acquired immunodeficiency syndrome (AIDS) and Kaposi's sarcoma were compared in metropolitan Atlanta, Georgia. From 1983 through 1986 the age-adjusted incidence rate of Kaposi's sarcoma among White males ages 25-49 increased 11-fold (2.2-24.4/100,000 person years). The annual incidence rate of AIDS increased ten-fold (11.3-113.3/100,000). These findings do not support earlier reports that the proportion of AIDS patients with Kaposi's sarcoma has decreased over time.

Acquired Immunodeficiency Syndrome↗

PubMed1988

Factors associated with maternal mortality in Addis Ababa, Ethiopia.

A housing probability survey in which 9315 women were interviewed was conducted in 1983 to detect the incidence and aetiology of maternal mortality in Addis Ababa, Ethiopia. Maternal mortality for the two-year period from 11 September 1981 was 350/100,000 livebirths (excluding abortions). A logistic regression analysis selected antenatal care, occupation and income as risk factors for maternal mortality, after adjusting for age, parity, education and marital status. Odds ratios were 2.5 for unbooked women compared to those receiving antenatal care, about 3 for students, and maids/janitresses compared to housewives, and between 3 and 5 for those earning less than US$25 monthly, compared to those earning US$150 or more.

Adolescent↗

PubMed1988

Correlates of cervical cytologic screening.

We investigated factors associated with the frequency of Papanicolaou cytologic screening among women between the ages of 20 and 54 years in metropolitan Atlanta. In a sample of 393 women who had not had a hysterectomy, the frequency of screening was uniformly high for women aged 20 to 49 years, but declined for women aged 50 to 54 years. Low household income and low gravidity were associated with less frequent screening among whites, but low income and low gravidity correlated positively with the frequency of screening among blacks.

Adult↗

PubMed1988