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Biomedical subjects

J W Berg

Publications and source records attributed to J W Berg.

At least 19 recordsLinked to original sources
PubMed2001

The family covenant and genetic testing.

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial argument defines the boundaries of autonomy and benefit for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received.

Advance Directives↗
PubMed1995

Cancer. Introduction.

This supplement presents the study of various histologic types of cancers diagnosed in the populations covered by the Surveillance, Epidemiology, and End Results (SEER) Program. It describes the SEER program and the coding of histologic type by the International Classification of Diseases for Oncology. Each of the 19 articles deals with the histologic types of cancer found in major sites or with specific histologic types, such as lymphomas or melanomas. Histologic types have been grouped based on those developed by Dr. John Berg. Data presented in this supplement are based on more than one million microscopically proven invasive cancers and 98,000 in situ cancers diagnosed during the period 1973-1987 in areas covered by the SEER Program.

Adolescent↗
PubMed1995

Breast cancer.

BACKGROUND: Breast cancer is the most common cancer and the second leading cause of cancer death among women in the United States; annual breast cancer deaths are exceeded only by those for lung cancer. METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) program registry of the National Cancer Institute comprising 158,621 invasive and 10,639 in situ cases of microscopically confirmed breast carcinomas registered for the years 1973-1987 have been analyzed. Relative frequencies, incidence rates, and 5-year relative survival rates were examined by selected variables of interest. Invasive and in situ breast carcinomas and sarcomas were analyzed separately. RESULTS: Infiltrating duct carcinoma was the largest group of female breast cancer, constituting 67.9% of the total with a 5-year relative survival of 79%. All other invasive carcinomas were compared with this group. Lobular carcinoma was the second largest group, only 6.3%, and a 5-year relative survival of 84%. Medullary carcinoma was the third most common with 2.8% and a 5-year relative survival of 82%. Other types included mucinous (colloid) adenocarcinoma, 2.2%, 5-year relative survival of 95%; comedocarcinoma, 1.4%, 5-year relative survival of 87%; Paget's disease (nipple and other breast), 1.1%, 5-year relative survival of 79%; papillary carcinoma, 0.9%, 5-year relative survival of 95%; tubular adenocarcinoma, 0.7%, 5-year relative survival of 96% and inflammatory carcinoma, 0.5%, 5-year relative survival of 18%. Carcinoma in situ was registered as intraductal, lobular, combined ductal and lobular, papillary, and carcinoma in situ, not otherwise specified. The relative survival for all forms of carcinomas in situ was approximately 100%. Sarcomas and malignant tumors not further classified are also considered. CONCLUSIONS: The various histologic types of breast cancer exhibit differences in regard to relative frequency, site pattern within the breast, and patient survival. The SEER program data base of breast cancer is the largest single population-based reference source for breast cancer in the United States. This program is a valuable resource for information on frequency, percentage, and incidence rates by histologic type as well as survival rates of patients with breast cancer.

Adult↗
PubMed1992

Investigation of an occupational cancer cluster using a population-based tumor registry and the National Death Index.

Occupational physicians investigate perceived cancer clusters to alleviate employee concerns and pursue etiologic hypotheses. We conducted a retrospective cohort analysis of all past and present employees of a metal fabrication plant and a comparison plant after employees recognized five cancer cases in 1987. We ascertained cases of all subjects who were employed at some time in the 8 years before 1987 through the Colorado Central Cancer Registry and determined vital status through the National Death Index. Cancer incidence at the index plant was almost identical to that of the population of the Denver metropolitan area (standardized incidence ratio [SIR] = 99, 95% confidence interval [CI] 59-165). Proportional incidence ratios revealed that no type of cancer occurred with significant excess in the index plant population during 1979 through 1986. Where population-based tumor registries exist, occupational physicians can employ this inexpensive and robust methodology to assess cancer incidence in exposed cohorts, pursue exposure-response relations, and evaluate clusters.

Adult↗
PubMed1985

The contribution of subclinical cancer to Denver's high prostatic cancer incidence rate.

In order to quantitate the contribution of latent prostatic cancer to the very high prostatic cancer incidence rate in Denver, we conducted a population-based study. In 1979, 33% of 402 incidence cases were discovered incidentally, 4% at autopsy and 29% because of surgery for presumably benign prostatic disease. Of the unsuspected cases, 43% were stage A1, i.e. low grade and focal. The rest were high grade, more extensive, or both. It is expected that unsuspected cancers are a highly variable component of reported rates of prostatic cancer from other areas since their frequency of discovery depends upon urological and pathological practices that have been demonstrated to vary greatly from region to region.

Adult↗
PubMed1985

Prognostic features of pediatric soft-tissue sarcomas.

Eight hundred ninety-two patients under 20 years of age with soft-tissue sarcomas histologically diagnosed between 1955 and 1971 (before the era of combined modality therapy) were reviewed to delineate important prognostic variables. Differing histologic findings, extent of disease at initial presentation, and site of the primary tumor correlated with prognosis; age, sex, and race did not affect survival significantly. Patients with fibrosarcomas, liposarcomas, and leiomyosarcomas had improved survival rates when compared with adults with the same histologic findings; patients with localized tumors and extremity primary sites had the best prognosis. Patients with rhabdomyosarcomas, disseminated disease, or retroperitoneal primary sites had the worst prognosis. These data suggest that some childhood sarcomas are not as aggressive as adult sarcomas or childhood rhabdomyosarcomas. Therefore they may not require the adjuvant therapy shown to be beneficial in childhood rhabdomyosarcomas.

Adolescent↗
PubMed1985

Problems in classification of cancer for epidemiologic research.

In vital statistics and most epidemiologic studies, cancers have been classified mostly by site of origin alone. This continues to be true even though it is continually being demonstrated that among cancers of a site important subsets with different epidemiologies almost always are present. Reasons for epidemiologists' failure to use all the information contained in the standard cancer classification are explored as are problems that arise from the nature of the classification, from the nature of the cancers being classified, and even from patient characteristics that determine how much information on the cancer can be gathered. The solution to the problem of too little information is generally difficult, but pathologists can say more about the epidemiologic implications of their various diagnoses and epidemiologists can learn to use these diagnoses in their cohort and other studies.

Epidemiologic Methods↗
PubMed1984

Clinical implications of risk factors for breast cancer.

Little is known about the actual causes of breast cancer, but a great deal is known about risk factors: characteristics of individual patients that increase their chances of developing breast cancer above the level of risk in the general population. The factors may be classed generally as genetic (familial history), hormonal (age at menarche and at menopause, parity, age at first birth, etc.), nutritional (possibly including social, economic, and ethnic factors), morphologic (proliferative breast disease, including cancer predictive of later risk), and breast irradiation. Because current understanding of how these risk factors relate to breast cancer causation is minimal (except for irradiation), there are few practical measures for primary prevention. However, there can and should be major use of current knowledge in arranging secondary prevention through screening and possibly even prophylactic mastectomy. The author's concern was that, at the time the National Conference on Breast Cancer was arranged, there was little consideration of breast cancer risk in the woman who lacked risk factors. Since that time, other authors have published a strong statement to the effect that breast cancer rates still are substantial and important in these women. In the current report, the author illustrates the same point for other "low-risk" groups to support the argument that by current knowledge, no adult American woman is at such low risk for breast cancer that she can safely be excluded from the educational and screening programs appropriate for her age.

Adolescent↗
PubMed1982

Epidemiologic pathology of ovarian tumors: a histopathologic review of primary ovarian neoplasms diagnosed in the Denver Standard Metropolitan Statistical Area, 1 July-31 December 1969 and 1 July-31 December 1979.

We report a population-based histopathologic review of primary ovarian neoplasms. No significant changes in incidence were encountered between the 1969 and 1979 review periods. The most frequent single tumor was benign cystic teratoma (26.5%), while the coelomic-derived "epithelial" tumors constituted the most frequent group (57.6% of all tumors and 93.8% of all malignant tumors). The high frequency of borderline tumors reported by others in nonpopulation-based material is confirmed, and the usual disseminated state of invasive carcinomas at the time of diagnosis is noted. Other data concerning incidence and bilaterality rates, patient ages, multiple primary malignancies, and problems in differential diagnosis and tumor grading are discussed.

Adenocarcinoma↗
PubMed1981

High-risk factors in gynecologic cancer.

Cervical cancer retains its character as a venereal disease associated with infections and multiple sexual partners, but poverty also is important. Precise incidence figures for cervical and endometrial cancer are almost nonexistent because in areas with precise case counts there is rarely accurate knowledge of hysterectomy prevalence. For endometrial cancer little recent attention has been paid to any risk factor except exogenous estrogen. It is now suggested that a low pregnancy rate is a cause, not a consequence, of ovarian pathology leading to cancer. Some progress has been made in separating the epidemiologies of various kinds of ovarian and uterine cancer. A few clues are available regarding the epidemiology of fallopian tube cancers and vaginal cancers other than those produced by maternal stilbestrol. Vulvar cancer becomes common only after the age of 75 and so has been neglected epidemiologically.

Adenocarcinoma↗