The association between cigarette smoking and age at cancer diagnosis.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
K M Cummings
Publications and source records attributed to K M Cummings.
Compliance of pediatric and adolescent cancer patients.
Compliance with self-administered therapy in pediatric and adolescent patients is not always complete. Noncompliance may result in erroneous conclusions about the efficacy of a given therapy and lead to unnecessary tests and alteration of treatment regimens. To examine the causes of noncompliance, 46 cancer patients aged 2.5 to 23 years (mean age, 6.85 years) and 40 parents were extensively interviewed at 2 weeks, 20 weeks, and 50 weeks post-diagnosis. The results of self-reported compliance were corroborated by serum bioassay of the prescribed medications. A significant correlation between the age of patient and compliance with chemotherapeutic agents and nonchemotherapeutic medications was found (P less than 0.05 and P less than 0.02, respectively), with adolescent patients being compliant less often. Over the course of therapy, compliance among patients decreased, but not significantly. A significant negative correlation was found between compliance and the number of children in the family. Compliers and noncompliers did differ significantly in how well they understood instructions concerning how to take their medication (P = 0.04). No significant correlations between compliance and stage of the disease, number or type of drugs used, complexity of the regimen, degree of satisfaction with information given to the patient, understanding of disease, treatment, or belief in medication efficacy were found. The main reasons given for noncompliance were forgetfulness, busy schedules, and nonavailability of medication. More compliers than noncompliers were in agreement with their parents regarding who was responsible for the administration of the medication. Compliance is a complex and multifaceted issue which interrelates with a large number of medical and social factors.
Administration, Oral↗
The current status of early detection and screening for colorectal cancer.
There are several approaches to the early detection of colorectal cancer that currently are in use in various segments of the health care system. Herein, the status of cancer control research regarding symptom and risk factor assessment, sigmoidoscopy and colonoscopy, double contrast barium enema, and fecal occult blood testing is reviewed. In addition to the different technologies of early cancer detection, there are different models of disease control intervention. These include the routine clinical activities of primary care providers as well as programmatic screening of mass populations. The currently available techniques for early colorectal cancer detection appear better suited for existing patient care settings than for programs outside the direct supervision and follow-up of the health professional.
Barium Sulfate↗
Cigarette smoking in women with cancers of the breast and reproductive organs.
This case-control study addressed the relationship between cigarette smoking and cancers of the breast (1,741 cases), endometrium (476 cases), uterine cervix (1,174 cases), and ovary (296 cases). The lifetime smoking history of cases was compared with that of 2,128 controls, and relative risks (odds ratios) for smoking were estimated using multiple logistic regression to adjust for potential confounding by age, marital status, number of pregnancies, and Quetelet's index. With increasing amount smoked there was a statistically significant decrease in endometrial cancer risk and a statistically significant increase in cervical cancer risk. In the highest smoking category (greater than or equal to 15 pack-yr), the endometrial cancer relative risk was 0.57 [95% confidence interval (CI) of 0.37, 0.86] and the cervical cancer relative risk was 1.81 (95% CI of 1.47, 2.22). There was no apparent relationship between smoking and cancers of the breast or ovary.
Adult↗
Results of a public screening program for colorectal cancer.
Explore the source record for details and available documents.
Aged↗
Cigarette smoking, tumor recurrence, and survival from bladder cancer.
Results are presented from an investigation into the effects of cigarette smoking on tumor recurrence and survival in a group of 302 patients with bladder cancer. A regression analysis using Cox's proportional hazards model was done to evaluate the effect of cigarette smoking status, stage of disease at diagnosis, histology, race, sex, and the patient's age at diagnosis on length of survival. Results showed that younger patients, those with less extensive disease, and those with transitional cell tumors showed the best survival. Cigarette smoking was unrelated to survival. The effects of cigarette smoking on tumor recurrence were examined in patients with localized disease. Smoking status was not associated with either recurrence-free survival or the number of tumor recurrences. These findings suggest that cigarette smoking is not an important prognostic factor for patients with bladder cancer.
Adult↗
Circumstances surrounding relapse in a group of recent exsmokers.
This study examined the situational factors leading to relapse in a group of 69 smokers who quit and returned to smoking during a 1-year period following participation in a stop smoking clinic. Two-thirds of relapses occurred in the first 3 months after quitting, with the largest percentage (13/47 = 40%) occurring in the first week following cessation. Results showed that the circumstances leading to relapse varied as a function of the amount of time off of cigarettes. Among subjects relapsing in the first week after quitting, withdrawal symptoms and craving a cigarette was the most frequently cited reason for relapse. After the first week of cessation, coping with crisis situations and exposure to certain smoking triggers, such as the presence of other smokers and consumption of alcohol and coffee, were the main reasons given for relapse. The findings from this study suggest that pharmacologic influences associated with withdrawal from nicotine play an important role in early relapse, while psychosocial aspects of the smoking habit (i.e., coping with stress, other smokers) are the main causes of later relapse. The implications of these findings for relapse prevention are discussed.
Adult↗
Reports of smoking withdrawal symptoms over a 21 day period of abstinence.
This paper presents results from a study which examined the occurrence and time course of smoking withdrawal symptoms in a group of 33 smokers followed over a 21 day period of abstinence. Smoking withdrawal symptoms examined included: irritability, feeling sleepy, sleeplessness, dizziness, coughing, tightness in the chest, constipation, mouth sores, and cravings for a cigarette. Findings showed a fairly consistent pattern of reduction across days of abstinence for six of the nine symptoms examined--irritability, feeling sleepy, dizziness, coughing, tightness in the chest, and cravings. Most symptoms decreased sharply during the first few days of cessation followed by a continued, but slower rate of decline in the second and third week of abstinence. Heavy smokers tended to report more withdrawal symptoms than light smokers, although the difference between heavy and light smokers was statistically significant only with respect to irritability. The implications of these findings for relapse prevention are discussed.
Adult↗
An outbreak of invasive aspergillosis among allogeneic bone marrow transplants: a case-control study.
Between April 1982 and March 1983, 10 of 26 (38.4%) allogeneic bone marrow transplant recipients housed on a newly opened bone marrow transplant unit developed invasive aspergillosis. By contrast, between September 1977 and March 1982, only 3 of 46 (6%) transplant recipients developed invasive aspergillosis. A case-control study to identify host factors related to Aspergillus infection found that aspergillosis was more common in patients with chronic myelogenous leukemia and aplastic anemia, older patients, patients having cytomegalovirus disease, patients who experienced prolonged granulocytopenia, patients conditioned with ara-C (100-200 mg/day), and patients who received longer duration of antimicrobial therapy. A series of logistic regression analyses revealed that underlying disease was the single best predictor of Aspergillus infection. This study demonstrates that underlying disease is an important risk factor for aspergillosis and that special measures may be warranted when transplanting certain patients.
Adult↗
Risk factor and behavioral correlates of willingness to participate in cancer prevention trials.
Because of the growing interest in prospective trials of dietary and chemopreventive interventions for cancer, we studied the characteristics of persons likely to participate in such investigations. The study population consisted of a random sample of 576 persons who had previously attended the Prevention-Detection Center at Roswell Park Memorial Institute to receive a cancer screening examination and a risk assessment. Data were collected using a mailed questionnaire. Of the respondents, 77% indicated some degree of interest in participating in a cancer prevention study involving dietary changes, 27% indicated a definite interest and 50% indicated a possible interest. A similar pattern of response was obtained with respect to participation in a cancer prevention study that involves subjects taking medication, such as vitamin supplements. The findings suggest that those who are the most interested in participating in cancer prevention research are more likely to (on average) be younger, better educated, have higher annual family incomes, be regular vitamin users, have greater awareness of the possible link between dietary practices and cancer risk, be more concerned about getting cancer, and be more likely to believe that changes in dietary practices can decrease the cancer risk. These findings may have important implications for the planning and conduct of prospective trials of cancer prophylaxis.
Adult↗
Comparison of three methods of teaching women how to perform breast self-examination.
This paper presents results from an experimental study designed to evaluate the relative effectiveness of three methods of teaching women how to do breast self-examination (BSE). Frequency of BSE, confidence in examination performance, proficiency of BSE technique, and lump detection performance were the main outcome variables assessed. The three training methods compared in this study were provision of a pamphlet describing how to do BSE, having women view a videotape depicting proper performance of BSE, and having women practice doing BSE on a life-like breast model. Results showed that passive methods of BSE instruction such as the use of pamphlets or films were of little value in helping women develop the tactile skills necessary for proficient BSE. Three months after training, it was found that lump detection performance, as measured on silicone breast models, was significantly higher among those women who had been given an opportunity to practice doing the breast examination on a breast model with corrective feedback given by a BSE instructor. The opportunity to practice doing the examination with corrective feedback on performance appears to be a critical variable in the acquisition of BSE skill.
Adolescent↗
Teaching patients about testicular cancer.
Explore the source record for details and available documents.
Adolescent↗
Screening for colorectal cancer using the Hemoccult II stool guaiac slide test.
Following a series of educational spots on colorectal cancer shown on a local television news program, stool guaiac slide kits (Hemoccult II; Smith Kline Diagnostics) were distributed in shopping malls in Erie County, New York during a 3-day period in February 1982. The tests kits were sold for $1.00 a piece. A total of 8711 persons purchased test kits and 3822 persons (44%) returned slides for testing. One or more slides were positive in 107 persons (2.8%). Ninety of the 107 positive screenees (84%) saw a physician for further evaluation after screening. Eighteen positive screenees had no evidence of pathology which could cause blood in their stool when evaluated by a physician, yielding an overall false-positive rate of less than 0.5%. Seven new cases of colorectal cancer were found through screening. Five of the seven cancers (71%) detected were localized disease (Dukes' Stage A, B1 or B2), and four cases had no symptoms of disease prior to diagnosis. The findings from this study suggest that screening for fecal occult blood using the stool guaiac slide test is effective in detecting some colorectal cancers at an early stage of disease, often before symptoms appear.
Adolescent↗
A graduate program designed for medical and other doctoral degree applicants.
The data collected during the evaluation of the natural science program at Roswell Park revealed a high rate of success in preparing students to enter health and science related careers. An average of 50 percent of the entering students each year had been unsuccessful medical school applicants or students preparing to enter Ph.D. programs following an initial research experience. The program assists students in admission to medical and research programs and encourages research participation. Many graduate programs will not accept or find difficulty dealing with students who have career goals in medicine and are not necessarily in research. This is understandable, especially in Ph.D. granting programs with substantial investments of faculty time and funding. The philosophy of the program reported here is to assist the students to enter the career of their choice; however, at the same time, the faculty members insist on a high level of scholarship in course work and research during the program. With this philosophy, the program continues to be successful in attracting students of high quality.
Education, Graduate↗
Changes in the smoking habits of adults in the United States and recent trends in lung cancer mortality.
Recent shifts in lung cancer mortality in the United States are believed to be related to changing patterns of cigarette smoking among adults. From 1960-1977 the age-adjusted mortality rate for lung cancer increased by 85%. Increases in lung cancer mortality rates were much greater among females than males. The recent rapid increase in female lung cancer mortality appears to be the result of higher rates of cigarette smoking among women born between 1920 and 1940 compared to earlier generations. These women, who are now in their 40's, 50's, and 60's are now beginning to reach an age where lung cancer rates will be adversely affected. In contrast, peak smoking prevalence rates occurred among men who are now in their 60's and 70's. The proportion of men who smoke cigarettes has been declining steadily with successive generations born after 1930. Findings from this analysis suggest that recent shifts in lung cancer mortality in the United States can be largely explained by examining changes in the smoking habits of adults.
Adolescent↗
Construct validity comparisons of three methods for measuring patient compliance.
A multitrait - multimethod design was employed to assess the construct validity of three commonly used methods for assessing patient compliance: physiological assessments (e.g., blood chemistries), ratings by health professionals, and patient self-reports. Subjects were patients receiving ambulatory hemodialysis treatments for end-stage renal disease, whose regimen required them to take medications, to follow dietary restrictions, and to limit fluid intake. Study findings indicated that of the three methods examined, the nurse rating approach was the most valid (although it contained only about 50 percent valid variance). Measures derived from physiological assessments contained a substantial proportion of residual error (over 70 percent), and the patient self-report method contained only about 12 percent valid variance (with about 18 percent method-effects variance, and 68 percent residual-error variance). These results make clear the need for additional research directed at developing valid methods for evaluating patient compliance behaviors.
Adult↗
What young men know about testicular cancer.
A survey to asess what young men know about testicular cancer and to determine awareness and practice of testicular self-examination (TSE) was conducted among 266 male graduate and undergraduate students at the State University of New York at Buffalo. Findings indicate that the majority of young men were either uninformed or misinformed about their risk of getting testicular cancer and about the symptoms of testicular cancer. Only 16% of respondents had heard of TSE before the survey, and only a small percentage of these individuals reported doing TSE on a routine basis. The findings from this study point out the need for increased public education directed at symptom recognition, especially at the high school and post-high school levels.
Adolescent↗
Dietary history from the distant past: a methodological study.
One of the major concerns regarding case-control studies of diet and cancer is that dietary measures based on current habits may not accurately reflect dietary intake from the time period of cancer initiation and early promotion in the more distant past. Thus, the extent to which current diet correlates with past diet and the reliability of retrospective estimates of past diet are important questions for researchers investigating dietary factors in cancer causation. For these reasons, we conducted this study of the reliability of dietary history as recalled from the distant past. Individuals (N = 175) who completed dietary interviews between the years 1957 and 1965 were reinterviewed in 1982. Subjects were asked to report the usual frequency of intake of selected food items, both at the time of their original interview in the 1957-1965 era as well as at the current time. Dietary histories as recalled from the distant past more closely agreed with those originally recorded than did current diets. The diets as recalled from the distant past appeared to be biased, however, by current dietary habits. The implications of these findings for diet and cancer research are discussed.
Aged↗