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Biomedical subjects

L Le Marchand

Publications and source records attributed to L Le Marchand.

At least 73 records · Page 4Linked to original sources

Smoking history and survival among lung cancer patients.

Two population-based case-control studies of lung cancer were conducted on the Island of Oahu, Hawaii, between 1979 and 1985. Interview information concerning smoking habits and other characteristics was obtained from a total of 463 men and 212 women with histologically confirmed lung cancer. Records from the Hawaii Tumor Registry were reviewed for information on the stage, histology, and follow-up status of these patients. Cigarette smoking was found to be positively related to the age-adjusted risk of death among women (relative risk (RR) = 1.6; 95 percent confidence interval (CI) = 1.0-2.4), but not among men (RR = 0.8; 95 percent CI = 0.5-1.2). Among women, the age-adjusted median survival time for never smokers was 33 months (n = 53) compared with a median survival of 18 months (n = 159) for smokers. Both past and current female smokers were at greater risk of death than never-smokers, and there was a significant trend in the risk of death by the number of cigarettes smoked per day (P = 0.04), and the age at which the subjects started smoking (P = 0.01). The effects of tumor stage and histology upon the association between tobacco smoking and survival were also explored.

Adenocarcinoma↗

Vegetable consumption and lung cancer risk: a population-based case-control study in Hawaii.

We conducted a population-based study of diet and lung cancer among the multiethnic population of Hawaii in 1983-1985. We completed interviews for 230 men and 102 women with lung cancer and 597 men and 268 women controls, frequency-matched to the patients by age and sex. A quantitative dietary history assessed the usual intake of foods rich in vitamins A and C and carotenoids. A clear dose-dependent negative association was demonstrated between dietary beta-carotene and lung cancer risk in both sexes. After adjusting for smoking and other covariates, the men in the lowest quartile of beta-carotene intake had an odds ratio of 1.9 (95% confidence interval, 1.1-3.2) compared to those in the highest quartile of intake. The corresponding odds ratio for women was 2.7 (95% confidence interval, 1.2-6.1). No clear association was found for retinol, vitamin C, folic acid, iron, dietary fiber, or fruits. All vegetables, dark green vegetables, cruciferous vegetables, and tomatoes showed stronger inverse associations with risk than beta-carotene. This observation suggests that other constituents of vegetables, such as lutein, lycopene, and indoles, and others, may also protect against lung cancer in humans.

Ascorbic Acid↗

Relationship of alcohol consumption to diet: a population-based study in Hawaii.

The relationship of alcohol use to diet was examined in 2272 male and 2337 female adults aged 45 y and older who provided a quantitative diet history during 1977-1979. Mean values for each dietary variable, adjusted for smoking, ethnicity, income, and education, were compared in each sex between abstainers and drinkers and by tertile of ethanol intake. Linear relationships with extent of drinking were also sought. Drinkers were found to be less obese than abstainers. Consumption of carbohydrate, vitamins, calcium, fruits, fruit juices, and raw vegetables was greater among abstainers whereas consumption of fat (particularly polyunsaturated fatty acids), cholesterol, zinc, meat, pickled vegetables, and dried fish was greater among drinkers. Because validations of dietary questionnaires have shown that alcohol consumption is more accurately recalled than food intake, the possibility of a residual confounding effect for these dietary variables should be considered in epidemiologic studies of alcohol and health.

Adult↗

Body size at different periods of life and breast cancer risk.

The inconclusive findings of past analytic epidemiologic studies on diet and breast cancer may have resulted from the inability of these studies to assess early dietary exposures. The role of macronutrient intake during early life can be indirectly studied, however, by examining past and present body size. The authors identified by computer linkage a population-based historical cohort of 38,084 women born between 1918 and 1943, on whom information about weight and height had been recorded in Hawaii in both 1942-1943 and 1972. Linkage of this cohort to the Hawaii Tumor Registry resulted in the identification of 607 incident cases of breast cancer for 1972-1983. An average of 4.4 cancer-free controls were matched to each case on year and month of birth and race of the parents. A matched case-control analysis, conducted in each five-year birth cohort, revealed a negative association of adolescent body mass to premenopausal breast cancer. This negative association was statistically significant in girls aged 10-14 years in 1942 (p for trend, 0.004), was present in all ethnic groups, and was strongest among overweight young women who remained overweight in adulthood. Early-age weight, height, and body surface area were not associated with either pre- or postmenopausal breast cancer. Adult weight and gain in body mass since 1942 were positively associated with postmenopausal breast cancer risk. Adjustment for age at first birth, parity and socioeconomic indicators for 1942 and 1972 did not modify the results. This study provides evidence for a protective role of adolescent obesity against premenopausal breast cancer, and for an enhancing role of a positive energy balance during adult life on postmenopausal breast cancer.

Adolescent↗

Validation of body size information on driver's licenses.

Weight and height values measured in a population-based case-control study of breast cancer conducted in Hawaii were used to validate body size information recorded on driver's licenses. It is concluded that this information is sufficiently accurate to justify the use of driver's license registration files as a means of assembling large prospective or historical cohorts to study the health hazards of obesity.

Adult↗

Time trends in characteristics at diagnosis and subsequent survival for Caucasian, Japanese and Hawaiian women with breast cancer in Hawaii.

This study examines whether the improvement in breast cancer survival in Hawaii suggested by an earlier analysis might be explained by concomitant temporal variations in prognostic factors. Characteristics at diagnosis and survival experience were compared for 1251 Caucasian, 1015 Japanese and 505 Hawaiian women diagnosed with invasive breast carcinoma during 1960-1979 and followed until the end of 1982. Time-trends were present for the patients' stage at diagnosis, age and socioeconomic status. A multivariate analysis using the Cox proportional hazards regression model revealed that adjustment for temporal variations in stage and age at diagnosis yielded a positive survival trend of a greater magnitude than that observed without adjustment, indicating that multivariate methods should be considered in time-trend analyses of cancer survival. Further analysis revealed that such improvement in breast cancer survival occurred for certain race-stage groups of patients only. Possible reasons for these trends in breast cancer prognostic factors and survival are discussed, along with potential biases. The data suggest that early detection might explain most of the survival improvement in Hawaii during the period of the study.

Adult↗

Trends in birth defects for a Hawaiian population exposed to heptachlor and for the United States.

The 1980-1982 milk supply contamination on the island of Oahu, Hawaii, by the insecticide heptachlor offered an opportunity to investigate the possible human teratogenicity of this organochlorine. An analysis of incidence rates for 23 major congenital malformations, derived from hospital-generated data collected by the Birth Defects Monitoring Program of the Centers for Disease Control, failed to show any remarkable rate increase on Oahu in 1981-1983, based on comparisons with the rates for previous time periods on this island and with the rates for two unexposed populations (the other Hawaiian islands and the total U.S.). A rise in the rates of cardiovascular malformations and hip dislocation was apparent but antedated the exposure. These results suggest that no major rate increase for malformations recognized at birth resulted from the heptachlor contamination on Oahu. However, misclassification of exposure status in this study may have obscured a more moderate effect.

Adolescent↗

Association of metabolic gene polymorphisms with alcohol consumption in controls.

The objectives were to study the association between metabolic genes involved in alcohol metabolism (CYP2E1 RsaI, CYP2E1 DraI, ADH1C, NQO1) and alcohol consumption in a large sample of healthy controls. Healthy subjects were selected from the International Collaborative Study on Genetic Susceptibility to Environmental Carcinogens (GSEC). Subjects with information on both alcohol consumption and at least one of the studied polymorphisms were included in the analysis (n=2224). Information on the amount of alcohol consumption was available for a subset of subjects (n=844). None of the studied genes was significantly associated with drinking habits. A significant heterogeneity with age was observed when studying the association between CYP2E1 RsaI and alcohol drinking. CYP2E1 RsaI polymorphism was significantly associated with being a never drinker at older ages (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2-4.8; at ages above 68 years), while the association was reversed at ages below 47 years (OR 0.5, 95% CI 0.2-1.4). For subjects with detailed information on alcohol intake, no association between alcohol quantity and polymorphisms in metabolic genes was observed; subjects carrying the NQO1 polymorphism tended to drink more than subjects carrying the wild-type alleles. Therefore, no significant association between CYP2E1 RsaI, CYP2E1 DraI, ADH1C, NQO1 polymorphisms and alcohol consumption was observed in healthy controls.

Adult↗

Ethnic differences in the lung cancer risk associated with smoking.

Mortality trends and ecological data strongly suggest that the lung cancer risk associated with smoking is greater among Hawaiians than among the other ethnic groups in Hawaii. The authors combined data from two consecutive population-based case-control studies to formally test this hypothesis among 740 cases and 1616 controls. A multiple logistic regression analysis adjusting for pack-years of smoking, occupation, education, and age revealed that Hawaiian, Filipino, and Caucasian male smokers were at 121%, 53%, and 46% greater risk for lung cancer than Japanese male smokers. These risk differences were statistically significant, were consistent across sexes and histological types, and were not explained by the type of cigarettes, the level of inhalation, or by cholesterol or beta-carotene intake. Additionally, an increased lung cancer risk unrelated to smoking was observed among Chinese women. The possibility that other dietary antioxidants and/or genetic risk factors are responsible for these ethnic differences needs to be investigated.

Adult↗

Correlations between mutagen sensitivity and plasma nutrient levels of healthy individuals.

Increased mutagen sensitivity and decreased intake of antioxidant-rich fruits and vegetables have been associated with an increased risk of upper aerodigestive tract cancers. The objective of this study was to investigate the intraindividual variation in mutagen sensitivity and its possible correlation with plasma nutrient levels in a group of 25 healthy individuals in Hawaii. Mutagen sensitivity, as assessed by bleomycin-induced chromosomal breaks in cultured peripheral blood lymphocytes and plasma nutrient levels were measured monthly for 11 months. The monthly numbers of chromosomal breaks/cell ranged from 0.04 to 0.80 and showed considerable intraindividual variation. Based on individual means, significant inverse correlations were found between mutagen sensitivity scores and the plasma levels of alpha-carotene (r = -0.64), total carotenoids (r = -0.41), and ascorbic acid (r = -0.40). There were also significant inverse associations between monthly mean plasma levels of alpha-carotene (r = -0.58), beta-carotene (r = -0.76) and total carotenoids (r = -0.72) and monthly mean chromosomal breaks. In contrast, there was a significant positive correlation between monthly mean plasma triglyceride level (r = 0.60) and monthly mean mutagen sensitivity. These results suggest that mutagen sensitivity as assessed by the bleomycin assay may be influenced by plasma levels of certain nutrients and could potentially be modified by dietary interventions or micronutrient supplementation.

Adult↗

Seasonal variations in plasma micronutrients and antioxidants.

Plasma samples were collected at monthly intervals for a period of 1 year from a group of healthy nonsmoking men and women (n = 21) living in Honolulu, HI. Analysis of plasma cholesterol and triglyceride levels showed marked seasonal variations, with higher mean levels in winter months and lower values in the summer. Cholesterol and triglycerides were highly and inversely correlated with plasma levels of the provitamin A carotenoids. Mean beta- and alpha-carotene levels were highest in late summer and fall. Plasma retinol levels were significantly lower in the summer and higher in the winter. Variations (either between individuals or seasonally) in plasma retinol were unrelated to plasma provitamin A carotenoid levels. Plasma levels of alpha-tocopherol, gamma-tocopherol, beta-cryptoxanthin, and lutein were also higher in the winter and lower in the summer. Significant seasonal correlations, both positive and negative, with environmental variables, such as temperature, solar UV radiation, and rainfall, are noted for many of these plasma micronutrients. The number of samples required to accurately characterize long-term plasma levels for an individual generally ranged from 1 to 4. However, plasma retinol levels exhibited the highest ratio of intra- to interindividual variability, suggesting the need for multiple sampling (> 8 samples) for this micronutrient. Some of this variability for retinol was associated with seasonal changes. Assessment by a diet history of food and supplement intake of micronutrients and phytochemicals for 1 year showed good agreement with 1-year mean plasma levels for most carotenoids, vitamin C, and alpha-tocopherol. Retinol, gamma-tocopherol, cholesterol, and triglyceride levels in plasma were unrelated to estimates of dietary intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗