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M Ewertz

Publications and source records attributed to M Ewertz.

53 records · Page 3Linked to original sources
PubMed1988

The joint effect of risk factors on endometrial cancer.

The joint effect of risk factors on endometrial cancer was examined by applying general statistical models to the data of a hospital-based case-control study conducted in Copenhagen, Denmark. The analysis included 149 cases of histologically confirmed adenocarcinoma of the endometrium and 154 age-matched controls with cervical cancer. Information on risk factors derived from the medical records. Estrogen use and body mass were found to be the main predictors of endometrial cancer risk. In the model proposed, women who ever used non-contraceptive estrogens had a 10-fold increased risk irrespective of their weight and height. Among non-users of estrogen, the risk of endometrial cancer rose with increasing body mass, the largest showing a five-fold increased risk. These data provide further evidence of the significant role that excess estrogens play, whether exogenous from replacement therapy or endogenous from enhanced androgen conversion, in the etiology of endometrial cancer.

Adenocarcinoma↗
PubMed1988

Risk of breast cancer in relation to reproductive factors in Denmark.

The effect of reproductive factors on breast cancer risk was evaluated in a population-based case-control study, including 1,486 breast cancer cases diagnosed over a one-year period in Denmark. They were identified from the files of the nationwide trial of the Danish Breast Cancer Co-operative group and the Danish Cancer Registry. The control group was an age-stratified random sample of 1,336 women from the general population. Data on risk factors were collected by self-administered (mailed) questionnaires. Significantly increased relative risks (RR) were associated with never being pregnant (RR = 1.47), an early terminated first pregnancy (RR = 1.43), and having a natural menopause after the age of 54 (RR = 1.67). Trends of decreasing risk were observed by increasing parity and age at menarche. These findings were independent of age at first full-term pregnancy which overall was not related to breast cancer risk, though a weak association appeared in women less than 50 years at diagnosis. The study confirmed that pregnancies must continue to term to offer protection against breast cancer.

Abortion, Induced↗
PubMed1988

Risk factors for breast cancer and their prognostic significance.

Since 1960 a 50% increase has occurred in breast cancer incidence in Denmark. With the present rates one out of fifteen Danish women will develop breast cancer before the age of 75 years. To evaluate the influence of known and suspected epidemiologic factors on the risk of developing breast cancer and on prognosis, a population-based study has been carried out, where cases were identified from the files of the Danish Breast Cancer Cooperative Group (DBCG) and the Danish Cancer Registry. Results are communicated from the case-control part of this study, including 1486 breast cancer cases aged less than 70, diagnosed over a one-year period, and an age-stratified-random sample of 1336 women without breast cancer from the general population. Data on risk factors were collected by self-administered (mailed) questionnaires. Classical risk factors, such as high social status, nulliparity, early menarche and late natural menopause were confirmed, while no association was found between breast cancer and maternal age at first childbirth.

Adult↗
PubMed1988

Risk of breast cancer in relation to social factors in Denmark.

The influence of social factors on breast cancer risk was examined in a population-based case-control study in Denmark. The case group included 1,486 women, aged less than 70, diagnosed with breast cancer over a one-year period. They were identified from notifications to the nationwide clinical trial of the Danish Breast Cancer Co-operative Group and the Danish Cancer Registry. As controls, an age-stratified sample of 1,336 women was selected from the general population. Data on risk factors were collected by self-administered (mailed) questionnaires. Elevated relative risks (RR) were found for women with husbands in white collar jobs (RR = 1.22), and of the highest social class (RR = 1.35). No clear trend in RR was observed with increasing duration of education. Altogether, the association between breast cancer and high socio-economic status was confirmed, though none of the examined factors was a better predictor of risk than the others. Women working in offices had an increased RR while no other occupation was significantly associated with breast cancer. Social or occupational factors did not explain the urban/rural difference in risk seen in this study.

Adult↗
PubMed1987

Breast cancer incidence subsequent to surgical reduction of the female breast.

The incidence of breast cancer was determined in 1245 women who were treated surgically for breast hypertrophy in Copenhagen, Denmark, between 1943 and 1971. Breast cancer cases were identified by a linkage to the Danish Cancer Registry. The expected number of breast cancers was estimated from age and calendar-time specific incidence rates in the Danish female population. A total of 18 breast cancers developed compared to 30.28 expected, yielding a relative risk (RR) of 0.59 (95% confidence interval (CI) 0.35-0.94). The greatest risk reduction was observed ten or more years after the plastic surgery operation in women who had 600 g or more of breast tissue removed (RR = 0.27; 95% CI 0.03-0.99). This suggests that the number of potential foci are important for cancer development in the breast.

Adult↗
PubMed1985

Second cancer following cancer of the female breast in Denmark, 1943-80.

The risk of a person developing a second primary cancer was evaluated in approximately 55,000 women diagnosed with breast cancer in Denmark between 1943 and 1980. Excluding second cancers of the contralateral breast, 2,480 new cancers were observed compared with 2,398 expected (relative risk = 1.03; 95% CI = 0.99-1.08). Breast cancer patients followed for 10 years or more showed a significant 13% excess of all second primary tumors. Significant excesses of cancers of the lung, bone, and connective tissue were observed. Although some misclassification of metastases may have occurred, the risk of second cancers at these sites (as well as the salivary gland and esophagus) increased significantly with time and was especially high among women followed for 10 years or more. These observations suggest that radiation, as a part of the initial treatment, may have been involved. Radiation or chemotherapy, or both, may also have influenced the risk of acute nonlymphocytic leukemia (51 cases observed vs. 20.7 expected), which remained significantly elevated after the first year of follow-up. Common risk factors, related to reproductive experience and nutrition, may have contributed to the excess risk of cancers of the ovary and colon. On the other hand, an anticipated excess of cancer of the corpus uteri was not found, although cancer of the uterus not otherwise specified was significantly increased. Significant deficits were observed for second cancers of the liver and biliary tract, due perhaps to underreporting or conservative coding practices, or both. A significant excess of malignant melanoma was not easily explained but might indicate a common hormonal etiology with breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗
PubMed1985

Second cancer following cancer of the female genital system in Denmark, 1943-80.

Between 1943 and 1980, approximately 53,000 women in Denmark survived 2 or more months after initial diagnosis of cancers of the cervix uteri, corpus uteri, ovaries, fallopian tubes, and ligaments. No significant excess of new cancers was observed following cancers of the cervix and corpus uteri. However, after second cancers of both the cervix and corpus uteri were eliminated from the analysis (because it was likely they were surgically removed or not recorded due to conservative coding practices), 6 and 4% excess risks of borderline significance were found among women with cancer of the cervix and uterus, respectively. A significant 25% excess of all second primary cancers was observed following cancer of the ovary (relative risk = 1.25; 95% CI = 1.14-1.37). Significant excesses of colon and breast cancers followed cancers of the ovary and corpus uteri. Subsequent to cervical cancer, the risk of cancers of the lung, esophagus, bladder, and kidney occurred significantly above expectation. These associations may be explained by common risk factors related to reproduction and possibly diet for cancers of the breast, colon, ovary, and corpus uteri; and to cigarette smoking for cancers of the lung, esophagus, bladder, and cervix uteri. The significant deficit of breast cancer after cervical cancer could be due to different patterns of risk factor (i.e., reproductive and socioeconomic variables) and loss of functioning ovaries as a part of the treatment for cervical cancer. Each of the female genital sites showed significant excesses of second bladder cancers, and the risk increased significantly with time, which indicate a relation to radiotherapy. The pattern of risk of leukemia observed following cancer of the ovary was also compatible with effects of treatment, especially chemotherapy.

Denmark↗
PubMed1985

Second cancer following cutaneous melanoma and cancers of the brain, thyroid, connective tissue, bone, and eye in Denmark, 1943-80.

Second primary cancers were studied in persons with rare tumors between 1943 and 1980. The risk of developing a new cancer was evaluated in 7,211 persons with cutaneous melanoma, 1,784 persons with eye cancer, 10,273 persons with tumors of the brain and nervous system, 1,935 persons with thyroid cancer, 1,542 persons with bone tumors, and 2,318 persons with malignant neoplasms of the connective tissue. All cancer patients were diagnosed in Denmark between 1943 and 1980 and survived for 2 or more months. Nonmelanoma skin cancers were excluded from the analysis, whereas tumors of the brain and nervous system included both benign and malignant neoplasms. Overall, patients with these cancers showed no greater incidence of new tumors than expected from comparisons with the general population. An excess of chronic lymphocytic leukemia was observed subsequent to all cancers derived from the neural tube, i.e., melanoma and tumors of the eye, brain, and nervous system. Bone cancer occurred excessively, although the possibility of misclassified metastases could not be eliminated. Patients with tumors of the brain and nervous system who survived for 10 or more years developed significantly more cancers of the kidney and connective tissue and melanoma than anticipated. A deficit of second cancers of the digestive system was noted after primary bone and connective tissue cancers, in contrast to an excess of second cancers of the lung and kidney. Although based on few cases, patients with bone cancer showed a large excess of eye cancer as a second primary. The association between cancers of the breast and connective tissue was found to be bidirectional. Persons with connective tissue cancer were at increased risk of developing non-Hodgkin's lymphoma. Thyroid cancer patients were at high risk of subsequent tumors of the brain and nervous tissue and non-Hodgkin's lymphoma. However, contrary to previous reports, the risk of breast cancer was not elevated following thyroid cancer.

Bone Neoplasms↗
PubMed1985

Summary: multiple primary cancers in Denmark, 1943-80.

The risk of developing a second primary cancer was studied among 171,749 men and 208,192 women who were reported to the Danish Cancer Registry between 1943 and 1980. Only those who survived at least 2 months were included in the analysis, and more than 1.7 million person-years of observation were accrued. Altogether, 15,084 second primary cancers developed in organs other than the initial cancer site [relative risk (RR) = 0.99]. Adjustment for possible underreporting of multiple primary cancers increased the RR to 1.06. The overall RR of a second cancer developing for all sites was 0.91, but interpretation of this risk is difficult because new tumors arising within the same organ are generally not recorded in Denmark. The RR for all sites increased with time from 0.94 during the first decade of follow-up (excluding the first year) to 1.13 among 30-year survivors. Patients below the age of 20 years when first diagnosed with cancer experienced significantly increased risk of developing a second cancer. Elevated risks were also observed for sites thought to have a common etiology. For example, cancers of smoking-related sites were increased in both directions for cancers of the oral cavity, respiratory tract, and urinary organs. For cancers suspected to have a hormone- or dietary fat-related association, significant reciprocal relationships were seen among cancers of the endometrium, ovary, and colon. Cancer treatment probably is an important factor in second cancer development, even when judged indirectly in the present study. For example, radiotherapy may have been responsible for an elevated risk of subsequent cancers of the thyroid, breast, colon, rectum, bladder, connective tissue, and hematopoietic system in long-term survivors. Chemotherapy may have increased the risk of subsequent leukemias. Our data further indicate that cancer patients have no general susceptibility to develop new malignant tumors, although high rates may be found for particular sites sharing common risk factors. Conversely, the occurrence of one cancer does not appear to protect against developing a new cancer.

Adolescent↗
PubMed1984

Endometrial cancer following treatment for breast cancer: a case-control study in Denmark.

To evaluate the risk of endometrial cancer subsequent to breast cancer, a case-control study was carried out in Denmark. Between 1943-1977, 115 cases of histologically confirmed endometrial carcinoma developed more than 3 months after the diagnosis of a primary breast cancer in 51,638 women. A total of 235 breast cancer patients with no second primary cancer were matched to the cases on age, calendar year of diagnosis, and survival with an intact uterus. Identification of cases and controls relied upon records available in the Danish Cancer Registry. Information on risk factors and reproductive histories was abstracted from hospital records. Increased relative risks (RR) for endometrial cancer were associated with menopausal oestrogen use (RR = 4.9), nulliparity (RR = 2.1), late age at natural menopause (RR = 2.9), and pelvic irradiation (RR = 1.4). No association was apparent for drugs used to treat breast cancer. This study indicates that breast and endometrial cancer share several common aetiologic factors and that studies of second primary cancers have the potential to provide information on risk factors other than those associated with therapy.

Age Factors↗
PubMed1984

Trends in the incidence of cancer of the corpus uteri in Denmark, 1943-1980.

The occurrence of cancer of the corpus uteri in Denmark is examined by the use of data from the Danish Cancer Registry. The study population consists of 14,149 cases diagnosed with cancer of the corpus uteri between 1943 and 1980. Since 1943, the incidence has been steadily increasing. The trend in the incidence rates varies in different age groups, and examination of birth cohorts shows higher rates after the age of 50 for more recent generations. The trend is evaluated in relationship to changes in diagnostic practices and to changes in prevalence of risk factors. Of the latter, estrogen use is considered a plausible explanation for the increasing incidence in women aged 55-64 years Correction of the age-specific incidence rates for hysterectomy reveals a pattern very similar to that of breast cancer.

Adult↗