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Biomedical subjects

M Frisch

Publications and source records attributed to M Frisch.

At least 55 records · Page 3Linked to original sources

Incidence patterns of lyme disease and cutaneous B-cell non-Hodgkin's lymphoma in the United States.

BACKGROUND: Several reports have suggested a link between infection with Borrelia burgdorferi (the spirochete causing Lyme disease) and development of cutaneous B-cell non-Hodgkin's lymphoma (CBCL). METHODS: We did a correlation analysis of CBCL and Lyme disease using data from the Surveillance, Epidemiology and End Results program and from the Centers for Disease Control and Prevention. RESULTS: We could not demonstrate a geographic correlation between incidence rates of Lyme disease and CBCL. CONCLUSION: This observation suggests that infection with B. burgdorferi is not a major risk factor for CBCL in the USA.

Borrelia burgdorferi Group↗

Is history of squamous-cell skin cancer a marker of poor prognosis in patients with cancer?

BACKGROUND: Nonmelanoma skin cancer is associated with increased occurrence of subsequent cancer and death from cancer, but it is not known whether a history of skin cancer is associated with poor prognosis after a second diagnosis of cancer. OBJECTIVE: To determine whether history of squamous-cell skin cancer is a marker of poor prognosis in patients with cancer. DESIGN: Population-based cohort study. SETTING: Sweden, 1958 to 1996. PATIENTS: All patients in the Swedish Cancer Registry with or without a first diagnosis of squamous-cell skin cancer and a subsequent or first diagnosis of non-Hodgkin lymphoma (including chronic lymphocytic leukemia) or cancer of the colon, breast, prostate, or lung. MEASUREMENTS: Relative risk (RR) for death determined by using Cox proportional hazards regression analysis. RESULTS: Patients with a history of squamous-cell skin cancer had a significantly greater risk for death than those with no such history after receiving a diagnosis of non-Hodgkin lymphoma (RR, 1.33), colon cancer (RR, 1.24), breast cancer (RR, 1.19), or prostate cancer (RR, 1.17). Patients with lung cancer and a history of squamous-cell skin cancer who survived for 1 year after diagnosis of lung cancer also had an increased risk for death (RR, 1.29). CONCLUSION: Patients with a registered history of squamous-cell skin cancer have a poor prognosis after diagnosis of subsequent cancer and warrant careful medical attention.

Adult↗

Smoking and oral contraceptives as risk factors for cervical carcinoma in situ.

Human papillomavirus (HPV) is probably a necessary but definitely not a sufficient cause of cervical carcinoma. However, it remains unclear which factors, in addition to HPV, are important for the development of cervical carcinoma and its precursor lesions. To address this issue, we conducted a case-control study nested in a population-based cohort consisting of women participating in cytological screening in one Swedish county, any time during 1969 through 1995. Detailed information on sexual practice, smoking habits and oral contraceptive (OC) use were collected through telephone interviews with 422 case patients diagnosed with cervical carcinoma in situ and 422 control subjects. All cytological smears were analyzed for presence of HPV 16/18 by a polymerase chain reaction (PCR)-based method. Odds ratios (OR) were used as measures of relative risk. After multivariate adjustment, a 2-fold higher risk was observed among current smokers compared with never smokers [OR 1.94; 95% confidence interval (CI 1.32-2.85)], an association apparently confined to women younger than 45 years. Current use of OCs was associated with a 4-fold increased risk overall (OR 3.64; 95% CI 1.91-6.93) with a monotonic increase with increasing duration of use (p for trend < 0.001). The number of sexual partners was significantly, positively associated with risk among HPV 16/18-negative (p for trend < 0.005) but not among HPV 16/18-positive women. Our data confirm the association between smoking and cervical carcinoma in situ, which might be age-dependent. Our results further indicate a relation with OC use and the risk for cervical carcinoma in situ.

Adult↗

Tobacco smoking as a risk factor in anal carcinoma: an antiestrogenic mechanism?

BACKGROUND: Human papillomavirus-associated anogenital carcinogenesis depends on poorly defined cofactors. Smoking was recently suggested to increase the risk of anal cancer more in premenopausal women than in postmenopausal women. Thus, we used our population-based anal cancer case-control study in Denmark and Sweden to test this hypothesis. METHODS: Our study included 417 patients (324 women and 93 men) who were diagnosed with anal cancer (84% invasive cancer) from 1991 through 1994; it also included five patients diagnosed in 1995. Two control groups were used: 1) 554 population control subjects (349 women and 205 men) and 2) 534 patients with rectal adenocarcinoma (343 women and 191 men). Odds ratios (ORs), calculated from logistic regression analyses, were used as measures of relative risk. All P values are two-sided. RESULTS: Compared with the risk for lifelong nonsmokers, the risk of anal cancer was high among premenopausal women who currently smoked tobacco (multivariate OR = 5.6; 95% confidence interval [CI] = 2.4-12.7) and increased linearly by 6.7% per pack-year smoked (one pack-year is equivalent to one pack of cigarettes smoked per day for 1 year) (P for trend <.001). Smoking was not statistically significantly associated with anal cancer risk in postmenopausal women or men. Women whose menstrual periods started late were at high risk (multivariate OR = 3.6; 95% CI = 1.8-7.3, for > or = 17 years of age versus < or = 12 years of age; P for trend <.001), and body mass index (weight in kg/[height in m]2) was inversely associated with risk among women (P<.001). CONCLUSIONS: Because the risk of anal cancer associated with smoking was restricted to premenopausal women and because higher risk was associated with late menarche and lean body composition, female sex hormones may be a factor in anal cancer development in women. Since the anal mucosa is an estrogen-sensitive area, we hypothesize an antiestrogenic mechanism of action for smoking in anal carcinogenesis.

Adult↗

Variants of squamous cell carcinoma of the anal canal and perianal skin and their relation to human papillomaviruses.

High-risk types of human papillomaviruses (hrHPVs) may be a necessary cause in cervical cancer and in some subtype of anal, vulvar, and penile cancers. Large studies aimed at characterizing hrHPV-associated and non-hrHPV-associated subtypes of anal carcinomas are, however, lacking. We searched for human papillomavirus type 16 and 13 other hrHPVs in tumor tissue by PCR and performed a systematic histological evaluation of specimens from 386 patients with anal cancer (86% invasive; 302 women and 84 men). Cancers in women and homosexual men were more often hrHPV positive (P < 0.01) and located in the anal canal (P < or = 0.01) than were cancers in heterosexual men. In both women and men, anal canal cancers contained hrHPV clearly more often than did perianal skin cancers, and increasing hrHPV positivity was seen with higher localization in the anal canal. Indeed, 95 and 83% of cancers involving the anal canal in women and men, respectively, were hrHPV positive versus 80 and 28% of perianal skin cancers (P-trend < 0.001). Basaloid feature, adjacent anal intraepithelial neoplasia, poor or absent keratinization, and a predominance of small or medium neoplastic cells were all strongly positively associated with hrHPV status. Like cancer of the uterine cervix, the development of cancer of the anal canal may require infection with hrHPV, whereas a dual etiology of perianal skin cancers bears parallels to vulvar and penile cancers.

Age Factors↗

Bowen disease and risk of subsequent malignant neoplasms: a population-based cohort study of 1147 patients.

OBJECTIVE: To address the long-standing question of whether patients with Bowen disease are at increased risk of internal malignant neoplasms. PATIENTS: A total of 1147 Danish patients diagnosed between 1978 and 1993 as having Bowen disease at nongenital sites were followed up for 6463 person-years for cancer occurrence up to 16 years after the skin lesion. MAIN OUTCOME MEASURE: Standardized incidence ratios (SIRs)--the ratios of observed-to-expected numbers of cancer--served as measures of relative risk. RESULTS: The observed number of noncutaneous cancers occurring in the cohort (n = 115) was close to expected (n = 103.0) (SIR = 1.1; 95% confidence interval, [CI], 0.9-1.3). However, nonmelanoma skin cancer (SIR = 4.3; 95% CI, 3.5-5.4; n = 83), lip cancer (SIR = 8.2; 95% CI, 2.6-19.1; n = 5), and, among men, leukemia (SIR = 3.2; 95% CI, 1.04-7.5; n = 5) occurred in excess. CONCLUSIONS: Patients with Bowen disease do not appear to constitutionally be at any unusually high general cancer risk. The increased risk of invasive skin and lip cancers is likely due to the common risk factor of UV light.

Adult↗

Economic impact of accelerated cleanup on regions surrounding the U.S. DOE's major nuclear weapons sites.

The regional economic impacts of the U.S. Department of Energy's accelerated environmental cleanup plan are estimated for the major nuclear weapons sites in Colorado, Idaho, New Mexico, South Carolina, Tennessee, and Washington. The analysis shows that the impact falls heavily on the three relatively rural regions around the Savannah River (SC), Hanford (WA), and Idaho National Engineering and Environmental Laboratory (ID) sites. A less aggressive phase-down of environmental management funds and separate funds to invest in education and infrastructure in the regions helps buffer the impacts on jobs, personal income, and gross regional product. Policy options open to the federal and state and local governments are discussed.

Government Agencies↗

[Sexually transmitted infection as a cause of anal cancer].

Interviews were carried out with 423 women and 93 men with invasive or in situ anal cancer in Denmark and Sweden in a search for clues to the aetiology of this neoplasm. Patients with rectal adenocarcinoma (n = 534) and persons drawn from the background population (n = 554) served as controls. Multivariate logistic regression analyses confirmed previous observations of a strong association between either male homosexual experience or a history of anogenital warts and the risk for anal cancer. Moreover, hitherto unknown, but strong and consistent associations were observed between measures of high heterosexual activity and the risk for anal cancer among both sexes. Polymerase chain reaction analysis revealed human papilloma-virus DNA in the majority (88%) of anal cancer specimens but in none of 20 examined rectal adenocarcinomas. It is concluded that most anal cancers appear to be caused by sexually transmitted types of human papillomaviruses and, consequently, that anal cancer is a potentially preventable neoplasm.

Adenocarcinoma↗

[Risk factors for epidermoid carcinoma of the vulva].

There is mounting evidence that epidermoid carcinoma of the vulva may be divided into two aetiologically distinct categories. One category, that is closely linked to infection with high-risk types of human papillomaviruses, comprises malignancies whose histological picture is either basaloid or warty carcinoma. Another category, keratinizing squamous cell carcinoma, has a much weaker association with human papillomaviruses and occurs mainly in elderly women. This review describes the current status with regard to risk factors for epidermoid carcinoma of the vulva.

Carcinoma, Squamous Cell↗

[Induced abortion and risk of breast cancer].

It has been hypothesized that an interrupted pregnancy might increase the risk of breast cancer, because proliferation of breast cells will take place without the protective effect of subsequent differentiation. In a cohort of 1.5 million women (28.5 million person-years) we identified 370,715 induced abortions in 280,965 women (2.7 million person-years) and 10,246 women with breast cancer. After adjustment for other risk factors, induced abortion was not associated with the risk of breast cancer (relative risk: 1.00; 95 percent confidence interval 0.94 to 1.06). However, the relative risk of breast cancer increased with increasing gestational age of the most recently induced abortion: < 7 weeks: 0.81; 7 to 8 weeks; 1.01; 9 to 10 weeks: 1 (reference); 11 to 12 weeks: 1.12; 13 to 14 weeks: 1.13; 15 to 18 weeks: 1.23; > 18 weeks: 1.89; P(trend) = 0.016. On a population basis, induced abortion was not associated with an increased risk of breast cancer. An increase was only seen for the special group of late second trimester abortions, but this finding was based on small numbers.

Abortion, Induced↗

[Rheumatoid arthritis and risk of cancer].

In the current study we linked data from the Danish Hospital Discharge Register and the Danish Cancer Registry to estimate cancer occurrence among more than 20,000 patients hospitalized at least once with rheumatoid arthritis during 1977-1987. During a follow-up interval of up to 15 years, we found increased risks of non-Hodgkin's lymphoma, Hodgkin's disease and lung cancer, while the risk of colorectal cancer was decreased. These findings were all in agreement with the results of previous studies from two other Nordic countries, which were based on a similar type of data. We also found an excess of non-melanoma skin cancer and a deficit of female breast cancer, of which only the breast cancer observation had been seen in an earlier study.

Adult↗

[Risk of cancer among patients with cutaneous basal cell carcinoma].

A population-based cohort of 37,674 patients diagnosed during the period 1978-1991 and registered in the Danish Cancer Registry with basal cell carcinoma of the skin (BCC) were followed for the occurrence of new malignancies. BCC patients experienced significantly increased cancer incidence rates compared with the general Danish population. The elevated cancer risk was not restricted to new cutaneous malignancies. Cancers at various sites, including lip, salivary glands, larynx, lung, breast, kidney and non-Hodgkin lymphoma occurred in significant excess. Patients diagnosed with BCC before the age of 60 years were at higher risk of developing new malignancies than patients diagnosed with BCC at an older age. This age association pertained particularly to breast cancer, testicular cancer and non-Hodgkin lymphoma.

Adult↗

The role of human papillomaviruses in anogenital cancers.

There is substantial evidence to suggest that common risk factors exist for cancer of the cervix and other anogenital cancers. Cervical cancer has been etiologically linked with venereal types of human papillomavirus (HPV) and the same types of HPV are being found in other anogenital tissues. The question is to what extent these HPV types may also contribute to carcinogenesis in anogenital cancer other than cervical cancer. In this review some general aspects of the natural history of HPV are presented followed by a description of the incidence and risk factors for anal, vulvar, and penile cancer. Main focus is given to the evidence for an association between these cancers and HPV.

Anus Neoplasms↗

Testicular cancer risk and maternal parity: a population-based cohort study.

The aim was to study, in a population-based cohort design, whether first-born sons run a higher risk of testicular cancer than later born sons; to investigate whether this difference in risk was affected by birth cohort, age of the son, maternal age, interval to previous delivery and other reproductive factors; and, finally, to evaluate to what extent changes in women's parity over time might explain the increasing incidence of testicular cancer. By using data from the Civil Registration System, a database was established of all women born in Denmark since 1935 and all their children alive in 1968 or born later. Sons with testicular cancer were identified in the Danish Cancer Registry. Among 1015994 sons followed for 15981 967 person-years, 626 developed testicular cancer (443 non-seminomas, 183 seminomas). Later born sons had a decreased risk of testicular cancer (RR = 0.80, 95% CI = 0.67-0.95) compared with first-born sons. The RR was 0.79 (95% CI = 0.64-0.98) for non-seminomas and 0.81 (95% CI = 0.58-1.13) for seminomas. There was no association between testicular cancer risk and overall parity of the mother, maternal or paternal age at the birth of the son, or maternal age at first birth. The decreased risk of testicular cancer among later born sons was not modified by age, birth cohort, interval to the previous birth, sex of the first-born child, or maternal age at birth of the son or at first birth. The increased proportion of first-borns from birth cohort 1946 to birth cohort 1969 only explained around 3% of an approximated two-fold increase in incidence between the cohorts. Our data document a distinctly higher risk of testicular cancer in first-born compared with later born sons and suggest that the most likely explanation should be sought among exposures in utero. The increase in the proportion of first-borns in the population has only contributed marginally to the increase in testicular cancer incidence.

Adolescent↗

High incidence of classical Kaposi's sarcoma in Iceland and the Faroe Islands.

We have examined the incidence of non-AIDS-related Kaposi's sarcoma in Iceland (1955-79) and the Faroe Islands (1974-95). In Iceland, 19 cases, nine in men and ten in women, were identified, and in the Faroe Islands four cases in men and three cases in women were found. This corresponded to surprisingly high incidence rates. In men, world standardized rates (per 100000 person-years) were 0.4 and 0.6 in Iceland and the Faroe Islands, respectively, and for women, the figures were 0.3 (Iceland) and 0.5 (the Faroe Islands). These are among the highest rates ever reported. No explanation for the high rates of Kaposi's sarcoma in these two North Atlantic communities could be identified.

Aged↗

Incidence rates of classical Kaposi's sarcoma and multiple myeloma do not correlate.

We compared population-based incidence rates for classical Kaposi's sarcoma and multiple myeloma. Neither for men (Spearman's rank correlation coefficient (r) = 0.01, P = 0.97, 13 pairs) nor for women (r = 0.24, P = 0.42, 13 pairs) did the incidences of the two conditions correlate. This absence of correlation does not support the hypothesis that Kaposi's sarcoma and multiple myeloma share a common aetiology, such as HHV-8.

Denmark↗