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Biomedical subjects

M Frisch

Publications and source records attributed to M Frisch.

At least 73 records · Page 4Linked to original sources
PubMed1998

Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma.

A central role in anal carcinogenesis of high-risk types of human papillomaviruses (hrHPV) was recently established, but the possible role of benign anal lesions has not been addressed in hrHPV-positive and -negative anal cancers. As part of a population-based case-control study in Denmark and Sweden, we interviewed 417 case patients (93 men and 324 women) diagnosed during the period 1991-94 with invasive or in situ anal cancer, 534 patients with adenocarcinoma of the rectum and 554 population controls. Anal cancer specimens (n = 388) were tested for HPV by the polymerase chain reaction. Excluding the 5 years immediately before diagnosis, men, but not women, with anal cancer reported a history of haemorrhoids [multivariate odds ratio (OR) 1.8; 95% confidence interval (CI) 1.04-3.2] and unspecific anal irritation (OR 4.5; CI 2.3-8.7) significantly more often than controls. Women with anal cancer did not report a history of benign anal lesions other than anal abscess to any greater extent than controls, but they had used anal suppositories more often (OR 1.5; CI 1.1-2.0). Patients with hrHPV in anal cancer tissue (84%) and those without (16%) reported similar histories of most benign anal lesions, but anal fissure or fistula was more common among hrHPV-positive cases. Ulcerative colitis and Crohn's disease, reported by <1% of study participants, were not associated with anal cancer risk. The higher proportion of hrHPV-positive anal cancers among case patients with anal fissure or fistula suggests that such mucosal lesions may provide direct viral access to basal epithelial layers. Since risk associations with benign anal lesions in men may be confounded by unreported sexual behaviour, and since risk associations in women were generally negative, it seems unlikely that benign anal lesions act as promoters in hrHPV-associated anal carcinogenesis. Moreover, benign anal lesions appear not to be linked to an alternative, hrHPV-unassociated causal pathway to anal cancer. Ulcerative colitis and Crohn's disease were not supported as causal factors for anal cancer.

Abscess↗
PubMed1997

Risk of second cancers in classical Kaposi's sarcoma.

An association between Kaposi's sarcoma (KS) and malignant lymphoma has been suspected for many years. Both cancers belong to the group of malignancies associated with immune suppression and have been known to occur in the same individual. Accordingly, a common etiology has been suspected. Through linkage within the Nordic cancer registries, we studied the occurrence of cancers in a population-based cohort of 741 patients with classical KS. The relative risk of subsequent malignancies was expressed as the ratio of the observed numbers of cancer to the numbers expected based on age-, sex-, period- and country-specific incidence rates, i.e., the standardized incidence ratio (SIR). A total of 104 cancers was observed during 5,802 person-years of follow-up, which was close to the expected 98.8 cases (SIR, 1.05). During the first year of follow-up, 3 lymphomas were observed, which is in significant excess of the 0.2 lymphomas expected (SIR, 13.0). In contrast, no lymphomas occurred in the period beyond the first year of follow-up vs. 2.3 expected. Cancers of the buccal cavity and pharynx (SIR, 10.6; n = 4) and of the colon (SIR, 2.7; n = 7) occurred in excess among women but not among men. Accordingly, our results indicate that patients with classical KS are not at increased risk of cancer in general. In particular, the overall risk of lymphomas was not significantly increased. The high relative risk of malignant lymphoma immediately after KS was based on a limited number of cases, and this observation is unlikely to indicate a common etiology.

Age Factors↗
PubMed1997

Sexually transmitted infection as a cause of anal cancer.

BACKGROUND: The incidence of anal cancer has increased in recent decades, particularly among women. To identify underlying risk factors, we conducted a population-based case-control study in Denmark and Sweden. METHODS: We conducted telephone interviews with 324 women and 93 men in whom invasive or in situ anal cancer was diagnosed between 1991 and 1994, 534 controls with adenocarcinoma of the rectum, and 554 population controls. The interviews covered a wide spectrum of possible risk factors for anal cancer. Odds ratios were calculated by logistic regression. Specimens of anal-cancer tissue and samples of rectal adenocarcinomas were tested for human papillomavirus (HPV) DNA with the polymerase chain reaction. RESULTS: Multivariate analysis revealed consistent and statistically significant associations between measures of sexual promiscuity and the risk of anal cancer in both men and women. There was a significant trend toward an association between higher numbers of partners of the opposite sex in women (P<0.001) and men (P<0.05) and strong associations with a variety of venereal diseases. In women, receptive anal intercourse, particularly before the age of 30 years, and venereal infections in the partner were also associated with an increased risk (odds ratios, 3.4 and 2.4, respectively). Fifteen percent of the men with anal cancer reported having had homosexual contact, as compared with none of the controls (P<0.001). High-risk types of HPV, notably HPV-16, were detected in 84 percent of the anal-cancer specimens examined, whereas all rectal-adenocarcinoma specimens tested were negative for HPV. CONCLUSIONS: Our study provides strong evidence that a sexually transmitted infection causes anal cancer. The presence of high-risk types of HPV, notably HPV-16 (which is known to cause cancer of the cervix), in the majority of anal-cancer tissue specimens suggests that most anal cancers are potentially preventable.

Adult↗
PubMed1997

Birth order, sibship size and risk of Hodgkin's disease in children and young adults: a population-based study of 31 million person-years.

It has been proposed that Hodgkin's disease (HD) may have an infectious origin and that delayed exposure to infection may increase the risk of HD in young adults. This hypothesis is addressed by studying the family structure among children and young adults. The Civil Registration System was used to establish a population-based cohort consisting of all persons whose mothers were born in Denmark since 1935. Persons who developed HD were identified by linkage with the Danish Cancer Registry. HD incidence rate ratios were estimated based on a log-linear Poisson regression model. The cohort of 2.1 million persons (aged 0-42 years) was followed for 31.1 million person years, during which period 378 cases of HD occurred. Among children (< 15 years, n = 72), the relative risk (RR) of HD tended to increase with increasing sibship size, the relative increase in risk per increase in sibship size (the trend) being 1.28 [95% confidence interval (CI) 1.00-1.63]. The trend for birth order was 1.26 (95% CI 0.92-1.73). Among young adults (> or = 15 years, n = 306) the risk of HD, on the contrary, tended to decrease with increasing sibship size [trend = 0.91 (95% CI, 0.81-1.03)] and birth order (trend = 0.85 (95% CI, 0.71-1.01). These trends among young adults were significantly different from the corresponding trends among children (p < 0.05). Siblings of cases were at increased risk of HD (RR = 18; 95% CI, 2.2-65, n = 2). Our findings are compatible with the hypothesis that delayed exposure to infection may be a risk factor for HD in young adults, and that early exposure perhaps to another infectious agent may increase the risk of HD in children.

Adolescent↗
PubMed1997

Birth characteristics, sibling patterns, and acute leukemia risk in childhood: a population-based cohort study.

BACKGROUND: The occurrence of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) during childhood may be influenced by factors operating in fetal life. Furthermore, childhood ALL has been suggested to be linked to patterns of infection during infancy. PURPOSE: To explore these hypotheses and other associations, we studied the impact of sibling patterns (e.g., birth order) and birth characteristics (e.g., birth weight) on the risk of childhood ALL and AML. METHODS: By linkage of records of population-based registries, a cohort of all children whose mothers were born in Denmark from April 1935 through March 1978 was established. Children who developed ALL or AML during the period from April 1968 through December 1992 were identified by linkage with the Danish Cancer Registry. Birth weights were obtained for children born during the period from January 1973 through December 1992 by linkage with the Medical Birth Registry. RESULTS: The cohort of approximately 2.0 million children was followed for the diagnosis of ALL or AML for 20.9 million person-years. A total of 704 cases of childhood ALL were identified. Among 0-4 year olds, the relative risks (RRs) of ALL for birth order positions 1, 2, 3, and 4+ were 1.00 (reference), 0.85 (95% confidence interval [CI] = 0.68-1.07), 0.91 (95% CI = 0.66-1.25), and 0.57 (95% CI = 0.30-1.06), respectively (P for trend = .09). A decreasing trend was not observed among 5-14 year olds. A significant log-linear association between birth weight and the risk of ALL was observed for both age groups. Overall, the RR of ALL increased by a factor of 1.46 (95% CI = 1.18-1.81) (P = .0005) for each kilogram of increase in birth weight. A total of 114 cases of childhood AML were identified. Children born second or later in the birth order had an increased risk of AML (RR = 1.53; 95% CI = 1.01-2.32) compared with firstborns. A particularly high risk of AML at ages 2 (RR = 2.53; 95% CI = 1.46-4.40) and 3 years was associated with having siblings compared with being an only child at those ages. Similar to the findings for ALL risk, there was a significant association between birth weight and AML risk. The relative increase in AML risk per 1-kg increase in birth weight was 2.14 (95% CI = 1.19-3.85; P = .009). CONCLUSION AND IMPLICATIONS: The association between birth weight and childhood leukemia suggests the importance of intrauterine factors. A plausible explanation may be that increasing birth weight is associated with a higher rate of cell proliferation and/or a larger number of precursor cells being at risk of malignant transformation. The inverse association between birth order and ALL risk among 0-4 year olds was weak, but it was compatible with the hypothesis that delayed exposure to infection may increase the risk of ALL in this age group. The association of childhood AML with birth order and sibship size at young ages deserves further attention in the search for environmental factors that affect childhood AML risk.

Acute Disease↗
PubMed1997

[Marked increase in incidence of non-Hodgkin's lymphoma among young people in Denmark during 1943-1989].

Time related trends in incidence of non-Hodgkin's lymphoma in Denmark in the period 1943-1989 were analysed. A total of 13,822 patients were included in the study. World standardized incidence rates per 100,000 population increased from 2.5 in men and 1.9 in women in 1943-1947 to 9.3 in men and 6.5 in women in 1988-1989. Trends in age-specific incidence were analysed for two periods, i.e. 1943-1977 and 1978-1989. In both periods, the incidence of NHL increased in all age-groups. In general, the rate of increase was higher in the recent period, with the exception of the oldest age-group among whom the incidence increased by 7% annually between 1943 and 1962. In recent years an increase in incidence averaging 8% annually was observed in men and women aged 40 to 49 years. The remarkable and parallel time trends observed in young men and women in recent years indicate that factors other than AIDS must be contemplated.

Adolescent↗
PubMed1997

Induced abortion and the risk of breast cancer.

BACKGROUND: It has been hypothesized that an interrupted pregnancy might increase a woman's risk of breast cancer because breast cells could proliferate without the later protective effect of differentiation. METHODS: We established a population-based cohort with information on parity and vital status consisting of all Danish women born from April 1, 1935, through March 31, 1978. Through linkage with the National Registry of Induced Abortions, information on the number and dates of induced abortions among those women was combined with information on the gestational age of each aborted fetus. All new cases of breast cancer were identified through linkage with the Danish Cancer Registry. RESULTS: In the cohort of 1.5 million women (28.5 million person-years), we identified 370,715 induced abortions among 280,965 women (2.7 million person-years) and 10,246 women with breast cancer. After adjustment for known risk factors, induced abortion was not associated with an increased risk of breast cancer (relative risk, 1.00; 95 percent confidence interval, 0.94 to 1.06). No increases in risk were found in subgroups defined according to age at abortion, parity, time since abortion, or age at diagnosis of breast cancer. The relative risk of breast cancer increased with increasing gestational age of the fetus at the time of the most recent induced abortion: <7 weeks, 0.81 (95 percent confidence interval, 0.58 to 1.13); 7 to 8 weeks, 1.01 (0.89 to 1.14); 9 to 10 weeks, 1.00 >12 weeks, 1.38 (1.00 to 1.90) (reference category, 9 to 10 weeks). CONCLUSIONS: Induced abortions have no overall effect on the risk of breast cancer.

Abortion, Induced↗
PubMed1997

Cervical intraepithelial neoplasia, anogenital cancer, and other cancer types in women after hospitalization for condylomata acuminata.

To investigate the possible association between condylomata acuminata and anogenital neoplasia, a cohort of 9552 women recorded as having condylomata acuminata in the Danish Hospital Discharge Register during 1977-1989 was followed through 1991 for the occurrence of cancer and cervical intraepithelial neoplasia grade III (CIN III) by linkage to the Danish Cancer Registry. Eleven cases of vulvar cancer were identified, with 0.3 expected (standardized incidence ratio [SIR], 40.1; 95% confidence interval [CI], 20.0-71.7), and there were increased risks for cervical cancer (SIR, 2.0; 95% CI, 1.3-3.0), anal cancer (SIR, 8.5; 95% CI, 0.9-30.5), and CIN III (SIR, 2.6; 95% CI, 2.3-2.9). Risks were also elevated for non-anogenital cancers, notably lung cancer (SIR, 3.8; 95% CI, 2.2-6.0). Although confounding by smoking and other factors may exist, these results support the view that condylomata acuminata are associated with an increased risk of anogenital neoplasias, particularly vulvar cancer, and emphasize that women hospitalized with these lesions should undergo thorough anal and gynecologic examinations at regular intervals.

Adolescent↗
PubMed1997

Cancer and diabetes--a follow-up study of two population-based cohorts of diabetic patients.

OBJECTIVES: To study the occurrence of cancer amongst patients with diabetes mellitus (DM). DESIGN: Population based cohort study. SETTING: Denmark. SUBJECTS: Two cohorts of patients with DM were identified. One cohort comprised 1659 conscripts diagnosed with type I DM before the age of 20 years. Another cohort comprised 1499 men and women with insulin treated DM identified by means of medical prescriptions on 1 July 1973. Both cohorts were followed until the end of 1992. MAIN OUTCOME MEASURES: The relative risk of cancer in the two cohorts was estimated as the ratio of observed to expected number of cancers in the cohort (SIR). RESULTS: No unusual risk of cancer was observed amongst the conscripts (SIR 0.9, n = 13) or amongst patients with onset of DM before the age of 30 years in the prescription cohort (SIR 0.9, n = 32). Amongst those aged 30 years or more at DM onset in the prescription cohort, the overall risk of cancer did not depart from normal (SIR 1.0, n = 103), however, pancreatic cancer occurred in excess both immediately (< 1 year) (SIR 190, n = 1), and during 1-9 years after DM onset (SIR 9.0, n = 4). Similarly, the risk of non-Hodgkin's lymphoma was increased significantly (SIR 3.3, n = 6), all cases occurring more than 10 years after DM onset. CONCLUSIONS: Our data suggest that there is no unusual risk of cancer associated with type I DM. Type II DM may be the first symptom of pancreatic cancer and may be associated with an increased risk of non-Hodgkin's lymphoma.

Adult↗
PubMed1997

Cancer risk in a cohort of Danes working in Greenland.

Greenland is a high-incidence area for certain virus-associated cancers. The long term cancer risk in a cohort of 7,761 Danish employees who had been working for some time (median 19.7 months) in Greenland during the period 1955-1978 was studied. During a total of 162,300 person-years (average 20.9 years) of follow-up ending on December 31, 1992, the number of cancers observed was 732 vs. 669 expected (relative risk (RR) = 1.09, 95% confidence interval (CI) 1.02-1.18). Whereas the men did not experience any unusual cancer incidence at any cancer site, the women were at elevated risk of developing breast cancer (RR = 1.5, 95% CI 1.2-1.8 (n = 96)); malignant melanoma (RR = 1.8, 95% CI 1.0-2.9 (n = 16)); and lymphatic and hematopoietic malignancies (RR = 1.7, 95% CI 1.0-2.8 (n = 16)). Exposure during adulthood to a high-incidence area for cervical cancer, nasopharyngeal carcinoma and tumors of the major salivary glands did not confer any measurable increase in the risk for these virus-associated cancers. Postponement of childbearing might explain part of the elevated breast cancer risk. Intensive exposure to ultraviolet light, that is likely to explain the increased risk of malignant melanoma among the women, might also be involved in the excess incidence of lymphatic and hematopoietic malignancies observed in these women. However, why the men did not experience similar alterations in the risk of melanoma and cancers of the immune system is enigmatic.

Adolescent↗
PubMed1996

Risk for subsequent cancer after diagnosis of basal-cell carcinoma. A population-based, epidemiologic study.

BACKGROUND: Considerable debate is taking place over whether patients with basal-cell carcinoma and other skin neoplasms are at increased risk for internal cancer. OBJECTIVE: To investigate risk for subsequent cancer in patients with basal-cell carcinoma. DESIGN: Population-based cohort study. SETTING: Denmark, from 1978 ot 1991. PATIENTS: 37674 patients followed for a maximum of 14 years after a first diagnosis of basal-cell carcinoma. MEASUREMENTS: The occurrence of subsequent cancer was compared with the expected cancer pattern (which was determined on the basis of national incidence data). Standardized incidence ratios (SIRs), ratios of actual to expected number of cases of cancer, yielded estimates of the relative risk. RESULTS: During 190945 patient-years of follow-up, 3663 new cases of cancer occurred where only 3245 were expected. As anticipated, malignant melanoma occurred frequently (SIR, 2.64 [95% CI, 2.21 to 3.13]), but patients were also at increased risk for noncutaneous cancer (SIR, 1.19 [CI, 1.13 to 1.24] for men and 1.09 [CI, 1.03 to 1.16] for women). The excess risk for noncutaneous cancer pertained to cancer of the lip (SIR, 2.07), salivary glands (SIR, 2.45), larynx (SIR, 1.41), lung (SIR, 1.40), breast (SIR, 1.13), and kidney (SIR, 1.30) and non-Hodgkin lymphoma (SIR, 1.36). Patients receiving a diagnosis of basal-cell carcinoma before 60 years of age (SIR, 1.26) had a statistically higher risk for developing new cancer (P < 0.01) than did those receiving the diagnosis at 60 years of age or older (SIR, 1.11). This applied to breast cancer (SIR, 1.37 in patients < 60 years of age compared with 1.05 in those > or = 60 years of age), testicular cancer (SIR, 3.52 in patients < 60 years of age compared with 0 seen and 1.96 expected in those > or = 60 years of age), and non-Hodgkin lymphoma (SIR, 2.50 in patients < 60 years of age compared with 1.16 in those > or = 60 years of age), and non-hodgkin lymphoma (SIR, 2.50 in patients < 60 years of age compared with 1.16 in those > or = 60 years of age). CONCLUSION: In addition to having an increased risk for new skin cancer, patients with basal-cell carcinoma have an increased risk for noncutaneous cancer at various sites. Increased risks for testicular cancer, breast cancer, and non-Hodgkin lymphoma should be kept in mind, particularly for patients in whom basal-cell carcinoma is diagnosed when they are at a young age.

Adult↗
PubMed1996

Cancer risk in fathers and brothers of testicular cancer patients in Denmark. A population-based study.

There are several reports of familial testicular cancer in the literature but few systematic attempts have been made to estimate the risk of testicular cancer in first-degree relatives of patients with this neoplasm, and the risk remains to be fully assessed in population-based studies. By means of data from the Danish Cancer Registry, we identified all testicular cancer patients (index cases) born and diagnosed during 1950-1993 in Denmark. Their fathers were identified from national registries, as were the brothers of a subcohort of these patients. Familial cancer occurrence was determined through linkage with the cancer registry and compared with the cancer incidence in the general male population in Denmark. The ratio of observed to expected cancers generated the measure used for the relative risk. Fathers of 2,113 index cases with testicular cancer experienced an almost 2-fold risk of developing testicular cancer themselves (RR = 1.96; 95% CI: 1.01-3.43). Overall, the fathers had a decreased relative cancer risk (RR = 0.84; 95% CI: 0.74-0.95) with a significantly decreased risk of cancers of the lung and digestive organs. Brothers of a subcohort of 702 index cases showed a markedly increased risk of testicular cancer (RR = 12.3; 95% CI: 3.3-3 1.5). In conclusion, we documented a significantly increased familial risk of testicular cancer which was relatively more pronounced between brothers than between fathers and sons. These findings support the possible involvement of a genetic component in the aetiology of testicular cancer, but also leave room for a hypothesized influence of in-utero exposures, such as specific maternal hormone levels, that might be shared by brothers.

Adult↗
PubMed1996

[Carcinoid tumors in Denmark 1978-1989 and the risk of development of new cancers].

Previous studies have suggested an excess cancer risk in patients with carcinoid tumours. We re-examined this association by the use of truly population-based data from the Danish Cancer Register. One thousand and twenty-nine patients with carcinoid tumours diagnosed in Denmark 1978-89 were identified and followed for the occurrence of subsequent cancers. The ratio of observed to expected cancers calculated from population rates served as a measure of the relative cancer risk (RR). The annual age-adjusted incidence rate for carcinoid tumours was 1.1 per 100,000 person-years (world standardized). The overall relative risk of subsequent cancers was 1.1 (95% CI 0.8-1.6). Thyroid cancer, tumours of the brain and nervous system and non-Hodgkin's lymphomas were in excess. Overall, this study does not support previous findings of a general excess cancer risk in patients with carcinoid tumors. Significantly increased risks of cancer were observed at some sites, but these findings were based on small numbers, and consequently need further confirmation.

Adult↗
PubMed1996

Oestrogen-related cancer risk in mothers of testicular-cancer patients.

The belief that oestrogens are involved in the pathogenesis both of testicular cancer in young men and of cancers of the endometrium and female breast has become widespread. In a search for possible hormonal links between these cancers, we investigated the cancer pattern in a cohort of women who had given birth to sons who developed testicular cancer. Particular focus, was given to oestrogen-related cancers. The present retrospective population-based cohort study is based on data from the Danish Cancer Registry. Mothers of 2,204 testicular-cancer patients were followed for the occurrence of cancer over a total of 70,063 person years. The ratio of observed cancers in the cohort over the expected numbers based on cancer incidence in the underlying female population served as measure of the relative risk (RR). The RR of developing breast cancer among mothers of testicular-cancer patients was 0.8 (95% confidence interval 0.6-1.1), the relative risk of endometrial cancer 0.6 (0.3-1.0) and of ovarian cancer 1.0 (0.6-1.6). Mothers of testicular-cancer patients are not at increased risk of developing oestrogen-related cancers.

Adult↗
PubMed1996

Epidemiology of classic Kaposi's sarcoma in Denmark between 1970 and 1992.

BACKGROUND: Studies have suggested that the incidence of classic Kaposi's sarcoma (KS) varies considerably within Europe. The epidemiology of classic KS in Denmark was described for the period between 1970 and 1992 and association with marital status and country of origin were evaluated. METHODS: A descriptive epidemiology study was carried out using data from the Danish Cancer Registry and from all Danish pathology departments. The effects of marital status and of immigration were evaluated in a case-control study with sex- and age-matched controls for 50 cases of classic KS. RESULTS: A total of 59 patients with classic KS, 34 men, 25 women, were identified between 1970 and 1992, yielding world standardized incidence rates of 0.40 and 0.22 per 1,000,000 population among men and women, respectively. Among men, a larger proportion of the patients with classic KS were of non-Danish origin [odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.5-9.6]. No excess of foreign born persons was observed among women with KS. Never-married men were at a markedly increased risk for classic KS (OR = 2.8, 95% CI = 1.2-6.7). This risk was, however, restricted to men younger than 60 years (OR = 18.8, 95% CI 3.4-104.8), whereas no increased risk was observed in men age 60 years or older nor was there an increased risk in women. CONCLUSIONS: Classic KS is a rare disease in Denmark. However, men, immigrants and never-married men age 60 years or younger experienced an excess risk. Even though the latter finding might reflect an association with male homosexuality, the observation should be interpreted with caution due to the limited number of observations.

Case-Control Studies↗
PubMed1996

[New cancers after squamous cell skin cancer].

The subsequent cancer experience in 5,100 patients with squamous cell skin cancer (SCC) was compared with the cancer incidence in the Danish population. Ratios of observed to expected cancers served as the measure of the relative cancer risk (RR). Overall, SCC patients were at significantly increased cancer risk due to cancers of the respiratory organs (RR = 1.7); cancers of the lip, buccal cavity and pharynx (RR = 3.1); non-Hodgkin's lymphoma (RR = 2.3); leukaemia (RR = 2.5); malignant melanoma (RR = 2.6); and small intestine cancers in men (RR = 4.1). The risk of new cancers was higher in patients diagnosed with SCC before the age of 60 years than in those diagnosed with SCC after that age. A previously undocumented, significant excess of smoking-related cancers was observed after a diagnosis of SCC. Since a variety of other squamous cell cancers have been linked to smoking, the authors hypothesize that some general effect of smoking might act on all human squamous epithelia.

Adult↗