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P Hartge

Publications and source records attributed to P Hartge.

At least 19 recordsLinked to original sources
PubMed1995

Effect of human T-lymphotropic virus type I infection on non-Hodgkin's lymphoma incidence.

BACKGROUND: We previously reported from a case-control analysis that T-cell non-Hodgkin's lymphoma (NHL) was strongly associated with human T-lymphotropic virus type I (HTLV-I) infection in Jamaica and Trinidad and that the relative risk for HTLV-I infection was very high in younger patients. PURPOSE: The objective of this study was to estimate the age-specific incidence rates of NHL among HTLV-I-infected and HTLV-I-uninfected adults in Jamaica and Trinidad. METHODS: Population rates of HTLV-I infection were calculated from available census reports and serosurvey data. Incidence rates for NHL were calculated from all incident cases in Jamaica during 1984-1987 (n = 135) and from all incident cases in Trinidad during 1986-1990 (n = 117). Using biopsy material, we determined whether the immunophenotype of the tumor cells was T cell, B cell, or other. NHL incidence rates were computed according to HTLV-I status, age, sex, and tumor phenotype for each country separately and for both countries combined by weighting to the relative population size of each country. RESULTS: The age-standardized NHL incidence rate (mean +/- SE) in Jamaica was 1.9 +/- 0.2 per 100,000 person-years (PY). In Trinidad, the rate was 2.9 +/- 0.4 per 100,000 PY. Overall, the incidence of NHL increased with age and was higher in males than in females. In the HTLV-I-infected population, the incidence of NHL was inversely related to age, and age-specific rates were higher in males than in females. The NHL incidence in those estimated to have acquired HTLV-I infection in childhood, however, showed no sex difference, and one in 1300 such carriers (95% confidence interval: one in 1100 to one in 1600) per annum were estimated to be at such risk. For T-cell NHL, as proxy for adult T-cell lymphoma/leukemia, incidence was highest in those patients infected with HTLV-I early in life (perinatally or via breast milk), with high, sustained risk from early adulthood in both sexes. CONCLUSIONS: While overall NHL incidence rates reveal that HTLV-I endemicity does not impose an exaggerated lymphoma burden on these populations, the risk for lymphoma among carriers who acquire infection early in life is dramatic and is consistent with the hypothesis that virus exposure early in life is most important for lymphoma-genesis. IMPLICATIONS: Studies of HTLV-I carriers known to be infected in childhood may provide insight into markers intermediate in the lympho-magnetic process. Strategies to disrupt early-life transmission of HTLV-I, notably mother-infant transmission, may be critical in reducing the burden of lymphoreticular disease in these populations.

Adolescent↗
PubMed1994

Hodgkin's and non-Hodgkin's lymphomas.

Incidence of HD varies from about 0.5 per 100,000 person-years in parts of Asia to over 3 in parts of North America. In recent decades, many registries have reported slightly declining age adjusted incidence among men and women. Some lymphomas previously diagnosed as HD now would be classified as NHL, but this shift does not explain all of the decline. When analysed by age group, incidence has decreased substantially at older ages, whereas increases have been reported among young adults in some industrial countries. Less developed countries continue to show high rates in childhood. Hodgkin's disease of the nodular sclerosis subtype has increased over time, whereas HD of mixed cellularity has declined. Improved therapy for HD has led to sharply declining mortality rates, but further understanding of the role of EBV and other possible causal agents should afford opportunities for prevention. Non-Hodgkin's lymphoma stands out from most other malignancies because incidence and mortality rates have risen dramatically, steadily and almost universally during the past few decades. Incidence overall has been rising 3-4% per year. No sudden rise has occurred in specific birth cohorts or calendar year of diagnosis, although incidence rates have increased more steeply at older ages. Diagnosis of NHL has improved with time, perhaps beyond the ways considered herein, but has it improved so much more than diagnosis of other malignancies, and roughly simultaneously around the world? Although it appears that diagnostic improvements are partly responsible for the upward trend, it is likely that aetiological factors are playing an important part. Infections with HIV have started to inflate NHL incidence rates further but cannot account for the striking trend already under way for several decades. Clues should be vigorously pursued to determine the role of other known viruses, immunosuppressive states, herbicides and other chemicals in the environment, and commercial products such as hair dyes. To clarify reasons for the upward trends and to take preventive action will require a better understanding of the origins of the lymphomas through epidemiological research, including interdisciplinary approaches that can identify new viruses, host-environmental interactions and lifestyle and other exposures that alter susceptibility.

Adolescent↗
PubMed1992

Age at onset for familial epithelial ovarian cancer.

OBJECTIVE: To provide age-specific risks for ovarian cancer for relatives of ovarian cancer case patients. To characterize the age at onset for ovarian cancer for women with a single relative vs several relatives affected with ovarian cancer. DESIGN: Three previous studies were reexamined. The cumulative probability of ovarian cancer in first-degree relatives of women with histologically confirmed epithelial ovarian cancer and matched control subjects who participated in the Cancer and Steroid Hormone (CASH) Study was determined. The age of onset of ovarian cancer in women with and without relatives with ovarian cancer in a Washington, DC, case-control study was contrasted with that of women with at least two first-degree relatives studied at the National Cancer Institute (NCI). RESULTS: The CASH Study data showed that first-degree relatives of women with ovarian cancer had an increased risk for ovarian cancer, especially at older ages, when compared with relatives of control subjects. However, the median age at onset was the same among women in the Washington, DC, study with and without an affected relative. Among the women with an extensive family history of ovarian cancer studied at the NCI, the age at onset was considerably younger (47 years) than is typical for this disease (59 years). Of these, 17% had been diagnosed as having primary ovarian cancer by age 40 years. CONCLUSIONS: Women who have one first-degree relative affected by ovarian cancer are at greater risk for ovarian cancer but not at an age earlier than the general population. The small proportion of women who have several affected relatives are, however, at a greater risk of early onset of ovarian cancer. Prophylactic oophorectomy may be reasonable for these women.

Adult↗
PubMed1992

Quantification of the impact of known risk factors on time trends in non-Hodgkin's lymphoma incidence.

The incidence of non-Hodgkin's lymphoma among white men in the United States was measured as 6.9/100,000 person-years in 1947-1950 and as 17.4 in 1984-1988. We have estimated how much the known and suspected diagnostic and risk factors might have contributed to this apparent increase of 152%. Firm conclusions cannot be drawn without more data on risk and changes in prevalence, but a reasonable range of impacts can be constructed. After accounting for the likely effects of misdiagnosis of Hodgkin's disease as non-Hodgkin's lymphoma, of the acceptance of new entities of non-Hodgkin's lymphoma, of familial factors, of human immunodeficiency virus and other immunosuppressive conditions or drugs, and of occupation, we estimate that the percentage increase in incidence was still 80% among all males and 42% among those aged 0-64. An agent carrying a relative risk of 2.0 rising in prevalence from 0 to 42% would account for the latter rise. Diet, hair dyes, and general environmental exposures to pesticides may be contributing, but currently estimated risks and changes in exposure levels do not appear large enough to account for the residual rise. Among men aged 75-84, some of the residual rise of 109% probably is diagnostic, but only further research will clarify the issue.

Humans↗
PubMed1992

Risk factors for epithelial ovarian cancer in Beijing, China.

A study in Beijing, China of 112 pathologically confirmed epithelial ovarian cancer cases and 224 age-matched community controls enabled evaluation of risk in relation to reproductive, medical, familial, and selected lifestyle factors. An inverse relationship was observed between the number of full-term pregnancies and ovarian cancer risk. Compared to nulliparous women, subjects with one, two, or three full-term pregnancies were at 50%, 70%, or 90% reduced risks, respectively (P for trend less than 0.01). A positive correlation was found between the number of ovulatory years and risk, with a 2.6-fold increased risk for women with 30 or more compared to less than 10 ovulatory years (P for trend less than 0.01). Infertility, as estimated in various ways, was also found to be an important risk factor. When parity was taken into account, age at first pregnancy was not related to ovarian cancer risk. No protective effect was associated with mumps virus infection. In contrast, risk increased significantly as serum mumps virus antibody titres increased (P for trend less than 0.01). An elevated risk was found in women with a history of long-term (greater than 3 months) application of talc-containing dusting powder to the lower abdomen and perineum (Relative risk 3.9, 95% confidence interval: 0.9-10.63). These findings suggest that Chinese women have risk factors similar to those of occidental women.

Carcinoma↗
PubMed1992

Epidemiology of bladder cancer.

Approximately 49,000 persons in the United States develop bladder cancer each year, and about 9700 die of it. White men face a lifetime risk of almost 3%; white women and black men face a risk of about 1%, and black women, about 0.5%. Cigarette smoking is accepted widely as a cause of bladder cancer. Smoking accounts for about half of bladder cancer diagnosed among men and about one third of that among women. Moderate to heavy smokers typically show a two to five fold risk of bladder cancer, compared with persons who never smoked. When cigarette smokers quit smoking, their bladder cancer risk falls measurably within 2 to 4 years, but probably does not continue to decline with increasing years since quitting and does not appear to return to the baseline level of nonsmokers. Occupational exposure to certain aromatic amines causes human bladder cancer. Clear evidence of bladder cancer risk also is apparent for a small number of occupational groups: dye workers, rubber workers, leather workers, painters, truck drivers, and aluminum workers. Many other occupational groups have been reported to have increased bladder cancer risk, but evidence for these is not as strong. Coffee drinking has been studied extensively as a potential risk factor, but the inconsistency of the observed associations suggests that the relationship is either quite weak, noncausal, or dependent in a complex way on unmeasured factors. Artificial sweeteners confer little or no excess bladder cancer risk. Alcohol consumption apparently does not affect risk either. Consumption of fruits, vegetables, and foods high in vitamin A have been suggested as possible protective factors; consumption of high-fat foods, pork, and beef have been suggested as possible risk factors. Further epidemiologic research is needed to elucidate the role of diet in human bladder carcinogenesis. Less common risk factors for bladder cancer include ionizing radiation, cyclophosphamide use, and abuse of phenacetin-containing analgesics. Schistosomiasis infection may contribute substantially to the bladder cancer burden in Egypt and elsewhere, though not in the United States.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1990

Unexplained excess risk of bladder cancer in men.

In nearly all populations studied, the risk of bladder cancer is two to four times as great in men as in women. We estimated what the gender-specific incidence rates would be in the absence of exposure to known carcinogenic factors. The data used were obtained from interviews with 2,806 white individuals with bladder cancer and 5,258 white controls in the National Bladder Cancer Study and from incidence data for 1978 from the National Cancer Institute Surveillance, Epidemiology, and End Results Program. The total age-adjusted incidence of bladder cancer was 27.5 cases per 100,000 person-years for men and 7.0 for women, yielding a ratio of 3.9. Even in the absence of exposure to cigarettes, occupational hazards, or urinary tract infection, the gender-related risk persisted; the incidence of bladder cancer was 11.0 in men and 4.1 in women, yielding a ratio of 2.7. Possible explanations for the excessive risk in men include environmental and dietary exposures not yet identified and innate sexual characteristics such as anatomic differences, urination habits, or hormonal factors.

Adult↗
PubMed1990

Smoking patterns by occupation and duration of employment.

Lifetime patterns of smoking and occupation based on personal interviews were examined among 3,627 white men and 1,200 white women who were randomly selected from ten areas in the United States during the period 1977-1978. These individuals participated in the control series of the National Bladder Cancer Study. We estimated, based on Axelson's method, the extent to which smoking habits for given occupational groups would confound the estimated relative risk for lung cancer for 62 occupations among men and 18 occupations among women. Among men, confounding by smoking resulted in a 30% or greater increased risk of lung cancer in only three occupational groups--namely, stationary engineers and power station operators (relative risk (RR) = 1.6), printers (RR = 1.3), and fishermen and sailors (RR = 1.3). A decrease in lung cancer risk of 0.8 or less due to smoking habits was observed among the clergy (RR = 0.5) and chemical workers (RR = 0.7). Among women, a 30% increase or greater in the risk of lung cancer based on smoking habits alone was found for food service workers (RR = 1.5), building managers and administrators (RR = 1.3), telephone and telegraph operators (RR = 1.3), and operatives (RR = 1.3). A risk ratio of 0.8 or less was observed for those women employed as farmers (RR = 0.5) and teachers (RR = 0.8). Smoking habits by duration of employment were also examined for 38 occupations among men. The largest increase in the risk of lung cancer based on the smoking habits among long-term workers was only 1.3 and was observed for those men employed 20 or more years as painters and as electricians. These findings suggest that the smoking patterns, in only a few occupational groups that we evaluated, confound estimates of the relative risk by more than 30%, and for most occupational groups under investigation in this study, confounding by smoking alone did not produce trends in relative risks by duration of employment.

Adult↗
PubMed1989

Occupational risks of bladder cancer in the United States: I. White men.

We examined the relationship between occupation and bladder cancer risk using data obtained from interviews conducted with 2,100 white males with bladder cancer and 3,874 population controls during the National Bladder Cancer Study, a population-based, case-control study conducted in 10 areas of the United States. The strongest evidence of increased risk among white men was observed for painters, truck drivers, and drill press operatives. For painters, the overall relative risk was 1.5 [95% confidence intervals (CI) = 1.2-2.0]. Among painters who started working prior to 1930, a significant trend in risk with increasing duration of employment as a painter was apparent; the relative risk for such painters employed 10 or more years was 3.0. For truck drivers and drill press operatives, overall risks were 1.3 (CI = 1.1-1.4) and 1.4 (CI = 0.9-2.1), respectively. We observed a significant, positive trend in risk with increasing duration of employment in each of these occupations, with relative risks peaking at approximately two for long-term workers. Excess risks were also observed for workers in several other occupations. In all, we estimate that 21%-25% of bladder cancer diagnosed among white men in the United States is attributable to occupational exposures.

Adult↗
PubMed1989

Case-control study of female hormones and eye melanoma.

In a case-control study, we compared 238 women with intraocular malignant melanoma to 223 matched controls with detached retinas to evaluate the influence of hormonal factors on the risk of this cancer. We observed increased risk among women who had ever been pregnant (relative risk, 1.4; 95% confidence interval, 0.8, 2.2) and women who used replacement estrogens (relative risk, 2.0; 95% confidence interval, 1.2, 3.1), decreased risk among women who had undergone oophorectomy (relative risk, 0.6; 95% confidence interval, 0.4, 1.0), and no change in risk among women who had used oral contraceptives. Compared to hormonal effects on risk of reproductive tumors, these effects were weaker and less consistent, suggesting that hormonal factors may play only a limited role in causing melanomas of the eye.

Adult↗
PubMed1989

A case-control study of epithelial ovarian cancer.

With data from a study of 296 patients with primary epithelial ovarian cancer and 343 patients hospitalized because of other conditions, we estimated ovarian cancer risk in accordance with reproductive and other factors. Risk was greatest among women of lower parity, especially among women who said they planned to have children but could not. The protective effect of oral contraceptives seen in other studies was observed only in subgroups of our study population. Women who had breastfed their children had decreased risk, but the number of months of breastfeeding was not related to risk. Incomplete pregnancies did not provide the protection seen for live births. A family history of ovarian cancer and a medical history of breast cancer were both strong risk factors. None of the nonreproductive factors that we examined, including childhood illnesses, tobacco and alcohol consumption, obesity, and selected adult diseases, was convincingly associated with risk.

Adult↗
PubMed1988

Effects of timing and type of tobacco in cigarette-induced bladder cancer.

We analyzed a case-control study of bladder cancer in Torino (512 male and 55 female cases; 596 male and 202 female controls) with emphasis on the timing of cigarette smoking and the use of black or blond tobacco. The risk of bladder cancer was 2 to 3 times higher among smokers of black tobacco than among smokers of blond tobacco. Both groups of smokers showed a beneficial effect of smoking cessation, with an immediate decline in risk. This pattern is consistent with a late-stage effect of smoking. Among smokers of black tobacco, there was a gradient of risk with early exposure, and smokers who had quit never showed a drop to base-line levels of risk. These patterns, not apparent in users of blond tobacco, suggest an early stage effect of black tobacco, perhaps due to the higher concentration of aromatic amines in black than blond tobacco smoke and the higher blood levels of the hemoglobin adduct with 4-aminobiphenyl (a human bladder carcinogen) among smokers of black tobacco.

Age Factors↗
PubMed1988

Epidemiological characteristics of squamous cell carcinoma and adenocarcinoma of the bladder.

Recent incidence data from the United States indicate that transitional cell carcinoma accounts for the vast majority (95%) of bladder tumors in this country, with squamous cell carcinoma (less than 3%) and adenocarcinoma (less than 2%) comprising nearly all the remaining cases. Rates of squamous cell carcinoma and adenocarcinoma were higher in blacks compared to whites, while the reverse was true for transitional cell carcinoma. All three tumors predominated in males, especially transitional cell carcinoma. A population-based case-control study of bladder cancer conducted in 10 geographical areas of the United States identified 43 patients with squamous cell carcinoma and 32 with adenocarcinoma to permit an examination of risk factors. Cigarette smoking was significantly associated with risk of squamous cell carcinoma, with the relative risk rising to 6.1 among smokers of 40 or more cigarettes/day. Significantly elevated risks of squamous cell carcinoma were also associated with a history of 3 or more urinary tract infections (relative risk = 5.7) and with employment as welders and cooks. Risk factors were generally less conspicuous for adenocarcinoma, except for a significant trend with the amount of coffee drinking; however, this finding is based on small numbers and should be interpreted cautiously.

Adenocarcinoma↗
PubMed1988

Menopause and ovarian cancer.

Using data from a study of 296 patients diagnosed in greater Washington, D.C., from 1978 to 1981 with primary epithelial ovarian cancer and 343 patients hospitalized for other conditions, the authors estimated the rate ratios according to various characteristics of the menopause. Menopause induced by hysterectomy with preservation of both ovaries was associated with a 30 per cent reduction in risk of later development of ovarian cancer. Age at natural menopause was not consistently related to risk. Women who used menopausal estrogens showed a 40 per cent decreased risk.

Actuarial Analysis↗
PubMed1988

Racial differences in bladder cancer risk: a case-control study.

To determine why the incidence rate of transitional cell bladder cancer in whites in the United States is approximately twice that in blacks, the authors examined data from a large population-based case-control study of bladder cancer conducted in 1978 involving 2,982 cases and 5,782 controls. The relative risk of transitional cell carcinoma for whites compared with blacks was 1.9 before adjustment for the major bladder cancer risk factors, whereas after adjustment for cigarette smoking and occupation it was 1.6 (95% confidence interval (CI): 1.3-2.1). Further adjustment for other risk factors, including history of a bladder infection and a family history of urinary tract cancer, did not alter this estimate. The elevated risk of white compared with blacks was limited, however, to cases whose disease was confined to the mucosa and submucosa. Among cases whose disease had extended to the bladder musculature or beyond, whites were at slightly reduced risk compared with blacks. This suggests that whites may be diagnosed with conditions that go undetected in blacks but that are unlikely as a group to progress to more extensive disease. Because of the population-based nature of the study, it was possible to determine that if bladder cancer incidence among whites of both sexes was reduced to the level among blacks, total incidence in the United States would fall by 36 per cent.

Adult↗