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Biomedical subjects

R Flamant

Publications and source records attributed to R Flamant.

At least 19 recordsLinked to original sources
PubMed1992

Epidemiological evidence for a common mechanism for neuroblastoma and differentiated thyroid tumour.

Because genetic predisposition probably plays an important role in the aetiology of most of childhood cancers, studies of second primaries occurring after these cancers may be particularly informative about possible common genetic mechanisms in both of these cancers. We have studied the incidence of thyroid tumours occurring after cancer in childhood in a cohort of 592 children treated before 1970. Among these children, six later developed a thyroid carcinoma, and 18 developed a thyroid adenoma. Radiation doses received to the thyroid by each of the irradiated children have been estimated using individual radiotherapeutic technical records. Thyroid carcinomas and thyroid adenomas were five times more frequent after irradiation for neuroblastoma than after irradiation for any other first cancer. This ratio did not depend on sex, nor on time elapsed since irradiation, nor on dose of radiation received for the thyroid gland. This result suggests that there is a common mechanism for the occurrence of neuroblastoma and of differentiated thyroid tumour.

Adenoma↗
PubMed1991

Association between breast cancer and family malignancies.

In a case-control study, the relationship between a family history of cancer of the breast, ovary, colon, uterus or prostate and the risk of breast cancer was investigated. The data consisted of family histories from 495 breast cancer cases and 785 controls aged 20-56 years. A positive association was found between the occurrence of breast cancer and a history of breast cancer in the families of the subjects affected. This relationship increased linearly with both the degree of kinship of the affected relatives and with their number. The risk of breast cancer associated with other types of cancer in the family was not significantly different from unity.

Adult↗
PubMed1991

Oral contraceptives and breast cancer: a French case-control study.

The relationship between the risk of breast cancer and oral contraceptive use was investigated in a case-control study conducted in France between 1983 and 1987 in five public hospitals. Some 464 cases aged 25 to 56 years and 542 matched controls were interviewed about their history of the use of oral contraceptives (OC). Results are given for the entire population and for the subgroup of 358 and 379 premenopausal cases and controls. The multivariate relative risk estimate, for ever user, was 1.5 (p less than 0.01) in the whole group as well as in the premenopausal subgroup (p less than 0.02). However, there was no evidence that the effect varied appreciably according to duration of use, age at first use, use before first full-term pregnancy (FFTP) and time since first or last use. The risk was not altered for any particular brand of OC. We conclude that, because of the widespread attention given to the relationship between OC use and breast cancer, information bias might be responsible for part of the excess in risk observed among OC ever users.

Adenocarcinoma↗
PubMed1990

Cancer epidemiology: implications for prevention and treatment.

Due to the results achieved in epidemiological research for the last 30 years, we are able to reduce considerably mortality from cancer through prevention and early diagnosis. The data required to accomplish these actions have been provided by epidemiology: (a) Descriptive epidemiology is the study of the frequency and the distribution of cancers, based on data concerning mortality and morbidity. These frequencies vary according to different parameters (i.e., sex, age, geographical situation). (b) Analytical epidemiology is able to pinpoint different risk factors (i.e., alcohol, tobacco, iatrogenic factors) through adequately conducted surveys. Primary prevention can attenuate the incidence of cancers by the suppression or reduction of certain risk factors. Secondary prevention permits the screening and treatment of precancerous lesions and avoids the secondary emergence of cancer (cervix uteri, colon). Early diagnosis is able to detect lesions at an early stage in their evolution where treatment is facilitated and where there are optimal chances of survival (breast). All of these measures for prevention and early diagnosis are being organized as large-scale strategic campaigns (e.g., National Cancer Institute, European Communities).

Adult↗
PubMed1990

Occupational risk factors for cancer of the pancreas: a case-control study.

The role of the occupational environment in the occurrence of cancer of the pancreas was analysed in a case-control study of 171 cases of pancreatic cancer and 317 controls matched for age at interview, sex, hospital, and interviewer. The study was conducted in France between 1982 and 1985 and covered 15 important industries and various other occupations. The results are given for the whole population, a subgroup of manual workers (46 cases and 108 controls), and a subgroup of French nationals (114 cases and 253 controls). After adjustment for cigarette smoking, and coffee and alcohol consumption, workers in the food industry (OR = 1.86) and the leather industry (OR = 1.63) showed higher risks than other industries. In the sub-group of French nationals only the risk associated with the textile industry was significantly higher than unity (OR = 2.30). No significant increase in risk was associated with work in any of the other branches studied; printing showed a moderate increase in risk (OR = 1.54). The subgroup of manual workers showed an increase in risk for cancer of the pancreas among those working in the building materials and building trades classification (OR = 2.16) and transportation (OR = 1.57).

Case-Control Studies↗
PubMed1989

Coffee, alcohol, smoking and cancer of the pancreas: a case-control study.

A hospital case control study on smoking, alcohol and coffee consumption as risk factors for pancreatic cancer, in which 161 cases were matched to 268 control patients, was conducted in France between 1982 and 1985. The results showed no association between tobacco or alcohol consumption and cancer of the pancreas, whereas coffee consumption was associated with an increased risk [OR of 2 or more cups per day vs. less: 2.27 (1.11-4.64) and 1.45 (0.82-2.55) among females and males respectively]. A dose-response relationship was observed with coffee consumption in both sexes, stronger among females than among males: the linear increase estimates were 2.00 (1.22-3.29) and 1.32 (0.91-1.92) respectively. No interaction was found between coffee and tobacco, whereas the effect of coffee appeared to be limited to non-drinkers of alcohol.

Adolescent↗
PubMed1989

Role of radiotherapy and chemotherapy in the risk of second malignant neoplasms after cancer in childhood.

Of a cohort of 634 children treated from 1942 to 1969 at the Gustave Roussy Institute for a first cancer and alive 5 years after treatment, 32 later developed second malignant neoplasms (SMN). A case-control study was performed to determine the relationship between the dose of radiotherapy received on a given anatomical site for the treatment of a first cancer, and the risk of SMN development at the same anatomical site. Another aim of the study was to analyse the effects of the association of radiotherapy with chemotherapy on the risk of SMN. The 32 cases of second malignant neoplasms were individually matched with one to nine patients of the cohort (a total of 162) who did not develop a SMN after a first cancer, matching on age, sex, type of first cancer and follow-up duration. The doses of radiotherapy delivered for the treatment of the first cancer were retrospectively estimated at the 26 anatomical sites of SMN. When the SMN was a leukaemia, the mean active bone-marrow dose was estimated as a weighted mean of the doses received by 20 bone sites. As compared to anatomical sites in children who had not received radiotherapy, the sites which had received 50 Gy or more had a relative risk of SMN of 5.8 (P less than 0.05). When taking into account the dose received at the site of the SMN, neither the number of fractions nor the type of radiations were related to the risk of SMN. Children who had received chemotherapy had a relative risk of SMN of 2.7 (95% CI: 1.2-6.4), adjusted for the dose of radiotherapy, as compared to those who had not. The relative risk of SMN did not vary with the dose nor the duration of the chemotherapy. Dactinomycin was found to increase the relative risk of second soft tissue and bone sarcomas. Cyclophosphamide was found to be less carcinogenic than the other alkylants. The relative risk of SMN was equal to 2.0 (n.s.) after radiotherapy of more than 25 Gy, to 4.4 (n.s.) after chemotherapy, and to 21.4 (P less than 0.01) after the combination of these two treatments modalities, as compared to patients treated by surgery alone. This study suggests that the oncogenic effect of radiations might be increased by chemotherapy, and that the combination of the two treatment modalities might be one of the major factors responsible for overall risk of SMN.

Adolescent↗
PubMed1989

Changes in patterns of cigarette smoking and lung cancer risk: results of a case-control study.

Data from a case-control study on lung cancer were used to evaluate how changes in cigarette habits, mainly smoking cessation, switch from non-filter to filter brands, from dark to light tobacco, or from handrolled to manufactured cigarettes, and reduction in daily consumption influence lung cancer risk. The results presented concern all males, exclusive cigarette smokers, involved in the study, i.e. 1,057 histologically confirmed lung cancer and 1,503 matched controls. The general decrease in lung cancer risk with the years since cessation was also found in each subgroup of cigarette exposure defined by duration of smoking, daily consumption and type of cigarettes smoked. Among smokers who had given up smoking from less than 10 years earlier, the lung cancer risks were two-fold higher for those who had stopped smoking for coughing or health reasons than for those who had stopped smoking for reasons other than health problems. A decrease in lung cancer risk, although not significant, was found in people who switched from non-filter brands to filter brands and from dark to light tobacco and in smokers who reduced their daily consumption of cigarettes by more than 25% as compared to smokers who had not changed habits.

Carcinoma↗
PubMed1989

Long-term risk of second malignant neoplasm after a cancer in childhood.

The risk of subsequent second malignant neoplasm was studied in a cohort of 634 patients, treated for a childhood cancer at the Gustave Roussy Institute between 1942 and 1969, and in complete remission five years after diagnosis. The most frequent types of first primary cancers (FPC) were Wilms' tumours (28% of the children), neuroblastomas (16%), lymphomas (12%) and soft tissue sarcomas (11%). Median follow-up duration after FPC was 19 years. Thirty-two patients (obs = 32) developed a total of 35 second cancers. Bone, thyroid, connective tissues and skin were the most frequent types of second cancer, with six patients for each type. The average annual incidence of second cancer was 0.36%. The average annual incidence for the periods 5-9, 10-14, 15-19, 20-24 and 25+ years after FPC was respectively 0.16%, 0.34%, 0.36%, 0.71% and 1.18%. The cumulative incidence of second cancer for the periods 5-20, 5-25 and 5-30 years after FPC was, respectively, 4.3% (95% CI: 2.8-6.6%), 7.8% (95% CI: 5.1-11.8%) and 13.0% (95% CI: 8.2-20.0%). The expected number of cancers in the cohort, computed from Danish cancer incidence data, was exp = 2.2. When compared to this expected number, the average annual excess incidence of second cancer, defined as obs-exp divided by the number of person years of observation, was 0.33%. This rose from 0.15% for the period 5-9 years after FPC to 1.09% for the period beginning 25 years after FPC. The standardised incidence ratio of second cancer (i.e. obs/exp) was 15 (95% CI: 10-21), and was fairly constant in the period extending from 15 to 20 years after FPC diagnosis. Obs/exp was equal to 25 for the patients who had had chemotherapy and equal to 9 for those who had not. Cyclophosphamide seemed less carcinogenic than the other alkylating agents. Obs/exp was similar for the patients who had received radiotherapy and for those who had not. The risk of cancer increased with age in the reference population and increased faster in the cohort, because the standardised incidence ratio is constant over a long period.

Adolescent↗
PubMed1988

Two-day cefamandole versus five-day cephazolin prophylaxis in 965 total hip replacements. Report of a multicentre double blind randomised trial.

The aim of this trial was to compare a 5-day course of cephazolin with a regimen of 2 days of cefamandole in 965 total hip replacements (488 in the cefamandole group and 477 in the cephazolin group). The effect of the prophylactic antibiotic on the bacterial colonization of drains (mean duration of drainage: 3.2 +/- 0.3 days) and on the susceptibility of colonizing organisms was assessed. No significant difference was observed in the percentage of infected drains between the two groups. The cefamandole group had a lower rate of Gram-negative organisms (23% versus 44%, p less than 0.01). The rate of deep infections within one year after operation was 0.7% in the cefamandole group versus 0.5% in the cephazolin group, and the difference is not significant. Cefamandole given for two days appears to be an effective prophylaxis against sepsis in total hip replacements.

Aged↗
PubMed1988

Occupational risk factors of lung cancer in a French case-control study.

A case-control study of 1625 histologically confirmed cases of lung cancer and 3091 controls matched for sex, age, hospital admission, and interviewer was conducted in France between 1976 and 1980. The results presented concern the effects of different occupations on the occurrence of lung cancer among 1334 male cases and 2409 matched controls. Occupations were coded blindly according to the International Standard Classification of Occupations. An excess risk of lung cancer was observed for the following occupations after adjustment for cigarette exposure: farmers (RR = 1.24, p less than 0.06), miners and quarrymen (RR = 2.14, p less than 0.02), plumbers and pipe fitters (RR = 1.80, p less than 0.04), motor vehicle drivers (RR = 1.42, p less than 0.01).

Agricultural Workers' Diseases↗
PubMed1987

Decreased mortality among male prisoners.

The mortality among a population of male prisoners between 1977 and 1983 was compared with that among the general French population. The overall mortality rate (for all deaths except external causes) was lower among prisoners (SMR = 84; p less than 0.05). Moreover, the risk of dying from all causes, as well as from malignant neoplasms, diseases of the circulatory system, and suicides fell significantly with increasing duration of imprisonment. These findings suggest that the lifestyle specific to imprisonment might overcome the prejudicial effect of risk factors such as alcohol, tobacco, or drug abuse that tend to be common among prisoners.

Adolescent↗
PubMed1987

Nicotine dependence and secondary effects of smoking cessation.

The secondary effects of smoking cessation among subjects included in a randomized trial, performed to test the efficacy of acupuncture and nicotine chewing gum vs. the control group, are reported according to nicotine dependence. After 1 month of cessation, ex-smokers had modified their nutritional intake, had gained weight, and felt more irritable compared to subjects still smoking. After 1 year, secondary effects concerned greater weight gain and irritability. The percentage of subjects who presented these secondary effects was more frequent among high-dependent than among low-dependent ex-smokers.

Behavior Therapy↗
PubMed1987

Lung cancer and women: results of a French case-control study.

Ninety-six women with histologically confirmed lung cancer and 192 matched controls were involved in an international case-control study conducted from 1976 to 1980. The aim of this study was an examination of the effects of different smoking habits, especially the type of cigarettes smoked (light or dark tobacco and filter or nonfilter use) on the occurrence of lung cancer in French females. All these patients were either nonsmokers or lifetime cigarette smokers. Matched relative risk (RR) of smokers compared to nonsmokers was found to be increased for both Kreyberg I (RR = 6.6) and Kreyberg II (RR = 2.1) categories; however, this increase was significant (P less than 0.0001) only for Kreyberg I lung cancer. A significant increase (P less than 0.0001) in matched RR was found with early age at first cigarette smoked, daily consumption, duration of smoking, frequency of inhalation, use of dark tobacco and use of nonfilter cigarettes. Matched RR associated with smokers not always using dark tobacco and those smoking only dark tobacco as compared to nonsmokers were significantly increased (trend test P less than 0.0001). On the contrary, the increase of RR was not significant when either daily consumption, or duration of smoking, or age at first cigarette was taken into account. Lung cancer appeared to be associated with daily consumption and use of nonfilter cigarettes in a matched logistic regression.

Adult↗
PubMed1987

[Small cell bronchial cancer: epidemiology].

Small cell lung carcinoma is the most frequent cancer in man. In France, the geographic distribution is not homogenous and the frequency is time-dependent. The main risk factors are smoking and some professional exposures.

Carcinogens, Environmental↗
PubMed1987

[From the explanatory to the pragmatic].

The classical methodology of clinical trials has been conceived for improving scientific knowledge in therapeutic research. This methodology is often unsuitable for evaluating a treatment in clinical practice, i.e. taking into account all its advantages and disadvantages. For that very reason two approaches, explanatory and pragmatic, which differ in many aspects, were developed during the 1970's. This distinction is very useful in the design of a trial, but two main difficulties are related to the assessment criteria and the method of analysis. A possible solution is to use the decision-making procedures but it's still a research problem.

Clinical Trials as Topic↗