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R W Clapp

Publications and source records attributed to R W Clapp.

31 records · Page 2Linked to original sources
PubMed1992

The reliability of self-reported alcohol consumption in the remote past.

We examined the reliability of self-reported alcohol consumption in past age periods of women's lives. As part of a case-control study of breast cancer conducted in Massachusetts and Wisconsin in 1988-1991, the same questionnaire was administered for a second time to 211 controls (mean age = 54 years) after an interval of 6-12 months. The Spearman correlation coefficients between the average number of grams of alcohol consumed daily reported in the two interviews, by age period of consumption, were: 16-19 years, r = 0.81; 20-29 years, r = 0.84; 30-39 years, r = 0.75; and for recent consumption, r = 0.77. Self-reported alcohol consumption throughout adult life was reported with precision sufficient to make the ranking of subjects' intake consistent between interviews.

Adult↗
PubMed1991

Systematic underreporting of cutaneous malignant melanoma in Massachusetts. Possible implications for national incidence figures.

An independent tabulation of incidence of cutaneous malignant melanoma in Massachusetts indicates that 12% and perhaps as many as 19% of new cases of cutaneous malignant melanoma in Massachusetts are not recorded in the Massachusetts Cancer Registry, significantly more than the expected 5% (p = 0.0001). The increasing number of nonhospital medical settings in which melanomas can be diagnosed and/or treated appears to account for this discrepancy. We suspect that these findings in Massachusetts also apply to cancer reporting systems in other regions of the United States. We suggest that the true incidence of cutaneous malignant melanoma in Massachusetts, and perhaps in the United States, may be significantly higher than reported.

Humans↗
PubMed1991

Cancer surveillance of Veterans in Massachusetts, USA, 1982-1988.

This surveillance study is a follow-up to previous findings of elevated soft tissue sarcoma mortality in Massachusetts Vietnam veterans compared to other veterans. The roster of veterans was compiled from Massachusetts residents who received a state bonus for military service in the period 1958-1973. This computerized list was linked to the central files of the Massachusetts Cancer Registry and cases diagnosed between 1982 and 1988 were identified. Odds ratios (ORs) for several cancer sites were computed; only that for soft tissue sarcoma incidence was significantly elevated in Vietnam veterans compared to other veterans (OR = 3.08; 95% confidence interval: (CI) 1.07-8.73). Kaposi's sarcoma cases who were also AIDS patients were excluded from the analysis. Non-Hodgkin's lymphoma was also investigated but was not significantly elevated in these surveillance data. Sources of bias are discussed and recommendations for continued surveillance and follow-up studies are made.

Adult↗
PubMed1989

Associations between smoking status and stage of colorectal cancer at diagnosis in Massachusetts between 1982 and 1987.

To examine the relationship between smoking and stage of colorectal cancer at diagnosis, data on 2788 current smokers and 6313 nonsmokers with known stage at diagnosis were obtained from the Massachusetts Cancer Registry. The stage at diagnosis was treated as a polytomous response variable in a logit-type, log-linear (Poisson) model, with smoking status, age, sex, and race as covariates. The relative frequency of disseminated colorectal cancer was 45% greater in smokers, compared with nonsmokers (relative risk [RR] = 1.45; 95% confidence interval, 1.00 to 2.09). A substudy was conducted to determine the accuracy of the registry's smoking data; the findings suggest that the actual association may be larger than that presented above. These results confirm the presence of an association between smoking and advanced stage of colorectal cancer at diagnosis. Whether the association is due to a biologic or behavioral phenomenon cannot be determined from these data.

Aged↗
PubMed1989

The increasing frequency of adenocarcinoma of the esophagus.

Adenocarcinoma of the esophagus has been considered an uncommon tumor, accounting for fewer than 8% of all cases of esophageal cancer. To determine the current frequency of adenocarcinoma of the esophagus, we reviewed data from the tumor registries of the Commonwealth of Massachusetts, the University Hospital (UH), and the Boston VA Medical Center (BVAMC). From 1982 to 1984, 868 esophageal cancers were reported in Massachusetts, of which 231 (27%) were adenocarcinomas. In comparison with squamous cell carcinomas of the esophagus, esophageal adenocarcinomas occurred more frequently in males (P less than 0.01) and were uncommon among blacks (P less than 0.01). From 1980 to 1986, 262 cases of esophageal cancer were seen at the UH and the BVAMC, of which 81 (31%) were adenocarcinomas. An analysis of the latter group to identify true esophageal adenocarcinomas (tumors confined to the esophagus without gastric involvement) yielded 47 cases. Thus, true esophageal adenocarcinoma accounted for 18% of esophageal malignancies at our hospitals, a frequency threefold to fivefold higher than that found in four prior studies that used comparable anatomic diagnostic criteria. We conclude that adenocarcinoma of the esophagus is now being recognized at a substantially higher frequency than reported in the past.

Adenocarcinoma↗
PubMed1988

Soft tissue sarcoma mortality among Vietnam veterans in Massachusetts, 1972 to 1983.

Information from death certificates and veterans' bonuses identified 840 Vietnam veterans and 2515 Vietnam-era veterans who died in Massachusetts during 1972-1983. Causes of death among Vietnam veterans were compared to Vietnam-era veterans and other male decedents. Standardized PMRs and MORs were both elevated for soft tissue sarcoma compared to Vietnam-era veterans [sPMR = 880, sMOR = 5.16, 95% Cl = (2.4, 11.1)], as well as non-veteran males.

Adult↗
PubMed1981

Choosing populations to study the health effects of low-dose ionizing radiation.

In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgment, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public.

Adult↗
PubMedDate not supplied

Use of health services before the diagnosis of melanoma: implications for early detection and screening.

OBJECTIVE: To determine whether persons with melanoma were integrated into the health care system prior to diagnosis. DESIGN: Population-based survey by mailed questionnaire. PATIENTS/PARTICIPANTS: 216 persons with malignant melanoma diagnosed in Massachusetts in 1986. MAIN RESULTS: Of the 216 cases, 87% stated that they had regular physicians, 63% had seen those physicians in the year prior to diagnosis, but only 20% had regular dermatologists. Overall, only 24% had examined their own skin prior to diagnosis and 20% reported physician skin examinations. CONCLUSIONS: Persons diagnosed with melanoma reported extensive contact with regular physicians in the year prior to diagnosis. However, most of these persons neither received skin examinations nor examined their own skin during that time. While additional study is necessary to confirm these findings, the authors suggest that physicians caring for patients at risk for melanoma integrate melanoma screening into routine care.

Adult↗