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PubMed1995

Second cancers occurring after cancers of the mouth and pharynx: data from three population-based registries in Australia, Scotland and Slovenia.

Data over at least 20 years from three large population-based registries in Europe and Australasia have been used to assess the risk of second primary tumours occurring after a cancer of the mouth or pharynx. These patients have previously been shown in clinical series to be at a particularly high risk of subsequent tumours, while data from cancer registries have shown conflicting results on the magnitude of the risk. In this study, patients were found to have between a 2-fold (Scotland and New South Wales) and 4-fold (Slovenia) increase in risk of a subsequent tumour over that in the population, although the actual risk in each centre was similar (between 2.8 and 3.1 per 100 person years). The risk remained for 10 years after diagnosis of the original tumour and was primarily in the upper aerodigestive tract. The most elevated risks (approximately 10-fold) were for tumours in the oral cavity and oesophagus. These data provide higher estimates of risk than previously reported from European cancer registries for second primary tumours and emphasize the need for close follow-up of patients who may represent an appropriate population in which to assess possible new chemopreventive agents.

Digestive System Neoplasms↗
PubMed1996

[Hospital register for upper aerodigestive tract malignancies in health care in Zamora. A discriptive study].

Incidence of malignant tumours of the upper digestive tract and airway (naso-endooropharynx, hypopharynx, larynx, oral cavity, salivary glands and neck tumours of unknown origin) from 1992 to 1994 in Zamora's Sanitary Area (Virgen de la Concha Hospital) is evaluated. Geographic distribution according to the residence, tumour sitting, age and staging of the growth is exposed. The incidence is estimated at 24.7 cases per 100.000 inhabitants and year (lymphomas excluded). Utility of the cancer register for clinic activity and epidemiological research is stressed.

Adult↗
PubMed1989

Cancer risk in male veterans utilizing the Veterans Administration medical system.

Age-specific incidence curves, cumulative rates, and relative risks were estimated for selected malignancies among male veterans utilizing the Veterans Administration (VA) medical system during 1970 to 1982. Relative risks for malignant tumors of the lung, bronchus, larynx, oral cavity, and esophagus in males using VA hospitals were approximately double the rates for men of the Surveillance, Epidemiology, and End Results (SEER) cancer registry, thereby supporting the existence of strong effects of chronic cigarette smoking and alcohol consumption on the development of neoplasms at these specific anatomic sites. Relative to the SEER male population, there were significant reductions in the cumulative rates of neoplasms of the colon (15%) and extrahepatic biliary tract (30%), no differences in the rates of cancer of the stomach, small intestine, or pancreas, and a 50% increase in the cumulative rate of liver cancer among the veterans. Rates of malignancies of the genitourinary tract were similar in the VA and SEER registries with the exception of cancer of the penis, for which the cumulative rate was 50% higher in the veterans. These results are consistent with an excess of specific risk exposures among male veterans using VA hospitals, viz., cigarette smoking, alcohol consumption, poor nutrition, and other factors related to low socioeconomic status. The ultimate utility of the VA tumor registry will depend upon its exploitation by epidemiologists to provide leads for etiologic research.

Adult↗
PubMed1992

[Use of mortality data for the study of the distribution of respiratory tract tumors in Italy: characteristics and quality of the data].

This paper reviews Italian studies that deal with the accuracy of death certificates in patients with cancers of the respiratory system, particularly cancers of the larynx, lung, and pleura. These studies consider death certificates vs postmortem examinations, diagnoses histologically confirmed, and clinical and cancer registry records. The large number of cases cured by surgery is reflected in the lower levels of larynx cancers mortality vs incidence. Site misclassifications, and erroneous reports of cancer on death certificates for patients cured of the disease, lead to an overreporting of death certification vs autopsies. The death certificates for lung cancer have a high agreement with clinical diagnoses, but present underreporting when compared to autopsies, which frequently discover tumors at postmortem examination. Pleura cancer is often misclassified as lung cancer. Improvement in death certification over time could have influenced the observed increase in the mortality trend for this tumor.

Adult↗
PubMed1976

[Distant metastases in carcinomas of the upper airways and digestive tract (author's transl)].

144 patients with a carcinoma of the upper airways and digestive tract were examined at necropsy in the Institut Bordet, between January 1, 1960 and December 31, 1973. The study shows that 43% of these patients had distant metastases and that among these 2/3 were in local recurrence. Only 1/4 of the metastases had been recognized before death: most of them appearing in the first year following the diagnosis of the primary tumor. Survival of patients with metastases is short, most of them dying within 3 months after metastatic discovery. There seems to be no evident relationship between the initial degree of extension of the tumor and the risk of later metastatic dissemination. In the search for the most frequent metastases, located in the lungs, liver and skeleton, one should use pulmonary laminography and liver tests combined to scanning and laparoscopy.

Basal Cell Carcinoma↗
PubMed1992

[Incidence of respiratory tract system tumors in Italy: data from the Tumor Registry].

Nine population-based cancer Registries are active in Italy, covering about one tenth of the population. Six Registries (Torino, Varese, Trieste, Genova, Parma, and Forlì) are located in the North of Italy, two Registries (Firenze and Latina) in the Center and one (Ragusa) in the South. Incidence data (total number of registered cases; age-specific, age-standardized, truncated, and cumulative rates) and indices of reliability (% of cases with histological verification of diagnosis; % of cases registered only as a result of death certification; and mortality/incidence ratio) are tabulated for the period 1983-87. Respiratory tumors are classified according to the three-digit codes of the International Classification of Diseases, ninth revision: 160, nose and sinuses; 161, larynx; 162, lung; 163, pleura. Standardized incidence rates for lung cancer range between 48.8 x 10,0000 (Ragusa) and 115.3 (Trieste). All the Registries in the North and in the Center show high levels of risk; rates are reduced to half for the two southern Registries. Laryngeal tumors show a similar pattern: the highest rate is observed at Trieste (21.1), and the lowest is for Ragusa (10.1). The risk of primitive pleural cancer is very high for Trieste (6.1) and Genova (5.3), where the shipyard industry is present, and homogeneously low for the other Registries. Frequency of nasal tumor is too low to establish descriptive comparisons. As a whole, for larynx, lung, and pleura, the figures from incidence data confirm those from mortality data.

Death Certificates↗
PubMed1993

Carcinogen biomarkers related to smoking and upper aerodigestive tract cancer.

Smoking is the major cause of upper aerodigestive tract cancers. Among the many constituents of tobacco smoke, polynuclear aromatic hydrocarbons and tobacco-specific nitrosamines are strongly implicated as causative factors for these cancers. The probability that these compounds will induce cancer in a given individual will depend on that person's ability to metabolically activate or detoxify them. Chronic production of DNA damage by these metabolically activated carcinogens is consistent with current concepts of carcinogenesis in which multiple genetic changes, such as activation of oncogenes or inactivation of tumor suppressor genes, appear to be critical. Chemopreventive agents which decrease the level of DNA damage should therefore decrease the risk for cancer. Biomarkers such as carcinogen-DNA adducts, carcinogen-hemoglobin adducts, and urinary metabolites of carcinogens will indicate the amount of metabolically activated carcinogen which may damage DNA in an individual and can therefore be used as an index of risk. Selected biomarkers are discussed in this paper. These biomarkers of internal dose have great potential for application in chemoprevention trials.

Animals↗
PubMed1985

Second cancer following cancer of the respiratory system in Connecticut, 1935-1982.

The risk of a person developing a second primary cancer was evaluated in approximately 30,000 persons who developed cancer of the respiratory system in Connecticut between 1935 and 1982. A significant 44% excess of all second cancers was observed following cancer of the lung (614 observed vs. 426 expected). The excess of second tumors was 72% following cancer of the larynx (541 vs. 314) and 34% following cancer of the nasal cavities and sinuses (43 vs. 32). For cancers of the lung and larynx, second cancers arose mainly along the respiratory tract or other sites associated with cigarette smoking (oral cavity, bladder, kidney). A threefold excess of esophageal cancer followed cancer of the larynx, which was indicative of risk factors in common (alcohol and tobacco) and possibly an effect of radiotherapy. Radiotherapy may have contributed also to the increased risk of second lung and breast cancers. A slight excess risk of leukemia after lung cancer points to a possible effect of chemotherapy given for certain histologic types. An unexpected finding was a significant 50% increased risk of colon cancer following cancer of the larynx. Significant excesses of prostate cancer are probably artifacts associated with increased medical surveillance and higher autopsy rates among cancer patients than in the general population. No deficits of any second cancers were observed. The risk of a second cancer developing did not appear to vary by sex or time since initial diagnosis, except that the risks following cancer of the nasal cavities and sinuses returned to normal levels among long-term survivors. Among persons observed for 10 or more years after their initial diagnosis of cancers of the lung or larynx, the risk of developing a second cancer remained high, i.e., on the order of 50% above expectation. Further analytic studies should clarify the role of smoking, alcohol, other life-style and host factors, and various forms of therapy on the risk of second cancers following cancer of the respiratory system.

Connecticut↗
PubMed1987

Papillomaviruses in human cancer.

Twelve types of human papillomaviruses (HPV) have been isolated thus far from papillomatous and Bowenoid lesions of the human genital tract. Four type, HPV 6, 11, 16 and 18 are most frequently found. HPV 6 and 11 cause the typical genital warts (condylomata acuminata) and mild dysplastic lesions of the cervix characterized by a high degree of koilocytotic atypia. HPV 16 and 18 are preferentially found in Bowenoid papulosis and Bowen's disease at external genital sites. Moderate and severe cervical dysplasias with little or no koilocytosis appear to be common manifestations of these infections at cervical sites. HPV 16 is found in approximately 50% of all cervical, penile and vulvar cancers, HPV 18 in close to 20%. The majority of the remaining tumors reveals evidence for infections with additional types of HPV. Several cell lines have been identified containing either HPV 18 or HPV 16 genomes. The state of viral DNA in Bowenoid precursor lesions differs from that of cervical carcinomas. The former contain episomal DNA whereas integration seems to be a regular event in carcinomas. Integration regularly affects the E1-E2 open reading frames of HPV 16 or HPV 18 DNA. Fusion transcripts from the integrated HPV DNA (E6-E7 region) and adjacent host cell DNA have been documented. The available data support a causative role of specific HPV infections in the etiology of human genital cancer.

Anus Neoplasms↗
PubMed1999

Cancer in California school employees, 1988-1992.

BACKGROUND: Periodic concerns about excesses of cancer among teachers in California schools prompted our examination of cancer incidence in California school employees. METHODS: Records of school employees between 1987-1992 were linked to the California Cancer Registry of incident cases diagnosed 1988-1992. Sex-, race-, and age-adjusted standardized incidence ratios were calculated for specific cancer sites. Analyses stratified by sex, race/ethnicity, and job assignment were also performed. RESULTS: Melanoma of the skin, thyroid cancer, prostate cancer, and female cancers of the breast, uterus, and ovary all occurred more frequently than expected in these school employees. In contrast, cancers of the respiratory system, oral cavity, digestive system, urinary system, and uterine cervix occurred less frequently. CONCLUSIONS: The incidence of cancers thought to be related to hormones and/or higher socioeconomic status appeared elevated while cancers often linked to smoking and/or alcohol intake occurred less frequently in this large cohort of professional school employees.

Adult↗
PubMed1980

The changing prevalence of secondary cardiac neoplasms as related to cancer therapy.

A 25-year-review of 1303 autopsies with metastatic non-reticuloendothelial and non-central nervous system malignancies revealed secondary cardiac neoplasms in 179 cases (14%). When the autopsies were divided into two groups by time period, a significant increased prevalence of secondary cardiac neoplasms was demonstrated during the later period (1966-1977). This noted increase was not influenced by chemotherapy but was apparently related to attempted curative surgical and/or radiation therapy.

Female↗
PubMed1980

Causes of death in breast cancer: a clinicopathologic study.

Between January 1973 and October 1977, 166 patients who died of breast cancer were autopsied. The examination revealed consistently more tumor involvement than had been clinically suspected. Unsuspected areas of tumor involvement included the endocrine organs (40%), lungs (28%), cardiovascular system (21%), and the genitourinary system (21%). The error in diagnosis was smaller with metastasis to the bones (10%) and central nervous system (14%). The major causes of death included pulmonary insufficiency (26%), infection (24%), cardiac disease (15%), hepatic insufficiency (14%), hemorrhage (9%), central nervous system disease (9%), and hypercalcemia (3%). The most common cause of death was metastatic disease to various organs, accounting for 42% of all deaths. Infection was the second most common cause of death; however, only 27% of the patients with infection had significant neutropenia. In patients dying of hemorrhage, only 9% were thrombocytopenic. In conclusion, although many clinicians have expressed concern that chemotherapy would add to early mortality in cancer, our study shows that this is not the case for patients with breast cancer. Deaths due to chemotherapy were rare and the rise in the infection rate did not correlate with the advent of chemotherapy.

Adenocarcinoma↗