The present study aimed at exploring the relations between body mass index (BMI) and stature and testicular cancer in a huge Norwegian cohort with measured height and weight. Height and weight were measured in 600,000 Norwegian men aged 14–44 years during 1963–2001. Results from parts of the study cohort have been reported previously. During follow-up, 1,357 testicular cancers were registered. Relative risks (RRs) of testicular cancer were estimated using Cox proportional hazards regression. The risk of testicular cancer decreased with adult BMI. Compared with men with normal BMI, overweight and obese men had a relative risk of cancer of 0.89 (95% CI: 0.77–1.03) and 0.83 (95% CI: 0.58–1.17). The relative risk of testicular cancer per unit increase in BMI was 0.97 (95% CI: 0.95–1.00). The risk of testicular cancer was not associated with adolescent BMI. A moderate increase in risk of seminomas was seen with increasing adult height. Compared with men with height 170–79 cm, men with height 180 cm and above had a relative risk of 1.17 (95% CI: 1.00–1.37).

Objective

Genetic polymorphisms that modify the detoxifying activity of glutathione S-transferases (GSTs) can affect the level of carcinogenic metabolites created by endogenous steroid hormones and exogenous chemical substances. Although the GSTM1 null genotype has been shown to increase prostate cancer mortality in Caucasians, potential associations between GST polymorphisms and prostate cancer biochemical recurrence (BCR) have not been well studied, particularly in African-Americans.

Methods

We examined potential associations between the GSTM1 null, GSTT1 null and GSTP1 Ile105Val polymorphisms and BCR, after prostatectomy, in 168 African-American and 226 Caucasian patients treated at Henry Ford Hospital in Detroit, Michigan using Cox proportional hazards modeling.

Results

We found that African-Americans with the GSTT1 null genotype had increased BCR risk compared to those having GSTT1 present (hazard ratio (HR) = 2.30; 95% CI = 1.01–5.18; p = 0.04); and African-Americans with the GSTT1 null genotype and high grade tumors had an even greater risk (HR = 7.82; 95% CI = 2.49–24.50; p < 0.001). In Caucasians, an increased risk was observed in those patients with high grade tumors and the GSTM1 null genotype (HR = 2.88; 95% CI = 1.16–7.14; p = 0.02). Similar associations were observed for advanced stage and more aggressive (high grade or advanced stage) disease.

Conclusion

Our results suggest GSTs may hold promise as therapeutic targets in more advanced prostate cancers, particularly, in African-Americans.

Despite the policy and research attention on ensuring equitable access—equal access for equal need—to health care, research continues to identify inequities in access to cancer services. We conducted a literature review to identify the current state of knowledge about inequity in access to cancer health services in Canada in terms of the continuum of care, disease sites, and dimensions of inequity (e.g., income). We searched MEDLINE, CINAHL, and Embase for studies published between 1990 and 2009. We retrieved 51 studies, which examine inequity in access to cancer services from screening to end-of-life care, for multiple cancer types, and a variety of socioeconomic, geographic, and demographic factors that may cause concern for inequity in Canada. This review demonstrates that income has the most consistent influence on inequity in access to screening, while age and geography are most influential for treatment services and end-of-life care, even after adjusting for patient need. Our review also reports on methods used in the literature and new techniques to explore. Equitable access to cancer care is vitally important in all health systems. Obtaining information on the current status of inequities in access to cancer care is a critical first step toward action.

Purpose

To study the association between occupational exposure to metals including chromium, cadmium, nickel, and arsenic compounds, within a population-based study design, while adjusting for confounding factors.

Methods

A population-based lung cancer case–control study in Central/Eastern Europe and UK was conducted in 1998–2003, including 2,853 cases and 3,104 controls. Exposure to 70 occupational agents was assessed by local expert-teams for all subjects. Odds ratios (OR) for exposure to dust and fumes/mist of chromium, nickel, cadmium, arsenic, as well as inorganic pigment dust and inorganic acid mist, were adjusting for smoking, age, center, sex, and exposure to other occupational agents including the metals under study.

Results

Exposure to arsenic (prevalence = 1.4%) was associated with an increased lung cancer risk ((OR) 1.65, 95% confidence interval (95% CI):1.05–2.58). For chromium dust (prevalence = 4.8%, OR: 1.25, 95% CI: 0.95–1.65), a linear upward trend for duration and cumulative exposure was observed. A weak association was observed for exposure to cadmium fumes (prevalence = 1.8%, OR: 1.19, 95% CI: 0.77–1.82), which was strongest for the highest category of cumulative exposure (OR: 2.04, 95% CI: 1.07–3.90). No increased risk was observed for inorganic acid mist, inorganic pigment dust, or nickel, after adjustment for other metals. An independent effect of nickel cannot be excluded, due to its collinearity with chromium exposure.

Conclusions

Occupational exposure to metals is an important risk factor for lung cancer. Although the strongest risk was observed for arsenic, exposure to chromium dust was most important in terms of attributable risk due to its high prevalence.

Objective

This study examined the association between pre-conception and in utero maternal medical radiation exposure and Wilms tumor, using data from a large population-based case–control study.

Methods

Cases were identified from the National Wilms Tumor Study Group. Controls were identified by random digit dialing and frequency matched to child’s age and geographic area of residence in the United States and Canada. Interview data from 512 cases and 509 controls were analyzed using multivariable logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) for Wilms tumor and exposure to: (1) maternal X-ray alone and; (2) all medical radiation types (X-ray, CT, RT, Nuclear scans, Fluoroscopy) combined, for the period from two years before conception until child birth were estimated after adjustment for age, geographic area, maternal education, and household income.

Results

We found no consistent association between the risk of Wilms tumor and either maternal X-ray exposure (OR 0.9, 95% CI 0.7–1.3) or all medical radiation types combined (OR 0.9, 95% CI 0.7–1.2). No meaningful associations were seen for analysis of gonadal or non-gonadal radiation exposure.

Conclusion

Our study did not find any consistent pattern of association between Wilms tumor and maternal radiation exposure during pre-pregnancy or pregnancy period. In view of the negative findings from the largest case control study of this question to date, the reduced doses of biological radiation during pregnancy, and the requirements for an improved study design, we believe that future studies of this exposure may not be a priority for research on Wilms tumor.

Purpose

Exceptionally high incidence rates of thyroid cancer have been observed in New Caledonia, particularly in Melanesian women, but familial aggregation of thyroid diseases in this population is unknown. We study the association between family history of malignant or benign thyroid diseases and non-medullary thyroid cancer in this country.

Methods

We conducted a population-based case–control study including 332 cases with papillary or follicular carcinoma diagnosed in 1993–1999 and 412 controls, matched by sex and 5-year age-group.

Results

Thyroid cancer was associated with a history of thyroid cancer in first-degree relatives (odds ratio (OR), 3.2; 95 % CI, 1.6–6.2) and with a family history of multinodular goiter (OR, 3.6; 95 % CI, 1.9–7.0). The ORs did not change by age at diagnosis and with the number of affected relatives. The study provides evidence that the familial component of thyroid cancer is particularly strong in men. Thyroid cancer was not associated with a family history of thyroid diseases in Melanesians from the Loyalty Islands, the area with the highest incidence rates for thyroid cancer, possibly indicating a high frequency of genetic susceptibility variants and lack of genetic variation in this population subgroup.

Conclusion

Overall our findings confirm an elevated risk of thyroid cancer in individuals with a family history of malignant or benign thyroid diseases, particularly in Melanesians where familial aggregation of thyroid cancer had never been investigated before. The study of genetic variants in candidate susceptibility genes for thyroid cancer may help clarifying the absence of an association in the subgroup of Melanesians from the Loyalty Islands.

Objective: Only a few consistent findings on individual foods or nutrients that influence breast cancer risk have emerged thus far. Since people do not consume individual foods but certain combinations of them, the analysis of dietary patterns may offer an additional aspect for assessing associations between diet and diseases such as breast cancer. It is also important to examine whether the relationships between dietary patterns and breast cancer risk are consistent across populations.

Methods: We examined the risk of breast cancer with two dietary patterns, identified as “Vegetables” (VEG) and “Pork, Processed Meat, Potatoes” (PPP), common to all cohorts of the DIETSCAN project. During 7 to 13 years of follow-up, three of the cohorts – the Netherlands Cohort Study on diet and cancer (NLCS), the Swedish Mammography Cohort (SMC), and the Ormoni e Dieta nella Eziologia dei Tumori (Italy-ORDET) – provided data on 3271 breast cancer cases with complete information on their baseline diet measured by a validated food frequency questionnaire.

Results: After adjustment for potential confounders, VEG was not associated with the risk of breast cancer across all cohorts. PPP was also not associated with the risk of breast cancer in SMC and ORDET, but a high PPP score tended to be inversely associated with breast cancer in the NLCS study (RR  = 0.69; 95% CI, 0.52–0.92, highest versus lowest quartile). PPP differed in one aspect between the cohorts: butter loaded positively on the pattern in all cohorts except NLCS, in which butter loaded negatively and appeared to be substituted by low-fat margarine loading positively.

Conclusion: In general, the dietary patterns showed consistent results across the three cohorts except for the possible protective effect of PPP in the NLCS cohort, which could be explained by a difference in that pattern for NLCS. The results supported the suggestion derived from traditional epidemiology that relatively recent diet may not have an important role in the etiology of breast cancer.

Background

Little is known about correlates of first-trimester pregnancy hormones as in most studies maternal hormones have been measured later in gestation. We examined the associations of maternal characteristics and child sex with first-trimester maternal concentrations of four hormones implicated in breast cancer: human chorionic gonadotropin (hCG), α-fetoprotein (AFP), insulin-like growth factor (IGF)-I, and IGF-II.

Methods

About 338 serum samples donated to the Northern Sweden Maternity Cohort (NSMC), 1975–2001, during the first trimester of uncomplicated pregnancies, were analyzed for the hormones of interest as a part of a case–control study. The associations of maternal characteristics and child sex with hormone concentrations were investigated by correlation, general linear regression, and multivariate regression models.

Results

In the first trimester, greater maternal age was inversely correlated with IGF-I and IGF-II. In comparison with women carrying their first child, already parous women had higher IGF-I but lower hCG. Greater maternal weight and smoking were inversely correlated with hCG. No differences in hormone levels by child sex were observed.

Conclusions

Our analyses indicated that potentially modifiable maternal characteristics (maternal weight and smoking) influence first-trimester pregnancy maternal hormone concentrations.

A computer-aided search identified 16 case-control studies which specifically assessed sunburn as a risk factor for cutaneous malignant melanoma. Using unadjusted estimates, a history of sunburn was associated with significantly increased risk of melanoma in all but one study. Four studies were defined as core studies after assessment of study quality; however, only two of these had sufficiently similar definitions of sunburn to allow pooling of results. Using pooled data, the risk of melanoma in those ever sunburned was 2.0 (95 percent confidence interval [CI]=1.6–2.6), while the highest category of sunburn exposure had a risk of 3.7 (CI=2.5–5.4). The suggestion that sunburns in childhood carry greater risk of melanoma cannot be supported by pooled analysis. This review demonstrated considerable variation in design and method among the studies, and identified sources of bias which prevented a pooled analysis using all available data. The need for strong epidemiologic evidence relating sunburn to melanoma, particularly in childhood, is of prime importance, since avoidance of sunburn is one of the few potential means of primary prevention of melanoma.

Objective

Inflammation plays an important role in lung carcinogenesis. Epidemiologic studies have reported inverse associations of non-steroidal anti-inflammatory drug (NSAID) use and lung cancer risk. Previously, we found that ever use of glucosamine and chondroitin, which have anti-inflammatory properties, were inversely associated with lung cancer risk. After an additional year of follow-up, we further examined the association including frequency/duration of use, interaction with factors associated with inflammation, and lung cancer histology.

Methods

Participants were members of the VITamins And Lifestyle cohort. Adults, aged 50–76 years, who were residents of western Washington State, completed a baseline questionnaire in 2000–2002 (n = 76,904). Participants were queried on their use of glucosamine and chondroitin, over the 10 years prior to baseline, and categorized as nonuser, low use <4 days/week or <3 years, or high use ≥4 days/week and ≥3 years. Lung cancer cases (n = 808) were ascertained through linkage to the Surveillance, Epidemiology, and End Results cancer registry.

Results

High 10-year use of glucosamine [hazard ratio (HR), 0.77; 95% CI: 0.56–1.07; p trend = 0.04] but not chondroitin was associated with a reduction in lung cancer risk. The association with glucosamine was limited to adenocarcinoma (HR, 0.49; 95% CI: 0.27–0.90; p trend <0.01) and was not modified by NSAID use or smoking status.

Conclusions

Our results for glucosamine use are similar to the prior human studies of NSAID use and lung cancer, both in magnitude and the limitation of the association to adenocarcinoma. Unlike NSAIDs, glucosamine has no known adverse effects. Although confirmatory studies are needed, glucosamine is an attractive candidate for lung cancer chemoprevention.