To examine the risk of gastric cancer associated with alcohol consumption and smoking in men and women in Moscow, Russia.
A case-control study which includes 448 cases and 610 controls was conducted. Cases consisted of patients with newly diagnosed histologically confirmed gastric cancer. Controls were patients admitted during the study period to the hospital with diagnoses other than cancer and/or gastrointestinal diseases. Information on demographic variables, smoking, alcohol consumption and diet was collected from all subjects. Venous blood was drawn from 361 cases and 441 controls. A serological test for Helicobacter pylori immunoglobulin G was performed.
Alcohol consumption, particularly vodka consumption, was found to increase the risk of gastric cancer. In men the effect of hard liquor drinking was stronger for cancer of the cardia (OR = 3.4, CI = 1.2-10.2), while in women the effect was stronger for cancer of sites other than gastric cardia (OR = 1.5, CI = 1.0-2.3). Smoking increased the risk of developing gastric cancer in men, but not in women. In men a dose-response relationship between mean number of cigarettes smoked per day (p = 0.03), pack-years of cigarettes smoked (p = 0.01) and duration of smoking (p = 0.08) and the risk of cancer of gastric cardia was observed. Further statistical analysis revealed interactions between effect of smoking and alcohol consumption and between smoking and H. pylori infection status.
The findings further support the role of alcohol consumption and smoking in the etiology of gastric cancer.
A case-control study of stomach cancer which includes 448 cases and 610 hospital controls has been conducted in Moscow, Russia. Information on life-style habits, such as smoking, alcohol consumption, diet, medical history and use of different medications including aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) was collected using a self-administered structured questionnaire. Venous blood was drawn from 361 cases and 441 controls. A serological test for Helicobacter pylori immunoglobulin G was performed to detect infected individuals. Use of aspirin and other NSAIDs was associated with protection against cancer of the stomach (OR = 0.60, 95% CI 0.41-0.90). Analysis by subsite revealed that aspirin did not affect the risk of cancer of the gastric cardia but had a protective effect for non-cardia gastric cancer. The OR associated with use of aspirin adjusted for age and education for both sexes combined was 0.49 (95% CI 0.31-0.77). A decrease in relative risk was statistically significant for men (OR = 0.48, 95% CI 0.25-0.92) and women (OR = 0.52, 95% CI 0.28-0.97). Controlling for major risk factors did not attenuate the reduction in risk. The observed associations were also present in individuals who were H. pylori immunoglobulin G-positive. There was no reduction in risk associated with aspirin and/or non-aspirin NSAIDs among non-infected subjects.
Cancer incidence and mortality were evaluated among 4581 aniline dye production workers in Moscow.
A historical cohort was assembled and followed-up from 1 January 1975 to 31 December 1989. Moscow district oncologic dispensary registries furnished case ascertainment and employer records provided job exposure data. Expected cancers and deaths were calculated based on gender-, age-, and calendar time-specific incidence and mortality rates for the Moscow general population applied to the cohort's person-years of follow-up. Disease-specific standardized mortality and incidence values were derived from ratios of observed to expected cancers.
Men experienced elevated total cancer mortality (standardized mortality ratio [SMR] = 125; 95% CI: 110-142) and urinary bladder cancer mortality (SMR = 279; 95% CI: 192-391), and increased all malignancy (standardized incidence ratio [SIR] = 142; 95% CI: 125-160), oesophageal (SIR = 203; 95% CI: 108-347), respiratory tract (SIR = 154; 95% CI: 120-194) and bladder (SIR = 394; 95% CI: 268-559) cancer incidence. Women had elevated oesophageal (SMR = 313; 95% CI: 124-664) and bladder (SMR = 311; 95% CI: 149-571) cancer mortality and elevated all malignancy (SIR = 124; 95% CI: 106-144), oesophageal (SIR = 348; 95% CI: 140-719), and bladder (SIR = 861; 95% CI: 458-8002) cancer incidence. Bladder cancer rate increased with employment duration and younger age first hired. Rate estimates were highest among beta-naphthylamine exposed workers but was also increased among workers with other chemical exposures. A cancer prevention and control effort that limited benzidine exposure to
Comment In: Int J Epidemiol. 1996 Feb;25(1):226-78666499
OBJECTIVES: To study the carcinogenicity of inorganic mercury in humans. METHODS: We studied the mortality from cancer among 6784 male and 265 female workers of four mercury mines and mills in Spain, Slovenia, Italy and the Ukraine. Workers were employed between the beginning of the century and 1990; the follow-up period lasted from the 1950s to the 1990s. We compared the mortality of the workers with national reference rates. RESULTS: Among men, there was no overall excess cancer mortality; an increase was observed in mortality from lung cancer (standardized mortality ratio [SMR] 1.19, 95 percent confidence interval [CI] 1.03-1.38) and liver cancer (SMR 1.64, CI 1.18-2.22). The increase in lung cancer risk was restricted to workers from Slovenia and the Ukraine: no relationship was found with duration of employment or estimated mercu ry exposure. The increase in liver cancer risk was present both among miners and millers and was stronger in workers from Italy and Slovenia: there was a trend with estimated cumulative exposure but not with duration of employment, and the excess was not present in a parallel analysis of cancer incidence among workers from Slovenia. No increase was observed for other types of cancer, including brain and kidney tumours. Among female workers (Ukraine only), three deaths occurred from ovarian cancer, likely representing an excess. CONCLUSIONS: Exposure to inorganic mercury in mines and mills does not seem strongly associated with cancer risk, with the possible exception of liver cancer; the increase in lung cancer may be explained by co-exposure to crystalline silica and radon.
Two retrospective cohort studies were conducted to assess the risk of cancer among workers exposed to chloroprene (2-chloro-1,3-butadiene) (CP). One is a study of incidence and mortality among 2314 production workers employed in the CP production plant in Yerevan, Armenia, between 1940 and 1988. The cohort was followed up for cancer incidence for the years 1979-1990 and for cancer mortality for 1979-1988. The second study is a mortality study among 5185 shoe manufacturing workers in Moscow who used polychloroprene latex and glue. Shoe workers were employed between 1940 and 1976, and followed from 1979 through 1993. The standardized incidence ratios (SIR) and standardized mortality ratios (SMR) were calculated using the Armenian and Moscow population as reference. An internal comparison analysis based on Poisson regression modeling was conducted. In the Yerenan cohort, incidence and mortality from all cancers were below expectation, but increased incidence (SIR, 3.27; 95% confidence interval (CI), 1.47-7.27), and mortality (SMR, 3.39; CI, 1.09-10.5) from liver cancer were noted. A dose-response relationship was suggested between the risk of liver cancer and indices of CP exposure. For the entire Moscow cohort, all-cause mortality was close to expectation and all-cancer mortality was increased. There was an increase in the mortality from liver cancer (SMR, 2.4; CI, 1.1-4.3), kidney cancer (SMR, 1.8; CI, 0.9-3.4), and leukemia (SMR, 1.9; CI, 1.0-3.3). Mortality from liver cancer and leukemia was associated with various indicators of CP exposure. A similar, although less consistent, pattern was found for kidney cancer. The association between CP exposure and risk of leukemia may be due to concomitant exposure to benzene. The results for liver cancer point towards a carcinogenic effect of CP.
A case-control study was conducted in Moscow to assess the effect of diet on risk of breast cancer, and also to study the established reproductive risk factors. A notable finding of the study, which covered 139 case-control pairs matched by age and neighbourhood, is that dietary factors are more important for post-menopausal than for pre-menopausal breast cancer. The decreased risk of post-menopausal breast cancer was associated with high intakes of cellulose (OR 0.04; 95% CI 0.01-0.31), mono- and disaccharides (OR 0.02; 95% CI 0.002-0.27), vitamin C (OR 0.20; 95% CI 0.06-0.70), beta-carotene (OR 0.09; 95% CI 0.02-0.49), and also polyunsaturated fatty acids (OR 0.14; 95% CI 0.03-0.69). High intakes of total fat resulted in a statistically non-significant decrease in the odds ratio (OR 0.52; 95% CI 0.04-6.99), while saturated fats slightly increased the risk of breast cancer (OR 1.67; 95% CI 0.24-11.78). Protein intake was also associated with increased risk of breast cancer (OR 4.62; 95% CI 0.69-30.70). Alcohol use significantly increased the risk of breast cancer in postmenopausal women (OR 3.39; 95% CI 1.37-8.38). In general, the results of our study indicate that high risk of breast cancer is associated with high intakes of nutrients derived from animal products, and low risk with high intake of those from vegetables and fruits.
Two case-control studies of diet and colorectal cancer were conducted in Moscow and Khabarovsk. The Moscow study comprised 100 cases of colorectal cancer and 100 neighbourhood controls. The Khabarovsk study consisted of 117 cases of colorectal cancer and 117 population controls. A history of the usual dietary intake one year prior to interview was taken using a food frequency questionnaire. Effects were adjusted in analysis for energy intake and education. Significantly reduced risks were observed with high intakes of cellulose (P = 0.001), beta-carotene (P = 0.002), vitamin C (P = 0.007), polyunsaturated fatty acids (PUFA) (P = 0.004), cholesterol (P = 0.04), and with a high ratio of PUFA to saturated fatty acids (SFA) (P = 0.002). Significant increases in risk were observed in association with high ratios of intakes of protein to cellulose (P = 0.002) and of fat to cellulose (P = 0.008). High intake of total fat was associated with non-significant decrease in the risk (P = 0.12), while high intake of SFA resulted in statistically non-significant increase in risk (P = 0.40). Significant reductions in risk were associated with high frequencies of consumption of vegetables (P = 0.001) and fruit (P = 0.009). There were results suggestive of a decreased risk with a high frequency of milk consumption (P = 0.06) and an increased risk in association with a ratio of meat to vegetable frequencies (P = 0.09). After adjustment among factors effecting risk of colorectal cancer statistically significant increase in the risk was seen only for protein/cellulose ratio and significant protective effect for PUFA/SFA ratio, beta-carotene and vegetable consumption.
Plasma sex hormone-binding globulin (SHBG), testosterone, total oestradiol (E2) and proportion of E2 not bound to blood proteins (percentage free E2) have been measured in a case-control study to test whether any of these factors are related to the risk of breast cancer. The cases studied were 27 premenopausal and 34 postmenopausal women with newly diagnosed localized breast cancer who were admitted to the All-Union Cancer Research Centre, Moscow. The controls were an equivalent number of women from the same neighbourhood. These were matched for age (within 2 years) and menopausal status. The average levels of E2 in cases were significantly higher than controls (p = 0.004 and p
The association between exposure to ETS and the risk of lung cancer in life-time non-smoking women was investigated by means of a hospital based case-control study in Moscow, Russia. The main importance of our study is that it was conducted on a population with a specific smoking pattern from which no information is available on health effects of ETS. A total of 189 incident cases of histologically confirmed lung cancer were identified in 2 principal cancer treatment hospitals in Moscow. A total of 358 female oncology patients from the same hospitals were selected as controls. The controls matched by the hospitals to the cases were similarly restricted to never-smokers. Women diagnosed with cancer of the upper respiratory organs were ineligible for selection as controls. Personal interviews of cases and controls were conducted in the hospital wards, using a closed-form structured questionnaire. An elevated risk of lung cancer was observed in women whose husbands smoked. The odds ratio (OR) adjusted by age and education for husband's smoking was 1.53 (95% CI, 1.06-2.21). Smoking by other members of the family, by colleague's, or by fathers in the women's childhood do not affect the risk of lung cancer. The risk is higher for women whose husbands smoke "papirosy" (OR 2.12; 95% CI, 1.32-3.40), a special Russian type of cigarettes with a long mouthpiece, and usually very high levels of tar (> 30 mg/cig) and nicotine (> 1.8 mg/cig). Our study suggests that the association between exposure to ETS of the spouse and risk of lung cancer in non-smoking women is somewhat stronger for squamous-cell carcinoma (OR, 1.94; 95% CI, 0.99-3.81) than for adenocarcinoma (OR, 1.52; 95% CI, 0.96-2.39).