Conflicting data exist on the changes in the incidence of oesophageal (EAC) and oesophagogastric junction adenocarcinoma (EGJAC). In addition, risk factors of the disease are only partly known. The aim of the study was to evaluate the incidence of EAC and EGJAC in Finland as well as risk factors of these cancers.
The complete number of new EAC and EGJAC cases between January 1980 and December 2007 in Finland was provided by the Finnish Cancer Registry. All treated EAC and EGJAC patients in the Pirkanmaa Hospital District between January 1980 and December 2007 were included in the study.
The incidence of EAC increased significantly in Finland. Barrett's oesophagus (BE) was associated with the risk of EAC and cholecystectomy with the risk of EGJAC.
A significant increase in EAC was found in Finland over the course of nearly 30 years, indicating that the increase in EAC in Finland is existent in the long term. BE was associated with the risk of EAC and cholecystectomy with the risk of EGJAC.
BACKGROUND: Effective screening programs have contributed to a decrease in the incidence of cervical squamous cell carcinomas but have had a limited sensitivity in the detection of adenocarcinoma precursor lesions. The aim of our study was to analyze cervical adenocarcinoma in greater detail: symptoms preceding the detection, the method of detection and the prevalence of human papillomavirus (HPV) with respect to age at diagnosis. MATERIAL AND METHODS: Clinical data were abstracted from the medical records of 82 women with pure invasive cervical adenocarcinomas. As diagnostic tools we used polymerase chain reaction (PCR)-based single-strand conformation polymorphism (SSCP) and/or direct DNA sequencing for HPV detection. RESULTS: Age at diagnosis predicting factors were HPV status, positive lymph nodes, histology and stage. HPV-negativity, lymph node metastases, advanced stage and poor differentiation were all associated with a high diagnostic age. In the multivariate analysis only HPV status was shown to have an independent impact on age at diagnosis, while stage showed only borderline significance. Twenty-three percent of the cancers were detected by screening and the remaining were due to different symptoms. Among the women considered, 93% had a normal Papanicolaou (Pap) smear 3 years before diagnosis and 60% within 1 year. There was no significant correlation between smoking, oral contraceptives and HPV-positivity. CONCLUSIONS: The absence of HPV was significantly associated with a high age at diagnosis. Pap screening had a limited effect in detecting adenocarcinoma at an early stage.
BACKGROUND: The reasons for the increasing incidence of and strong male predominance in patients with oesophageal and cardia adenocarcinoma remain unclear. The authors hypothesised that airborne occupational exposures in male dominated industries might contribute. METHODS: In a nationwide Swedish population based case control study, 189 and 262 cases of oesophageal and cardia adenocarcinoma respectively, 167 cases of oesophageal squamous cell carcinoma, and 820 frequency matched controls underwent personal interviews. Based on each study participant's lifetime occupational history the authors assessed cumulative airborne occupational exposure for 10 agents, analysed individually and combined, by a deterministic additive model including probability, frequency, and intensity. Furthermore, occupations and industries of longest duration were analysed. Relative risks were estimated by odds ratios (OR), with 95% confidence intervals (CI), using conditional logistic regression, adjusted for potential confounders. RESULTS: Tendencies of positive associations were found between high exposure to pesticides and risk of oesophageal (OR 2.3 (95% CI 0.9 to 5.7)) and cardia adenocarcinoma (OR 2.1 (95% CI 1.0 to 4.6)). Among workers highly exposed to particular agents, a tendency of an increased risk of oesophageal squamous cell carcinoma was found. There was a twofold increased risk of oesophageal squamous cell carcinoma among concrete and construction workers (OR 2.2 (95% CI 1.1 to 4.2)) and a nearly fourfold increased risk of cardia adenocarcinoma among workers within the motor vehicle industry (OR 3.9 (95% CI 1.5 to 10.4)). An increased risk of oesophageal squamous cell carcinoma (OR 3.9 (95% CI 1.2 to 12.5)), and a tendency of an increased risk of cardia adenocarcinoma (OR 2.8 (95% CI 0.9 to 8.5)), were identified among hotel and restaurant workers. CONCLUSIONS: Specific airborne occupational exposures do not seem to be of major importance in the aetiology of oesophageal or cardia adenocarcinoma and are unlikely to contribute to the increasing incidence or the male predominance.
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.
Several epidemiological studies have been published regarding the risk of Crohn's disease- associated colorectal cancer. The findings are, however, contradictory and it has been particularly difficult to obtain indisputable information on the incidence of cancer limited to the rectum and the anus. During 1987-2000 rectal or anal cancer was diagnosed in 335 patients in Sweden (153 males, 182 females). In other words, approximately 3 Crohn patients per million inhabitants were diagnosed with rectal or anal cancer every year during that time period which is 1% of the total number of cases. At diagnosis of cancer 36% were aged below 50 years and 58% below 60 years. Corresponding figures for all cases of anal and rectal cancer were 5% and 18%, respectively. Present knowledge from the literature implies that there is an increased risk of rectal and anal cancer only in Crohn's disease patients with severe proctitis or severe chronic perianal disease. However, the rectal remnant must also be considered a risk factor. Multimodal treatment is similar to that in sporadic cancer but proctectomy and total or partial colectomy is added depending on the extent of the Crohn's disease. The outcome is the same as in sporadic cancer at a corresponding stage but the prognosis is often poor due to the advanced stage of cancer at diagnosis. We suggest that six high-risk groups should be recommended annual surveillance after a duration of Crohn's disease of 15 years including extensive colitis, chronic severe anorectal disease, rectal remnant, strictures, bypassed segments and sclerosing cholangitis.
Body height and weight in relation to breast cancer in women younger than 45 years were investigated in a case-control study in Sweden and Norway. The study included 317 Swedish and 105 Norwegian cases diagnosed in 1984-85 with 317 Swedish and 210 Norwegian age-matched population controls. Neither height nor body size, measured as body mass index, was associated with breast cancer. Change in body mass from the age of 20 years to 18 months before the time of diagnosis (cases) or interview (controls) had no effect on breast cancer risk. The study provides no evidence that anthropometric measures are risk factors for breast cancer in young women, indicating that the postulated inverse relationship between body mass index and pre-menopausal breast cancer could be limited to peri-menopausal women.
A case-control study of male-female differences in cigarette smoking and lung cancer was conducted during 1981-1985 in Toronto, St. Catharine's, and Niagara Falls, Ontario, Canada. In total, 442 female and 403 male histologically verified cancer cases were individually matched by age and area of residence to each other and to 410 female and 362 male randomly selected population controls. Subjects were interviewed concerning their exposures to various life-style factors, and in particular, they received detailed questioning regarding their lifelong histories of usage of tobacco products. It was found that, for both sexes, a greatly elevated risk of developing lung cancer was associated with cigarette consumption, increasing with pack-years of cigarettes smoked and declining with duration of time since quitting smoking. Furthermore, the association was significantly (p = 0.010) and appreciably stronger for females than for males. At a history of 40 pack-years relative to lifelong nonsmoking, the odds ratio for women was 27.9 (95% confidence interval (CI) 14.9-52.0) and that for men was 9.60 (95% CI 5.64-16.3). Higher odds ratios for females were also seen within each of the major histologic groupings. Thus, the higher elevated risk of lung cancer currently observed in other studies for female ever smokers compared with male ever smokers, while possibly attributable in part to greater smoking cessation among males, may be due to higher susceptibility among females.
Firefighters are potentially exposed to a wide range of known and suspected carcinogens through their work. The objectives of this study were to examine the patterns of cancer among Nordic firefighters, and to compare them with the results from previous studies.
Data for this study were drawn from a linkage between the census data for 15 million people from the five Nordic countries and their cancer registries for the period 1961-2005. SIR analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates.
A total of 16 422 male firefighters were included in the final cohort. A moderate excess risk was seen for all cancer sites combined, (SIR=1.06, 95% CI 1.02 to 1.11). There were statistically significant excesses in the age category of 30-49 years in prostate cancer (SIR=2.59, 95% CI 1.34 to 4.52) and skin melanoma (SIR=1.62, 95% CI 1.14 to 2.23), while there was almost no excess in the older ages. By contrast, an increased risk, mainly in ages of 70 years and higher, was observed for non-melanoma skin cancer (SIR=1.40, 95% CI 1.10 to 1.76), multiple myeloma (SIR=1.69, 95% CI 1.08 to 2.51), adenocarcinoma of the lung (SIR=1.90, 95% CI 1.34 to 2.62), and mesothelioma (SIR=2.59, 95% CI 1.24 to 4.77). By contrast with earlier studies, the incidence of testicular cancer was decreased (SIR=0.51, 95% CI 0.23 to 0.98).
Some of these associations have been observed previously, and potential exposure to polycyclic aromatic hydrocarbons, asbestos and shift work involving disruption of circadian rhythms may partly explain these results.
Comment In: Occup Environ Med. 2014 Aug;71(8):525-624996680
In a cohort of 254,417 male Swedish farmers (4,330,717 person-years) the incidence of cancer of the respiratory organs was compared to a reference cohort of 1,725,845 men (30,131,664 person-years) employed in other economic activities than agriculture or forestry. In the study cohort 1450 cases of cancer in the respiratory organs were found in 1961 to 1979 resulting in an estimated relative risk (RR) of 0.38 (95% confidence interval [CI]: 0.36-0.40). For cancer of trachea, bronchus and lung, the decreased risk was equal for adenocarcinoma and squamous cell carcinoma. No time related trend in RR for any of the histologic subtypes could be seen. However, for squamous cell carcinoma in nose and nasal sinuses RR has increased from 0.42 (95% CI: 0.20-0.80) in 1961 to 1966 to 2.06 (95% CI: 1.22-3.50) in 1974 to 1979.