Uterine cervical carcinoma in Connecticut, 1935-1973: evidence for two classes of invasive disease.

The Connecticut Tumor Registry recorded 5,781 women with carcinoma in situ (CIS) and 7,614 with invasive cervical cancer from 1935 to 1973. True incidence rates for invasive disease were calculated. CIS rates indicated newly diagnosed cases, but true CIS incidence is unknown. Starting in 1945-49, the incidence of invasive cervical declined about 20% in Connecticut before CIS screening could have influenced the disease to that extent. Continuing declines in invasive disease rates after 1955 in Connecticut were probably attributable largely to screening. The persistent occurrence of invasive disease in screened populations and the rapid progression of cancer, with early death among some women with apparently localized disease at diagnosis, suggested that a second class of invasive cervical cancer may exist. Cancers in this class may develop and progress rapidly without a practical possibility of detection in the premalignant stage by cytologic methods. Other screening methods, e.g., metabolic, hormonal, immunologic, or virologic, may be required to control this disease.

Cancer incidence among cosmetologists.

This cohort study examined cancer incidence in 13,650 Connecticut cosmetologists who had held licenses for 5 years or more and had begun hairdressing school prior to January 1, 1966. Cancer incidence rates for the general Connecticut population, 1935-78, were compared with those for 11,845 female and 1,805 male cosmetologists. The females had a standardized cancer incidence ratio (SIR) of 112 (P less than .01). A significant excess of lung cancer (SIR = 141) and excesses of brain (SIR = 168) and ovarian cancer (SIR = 134) of borderline significance were observed. No significant cancer risk was evident for female cosmetologists licensed since 1935, even for those with 35 years or more of follow-up, although the SIRs for brain cancer, lymphoma, and leukemia were elevated. Female cosmetologists who entered the profession between 1925 and 1934, however, experienced a significant overall cancer incidence (SIR = 129) and significant excesses of respiratory, breast, corpus uterine, and ovarian cancers. Those with 35 years or more from time of first license appeared to be at the highest risk. Among males the overall cancer incidence rate was close to that expected (SIR = 105). Smoking habits and reproductive factors that could not be taken into account may explain some of the excesses among females. Although no specific occupational agent could be identified, the excess numbers of leukemias in females and brain cancers among males and females merit continued surveillance.

Bladder tumor incidence among workers exposed to benzidine: a thirty-year follow-up.

Linkage with records of the Connecticut Tumor Registry was used to determine cancer incidence in a cohort of workers (n = 984) at a benzidine manufacturing facility. Compared to the findings for the Connecticut population, there was a statistically significant excess of bladder tumor among male cohort members [standardized incidence ratio (SIR) = 343; 95% confidence limits (CL) = 148, 676; n = 830], which was confined to those with the highest estimated level of benzidine exposure (SIR = 1,303; CL = 479, 2,839; n = 105). No significantly elevated risks were found for cancers at other anatomic sites in men or at any anatomic sites in women; nor was there any pattern of increasing risk with increasing benzidine exposure for sites other than bladder. In addition, the elevated bladder cancer risk was greater for men first employed during the earliest years of the plant, namely, 1945-49 (SIR = 976; CL = 262, 2,498) as compared to those first employed in 1950-54 (SIR = 213; CL = 3, 1,184) after equalization of duration of follow-up. These results suggest that the major preventive measures instituted around 1950 may have reduced bladder cancer risk in this plant.

Epidemiology of renal cell carcinoma in Connecticut, 1935-1973.

Data on over 3,700 patients with renal cell carcinoma, reported to the Connecticut Tumor Registry from 1935 through 1973, were used to assess incidence, survival, and associations of risk with demographic characteristics. Incidence increased over time among men, but not among women; a birth cohort effect suggesting increasing incidence rate over time was demonstrated for men. A comparison of male and female age-specific incidence rates indicated that, in the 15- to 39-year-old age group, men were three times more likely than women to develop the disease; after age 40, renal cell carcinoma was diagnosed in men twice as often as in women. Survival probability has increased from 1940 to the present time. A high density of persons per square mile was associated with a higher-than-expected incidence. No trends in incidence according to socioeconomic status were observed.

Cancer risk among women exposed to exogenous estrogens during pregnancy.

A cohort of 3,139 obstetric patients, who delivered children between 1946 and 1965, was followed retrospectively to assess the relationship between exposure to diethylstilbestrol [(DES) CAS: 56-53-1; alpha, alpha'-diethyl-4,4'-stilbenediol] or other estrogenic substances during pregnancy and subsequent cancer incidence. Among the 1,531 women exposed to DES, the relative risk (RR) for all cancers was 1.46 [95% confidence interval (CI), 1.07-2.00]. The RR for cancers of the breast, cervix, and ovary were 1.37 (adjusted), 1.40, and 2.83, respectively, but none of these estimates was statistically significant. For breast cancer an RR in excess of 2.28 can be excluded, with 95% CI for doses averaging 2,100 mg. Within the exposed group there was no evidence for a dose-response relationship.

Children's blood lead levels in New Haven: a population-based demographic profile.

This report presents the geometric mean blood lead levels of an 80% cross-sectional sample of children aged 1-72 months in New Haven, Connecticut. Blood lead levels were related to age, sex and race. It was found that age and race were independently important sources of variation in blood lead levels. Sex of children in this age group was not related to differences in blood lead levels. The highest geometric mean blood lead levels occurred in children between 25 and 36 months of age. Black children had higher levels than white or Hispanic children.

Occupations of fathers of patients with Wilms's tumour.

A case-control study of 149 Connecticut-born children with Wilms's tumour reported to the Connecticut Tumor Registry during the period 1935--1973 and of 149 matched controls was undertaken in order to explore the possibility that children with Wilms's tumour may have been exposed perinatally to carcinogenic agents. The occupation of the father at the time of the child's birth was investigated and used as an indicator of potential sources of carcinogens to which infants in the study may have been exposed. An association was found between paternal occupations related to lead in the group developing Wilms's tumour compared with the controls.

Relationship of sociodemographic factors to blood lead concentrations in New Haven children.

From September 1974 to 28th February 1977 80% of the children in New Haven, Connecticut, aged from 1 month to 72 months were screened for blood lead concentrations. This report examines the relationship of several socioeconomic factors to blood lead concentrations. In addition, a set of hypotheses regarding the effect of environmental and social factors on blood level concentrations in racially defined groups was tested. Characteristics associated with increased blood lead concentrations were found to be those that tend to impair the ability of a family to provide the necessary care and supervision for the young child. The risk factors, however, produce different effects on the various race groups. The analyses support the belief that the elimination of childhood lead poisoning as a public health problem will require recognition of social-demographic and family operational factors that underlie the interactions of childhood behaviour and environmental lead potentially available to children.

Family operational co-factors in the epidemiology of childhood lead poisoning.

A large-scale data base was derived from the New Haven Connecticut Childhood Lead Poisoning Prevention and Control Program. A subset of 918 children was examined to explore the associations of blood lead levels in these children and four family operational factors. Elevated lead in the children was positively associated with: (a) larger numbers of children under 6 yr in the family; (b) fewer parents at home; (c) fewer parents employed; and (d) lack of day care. Additional environmental, demographic, and socioeconomic factors in childhood lead poisoning and its control are under study.