RESUMEN
BACKGROUND: Despite many studies on diet and bladder cancer, there are areas that remain unexplored including meat mutagens, specific vegetable groups, and vitamins from diet. METHODS: We conducted a population-based case-control study of bladder cancer in Maine, New Hampshire, and Vermont. A total of 1171 cases were ascertained through hospital pathology records and cancer registries from 2001 to 2004. Overall, 1418 controls were identified from the Department of Motor Vehicles (<65 years) and Center for Medicaid and Medicare Services (65-79 years) and were frequency-matched to cases by state, sex, and age (within 5 years). Diet was assessed with a self-administered Diet History Questionnaire. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Processed meat intake was positively associated with bladder cancer (highest vs lowest quartile OR: 1.28; 95% CI: 1.00-1.65; P(trend)=0.035), with a stronger association for processed red meat (OR: 1.41; 95% CI: 1.08-1.84; P(trend)=0.024). There were no associations between intake of fruits or vegetables and bladder cancer. We did, however, observe an inverse association with vitamin B12 intake (OR: 0.77; 95% CI: 0.61-0.99; P=0.019). CONCLUSION: Vitamin B12 from diet may be protective against bladder cancer, whereas consuming processed meat may increase risk.
Asunto(s)
Dieta , Frutas , Carne/efectos adversos , Micronutrientes , Neoplasias de la Vejiga Urinaria/epidemiología , Verduras , Adulto , Anciano , Animales , Estudios de Casos y Controles , Dieta/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , New England/epidemiología , Factores de Riesgo , Complejo Vitamínico BRESUMEN
Associations between bladder cancer risk and NAT2 and GSTM1 polymorphisms have emerged as some of the most consistent findings in the genetic epidemiology of common metabolic polymorphisms and cancer, but their interaction with tobacco use, intensity and duration remain unclear. In a New England population-based case-control study of urothelial carcinoma, we collected mouthwash samples from 1088 of 1171 cases (92.9%) and 1282 of 1418 controls (91.2%) for genotype analysis of GSTM1, GSTT1 and NAT2 polymorphisms. Odds ratios and 95% confidence intervals of bladder cancer among New England Bladder Cancer Study subjects with one or two inactive GSTM1 alleles (i.e. the 'null' genotype) were 1.26 (0.85-1.88) and 1.54 (1.05-2.25), respectively (P-trend = 0.008), compared with those with two active copies. GSTT1 inactive alleles were not associated with risk. NAT2 slow acetylation status was not associated with risk among never (1.04; 0.71-1.51), former (0.95; 0.75-1.20) or current smokers (1.33; 0.91-1.95); however, a relationship emerged when smoking intensity was evaluated. Among slow acetylators who ever smoked at least 40 cigarettes/day, risk was elevated among ever (1.82; 1.14-2.91, P-interaction = 0.07) and current heavy smokers (3.16; 1.22-8.19, P-interaction = 0.03) compared with rapid acetylators in each category; but was not observed at lower intensities. In contrast, the effect of GSTM1-null genotype was not greater among smokers, regardless of intensity. Meta-analysis of the NAT2 associations with bladder cancer showed a highly significant relationship. Findings from this large USA population-based study provided evidence that the NAT2 slow acetylation genotype interacts with tobacco smoking as a function of exposure intensity.
Asunto(s)
Arilamina N-Acetiltransferasa/genética , Glutatión Transferasa/genética , Fumar/efectos adversos , Neoplasias de la Vejiga Urinaria/etiología , Acetilación , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Riesgo , Neoplasias de la Vejiga Urinaria/genéticaRESUMEN
Several epidemiological studies suggested an association between the risk of bladder cancer and the exposure to trihalomethanes (THMs), the main disinfection by-products (DBPs) of chlorinated water. A previous pooled analysis of case-control studies from North America and Europe estimated a summarized dose-response relation. For policy guidance of drinking water disinfection in Europe and because major differences exist in water disinfection practices and DBPs occurrence between both continents, specific risk estimates for bladder cancer in relation to DBPs exposure for European populations were needed. We conducted a pooled and a two-stage random-effect meta-analyses of three European case-control studies from France, Finland, and Spain (5467 individuals: 2381 cases and 3086 controls). Individual exposure to THMs was calculated combining information on residential history, estimates of the average total THMs (TTHM) level in tap water at the successive residences and personal water consumption. A significant odds-ratio was observed for men exposed to an average residential TTHM level > 50 µg/l (OR = 1.47 (1.05; 2.05)) when compared to men exposed to levels ≤ 5 µg/l. The linear trend of the exposure-risk association was significant (p = 0.01). Risks increased significantly for exposure levels above 25 µg/l and with more than 30 years of exposure to chlorinated water, but were mainly driven by the level rather than the duration of exposure. No significant association was found among women or with cumulative exposure through ingestion. There was no evidence of a differential exposure-response relation for TTHM and bladder cancer in Europe and North America. Consequently, a global exposure-risk relation based on 4351 cases and 7055 controls is now available.
Asunto(s)
Trihalometanos/toxicidad , Neoplasias de la Vejiga Urinaria/inducido químicamente , Contaminantes Químicos del Agua/toxicidad , Purificación del Agua/métodos , Abastecimiento de Agua/análisis , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Desinfección , Relación Dosis-Respuesta a Droga , Ingestión de Líquidos , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trihalometanos/análisis , Neoplasias de la Vejiga Urinaria/epidemiología , Contaminantes Químicos del Agua/análisisRESUMEN
OBJECTIVES: To evaluate lifetime exposure to trihalomethanes (THM) through ingestion, inhalation, and dermal absorption in a hospital based case-control study of bladder cancer conducted between 1998 and 2001 in five areas of Spain. The study base was comprised of subjects living in the catchment areas of the participating hospitals. METHODS: Individual information on water related habits was obtained from personal interviews of 1219 cases and 1271 controls: residential and occupational history, drinking water source at each residence and job, amount of water consumption, frequency and duration of showering, bathing, and swimming pool attendance. THM levels, water source history, and year when chlorination started in study areas were ascertained through measurements in drinking water samples and questionnaires to water companies and local authorities. Estimates of THM levels covered 79% of the subjects' person-years of exposure. RESULTS: Current and historical average THM levels in water were correlated. Control subjects reported that drinking water source in the last residence was municipal for 63%, bottled for 22%, private well for 2%, and other sources for 13%. For the time window between age 15 and the time of interview, average residential THM level was 32.2 mug/l. THM exposure through ingestion was 23.7 mug/day on average, and was correlated with the ingestion THM level in the workplace. Overall, 79% usually took showers, 16% usually took baths, and 13% had ever attended a swimming pool. Between 21% and 45% of controls unexposed to THM through ingestion were evaluated as moderately or highly exposed through showering or bathing, and 5-10% were exposed through swimming in pools. CONCLUSION: The importance of evaluating different routes is underscored by findings from experimental studies showing substantial differences in THM uptake and internal distribution by route.
Asunto(s)
Exposición a Riesgos Ambientales/análisis , Trihalometanos/análisis , Contaminantes Químicos del Agua/análisis , Adulto , Anciano , Anciano de 80 o más Años , Baños/estadística & datos numéricos , Estudios de Casos y Controles , Femenino , Humanos , Exposición por Inhalación/análisis , Absorción Intestinal/fisiología , Masculino , Persona de Mediana Edad , Características de la Residencia , Estudios Retrospectivos , Absorción Cutánea/fisiología , España/epidemiología , Piscinas/estadística & datos numéricos , Neoplasias de la Vejiga Urinaria/epidemiología , Purificación del Agua/estadística & datos numéricos , Abastecimiento de Agua/análisisRESUMEN
A case-control study of multiple myeloma among males was conducted with the use of digitized mortality listings for 1968-76 from the State of Wisconsin. Age, year of death, race, county of usual residence, marital status, and usual occupation were available for the 411 male deaths due to multiple myeloma and for a matched series of deaths due to other causes. Farmers were at an elevated risk compared to nonfarmers [odds ratio (OR) = 1.4], with decedents 65 years of age or older having a stronger association (OR = 1.5) than younger farmers (OR = 1.1). County levels of selected agricultural characteristics were used as surrogate measures of exposure. Significantly elevated OR were observed for farmers residing in counties high in chicken inventory (OR = 1.6), fertilizer use (OR = 1.7), and acres treated with insecticides (OR = 1.9). Further investigation of multiple myeloma among farmers is warranted.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/mortalidad , Mieloma Múltiple/mortalidad , Adulto , Factores de Edad , Anciano , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores SocioeconómicosRESUMEN
Associations between site- and sex-specific county cancer mortality rates and levels of trihalomethanes (THM's) in drinking water were examined after adjustment of rates for the influence of multiple socioeconomic, industrial, and demographic factors. U.S. counties with sampled supplies were grouped by percent of the county population receiving water from the supply, as well as by region of the country. For two sites (bladder and lung), county rates were also adjusted for the activity level in specific high-risk industries. Positive correlations with THM levels were observed for several cancers, including bladder and brain cancers in both sexes, and non-Hodgkin's lymphoma and kidney cancer in males. Stomach cancer in females showed a negative association. Bladder cancer mortality rates showed the strongest and most consistent association with a THM exposure index, after control for differences in social class, ethnic group, urban versus rural residence, region of the United States, and industrialization of the county. These ecologic associations suggested that further evaluation in analytic investigations is warranted.
Asunto(s)
Cloroformo/análogos & derivados , Cloroformo/envenenamiento , Neoplasias de la Vejiga Urinaria/etiología , Contaminantes Químicos del Agua/envenenamiento , Contaminantes del Agua/envenenamiento , Neoplasias Encefálicas/etiología , Bromotriclorometano/envenenamiento , Métodos Epidemiológicos , Femenino , Humanos , Neoplasias Renales/etiología , Linfoma/etiología , Masculino , Neoplasias/mortalidad , Enfermedades Profesionales/etiología , Riesgo , Estados UnidosRESUMEN
Data from a population-based case-control interview study of incident bladder cancer in 10 areas of the United States were used to estimate relative risks among white men (2,116 cases, 3,892 controls) and women (689 cases, 1,366 controls) according to beverage intake level and type of water source. Individual year-by-year profiles of water source and treatment were developed by linking lifetime residential information with historical water utility data from an ancillary survey. Risk of bladder cancer increased with intake level of beverages made with tap water. The odds ratio (OR) for the highest vs. lowest quintile of tap water consumption was 1.43 [95% confidence interval (CI) = 1.23, 1.67; chi 2 for trend = 26.3, P less than .001]. The risk gradient with intake was restricted to persons with at least a 40-year exposure to chlorinated surface water and was not found among long-term users of nonchlorinated ground water. The ORs for the highest vs. lowest quintiles of tap water intake were 1.7 and 2.0, respectively, among subjects with 40-59 and greater than or equal to 60 years' exposure. Duration of exposure to chlorinated surface water was associated with bladder cancer risk among women and nonsmokers of both sexes. Among non-smoking respondents with tap water consumption above the population median, the OR increased with exposure duration to a level of 3.1 (CI = 1.3, 7.3; chi 2 for trend = 6.3, P = .01) for greater than or equal to 60 years of residence at places served by chlorinated surface water (vs. non-chlorinated ground water users). These results extend findings of earlier epidemiologic studies and are consistent with environmental chemistry and toxicologic data demonstrating the presence of genotoxic by-products of chlorine disinfection in treated surface waters.
Asunto(s)
Ingestión de Líquidos , Neoplasias de la Vejiga Urinaria/epidemiología , Abastecimiento de Agua , Cloro , Femenino , Geografía , Humanos , Masculino , Factores de Riesgo , Factores Sexuales , Estados Unidos , Neoplasias de la Vejiga Urinaria/etiologíaRESUMEN
A hospital-based case-control study of companion dogs examined the risk of developing canine malignant lymphoma associated with the use of chemicals in and about the home. Information from a self-administered owner questionnaire and/or a telephone interview of about 491 cases, 466 nontumor controls, and 479 tumor controls indicated that owners in households with dogs that developed malignant lymphoma applied 2,4-dichlorophenoxyacetic acid (2,4-D) herbicides to their lawn and/or employed commercial lawn care companies to treat their yard significantly more frequently than control owners (odds ratio = 1.3). In addition, the risk of canine malignant lymphoma rose to a twofold excess with four or more yearly owner applications of 2,4-D. The findings in this study are consistent with occupational studies in humans, which have reported modest associations between agricultural exposure to 2,4-D and increased risk of non-Hodgkin's lymphoma, the histology and epidemiology of which are similar to those of canine malignant lymphoma. The present study suggests that human health implications of 2,4-D exposure in the home environment should receive further investigation.
Asunto(s)
Ácido 2,4-Diclorofenoxiacético/efectos adversos , Enfermedades de los Perros/etiología , Linfoma/veterinaria , Animales , Estudios de Casos y Controles , Perros , Femenino , Entrevistas como Asunto , Linfoma/etiología , Masculino , Análisis Multivariante , Encuestas y CuestionariosRESUMEN
Age-adjusted mortality rates for non-Hodgkin's lymphoma in counties of the contiguous United States were examined by sex and race during 1950 to 1975 and were correlated through 1969 with demographic and industrial data. Mortality was consistently elevated in counties with large populations, especially in those with higher income and education levels. Among males, but not females, elevated rates appeared in counties with high percentages of residents of Russian or Greek descent. A series of contiguous counties with high rates was seen along the coast of California. Lower rates in the South were explained in a multivariate analysis by the generally lower socioeconomic levels in this region. Counties with industrial concentration in food packing showed higher mortality rates among males than did comparable counties without these industries. All regions and all sex-race groups showed an increase over time in mortality from non-Hodgkin's lymphoma, especially reticulum cell sarcoma.
Asunto(s)
Linfoma/epidemiología , Factores de Edad , Industria de Procesamiento de Alimentos , Humanos , Linfoma/mortalidad , Linfoma de Células B Grandes Difuso/epidemiología , Linfoma no Hodgkin/epidemiología , Medicina del Trabajo , Grupos Raciales , Factores Sexuales , Factores Socioeconómicos , Estados UnidosRESUMEN
Mortality surveys and death certificate studies have suggested an association between leukemia and farming. To investigate whether exposure to carcinogens in an agricultural setting is related to risk of leukemia, the authors conducted a population-based case-control interview study of 578 white men with leukemia and 1245 controls living in Iowa and Minnesota. Consistent with recent mortality studies, there were slight, but significant, elevations in risk for all leukemia [odds ratio (OR) 1.2] and chronic lymphocytic leukemia (OR 1.4) for farmers compared to nonfarmers. There were no significant associations with leukemia for exposure to specific fungicides, herbicides (including 2,4-D and 2,4,5-T), or crop insecticides. However, significantly elevated risks for leukemia of greater than or equal to 2.0 were seen for exposure to specific animal insecticides including the organophosphates crotoxyphos (OR 11.1), dichlorvos (OR 2.0), and famphur (OR 2.2) and the natural product pyrethrins (OR 3.7) and the chlorinated hydrocarbon methoxychlor (OR 2.2). There were also smaller, but significant, risks associated with exposure to nicotine (OR 1.6) and DDT (OR 1.3). This finding of elevated risks for insecticides used on animals deserves further evaluation.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Leucemia/inducido químicamente , Exposición Profesional , Plaguicidas/efectos adversos , Animales , Estudios de Casos y Controles , Humanos , Iowa , Masculino , Minnesota , Factores de RiesgoRESUMEN
Data from an in-person interview study of 622 white men with newly diagnosed non-Hodgkin's lymphoma and 1245 population-based controls in Iowa and Minnesota were used to measure the risk associated with farming occupation and specific agricultural exposures. Men who ever farmed were at slightly elevated risk of non-Hodgkin's lymphoma (odds ratio = 1.2, 95% confidence interval = 1.0-1.5) that was not linked to specific crops or particular animals. Elevated risks were found, with odds ratio generally 1.5-fold or greater, for personal handling, mixing, or application of several pesticide groups and for individual insecticides, including carbaryl, chlordane, dichlorodiphenyltrichloroethane, diazinon, dichlorvos, lindane, malathion, nicotine, and toxaphene. Associations were generally stronger for first use prior to 1965 than more recently, and when protective clothing or equipment was not used. Small risks were associated with the use of the phenoxyacetic acid herbicide 2,4-dichlorophenoxyacetic acid, but the risks did not increase with latency or failure to use protective equipment. Exposure to numerous pesticides poses problems of interpreting risk associated with a particular chemical, and multiple comparisons increase the chances of false-positive findings. In contrast, nondifferential exposure misclassification due to inaccurate recall can bias risk estimates toward the null and mask positive associations. In the face of these methodological and statistical issues, the consistency of several findings, both within this study and with observations of others, suggests an important role for several insecticides in the etiology of non-Hodgkin's lymphoma among farmers.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Linfoma no Hodgkin/epidemiología , Plaguicidas/efectos adversos , Adulto , Anciano , Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Estudios de Casos y Controles , Humanos , Entrevistas como Asunto , Iowa/epidemiología , Linfoma no Hodgkin/inducido químicamente , Masculino , Persona de Mediana Edad , Minnesota/epidemiología , Plaguicidas/clasificación , Factores de RiesgoRESUMEN
The review of the literature regarding non-Hodgkin's lymphoma and occupational and environmental factors presented at this workshop suggested associations with viruses, solvents, and hair dyes. A population-based case-control study among men from Iowa and Minnesota notes similar associations. Workers engaged in metal working, hair care, painting, and dry cleaning experienced nonsignificant excesses. Risks from specific exposures showed some variation by histological type. Both follicular and diffuse non-Hodgkin's lymphoma were associated with benzene. The diffuse type was linked to solvents other than benzene and formaldehyde, while the follicular was excessive among workers exposed to oils and greases.
Asunto(s)
Linfoma no Hodgkin/epidemiología , Enfermedades Profesionales/epidemiología , Adulto , Anciano , Humanos , Iowa/epidemiología , Linfoma no Hodgkin/inducido químicamente , Linfoma no Hodgkin/etiología , Masculino , Persona de Mediana Edad , Minnesota/epidemiología , Enfermedades Profesionales/inducido químicamente , Enfermedades Profesionales/etiología , Factores de RiesgoRESUMEN
The relation between use of hair dyes and risk of bladder cancer was assessed using data from a case-control study of bladder cancer. Incident cases (2982) and general population controls (5782) were interviewed. The overall estimate of relative risk of bladder cancer for users of hair dyes was 1.0 (95%) confidence interval, 0.9 to 1.2) compared to nonusers. No consistent pattern of association was detected between bladder cancer risk and various indices of timing or intensity of exposure to hair dyes. Various explanations of the lack of association are discussed.
Asunto(s)
Tinturas para el Cabello/efectos adversos , Preparaciones para el Cabello/efectos adversos , Femenino , Humanos , Masculino , Riesgo , Factores Sexuales , Factores de Tiempo , Neoplasias de la Vejiga UrinariaRESUMEN
Data from a continuing multiyear seroprevalence survey of human T-lymphotropic virus types I or II (HTLV-I/II) among intravenous drug users in seven U.S. locations were analyzed to detect demographic patterns of seropositivity and coinfection with human immunodeficiency virus type 1 (HIV-1). Seropositivity for HTLV-I/II and HIV-1 was detected by whole-virus enzyme immunoassay, with Western blot confirmation. Of 1,800 subjects recruited from methadone maintenance and detoxification clinics, 207 (11.5%) were infected with HTLV-I/II. Seropositivity for HTLV-I/II varied by racial group, age, sex, and geographic location. Blacks had a higher (age- and location-adjusted) infection rate (17.1%) than Hispanics (8.7%) or whites (5.6%), and seropositivity showed a strong gradient with increasing age. Females had a slightly higher rate (14.0%) than males (10.0%), after adjustment for age and location. Among the seven locations, the rate varied from approximately 1% (Miami and Baltimore) to 20% (Los Angeles), although the former rates were based on relatively few subjects (47 and 65, respectively). Overall, the occurrence of coinfection by HIV-1 and HTLV-I/II did not occur more frequently than expected by chance.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/epidemiología , Abuso de Sustancias por Vía Intravenosa , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Adulto , Negro o Afroamericano , Factores de Edad , Femenino , Seroprevalencia de VIH , Infecciones por HTLV-I/complicaciones , Infecciones por HTLV-II/complicaciones , Hispánicos o Latinos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Abuso de Sustancias por Vía Intravenosa/complicaciones , Estados Unidos/epidemiología , Población BlancaRESUMEN
A family history of prostate cancer has been associated with prostate cancer risk in most prior studies, and more limited data suggest that a family history of breast cancer may also be important; however, there are no data from a population-based cohort study of prostate cancer incidence that adjusts for major confounders. We conducted follow-up through 1995 on 1557 men, ages 40-86 years, who were randomly selected (81% response rate) as cancer-free controls for a population-based case-control study conducted in Iowa from 1987-1989. Family history of cancer in parents and siblings was obtained using a mailed questionnaire. Incident cancers and deaths were ascertained through linkages to state and national databases; 101 incident cases of prostate cancer were identified. At baseline, 4.6% of the cohort reported a family history of prostate cancer in a brother or father, and this was positively associated with prostate cancer risk after adjustment for age [relative risk (RR) = 3.2; 95% confidence interval (CI), 1.8-5.7] or after multivariate adjustment for age, alcohol, and dietary factors (RR = 3.7; 95% CI, 1.9-7.2). Risk was greater if a brother had prostate cancer (RR = 4.5; 95% CI, 2.1-9.7) than if a father had prostate cancer (RR = 2.3; 95% CI, 1.0-5.3). Also at baseline, 9.6% of the cohort had a family history of breast and/or ovarian cancer in a mother or sister, and this was positively associated with prostate cancer risk (age-adjusted RR = 1.7; 95% CI, 1.0-3.0; multivariate RR = 1.7; 95% CI, 0.9-3.2). Men with a family history of both prostate and breast/ovarian cancer were also at increased risk of prostate cancer (RR = 5.8; 95% CI, 2.4-14). There was no association with a family history of colon cancer. Exclusion of well-differentiated, localized tumors did not alter these findings. These data from an incidence study confirm that a family history of prostate cancer is a strong prostate cancer risk factor after adjustment for dietary and other risk factors, and suggest that selection and recall bias have not had an important influence on most case-control study results. These data also support the idea that a family history of breast cancer may also be a prostate cancer risk factor.
Asunto(s)
Neoplasias de la Próstata/genética , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas , Neoplasias de la Mama/genética , Estudios de Casos y Controles , Estudios de Cohortes , Neoplasias del Colon/genética , Intervalos de Confianza , Factores de Confusión Epidemiológicos , Bases de Datos como Asunto , Conducta Alimentaria , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Iowa , Masculino , Persona de Mediana Edad , Análisis Multivariante , Neoplasias Ováricas/genética , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
In a cross-sectional study of 926 subjects from 10 drug treatment programs conducted in 1984 in New Jersey, the seroprevalence of human immunodeficiency virus (HIV) was 35% overall; 30% in whites, 33% in hispanics, and 46% in blacks (p = 0.01 for comparison of blacks to non-blacks). Univariate analysis showed the seroprevalence of HIV was not associated with age or gender, but did correlate with frequency of cocaine or heroin injection (p trend less than 0.001); frequency of needle sharing (p trend = 0.007); and inversely with levels of education (p = 0.05). The prevalence of HIV was also inversely related to the distance of the treatment center from lower Manhattan; being highest for distances of less than 5 miles from lower Manhattan and lowest for distances of 80 miles, with intermediate rates for the intervening distances (p trend less than 0.001). In multivariate analyses, HIV seropositivity was consistently associated with the frequency of needle sharing (p = 0.02) and less than 12 years (high school level) of education (p = 0.02), but not with black race. However, blacks who shared needles less than once a month had a relative risk of 3.2 (95% CI 1.2, 7.7) while non-blacks who shared less than once a month had a relative risk of only 0.9 (95% CI 0.3, 2.4). The risk in non-blacks increased to more than twofold with more frequent needle sharing. When the analysis was stratified by gender and adjusted for needle sharing and geography, a significant twofold increased risk was observed for female (but not male) subjects who had two or more heterosexual partners compared with those who had one partner.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Infecciones por VIH/epidemiología , Seroprevalencia de VIH , Conducta Sexual , Abuso de Sustancias por Vía Intravenosa , Adulto , Análisis de Varianza , Cocaína , Estudios Transversales , Etnicidad , Femenino , Heroína , Humanos , Masculino , Persona de Mediana Edad , Agujas , New Jersey/epidemiología , Factores de Riesgo , Centros de Tratamiento de Abuso de SustanciasRESUMEN
PURPOSE: Although there are numerous reports on the effects of cigarette smoking and cancer, they have infrequently compared risks at more than one cancer site after multivariate adjustment. We analyzed data from a population-based case-control study that included five anatomic sites to evaluate the association between cigarette smoking and each cancer site and to rank the associations by site. METHODS: Study respondents included 1452 bladder, 406 kidney, 376 pancreatic, 685 colon, and 655 rectal cancer cases, as well as 2434 population controls. A self-administered questionnaire was used to collect information on cigarette smoking and other potential confounders including occupation, drinking water source, and dietary practices. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), after adjustment for age, total energy intake, and other site- and sex-specific confounders. RESULTS: In both sexes, cigarette smoking (ever vs. never) was associated with risk of bladder cancer (OR = 2.5; 95% CI, 2.0-3.1 for males; OR = 2.7; 2.0-3.6 for females) and pancreatic cancer (OR = 1.8; 1.2-2.8 for males; OR = 2.1; 1.4-3.1 for females). Cigarette smoking also increased the risk of kidney cancer among males (OR = 1.8; 1.3-2.7), and to a lesser degree, among females (OR = 1.2; 0.8-1.8). No association was found for colon or rectal cancer in either sex. CONCLUSIONS: Cigarette smoking increased the risk of bladder, kidney, and pancreatic cancer in men and women. The rankings of multivariate-adjusted ORs from highest to lowest were bladder, pancreas, kidney, and colorectum, with little difference between men and women.
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Adenocarcinoma/epidemiología , Neoplasias Colorrectales/epidemiología , Neoplasias Renales/epidemiología , Neoplasias Pancreáticas/epidemiología , Fumar/epidemiología , Neoplasias de la Vejiga Urinaria/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Humanos , Iowa/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Factores de RiesgoRESUMEN
PURPOSE: Several lines of evidence suggest that prostate cancer has a hormonal etiology. We evaluated factors known to modulate the endocrine system, including alcohol and tobacco use, physical activity, and obesity as risk factors for prostate cancer. METHODS: Cancer-free controls who participated in a population-based case-control study from 1986-1989 (81% response rate) were followed through 1995 for cancer incidence by linkage to the Iowa Cancer Registry; 101 incident prostate cancers were identified. RESULTS: Compared with non-users of alcohol, men who consumed <22 grams alcohol per week (relative risk [RR] = 1.1; 95% Confidence Interval [CI] 0.6-2.1), 22-96 grams alcohol per week (RR = 2.6; 95% CI 1.4-4. 6) and >96 grams alcohol per week (RR = 3.1; 95% CI 1.5-6.3) were at increased risk of prostate cancer after adjustment for age, family history of prostate cancer, body mass index, total energy, and intake of carbohydrate, linoleic acid, lycopene, retinol, and red meat (p for trend < 0.0001). The respective RRs were similar when assessing type of alcohol consumed (beer, wine or liquor) or when well-differentiated, localized tumors were excluded. Body mass index was only weakly and positively associated with prostate cancer after adjustment for age, but this association strengthened after multivariate adjustment and exclusion of well-differentiated, localized tumors. For the latter tumors, men with a BMI of 24.1-26.6 kg/m(2) and >26.6 kg/m(2) were at elevated risk compared to men with a BMI <24.1 kg/m(2). Tobacco use (cigarettes, cigar/pipe, chewing tobacco and snuff use), height, weight, and both leisure and occupational physical activity were not associated with risk of prostate cancer in this cohort. CONCLUSIONS: These data suggest that in white men obesity is a risk factor for more clinically significant prostate cancer and confirm limited previous reports showing that alcohol consumption is positively associated with prostate cancer and that this risk is not limited to any specific type of alcohol.
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Consumo de Bebidas Alcohólicas/efectos adversos , Estilo de Vida , Obesidad/complicaciones , Neoplasias de la Próstata/etiología , Adulto , Anciano , Anciano de 80 o más Años , Antropometría , Estudios de Casos y Controles , Estudios de Cohortes , Humanos , Iowa/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/epidemiología , Factores de Riesgo , Fumar/efectos adversosRESUMEN
Concern has recently been voiced over possible chronic toxicity associated with chlorination of public drinking water supplies in the United States. This paper reviews the available evidence and the studies underway to further evaluate hypothesized associations between cancer risk and byproducts of chlorination. Preliminary data from measures of halogenated volatiles and personal exposure histories from respondents in a large epidemiologic study of bladder cancer are presented. These data support the use in epidemiologic studies of categorical measures of exposure and suggest that results from completed case-control studies, based on death certificates, may have underestimated the true risk of exposure to chlorination by-products. The current generation of studies which use a case-control interview design offer many advantages over earlier efforts to evaluate this issue.
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Cloro/efectos adversos , Neoplasias/inducido químicamente , Abastecimiento de Agua , Cloro/análisis , Cloroformo/análisis , Métodos Epidemiológicos , Humanos , Neoplasias/epidemiología , Estados Unidos , Contaminación Química del Agua/efectos adversos , Abastecimiento de Agua/análisisRESUMEN
Pesticides used in agriculture may cause adverse health effects among the population living near agricultural areas. However, identifying the populations most likely to be exposed is difficult. We conducted a feasibility study to determine whether satellite imagery could be used to reconstruct historical crop patterns. We used historical Farm Service Agency records as a source of ground reference data to classify a late summer 1984 satellite image into crop species in a three-county area in south central Nebraska. Residences from a population-based epidemiologic study of non-Hodgkin lymphoma were located on the crop maps using a geographic information system (GIS). Corn, soybeans, sorghum, and alfalfa were the major crops grown in the study area. Eighty-five percent of residences could be located, and of these 22% had one of the four major crops within 500 m of the residence, an intermediate distance for the range of drift effects from pesticides applied in agriculture. We determined the proximity of residences to specific crop species and calculated crop-specific probabilities of pesticide use based on available data. This feasibility study demonstrated that remote sensing data and historical records on crop location can be used to create historical crop maps. The crop pesticides that were likely to have been applied can be estimated when information about crop-specific pesticide use is available. Using a GIS, zones of potential exposure to agricultural pesticides and proximity measures can be determined for residences in a study.