Malignant melanoma associated with breast cancer.

The experience of the population-based Connecticut Tumor Registry was analyzed for the occurrence in the same patient of breast cancer and malignant melanoma. A total of 18,010 women with breast cancer were followed up for the subsequent development of malignant melanoma of the skin or eye. Similarly, 835 women with cutaneous or ocular malignant melanoma were followed up for the subsequent development of breast carcinoma. Survival experience for these cohorts and appropriate Connecticut Tumor Registry incidence rates were used to calculate an expected number of individuals with both types of malignant neoplasms. Twenty-three women had both types of tumors diagnosed at least one month apart. Fewer than 14 such occurrences were expected (P < .05). The two tumors may be related through hormonal factors, particularly when considered with regard to the findings of other laboratory and epidemiologic studies.

The resolution of discrepancies in the reported incidence of primary brain tumors.

Population-based morbidity studies of primary intracranial neoplasms reveal a general pattern of age-specific incidence: a small childhood peak, followed by a taller peak between ages 50 and 80. One notable exception is Rochester, Minnesota, where there is a sustained increase in incidence with increasing age, together with higher age-specific rates than seen in data from other locations. Comparing data from Rochester and Connecticut reveals that the larger percentage of cases first diagnosed at autopsy in Rochester accounts in large part for these discrepancies and suggests that a substantial number of brain tumors remain undiagnosed in the elderly during life.

High school contact among persons with leukemia and lymphoma.

We studied frequency of contact among Connecticut high school students and teachers with leukemia and lymphoma diagnosed during or after high school from 1960 through 1971. Risk of having attended the same grade at the same school during the same year was greater among students with Hodgkin's disease (HD) than among simulated controls drawn in proportion to school enrollment (relative risk = 1.44; approximate 95% lower confidence limit = 1.05). Risk of developing HD was also greater among students enrolled simultaneously at the same school as students already diagnosed with HD than among students not so enrolled (relative risk = 2.05; 95% lower confidence limit = 1.39). However, fewer HD cases (16) were diagnosed from 1965 through 1970 at schools that formerly had patients enrolled (1959-64) than at matched schools without such patients (24). We found no evidence of increased contact among persons with non-HD lymphomas or leukemias, except between HD and non-HD lymphomas (relative risk = 1.41; approximate 95% lower confidence limit = 1.11).

The descriptive epidemiology of primary intracranial neoplasms: the Connecticut experience.

The age-specific incidence pattern for tumors of the brain and cranial meninges in Connecticut over a 30-year period shows an early peak followed by a taller and sharper peak with a maximum in the 55-65 year age group. This overall curve reflects the pattern shown for glioblastoma, the tumor accounting for the majority of the histologically confirmed cases. The reported rates are probably underestimates of the actual rates. The various histologic types of brain tumors reveal sufficiently distinct epidemiologic patterns to be considered as separate diseases.

The epidemiology of primary intracranial neoplasms of childhood. A population study.

All primary intracranial neoplasms diagnosed between 1935 and 1964, inclusive, in the well-defined populations of children under age 15 residing in the state of Connecticut and the city of Rochester, Minnesota, formed the basis for this study. The tumors occurring in this group were characterized by histologic type and by the patient's sex and the age when the tumor occurred. In Connecticut, over the 30-year period, a primary intracranial neoplasm was diagnosed in 380 patients in a mean population of 582,286 children, yielding an average annual incidence rate of 2.17 cases/100,000 population per year. Of the microscopically confirmed tumors, the most common, in order, were medulloblastoma (24.2%), astrocytoma (20.6%), glioblastoma (20.3%), ependymoma (6.5%), craniopharyngioma (5.6%) and meningioma (4.6%). These figures contrast sharply with the corresponding frequency of these tumors in the adult Connecticut population. In Rochester during the same years, 12 primary intracranial neoplasms occurred in a mean population of 7,981 children, yielding an average annual incidence rate of 5.01 cases/100,000 population per year.

Nervous system neoplasms and primary malignancies of other sites. The unique association between meningiomas and breast cancer.

To determine whether nervous system neoplasms are associated with primary malignancies elsewhere, we studied the frequency of multiple primary tumous in patients in whom at least one of the primary tumors was within the nervous system. The patients were Conneticut residents with tumors diagnosed between 1935 and 1964. Of 135 patients, 130 had two primary tumors, four had three primary tumors, and one had four primary tumors. Only with multiple primary tumors involving the brain and breast did the number of observed cases significantly exceed the number of expected cases; eight patients who had a meningioma associated with a breast cancer accounted for this excess. Patients with breast cancer presenting with signs or symptoms of an intracranial neoplasm should be carefully evaluated, for the intracranial lesion may be a potentially curable meningioma.

Cervical cancer screening.

PIP: The aims of Connecticut's cervical cancer screening program are to reduce the incidence and mortality of cervical cancer, to determine the most effective means of reaching minority and women over 40 of low socioeconomic status, to bring all women with confirmed positive Pap smears to diagnosis, and to use the data obtained to establish a regular screening program for all Connecticut women aged 16 and above. In 1972, 637 cases of cervical cancer (43.6 per 100,000) were diagnosed. The lower one is on the socioeconomic scale, the higher the incidence is of cervical cancer. Nurse practitioners will perform the Pap and pelvic examinations, and instruction in breast self-examination will be given.^ieng

Cancer in Connecticut, 1970.

PIP: The number of malignant tumors diagnosed among residents of Connecticut increased slightly in 1970. However, the age-adjusted rate declined from 1969 to 1970. Cancer cases were analyzed by primary site, cancer incidence rates per 100,000 population, cancer deaths, and cancer mortality rates per 100,000 population, and these figures were broken down by primary site, sex and age. There was a slight increase in cancers among men, and cancer of the digestive system had the highest age-adjusted rate of 92.2/100,000. Cancer in women decreased. The age-adjusted rate of 76.7/100,000 was 5.9% less than in 1969. Cervical cancer was up to 41.2 from 40.4 in 1969. Breast cancer deaths declined from an age-adjusted mortality rate of 28.9/100,000 in 1969 to 25.4 in 1970. The percentage of neoplasms diagnosed while still localized remained stable at 43% localized and 55% in situ. 70.7% of lesions diagnosed in situ were of the cervix uteri.^ieng

Cancer in Connecticut, 1969.

PIP: There were a total of 9788 newly-diagnosed cancers in Connecticut residents in 1969, an increase of 475 (5.1%) over 1968. 4620 were in males and 5168 in females. Tumors of the digestive organs were the most frequent, 2680 cases (27.4%). There were 1895 tumors of the genital organs (19.4%), 1421 of the breast (14.5%), and 1285 of the respiratory system (13.1%). The age-adjusted incidence rates for all tumors were 297.3 per 100,000 for males, an increase of 1% over 1968, and 295.1 for females, an increase of 5.4%. Among females the increased numbers of tumors were mostly breast, digestive organs, and lymphatic and hematopoietic tissues. For males cancer of the respiratory system showed the most increase. Female respiratory cancer declined slightly. Breast cancers in females increased 13.9%, the largest yearly increase ever recorded in Connecticut. The older age group (75-79 years) showed the most marked increase, from 311 to 403.1 per 100,000. Of the breast cancers 50.4% were localized, 37.2% had regional spread, and 7.8% remote metastases. In the others the stage was not recorded. Earlier diagnoses are obviously needed. In males cancer of the respiratory system increased from 63.7 per 100,000 in 1968 to 67.3 in 1969. Men over age 85 showed an increase of 156%. The rates in males for tongue and prostate cancer decreased. For children leukemia was the most frequent cancer, for girls 15-19 and boys 19-24 Hodgkin's disease was more frequent. In women aged 20-39 cancer of the cervix was most often diagnosed; after age 40, cancer of the breast; after age, 80, tumors of the large intestine. In men aged 25-34 cancer of the testes predominated; from 40-74, cancers of the lung and bronchus; and over 75, cancer of the prostate. During 1969 there were a total of 5073 cancer deaths, exclusive of nonmelanotic skin and myelofibrosis, 2759 males and 2314 females. 301.% of the deaths among males were digestive organ cancers, 27.8% were respiratory organ disease. Among females 29.4% of deaths were tumors of the digestive organs and 23.7% were breast cancers. Age-adjusted mortality rates were 176.6 per 100,000 for males and 122.4 for females, a slight decrease from 1968.^ieng