Evaluation of antihypertensive medications use and survival in patients with ovarian cancer: a population-based retrospective cohort study.

BACKGROUND: Despite declining mortality in most countries and in Lithuania, ovarian cancer burden has remained high. Studies have indicated that antihypertensive medications use may help to improve ovarian cancer survival, however findings remain controversial. The aim of the study was to analyse the association between post-diagnosis antihypertensive medications intake and cancer-specific survival in ovarian cancer patients. METHODS: This retrospective cohort study included 588 ovarian cancer cases diagnosed between 2013 and 2015. Hazard ratios (HR) and corresponding 95% confidence intervals (95%CI) were estimated using multivariable Cox proportional hazards models to assess associations between antihypertensive medications and ovarian cancer-specific mortality. RESULTS: In total, 279 (47%) patients died during the follow-up; 242 (87%) of them died due to ovarian cancer. The risk of ovarian cancer death was reduced in angiotensin-converting enzyme inhibitors (ACE inhibitors) users vs. non-users (HR 0.55, 95% CI: 0.36-0.83). Subgroup analysis showed better ovarian cancer survival in higher dose ACE inhibitors users (HR 0.46, 95% CI: 0.28-0.77, p for trend 0.002); the effect was also stronger in age 51-65 years, stage I-III, surgery or chemotherapy treatment, pre-diagnosis ACE inhibitor users' and pre-diagnosis hypertension subgroups. The risk of cancer-specific death was slightly lower among calcium-channel blocker and angiotensin-receptor blocker users and higher among beta-blocker users as compared to non-users, however chance and confounding could not be ruled out. We found no association between the use of centrally and peripherally acting antiadrenergic agents and diuretics and risk of ovarian cancer-specific mortality. CONCLUSIONS: Our findings imply that post-diagnosis use of ACE inhibitors may be associated with reduced ovarian cancer-specific mortality; however, further research is needed for the comprehensive assessment.

Effectiveness of the cervical cancer prevention programme: a case-control mortality audit in Lithuania.

The cervical cancer burden in Lithuania has remained high, and there are no previous effectiveness studies of cervical cancer prevention programme in the country. We investigated the effect of a prevention programme on the risk of mortality from cervical cancer in Lithuania by conducting a mortality audit study. The register-based case-control study included 715 cervical cancer deaths that occurred during 2010-2015 in Lithuania and their 2145 matched controls. Screening histories for cases and controls were obtained from the National Health Insurance Fund database. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression and corrected for self-selection bias. Index screening was associated with a 56% reduction in the cervical cancer death risk, OR: 0.44; 95% CI 0.26-0.74. The ORs for stage I and stage II+ cancers were 0.80; 95% CI 0.32-2.00 and 0.36; 95% CI 0.21-0.62, respectively. The preventive effect was statistically significant for women aged ≥40 years, while nonsignificant for younger. In women who died of cervical cancer, 71% were not invited and 88% were not screened within the recommended 36 months prior to index date. Among cases with index invitation, 32% had index screening compared to 70% in controls. In conclusion, participation in screening has been effective in reducing cervical cancer mortality in Lithuania. The study shows poor screening attendance, emphasizing the importance of greater efforts at the national level to improve the effectiveness of the screening.

Impact of season of diagnosis on mortality among breast cancer survivors.

INTRODUCTION: There is mounting evidence that the time of breast cancer diagnosis and the start of treatment can improve survival rates. The aim of this study was to test the relationship between the season of breast cancer diagnosis and the survival of women patients receiving standard surgery treatment with radiotherapy. MATERIALS AND METHODS: The nonmetastatic breast cancer patients (n = 991) were followed from the date of diagnosis until death. Cox proportional hazards models were used to calculate multivariate hazard ratios (HRs) for all-cause mortality. HRs and 95% confidence intervals (CIs) were estimated in models adjusted for clinicopathologic and treatment factors. RESULTS: After adjusting for independent prognostic variables, we found that patients diagnosed in summer and autumn had a 40% reduced risk for 0-3-year mortality when compared to those diagnosed in spring. Among women aged <50 years, HRs comparing autumn with spring diagnosis categories were 0.53 (95% CI: 0.31-0.91) for 0-5-years and 0.68 (95% CI: 0.46-0.89) for 5-10-years after diagnosis. Diagnosis in autumn was associated with improving survival in younger patients treated with adjuvant chemotherapy (HR = 0.61, 95% CI: 0.39-0.96, P = 0.003). CONCLUSIONS: The diagnosis in summer and autumn was associated with a better overall prognosis. The effect of season of diagnosis on survival rate was most pronounced in the young age patients receiving chemotherapy.

Non-pulmonary cancer risk following tuberculosis: a nationwide retrospective cohort study in Lithuania.

BACKGROUND: Lithuania remains one of the highest tuberculosis burden countries in Europe. Epidemiological studies have long pointed to infections as important factors of cancer aetiology, but the association between tuberculosis and the risk of non-pulmonary cancers has rarely been tested and results have been inconsistent. The aim of this population-based cohort study was to examine the risk of cancer among patients diagnosed with tuberculosis using data from Lithuanian Tuberculosis, Cancer and Resident's Registries. METHODS: The study cohort included 21,986 tuberculosis patients yielding 1583 cancers diagnosed during follow-up (1998-2012). Standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) were calculated to compare the incidence of cancer among cohort participants with the general population for overall, non-pulmonary, site-specific cancers, as well as for subgroups of smoking-related, alcohol-related, hormone-related and haematological cancers. RESULTS: The SIRs of all cancers combined were 1.89, 95% CI: 1.79-2.00 in men and 1.34, 95% CI: 1.19-1.50 in women. Risk was increased 3-fold within the first year following diagnosis; it decreased during later years, although remained significantly elevated for ≥5 years. Elevated long-term increased risks persisted for non-pulmonary cancers overall, and for cancers of mouth and pharynx, oesophagus, stomach, larynx, cervix uteri and leukaemias. Tuberculosis was associated with a decreased risk of melanoma. Increased risks were observed for smoking-related cancers in men (SIR 1.95, 95% CI: 1.79-2.13) and women (SIR 1.46, 95% CI: 1.22-1.73), alcohol-related cancers in men (SIR 2.40; 95% CI: 2.14-2.68) and haematological cancers in men (SIR 1.73, 95% CI: 1.33-2.23). The risk of hormone-related cancers was 18% lower (SIR = 0.82, 95% CI: 0.66-0.997) among women, the inverse association was weaker among men (SIR = 0.95, 95% CI: 0.84-1.07). CONCLUSIONS: The risk of total and several non-pulmonary cancers was elevated in a cohort of tuberculosis patients. The recommendation for the awareness of this association among physicians is warranted. Analysis suggests a reduction in risk of hormone-related cancers and melanoma.

Hypertension, serum lipids and cancer risk: A review of epidemiological evidence.

Although the association between blood pressure, serum lipids and cancer risk has been investigated, the results are controversial. The aim of this literature review was to examine the epidemiological evidence and provide overview of the association between blood pressure, serum lipids and cancer risk. The arterial hypertension is closely linked with renal cell cancer development. Risk of renal cell cancer was 2-4 times higher for persons with arterial hypertension, independently of sex. In some studies arterial hypertension as one of the components of the metabolic syndrome, was associated with a higher risk of colorectal, prostate cancer and malignant melanoma. Studies suggest that a higher total serum cholesterol level is linked with higher risk of colorectum, colon, prostate and testicular cancer and lower risk of stomach, liver and hematopoietic and lymphoid tissues cancer. There was positive association between serum triglycerides and esophageal, colorectal, lung, renal, thyroid cancer. Given that hypertension is a common risk factor worldwide and its control remains inadequate, our analysis supports the relevance of public health programs aimed at reducing hypertension to reduce the incidence of a number of cancers including renal cell cancer. Effective cholesterol control may lower the risk of cancer, but further studies with longer follow-up and repeated measurements of cholesterol and other lipids are needed.

Postmastectomy internal mammary nodal irradiation: a long-term outcome.

BACKGROUND AND OBJECTIVE: The internal mammary lymph nodes (IMN) have been recognized as a potential site of regional breast cancer spread. The aim of this study was to evaluate the impact of internal mammary node radiotherapy (RT) to on clinical outcomes in breast cancer patients treated with mastectomy and postoperative radiation therapy. MATERIALS AND METHODS: This cohort study included 588 patients with breast cancers located in the central and medial quadrants. IMN RT was applied to 320 patients and 268 patients did not receive it IMN RT. Inside the IMN RT group, 165 patients received external beam IMN irradiation (IMN-EB). Mastectomy combined with using Californium-252 neutron source implantation was applied to 155 patients (IMN-BT). Cox proportional hazards modeling was used to determine the influence of IMN RT on clinical outcome. Age, tumor size, lymph nodal status, adjuvant radiotherapy, chemotherapy and hormonal therapy were assessed. RESULTS: IMN-EB resulted in a significant improvement of distant metastasis-free survival, breast cancer-specific survival and overall survival (P=0.033, P=0.037 and P=0.011, respectively). The IMN-EB radiotherapy has a significant impact on event-free survival (HR, 0.67; 95% CI, 0.46-0.91; P=0.043) and breast cancer-specific survival (HR, 0.64; 95% CI, 45-0.91; P=0.013) in patients with moderate-risk (stage T1-2N1). There was no association between IMN RT and clinical outcomes of patients with high-risk disease (stage T3-4N2-3) in any of the study end points. CONCLUSIONS: The effects of IMN-EB radiotherapy on event-free survival and breast cancer-specific survival were benefit for women with moderate-risk breast cancer.

Body mass index, cholesterol level and risk of lung cancer in Lithuanian men.

OBJECTIVE: Our objective was to investigate the association between body mass index (BMI), total serum cholesterol (TSC) level and risk of lung cancer in a Lithuanian population-based cohort study. MATERIALS AND METHODS: The study included 6729 men initially free from cancer. During the follow-up (1978-2008), 358 lung cancer cases were identified. Cox proportional hazards models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). RESULTS: Following adjustment for age, smoking, alcohol consumption, and education, BMI 25-29.9 and ≥30.0kg/m(2) hazard ratios (HR) were significantly associated with decreasing risk for lung cancer, HR=0.73; 95% CI: 0.59, 0.91 and 0.62; 95% CI: 0.45, 0.87, respectively (ptrend=0.001) compared to BMI<25 kg/m(2). Inverse association between BMI and lung cancer was observed among current smokers. We found no evidence that BMI was associated with decreased lung cancer risk in never smokers, although small sample size precluded meaningful analysis. Not significantly lower risk of lung cancer among participants in the 5th quintile compared with the 1st quintile of TSC concentrations was observed. HR per 1 mmol/l increase of TSC was 0.90; 95% CI: 0.82, 1.00. Findings suggest consistent effects of BMI and TSC when follow-up was 1993-2008. CONCLUSION: Our results show an inverse dose-dependent association between lung cancer risk and BMI in Lithuanian men, especially among current smokers. The inverse association could not be attributed to preclinical cancer effect hypothesis. TSC level was not statistically significantly related to a lung cancer incidence.

Cigarette smoking, educational level and total and site-specific cancer: a cohort study in men in Lithuania.

Smoking is an established risk factor for cancer. However, most studies have been carried out on western populations, and less is known about the impact in central and eastern Europe. Our objective was to investigate the association between cigarette smoking, educational level and risk of cancer in a Lithuanian population-based cohort study. The study included 6976 men initially free from cancer. During the follow-up (1978-2008), 1780 cancer cases were identified. Cox proportional hazards models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs). In addition, the burden of cancer attributable to smoking was assessed by the population attributable fraction. Following adjustment for age, education, alcohol consumption and BMI, for current compared with never smokers, highly significant and strongly elevated estimates were found for total (HR=1.79, 95% CI 1.59-2.02), tobacco-related (HR=2.52, 95% CI 2.16-2.95), upper aerodigestive tract (UADT) (HR=5.77, 95% CI 2.73-12.21), lung (HR=10.47, 95% CI 6.74-16.25), bladder (HR=3.31, 95% CI 1.71-6.41) and liver (HR=4.64, 95% CI 1.53-14.08) cancer. Findings suggest a lower risk of prostate cancer in current smokers. In addition, the occurrence of lung and UADT cancer was significantly elevated in men in the lowest educational attainment category. If smoking had not occurred, ∼23% of total cancer, 37% of tobacco-related, 77% of lung, 58% of UADT, 43% of liver and 45% of bladder cancer cases could have been prevented in this cohort of men. Cancer-control strategies focused on reducing smoking should be a public health priority.

Consumption of alcohol and risk of cancer among men: a 30 year cohort study in Lithuania.

Studies have indicated hazardous consumption of large quantities of alcohol among adults in Lithuania. We assessed the associations of alcohol consumption at baseline with cancer incidence among men in a population-based cohort study, using Cox models adjusted for smoking, education and body mass index. Attained age was used as a time-scale. During follow-up (1978-2008) 1,698 men developed cancer. A higher amount of alcohol consumption (≥140.1 g/week vs. 0.1-10.0 g/week) was positively associated with increased risk of total cancer [hazard ratio (HR) = 1.36, 95 % confidence interval (95 % CI) 1.11, 1.65], upper aerodigestive tract cancer (HR = 2.79, 95 % CI 1.23, 6.34) and alcohol-related cancers (i.e. oral cavity, pharynx, larynx, oesophagus, colorectal and liver cancer) (HR = 1.88, 95 % CI 1.25, 2.85). Compared to occasional drinkers (a few times/year), drinkers 2-7 times/week showed an increased risk of total (HR = 1.45, 95 % CI 1.16, 1.83), alcohol-related (HR = 1.83 95 % CI 1.14, 2.93) and other cancers (HR = 1.35, 95 % CI 1.04, 1.76). Our results showed no statistically significant associations between quantity of alcohol intake per one occasion and risk of cancer. About 13 % of total, 35 % of upper aerodigestive tract, 22 % of alcohol-related and 10 % of other cancer cases were due to alcohol consumption in this cohort of men.

Second malignancies following conventional or combined ²5²Cf neutron brachytherapy with external beam radiotherapy for breast cancer.

We retrospectively evaluated the risk of second malignancies among 832 patients with inner or central breast cancer treated with conventional external beam schedule (CRT group), or neutron brachytherapy using Californium-252 (²5²Cf) sources and hypofractionated external beam radiotherapy (HRTC group), between 1987 and 1996 at the Institute of Oncology, Vilnius University. Patients were observed until the occurrences of death or development of a second malignancy, or until 31 December 2009, whichever was earlier. Median follow-up time was 10.4 years (range, 1.2-24.1 years). Risk of second primary cancers was quantified using standardized incidence ratios (SIRs). Cox proportional hazards regression models were used to estimate hazard ratios (HRs). There was a significant increase in the risk of second primary cancers compared with the general population (SIR 1.3, 95% CI 1.1-1.5). The observed number of second primary cancers was also higher than expected for breast (SIR 1.8, 95% CI 1.3-2.4) and lung cancer (SIR 3.8, 95% CI 2.0-6.7). For second breast cancer, no raised relative risk was observed during the period ≥10 or more years after radiotherapy. Compared with the CRT group, HRTC patients had a not statistically significant higher risk of breast cancer. Increased relative risks were observed specifically for age at initial diagnosis of <50 years (HR 2.9, 95% CI 1.6-5.2) and for obesity (HR 2.8, 95% CI 1.1-7.2).

Smoking and other risk factors for pancreatic cancer: a cohort study in men in Lithuania.

BACKGROUND: Cancer of the pancreas is a relatively rare, but highly fatal cancer worldwide. Cigarette smoking has been recognized as an important risk factor, but the relation to other potential determinants is still inconsistent. We investigated the association between different lifestyle, biological and anthropometric factors and the risk of pancreatic cancer in a prospective population-based cohort study from Kaunas, Lithuania. METHODS: Our study included 7132 urban men initially free from any diagnosed cancer, followed for up to 30 years. 77 incident cases of pancreatic cancer were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). RESULTS: Compared to never smokers, current smokers had a significantly increased risk of pancreatic cancer, HR was 1.79 (95% CI 1.03-3.09) after adjustment for age, body mass index, education and alcohol consumption. Among smokers, a significant association with higher smoking intensity was shown (≥ 20 cigarettes/day: HR = 2.60; 95% CI 1.42-4.76, P(trend) = 0.046). We also observed a significantly increased risk for ≥ 30 pack-years of smoking (HR = 2.24; 95% CI 1.12-4.49, P(trend) = 0.16) and for age at starting smoking < 18 years (HR = 2.29; 95% CI 1.11-4.70, P(trend) = 0.43) as compared to never smokers. Alcohol consumption, body mass index and total cholesterol level were not significantly associated with pancreatic cancer. CONCLUSIONS: Smoking significantly increases pancreatic cancer incidence and its high prevalence in Lithuania may partly explain high incidence of the disease. No convincing evidence was found that alcohol consumption, body mass index or serum cholesterol level were associated with pancreatic cancer risk, although the assessment was limited by the lack of statistical power.

Alcohol consumption and risk of gastric cancer: a cohort study of men in Kaunas, Lithuania, with up to 30 years follow-up.

BACKGROUND: Gastric cancer is the second most common cause of death from cancer in the world. Epidemiological findings on alcohol use in relation to gastric cancer remain controversial. The aim of this study was to examine the effect of alcohol consumption on the risk of gastric cancer. METHODS: The association between alcohol intake and the risk of gastric cancer was examined in a population-based cohort of 7,150 men in Kaunas, Lithuania, who were enrolled during 1972-1974 or 1976-1980. After up to 30 years of follow-up, 185 gastric cancer cases were identified. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). The attained age was used as a time-scale. RESULTS: After adjustment for smoking, education level and body mass index, the HR of gastric cancer was 2.00 (95% CI: 1.04-3.82) for the highest alcohol consumption frequency (2-7 times per week) compared with occasional drinking (a few times per year) and 1.90 (95% CI: 1.13-3.18) for ≥ 100.0 g ethanol/week versus 0.1-9.9 g ethanol/week. A stronger effect of alcohol consumption on gastric cancer risk was observed during the second half of the study (1993-2008). In the analysis of gastric cancer risk by alcoholic beverage type, all beverages were included simultaneously in the model. The multivariate HR for men who consumed ≥ 0.5 litre of wine per occasion (compared with those who consumed <0.5 litre) was 2.95 (95% CI: 1.30-6.68). Higher consumption of beer or vodka was not statistically significantly associated with gastric cancer risk. After adjustment for smoking, education level, body mass index and ethanol, we found no excess risk of gastric cancer in association with total acetaldehyde intake. CONCLUSIONS: This study supports a link between alcohol consumption (primarily from ethanol) and the development of gastric cancer in the Lithuanian population. Although an association with heavy wine consumption was observed, the effect of exposure to acetaldehyde on the development of gastric cancer in this cohort was not confirmed. Further research is needed to provide a more detailed evaluation of alcohol drinking and gastric cancer risk.

Cigarette smoking and trends in lung cancer incidence in Lithuania: an analysis by histological type.

OBJECTIVE: The aim of this study was to investigate time trends of lung cancer incidence by histological type in Lithuania during the period from 1996 to 2005. The results were evaluated in relation to tobacco smoking trends. MATERIAL AND METHODS: The incidence rates of the most common lung cancer cell types (squamous cell carcinoma, adenocarcinoma, small cell carcinoma, other types, and morphologically not specified cases) were studied using data from the Lithuanian Cancer Registry. The world standard population was used for age adjustment. Data on tobacco smoking in Lithuania were obtained from various published sources. RESULTS: Among men, squamous cell carcinoma was the most common type of lung cancer. The age-adjusted rates of squamous cell carcinoma decreased from 25 per 100,000 in 1998-1999 to 19.1 per 100,000 in 2004-2005; the incidence rates for adenocarcinoma and small cell carcinoma rose to around 7 per 100,000 in 2002-2003. Among women, adenocarcinoma was the most common histological type. The incidence rates for adenocarcinoma increased to 1.9 per 100,000 until 2002-2003 and thereafter did not change. The rates of squamous cell carcinoma in women were relatively stable at around 1.1 per 100,000. In 2000, the prevalence of regular smoking among men and women peaked at 51.5% and 15.8%, respectively; there was a significant change from smoking nonfilter cigarettes to filter cigarettes. CONCLUSIONS: The decreasing squamous cell carcinoma rates among men and increasing adenocarcinoma rates among men and women are similar to those reported in other European countries and may be due to a shift from nonfilter type cigarettes to filter type.

Cancer incidence among women flax textile manufacturing workers in Lithuania.

OBJECTIVE: To determine site-specific cancer incidence among women spinning-weaving and dyeing-finishing workers in the largest flax textile factory in Lithuania. METHOD: The cancer incidence of a cohort of 3447 women workers from a flax textile factory was investigated for the period 1978-2002. All subjects were employed at the plant in the period 1957-2000 for a minimum of 12 months. Standardised incidence ratios (SIRs) were estimated by use of the corresponding national rates. SIRs were calculated for the spinning-weaving and dyeing-finishing work categories, and for two durations of employment categories (<10 years, > or =10 years). RESULTS: The cancer SIRs among spinning-weaving and dyeing-finishing workers were 0.84 (95% CI 0.69 to 1.00) and 0.90 (95% CI 0.52 to 1.44). An incidence deficit for non-melanoma skin cancer was found for the spinning-weaving unit (SIR 0.45, 95% CI 0.18 to 0.92). The risk of oral cavity and pharynx cancer was significantly increased in spinning-weaving unit workers with <10 years of employment (SIR 5.71, 95% CI 1.56 to 14.60). A significant excess of thyroid cancer and nervous system cancer was found among dyeing-finishing workers. CONCLUSIONS: The overall cancer and non-melanoma skin cancer incidence rate among flax spinning-weaving workers was lower compared with the Lithuanian population. The present findings lend some support to an excess of thyroid and nervous system cancers among dyeing-finishing workers and of oral cavity and pharynx cancer in spinning-weaving workers.

Lung cancer risk among textile workers in Lithuania.

BACKGROUND: The textile industry is one of the largest employers in Lithuania. IARC monograph concludes that working in the textile manufacturing industry entails exposures that are possibly carcinogenic to humans. The purpose of this study was to investigate risk of lung cancer incidence in textile industry workers by the type of job and evaluate the relation between occupational textile dusts exposure and lung cancer risk in a cohort. METHODS: Altogether 14650 textile workers were included in this retrospective study and were followed from 1978 to 2002. Lung cancer risk was analyzed using the standardized incidence ratios (SIR) calculated by the person-years method. The expected number of cases was calculated by indirect methods using Lithuanian incidence rates. RESULTS: During the period of 25 years 70 cancer cases for male and 15 for female were identified. The SIR for male was 0.94 (95% CI PI 0.73-1.19), for female 1.36 (95% CI 0.76-2.25). The lung cancer risk for male in the cotton textile production unit was significantly lower after 10 years of employment (SIR = 0.34; 95% CI 0.12-0.73). The lung cancer risk decreased with level of exposure to textile dust (p for trends was <0.05): the SIR for the low, medium, high and very high level of cumulative exposure were 1.91 (95% CI 0.92-3.51), 1.30 (95% CI 0.52-2.69), 0.77 (95% CI 0.21-1.96), and 0.24 (95% CI 0.03-0.86) respectively. CONCLUSION: In our study the exposure to cotton textile dust at workplaces for male is associated with adverse lung cancer risk effects. High level of exposure to cotton dusts appears to be associated with a reduced risk of lung cancer in cotton textile workers.

Cancer incidence in the workers cohort of textile manufacturing factory in Alytus, Lithuania.

Altogether 14,650 workers employed at least for 1 year a the textile factory in Alytus, Lithuania, were included in the cohort and followed during the period from 1978 to 1997. The standardized incidence ratio (SIR) for men was 1.28. The incidence of esophagus cancer was significant higher (SIR 3.42). It increased only slightly for lung (SIR 1.35). In the women cohort, SIR was 1.05. However, there was a significant increase of the incidence of gallbladder cancer (SIR 3.19). Among textile-processing (spinning and weaving departments) women workers, we found elevated total cancer incidence (SIR 1.35), incidence of breast cancer (SIR 1.49), and cervical cancer (SIR 1.82). In this cohort increased SIR values were observed for more than 10 years since first exposure for all cancer (SIR 1.70) and cervical cancer (SIR 2.44).

[Malignant tumor incidence in employees of the Alytus textile factory (1978-1997)]. / Alytaus tekstiles imones darbuotoju sergamumas piktybiniais navikais (1978-1997).

UNLABELLED: The purpose of this study was to evaluate cancer incidence in the large cotton-manufacturing factory in Lithuania. Altogether 10,198 workers employed at least 1 year in 1969-1997 were included in the cohort and followed during the period 1978/01/01-1997/12/31. National cancer rates were used to calculate the expected number of cancer cases. The overall cancer risk for men was slightly higher than that in the general population (standardized incidence rate (SIR) 1.15, 95% confidence interval (95% CI) 0.98-1.34). A significant increase in the incidence of esophagus (11 observed cases, SIR 3.76, 95% CI 1.88-6.67) and slightly increased of lung (42 observed cases, SIR 1.26, 95% CI 0.91-1.70) cancer became evident. None of the cancer risk showed statistically significant excess cancer incidence in the textile-processing (spinning and weaving) departments (SIR 0.98). In the women cohort the level of the general incidence was very close to expected, standardized incidence rates (SIR) being 0.99 (95% CI 0.88-1.13). However, there was a significant increase in the number of cases of gall bladder (6 observed, SIR 3.19, 95% CI 1.17-6.95). The analysis of the results among textile-processing (spinning and weaving departments) workers indicated the elevated risk of breast cancer (44 observed cases, SIR 1.49, 95% CI 1.08-2.0) and cervical cancer (24 observed cases, SIR 1.68, 95% CI 1.08-2.50). The number of lung cancer cases in this group was a higher, but statistically not significant (5 observed cases, SIR 1.53, 95% CI 0.5-3.58). Increased SIR values were observed for > or = 10 years since the first exposure for all cancers, cervix uteri, ovary and kidney. CONCLUSIONS: The overall cancer risk for men cohort was slightly higher than that in the general population. There was a significant increase in the number of cancer of the esophagus. The overall excess risk in women cohort was only for gall bladder, but for spinners and weavers the elevated risk was for cervix uteri and breast cancer. After 10 years of employment the excess risk was already for all cancers, cervix uteri, ovary and kidney malignant tumors.