Ecologic correlates of cancer mortality patterns in an industrialized urban population.

Cancer mortality data for the period 1968-80 were analyzed to examine whether the high cancer burden for the city of Philadelphia was "evenly" distributed spatially and, if not, whether this distribution could be associated with socioeconomic variables and air pollution. Areas with significantly higher-than-expected rates tended to cluster; lung cancer and non-lung cancers showed distinctive cluster patterns, which were evident only for males; female rates for any cancer or groups of cancers were almost uniformly distributed over the neighborhoods. Both the high lung cancer and the high non-lung cancer clusters were characterized by low socioeconomic status, but only the high lung cancer clusters exhibited high levels of air pollution. These neighborhood characteristics suggested that socioeconomic variables explain non-lung cancer mortality patterns; socioeconomic variables, together with air pollution, could be responsible for the observed lung cancer patterns. The uniform distribution of female lung cancer rates suggested that air pollution by itself cannot be a prominent factor in lung cancer mortality.

Patterns of mortality from selected causes in an urban population.

Mortality data for selected non-cancer causes for the period 1974-1980 were analyzed for the City of Philadelphia to examine spatial patterns. Four categories of conditions--ischemic heart disease (including acute myocardial infarction), chronic liver disease and cirrhosis, cerebrovascular disease, and external causes--demonstrated significant variation in death rates. Moreover, neighborhoods with high levels of mortality for these conditions appeared in significant clusters. With the exception of ischemic heart disease, neighborhoods with high levels of mortality were characterized by below average levels of SES. A group of predominantly black neighborhoods in the central part of the city had extremely high rates for five or more of the nine causes investigated in this paper. In an earlier analysis, all but one of these neighborhoods were found to have the highest level of overall cancer mortality. These findings support the hypothesis that there are social and behavioral factors that are associated with a wide range of disease conditions, and many of these factors are associated with socioeconomic status.

Phase II study of low-dose mitomycin in patients with ovarian cancer previously treated with chemotherapy.

Forty-three evaluable patients with ovarian cancer who had failed one or more chemotherapy regimens were treated with mitomycin iv at 28-day intervals. Thirty-six patients with good bone marrow reserve received 10 mg/m2 and seven patients with poor bone marrow reserve received 6.7 mg/m2 initially. Ten patients (23%) responded. Patients with an Eastern Cooperative Oncology Group performance status of 0-1 had better response rates and survivals as compared to patients with a performance status of 2-4 (44% vs 8%; median survival, 8 vs 4 months). The acute hematologic and gastrointestinal toxicity was minimal. No patients developed pulmonary, renal, cardiovascular, or local tissue toxicity.