Etiology of cancer of the renal pelvis.

A population-based case--control interview study of cancer of the renal pelvis (74 cases and 697 controls) conducted in the Minneapolis--St. Paul metropolitan area showed cigarette smoking to be the major cause of this cancer. The odds ratio (OR) for cigarette smoking was 7.6 among males [95% confidence interval (CI): 2.2-31.5] and 5.8 among females (95% CI: 2.0-17.3), with the OR exceeding 10 for heavy smokers of both sexes. Long-term use of analgesics and several occupational exposures were also found to be risk factors. In addition, there were unexpected positive associations among females for heavy tea consumption and for use of estrogen medications, although the significance of these relationships remains to be clarified.

A population--based case--control study of renal cell carcinoma.

A population-based case-control study of renal cell carcinoma (495 cases and 697 controls) in the Minneapolis-St. Paul seven-county metropolitan area implicated cigarette smoking as a risk factor with an odds ratio (OR) among men of 1.6 (95% confidence intervals: 1.1-2.4) and among women of 1.9 (1.3-3.0). A statistically significant dose response was observed in both sexes for pack-years of cigarette use. On the basis of calculations of attributable risk, it was estimated that 30% of renal cell cancers among men and 24% among women were due to smoking. High relative adult weight as measured by the body mass index (BMI) was found to be a major risk factor among women but not among men, with those in the highest 5% of the BMI having an OR of 5.9 (1.8-20.4) in comparison to the lowest quartile. This association with excess weight was not seen at age 20, but it became more pronounced with increasing age, suggesting that the primary influence of weight gain is during the late stages of renal carcinogenesis. Excess risks were also related to ethnic background (particularly, German), which may account in part for the elevated incidence of renal cancer in the North Central area of the United States. In addition, positive associations were observed for long-term use of phenacetin-containing analgesics, heavy meat consumption, and heavy tea drinking (females only). An occupational clue was provided by an increased risk for exposure to petroleum, tar, and pitch products. Excesses of certain urologic and cardiovascular diseases were also observed among the cases compared to controls.

Pesticide exposures and other agricultural risk factors for leukemia among men in Iowa and Minnesota.

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.

Diet, tobacco use, and fatal prostate cancer: results from the Lutheran Brotherhood Cohort Study.

A cohort of 17,633 white males age 35 and older responded to a mailed epidemiological questionnaire in 1966 and was followed until 1986 to determine the risk of cancer associated with diet, tobacco use, and other factors. During the 20-year follow-up, 149 fatal prostate cancer cases were identified. Relative risks for prostate cancer were significantly elevated among cigarette smokers (relative risk, 1.8; 95% confidence interval, 1.1-2.9) and users of smokeless tobacco (relative risk, 2.1; 95% confidence interval, 1.1-4.1). No significant associations were found with frequency of consumption of meats, dairy products, fruits, or vegetables. There were no overall significant associations between consumption of vitamin A from animal sources (retinol) and provitamin A from plant sources (carotene) and risk, but positive trends were seen for ages under 75, while inverse associations were found at older ages. Beverage consumption, including drinking coffee and alcohol, was unrelated to risk. Marital status, education, rural/urban status, and farming residence were also unrelated to the risk of fatal prostate cancer. The findings add to limited evidence that tobacco may be a risk factor for prostate cancer, but fail to provide clues to dietary or other risk factors.

No involvement of bovine leukemia virus in childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma.

Bovine leukemia virus (BLV) is the causative agent of enzootic bovine lymphosarcoma. Much speculation continues to be directed at the role of BLV in human leukemia. To test this hypothesis rigorously, a case-control study of childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma was conducted between December 1983 and February 1986. Cases (less than or equal to 16 years at diagnosis) derived from patients diagnosed at the primary institutions and affiliated hospitals were matched (age, sex, and race) with regional population controls. DNA samples from bone marrow or peripheral blood from 157 cases (131 acute lymphoblastic leukemia, 26 non-Hodgkin's lymphoma) and peripheral blood from 136 controls were analyzed by Southern blot technique, under highly stringent conditions, using cloned BLV DNA as a probe. None of the 157 case or 136 control DNA samples hybridized with the probe. The high statistical power and specificity of this study provide the best evidence to date that genomic integration of BLV is not a factor in childhood acute lymphoblastic leukemia/non-Hodgkin's lymphoma.

HLA antigens in renal cell carcinoma.

HLA antigen type was studied in 35 renal cell carcinoma patients who had bilateral disease, an early age of onset (less than age 45), or a family history of kidney cancer. Increased frequencies of the single-locus antigens HLA-DR8 (relative risk, 3.3) and HLA-Bw44 (relative risk, 2.1) and a deficit of HLA-DR1 (relative risk, 0.4) were found. Although based on small numbers, the relative excess was highest among persons phenotypically HLA-Bw44DR8. A higher frequency of the three-locus phenotype HLA-A3B7DR2 was also noted. The unusual HLA patterns were most pronounced among patients of German or Scandinavian origin, population groups reported to have an elevated risk of renal cancer.

Head injury as a risk factor for Alzheimer's disease.

A case-control study was performed in which the frequency of prior head injury was assessed in 78 patients with dementia of the Alzheimer type (DAT) and 124 control subjects matched for age, sex, and race. A history of head injury with loss of consciousness was reported in 25.6% of patients and 5.3% and 14.6% of hospital and neighborhood controls, respectively. Matched-pair analysis of patients and hospital controls yielded an odds ratio of 4.50, which was significant (p less than 0.01). The ranges of times of occurrence of head injuries were similar in patients and controls, spanning several decades. The findings suggest a possible etiologic role for head injury in DAT.

Alcohol consumption and risk of leukemia, non-Hodgkin's lymphoma, and multiple myeloma.

Population-based case-control interview studies of white men, 578 with leukemia, 622 with non-Hodgkin's lymphoma, and 820 controls from Iowa and Minnesota and 173 with multiple myeloma and 452 controls from Iowa, offered the opportunity to investigate the relationship of these cancers with alcohol consumption. Although drinkers had non-significantly elevated risks for specific subtypes of leukemia (acute lymphocytic leukemia (OR = 3.0), myelodysplasia (OR = 1.6), and other leukemia (OR = 1.5)) and multiple myeloma (OR = 1.3), there were no statistically significant findings and no dose-response gradients with amount of alcohol consumed. Thus, these data suggest that alcohol is not an important contributor to the etiology of lymphatic and hematopoietic tumors.

Familial cancers associated with subtypes of leukemia and non-Hodgkin's lymphoma.

To investigate whether a history of hematolymphoproliferative cancers (HLP) and other cancers among a parent or sibling is a risk factor for specific subtypes of leukemia and non-Hodgkin's lymphoma (NHL), data from a population-based case-control study, in Iowa and Minnesota, of 578 leukemia cases, 622 NHL cases and 1245 controls were evaluated. Having at least one sibling with HLP significantly increased the risk for all leukemias combined (odds ratio (OR) = 2.3) and for NHL (OR = 2.7). In particular, chronic lymphocytic leukemia (CLL) was significantly increased among those reporting a sibling with leukemia (OR = 3.0) or lymphoma (OR = 4.3). Elevated risks of small lymphocytic NHL (SML) (OR = 7.3) and diffuse NHL (DIF) (OR = 5.4) were also observed among subjects who had a sibling with lymphoma (primarily Hodgkin's disease). A significantly increased risk of follicular NHL was noted among those with a sibling history of pancreatic cancer (OR = 4.8) and colorectal cancer (OR = 2.7). Parental history of HLP was not associated with any type of leukemia or NHL. A history of stomach cancer among parents was associated with a 2-fold elevation of CLL and DIF compared to controls. Increased risks of CLL and DIF were also linked to breast cancer among sisters and mothers, respectively. Prostate cancer among fathers increased the risk 2-fold for CLL and 3-fold for SML. This study confirms some familial cancer associations previously reported for leukemia and NHL, and provides new information regarding the various subtypes of leukemia and NHL.

Is cigarette smoking a risk factor for non-Hodgkin's lymphoma or multiple myeloma? Results from the Lutheran Brotherhood Cohort Study.

Among 17,633 U.S. white male insurance policy holders whose use of tobacco was characterized in a 1966 self-administered questionnaire, there were 49 deaths from non-Hodgkin's lymphoma (NHL) and 21 from multiple myeloma (MM) during a 20-year follow-up. Men who had ever smoked cigarettes had an elevated mortality from NHL (RR = 2.1; CI = 0.9-4.9), with risk almost four-fold greater among the heaviest smokers (RR = 3.8; CI = 1.4-10.1) compared with those who used no tobacco. In contrast, risk of MM was only slightly elevated among those who had ever smoked cigarettes (RR = 1.3; CI = 0.4-3.9) and without evidence of a dose-response trend. Since this is the first cohort study suggesting a link between cigarette smoking and NHL and findings from case-control studies have been inconsistent, additional clarification should be sought from larger incidence-based cohort investigations.

Incidence of skin carcinoma after renal transplantation.

The development of de novo malignant neoplasms after renal transplantation continues to be of importance. The incidence of skin cancer in the renal transplant population at the University of Minnesota Hospital is compared with that expected on the basis of rates from the special nonmelanoma part of the Third National Cancer Survey. Overall, the risk of skin cancer in the renal transplant population was 7.1 times that expected. This excess was due primarily to squamous cell carcinomas, which were 36.4 times as frequent as expected.

Sexual factors and prostatic cancer: results from a case-control study.

A case-control study of a number of factors of possible etiologic significance for prostatic cancer was conducted in the Minneapolis-St. Paul area. The focus was primarily on sexual factors. Two hundred and fifty incident cases of prostatic cancer, 238 hospital controls, and 240 neighborhood controls were included. Controls were matched to cases on age, sex, and race. Cases were somewhat more educated than controls. An association was found between prostatic cancer and a history of venereal disease in their sexual partners: odds ratio (OR) = 2.71, 95% confidence interval (CI) = 1.14 to 6.46 and OR = 2.09, 95% CI = 1.02 to 4.29 for hospital and neighborhood controls, respectively. Cases had more sexual experiences with prostitutes, although their overall lifetime frequency of sexual intercourse with all partners was somewhat lower. Cases also reported more homosexual partners than controls. The results from the study lend some support to an infectious hypothesis for prostatic cancer. The lower frequency of sexual intercourse (OR = .54, 95% CI = .34 to .83 and OR = .68, 95% CI = .47 to 1.01 for hospital and neighborhood controls, respectively) is also noteworthy and may be indicative of a hormonal difference related to sexual interest or drive.

Projection of asbestos related diseases in the United States, 1985-2009. I. Cancer.

Projections of asbestos associated cancer mortality in the United States during the 25 year period 1985-2009 were made based on previously published estimates. These estimates were reviewed for malignant mesothelioma, lung cancer, and gastrointestinal cancers. Particular attention was given to the assumptions used in the original derivation of the estimates. For malignant mesothelioma mortality, previous estimates ranged from 15,500 to 300,000. Using recently published data from the Surveillance, Epidemiology, and End Results project, coupled with the previously published estimates, projected asbestos related malignant mesothelioma mortality in the United States for the period 1985-2009 was estimated to be 21,500. For lung cancer, previous estimates were reviewed, particularly with regard to the ratio of deaths from lung cancer to deaths from malignant mesothelioma. Using these ratios, a range of projected deaths was established and a median of those estimates used as a project, which was 76,700 such deaths in the United States between 1985 and 2009. Gastrointestinal cancer mortality has been projected by only three investigators. A median of those estimates (33,000) was used. In conclusion it is estimated that 131,200 deaths from asbestos associated cancer will occur in the United States between 1985 and 2009.

A retrospective cohort mortality study of iron ore (hematite) miners in Minnesota.

In a retrospective cohort mortality study of 10,403 Minnesota iron-ore (hematite) miners no excesses of lung cancer mortality were found among either underground (Standardized mortality ratio [SMR] = 100) or above ground (SMR = 88) miners. Yugoslav-born miners incurred a two-fold significant excess mortality for lung cancer that did not appear to be associated with their mining exposures. Significant excesses in mortality due to stomach cancer were found for both underground (SMR = 167) and aboveground (SMR = 181) miners as compared with U.S. white males. However, except among Finnish-born miners, these excesses disappeared when comparisons were made with the appropriate county rate. The apparent absence of significant radon exposure, a strict smoking prohibition underground, an aggressive silicosis control program, and the absence of underground diesel fuel use may explain why these underground miners did not appear to incur the lung cancer risk reported in other studies.

Epidemiologic study of prostatic cancer: preliminary report.

In a preliminary report on a small fraction of the projected subject population, some evidence in support of both sexual activity and venereal transmission hypotheses is accumulating. Prostatic cancer cases, in contrast to hospitalized and/or neighborhood controls, are beginning to show greater proportions of selected sexual activities compatible with venereal transmission of an infectious agent, such as number of sexual partners, use of prostitutes, prior venereal disease, and genital infections in the spouse. Patients with prostatic cancer also appear to have had higher fertility and more prostatic cancer in blood relatives than controls. Age at first intercourse and at first marriage are lower among the cancer patients than among the controls. Antibody titrations for herpesvirus and cytomegalic virus, although currently not revealing striking disparities in positivity, tend to show higher titers among the cancer cases.