Comparative epidemiology of tobacco-related cancers

In a retrospective study, interviews were obtained with 3,716 patients with histologically proven cancer of the lung (Kreyberg types I and II), mouth, larynx, esophagus, or bladder and with over 18,000 controls. For each of these cancers, the relative risk of both male and female present smokers increased with the quantity smoked and the duration of the habit. The strongest increase occurred for cancer of the lung and larynx, and the least increase occurred for cancer of the esophagus and bladder. For exsmokers the risk decreased with years of cessation. The risk for mouth cancer of pipe and cigar smokers who inhaled much less than cigarette smokers was less than that of the latter and increased with the quantity smoked. The risk of mouth, larynx, and esophagus cancer among smokers increased with the quantity of alcohol consumed. Greater smoking habits and lesser cessation rates were noted among lower socioeconomic groups, suggesting that these groups will bear an ever increasing proportion of the burden of tobacco-related cancer

The "Over-Exposed" Control Group

Relative risk is determined as much by the level of exposure among controls as among cases. If cases and controls are drawn from a population in which the range of exposures is narrow, then a study may yield little information about potential health effects. This may be one reason why an association between dietary fat and cancer has not been consistently observed in Western populations. Since the fat intake as a percent of total calories in the US general population varies little, only very large relative risks can be detected in epidemiologic studies. Investigators of the dietary fat hypothesis need to select study groups from populations where the risk factor is not, essentially, narrowly distributed

Effect of Occupational and Recreational Activity on the Risk of Colorectal Cancer among Males: A Case-Control Study

Epidemiological studies have consistently demonstrated that either occupational or recreational physical activity is pro tective against colon cancer. However, it is unclear whether recreational activity is similarly protective among those who engage in high or low occupational activity. We therefore compared 440 male cases of colorectal cancer with 1164 male hospital patients. Occupational activity was defined according to job title, while recreational activity was assessed by questionnaire for three different periods of life. Occupational activity was protective with respect to colorectal cancer irrespective of whether one engaged in recreational activity at any different period of life. In contrast, recrea tional activity, performed at 20-44 years of age appeared to decrease colon cancer risk by 10-25% irrespective of the in tensity of job activity. The present results suggest that, although we observed a larger effect with occupational activity than with recreational activity, middle-aged men may reduce their risk of colorectal cancer if they exercise when they are not working. These findings need to be confirmed in other population

Cervix cancer and cigarette smoking: a case-control study

The association between cervix cancer and cigarette smoking was examined among 332 white cases and 1725 white controls. Cases were of lower socioeconomic status (SES) and smoked more than controls. After adjustment for both age and SES, no significant association was observed between cervix cancer and cigarette smoking. Many variables related both to cigarette smoking and to known risk factors for cervix cancer are sources of confounding and inadequate control for these variables may cause an overestlmation of the effect of smoking

Parakeets, canaries, finches, parrots and lung cancer: no association.

The relationship between pet bird keeping and lung cancer according to exposure to tobacco smoking was investigated in a case-control study in hospitals of New York City and Washington, DC, USA. Newly diagnosed lung cancer cases (n = 887) aged 40-79 years were compared with 1350 controls with diseases not related to smoking, of the same age, gender and date of admission as the cases. The prevalence of pet bird keeping was 12.5% in men and 19.1% in women. There was no association between ever keeping a pet bird and lung cancer in never smokers (men adjusted odds ratio (OR) = 0.70, 95% confidence interval (Cl) 0.15-3.17; women, 1.32, 95% Cl 0.65-2.70), or in smokers and non-smokers combined, after adjustment for ever smoking (men: 1.28, 95% Cl 0.88-1.86; women: 1.17, 95% Cl 0.83-1.64; all: 1.21, 95% Cl 0.95-1.56). Risk did not increase in relation to duration of pet bird keeping. Cases and controls kept similar types of birds. There was a tenfold increase of lung cancer risk associated with smoking among non-bird keepers (adjusted OR = 9.15). There was no indication of a synergism, either additive or multiplicative, between smoking and pet bird keeping with respect to lung cancer risk. Either alone or in conjunction with smoking, keeping parakeets, canaries, finches or parrots is not a risk factor for lung cancer among hospital patients in New York and in Washington, DC

Tobacco Usage in France: An Epidemiological Study

A survey of tobacco and alcohol consumption was conducted among 3,453 noninstitutionalized men and women in 65 départements in France. Over four-fifths of the men and half of the women surveyed had smoked cigarettes. Men were far more likely than women to have stopped smoking, especially older men in higher social classes. Fifty-five percent of the men smoked cigarettes made with black tobacco (Gauloises, Gitanes), while women preferred blond tobacco products. Younger smokers of both sexes preferred filtered cigarettes, while older respondents smoked nonfiltered ones. Filter usage among men, but not women, increased with education. Inhalation was more prevalent among men than women, among the young than the old, and among the more educated than the less educated. “Drooping” or carrying a lighted cigarettes in the mouth without inhaling, was a practice more common in older, less educated male smokers. These data also provide some evidence in support of the hypothesis that black tobacco, with its higher pH, provides unprotonated nicotine which is easily absorbed by oral mucosa, thus making deep inhalation of the smoke less important to the smoker. The observed differences between the smoking practices of the French and those in the United States and United Kingdom along with the relatively higher alcohol consumption noted throughout France, may partially explain the lower rates of lung cancer and higher rates of larynx, esophagus, and oral cavity cancer found in French men

Smoking and Pancreatic Cancer in Men and Women

Most studies of smoking and pancreatic cancer have used male subjects or combined men and women together in statistical analyses. There is little information on the relative risk of smoking and pancreatic cancer in women. Because of the high case-fatality rate, many of these studies were also based on information gathered from proxy respondents, in which smoking habits may not be recalled with certainty. A hospital-based study of 484 male and female patients with pancreatic cancer and 954 control subjects was conducted based on direct interviews of incident cases. Compared to never smokers, the odds ratio (OR) for current cigarette smokers was 1.6 [95% confidence interval (CI), 1.1-2.4] for men and 2.3 (95% CI, 1.4-3.5) for women. In women, but not in men, there was a trend in the ORs with years of daily cigarette consumption (P < 0.01). Filter cigarettes offered no protective advantage compared to nonfilter cigarettes. Among men, the OR was 2.1 (95% CI, 1.2-3.8) for pipe/ cigar smokers and 3.6 (95% CI, 1.0-12.8) for tobacco chewers. Tobacco smoke causes pancreatic cancer when inhaled into the lungs. Tobacco juice may also cause pancreatic cancer when ingested or absorbed through the oral cavity. These data suggest that smoking is a cause of pancreatic cancer in women and that the risks for female smokers are comparable to male smokers. Nevertheless, the causes of most pancreatic cancers are unknown

Artificial Sweetener Use and Bladder Cancer: A Case-Control Study

In a case-control study of 302 male and 65 female bladder cancer patients and an equal number of other patients matched to them in age, sex, hospital, and hospital-room status, no association was found between use of artificial sweeteners or diet beverages and bladder cancer. No dose-response was observed with respect to quantity or duration of use or the two combined. No evidence was found to suggest that artificial sweeteners or diet beverages promote the tumorigenic effect of tobacco smoking. Artificial sweetener and diet beverage use strongly reflected socioeconomic status among controls with various diagnoses

The epidemiology of left-handedness in a hospital population

PURPOSE: We evaluated the association between left-handedness (LH) and age, education, cigarette smoking, alcohol consumption, and disease status in a case-control study of 8801 hospitalized patients with cancer and those with other conditions. METHODS: Subjects were interviewed in person using a structured questionnaire that contained detailed sections of lifestyle behaviors. RESULTS: The overall prevalences of LH were 7.6% among men and 6.5% among women. Among both sexes LH declined with increasing age (p > 0.05). After adjustment for age, the following associations were observed. Men had a higher risk of LH than women. The prevalence of LH was lower in ever-married subjects compared with never-married subjects (odds ratio [OR] for men, 0.7; 95% confidence intervals [CI], 0.5-0.9; for women, OR, 0.5; 95% CI, 0.3-0.9). Among men, the prevalence of LH was not associated with race, years of education, smoking status, or levels of alcohol consumption. The risk of LH was elevated in men diagnosed with fractures as compared with all other male patients (OR, 2.4; 95% CI, 1.3-6.7). Among women, LH was not associated with race, smoking, or hormonal and reproductive factors, but LH was more common among female high-school and college graduates and among self-reported alcoholics. The odds ratio of LH was significantly lower in women with breast cancer (OR, 0.3; 95% CI, 0.1-0.7). CONCLUSIONS: The increased risk of serious injuries in LH IS not a result of higher alcohol use. Handedness might be an important factor in the safe use of industrial equipment

The relationship between cognitive maturity and information about health problems among school age children

This study of urban, multi-ethnic children was undertaken to explore the relationships between age, cognitive developmental capability (termed ‘cognitive maturity’) and accuracy of information about health problems. A total of 299 children in the first, second and third grades from six public and one private school hi New York City were individually interviewed using an open-ended set of questions. Findings indicated that having accurate health information is not the same as comprehending the abstract internal nature of the ‘facts’. Results supported Piaget\u27s levels of cognitive development applied to the area of health. Findings also showed that age is a better predictor of children\u27s accuracy about health information than their cognitive maturity. The findings underscore the need for those providing health education to place emphasis on the cognitive abilities of children and not to mistake recitation of factual information for understanding of conceptual elements of a health problem