Increase in Distant Stage Breast Cancer Incidence Rates in US Women Aged 25–49 Years, 2000–2011: The Stage Migration Hypothesis

Background. Unexplained increases have been reported in incidence rates for breast cancer diagnosed at distant stage in younger U.S. women, using data from the Surveillance, Epidemiology and End Results (SEER) Program. Methods. This report focused on recent SEER trends (2000–2011) in age-standardized incidence rates of invasive breast cancer at ages 25–39 and 40–49 years and the hypothesis that stage migration may have resulted from advances in detecting distant metastases at diagnosis. Results. Increases in the rates for distant stage were roughly equal to decreases in the rates for the most advanced stage subgroups within regional stage; this was evident for estrogen receptor (ER) negative cancers, associated with poorer prognosis, but not for ER positive cancers. The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis. Conclusions. Findings provide some support for stage migration as one explanation for the recent increase in incidence of distant stage breast cancer, but additional studies are needed using other databases

Birth Defects in Blacks and Whites in Relation to Prenatal Development: A Review and Hypothesis

Lower rates of certain birth defects (e.g., neural tube defects, oral clefts, hypospadias, some types of clubfoot) have been reported in Blacks vs. Whites in various countries. The explanation is unknown, but an hypothesis is advanced regarding maturation rates during critical periods of embryonic-fetal development. Analysis of data from several studies in the U.S. indicates that lower rates among Black relative to White live births for some defects (certain neural tube defects, oral clefts, hypospadias) hold mainly within lower birth-weight categories; different etiological factors may be involved in defects occurring in different birth-weight groups. Additional data needed to explore this hypothesis of accelerated maturation as a factor in reducing the risk of certain defects among Blacks include: (1) malformation rates, from unbiased sources, in Blacks and Whites within categories of gestation length and birth weight, among live births and fetal deaths; and (2) ultrasound data on the development of living embryos and fetuses, and morphologic data on early abortions, by racial group

Racial Differences in Mortality from Obesity-Related Chronic Diseases in US Women Diagnosed with Breast Cancer

Objective: Previous studies have focused on racial differences in cancer-specific mortality among US women diagnosed with breast cancer. In view of rising prevalence rates of obesity and persistent racial differences in obesity in the United States, this study considered risk of death from obesity-related causes. Methods: For 233,329 women diagnosed with invasive breast cancer in 9 SEER areas in 1975±1995, all with at least 5 years of potential follow-up after diagnosis, Cox proportional hazards regression was used to analyze relative risks (RRs) of death (underlying cause) from 4 obesity-related chronic diseases (diabetes mellitus, hypertension, coronary heart disease or CHD, and cerebrovascular disease) for ``White,'' ``African-American,'' and ``Asian-American'' patients. Results: RRs were statistically significantly higher for African Americans vs Whites for the 4 obesity-related causes, and for diabetes in Asian Americans vs Whites. Conclusions: Interventions must be designed to address these racial disparities among women diagnosed with breast cancer

Human Biology and Epidemiology of Childhood Bone Cancers: A Review

Clinical case series and descriptive epidemiologic studies have suggested a rela­tionship between childhood bone cancers and accelerated skeletal growth, but definitive studies are lacking. Anthropometric studies of osteosarcoma and Ewing’s sarcoma cases and normal controls, along with their families, are needed to assess the role of growth and maturation. Some descriptive epidemiologic features of these two histologic types of childhood bone cancer are reviewed, along with evidence for the role of hormones (i.e., growth hormone, somatomedins, androgens). Theoretical mechanisms involving hormones are outlined including their possible role as promoters or as factors interacting with environmental agents (such as ionizing radiation). Clinical-epidemiologic studies of families prone to osteosarcomas and to constellations of cancers (and/or skeletal diseases and malformations) may aid in distinguishing genetic and environmental factors and defining specific mechanisms (e.g., hormonal, cytogenetic) of susceptibility. Our understanding of the etiologies of osteosarcoma and Ewing’s sarcoma in children may depend on the integration of knowledge from various areas, including: the differentiation and growth of bone cells and their precursors; the hormonal control of human skeletal growth and maturation; epidemiologic studies of exposures to environmental agents; clinical-epidemiologic studies of families prone to certain cancers; and developments regarding the role of oncogenes and cytogenetic abnormalities in spe­cific cancers

Paternal Age in Relation to Selected Birth Defects

The association between paternal age, within six maternal age categories, and malformations reported on birth certificates was studied in 776,642 white, single live births in Upstate New York (1968-73). The association between paternal age and total malformation rate was not statistically significant (chi-square test); in some maternal age groups, however, high malformation rates occurred in the older paternal age groups (55-59 or 60+ years). Specific defect categories with some evidence for dominant inher­itance were analyzed separately. The only statistically significant associa­tion with paternal age was for syndactyly (chi-square test, p\u3c. 05), due largely to a larger-than-expected number of defects in 50-59 year-old fathers. A relatively high frequency of polydactyly was evident in the 60 + year-old fathers (i.e., 4.25 per 1,000, vs. 0.42 per 1,000 overall rate), but the overall association was not statistically significant. Some possible interpretations of the findings are discussed

Body Build and Age in Relation to Thyroid Function Tests in Adult Women

Cross-sectional data on age and physique in relation to thyroid function test results were analyzed among 174 women aged 26-82 years who were examined in Illinois in 1974-80. There is little evidence for age changes in serum thyroxine (T4), T3 resin uptake (T3RU), free thyroxine index (T7), or estimated concentration of thy­roid binding globulin (TBG). Weight and weight/height are significantly correlated with T3RU (negative r’s) and TBG (positive r’s). Among a subgroup of 51 women who had radial bone mineral measurements, weight was a significant predictor of T3RU and TBG in multiple regression analysis while radial bone mass/bone width was not. These findings appear to represent an association of TBG with body fat, probably due to the effects of peripheral production of estrogens. Significant seasonal variations are evident in T4 and T7 among the 174 women, and analyses in two weight/height categories showed that seasonal variation in T3RU and TBG are evident only in the higher weight/height group. The latter findings are discussed in terms of obesity and thermogenesis

Adult Height and Weight of Female Radium Dial Painters with Analysis of Radiation Effect on Growth

The relationship between exposure to internal radiation and adult height and weight was considered in a group of 556 females who worked as radium dial painters. These persons were first exposed at age 14-29 years, and height and weight were measured at age 46-80. Univariate and multivariate (multiple regression) analysis disclosed no significant overall effect of age at first exposure, or average skeletal dose, on height and weight. Possible effects of radiation on growth were assessed. For persons in the earliest birth cohort (1900-09) who were 14-17 and 18-21 years old at first exposure, skeletal dose in rads received from first exposure to age 21 was estimated and height and weight compared by dose group (0-9, 10-99 and 100+ rads). There was no evidence for an effect of dose, or age-at-first-exposure, on adult height, in agreement with findings on Japanese atomic bomb survivors exposed to external radiation at age 12-17 years

The longevity of athletes

xvii, 257 p.; 23 cm

Body Build and Peptic Ulcer Mortality

Physique was compared between 163 peptic ulcer decedents (79 gastric and 84 duodenal) and 163 controls matched by year of birth. All men were measured anthropometrically while at Harvard University, at a mean age of 20 years, and a smaller number was photographed for body-type ratings. Although differences were in the direction expected from previous studies, only one of 17 differences was statistically significant (i.e., neck girth). The 79 gastric ulcer decedents were .8 kg lighter (not significant) and had a significantly smaller mean neck girth, in comparison with their controls. According to gynandromorphy ratings, duodenal ulcer decedents were significantly more masculine than gastric ulcer decedents. As age at death increased height tended to decrease among duodenal ulcer decedents but tended to increase among gastric ulcer decedents. These data provide further support for a distinction between gastric and duodenal ulcer