摘要:

It is now more than 40 years the seminal paper by Doll and Hill On tobacco-related disease in the UK demonstrated the strong link between cigarette smoking and the risk of lung cancer. Since then the information has steadily built up to the point now where very few people outside of the tobacco industry would deny the causal relationship between the two. In addition there is strong evidence of a causal relationship between cigarette smoking and cancers at several other sites including the urinary bladder, pancreas oesophagus and oropharynx. Amongst men in the 26 European countries studied by Levi et al (1989) lung in 25 countries (it was second highest in Portugal), Whilst cancer of the pancreas was either fifth or sixth commonest in 20 countries and bladder cancer was between fifth and seventh commonest in 16 countries. Lung cancer has a very poor prognosis and so a successful anti-smoking campaign should have a notable effect on lung cancer mortality as well as on cancers of the bladder and pancreas. Since data from the USA and the UK suggest that the lung cancer mortality reflects the prevalence and extent of smoking 20 years previously we would expect a lag before the tangible benefit to the population of a successful anti-smoking campaign would be evident; this has in fact happened in both the USA and the UK where the prevalence of smoking and the amount of tobacco consumed has shown a steady decrease for 20 years and the lung cancer mortality rates first levelled and then began a decrease that has been sustained in the UK for 10 Years..The case against smoking appears to be unanswerable, and has resulted in the health department of all European governments organizing campaigns against smoking; the Europe Against Cancer programme has been particularly active in this Nevertheless, Smoking is still depressingly prevalent (Table 1) and production of cigarettes appears to be static (Table 2). So why are we not winning the battle?Some of the answers are familiar and some are less so. Most people are aware that the EC subsidizes the production of tobacco, a justification for the subsidy being that if people are going to kill themselves by smoking then European farmers may as well have the profits from growing the tobacco. At the time that this policy was instigated, tobacco growing was limited to parts of Italy and small areas in France.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Colorectal carcinogenesis is preceded by a phase of epithelial hyperproliferation. Detection of measurement of this hyperproliferation could be useful as a marker of risk for neoplasia or a measure of response to intervention therapy today bromodeoxyuridine labeling and immunohistology is the easiest to perform and most standardized technique for evaluating proliferation in experimental and human studies. In general measurement of proliferation has fulfilled expectation in experimental studies, however, in humans it has been less conclusive. The reasons are multifactorial and include: limitations in obtaining tissue samples and sampling error, the type of labeling technique used, lack of an objective method for quantifying proliferation and confounding factors influencing the degree of proliferation. The use of matched controls, sophisticated statistical analysis and the search for trends and not just statistical significance, is to be recommended. At present, evaluation of rectal epithelial proliferation is of limited value in assessing risk for colorectal neoplasia in the individual. On the other hand, it seems a useful biomarker of response within the context of a matched control intervention trial.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Plasma sex hormone-binding globulin (SHBG), testosterone, total oestradiol (E2) and proportion of E2 not bound to blood proteins (percentage free E2) have been measured in a case-control study to test whether any of these factors are related to the risk of breast cancer. The cases studied were 27 premenopausal and 34 postmenopausal women with newly diagnosed localized breast cancer who were admitted to the All-Union Cancer Research Centre, Moscow. The controls were an equivalent number of women from the same neighbourhood. These were matched for age (within 2 years) and menopausal status. The average levels of E2 in cases were significantly higher than controls (p= 0.004 andp< 0.001 for pre- and postmenopausal groups, respectively). Percentage free E2 was significantly raised only in premenopausal cases (p = 0.019). The plasma concentrations of testosterone and SHBG were similar for both pre- and postmenopausal groups. Raised E2 or percentage free E2 was associated with an increased relative risk of breast cancer. However, only E2 levels (crude or adjusted for body build) were significantly related to risk in the two menopausal sets (p= 0.022 andp= 0.002, respectively). High percentage free E2 was associated with almost a threefold increase in the risk of breast cancer in premenopausal women; however, this increase was not statistically significant (p = 0.083). The levels of SHBG or testosterone, crude or adjusted for body build and E2 concentration, were not related to risk of breast cancer.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Mammography uptake has been discouragingly low since the introduction of breast cancer screening in Northern Ireland. This questionnaire survey was undertaken to appraise the views of participating general practitioners (GPs) about mammography and the extent to which they followed good practice in facilitating the screening programme. Of 173 GPs, 152 returned a questionnaire. Approximately three-quarters of these GPs believed the screening programme was worthwhile for the eligible women on their list. When sent the prior notification lists from the screening unit, less than half of the GPs always checked the accuracy of patients addresses. Fifty-five per cent of the GPs said they routinely took opportunities (as they arose) during normal surgeries to counsel women about mammography and 90% did so in health promotion or well-woman clinics. Despite this, only 56% routinely recordednon-attendancein patients case notes and less than 20% contacted non-attenders to advocate mammography. Such a pro-active approach was more commonly adopted with women who had not attended when invited for a cervical smear. There was no significant difference in mammography uptake among the women on the lists of GPs with differing views or whose doctors differed in their degree of active commitment to the programme. The results point to a need for the screening unit to evaluate its own advocacy role to GPs and for Health Board to devise effective appraisal strategies for health promotion clinics in primary care.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A case-control study of prostatic cancer was carried out to examine the association between selected physical characteristics and factors related to sexual development and behaviour and the risk for this disease. In consideration of an endocrinologic mechanism for these putative risk factors, the association between selected factors and serum hormone level in a comparison group, free of prostate cancer, was also examined. One-hundred cases and 113 controls were included for study. An elevated risk for prostatic cancer was found for those currently married (odds ratio (OR) = 4.0), those who had been married once (OR = 2.8), and those who were currently practising a religion (OR = 2.0). Compared to subjects with one child, those with more than one child and those with no children were more common among cases than controls. Prostatic cancer risk was associated with large body size and, in particular, with greater weight (p< 0.01). Early age at attainment of adult height was also associated with prostatic cancer risk (p< 0.01). Only moderate associations were found between increased frequency of sexual intercourse and prostatic cancer risk. The levels of testosterone (T), dihydrotestosterone, salivary testosterone and T/SHBG (sex hormone binding globulin) did not vary with age. Older men had higher oestradiol levels. Further, little association between hormone levels and risk factors was found, except for married subjects having increased serum androgens (p< 0.05) and heavy subjects having decreased serum androgens (not significant).

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Rough estimates of the effect in 2005 of various preventive measures aimed at reducing cancer mortality in the in the Nordic countries were made using the American software CAN*TROL., The effect was measured as the percentage reduction in cancer mortality in 2005. The calculation were performed for changes in the smoking, dietary and sunbathing habits of the population (primary prevention), earlier diagnosis (secondary prevention) and improvements in survival resulting from better treatment (tertiary prevention). The calculations incorporate many assumptions, some of them more firmly based than others, such as uniformity of incidence trend in all the Nordic countries and also concerning the causality of various relations. For lack of evaluated Nordic data, we have used American figures concerning stage distributions and stage-specific relative survival rates. These assumptions should be borne in mind when drawing conclusions from the results obtained. The results show that there is a potential of up to several tens of percent for reducing total cancer mortality by the year 2005.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The geographical distribution of cancer of the oesophagus shows wide inter- and intra-national variation both in mortality and sex ratio. Numerous analytical studies have demonstrated alcohol and tobacco as important risk factors. Poor diet, particularly those lacking fresh fruit and vegetables, appears to be an equally important determinant in certain areas. In addition to alcohol and tobacco, Maté drinking in Southern South America independently increases risk. The possible role of thermal injury when Maté is drunk hot is still being investigated. Analysis of incidence data by histological subtype and site of disease has revealed rising rates for adenocarcinomas, generally of the lower third of the oesophagus, and predominantly in males. These data are paralleled by increasing rates of adenocarcinoma of the cardia of the stomach. The aetiology of these tumours in adjacent sites remains to be fully investigated but one known predisposing factor is the presence of Barrett's oesophagus. This poor prognosis disease does not appear amenable to widespread screening. Preventative measures would necessarily incorporate plans to reduce alcohol and tobacco use while improving the marginal diets of many populations.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The incidence of cancer of the oesophagus and stomach in the West Midlands region of England have been analysed for the 25year 1962–86 Overall, cancer of the oesophagus is increasing (from 3.45 per 100,000 in 1962–66 to 4.37 in 1982–86) and stomach cancer is decreasing (19.22 and 16.54 respectively). However, when analysed by histological type and subsite the picture is very different. In oesophagus, squamous cell carcinoma shows only a slight increase whereas for adenocarcinoma the increase is highly significant (from 0.14 to0.76). In stomach, cardia shows a very similar pattern to adenocarcinoma of oesophagus (increasing from 0.75 to 2.96) but pyloric antrum is decreasing (from 2.63 to 2.32). The rapid changes in investigative procedures over the period have resulted in increasing numbers with histological confirmation and subsite specification but despite these confounding factors, comparative analyses still indicate a real increase in adenocarcinoma of oesophagus and cardia. Although the incidence of both are greater in men than in women, the proportional rates of increase, particularly for cardia, are very similar in both sexes, indicating a common aetiological factor or factors. Anlysis by social-economic group reveals that the increases observed are not uniform throughout the population but are relatively higher in professional classes (1 and 2).

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In the Oxford region 8,903 residents with oesophageal or gastric cancers were registered by the Oxford Cancer Registry between 1974 and 1988. For most of this time the Registry's practice was to code all adenocarcinomas of the oesophagus as adenocarcinomas of the cardia of stomach. There was a significant increase over time in the registered incidence of adenocarcinoma of the cardia, no appreciable change in the incidence of oesophageal cancers registered as such, and a decline in registered incidence of cancers of the stomach other than cardia.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This paper reports the incidence of oesophageal carcinoma in five cancer registries from France and in a further two from the francophone regions of Switzerland. The cancers are segregated into the two main histological types (squamous cell carcinoma and adenocarcinoma). In Belgium the proportion of adenocarcinomas is much higher than in any of the French registries. A study of time trends shows no clear trend in overall incidence of oesophageal cancer. There is a trend towards an increasing proportion of adenocarcinomas with time, that is most apparent in Doubs, Dijon and Vaud registries.

ISSN:0959-8278    

出版商:OVID    

年代:1992

数据来源: OVID