It may be important to identify early childhood trauma and adult psychological distress in programs that focus on reducing alcohol abuse.

To determine how maternal exposure to environmental tobacco smoke affects birthweight, maternal sera obtained from 3529 pregnant women around 27 weeks gestation were analyzed for cotinine, a metabolite of nicotine. Based on cotinine levels, nonsmokers were divided into those exposed to environmental tobacco smoke (2-10 ng/mL) and those unexposed (< 2 ng/mL), and smokers were divided into tertiles. Compared with unexposed nonsmokers' infants, infants of exposed nonsmokers averaged 45 g less (P = .28) after adjustment for confounders, and smokers' infants averaged 78, 191, and 233 g less for the first, second, and third cotinine tertiles, respectively. Birthweight decreased 1 g for every nanogram per milliliter of cotinine increase (P < .001).

BACKGROUNDInformation is limited for Asian subgroups regarding survival after diagnosis of the common cancers amenable to routine screening. The authors examined survival after carcinomas of the prostate, colon/rectum, breast, and cervix separately for Chinese, Japanese, Filipinos, and non‐Hispanic whites in the United States.METHODSUsing data from the Surveillance, Epidemiology, and End Results program, the authors compared the distributions of stage at diagnosis and computed 5‐year cause specific survival probabilities, overall and by stage of disease, for cancer patients whose diagnosis was in 1988–1994 and who were observed through 1997.RESULTSAmong males, Filipinos were more likely to be diagnosed with advanced stage colorectal and prostate carcinomas than other Asians and non‐Hispanic whites; they also experienced worse survival after these cancers. This survival deficit occurred across all stages of colorectal carcinoma and remained apparent within distant stage prostate carcinoma. Among females, Chinese were less likely to receive diagnoses of early stage colorectal carcinoma than Japanese and Filipinas. In addition, their survival was consistently lower across more advanced stages of disease. Chinese also experienced somewhat worse survival after diagnosis of early stage cervical carcinoma. Japanese were more likely to be diagnosed with early stage carcinomas but also tended to experience better survival after prostate, colorectal, and breast carcinomas regardless of stage.CONCLUSIONSChinese, Japanese, and Filipinos experienced unequal survival after these screenable carcinomas, indicating that certain groups may benefit from more aggressive screening efforts. The heterogeneity of cancer outcomes observed within the community classified as Asian reinforces the need for cancer statistics to be reported for disaggregated subgroups. Cancer 2002;94:1175–82. © 2002 American Cancer Society.DOI 10.1002/cncr.10319

BACKGROUNDMany studies have examined racial/ethnic differences in treatment for localized breast carcinoma, but to the authors' knowledge few have included Asian/Pacific Islander (API) women.METHODSThe population‐based study included API and non‐Hispanic white women diagnosed with localized invasive breast carcinoma in the Greater San Francisco Bay Area during 1994 (n = 1772). Multiple logistic regression was used to assess the association between race/ethnicity and type of surgery, radiation therapy following breast‐conserving surgery (BCS), and hormone therapy for estrogen receptor‐positive tumors while adjusting for demographic, medical, and census block‐group socioeconomic characteristics.RESULTSAPI women were significantly more likely to undergo mastectomies than white women (58% vs. 42%). This difference remained for Chinese and Filipino women after multivariate adjustment (odds ratio vs. whites [OR] = 2.4, 95% confidence interval [95% CI] = 1.4–4.2; OR [95%CI] = 1.8[1.0–3.1], respectively). Chinese women were also more likely than white women to not receive adjuvant therapy, be it radiation after BCS or hormone therapy for estrogen receptor‐positive disease. Other API women did not differ from white women in adjuvant therapy use.CONCLUSIONSThis population‐based study identified differences in treatment for localized breast carcinoma by race/ethnicity that were not explained by differences in demographic, medical, or socioeconomic characteristics. These results underscore the importance of looking at treatment patterns separately for API subgroups and support the need for research into cultural differences that may influence breast carcinoma treatment choices. Cancer 2002;95:2268–75. © 2002 American Cancer Society.DOI 10.1002/cncr.10965