The risk of cancer was evaluated among 77,952 asthma patients with bronchial asthma. The series was obtained through linkage of two registers: the Finnish Social Insurance Institution's file of asthma patients and the Finnish Cancer Registry. There was a significant excess risk of lung cancer in both sexes, the standardized incidence ratio (SIR) being 1.32 among men and 1.66 among women. In women, the risk of cancer of the rectum was significantly increased (SIR 1.42), whereas the risks of cancer of the corpus uteri and multiple myeloma were lower than expected (SIR 0.76 and 0.53, respectively). In men, the incidence of cancer of the larynx was significantly reduced (SIR 0.63) and that of the bladder increased (SIR 1.25). When both sexes were combined, cancers of the colon (SIR 1.17) and rectum (SIR 1.28) also showed a significantly elevated risk. A reduction in risk was seen in stomach cancer (SIR 0.88) and lymphatic leukaemia (SIR 0.55). The increased lung cancer risk may be due to local inflammatory changes. It is possible that differences in the immune system, e.g. natural killer cell activity, explain some of the reduced cancer risks.

Sensitization to additional allergenic pollen components frequently occurs during prolonged birch RIT. However, the IgE levels are low and the clinical relevance is not known.

The prevalence and incidence of asthma in relation to cigarette smoking habits was studied in a population of 14

Some of the inconsistency may have arisen from confounding since, although many studies Background -Few studies have been published on the overall survival of adult have controlled for the effect of age, sex and smoking, 2 5 15 the effects of occupation 15 and patients with asthma. A cohort study was performed to assess the mortality from all other lung diseases 2 may also be important. We have studied mortality from all causes among causes, from chronic obstructive pulmonary disease, and from lung cancer persons with asthma in Finland in a population based cohort study, in addition to the specific among adult asthmatic subjects. Methods -A population of 31 110 Finnish risk of death due to asthma, chronic obstructive pulmonary disease, and lung cancer. Possible adult women and men, mostly twins, was studied to compare the 16 year mortality confounding due to smoking, social class, domestic animals and pets, other respiratory morrates among asthmatic (n=471) and nonasthmatic persons. A further 293 twin bidity, and atopy have been taken into account. pairs, discordant for asthma, were also studied to determine whether the mortality of patients with asthma differs from Methods that of their age matched siblings.  Results -Mortality from all causes was The study population was based on the Finnish increased among asthmatic adults (age twin cohort which consists primarily of adult adjusted hazard ratios 1.49, 95% CI 1.09 twin pairs, with both members alive in 1967 to 2.05 for men and 1.53, 95% CI 1.10 and born before 1958, as well as some unrelated to 2.13 for women), and mortality due to individuals included because of the selection chronic obstructive pulmonary diseases criteria used to form the cohort. 16 Pairs of was also significantly increased in asth-persons with the same date of birth, same matic subjects. The risk of death due to surname at birth, same local community of lung cancer was increased in men with birth, and same sex were identified from the asthma (hazard ratio adjusted for smoking Central Population Registry of Finland. A 3.19, 95% CI 1.39 to 7.31). The risk ratios postal questionnaire was mailed in the autumn found among twins discordant for asthma of 1975 with questions that covered twinship, corresponded to those found in the whole medical history, symptoms, state of health, socohort.cial factors, and psychological traits. The reConclusions -Survival in adults with sponse rate of the questionnaire study was 89%, asthma is worse than in those without yielding 31 110 responses, 26 533 from twins asthma. The excess deaths due to chronic and 4577 from singletons. Twinship was deobstructive pulmonary disease may ex-termined from questionnaire responses and plain some part of the increased mortality confirmed, when necessary, from birth records rates, but not all of it.in local parish registers. Zygosity was de- (Thorax 1997;52:49-54) termined by a validated questionnaire method. 17 Department of Public Health, FIN-00014Keywords: asthma, mortality, cohort study. The medic...

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