The anatomic site distribution of large bowel cancer was studied in 2079 patients between 1967 and 1980. To measure the trend in the localization of the carcinomas, the slope of the regression line of the proportions at each site over the years was computed. The large bowel was divided into five segments: cecum, ascending colon and hepatic flexure, transverse and descending colon, sigmoid and rectosigmoid junction, and rectum. A significant decrease in the proportions of cancer in the sigmoid for both sexes (slope [b] = −0.89; P < 0.001) and an increase of cecal cancer (b = 0.54; P < 0.004) was observed. Sex‐specific results indicated the diminishing proportion of sigmoid cancer in men (b = −1.04; P < 0.004) with an increase in transverse and descending colon cancer proportions (b = 0.52; P = 0.012). In women, a negative slope of ‐‐0.74 was not significant for sigmoid cancer, but cancer of the cecum showed an increase in proportions (b = 0.80; P = 0.01). The age distribution indicated a significant decrease in proportion of men older than 80 years and of women in the age group of 40 to 49 years and an increase in women older than 80 years. However, age adjustment did not change any of the previous conclusions. The observed sex differences in the changing distribution within the large bowel over a 14‐year period cannot be explained by the improvement of diagnostic tools in the last years. In view of these findings, it is important to evaluate the possible sex‐related bias in the application of screening and preventive measures as well as the changes in the ecologic features of the large intestine.
Two hundred and seven large bowel cancer patients (93% of all cases diagnosed in a defined community between 1965 and 1976) were matched at random with non‐cancer subjects of same age, sex, and place of residence. Men with cancer, aged 75 years and younger than, had a more frequent history of work in a local factory handling synthetic fiber than controls (22 versus 10; P < 0.025). In this factory 45% of cancers occurred before age 60, while this was true in only 24% of cancer cases outside the factory (P < 0.05). There was a greater tendency for cancers in factory workers to occur in the colon than in the rectum. Heredity was not found to be a risk factor for large bowel cancer. The rate of prior appendectomy was higher in men with colon cancer (P < 0.05) and the rate of prior cholecystectomy was lower in females with colonic cancer (P < 0.05). A previous hemorroidectomy was also found more often in males with colonic cancer (P < 0.05). Long‐standing severe constipation was present more often in patients with cancer (P < 0.01). There was some evidence for a compounding influence of different risk factors, as studied by relative risk ratio. This study confirms the existence of a high risk of large bowel cancer in a group of workers in a synthetic fiber factory and suggests other factors antecedent to large bowel cancer.
The nutritional status of 556 infants born in good health was measured by selected biochemical parameters in maternal venous blood, in mixed arteriovenous cord blood at delivery, and in infant's capillary blood collected at 5 days. The determinations indicating nutritional status were: Hb, hematocrit, protein, cholesterol, triglycerides, vitamins A, C, E, and folic acid, iron, calcium and magnesium. In maternal venous blood, a significant number of women were found to be deficient; 3.4% had Hb below 9.5 g/dl; 6.1% had hematocrit less than 30%; 4.0% had total protein below 5.5 g/dl; 7.0% had vitamin C below 0.20 mg/dl; 3.0% were deficient in iron (less than 40 microgram/dl), 3.6% in folic acid (less than 2.0 ng/ml) and 5.2% in calcium (less than 7.5 mg/dl). Significant correlations were more frequent between maternal and cord blood than in other comparisons. An influence of parity and maternal age was more evident for vitamin C in cord blood than in maternal venous blood. Iron in maternal and cord blood decreased in relation to parity.
The consumption of a low-fat diet is advocated as beneficial in the prevention of cardiovascular disease. Because of still existing controversy the hypothesis whether low fat intake < 30% of total calories can maintain optimal growth and supply the desirable quantity of micronutrients was tested in a cohort of 500 children in preschool age. The children, apparently in good health and without any special dietary regimen, were stratified according to fat intake in three groups: < 30, 30-40 and > 40% of calories provided by fat. Our findings indicate that children with low fat intake were at a quite important risk of unsatisfactory intakes of fat-soluble vitamins, and also the nutritional density of consumed food was lower. The proportions of saturated (SFA), polyunsaturated and monounsaturated fatty acids were rather similar in all three groups, but cholesterol and SFA intakes decreased significantly in those with low fat intake. Serum cholesterol and triglyceride levels were however not significantly influenced.
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