As a means of examining the virus-relatedness of acute lymphoblastic leukemia (ALL) in children, we investigated the association between month-of-birth and the occurrence of ALL in 1487 children aged 0-15 years at the time of diagnosis. Our hypothesis being that evidence of seasonal variation in births of ALL cases would suggest exposure to a transmissible etiologic agent during the perinatal period. The data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program and consisted of children diagnosed during the years 1973-1986. Aggregate monthly incidence rates of ALL stratified by month-of-birth, for each SEER site, all sites combined, and for broad geographic regions were calculated. No evidence for an association between month-of-birth and childhood ALL was found.
The subsequent primary cancer experience of 498 patients with major salivary gland carcinoma was evaluated using a life-table approach. Expected numbers were generated from two sources. These were population-based tumor registry data and an internal comparison group of randomly selected individually matched patients drawn from the same institution. Compared with either referent group, elevated risk ratios for all cancer sites combined were demonstrated. Risks for subsequent lung cancer were raised but were not statistically significant. For subsequent skin cancer, significantly elevated risks were noted.
Primary care physicians are uniquely positioned to practice primary and secondary cancer prevention. However, despite a positive commitment, many physicians are pessimistic about the success of their interventions. This study describes the self-reported cancer prevention practices and perceived obstacles of 1600 Texas primary care physicians. These practices differed by primary care specialty and by length of time in practice. Time constraints were uniformly perceived as the leading obstacle to the provision of smoking cessation counseling. High cost, lack of third-party reimbursement, and poor patient compliance were cited as the leading barriers to patient referral for screening mammography. Professional education should stress to physicians that interventions need not be elaborate, expensive, or time consuming, the main purpose being to motivate and reinforce patient behavior. The special challenges of introducing health promotion activities into the clinical setting must be addressed with practical aids such as prompting systems, flowsheets, and computer-based aids for monitoring compliance rates.
One of the most consistently observed exposure-disease relationship is the one between cigarette smoking and lung cancer. Aromatic amines and their metabolites are found in tobacco smoke and may be a class of carcinogen involved in lung carcinogenesis. T he human N -acetyltransferase 1 (NAT 1) enzyme can activate or deactivate aromatic amines, making it a candidate genetic susceptibility gene. We evaluated the potential role of the NAT 1 gene in lung cancer risk in a hospital-based case-control study in a minority population composed of Mexican- and African-Americans. We also assessed the potential interaction between NAT 1 and other environmental exposures such as cigarette smoking. T here was no overall association between the NAT1*10 genotypes and lung cancer risk. T he adjusted odds ratio for the rapid acetylation genotypes was 0 72 (95 % CI 0 37-1 39) for NAT1 defined as the presence of at least one copy of the NAT1*10 allele when compared with all genotypes without the NAT1*10 allele. Analyses by histological subtype or smoking history did not alter these findings. Other NAT 1 alleles will need to be studied for more conclusive results regarding the relevance of NAT 1 activity to lung carcinogenesis.
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