Bladder cancer mortality in diabetics in relation to saccharin consumption and smoking habits.

The frequency with which diabetes mellitus was mentioned on the death certificates of 18,733 patients dying from bladder cancer has been compared with that of 19,709 patients dying from other cancers (excluding cancer of the lung and pancreas). The estimated relative risk of bladder cancer in diabetics was 0-98 with 95% confidence limits 0-70-1-38. There was no increase in risk of bladder cancer in patients with diabetes of long duration. Diabetics were shown by questionnaire to consume substantially more saccharin than non-diabetics, and the duration of regular saccharin use by diabetics was highly correlated with the duration of diabetes. There was therefore no evidence from this study that consumption of above average amounts of saccharin had led to bladder cancer in diabetics. The proporation of current smokers among diabetics was significantly less than among non-diabetics, and this may account for a low relative risk of lung cancer in the former (0-72).     

Bladder cancer mortality in England and Wales in relation to cigarette smoking and saccharin consumption

Cohort analyses of bladder cancer mortality rates in men and women in England and Wales have been compared with figures for the per caput consumption of saccharin and cigarette tobacco and with similar analyses of cigarette smoking habits. The increase in bladder cancer mortality rates in male cohorts born since 1870 can be attributed to cigarette smoking, and there is no evidence of any break in the continuity of the trends in either men or women which corresponds to the introduction of saccharin.     

Cancer mortality and saccharin consumption in diabetics.

The mortality experience of 5971 members of the British Diabetic Association (BDA) was followed-up for between five and eight years to mid-1973. Overall, 1207 deaths occurred compared with 778 expected from the mortality of the population of England and Wales in 1972. This excess of deaths was due almost entirely to diabetes mellitus and ischaemic heart disease. Deaths from cancer (128) were significantly fewer than expected (168), mainly because of a deficit in the number of deaths from cancers related to smoking (cancers of the buccal cavity and pharynx, oesophagus, respiratory system, and bladder). There was also a lower than expected mortality from chronic bronchitis and emphysema. Data on saccharin consumption by BDA members showed that more than half of them used saccharin tablets daily, with an overall daily intake of three to six tablets, depending on age and sex. Information on a small sample of survivors from the mortality study suggested that about 23% of them would have taken saccharin daily for 10 years or more and 10% for 25 years or more by the end of the follow-up. It was concluded that these relatively high levels of saccharin intake had not increased the risk of cancer in general among BDA members.     

Lung cancer mortality and smoking habits: Mexican-American women.

Lung cancer mortality was reported to be higher among Mexican-American women as compared with Anglo women from 1950 until 1970; however, smoking habits of Mexican-American women have not been adequately described. This study updates lung cancer mortality data in Texas, describes smoking patterns of 1,255 Mexican-American women from a household survey in the four states bordering Mexico, and compares these findings to a reference group of Anglo women residing in the same area. In 1970, lung cancer mortality rates were similar for Mexican-American and Anglo women in Texas; however, by 1974-1976 Mexican-American women in Texas had a 40 per cent lower rate than Anglo women and by 1979, a 49 per cent lower rate. In our 1979 survey results, Mexican-American women reported lower levels of smoking, both in prevalence and amount smoked, as compared with Anglo women. The lower prevalence was reported for all social and demographic categories examined. The relatively low lung cancer mortality rate is most likely due to relatively low levels of cigarette smoking among Mexican-American women. Based on the trend in lung cancer deaths and our survey findings, we would anticipate a continuing low level of lung cancer mortality among Mexican-American women.     

Tobacco smoking,coffee, cocoa and tea consumption in relation to mortality from urinary bladder cancer in Italy

This paper examines changes in mortality from urinary bladder cancer in Italy during the years 1950-81 in relation to changes in smoking habits and in coffee, cocoa and tea consumption. The authors found that, in both sexes and for all ages, mortality has been increasing throughout this period, although the rates and relative increase have consistently been much lower and more gradual for women than for men.From the analysis of age-cohort-period variation it seems that bladder cancer mortality can also be influenced by changes in smoking habit patterns and by variation in the quality of diagnoses. The increase in death risk for both sexes in Italy up to cohorts born around 1905-10 can be related to occupational exposures and to high-tar-content tobacco smoking, whereas the tendency for mortality rates to stabilize and decline in cohorts born after 1910 were influenced by changes from high-tar-content and no-filter cigarettes to low-tar-content and filter cigarettes and by prevention measures taken in at-risk working environments.The consumption of coffee, cocoa and tea does not seem to be related to the increase in bladder cancer risk in Italy.Corresponding author.     

Risk of papillary thyroid cancer in women in relation to smoking and alcohol consumption

Both smoking and alcohol consumption may influence thyroid function, although the nature of these relations is not well understood. We examined the influence of tobacco and alcohol use on risk of papillary thyroid cancer in a population-based case-control study. Of 558 women with thyroid cancer diagnosed during 1988-1994 identified as eligible, 468 (83.9%) were interviewed; this analysis was restricted to women with papillary histology (N = 410). Controls (N = 574) were identified by random digit dialing, with a response proportion of 73.6%. We used logistic regression to calculate odds ratios (OR) and associated confidence intervals (CI) estimating the relative risk of papillary thyroid cancer associated with cigarette smoking and alcohol consumption. A history of ever having smoked more than 100 cigarettes was associated with a reduced risk of disease (OR = 0.7, 95% CI = 0.5-0.9). This reduction in risk was most evident in current smokers (OR = 0.5, 95% CI = 0.4-0.7). Women who reported that they had ever consumed 12 or more alcohol-containing drinks within a year were also at reduced risk (OR 0.7, 95% CI = 0.5-1.0). Similar to the association noted with smoking, the reduction in risk was primarily present among current alcohol consumers. The associations we observed, if not due to chance, may be related to actions of cigarette smoking and alcohol consumption that reduce thyroid cell proliferation through effects on thyroid stimulating hormone, estrogen, or other mechanisms.     

Trends in lung cancer mortality in Scotland and their relation to cigarette smoking and social class.

This paper describes the trends in lung cancer rates in Scottish men and women during 1959-85, the relationship between lung cancer and cigarette consumption, and between lung cancer and social class, and the urban-rural gradient of lung cancer. Lung cancer rates in Scottish men have declined in all age groups under the age of 74 for at least the past two decades; the most notable decrease was in men aged 40-44 years, whose rates halved between 1970 and 1980. In women, who began smoking in large numbers only after World War II, lung cancer mortality declined slightly in those between 40-54 years and rose in those over 54 years. Trends in cigarette consumption did not fully explain the decline in lung cancer. Marked urban-rural gradients in the SMRs for lung cancer were evident in all periods, and these strengthened over time. Correlations between lung cancer and social class differed markedly from those found in previous studies, except for those with social classes II and V.     

Diet and cancer in Northeast Brazil: evaluation of eating habits and food group consumption in relation to breast cancer

A hospital-based case-control study was performed from August 2002 to November 2003 in Northeast Brazil. Eighty-nine women were recruited with histologically confirmed breast cancer (age 30-80 years), matched for age with 94 controls. Food consumption of cases and controls was evaluated by foods and food groups, categorized in consumption tertiles. Odds ratio (OR) and 95% confidence intervals (95%CI) were obtained through unconditional logistic regression. Intake of fruits and juices, beans, and dairy products showed a strong association with reduced risk of breast cancer. Consumption of red and fried meat was positively associated with risk of breast cancer (red meat-OR=4.30; 95%CI: 1.74-10.67; p for trend=0.00). No association was observed in vegetable and sausage meat groups and breast cancer. Red and fried meat may be risk factors, and intake of fruit, beans, and dairy products may protect against breast cancer.     

Use of oral contraceptives in relation to dietary habits and alcohol consumption

The relationship between oral contraceptive (OC) use, dietary habits and alcohol consumption in young women was studied in Troms?, Norway. A total of 5,800 women aged 20-39 years answered a questionnaire in 1986/1987. Women with long-term duration of OC use reported more frequent intake of meat for dinner, preferred low-fat milk and drank less coffee. For other food items such as intake of fats, fish, fruit and vegetables, no differences were found. Strong associations were found for alcohol consumption, with increasing frequency of use among long-term users of OCs. These results are discussed in relation to the possible association between OC use and breast cancer in young women.     

Trends of lung cancer mortality in Italy in relation to consumption of tobacco products

This paper examines changes with time of mortality from lung cancer in Italy during the years 1950-1979 in relation to changes in smoking habits since 1900. In both sexes and for all ages mortality rose throughout this period, although for women the rates and the relative increases per year have been consistently much lower than for men. Between 1950-1952 and 1977-1979 the age-adjusted death rate per 100,000 men rose almost five times (from 10.01 to 49.55) whereas that for women only doubled (from 2.65 to 5.74), so that the male/female ratio increased from 3.78 to 8.65. In men successive cohorts show an increase of age-specific death rate, but there are indications that for men born after 1925 the mortality rate is beginning to level off. In women over 50 years of age mortality continues to rise, but below this age it tends to level off and decline. Analysis of the consumption of different types of tobacco products since 1900 suggests that the trends of mortality with time in different birth cohorts are explicable in terms of changes of use of cigarettes.     

Bladder cancer and alcoholic beverage consumption

A population-based case-control study of bladder cancer was conducted in 10 geographic areas in the United States. Risk of bladder cancer was not related to overall alcohol intake, nor to amounts of wine, beer, or spirits consumed. Alcohol also did not interact with known or suspected bladder carcinogens to increase risk, and no evidence was found that indirect mechanisms associated with alcohol ingestion the risk of bladder cancer.     

The effects of changes in smoking habits on coronary heart disease mortality.

Coronary heart disease (CHD) mortality declined by about 20 per cent between 1965 and 1976. During the same period there were substantial decreases in the proportion of adults who smoked based on data from the National Health Interview Survey (HIS). This study examines the extent to which changes in smoking can account for the decrease in CHD mortality for men and women aged 35-64 years. By applying US smoking levels (estimated from HIS) to data from four epidemiologic studies on the relative risk of CHD death by amount smoked, we obtain estimates of the portion of the decline in CHD mortality attributable to changes in smoking. Smoking changes among women were not generally consistent with declines in CHD mortality. For men, the estimated impact of smoking on CHD mortality varied considerably depending upon which study was used to estimate the relative risk by amount smoked.     

Bladder cancer and black tobacco cigarette smoking

A retrospective study was planned in the Hérault (Mediterranean) region of France where bladder cancer mortality and incidence rates are high. In the present paper, variations in bladder cancer risk according to various smoking-related variables, in particular time of exposure and type of tobacco, are examined. This case-control study with 219 male incident cases and 794 male population controls randomized from electoral rolls was carried out in 1987–89. Trained interviewers obtained information on demographics, dietary habits (coffee, alcohol, artificial sweeteners, vegetables, spices, etc.), occupational exposures and detailed history of tobacco smoking (average number of cigarettes per day, number of years of smoking, age at which they began and/or quitted smoking, use of filter-tip and type of tobacco). The odds ratio (OR) for cigarette smokers versus non-smokers was greater than 5. Results for number of cigarettes daily, duration of smoking and lifetime smoking showed a highly significant dose-response relationship, which was confirmed when these variables were treated as continuous in a logistic regression model. Eighty-eight percent of the smokers used black tobacco. Quitting smoking did not result in a significant reduction in bladder cancer risk. Higher risks were associated with starting to smoke at an early age (OR before age 13 versus after age 21=3.42; 95% CI 1.07–10.9) and with black tobacco smoking (OR black versus blond =1.63; 95% CI 0.73–3.64). Results suggest that black tobacco may be more harmful than blond tobacco and may have an early non-reversible role in bladder carcinogenesis.     

Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age

In the elderly, cigarette smoking has been related to reduced cognitive performance and moderate alcohol consumption to increased cognitive performance. It is not clear whether these associations also exist in middle age. The authors examined these relations in a population-based cohort study of 1,927 randomly selected, predominantly middle-aged subjects aged 45-70 years at the time of cognitive testing and living in the Netherlands. From 1995 until 2000, an extensive cognitive battery was administered, and compound scores were calculated. Risk factors had been assessed approximately 5 years previously. Multiple linear regression analyses (in which one unit of the cognitive score = one standard deviation) showed that, after the authors adjusted for age, sex, education, alcohol consumption, and cardiovascular risk factors, current smokers had reduced psychomotor speed (beta = -0.159, 95% confidence interval: -0.071, -0.244; p = 0.0003) and reduced cognitive flexibility (beta = -0.133, 95% confidence interval: -0.035, -0.230; p = 0.008) compared with never smokers. This effect was similar to that of being approximately 4 years older. Alcohol consumption was related to increased speed and better flexibility, especially among women who drank 1-4 alcoholic beverages a day. In conclusion, among middle-aged subjects, current smoking was inversely and alcohol consumption positively related to psychomotor speed and cognitive flexibility. This finding suggests that actions to prevent cognitive decline can be taken in middle age.     

Nutrient intakes in relation to cancer mortality in Taiwan

To provide more information on the international variations of nutrient intake in relation to cancer mortality rates, we investigated the association between nutrient intake and common cancer mortality rates in Taiwan by using the ecological design. Cancer mortality rates in Taiwan from 1997-2000 were obtained from the Office of Statistics, Department of Health. The data of nutrient intake were obtained from the third national survey (Nutrition and Health Survey in Taiwan; NAHSIT) (1993–1996). Data was drawn from 7 geographical districts. Stomach, lung, prostate, liver, and colorectal cancer mortality rates in men were attributed to regional variations in the consumption of either lipid, calcium, thiamin, and/or vitamin E; breast and liver cancer mortality rates in women were related to the regional variations in consumption of either lipid, carbohydrate, calcium, or iron. Not all cancer (i.e., esophageal cancer in men and women; stomach, lung, and colorectal cancer in women) mortality rates could be explained by the regional variations in the consumption of nutrients. Time-lag and potential confounders might be considered in the ecological study.