Risk factors for nasopharyngeal carcinoma

In an effort to assess the relative importance of various risk factors of nasopharyngeal carcinoma (NPC), which includes antibodies to Epstein-Barr virus capsid antigen (anti-VCA) and early antigen (anti-EA) as well as other environmental factors, a multivariate logistic regression method was applied to analyze previously collected data from an epidemiologic study on 343 cases with NPC and 1017 neighborhood controls. Anti-VCA and anti-EA titers were found significantly associated with NPC. The relative risk increased with the increase of antibody titers. Individuals who smoked 30 or more cigarettes per day had more than 3.4 times higher risk than those who never smoked, while no increase in the risk was observed for those smoking less than 20 cigarettes per day and ex-smokers. Use of herb drugs, working under poor ventilation and nativity were also found to increase the NPC risk. In cases other than smoking 20 or more cigarettes per day and the frequent use of herb drugs, the synergistic interaction was not observed. In addition, male NPC individuals and Mainland Chinese were found to have relatively lower antibody titers as compared with female individuals or native Taiwanese.     

放射性肺炎的临床危险因素

目前放射治疗是胸部恶性肿瘤的重要治疗手段之一,而放射性肺炎是放疗常见的不良反应。放射性肺炎的发生不利于肿瘤的治疗、影响患者的生活质量,且增加患者的经济负担。明确放射性肺炎的危险因素将有利于胸部恶性肿瘤患者放疗前的评估,可对高危个体提前预知或预防,进一步指导患者的个体化治疗。     

Risk factors for laryngeal cancer

One hundred seven patients afflicted with incident laryngeal cancer and 290 controls with diseases considered not related to tobacco and alcohol exposure were interviewed in the University Hospital of Montevideo, Uruguay. The study followed a case-referent design, and epidemiologic analysis was carried out at the Louisiana State University, New Orleans. Dark tobacco smoking was the strongest risk factor, with an RR 2.5 times higher than that showed by light (flue-cured) tobacco smokers and 35 times that of non-smokers. Alcohol exposure displayed lesser effects but its interaction with tobacco smoking resulted in very high risks (more than 100 times higher). Among particular types of alcoholic beverages, red wine showed RR's similar to those displayed by hard liquor consumption. The habit of drinking a local tea called "mate" was associated with a threefold increase in risk, after controlling for the effects of age and tobacco and alcohol consumption. Infrequent consumption of vegetables and fruits showed RR on the order of 2.7, suggesting a role of diet in the causation of laryngeal cancer.     

Risk factors for bladder cancer

AIMS AND BACKGROUND: To summarize risk factors for bladder cancer, emphasizing the role of recently established associations and to present some ongoing debates on the issue. Methods: A systematic literature search was performed using MEDLINE database on bladder cancer risk factors between January 1985 and June 2006 and by detailed examination of the references of original articles, reviews and monographs retrieved. RESULTS: Cigarette smoking is recognized as the main cause of bladder cancer and accounts for about 50% of cases in developed countries. A strong link exists between the amount and duration of cigarette smoking. A high risk of bladder carcinoma has been observed in workers exposed to some aromatic amines. Based on these and other occupational risks, it has been estimated that 5-10% of bladder carcinomas in industrialized countries were due to exposures of occupational origin. Infectious agents have a major influence on bladder cancer risks in the areas of the world where Schistosoma haematobium infestation is endemic. Other potential risk factors for bladder cancer are other urinary tract infections and drinking tap water with chlorination by-products or arsenic. Exposure to certain drugs, like cyclophosphamide used in chemotherapy and heavy consumption of phenacetin-containing analgesics, has been shown to cause bladder cancer in humans. Total fluid intake and high consumption of fruits and vegetables are probably associated with a small decrease in risk. CONCLUSIONS: Avoidance of tobacco smoking and incriminated occupational exposures, habitual intake of fresh fruits and vegetables, and prevention and control of urinary tract infections should be recommended for bladder cancer prevention. Further studies are required to assess the role of genetic polymorphisms and their modifying effect of lifestyle risk factors for bladder cancer occurrence and to evaluate the benefit of bladder cancer screening, particularly in those at high risk.     

Risk factors for young-onset colorectal cancer

Purpose

We investigated risk factors for colorectal cancer in early-onset cancers, to provide quantitative estimates for major selected risk factors.

Methods

We analyzed data from three Italian and Swiss case–control studies conducted between 1985 and 2009, including 329 colorectal cancer cases and 1,361 controls aged ≤45 years. We computed odds ratios (ORs) from unconditional logistic regression models, adjusted for major confounding factors.

Results

The OR of young-onset colorectal cancer was 4.50 for family history of colorectal cancer in first-degree relatives, the association being higher in subjects with affected siblings (OR 11.68) than parents (OR 3.75). The ORs of young-onset colorectal cancer were 1.56 for ≥14 drinks/week of alcohol, 1.56 for the highest tertile of processed meat, 0.40 for vegetables, 0.75 for fruit, and 0.78 for fish intake. Among micronutrients, the ORs were 0.52 for β-carotene, 0.68 for vitamin C, 0.38 for vitamin E, and 0.59 for folate. No significant associations emerged for physical activity, overweight, and diabetes.

Conclusions

This study—the largest on young-onset colorectal cancer—confirms that several recognized risk factors for colorectal cancer are also relevant determinants of young-onset colorectal cancer. Family history of colorectal cancer in particular is a stronger risk factor in young subjects, as compared to middle age and elderly ones.     

特发性肉芽肿性乳腺炎发病的危险因素分析

目的研究与特发性肉芽肿性乳腺炎(IGM)发病相关的危险因素。 方法收集2018年1～12月武汉市红十字会医院甲乳外科收治的58例IGM患者(IGM组)及91例良性乳腺病患者(对照组)的临床资料进行回顾性分析。采用Pearson χ²检验或Wilcoxon秩和检验分析2组的一般资料,取P<0.050的变量进入二元Logistic回归分析,从而筛选出与IGM相关的危险因素。 结果单因素分析结果显示,IGM组与对照组比较,以下因素的差异有统计学意义：自身免疫疾病、胸部撞击、服用避孕药、足月妊娠次数、近5年足月妊娠、双乳交替母乳喂养及催乳素升高(χ² ＝4.180、8.649、4.650、－2.782、19.607、5.419、10.740,P均<0.050)。多因素分析结果显示：自身免疫性疾病、催乳素升高、胸部撞击、近5年内足月妊娠、服用避孕药及非双乳交替母乳喂养为IGM的独立危险因素(OR＝6.793、4.553、4.248、3.657、3.101、2.492;95%CI：1.759～26.240、1.519～13.648、1.007～18.093、1.652～8.095、1.286～7.476、1.146～5.419;P＝0.005、0.007、0.047、0.001、0.012、0.021)。 结论对于有以上IGM相关危险因素的患者,医师要高度警惕IGM的发病风险,必要时可以提供一定的预防和干预措施。     

Risk factors for basal cell carcinoma

The aim of this study was to assess the risk factors for basal cell carcinoma (BCC). A case-control study, carried out in two towns in Yugoslavia, comprised 200 BCC cases and 399 controls. For statistical analysis, univariate and multivariate logistic regressions were used. The risk factors found for BCC were: freckling before the age 15, seven or more weeks per year spent at the seaside during holidays (lifetime average), outdoor work during summer-time, occupational exposure to organic and non-organic dissolvents and organophosphatic compounds, use of tar for cosmetic purposes, and previous BCC in personal history. Subjects who tended to burn and not to tan after sun exposure also showed a significantly higher risk for BCC. Brown eyes and history of acne had a protective effect. This study confirmed the role of both constitutional and environmental factors in the development of BCC.     

Risk factors for small intestine cancer

Small intestine cancer is relatively rare. Clinical reports have suggested that several medical conditions may predispose to increased occurrence of this cancer, but otherwise its etiology is unknown. In one of the first case-control studies of this cancer, we compared questionnaire responses provided by next-of-kin of 430 persons who died of small intestine cancer cf921 controls who died of other causes. Subjects were identified from decedents included in the 1986 United States National Mortality Followback Survey. The questionnaires sought information on demographic and lifestyle characteristics, including diet and use of tobacco and alcohol. Tobacco and alcohol consumption were unrelated to risk of small intestine cancer, but weekly or more frequent consumption of red meat and monthly or more frequent intake of salt-cured/smoked foods were associated with two-to three fold increases in risk. The findings suggest that dietary factors probably are involved in risk of small intestine cancer, but additional research in other settings is required to clarify the determinants of these rare cancers.Drs Chow, Linot, McLaughlin, Hsing, and Blot are with the Epidemiology and Biostatistics Program, US National Cancer Institute, Bethesda, MD, USA. Mr Co Chien is with Westat, Inc., Rockville, MD, USA. Address correspondence to Dr Chow, Epidemiology and Biostatistics Program, Division of Cancer Etiology, 6130 Executive Blvd, EPN Room 403, Rockville, MD 20852, USA.     

Risk factors for ovarian cancer histotypes

To analyse the risk factors for different histologic types of ovarian cancer, we conducted a case-control study. The cases included 750 women with incident, histologically confirmed invasive epithelial ovarian cancer subdivided into: 493 serous, 81 mucinous, 78 endometrioid, and 98 other histologies. The controls included 2411 women admitted to the same hospitals as cases. The odds ratios for women with three or more births, in comparison with nulliparae, were 0.6 for serous, 0.4 for endometrioid, 1.0 for mucinous and 0.7 for other histological types of ovarian cancer. Family history of ovarian/breast cancer was associated to the risk of all ovarian cancer types, except mucinous ones. Selected dietary factors were less strongly directly (meat and starch), or inversely (fish and vitamin E) related to mucinous than to other histological types of ovarian cancer. High occupational physical activity was inversely related to the risk of ovarian cancer, with no heterogeneity across histologies. In conclusion, the association of reproductive factors and of selected dietary habits was weaker for mucinous ovarian cancer than for other histologic types.     

Risk factors for male breast cancer

To investigate risk factors in male breast cancer, a case-control study of 52 histologically diagnosed cases and 52 controls--matched for age, race, marital status, and hospital--was conducted in 5 U.S. metropolitan areas. Cases were significantly more likely to be Jewish than were the controls, supporting earlier suggestions of an increased risk in Jewish males. A significant association of male breast cancer with mumps infections at age 20 years or older, along with the possible association with antecedent testicular injury and the excess frequency of mumps orchitis among cases, suggests that testicular factors may be important in the development of breast cancer among males. An increased frequency of breast cancer among persons who have worked in blast furnaces, steel works, and rolling mills is of interest because of the possible testicular effect of high environmental temperatures. The observed association between breast cancer and a prior history of swollen breast is difficult to interpret because of potential recall bias, and a possible relationship with military service needs further confirmation.     

Risk factors for classical Kaposi's sarcoma

BACKGROUND: Classical Kaposi's sarcoma (KS) is a malignancy of lymphatic endothelial skin cells. Although all forms of KS are associated with the KS-associated herpesvirus (KSHV), classical KS occurs in a small fraction of KSHV-infected people. We sought to identify risk factors for classical KS in KSHV-infected individuals. METHODS: Lifestyle and medical history data from case patients with biopsy-proven non-AIDS (non-acquired immunodeficiency syndrome) KS in Italy were compared by logistic regression analysis with data from population-based KSHV-seropositive control subjects of comparable age and sex. After KSHV immunofluorescence testing, randomly selected patients on the rosters of local physicians were identified as control subjects. Risk of KS was estimated by odds ratios (ORs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS: From April 13, 1998, through October 8, 2001, we enrolled 141 classical KS case patients and 192 KSHV-seropositive control subjects of similar age (mean = 72 years for case patients and 73 years for control subjects) and sex (30% female case patients and 35% female control subjects). The strongest association was a reduced risk of KS with cigarette smoking (OR = 0.25, 95% CI = 0.14 to 0.45). Cigarette smoking intensity and duration could be evaluated for men, among whom the risk for KS was inversely related to the amount of cumulative smoking (P(trend)<.001). KS risk decreased approximately 20% (OR = 0.81, 95% CI = 0.74 to 0.89) for each 10 pack-years reported, and it was decreased sevenfold (OR = 0.14, 95% CI = 0.07 to 0.30) with more than 40 pack-years. In multivariable analysis, a decreased KS risk was associated with smoking (OR = 0.23, 95% CI = 0.12 to 0.44); but an increased KS risk was associated with topical corticosteroid use (OR = 2.73, 95% CI = 1.35 to 5.51), infrequent bathing (OR = 1.85, 95% CI = 1.04 to 3.33), and a history of asthma (OR = 2.18, 95% CI = 0.95 to 4.97) or of allergy among men (OR = 2.59, 95% CI = 1.15 to 5.83) but not among women (OR = 0.09, 95% CI = 0.003 to 2.76). KS was not related to other exposures or illnesses examined. CONCLUSION: Risk for classical KS was approximately fourfold lower in cigarette smokers, a result that requires confirmation by other studies. Identification of how smoking affects KS risk may lead to a better understanding of the pathogenesis of this malignancy and interventions for its prevention.     

Risk factors for cervical intraepithelial neoplasia.

To evaluate risk factors for cervical intraepithelial neoplasia (CIN), data were collected in a case-control study based on 366 patients (58 with CIN class 1, 70 with CIN class 2, and 238 with CIN class 3) and 323 control subjects with normal cervical smears interviewed on selected days at the same screening clinics where cases had been identified. No relationship emerged between indicators of socioeconomic status (education and social class) and risk of mild/moderate (considered together) and severe dysplasia. A total of 55 (43%) patients with CIN class 1 or 2, 107 (45%) patients with CIN class 3, and 94 (29%) controls were current smokers. The corresponding relative risk (RR) estimates for current versus never smokers were 1.9 (95% confidence interval [CI] 1.2 to 3.0) for patients with CIN class 1 or 2 and 2.5 (95% CI 1.7 to 3.6) for patients with CIN class 3, and the risk increased with the number of cigarettes smoked per day. No relationship was observed between oral contraceptive use, parity, spontaneous or induced abortions and the risk of CIN, but patients tended to report earlier age at first birth than control subjects. Compared with women reporting their first birth before the age of 20 years, the risk estimates were 0.5 and 0.4, respectively, for patients with CIN 1 or 2 and patients with CIN 3 in women reporting first birth at 20 to 24 years of age. The risk estimates were 0.5 and 0.6 for those reporting their first birth at age 25 or later, but the trends in risk were not statistically significant. The number of sexual partners was directly associated with the risk for both histopathologic subgroups. Compared with women reporting no intercourse or their first intercourse after 22 years of age, women with first intercourse before the age 18 had a RR estimate of CIN class 1 or 2 of 2.3 and of CIN class 3 of 2.4, with the trends in risk being statistically significant. This study confirms considerable similarities in the epidemiology of mild/moderate and severe cervical dysplasia. In addition, it suggests consistency between the epidemiology of intraepithelial and invasive cervical neoplasia for risk factors that are likely to act on one of the first stages of the process of carcinogenesis (i.e., indications of sexual habits) but differences for hormone-mediated factors (i.e., reproductive variables or oral contraceptives).     

Risk factors for persistent gestational trophoblastic neoplasia

This retrospective study evaluated the risk factors for persistent gestational trophoblastic disease (GTN) and determined their odds ratios. This study included 100 cases with GTN admitted to our clinic. Possible risk factors recorded were age, gravidity, parity, size of the neoplasia, and beta-human chorionic gonadotropin levels (beta-hCG) before and after the procedure. Statistical analyses consisted of the independent sample t-test and logistic regression using the statistical package SPSS ver. 15.0 for Windows (SPSS, Chicago, IL, USA). Twenty of the cases had persistent GTN, and the differences between these and the others cases were evaluated. The size of the neoplasia and histopathological type of GTN had no statistical relationship with persistence, whereas age, gravidity, and beta-hCG levels were significant risk factors for persistent GTN (p < 0.05). The odds ratios (95% confidence interval (CI)) for age, gravidity, and pre- and post-evacuation beta-hCG levels determined using logistic regression were 4.678 (0.97-22.44), 7.315 (1.16-46.16), 2.637 (1.41-4.94), and 2.339 (1.52-3.60), respectively. Patient age, gravidity, and beta-hCG levels were risk factors for persistent GTN, whereas the size of the neoplasia and histopathological type of GTN were not significant risk factors.     

Risk factors for male breast cancer.

Risk factors for male breast cancer were investigated in a case-control study of 21 cases and 82 controls admitted to hospital for acute, non-neoplastic, non-hormone-related diseases in the Greater Milan area between 1988 and 1994. More educated men tended to be at higher risk of breast cancer, with a multivariate odds ratio (OR) of 2.6 [95% confidence interval (CI) 0.7-9.4]. The OR was 3.2 (95% CI 1.1-9.6) for those in the higher social class. Men with no offspring were at higher risk than fathers, with an OR of 5.5 (95% CI 1.8-16.7). A history of breast cancer in female relatives was reported by two cases and one control, giving an OR of 8.5 (95% CI 1.1-69.0). Cases were somewhat heavier than controls, and significantly taller, with an OR of 5.7 (95% CI 1.6-19.9) for subjects taller than 170 cm vs shorter ones. The association with weight, however, decreased after allowance for height, and no difference was observed for body mass index. Socioeconomic correlates and family history are similar to well-assessed risk factors for female breast cancer. The associations with anthropometric measures and childlessness may find an explanation in chromosomal abnormalities, such as Klinefelter''s syndrome, or other hormone-related disorders.     

Risk factors for multiple oral premalignant lesions

Oral leukoplakia, oral submucous fibrosis and erythroplakia are 3 major types of oral premalignant lesions. Multiple oral premalignant lesions may possibly develop due to field cancerization, where carcinogenic exposures can cause simultaneous genetic defects to the upper aerodigestive tract epithelium, putting the epithelium at high risk for development of premalignant lesions at different stages of carcinogenesis. There have been no epidemiological studies on risk or protective factors of the disease. A case-control study was conducted with data from the baseline screening of a randomized oral cancer screening trial in Kerala, India. A total of 115 subjects with multiple oral premalignant lesions (8-10% of oral premalignant lesions in our case series) were included: 64 subjects with oral leukoplakia and oral submucous fibrosis, 19 subjects with oral leukoplakia and erythroplakia, 22 subjects with oral submucous fibrosis and erythroplakia and 10 subjects with all 3 lesions. Individuals without oral lesions were considered controls (n=47,773). The odds ratio (OR) for ever tobacco chewers was 37.8 (95% confidence interval (CI)=16.2-88.1) when adjusted for age, sex, education, BMI, smoking, drinking and fruit/vegetable intake. Dose-response relationships were seen for the frequency (p<0.0001) and duration of tobacco chewing (p<0.0001) with the risk of multiple oral premalignant lesions. Whereas alcohol drinking may possibly be a risk factor for multiple oral premalignant lesions, smoking was not associated with the risk of multiple oral premalignant lesions (OR=0.9, 95%CI=0.5-1.7). The results suggest that tobacco chewing was the most important risk factor for multiple oral premalignant lesions and may be a major source of field cancerization on the oral epithelium in the Indian population.     

Risk factors for benign ovarian teratomas.

Risk factors for benign ovarian teratomas have been analysed in a case-control study conducted in Milan. Cases were women aged less than 65 years with a histologically confirmed diagnosis of benign ovarian teratoma who were admitted to a network of Obstetrics and Gynecology Departments in Milan. A total of 77 women aged 16-64 years were interviewed. Controls were women admitted to hospital for acute, non-gynaecological, non-hormonal and non-neoplastic diseases; 231 controls were interviewed (age range 15-64 years). Cases tended to be more educated: in comparison with women with less than 7 years of education, the estimated relative risk (RR) of ovarian benign teratoma was 1.6 and 2.5 respectively in women with 7-11 and 12 or more years of schooling, the trend in risk being statistically significant (chi 2(1) trend 5.39, P < 0.01). Four of the 77 cases (5.2%) and two of the 231 controls (0.9%) reported a history of infertility, with a corresponding RR of 8.3 (95% confidence interval 1.3-54.0). There was no clear relation between parity and risk of ovarian benign teratomas: in comparison with nulliparae, the estimated RRs were 1.1 and 0.7 respectively in women reporting one or two or more births (chi 2(1) trend 0.53, P = not significant). No relation emerged between marital status, age at menarche, menstrual cycle pattern, menopausal status, abortions, age at first pregnancy, oral contraceptive use and risk of ovarian benign teratomas.     

结肠癌危险因素的Meta分析

目的 运用系统评价方式探讨结肠癌危险因素,为更好地预防结肠癌提供循证依据。方法 计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、维普系列数据库、The Cochrane Library、PubMed、SpringerLink、EBSCO、MEDLINE等数据库,检索文献发表时间为2000年1月1日至2018年10月31日,检索词包括“结肠癌”、“结肠肿瘤”、“结肠组织癌性病变”、“危险因素”及其自由词的病例对照试验相关文献。在尽可能全面地收集相关病例对照试验数据资料的基础上,根据纳入和排除标准,并采用Newcastle Ottawa Scale(NOS)文献质量评价表的评价标准对所提取文献进行质量评价,将得分≥7分(高质量)的文献纳入研究,最后采用RevMan53对其进行Meta分析。结果 13篇文献符合纳入标准,累计病例数和对照数分别为该2 773例和8 117例,经Meta分析结果显示,结肠癌的危险因素为:结肠癌家族史(OR=213,95％CI:158～287)、精神心理问题(OR=150,95％CI:109～205)、低膳食纤维饮食(OR=117,95％CI:094～146)、高脂高蛋白饮食(OR=135,95％CI:111～164)、缺乏运动(OR=116,95％CI:097～138)、消化系统疾病(OR=182,95％CI:131～253)及饮酒(OR=138,95％CI:111～171)。结论 结肠癌家族史、精神心理问题、低食纤维饮食、高脂高蛋白饮食、缺乏运动、消化系统疾病及饮酒是结肠癌的独立危险因素,控制上述因素可以有效降低结肠癌患者的死亡风险。     

Risk factors for oesophageal cancer in northeast China

A hospital-based case-control study of oesophageal cancer was carried out in the Heilongjiang Province, a low-risk area for oesophageal cancer in China. From May 1985 to May 1989, 196 histologically confirmed cases and 392 controls with other (non-neoplastic) diseases were personally interviewed in the wards of 5 major hospitals. Information was obtained about usual consumption in the early 1980s of 32 major contributors to the diet in the province, socio-demographic status, smoking and alcohol consumption. Odds ratios (OR) were obtained from logistic regression models, and confounding was controlled by means of multivariate models. Smoking and alcohol consumption were major risk factors for oesophageal cancer in this population. Smokers of handmade cigarettes exhibited a particularly high risk. A near multiplicative synergism was found between smoking and alcohol consumption. There was a significant inverse dose-risk trend for combined consumption of vegetables and fruits; a 300-g increase per day lowered risk by 35%. Vitamin C intake was negatively associated with risk; a 100-mg increase per day lowered risk by 39%. Our data suggest a modifying effect of vitamin C and β-carotene on risk associated with smoking, but the power of analyses was low. Salt, salt-preserved foods and pickled vegetables were not associated with increased risk. High temperature of meals and drinks was a strong risk indicator in this population. The strength of tea and overall tea consumption were independent determinants of the risk. © Wiley-Liss, Inc.     

Risk factors for endometrial cancer at different ages

The importance of the major risk factors for endometrial cancer in women of different ages was evaluated with the use of data from a hospital-based case-control study conducted in Milan, Italy, on 283 women with endometrial cancer and 566 age-matched controls. Current weight was related strongly to the risk of endometrial cancer both in younger (premenopausal) and in older women (with risk estimates for the heaviest categories of 20.3 and 7.7, respectively), thus confirming that obesity is the major cause of endometrial cancer in Northern Italy. Endometrial cancer risk appeared to be approximately proportional to the second power of body mass index. Early menarche and nulliparity were associated with an increased risk of endometrial cancer in premenopausal women, the point estimate for nulliparity rising to 35.1 (with lower confidence limit of 10.2) after adjustment for marital status. However, no association with these factors was evident in postmenopausal women. Combination oral contraceptives were used by 2 cases and 19 controls only [relative risk (RR) = 0.2, with 95% confidence interval = 0.1-0.8]. The use of noncontraceptive estrogens was associated with an elevated risk, which was greater in perimenopausal women (RR = 5.1 for greater than 2 yr of use), and decreased progressively with increasing time after menopause. Late menopause was also related to endometrial cancer. However, the risk estimates for late menopause apparently were more elevated in older women (greater than or equal to 65 yr) than in perimenopausal women. Most of the risk factors identified (excluding late menopause) apparently act on one of the later stages of the process of carcinogenesis, because the excess risk drops after cessation of exposure.