Showing papers by "Elsebeth Lynge published in 1992"

Leukaemia and reproductive outcome among nurses handling antineoplastic drugs.

Abstract: During the past decades conclusive evidence has accumulated that alkylating antineoplastic drugs (ADs) can cause cancer, most notably acute non-lymphocytic leukaemia, and that most ADs are reprotoxic. Studies on health workers handling ADs have shown significantly increased risks for miscarriages (two studies) and malformations (two studies). The present study monitored the risk for cancer and adverse reproductive outcome among Danish nurses handling ADs. No increased risks were found for miscarriages, malformations, low birth weight, or preterm birth among the offspring of nurses handling ADs during pregnancy. The sex ratio was normal. The relative risk (RR) for leukaemia was significantly increased (10.65) but based on only two cases, one of acute myeloblastic and one of chronic myeloid leukaemia. From the available exposure data occupational exposures to ADs were apparently higher in the studies that have reported increased risks for miscarriages and malformations than in the present one. Regarding reproductive outcome the study gives some confidence that the safety measures which were implemented in the oncology departments around 1980 can protect the health personnel against adverse effects of ADs on reproduction. As the study is as yet the only negative one in a well protected setting, it should be followed up by other studies of well protected health personnel handling ADs. The findings concerning the leukaemia risk, although based on small numbers, encourage larger studies.

Cancer risk among Danish and Italian farmers.

Abstract: Cancer risk for farmers in Denmark and Italy was studied by linking occupational census data with incidence of cancer in Denmark and with cancer mortality in Italy. Farmers in the two countries had a consistent risk reduction for cancer of the lung, bladder, small intestine, colon, rectum, and prostate. No excess of stomach cancer was found among farmers in the two countries, which is in agreement with the most recent data from other surveys. The risk of oesophageal cancer was reduced among the Danish and increased among the Italian male farmers. This can probably be explained by differences in alcohol consumption between the Danish and Italian farmers compared with the general population. The risk of brain cancer was significantly reduced among Italian farmers. There was a significant risk reduction for Hodgkin's disease and no excess for non-Hodgkin's lymphoma in Denmark, whereas in Italy a statistically significant excess risk was found for the first and a slight excess risk for the second of these diseases. The per capita consumption of phenoxy-herbicides between 1950 and 1970 was lower in Italy than in Denmark but treatments were performed mainly by professional applicators in Denmark and by the farmers themselves in Italy. Risk of leukaemia among Italian female farmers was increased. In Denmark, this increase was limited to women who were themselves owners of a farm. Specific occupations in agriculture showing a high risk for cancers of the lymphopoietic system in Denmark mostly entailed contact with animals.

Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of sexual activity, reproductive factors, and venereal infections.

Abstract: Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n=614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.

Sexual behaviour of women attending an inner-city STD clinic before and after a general campaign for safer sex in Denmark.

Abstract: OBJECTIVES--To examine the sexual behaviour and the prevalence of sexually transmitted diseases (STD) among females attending an inner-city STD clinic before and after safer sex campaigns. SUBJECTS--In 1984 981 women and in 1988 684 women were interviewed immediately after the venerological examination. SETTING--Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark. METHODS--In a face to face interview, details of symptoms, age at coitarche, number of sexual partners (lifetime and during the last year), obstetric history, and contraceptive methods were recorded. RESULTS--A substantially higher proportion of women used condoms in 1988 than in 1984. A dramatic decrease in the prevalence of gonorrhoea occurred (from 22% in 1984 to 6% in 1988, p < 0.01), whereas an increase in the number of patients with genital warts was observed (from 4% in 1984 to 10% in 1988, p < 0.05). The prevalence of chlamydia, genital herpes, and cervical dysplasia remained unchanged. No significant changes in the number of sexual partners, or the frequency of sexual intercourse or unplanned pregnancy could be detected from 1984 to 1988. CONCLUSIONS--The safer sex campaigns have only been partly successful, as a general reduction in all sexually transmitted diseases should be expected as a result of the increased use of condoms. Future campaigns should focus on the correct use of condoms, and encourage a lifestyle with stable sexual relationship.

Cancer morbidity by occupation.

Abstract: Data on cancer morbidity by occupation are available from surveillance systems, such as linkage studies based on census data and cancer register data. These data serve various purposes. First, they show the social distributions of cancer diseases. Second, they can form the background for generating hypotheses about chemical carcinogens by identifying occupations at high risk of cancer. Third, cancer morbidity data can be used in the interpretation of results from hypothesis-testing studies. Fourth, the data can facilitate the identification of cancer risks associated with new technologies and way of life in the service society. Finally, the data can be considered for inference about future trends in cancer mortality. Data from the Danish occupational cancer study are used for illustration.

[Screening for uterine cervix cancer in Storstrøm, Vestsjaelland and Bornholm counties during 1979-1989].

Abstract: We studied the use of Pap smears in three counties in Denmark, where the screening activity has been organized in different ways. The county of Storstrom had an organized screening programme in 1979-82. Women aged 30-50 years were invited personally, and 91% participated. The same response rate is seen in the county of Bornholm today, where women aged 25-54 years are invited. No invitations are sent in the counties of Storstom and Vestsjaelland today, and only 66%-69% of the 30-50 year old women are screened. The Danish National Board of Health recommends commencement of screening at the age of 23 years. However, 53%-57% of the women aged 15-22 years are screened in Storstrom and Vestsjaelland counties today. The percentages of women screened in the older age groups are, on the other hand, low. Only 10%-17% of women aged 60-75 years were screened in 1985-89. The Danish National Board of Health recommends that women aged 23-75 years should be screened once every third year and that positive, atypical and unqualified smears should be followed-up. The county of Bornholm has an organized screening programme, but 21% of the Pap smears are nevertheless used outside the national recommendations. The county of Vestsjaelland has no organized screening programme and 42% of the Pap smear are used outside the national recommendations. It would be possible to screen a considerably higher percentage of the women aged 23-75 years if the screening activity was well organized.

Status of preventive examinations against uterine cervix cancer in Denmark

Abstract: In 1986, The Danish National Board of Health published guidelines for cervical cancer screening. These guidelines recommend organized screening with personal invitations every three years to women in the age group 23-59 years, and in the years to come also invitations to women aged 60-74 years. Five years have now elapsed since publication of these guidelines, and we have therefore studied the present organization of cervical cancer screening in Danish counties. Organized screening programmes are now, medio 1991, running in 11 out of the 16 "counties" (this includes the municipalities of Copenhagen and Frederiksberg). One county follows the national guidelines entirely. Six counties follow these guidelines in general, but they do not invite women over the age of 60 years. In all, 45% of women aged 25-74 years are at present invited for cervical cancer screening in Denmark. Two counties have decided to start organized screening programmes in 1992.

[The significance of organized screening for uterine cervix cancer in Denmark during 1968-1987].

Abstract: The policy concerning organization of screening for cervical cancer has varied in the Danish counties. Organized programmes started in the municipality of Frederiksberg in 1962, in the municipality of Copenhagen and the county of Maribo in 1967, and in the country of Copenhagen in 1968. On the other hand organized screening programmes have never existed in the counties of Vestsjaelland, Viborg, Ringkobing and Ribe. We have used this "natural experiment" to study the influence of organized screening on the incidence and mortality of cervical cancer in Denmark. Women aged 30-59 years during the period 1968-87 are included in the study. The effect of organized screening has been estimated employing multiplicative Poisson models, where age, period, region and organized screening have been considered. Women living in counties where organized screening started three or more years ago have a statistically significantly reduced risk of cervical cancer. The relative risk for the incidence in this group is 0.77 (95% confidence interval 0.69-0.86), and the relative risk for the mortality is 0.75 (95% confidence interval 0.61-0.92). Only a part of the decrease in the incidence and mortality of cervical cancer which can be attributed to the organized screening activity. The additional decrease can be attributed to the considerable unorganized screening activity during the past 20 years, and to changes in exposure to risk factors.

Cancer risk among DanishandItalian farmers

Abstract: CancerriskforfarmersinDenmarkandItaly was studiedby linking occupational census datawithincidence ofcancerinDenmarkand withcancermortality inItaly. Farmersinthe twocountries hadaconsistent riskreduction forcancerofthelung, bladder, smallintestine, colon,rectum,and prostate. No excessof stomachcancerwasfoundamongfarmersin thetwocountries, whichisinagreementwith themostrecentdatafromothersurveys. The riskofoesophageal cancerwasreduced among theDanishandincreased among theItalian malefarmers. Thiscanprobably beexplained bydifferences inalcohol consumption between theDanishandItalian farmers compared with thegeneral population. Theriskofbraincancerwas significantly reducedamong Italian farmers. Therewasasignificant risk reduction forHodgkin's disease andnoexcessfornonHodgkin's lymphomainDenmark,whereas in Italy astatistically significant excessriskwas foundforthefirst andaslight excessrisk forthe secondofthesediseases. Thepercapita consumption ofphenoxy-herbicides between1950