Showing papers by "American Cancer Society published in 1979"

Asbestos exposure, cigarette smoking and death rates*

Abstract: The authors examine the relationship between exposure to asbestos dust cigarette smoking and mortality. The data covering 17800 asbestos workers in the United States and Canada were compiled from the records of the International Association of Heat and Frost Insulators and Asbestos Workers (ANNOTATION)

Hydroxyurea or placebo combined with radiation to treat stages iiib and iv cervical cancer confined to the pelvis

Abstract: In a prospective study by the Gynecologic Oncology Group (GOG), 104 evaluable patients with cervical squamous cell carcinoma Stages IIIB and IVA were randomly assigned to treatment with hydroxyurea or placebo in combination with radiation. There were no deaths resulting from the treatment. Hematologic toxicity was more common and more severe in patients who received hydroxyurea. Response was evaluated in terms of complete tumor regression, duration of progression-free interval and survival probability. By all those parameters the response was significantly better in the groups of patients receiving hydroxyurea.

Scar cancer of the lung: increase over a 21 year period.

Abstract: In a review of 1,186 cases of lung cancer found amoung 7,629 autopsied cases over a 21 year period a total of 82 peripheral cancers related to scars were found, constituting 1% of the autopsied cases and 7% of the lung tumors. 15% of all lung tumors were peripheral (vs. bronchogenic) and the percentage rose from less than 7 in the time period of 1955 to 1960 to a little more than 23 in the 1970 to 1976 time period. 45% of all peripheral lung cancers originated in a scar. Less than 2% of all lung cancers were found associated with scars in the 1955 through 1959 time period. This increased to nearly 16% in the 1970 through 1975 time period. 72% of the scar cancers were adenocarcinomas and 18% were of squamous cell type. The rest were large cell undifferentiated carcinomas and none was oat cell or small cell type. Over three-quarters of these scar cancers were found in the upper lobes and more than half were related to infarcts. Less than a quarter were related to tuberculosis scars. No relationship was found between smoking habits and scar cancer.

The variability of estrogen receptors in metastatic breast cancer

Abstract: Estrogen receptor protein (ERP) concentrations were determined by the sucrose diffusion method in primary tumors and one or more metastases in twenty-nine patients with breast cancer. Concurrence of ERP concentrations between primaries and at least some metastases was found in 76 per cent of cases. Multiple metastases were assayed in ten cases, three of which demonstrated highly variable concentrations. It was concluded that clinically significant differences in ERP concentrations often exist between primary breast cancers and their metastases as well as between different metastases from the same tumor, accounting for the lack of responsiveness of some ERP-“positive” tumors and for mixed responses to hormonal or endocrine therapy. Assay of an isolated metastasis may be no more reliable in predicting overall patient benefit from therapy than assay of the primary itself.

Long‐term mortality experience of chrysotile miners and millers in thetford mines, quebec*

Abstract: Among a cohort of 544 men with at least 20 years of employment in chrysotile mining and milling at Thetford Mines, Canada, 16% of the deaths were from lung cancer and 15% from asbestosis. The excess over expected deaths from these causes account for 43 of 178 deaths in the group. The risk of death of asbestosis, at equal times fron onset of exposure, is very similar in miners and millers, factory workmen and insulators. The ratio of observed to expected deaths from lung cancer is similar in the miners and millers and factory workers, but higher in insulators. The risk of death of mesothelioma in miners and millers is decidedly less than the other two groups. The exact causes of the reduced risk in this category are not yet completely clarified.

Cancer statistics, 1979.

Abstract: CA-ACANCERJOURNALFORCLINICIANS 6 Cancer Statistics, 1979 TheestimatesoftheincidenceofcancerarebasedupondatafromtheNational CancerInstitute's Surveillance, Epidemiologyand EndResults(SEER)Program(1973-1976). Non-melanomaskin cancerand carcinomain situ havenot been includedin the statistics.The incidenceof non melanomaskincanceris estimatedto be over300,000.Preparedby EdwinSilverberg,Project Statistician,Departmentof Epidemiologyand Statistics.AmericanCancerSociety,NewYork, New York.

Hereditary cancer: Ascertainment and management

Abstract: in genetically predisposed families with or without polyposis, the mean age at onset is 45 years,2-4 (2) a marked ex cess of bilateral cancer occurrence in paired organs, e.g., breasts, adrenal (pheochromocytomas) and thyroid glands, carotid body, kidney (Wilms' tumor), acoustic neurinoma;5'6 (3) in nonpaired organs, multiple primary or multicentnc cancer occurs with a fre quency many times greater than other wise expected.7 Tumor registry data have shown that the risk of other cancer in patients with certain histologic vari eties is significantly higher than in cancer free patients of the same age.8 While these studies did not evaluate specific etiologies, many of the most frequently occurring multiple primary tumor asso ciations in cancer registry data were con sidered consistent with a genetic etiol ogy; (4) although there are well estab lished autosomal recessive, sex-linked, and cytogenetic cancer and precancerous disorders, in many cases vertical trans mission in consecutive generations of families has been identified with segre gation patterns consistent with autoso mal dominant inheritance.2 These characteristics can be utilized as familial cancer selection criteria when identified in isolated patients and nuclear family cancer clusters, with or without an immediate impression as to the spe cific hereditary cancer or precancer syn Generalities in Family Cancer

The modern dilemma

Abstract: Success, no matter how defined, generally relieves us of some old worries but is often accompanied by new worries. So it is with modern civilization which is a magnificent monument to the success of those who preceded us. I have in mind especially those whose achievements have so greatly reduced incidence rates and death rates from infections and parasitic diseases, malnutrition and infant mortality-and those whose achievements have so greatly raised the standards of living of the average citizen, provided him with manifold luxuries, and made possible the shift from sunrise to sunset labor six days or more per week to the eight hour work-day, five days per week. Few of us would willingly give up any of these benefits. But a price is being paid in more than one coin, for example: the problems of unemployment and overcrowding in city slums; how to care humanely for the aged who in past times would have lived a t home with their children and grandchildren; and worries concerning the adverse health effects of some of the products and waste products of an industrial society, the price of which concerns us here. The modern dilemma of which we speak is how to retain present benefits and obtain still greater benefits while at the same time reducing the social costs in so far as it is possible to do so. Attention at this conference will be focused on the control of environmental health hazards. But the subject of benefits cannot be altogether avoided. From the standpoint of mortality, the problem is simple-though a decision may be difficult-in those instances where the entire price is paid by the same person who expects to reap virtually all of the benefits. For example, when sulfa drugs and antibotics were first introduced, these therapeutic agents were highly effective in the treatment of several often fatal diseases. Unfortunately, some of these agents were also very toxic. The patients to whom they were administered received the benefit of probable cure but also took the risk of possible injury or even death from the toxic effects. It was usually the doctor who had to make the difficult decision (especially as to dosage) for which he later might be thanked or cursed. The moral issue is far more complex in instances where the benefits go mainly to one group of people while the price (in terms of risk to health) is paid by another group. For example: a part of the price paid for most major bridges and tunnels has been the death (by accident, the bends or silicosis) of one or more of the construction workers. Those who died paid the highest possible price. All of the workers took a risk. The benefit (improved transportation) is reaped by the general public. How does one weigh the value of one or several human lives against a benefit of this sort? A similar problem is encountered in some manufacturing processes where the workers are exposed to agents which are (or are said to be) hazardous to their health. They take the risks; the public obtains benefits; the manufacturer makes a profit; and, of course, the workers have gainful employment. It is small wonder that in such instances the various groups concerned (and their advocates) often express different opinions on the facts of the case. They may deny the existence of a risk, underestimate

Small cell anaplastic carcinoma of the lung: changing concepts and emerging problems.

Abstract: Small cell carcinoma of the lung has joined the ranks of cancers that are increasingly susceptible to successful therapeutic attack. Cautious optimism about potential cures is being expressed in a disease that a few short years ago had a median survival of two months. Advances in cell biology, particularly in the area of metastases, are leading to new concepts in therapy, but more than ever there is a crying need for controlled studies of new approaches.

Classification of data in research.

Abstract: for cancer of the lung and bronchus which had been increasing at an average rate of 5.7 percent per year—suddenly increased by 9.6 percent. This caused con cern among some cancer control workers, but not among vital statisticians who were aware that a new classification (the Eighth Revision) of the International Classifica tion of Diseases (lCD) had gone into effect in 1968. They surmised that this sharp in crease was probably not real, but resulted from classification changes in coding causes of death. A subsequent analysis of a sample of death certificates for persons dying with cancer coded by both the Sev enth Revision and the Eighth Revision of the lCD proved that this hypothesis was correct. In the Eighth Revision of the lCD there was an increase of about 2.5 percent in the certificates coded to primary cancer of the lung and bronchus compared to the Seventh Revision.' The major effect of the changes in the Eighth Revision with respect to lung cancer was to code many additional cases previously recorded as cancer, primary site unknown, to primary lung cancer. Even when the same edition of the lCD is used, there can be substantial changes in classification of causes of death in international comparisons because of different interpretations of coding rules. In a recent study, a random sample of 1,246 death certificates which mentioned cancer were coded by experienced nosol ogists in seven different countries, includ ing the United States. The analysis showed that there was some difference in coding of the underlying cause of death by at least one nosologist in 47 percent of the death certificates.2 Compared to the cod ing by the United States nosologist, the coders in the six other countries coded a different cause of death in 12 to 27 percent of the death certificates. The physician who completes a death certificate indi cates what he believes to be the underlying cause of death in a majority of instances. Problems may arise either when more than one cause of death is entered on the death certificate and it is not clear which was the underlying cause of death, or when the physician uses ambiguous language. In these instances the coding clerk has to interpret what the physician had in mind and this can, of course, lead to discrep ancies (see box, p. 4). In the Ninth Revi sion of the lCD—which will go into effect on January 1, 1979—rules for coding neoplasms have been greatly expanded and will be applied similarly by all coun tries, thus making international cancer mortality rates more comparable. Problems of classification are present in a number of areas of medical and scien Lawrence Garfinkel is Assistant Vice President for Epidemiology and Statistics, American Cancer Society, New York, New York.