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  • 1
    ISSN: 1573-7225
    Keywords: Cohort effects ; incidence ; melanoma ; registries ; SEER ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: The incidence of malignant melanoma has been increasing steadily in the United States. The increase may be due to lifestyle changes in subsequent generations or birth cohorts. The nine population-based tumor registries in the Surveillance, Epidemiology, and End Results program (SEER) have been in existence for a sufficient time to begin to investigate cohort trends for the US population. Cases were the 18.787 Caucasians aged 20 to 84 years, who reported to SEER registries with a diagnosis of melanoma in 1974–86. Among men born between 1890 and 1919, each subsequent five-year birth cohort experienced 45 to 57 percent increases in age-adjusted melanoma incidence of the arm and trunk, and 14 to 20 percent increases were experienced across each site (arm, leg, head, and trunk) for the 1920–44 cohorts of men. Among women born between 1890 and 1919, 24 to 29 percent increases were seen for melanoma of the trunk, arms, and legs for each subsequent five-year birth-cohort, followed by six to 29 percent increases in the 1920–44 cohorts. Recent birth cohorts, 1945–64, have shown stabilizing rates, even after an attempt to adjust for the increasing tendency for diagnoses to be made in doctors' offices. Thus, the dramatic birth-cohort effects appear to have ended beginning with those born in 1945. However, melanoma rates will continue to rise until those born after 1945 represent the majority of the population. Furthermore, for the most recent cohorts, the trunk has become the most common site (per square meter of body surface) for men and the second most common site for women. This suggests that some lifestyle change has led to more damaging exposure (e.g., sunburns) of the trunk among recent cohorts than earlier cohorts.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7225
    Keywords: Indians/North American ; neoplasms ; survival analysis ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cancer survival among American Indians is worse than among other races in some regions of the United States, but has not been studied among American Indians in Washington state. Our purpose was to evaluate cancer survival among American Indians included in the Seattle-Puget Sound Cancer Registry. We compared site-specific survival among American Indians (n=551) and Whites (n=110,899) diagnosed from 1974 to 1989 for five cancer sites. For all sites except prostate, the distribution of cancer stage at diagnosis for American Indians was not significantly different from the distribution for Whites, and a similar proportion of American Indians and Whites received cancer treatment. After adjustment for age differences between American Indians and Whites, American Indians experienced poorer survival from prostate, breast, cervical, and colorectal cancer. Poorer survival among American Indians persisted after adjustment for differences in cancer stage at diagnosis, lack of cancer treatment, and residence in a non-urban county. The survival experience among American Indians who were recorded as non-American Indians in the cancer registry but whe were listed as American Indians in Indian Health Service records was more favorable than that among persons initially coded as American Indians in the cancer registry. We conclude that cancer survival among American Indians in western Washington is poorer than that among Whites in the same region, and that factors other than age, differences in stage at diagnosis, lack of cancer treatment, and residence in non-urban counties account for this.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7225
    Keywords: Age ; melanoma ; migration ; nevus ; pigmentation ; sunlight ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A survey to ascertain factors associated with benign melanocytic nevi or moles was conducted among randomly-selected White adults (aged 18 to 50 years) in Washington State (United States). Participants of the telephone interview in 1990–91 were questioned about lifetime places of residence and constitutional factors. Subjects counted raised nevi on their arms at the end of the survey. Logistic regression was used to examine the risk for two or more nevi compared with no nevi. Individuals who resided in warmer areas and lower latitudes than Washington State were at higher risk of having multiple nevi. This association held for residence at birth, during childhood, adolescence, and over lifetime: an odds ratio (OR) of 2.3 (95 percent confidence interval =1.2–4.3) for lifetime average daily maximum temperature of ≥64°F compared with 58.9°F, and similar ORs of 2.1 for adolescence and 1.8 for childhood. These associations remained significant after adjusting for potential confounding effects of constitutional factors and for childhood sunburns as a potential mechanism. Risk of multiple nevi was reduced for both early age at migration and longer duration of stay in Washington. These data are consistent with the importance of childhood and adolescent sun exposure in the etiology of nevi, but also suggest an effect of lifetime sun exposure.
    Type of Medium: Electronic Resource
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