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  • Articles  (4)
  • DKFZ Publication Database  (1,787)
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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Health Technology Assessment; VOL: 3; DOC03 /20070308/
    Publication Date: 2007-08-24
    Description: Background In Western countries hormone replacement therapy (HT) is widely used in the treatment of climacteric women who are affected with hot flashes and night sweats. Besides, long-term HT was frequently used to manage the higher risks for osteoporosis and heart attack in postmenopause. Estrogens alone or combined with progestin feature most frequently in HT. Objectives This HTA report addresses the questions on medical efficacy and cost-effectiveness of HT as a treatment of hot flashes and night sweats as well as in the primary prevention of osteoporosis and cardiovascular disease in postmenopause in general healthy women. Methods The literature search for articles published after 1998 was conducted in March 2004 in standard medical and economic databases. The analysis included randomised controlled trials, systematic reviews, meta-analysis and economic evaluations considering relevant clinical endpoints in English or German language. The quality of the studies was assessed using checklists corresponding to the study type. Results HT is highly effective in treating hot flashes in climacteric women. The question of economical efficiency cannot be answered due to the scarce database. As the positive effects (lower risk for fractures and endometrial cancer) do not outweigh the negative effects (higher risk for breast cancer and general cardiovascular risk) estrogen-progestin combination HT cannot be recommended for primary prevention of osteoporosis and cardiovascular disease in postmenopausal women. Discussion The observation period of most of the studies regarding therapy of hot flashes and night sweats were too short to evaluate possible risks of long-term HT. The economic publications assessing HT for this indication varied vastly in terms of applied methods and were not carried out with respect to the German health care system. Conclusions HT can be recommended in the short-term treatment of hot flashes and night sweats in climacteric women. To explore the economic effects of HT for this indication for Germany, studies constructed with respect to the German health care system are desirable.
    Description: Hintergrund Viele Frauen in westlichen Ländern sind von klimakterischen Beschwerden wie Hitzewallungen und nächtlichen Schweißausbrüchen betroffen, die häufig mit einer Hormontherapie (HT) behandelt werden. Darüber hinaus wurde das erhöhte Osteoporose- und Herzinfarktrisiko nach der Menopause (Postmenopause) häufig langfristig mit HT behandelt. Die wichtigste Rolle in der HT spielen bis heute die Estrogene, einzeln oder kombiniert mit Gestagenen. Fragestellung Ziel dieses Health Technology Assessment (HTA)-Berichts ist es, bei allgemein gesunden Frauen medizinische Effektivität und ökonomische Effizienz der HT zur Therapie von Hitzewallungen und nächtlichen Schweißausbrüchen sowie zur Primärprävention von Osteoporose und Herz-Kreislauferkrankungen in der Postmenopause anhand publizierter Studien zu bewerten. Methodik In den Datenbanken von MEDLINE, EMBASE, Int. Health Technology Assessment, der Cochrane Library u. a. wurden für den Zeitraum 1999 bis 23. März 2004 nur englisch- und deutschsprachige randomisierte Studien, systematische Übersichtsarbeiten und ökonomische Evaluationen zu patientinnennahen Endpunkten berücksichtigt und bei Erfüllung qualitativer Mindestanforderungen bewertet. Ergebnisse Zur Therapie von Hitzewallungen und nächtlichen Schweißausbrüchen im Klimakterium erwies sich die HT als effektiv. Die Frage der ökonomischen Effizienz konnte aufgrund einer schwachen Datenbasis nicht beantwortet werden. Kombinations-HT kann nicht zur Primärprävention von Osteoporose und Herz-Kreislauferkrankungen bei postmenopausalen Frauen empfohlen werden, da die negativen (erhöhtes Brustkrebs- und allgemeines kardiovaskuläres Risiko) durch die positiven (reduziertes Fraktur- und Darmkrebsrisiko) Effekte nicht aufgewogen werden. Diskussion Die Mehrzahl der Studien zur Therapie von Hitzewallungen und nächtlichen Schweißausbrüchen war zu kurz, um langfristige Therapierisiken zu beurteilen. Die ökonomischen Untersuchungen variierten stark hinsichtlich der Methodik und wurden nicht vor dem Hintergrund des deutschen Gesundheitswesens durchgeführt. Schlussfolgerung Die HT kann zur kurzfristigen Behandlung von Hitzewallungen und nächtlichen Schweißausbrüchen empfohlen werden. Zu den ökonomischen Auswirkungen der HT bei dieser Indikation besteht für Deutschland erheblicher Forschungsbedarf. Als primärpräventive Maßnahme bei gesunden Frauen in der Postmenopause kann sie nicht empfohlen werden.
    Keywords: HORMONE ; HORMONES ; HORMONE REPLACE THER ; HORMONE REPLACEMENT THERAPY ; HORMONE REPLACEMENT THERAPIES ; HORMONE REPLACEMENT THERAPY, POST MENOPAUSAL ; HORMONE REPLACEMENT THERAPY, POST-MENOPAUSAL ; MENOPAUSE ; CLIMACTERIC ; CLIMACTERICS ; PREVENTIVE MEDICINE ; RISK ; RISKS ; HORMONE ; HORMONE ; HORMON-SUBSTITUTIONSBEHANDLUNG ; HORMON-SUBSTITUTIONSBEHANDLUNG ; HORMON-SUBSTITUTIONSBEHANDLUNG ; ÖSTROGENSUBSTITUTIONSTHERAPIE ; ÖSTROGENSUBSTITUTIONSTHERAPIE ; MENOPAUSE ; KLIMAKTERIUM ; KLIMAKTERIUM ; PRÄVENTIVMEDIZIN ; RISIKO ; RISIKO ; Hormone ; Hormon-Substitutionsbehandlung ; Hormonsubstitutionstherapie ; Post-Menopause ; Menopause ; Klimakterium ; Praeventivmedizin ; Risisko ; ddc: 610
    Language: German
    Type: article
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  • 2
    ISSN: 1572-9915
    Keywords: RISK ; DIVERSIFICATION ; GEOGRAPHIC INFORMATION SYSTEM ; SOUTHWESTERN PREHISTORY ; POPULATION PRESSURE
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Energy, Environment Protection, Nuclear Power Engineering , Ethnic Sciences
    Notes: Abstract Diversification in agricultural techniques is a common strategy of risk minimization in nonindustrial societies. However, attribution of suboptimal behavior to risk minimization without consideration of the structure of risk and its environmental context obscures the complexity of agricultural decision-making. The productive potential of a prehistoric agricultural system that includes floodwater and dry farming and stream irrigation is modeled using Geographic Information System (GIS) analysis to evaluate whether diversification occurred as a response to population pressure or as a risk buffering strategy. The estimated productive potential of floodwater and irrigation farming is sufficient to have supported the estimated local population, suggesting that risk buffering is a more likely explanation. Floodwater farming and stream irrigation form a dual strategy that is effective at reducing risk. However, the potential of dry farming for subsistence production is insufficient for buffering more than a 2% productive shortfall. We propose that, within this generally risk-averse economy, dry farming was oriented toward the production of nonsubsistence crops such as cotton.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Archives of sexual behavior 27 (1998), S. 561-580 
    ISSN: 1573-2800
    Keywords: SEXUAL HARASSMENT ; RISK ; SEXISM ; ATTRACTIVENESS ; SEXROLE
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract A new model of the etiology of sexual harassment,the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model,and the sexrole spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sexrole). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1572-9915
    Keywords: AGRO-ECOLOGY ; DEVELOPMENT ; KARAKORAM ; PAKISTAN ; RISK
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Energy, Environment Protection, Nuclear Power Engineering , Ethnic Sciences
    Notes: Abstract Despite emerging appreciations of contextual knowledge systems, elements of diversity in mountain farming systems are often characterized as irrational and as obstacles to achieving the production goals of 'modernized' agriculture. In this paper, I suggest that these negative representations are produced at least in part as a function of the normalization of a large-scale agriculture as rational. A case-study of a mountain farming system in the Karakoram mountains of northern Pakistan is presented to expose a contextual rationality in relation to risk minimization and to challenge characterizations of this system as 'backward,' unsophisticated and irrational. Specifically I examine the risk mediating characteristics of practices such as field dispersal, delayed planting, intercropping, and polyvarietal planting and conclude that the characteristic feature of this local farming system is a contextually rational diversity. This conflicts with the modernist paradigm of rationality and economic growth subscribed to by a local development agency. Intervention based on ill-informed interpretations of “traditional” practice have the potential to increase vulnerability of villagers by failing to appreciate the contextual rationality of diversity.
    Type of Medium: Electronic Resource
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  • 5
    Keywords: HEALTH ; RISK ASSESSMENT ; SERIES ; human ; CANCER ; RISK
    Type of Publication: Book chapter
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  • 6
    Keywords: methods ; RISK-ASSESSMENT ; HEALTH ; CARCINOGENESIS ; RISK ASSESSMENT ; CANCER ; human ; MODEL ; MODELS ; RISK
    Type of Publication: Book chapter
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  • 7
  • 8
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    Springer Verlag
    Neuroblastoma. 27-40 
    Keywords: ENZYME ; cytogenetic ; GENETIC-POLYMORPHISM ; molecular ; neuroblastoma ; ENZYMES ; RISK ; LUNG-CANCER ; lung cancer ; CANCER ; human ; LUNG ; RISK ASSESSMENT ; cancer risk ; risk factors ; cytogenetics ; HEALTH ; POLYMORPHISMS ; polymorphism ; RISK-FACTORS ; GENETIC POLYMORPHISMS
    Type of Publication: Book chapter
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  • 9
    Keywords: SIZE ; RISK ; HISTORY ; human ; CANCER ; tumor ; AGE ; NATURAL-HISTORY ; RISK ASSESSMENT ; SERIES ; breast cancer ; BREAST-CANCER ; BREAST ; HEALTH
    Type of Publication: Book chapter
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  • 10
    Keywords: RISK ; EXPOSURE ; human ; MODEL ; MODELS ; STATISTICAL-ANALYSIS ; UNCERTAINTIES ; prevalidation study ; toxicokinetic ; TCDD ; UNCERTAINTY ; RISK ASSESSMENT
    Type of Publication: Book chapter
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  • 11
    Keywords: treatment ; ASSOCIATION ; polymorphism ; POLYMORPHISMS ; single nucleotide polymorphism ; SUSCEPTIBILITY ; VARIANTS ; SKIN ; mechanisms ; prevention ; HEALTH ; PROMOTER ; BREAST ; breast cancer ; BREAST-CANCER ; cancer prevention ; smoking ; SNP ; REPAIR ; WOMEN ; LYMPHOCYTES ; DAMAGE ; GENOTYPES ; cancer risk ; CANCER-PATIENTS ; INDIVIDUALS ; case-control studies ; DNA-DAMAGE ; CANCER PATIENTS ; SUSCEPTIBILITY GENE ; BODY ; RISK ; GENE ; ENZYMES ; DISEASE ; lung cancer ; LUNG-CANCER ; PATIENT ; MECHANISM ; DNA ; TUMORS ; validation ; DRUG ; RNA ; GENES ; THERAPY ; VITRO ; LUNG ; COMBINATION ; CANCER ; EXPRESSION ; IN-VITRO ; CELLS ; CELL ; tumor ; AGENTS ; radiotherapy ; NSCLC ; CANCER-RISK ; cancer research ; RNA EXPRESSION ; ENZYME ; case control studies ; analysis ; GENOTYPE ; PROFILES ; single-nucleotide ; development ; PROMOTER POLYMORPHISM ; XRCC1 ; VARIANT ; WEIGHT ; SINGLE NUCLEOTIDE POLYMORPHISMS ; SNPs ; case-control study ; GEMCITABINE ; CAPACITY ; DEFICIENCY ; small cell lung cancer ; AGENT ; SINGLE ; DNA repair ; MPO ; APE1
    Abstract: Cells in the body are permanently attacked by DNA-reactive species, both from intracellular and environmental sources. Inherited and acquired deficiencies in host defense mechanisms against DNA damage (metabolic and DNA repair enzymes) can modify cancer susceptibility as well as therapy response. Genetic profiles should help to identify high-risk individuals who subsequently can be enrolled in preventive measures or treated by tailored therapy regimens. Some of our attempts to define such risk profiles are presented. Cancer susceptibility: Single nucleotide polymorphisms (SNPs) in metabolic and repair genes were investigated in a hospital-based lung cancer case-control study. When evaluating the risk associated with different genotypes for N-acetyltransferases (Wikman et al. 2001) and glutathione-S-transferases (Risch et al. 2001), it is mandatory to distinguish between the three major histological subtypes of lung tumors. A promoter polymorphism of the myeloperoxidase gene MPO was shown to decrease lung cancer susceptibility mainly in small cell lung cancer (SCLC) (Dally et al. 2002). The CYP3A4*1B allele was also linked to an increased SCLC risk and in smoking women increased the risk of lung cancer eightfold (Dally et al. 2003b). Polymorphisms in DNA repair genes were shown to modulate lung cancer risk in smokers, and reduced DNA repair capacity elevated the disease risk (Rajaee-Behbahani et al. 2001). Investigations of several DNA repair gene variants revealed that lung cancer risk was only moderately affected by a single variant but was enhanced up to approximately threefold by specific risk allele combinations (Popanda et al. 2004). Therapy response: Inter-individual differences in therapy response are consistently observed with cancer chemotherapeutic agents. Initial results from ongoing studies showed that certain polymorphisms in drug transporter genes (ABCB1) differentially affect response outcome in histological subgroups of lung cancer. Stronger beneficial effects were seen in non-small cell lung cancer (NSCLC) patients following gemcitabine and in SCLC patients following etoposide-based treatment. Several DNA repair parameters (polymorphisms, RNA expression, and DNA repair capacity) were measured in vitro in lymphocytes of patients before radiotherapy and correlated with the occurrence of acute side effects (radio-hypersensitivity). Our initial analysis of several repair gene variants in breast cancer patients (n = 446) who received radiotherapy revealed no association of single polymorphisms and the development of side effects (moist desquamation of the irradiated normal skin). The risk for this side effect was, however, strongly reduced in normal weight women carrying a combination of XRCC1 399Gln and APE1 148Glu alleles, indicating that these variants afford some protection against radio-hypersensitivity (Chang-Claude et al. 2005). Based on these data we conclude that specific metabolic and DNA repair gene variants can affect cancer risk and therapy outcome. Predisposition to hereditary cancer syndromes is dominated by the strong effects of some high-penetrance tumor susceptibility genes, while predisposition to sporadic cancer is influenced by the combination of multiple low-penetrance genes, of which as a major challenge, many disease-relevant combinations remain to be identified. Before translating these findings into clinical use and application for public health measures, large population-based studies and validation of the results will be required.
    Type of Publication: Book chapter
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  • 12
    Keywords: TRANSPLANTATION ; C-JUN ; cell-cell interaction ; cell proliferation ; GM-CSF ; organotypic culture ; cell differentiation ; dermal fibroblasts ; epidermal keratinocytes ; epithelial cell culture ; dermal equivalent ; paracrine factors ; collagen matrix ; IL-1 ; KGF ; JunB
    Abstract: This chapter focuses on the role of dermal fibroblasts in epidermal keratinocyte proliferation and differentiation and proves the usefulness of an organotypic in vitro skin equivalent model to study mechanisms of tissue regeneration. Examples are given how these can be used to study the growth of keratinocytes after transplantation in vivo, alone or with a collagen matrix. This leads on to the development of in vitro organotypic models to generate skin equivalents composed of an organized epidermis on matrix-embedded dermal fibroblasts. Protocols are provided for both the in vivo transplantation models and the combined stromal/epithelial in vitro organotypic models, along with several variations of the methods. Characterization of the proliferation and differentiation of the cultures is described with an extensive discussion of recent results on the factors controlling tissue regeneration, with emphasis on the role of c-jun and junB gene products in the production of KGF and GM-CSF by fibroblasts in response to epithelium-derived IL1, and the effect of these cytokines on the proliferation and differentiation of epidermal keratinocytes.
    Type of Publication: Book chapter
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  • 13
    Keywords: CARCINOGENESIS ; STATISTICAL-ANALYSIS ; prevalidation study ; UNCERTAINTIES ; RISK ASSESSMENT ; UNCERTAINTY ; TCDD ; toxicokinetic ; MODELS ; MODEL ; human ; EXPOSURE ; RISK
    Type of Publication: Book chapter
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  • 14
    Keywords: WOMEN ; HEREDITARY ; HIGH-RISK ; BREAST ; BREAST-CANCER ; breast cancer ; RISK ; screening ; CANCER ; HEREDITARY BREAST ; PROGRESS
    Type of Publication: Book chapter
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  • 15
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    Wiley, Chichester, UK
    Keywords: quantitative ; UK ; analysis ; RISK
    Type of Publication: Book chapter
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  • 16
    Keywords: WORLD ; CANCER-RISK ; CANCER ; MODEL ; MODELS ; RISK ; LESIONS ; cancer risk
    Type of Publication: Book chapter
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  • 17
    Keywords: Genetic ; colorectal ; RISK ; METABOLISM ; VARIABILITY
    Type of Publication: Book chapter
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  • 18
    Keywords: CANCER ; human ; RISK ; cancer risk ; SERIES ; RISK ASSESSMENT ; HEALTH ; RISK-ASSESSMENT
    Type of Publication: Book chapter
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  • 19
    Keywords: RISK ; ENZYMES ; lung cancer ; LUNG-CANCER ; LUNG ; human ; CANCER ; cancer risk ; risk factors ; SERIES ; RISK ASSESSMENT ; polymorphism ; POLYMORPHISMS ; GENETIC POLYMORPHISMS ; RISK-FACTORS ; HEALTH ; GENETIC-POLYMORPHISM ; ENZYME
    Type of Publication: Book chapter
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  • 20
    Keywords: radiation therapy ; THERAPIES ; RADIATION-THERAPY ; THERAPY ; radiation ; segmentation ; RISK ; VOLUME
    Type of Publication: Book chapter
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  • 21
    Keywords: RISK ; segmentation ; radiation ; THERAPY ; ALGORITHM ; RADIATION-THERAPY ; therapy planning ; THERAPIES ; radiation therapy
    Type of Publication: Book chapter
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  • 22
    Keywords: CANCER ; Germany ; LUNG ; lung cancer ; LUNG-CANCER ; SYSTEM ; CANCER MORTALITY ; COHORT ; cohort studies ; cohort study ; cohort-studies ; DEATH ; DISEASE ; DISEASES ; DNA adducts ; EPIDEMIOLOGY ; EXPOSURE ; HEPATOCELLULAR-CARCINOMA ; HISTORY ; incidence ; iron foundry ; larynx ; liver ; LONG-TERM ; missing death certificates ; MORTALITY ; mouth ; NEW-YORK ; occupation ; PHARYNX ; POPULATION ; PRIMARY LIVER-CANCER ; RISK ; RISKS ; SITE ; SITES ; WORKERS
    Abstract: Background Observations of an increased incidence of cancers of the upper aero-digestive tract (pharynx, esophagus, larynx, lung) among workers of local German foundries gave rise to concern about a potentially elevated occupational risk of those cancer sites. The purpose of the study was to examine whether occupational exposure in iron foundries increases the risk of cancer. Methods A historical cohort study of 17,708 male German production workers in 37 iron foundries who were first employed in 1950-1985 with a minimum employment period of 1 year was initiated. Employment and occupational histories were collected. Mortality was compared with that of the German general population during 1950-1993 using a new method for computing the SMR when not all causes of death are available (called SMR*). Results Mortality from all causes was elevated to SMR = 115.4 (95% confidence interval (CI) = 111.9-119.1), as was for total cancer (SMR* = 123.8, CI = 102.1-152.6), especially cancers of the lung (SMR* = 163.9, CI = 123.9-223.0) and liver (SMR* = 322.5, CI = 149.5-844.8), and diseases of the respiratory system (SMR* = 147.6, CI = 100.4-221.5). Non- significant elevations of mortality were also found for cancers of the mouth and pharynx (SMR* = 153.5, CI = 82.3-359.8) and larynx (SMR* = 173.1, CI = 85.5-550.5). Mortality from various causes of death was higher among workers with shorter exposure periods than among long-term employees. The elevated mortality persisted for years and decades after termination of employment. Conclusions The results provide further evidence for an increased risk of lung cancer and possibly other cancers of the upper aero-digestive tract among foundry workers. Special attention should be paid to the strongly increased mortality from liver cancer and the mortality pattern among employees having terminated work. (C) 2003 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 12594777
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  • 23
    Keywords: CANCER ; CELLS ; EXPRESSION ; IN-VIVO ; LUNG-CANCER ; DNA adducts ; RISK ; GENE ; LINES ; ACTIVATION ; DNA ; 3-aminobenzanthrone ; 3-nitrobenzanthrone ; AIR ; CARCINOGENESIS ; CYP1A2 ; CYTO-TOXIC METABOLITES ; DIESEL EXHAUST ; DNA ADDUCT FORMATION ; ENVIRONMENTAL CONTAMINANT 3-NITROBENZANTHRONE ; GENETIC POLYMORPHISMS ; HETEROCYCLIC AMINES ; HETEROLOGOUS EXPRESSION ; HUMAN CYTOSOLIC SULFOTRANSFERASES ; IONS ; metabolic activation ; NAT : SULT ; nitro-PAH ; P-32- postlabeling ; PHENOL SULFOTRANSFERASES ; POSTLABELING ANALYSIS
    Abstract: 3-Nitrobenzanthrone (3-NBA) is a potent mutagen and suspected human carcinogen identified in diesel exhaust and ambient air pollution. 3-Aminobenzanthrone (3-ABA), 3- acetylaminobenzanthrone (3-Ac-ABA) and N-acetyl-N-hydroxy-3- aminobenzanthrone (N-Ac-N-OH-ABA) have been identified as 3-NBA metabolites. Recently we found that 3-NBA and its metabolites (3-ABA, 3-Ac-ABA and N-Ac-N-OH-ABA) form the same DNA adducts in vivo in rats. In order to investigate whether human cytochrome P450 (CYP) enzymes (i.e., CYPIA2), human N,O- acetyltransferases (NATs) and sulfotransferases (SULTs) contribute to the metabolic activation of 3-NBA and its metabolites we developed a panel of Chinese hamster V79MZ-hIA2 derived cell lines expressing human CYPIA2 in conjunction with human NATI, NAT2, SULTIAI or SULTIA2, respectively. Cells were treated with 0.01, 0.1 or I muM 3-NBA, or its metabolites (3- ABA, 3-Ac-ABA and N-Ac-N-OH-ABA). Using both enrichment versions of the P-32-postlabeling assay, nuclease P I digestion and butanol extraction, essentially 4 major and 2 minor DNA adducts were detected in the appropriate cell lines with all 4 compounds. The major ones were identical to those detected in rat tissue; the adducts lack an N-acetyl group. Human CYPIA2 was required for the metabolic activation of 3-ABA and 3-Ac-ABA (probably via N-oxidation) and enhanced the activity of 3-NBA (probably via nitroreduction). The lack of acetylated adducts suggests N-deacetylation of 3-Ac-ABA and N-Ac-N-OH-ABA. Thus, N-hydroxy-3-aminobenzanthrone (N-OH-ABA) appears to be a common intermediate for the formation of the electrophilic arylnitrenium ions capable of reacting with DNA. Human NAT I and NAT2 as well as human SULTIAI and SULTIA2 strongly contributed to the high genotoxicity of 3-NBA and its metabolites. Moreover, N,O-acetyltransfer reactions catalyzed by human NATs leading to the corresponding N-acetoxyester may be important in the bioactivation of N-Ac-N-OH-ABA. As human exposure to 3-NBA is likely to occur primarily via the respiratory tract, expression of CYPs, NATs and SULTs in respiratory tissues may contribute significantly and specifically to the metabolic activation of 3-NBA and its metabolites. Consequently, polymorphisms in these genes could be important determinants of lung cancer risk from 3-NBA
    Type of Publication: Journal article published
    PubMed ID: 12740904
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  • 24
    Keywords: CANCER ; PROTECTION ; MODEL ; DISEASE ; EPIDEMIOLOGY ; HISTORY ; RISK ; GENE ; GENES ; SAMPLE ; FAMILY ; RISK-FACTORS ; SUSCEPTIBILITY ; BREAST ; breast cancer ; BREAST-CANCER ; AGE ; BRCA1 ; case-only design ; family history ; gene carrier probability ; LINKAGE ANALYSIS ; mixture logistic model ; ovarian cancer ; OVARIAN-CANCER ; population and sibling controls ; WOMEN
    Abstract: Background The effect of environmental/lifestyle factors on breast cancer risk may be modified by genetic predisposition. Methods In a population-based case-control-family study performed in Germany including 706 cases by age 50 years, 1381 population, and 252 sister controls, we investigated main effects for environmental/lifestyle factors and genetic susceptibility and gene-environment interaction (G x E). Different surrogate measures for genetic predisposition using pedigree information were used: first-degree family history of breast or ovarian cancer; and gene carrier probability using a genetic model based on rare dominant genes. Possible G x E interaction was studied by (1) logistic regression using cases and population controls including an interaction term; (2) comparing results using sister controls and population controls; (3) case-only analysis with logistic regression and (4) a mixture logistic model. Results Familial predisposition showed the strongest main effect and the estimated gene carrier probability gave the best fit. High parity and longer duration of breastfeeding reduced breast cancer risk significantly, a history of abortions increased risk and age at menarche showed no significant effect. We found significant G x E interaction between parity and genetic susceptibility using different surrogate measures. In women most likely to have a high genetic susceptibility, high parity was less protective. Later age at menarche was protective in women with a positive family history. No evidence for G x E interaction was found for breastfeeding and abortion. Conclusions These findings corroborate results from other studies and provide further evidence that the magnitude of protection from parity is reduced in women most likely to have a genetic risk in spite of the limitations of using surrogate genetic measures
    Type of Publication: Journal article published
    PubMed ID: 12690006
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  • 25
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    Internist 44 (9), 1131-1139 
    Keywords: Germany ; THERAPY ; COMMON ; DIAGNOSIS ; DISEASE ; NEW-YORK ; POPULATION ; RISK ; TIME ; PATIENT ; NEPHRITIS ; INFECTION ; GRAFT ; renal ; STAGE ; IDENTIFICATION ; PROGRESSION ; EXPERIENCE ; RISK FACTOR ; RECURRENCE ; FREQUENT ; CLINICAL-FEATURES ; CLINICALLY-RELEVANT ; CYCLOPHOSPHAMIDE ; FAILURE ; glomerulonephritis ; HYPERTENSION ; INFECTIONS ; NATURAL-HISTORY ; NEPHROPATHY ; PREDICTORS ; PREVALENCE ; proteinuria ; RECURRENT ; renal insufficiency ; renoparenchymal hypertension ; RISK GROUP ; STAGE RENAL-FAILURE
    Abstract: IgA nephropathy (IgAN) is the most common type of glomerulonephritis in the western world. In the majority of cases, it manifests in adolescence or early adulthood as recurrent macrohematuria, frequently triggered by infections, or persistent microhematuria as well as mild proteinuria, hypertension and/or renal insufficiency. In view of the later, it is not surprising that IgAN is often a chance finding. The majority of affected persons probably never come to medical attention, since in autopsies a prevalence of up to 1% of the population has been reported. About 20-30% of patients with a diagnosis of IgAN suffer from chronic, slowly progressive renal failure. Predictors include the degree of proteinuria and arterial hypertension as well as the established renal impairment at the time of diagnosis. Early identification of this risk group is of particular importance, since adequate therapy can stop or at least retard the progression of renal failure. When end stage renal failure has developed and a renal transplant is performed, about 25% of the patients will experience a clinically relevant recurrence of IgAN with progressive graft dysfunction
    Type of Publication: Journal article published
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  • 26
    Keywords: SURVIVAL ; tumor ; Germany ; INHIBITION ; MODEL ; MODELS ; DISEASE ; DISEASES ; incidence ; liver ; RISK ; SITE ; SITES ; GENE ; TUMORS ; STORAGE ; TIME ; PATIENT ; NITRIC-OXIDE SYNTHASE ; INJURIES ; DNA ; INFECTION ; RISK-FACTORS ; CARCINOGENESIS ; RAT ; RATS ; PROTEIN-KINASE ; treatment ; virus ; prevention ; STRESS ; risk factors ; metastases ; DAMAGE ; chemoprevention ; COLON CARCINOGENESIS ; copper toxicity ; curcumin ; ETHENO-DNA ADDUCTS ; HEREDITARY HEPATITIS ; LEC rats ; LIPID-PEROXIDATION ; MOUSE FIBROBLAST CELLS ; NIH 3T3 ; ORNITHINE DECARBOXYLASE ; OXIDATIVE STRESS
    Abstract: Long-Evans Cinnamon (LEC) rats, an inbred mutant strain which accumulates copper due to an aberrant copper-transporting ATPase gene, develop acute hepatitis, chronic liver injury and liver tumors as a result of copper-induced oxidative stress, lipid peroxidation and DNA damage. Curcumin, an antioxidant and anti-inflammatory agent, has shown anticancer properties in many rodent models. We investigated the modulating role of curcumin in liver and kidney carcinogenesis in LEC rats. Two groups of 4-week-old LEC rats (n = 60 each) were fed either a standard diet (control) or received 0.5% curcumin in the diet for life. In untreated LEC rats, the rate of acute liver failure, the incidence of liver tumors and of kidney tumors were 32, 100 and 10% respectively, which was not altered by curcumin treatment. However, curcumin reduced tumor incidence at other organ sites (15% versus 0%; P = 0.025) and suppressed formation of metastases (18% versus 0%; P = 0.01). Median survival time was decreased from 88.7 to 78.1 weeks in curcumin-treated rats (P = 0.002). The lack of chemoprevention of liver and kidney tumors in LEC rats by curcumin may be caused by enhanced toxicity and oxidative stress due to excess copper. We conclude that curcumin should be contra-indicated for patients suffering from inherited and acquired metal storage diseases that include patients with hepatitis C virus infection. (C) 2002 Elsevier Science B.V. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 12628510
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    Keywords: CANCER ; FOLLOW-UP ; lung cancer ; LUNG-CANCER ; COHORT ; MORTALITY ; POPULATION ; RISK ; RISKS ; SITE ; SITES ; TIME ; SKIN ; IN-SITU ; MALIGNANCIES ; WOMEN ; smoking ; skin cancer ; bladder cancer ; BLADDER-CANCER ; SWEDEN ; cancer risk ; SQUAMOUS-CELL CARCINOMA ; CANCER RISKS ; COSMETOLOGISTS ; hair dyes ; hairdressers ; HEMATOPOIETIC NEOPLASMS ; NECK ; OCCUPATIONAL RISKS ; SAFETY ; SIR ; UNITED-STATES
    Abstract: More than a decade ago, an increased risk for bladder cancer among male hairdressers was established. Frequent changes of hair dye formulations together with their widespread use call for safety guarantees. We carried out a follow-up study of a cohort of 38,866 female and 6,824 male hairdressers from Sweden and analyzed all of their malignancies over a period of 39 years. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for 28 cancer sites were calculated using the economically active population as a reference. During the years 1960-1998 a total of 1,043 cancer cases were recorded in male hairdressers. Excess risks for cancers of the upper aerodigestive tract and lung and colorectal adenocarcinoma were observed. Additionally, male hairdressers working in 1960 had an increased risk for urinary bladder cancer, which was highest in the 1960s with an SIR of 2.56 (95% CI 1.36-4.39) and decreased with the follow-up time. A total of 2,858 cancers were recorded in female hairdressers. An increased risk was observed for cancers of the pancreas, lung and cervix and in situ cancer of the skin. The increased risk for in situ skin cancer specifically affected the scalp and neck, sites of contact for hair dyes, with an SIR of 2.43 (95% CI 1.14-4.44). The increase in lung cancer, the only site for which cancer was increased in either sex, may depend on confounding from smoking. Bladder cancer was not increased among hairdressers in the recent decades and is therefore not likely to be associated with modern hair dyes. (C) 2003 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 12672039
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  • 28
    Keywords: CANCER ; IN-VITRO ; tumor ; AGENTS ; Germany ; IN-VIVO ; INHIBITION ; screening ; SYSTEM ; SYSTEMS ; RISK ; ENZYMES ; DRUG ; NITRIC-OXIDE ; murine ; RISK-FACTORS ; CARCINOGENESIS ; INDUCTION ; KERATINOCYTES ; mechanisms ; culture ; IDENTIFICATION ; prevention ; risk factors ; MODULATION ; RISK FACTOR ; butyrate ; HEPATOMA ; fatty acids ; FATTY-ACIDS ; NF-kappa B ; ALCOHOL ; SODIUM-BUTYRATE ; curcumin ; ORNITHINE DECARBOXYLASE ; ANTIOXIDANT ; bioassay systems ; cancer chernoprevention ; CONSTITUENTS ; iNOS ; PEITC ; SULFORAPHANE ; SUPEROXIDE
    Abstract: Identification and use of effective cancer chemopreventive agents have become an important issue in public health-related research. For identification of potential cancer chemopreventive constituents we have set up a battery of cell- and enzyme-based in vitro marker systems relevant for prevention of carcinogenesis in vivo. These systems include modulation of drug metabolism (inhibition of Cyp1A activity, induction of NAD(P)H:quinone reductase (QR) activity in Hepalclc7 murine hepatoma cell culture), determination of radical scavenging (DPPH scavenging) and antioxidant effects (scavenging of superoxide anion-, hydroxyl- and peroxyl- radicals), anti-inflammatory mechanisms (inhibition of lipopolysaccharide (LPS)-mediated nitric oxide (NO) generation by inducible NO synthase (iNOS) in Raw 264.7 murine macrophages, cyclooxygenase-1 (Cox-1) inhibition), and anti- tumor promoting activities (inhibition of phorbol ester-induced ornithine decarboxylase (ODC) activity in 308 murine keratinocytes). We have tested a series of known chemopreventive substances belonging to several structural classes as reference compounds for the identification of novel chemopreventive agents or mechanisms. These include organosulfur compounds (phenethylisothiocyanate (PEITC), diallylsulfide, diallyldisulfide), terpenes (limonene, perillyl alcohol, oleanolic acid, 18-beta-glycyrrhetinic acid), short- chain fatty acids (sodium butyrate), indoles (indole-3- carbinol), isoflavonoids (quercetin, silymarin, genistein), catechins ((-)-epigallocatechin gallate (EGCG)), simple phenols (ellagic acid, resveratrol, piceatannol, curcumin), pharmaceutical agents (piroxicam, acetylsalicylic acid, tamoxifen), and vitamins/derivatives (ascorbic acid, Trolox). We confirmed known chemopreventive mechanisms of these compounds. Additionally, we could demonstrate the usefulness of our approach by identification of hitherto unknown mechanisms of selected agents. As an example, we detected anti- inflammatory properties of PEITC, based on NF-kappaB-mediated inhibition of NO production. Further, PEITC inhibited phorbol ester-induced superoxide anion radical production in granulocytes, and ODC induction in the 308 cell line. These mechanisms might contribute to the chemopreventive potential of PEITC. (C) 2002 Elsevier Science B.V. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 12628514
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    Keywords: CANCER ; EXPRESSION ; carcinoma ; CELL ; Germany ; human ; LUNG ; lung cancer ; LUNG-CANCER ; EXPOSURE ; RISK ; GENE ; PROTEIN ; METABOLISM ; TISSUE ; PATIENT ; RISK-FACTORS ; FREQUENCY ; polymorphism ; SUSCEPTIBILITY ; PROMOTER ; OVARIAN-CANCER ; WOMEN ; MEN ; risk factors ; smoking ; PROSTATE-CANCER ; cancer risk ; RISK FACTOR ; CYP3A4 ; LINKAGE DISEQUILIBRIUM ; CANCER-PATIENTS ; CARCINOMAS ; POLYMERASE-CHAIN-REACTION ; adenocarcinoma ; ADENOCARCINOMAS ; CARRIERS ; case-control studies ; CLINICAL PRESENTATION ; CYP3A,genetic polymorphism,lung cancer susceptibility,small cell lung cancer,LightCycler ; EXPRESSED HUMAN CYTOCHROME-P450S ; GENETIC VARIANT ; HUMAN LIVER-MICROSOMES ; PROSTATE TUMORS ; PROTEIN LEVELS ; squamous cell carcinoma ; TOBACCO
    Abstract: CYP3A isozymes are involved in tobacco carcinogen- and steroid-metabolism, and are expressed in human lung tissue showing interindividual variation in expression and activity. The CYP3A4* 1 B allele has been associated with a two-fold higher promoter activity and with high-grade prostate cancers. The very frequent intron 3 polymorphism in the CYP3A5 gene (CYP3A5*3) results in decreased CYP3A5 protein levels. A case-control study was conducted in 801 Caucasian lung cancer patients that included 330 adenocarcinomas, 260 squamous cell carcinomas, 171 small cell lung cancers (SCLC) and 432 Caucasian hospital-based controls. CYP3A-genotyping was performed by capillary polymerase chain reaction followed by fluorescence-based melting curve analysis. A significantly increased SCLC risk for CYP3A4* 1B allele carriers [odds ratio (OR) 2.25, 95% confidence interval (CI) 1.11-4.55, P = 0.02] was found. After dividing cases and controls by gender, an increased lung cancer risk for CYP3A4* 1B carriers (OR 3.04, 95% CI 0.94-9.90, P= 0.06) for women but not for men (OR 1.00, 95% CI 0.56-1.81) was revealed. Heavier smoking men (greater than or equal to 20 pack-years) with the CYP3A4* 1 B allele had a significant OR for lung cancer of 3.42 (95% CI 1.65-7.14, P= 0.001) compared to * 1A/1* 1A carriers with lower tobacco exposure (〈 20 pack-years). For women, the respective OR was 8.00 (95% CI 2.12-30.30, P = 0.005). Genotype frequencies were generally in Hardy-Weinberg equilibrium, except for CYP3A5 where a greater than expected number of CYP3A5* 1 homozygotes was observed among cases (P = 0.006). In addition, we observed linkage disequilibrium of CYP3A4 and CYP3A5 (P 〈 0.00001), but a nonsignificantly increased lung cancer risk was only found for homozygous CYP3A5* 1 allele carriers (OR 5.24,95% CI 0.85-102.28, P = 0.14) but not for heterozygotes. To confirm our observation that the CYP3A4* 1B allele increases SCLC risk and modifies the smoking-related lung cancer risk in a gender-specific manner, further studies, including CYP3A haplotype analysis, will be necessary. Pharmacogenetics 13:607-618 (C) 2003 Lippincott Williams Wilkins
    Type of Publication: Journal article published
    PubMed ID: 14515059
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    Keywords: CANCER ; tumor ; carcinoma ; Germany ; LONG-TERM ; NEW-YORK ; RISK ; transcription ; TRANSCRIPTION FACTOR ; CARCINOGENESIS ; hormone ; NEOPLASIA ; WOMEN ; cervical cancer ; cervical intraepithelial neoplasia ; HPV ; HUMAN KERATINOCYTES ; ORAL-CONTRACEPTIVES ; intraepithelial neoplasia ; cervical carcinoma ; DEPENDENT TRANSFORMATION ; ESTROGEN METABOLISM ; GLUCOCORTICOID RESPONSE ELEMENTS ; HUMAN-PAPILLOMAVIRUS TYPE-16 ; LONG CONTROL REGIONS ; SQUAMOUS-CELL CARCINOMAS ; VIRAL GENE-EXPRESSION
    Abstract: Available data demonstrate an increase in the transcription of high-risk papillomaviruses by the 16alpha-hydroxylation of estrogens, which is in line with the epidemiologic data showing an increased cervical carcinogenesis risk for long-term contraceptive-using, HPV-infected women. No evidence exists for an increase in HPV-negative contraceptive users. (C) 2002 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 12516087
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    Keywords: CANCER ; BLOOD ; DISEASE ; RISK ; GENE ; PROTEIN ; SAMPLES ; PATIENT ; DNA ; FAMILY ; FREQUENCY ; BREAST ; BREAST-CANCER ; family history ; OVARIAN-CANCER ; WOMEN ; MUTATION ; MUTATIONS ; PREVALENCE ; BRCA1/2 ; BRCA2 MUTATIONS ; early-onset breast cancer ; German population ; germline mutations ; POPULATION-BASED SAMPLE
    Abstract: This study was undertaken to investigate the prevalence of BRCA1 and BRCA2 germline mutations in 91 German patients unselected for family history, who were diagnosed with breast cancer before the age of 41 years. Clinical information and blood samples were obtained from all patients. A comprehensive BRCA1 and BRCA2 mutational analysis was performed using the protein truncation assay and single-strand conformational polymorphism analysis followed by DNA sequencing of variant signals detected by these assays. Five different deleterious germline mutations including four frameshift mutations and one missense mutation were identified, three in BRCA1 (3.3%) and two mutations (2.2%) in BRCA2. Both BRCA2 mutations are novel and might be specific for the German population. An additional BRCA1 missense mutation previously described and classified as an unknown variant was found. This mutation was also detected in two breast cancer patients of family P 328 and not in 140 healthy controls suggesting that it is disease associated. In addition, one common polymorphism and five novel intronic sequence variants with unknown significance were found. Our findings show that mutations in BRCA1 and BRCA2 may contribute similarly to early-onset breast cancer in Germany. Given current constraints on health-care resources, these results support the notion that BRCA1 and BRCA2 mutation screening may have the strongest impact on health-care when targeted to high- risk populations
    Type of Publication: Journal article published
    PubMed ID: 12774040
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  • 32
    Keywords: GROWTH ; tumor ; Germany ; MORTALITY ; NEW-YORK ; RISK ; PROTEIN ; PATIENT ; TUMOR-NECROSIS-FACTOR ; INTERVENTION ; treatment ; PLASMA ; DECREASE ; AGE ; MUSCLE ; AMINO-ACIDS ; OXIDATIVE STRESS ; ANTIOXIDANT ; aging-related wasting ; ALPHA-LIPOIC ACID ; antioxidants and aging ; cysteine ; ELDERLY HUMANS ; INJURIOUS FALLS ; MUSCLE PROTEIN-SYNTHESIS ; muscular aging ; P70 S6 KINASE ; PLASMA REDOX STATE ; RAT SKELETAL-MUSCLE ; RESISTANCE EXERCISE ; role in aging ; tumor necrosis factor in aging
    Abstract: Aging-related loss of muscle function is a predictor of mortality and a surrogate parameter of the aging process. Its consequences include a high risk for falls, hip fractures, and loss of autonomy. Aging is associated with changes in the oxidant/antioxidant balance including a decrease in plasma thiol (cysteine) concentration. To assess the importance of cysteine, we determined in a double-blind study the effects of N-acetylcysteine on the functional capacity of frail geriatric patients and their response to physical exercise. The subjects on placebo showed only a relatively weak response, and 31% showed even a decrease in more than one parameter during the observation period. Low plasma arginine levels were correlated with a weak overall performance before exercise and a poor response to exercise. N-Acetyl-cysteine strongly enhanced the increase in knee extensor strength and significantly increased the sum of all strength parameters if adjusted for baseline arginine level as a confounding parameter. N-acetylcysteine had no significant effect on growth hormone and IGF-1 levels but caused a significant decrease in plasma TNF-alpha. These findings may provide a basis for therapeutic intervention and suggest that the loss of function involves limitations in cysteine and one or more other amino acids which may compromise muscular protein synthesis
    Type of Publication: Journal article published
    PubMed ID: 12601528
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    Keywords: RISK ; MELANOMA ; DATABASE ; MUTATIONS ; CANCER RISKS ; AUSTRALIA ; INCIDENCE RATES ; SPOUSES
    Type of Publication: Journal article published
    PubMed ID: 12873883
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    Keywords: CANCER ; FOLLOW-UP ; DISEASE ; RISK ; SAMPLE ; TIME ; RISK-FACTORS ; AGE ; WOMEN ; risk factors ; SWEDEN ; RISK FACTOR ; SIR ; ASBESTOS ; time trends ; TRENDS ; mesothelioma
    Abstract: Epidemiologic data on peritoneal mesothelioma are scarce but exposure to asbestos is an identified risk factor. To characterize the disease, time trends, age-incidence relationships, and occupational risk factors for peritoneal mesothelioma were studied based on the Swedish Family-Database covering years 1961 to 1998. Peritoneal mesothelioma is a rare disease and only 96 male and 113 female cases were recorded during the 38-year period, Age-standardized incidence of the disease has increased for men until 1985 and leveled off thereafter. The incidence in women has been equally high but it has continued to increase toward the end of the follow-up period. The incidence was maximal at an age around 80 years for both genders. No female occupational or socioeconomic group was at risk. For men, 29% of the cases had typical asbestos related jobs with a SIR of 1.70. Bricklayers and plumbers had the highest risk of 7.22 and 5.12 respectively Within limits of the sample,. size, no evidence was noted for risk from environmental exposures to asbestos because the risk of farmers and that of urban residents were not different
    Type of Publication: Journal article published
    PubMed ID: 12708149
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  • 35
    Keywords: FOLLOW-UP ; LUNG-CANCER ; CANCER MORTALITY ; DISEASE ; RISK ; RISKS ; WORKERS ; TIME ; PATIENT ; RISK-FACTORS ; AGE ; MEN ; risk factors ; RATES ; SWEDEN ; DATABASE ; SIR ; INCIDENCE RATES ; FAMILY-CANCER DATABASE ; ASBESTOS ; ASBESTOS EXPOSURE ; EUROPE ; MALIGNANT MESOTHELIOMA ; REFINERY/PETROCHEMICAL PLANT COHORTS
    Abstract: Epidemiologic data on pleural mesothelioma are scarce on regional and occupational time trends, which would monitor the effects of changes in exposure to asbestos. We aim to characterize time trends, regional, socioeconomic, and occupational risk factors for pleural mesothelioma in Sweden in the years from 1961 to 1998. The Swedish Family-Cancer Database was used to identify patients with pleural mesothelioma. Age- standardized incidence rates and standardized incidence ratio (SIR) were calculated for the population in the Database. A total of 1298 male and 233 female pleural mesotheliomas were retrieved. Age-standardized incidence of the disease was highest, and the trend increased in residents of large industrial and shipbuilding cities. In the last follow-up period, the male rate exceeded the female rate about 10-fold. Among male socioeconomic groups, manual workers showed the highest and ever-increasing SIR. No female socioeconomic group was at risk. For men, plumbers and seamen had the highest risk of 4.56 and 2.83, respectively, but the risks appeared to be decreasing for plumbers, whereas no clear trend was noted for seamen, probably because of indirect expose in ships. Farmers showed an SIR of 0.28, indicating that the population at large was at four times higher risk than farmers. The SIRs of many academic/college-educated groups were two to six times higher than those of farmers, suggesting indirect exposure to asbestos in these groups
    Type of Publication: Journal article published
    PubMed ID: 12708150
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    Keywords: CANCER ; LUNG-CANCER ; RISK ; SITES ; TIME ; SKIN ; lifestyle ; WOMEN ; risk factors ; MELANOMA ; DATABASE ; GASTRIC-CANCER ; HELICOBACTER-PYLORI ; ATTRIBUTABLE RISKS ; CARCINOID-TUMORS ; causes of cancer ; ENDOMETRIAL CANCER ; environmental risks ; EPSTEIN-BARR-VIRUS ; LIFE-STYLE ; sociol factors ; SWEDISH POPULATION
    Abstract: It is well known that certain cancers have shown clustering in socioeconomic groups, but limited data are available on recent results and time trends in such clustering. We determined standardized incidence ratios (SIR) for cancer, adjusted for age, period, region, parity and age at first childbirth among men and women in 6 socioeconomic groups based on the Swedish Family-Cancer Database. Persons had to be identified with the same socioeconomic status in the census of years 1960 and 1970, or of years 1960, 1970 and 1980; the comparison group was all people according to the same censuses. Cancers were followed from years 1970 to 1998 or from 1980 to 1998. Both increased and decreased SIRs were found, and a consistent pattern emerged, although the overall SIRs for cancer did not differ much, the lowest being for farmers (0.8S) and the highest for professional men (1.07) and women (1.11). At individual sites, manual workers were at risk of tobacco-, alcohol- and occupation- and human papilloma virus-related cancers and at a decreased risk at most other cancers. Manual workers and farmers showed an excess of stomach cancer; professionals had an excess of melanoma and squamous cell skin cancer. Male and female SIRs correlated highly for manual and blue-collar workers and for professionals. The overall population- attributable fraction for selected sites was 16.7% for men and 10.9% for women and it was highest, over 50%, for lung cancer in both genders
    Type of Publication: Journal article published
    PubMed ID: 12740920
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    Keywords: CANCER ; human ; RISK ; SWEDEN ; POPULATIONS ; SPOUSES ; LANGUAGE
    Type of Publication: Journal article published
    PubMed ID: 12673273
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  • 38
    Keywords: CANCER ; carcinoma ; SYSTEM ; HEPATOCELLULAR-CARCINOMA ; incidence ; liver ; POPULATION ; RISK ; RISKS ; GENE ; GENES ; FAMILY ; primary ; tumour ; MEMBER ; MEMBERS ; ASSOCIATION ; CANDIDATE GENE ; SUSCEPTIBILITY ; AGE ; ovarian cancer ; OVARIAN-CANCER ; CERVICAL-CANCER ; bladder cancer ; BLADDER-CANCER ; SWEDEN ; DATABASE ; SIR ; familial risk ; CARRIERS ; FAMILY-CANCER DATABASE ; bile duct ; BILE-DUCTS ; CHOLECYSTECTOMY ; GALLBLADDER-CANCER ; RELATIVES ; VIRAL-HEPATITIS
    Abstract: Background and aims: Familial risks in liver and biliary cancers have been assessed in small case control studies, usually based on reported, but not medically verified, cancers in family members. Thus the degree of familial clustering for these cancers remains to be established. Methods: The nationwide Swedish Family-Cancer Database was used, covering 10.2 million individuals for the years 1961-1998 from the Swedish Cancer Registry. Liver and biliary tract cancers were identified from 1121 offspring between the ages of 0 and 66 years and 17 131 parents. Standardised incidence ratios (SIRs) and 95% confidence intervals (Cls) were calculated for cancers in family members. Results: All cancers in the liver and biliary system showed a familial SIR of 1.65 (95% Cl 1.05- 2.46). This was mainly explained by a high risk for familial gall bladder cancer (SIR 5.21 (95% Cl 2.07-10.80)) and for familial primary liver cancer with hepatocellular carcinoma histology (SIR 4.69 (95% Cl 1.48-11.04)). For gall bladder and hepatocellular cancer, maternal transmission appeared to be favoured. Gall bladder cancer was associated with pancreatic cancer (SIR 2.39 (95% Cl 1.23-4.18)). Primary liver cancer was associated with cervical, urinary bladder, and endocrine gland tumours. Cancer in extrahepatic bile ducts was associated with ovarian cancer and that in ampulla of Vater with thyroid cancer; however, these associations may have been fortuitous. Conclusions: This study has provided the first data on familial clustering of liver and gall bladder cancers, based on medically confirmed records. The risks were so high that heritable factors were likely to contribute, possibly modified by environmental factors. The demonstration of candidate genes would help to further characterise the familial risks
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    Keywords: CANCER ; neoplasms ; THERAPY ; DISEASE ; incidence ; RISK ; RISKS ; SITE ; SITES ; PATIENT ; primary ; SKIN ; LYMPHOMA ; MALIGNANCIES ; skin cancer ; MELANOMA ; SWEDEN ; DATABASE ; SQUAMOUS-CELL CARCINOMA ; SIR ; PRIMARY CANCERS ; FAMILY-CANCER DATABASE ; 2ND PRIMARY NEOPLASMS ; CANCER-THERAPY ; immunological factors ; immunosuppression ; LONG-TERM SURVIVORS ; MULTIPLE PRIMARY CANCERS ; non-hodgkin's lymphoma ; second cancer ; therapeutic effects
    Abstract: Successes in cancer therapy have led to increasing numbers of cancer survivors, who are at risk of developing second primary cancers. Therapy- or disease-induced suppression of the immune function may predispose cancer patients to a second malignancy. An excess of squamous cell skin cancers (SCC) and non-Hodgkin's lymphomas has been found in immunosuppressed patients. We used the nationwide Swedish Family-Cancer Database on 10.2 million individuals to calculate the risk of second primary skin cancers and non-Hodgkin's lymphomas following a previous malignancy. A total of 4301 second skin cancers and 1672 non- Hodgkin's lymphomas were identified. Standardised incidence ratios (SIR)s and 95% Confidence Intervals (CIs) were calculated and compared. Among 14 different sites for male or female first primary malignancies, 11 of these sites were followed by an increased risk of skin cancer (SIRs for males for risk of skin cancer as a second primary cancer: 14.1 for SCC; 9.7 for melanoma; 6.1 for leukaemia as the first site; SIRs for females for risk of skin cancer: 14.6 for SCC; 6.8 for larynx; 6.2 for upper aerodigestive tract (UADT) as the first site). The risk of non-Hodgkin's lymphoma was increased after 10 of 14 different male neoplasms and 12 of 17 different female neoplasms. (SIRs for males for risk of non-Hodgkin's lymphoma as a second primary cancer: 6.4 for non-Hodgkin's lymphoma; 3.2 for leukaemias; 3.1 for multiple myeloma as the first site; SIRs for females for risk of non-Hodgkin's lymphoma as a second primary cancer: 12.5 for leukaemias; 7.0 for Hodgkin's disease; 3.6 for UADT as the first site). The high, and after certain sites, very high risks of second skin cancer and non-Hodgkin's lymphoma suggest that immune suppression may be a contributory mechanism. (C) 2002 Elsevier Science Ltd. All rights reserved
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  • 40
    Keywords: CANCER ; NEW-YORK ; RISK ; SKIN ; ASSOCIATION ; BREAST-CANCER ; IN-SITU ; RATES ; MELANOMA ; SWEDEN ; DATABASE ; SQUAMOUS-CELL CARCINOMA ; NATIONWIDE ; CUTANEOUS MELANOMA ; OCULAR MELANOMA ; FAMILY-CANCER DATABASE ; 2ND PRIMARY CANCERS ; MALIGNANT- MELANOMA
    Type of Publication: Journal article published
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  • 41
    Keywords: CANCER ; tumor ; carcinoma ; neoplasms ; FOLLOW-UP ; RISK ; RISKS ; SITE ; SITES ; TISSUE ; TUMORS ; primary ; RISK-FACTORS ; SKIN ; treatment ; ASSOCIATION ; BREAST-CANCER ; PATTERNS ; WOMEN ; leukemia ; SWEDEN ; DATABASE ; HEREDITARY ; SIR ; familial risk ; SMALL-INTESTINE ; BRCA2 MUTATIONS ; germline mutations ; double primaries ; endometrioid tumor ; FAMILY-CANCER DATABASE ; FIRST- DEGREE RELATIVES ; heritable effects ; HODGKINS- DISEASE ; multiple primaries ; NONPOLYPOSIS COLORECTAL-CANCER ; second carcinoma ; synchronous carcinoma
    Abstract: BACKGROUND. Population-based data on subsequent neoplasms after women are diagnosed with endometrial and ovarian carcinomas are limited, particularly regarding specific histologic tumor types. METHODS. The nationwide Swedish Family-Cancer Database of 10.2 million individuals, which includes 19,128 invasive endometrial carcinomas and 19,440 ovarian carcinomas, was used to calculate standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) for second primary carcinomas. SIRs were calculated for specific follow-up periods. Data on histopathologic types also were used. RESULTS. An excess of subsequent malignancies after women were diagnosed with endometrial carcinoma was noted at 11 sites. The highest SIRs were recorded for synchronous or metasynchronous ovarian carcinomas (SIR, 55.77; 95% CI, 48.82-63.43) and carcinomas of the small intestines (SIR, 14.71; 95% Cl, 4.64-34.59). Primary ovarian carcinoma was followed by an increased risk of developing endometrial carcinoma, and the risks of developing many other malignancies also were increased after women were diagnosed with endometrial carcinoma, including intestinal malignancies, renal cell carcinoma, bladder carcinoma, squamous cell skin carcinoma, connective tissue malignancies, and leukemia. When ovarian endometrioid histology was diagnosed synchronously with primary endometrial carcinoma, the SIR was 140; when endometrial carcinoma was the subsequent neoplasm, the SIR was 87. A small familial component was found in the cooccurrence of endometrial carcinoma and ovarian carcinoma. CONCLUSIONS. The current data show a strong clustering of endometrial carcinomas and ovarian carcinomas, particularly involving tumors of endometrioid morphology. The patterns of second neoplasms also suggest that hereditary nonpolyposis colorectal. carcinoma may contribute to the association between endometrial and ovarian malignancies. Increased risks for connective tissue tumors and leukemia may signal a response to treatment, and an increased risk for squamous cell skin carcinoma may signal a depressed immune function. (C) 2003 American Cancer Society
    Type of Publication: Journal article published
    PubMed ID: 12733142
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  • 42