Adele K. Polan

Prenatal stilbestrol experience of mothers of young cancer patients.

Prenatal histories, including drug use, were obtained for the mothers of 48 young females and males reported to the New York State Cancer Registry with tumors of the breast and urogenital organs (excluding vaginal adenocarcinomas previously reported in the literature). Stilbestrol was taken during pregnancy by the mother of only one patient, an 18‐year‐old girl, with an adenocarcinoma involving both the cervix and vagina. Time trends in incidence for the 0 to 24 year age group, born at a time when stilbestrol might have been used in pregnancy, were compared to the unexposed 25 to 34 year age group. There were no increases that could be attributed to stilbestrol use. There is thus far no indication that maternal use of stilbestrol contributes to the development of tumors other than those of the lower female genital tract.

SOME DEMOGRAPHIC CHARACTERISTICS OF AN AUTOPSIED POPULATION

Abstract The ways in which a series of autopsied hospital patients may or may not differ from other hospital deaths and from deaths in the general population are necessarily of concern to investigators conducting studies based upon postmortem observations, as well as to those concerned with epidemiological and sociological aspects of hospitalization and autopsy. In an effort to investigate this problem, certain demographic characteristics of a population of adults autopsied during a 4-year period at a large general teaching hospital were examined. This population was compared with its parent population, all deaths that occurred at this hospital, and with the population from which the latter, in turn, was derived, all deaths in the northeastern metropolitan county served by this hospital. The variables analyzed were age, sex, nativity, race, marital status, size of residence, place, religious preference, and cause of death. The composition of the autopsied population indicated that it had been significantly affected by various selective factors. Age exhibited perhaps the most striking effects: as age at death decreased, the likelihood increased that a person who died in this county had been hospitalized and autopsied at the institution under study. This trend was especially marked among females. Subsequent analyses were therefore adjusted to control the effects of age and sex. Certified cause of death also was found to be highly subject to selective factors. In particular, the proportions of all deaths in the county from heart disease that occurred and were autopsied at this hospital were strikingly smaller than those of any other of the causal categories employed. With respect to religion, there was suggestive evidence that deceased hospital patients who had indicated a Jewish preference were considerably less likely to be autopsied than those who had designated a Protestant group. Catholics appeared somewhat less likely to be autopsied than Protestants. Other differences found were that the foreign-born were somewhat more likely to be hospitalized at this institution than the native-born, but less likely to be autopsied. Negroes, the divorced, and residents of other states and of places in the state with less than 10,000 inhabitants were more likely to be hospitalized and autopsied at this hospital than those in other categories of race, marital status, and place of residence. In general, deaths at the hospital differed more from deaths in the general population than the autopsied deaths differed from all deaths at the hospital. These findings indicate a few of the kinds of selection that may be found in the composition of autopsied and hospital death populations. They are interpreted as pointing up the need for giving special attention to the effects of selective factors on populations used in autopsy-based research. More specifically, it is hoped that these analyses may illustrate a practicable means by which the extent of selection in a particular autopsy series may be gauged. Usually it should be possible to examine the distributions of variables that may be relevant to a particular study, to compare these with what is known regarding their distributions in other populations, and to control, by special analyses, the effects of such variables as appear to require this with at least sufficient precision to permit extending tentative inferences beyond the immediate study material. Where a unique contribution can be provided by postmortem observations, their use appears justified in the study of many disease problems with the qualification that appropriate care be given to the exploration and control of potential sources of bias.

Epidemiologic and histologic patterns of Hodgkin's disease in blacks.

The epidemiologic pattern for Hodgkins disease in blacks from two different communities in the United States was characterized by higher childhood rates and significantly lower rates in the young adult and older age groups than for whites. In addition, a significantly greater number of black patients belonged to low occupational groups. These observations and the different epidemiologic patterns for blacks in Southern Transvaal, South Africa, and other countries suggest that the natural history of Hodgkins disease might be strongly influenced by social milieu. The variability in Rye subtype distribution, particularly for whites and blacks in the young adult and other age groups raise the possibility that age related environmental factors might be important in the histologic reactivity of the host. Cancer 40:3133‐3139, 1977.

DEATH RATE FROM BRONCHOPNEUMONIA IN UPSTATE NEW YORK, 1954-59.

TIHE DEATH rate from pneumonia in New York State, exclusive of New York City, has risen since 1954. The rise in 1957 and 1958 was not unexpected since influenza was pandemic then, but the continued climb prompted a study in 1959. A review of available vital statistics showed that the mortality from all forms of pneumonia was at a low point in 1954, and that the rise thereafter was mainly in the category of bronchopneumonia. The death rate from bronchopneumonia doubled between 1954 and 1959, going from 10.2 to 20.8 per 100,000 population (see table). The study was undertaken to determine if the rise was real, and, if so, what were the responsible factors and how reliable were the statistics. A further increase to 22.3 per 100,000 population was noted in 1961 and 21.9 in 1962. The increase in the death rate from bronchopneumonia, category 491 in the sixth and seventh revisions of the International Statistical Classification of Diseases, was seen in all ages, but especially in those 65 years and over. Statistics for this category were not broken down by size of community. The death rate from all forms of pneumonia (I.S.C. 490-493) rose in metropolitan and nonmetropolitan areas, in communities with less than 10,000 population as well as in those with more than 10,000 population. The increase was somewhat greater in the larger communities. In Albany County, the death rate for all forms of pneumonia was 23.6 per 100,000 population in 1955 and 40.7 in 1959. Mortality from pneumonia of the newborn (I.S.C. 763) fluctuated, during 1949-61, between 0.4 and 0.7 per 1,000 live births.

An epidemiological approach to traffic accidents

New York State used the home interview technique to gather data for determining accident rates for a sample of motor vehicle drivers in Sarasota Springs. From this preliminary study, we learned that it is possible -- if the data are sufficient and the population is well-defined -- to obtain reliable rates on which to base future accident prevention activities. Language: en