Carl N. Yoshizawa

Descriptive epidemiology of thyroid cancer in Hawaii

Data were analyzed from 1110 thyroid cancer cases between 1960 and 1984 identified by the Hawaii Tumor Registry, a population‐based Statistics, Epidemiology and End Results (SEER) participant covering the entire state of Hawaii. Incidence rates for men and women were relatively stable during this 25‐year period. The overall age‐adjusted rates were 8.1 per 100,000 for women and 3.1 per 100,000 for men. There was a significant variation in incidence on the basis of ethnicity, with the highest rates for women occurring in Filipinos (18.2 per 100,000) and for men in Chinese (6.3 per 100,000). A comparison of different populations around the world showed that Hawaii has some of the highest reported incidence rates for thyroid cancer. In addition, a comparison of ethnic‐specific incidence rates for groups living in Hawaii with people of the same ethnic backgrounds living in other geographic areas showed that Hawaii residents generally have much higher rates, suggesting that environmental influences are responsible for the unusually high rates in Hawaii.

Dietary factors in lung cancer prognosis

A hypothesis-generating analysis of the role of diet on survival was conducted among a sample of 463 men and 212 women with histologically-confirmed lung cancer. Interview information was obtained from two population-based case-control studies of lung cancer conducted on the Island of Oahu, Hawaii, between 1979 and 1985. The interview consisted of a quantitative dietary history to assess the usual intake of foods 1 year prior to diagnosis, a complete tobacco history, and other demographic and lifestyle information. Records from the Hawaii Tumor Registry were reviewed for data on stage, histology, and follow-up status of these patients. A food group analysis showed a significant reduction in the risk of death with increasing consumption of all vegetables combined among women (P for trend = 0.03), but not among men. The covariate-adjusted median survival times for women from the highest to the lowest quartiles of vegetable intake were 33, 21, 15, and 18 months, respectively. The results also suggested an association of fruit intake and survival among women (P for trend = 0.02), although a similar effect was not found among men. Increased consumption of certain foods, such as tomatoes and oranges among men, and broccoli and, perhaps, tomatoes among women, appeared to improve survival. This exploratory analysis provides mixed indications that certain components of vegetables and fruits may prolong survival in lung cancer patients.

Smoking history and survival among lung cancer patients.

Two population-based case-control studies of lung cancer were conducred on the Island of Oahu, Hawaii, between 1979 and 1985. Interview information concerning smoking habits and other characteristics was obtained from a total of 463 men and 212 women with histologically confirmed lung cancer. Records from the Hawaii Tumor Registry were revicwed for information on the stage, histology, and follow-up status of these patients. Cigarette smoking was found to be positively related to the age-adjusted risk of death among women (relative risk (RR) -1.6; 95 percent confidence interval (CI)=1.0–2.4), but not among men (RR=0.8; 95 percent CI=0.5–1.2). Among women, the age-adjusted median survival time for never smokers was 33 months (n=53) compared with a median survival of 18 months (n=159) for smokers. Both past and current female smokers were at greater risk of death than never-smokers, and there was a significant trend in the risk of death by the number of cigarettes smoked per day (P=0.04), and the age at which the subjects started smoking (P=0.01). The effects of tumor stage and histology upon the association between tobacco smoking and survival were also explored.

Reproducibility of a diet history in older men in Hawaii

A diet history method was tested for reproducibility among 106 older men from the five major ethnic groups (Japanese, Caucasian, Hawaiian, Filipino, and Chinese) of Hawaii. The questionnaire, administered by trained interviewers, was designed to estimate the dietary intakes of total and saturated fat, cholesterol, vitamin A, beta-carotene, vitamin C, and zinc. Subjects were asked to recall their usual frequencies and amounts of consumption during a usual month of more than 100 food items, along with the intake of seasonal foods with a high vitamin A content. A second interview was conducted 1-14 months later to obtain a diet history covering the same time period as the first interview. The same questionnaire was utilized in both interviews. The effects of ethnicity, age, and recall interval (period between the diet reference date and initial interview) on the reproducibility of nutrient intakes were examined. The intraclass correlation coefficient (rI) and the weighted kappa statistic (Kw) were used to assess agreement. The overall levels of reproducibility were relatively good. Neither ethnicity, age, nor length of recall period had a major effect on reproducibility. The data suggested that this diet history method is an appropriate instrument for estimating the usual dietary intakes of a healthy heterogeneous group of older men in Hawaii.

Ethnic patterns of childhood cancer in Hawaii between 1960 and 1984

Cases of childhood cancer (<15 years of age at diagnosis), diagnosed between 1960 and 1984, were obtained from the Hawaii Tumor Registry, a population‐based Surveillance, Epidemiology, and End Results (SEER) participant covering the entire State of Hawaii. During the 25 years of data collection, cancer was diagnosed in 398 males and 302 females, with overall age‐adjusted incidence rates of 140.5 and 112.2 per million, respectively. Leukemia was the leading cause of childhood cancer, accounting for over 1/3 of diagnoses during the study period. Standardized incidence ratios (SIR) were calculated for each ethnic‐sex group separately based on US white age‐specific incidence rates for 1973 to 1982 from the SEER program. Overall, incidence rates for childhood cancer in Hawaii were generally similar to those found in all SEER areas.

Asymptotic equivalence of the harrell-davis median estimator and the sample median

This paper presents an asymptotic equivalence result with a sharp rate of convergence forthe sample median and the Harrell-Davis median estimator. The consequences of this result are discussed.

Urothelial Cancer in White and Japanese Patients in Hawaii: Pathology

The sites, growth patterns, histological grades and degrees of invasion of urothelial tumors were assessed among white and Japanese patients in Hawaii. Tissues were available from 225 white and 164 Japanese patients, representing virtually all of the urothelial tumors from these races entered into the Hawaii Tumor Registry for Oahu island between 1977 and 1986. No statistically significant interracial differences emerged from the analysis. Grade 1 papillary tumors were the most numerous types encountered, consisting of 43% of the urothelial tumors in men of both races, and 37.5% in white and 31% in Japanese women. Recently, observed increasing incidence trends of urothelial tumors among white men in the United States are associated with a synchronous decrease in mortality trends. Our analysis indicates that these diverging trends cannot be accounted for by increased numbers of noninvasive papillary tumors.