Edward A. Brann

NON-HODGKIN'S LYMPHOMA AND FAMILY HISTORY OF MALIGNANT TUMORS IN A CASE-CONTROL STUDY (UNITED STATES)

Using data froma case-control study in the United States (the Selected Cancers Study), weexamined the relationship between non-Hodgkins lymphoma (NHL) and family history of different cancers. Cases were 1,511 men aged 31 to 59 years and diagnosed pathologically with non-Hodgkins lymphoma during 1984-88. Controls were men, frequency-matched to cases by age range and cancer registry (n = 1,910). All study subjects with acquired immunodeficiency syndrome were excluded from analyses. Our results showed that the risk of NHL is associated with a history of lymphoma (odds ratio [OR] = 3.0, 95 percent confidence interval [CI] = 1.7-5.2) and hematologic cancer (OR = 2.0, CI = 1.2-3.4) in first-degree relatives after adjustment for age, ethnic background, and educational level. Further analyses were performed for the subgroups defined by age at diagnosis (younger than 45 years cf 45 years or older). The association of NHL with a family history of lymphoma and hematologic cancer was found primarily among men aged 45 and older (OR = 4.1, CI = 1.9-8.8 for lymphoma and OR = 2.3, CI = 1.3-4.0 for hematologic cancer). The association among men aged 45 and older did not vary by whether or not there were any familial patients diagnosed at the age of 45 or older. No significant associations could be found for a family history of lung cancer, breast cancer, prostate cancer, colon cancer, skin cancer, liver cancer, stomach cancer, brain cancer, thyroid cancer, or myeloma. This study suggests that the familial risk of NHL is influenced primarily by hematolymphoproliferative malignancies rather than other cancers. The familial effects of hema-tolymphoproliferative malignancies may be stronger for men aged 45 to 59, compared with those aged 31 to 44.

A population-based case-control study of the relationship between cigarette smoking and nasopharyngeal cancer (United States)

This case-control investigation, based on the Selected Cancers Study, assesses the association between cigarette smoking and nasopharyngeal cancer, a relatively rare neoplasm in the United States. Men who were diagnosed pathologically with nasopharyngeal cancer during 1984–88 were included as cases in the analysis if they were 15 to 39 years old in 1968, and lived in the areas covered by eight cancer registries in the US (n=113). Control men were selected by random-digit telephone dialing (n=1,910). Using logistic regression analysis with adjustment for potential confounding factors, it was found that relative to nonsmokers, the risks of nasopharyngeal cancer were 2.3 (95 percent confidence interval [CI]=1.3–4.0) and 1.4 (CI=0.8–2.6) for former and current smokers, respectively. Using pack-years as a measure, adjusted odds ratio (OR) estimates were 1.3, 1.8, 2.5, and 3.9 for smoking for less than 15, 15–29, 30–44, and 45 or more pack-years, respectively. When squamous cell carcinoma was used as an outcome, the smoking/nasopharyngeal-cancer association became stronger. The analysis did not show interactions between smoking and alcohol consumption, or prior nasal diseases. The results of this study suggest that cigarette smoking may be related to the occurrence of nasopharyngeal cancer (especially squamous cell carcinoma) among US men.

Occupational exposure to chlorophenol and the risk of nasal and nasopharyngeal cancers among U.S. men aged 30 to 60

BACKGROUND Elevated rates of nasal and nasopharyngeal cancers have been associated with wood-related occupational exposures, including chlorophenols, formaldehyde, and wood dust. METHODS Occupational information was obtained from 43 nasal carcinoma cases, 92 nasopharyngeal carcinoma cases, and 1909 controls, by interview. Exact conditional logistic regression was used to evaluate the association of these cancers with chlorophenol exposure, estimated from a review of verbatim responses. RESULTS Both nasal and nasopharyngeal cancers were significantly associated with estimated duration of chlorophenol exposure. For nasopharyngeal cancer, elevated risk was observed among those who held jobs assigned medium or high intensity chlorophenol exposure (n(exposed)=18, OR=1.94, 95% CI=1.03-3.50) and among those with 10+ years in jobs assigned high intensity with high certainty (n(exposed)=3, OR=9.07, 95% CI=1.41-42. 9). Controlling for estimated formaldehyde and wood dust exposure did not alter these findings, as much of the estimated chlorophenol exposure was among machinists. CONCLUSIONS These findings support the hypothesis that occupational exposure to chlorophenol is a risk factor for nasal and nasopharyngeal cancer, although the role of machining-related exposures warrants further assessment.

Occupational risk factors for selected cancers among African American and White men in the United States

OBJECTIVES This study examined occupational risks for non-Hodgkins lymphoma, Hodgkins disease, and soft-tissue sarcoma among African American and White men. METHODS Race-specific multivariate logistic regression analyses were conducted using data from a large US population-based case-control study. RESULTS Significant occupational risks were limited to African Americans; chromium was associated with non-Hodgkins lymphoma (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 1.2, 12.9) and wood dust was associated with Hodgkins disease (OR = 4.6, 95% CI = 1.6, 13.3) and soft-tissue sarcoma (OR = 3.7, 95% CI = 1.6, 8.6). CONCLUSIONS Race-specific occupational risk factors for cancer were evident only among African American men. This may reflect racial disparities in levels of exposure to occupational carcinogens.

Case-control study evaluating the homogeneity and heterogeneity of risk factors between sinonasal and nasopharyngeal cancers

Sinonasal cancer and nasopharyngeal cancer may share some risk factors because both are located within the upper aerodigestive tract. They may also have different etiological profiles because of anatomic or pathologic differences. However, the similarities and differences in risk factors have rarely been studied within the same population. We assessed the risk factor profiles of sinonasal and nasopharyngeal cancers, using data from a case‐control study. The 2 case groups consisted of men aged 31–59 and diagnosed pathologically with sinonasal cancer (n=70) and nasopharyngeal cancer (n=113), respectively. Controls were men without these cancers and selected from the same areas (n=1910). Logistic regression analysis showed that smoking was a risk factor for both sinonasal [odds ratio (OR)=2.5, 95% confidence interval (CI) 1.1–5.4] and nasopharyngeal cancer (OR=1.8, 95%CI 1.1–3.0). However, ever use of barbiturates without a prescription (OR=4.9, 95%CI 1.7–13.8), working with or around cutting oils on a job (OR=1.9, 95%CI 1.1–3.1) and ever having had sinus infections (OR=2.3, 95%CI 1.1–4.6) were associated with nasopharyngeal cancer only. Having received blood products other than a transfusion (OR=9.1, 95%CI 2.2–37.4) and exposure to a pesticide containing 2,4,5‐T (OR=5.9, 95%CI 1.5–23.7) were related to sinonasal cancer only. When data analyses were confined to squamous cell type, smoking and exposure to chlorophenols were related to squamous cell tumors at both sites. However, use of barbiturates and sinus problems other than infection only increased the risk of nasopharyngeal carcinoma. Our study suggests that except for smoking and chlorophenol exposure, which are associated with both sites, the risk factor profiles may differ between sinonasal and nasopharyngeal cancers.

Self-reported Infectious Mononucleosis and 6 Cancers: A Population-based, Case-control Study

A study was undertaken to estimate the magnitude of association between self-reported infectious mononucleosis (IM) and 6 types of cancer, including Hodgkins disease, non-Hodgkins lymphoma, nasopharyngeal cancer, nasal cancer, primary liver cancer, and sarcoma. Cases were male, aged 15-39 y in 1968, who lived in 8 cancer registry areas. Controls were men selected by random-digit telephone dialing. Cases included 1511 persons with non-Hodgkins lymphoma, 343 with Hodgkins disease, 386 with sarcoma and 168, 113 and 70 with primary liver, nasopharyngeal and nasal cancers, respectively. There were 1910 controls. For the 6 cancers combined, the overall odds ratio for IM occurring < 5 and > or = 5 y of the reference date were 5.40 [95% (Confidence Interval (CI) = 1.61, 18.09] and 1.08 (0.84, 1.40), respectively. Analogous values were 4.59 (1.25, 16.85) and 1.07 (0.78, 1.48) for non-Hodgkins lymphoma and 7.49 (1.52, 36.92) and 1.35 (0.87, 2.09) for Hodgkins disease. There was the suggestion of a protective association with IM occurring > or = 5 y before cancer onset for the 4 non-lymphomatous cancers. Strongly positive associations between self-reported IM and 6 types of cancer were observed for IM occurring < 5 y before the onset of cancer. There was a suggestion, which is noted with extreme caution, that IM earlier in life might have had a protective association with the 4 non-lymphomatous cancers.

Occupational chlorophenol exposure and non-Hodgkin's lymphoma.

Occupational exposure to chlorophenols is suspected to increase non-Hodgkins lymphoma (NHL) risk. This association was examined using data on 995 NHL cases and 1783 controls from the Selected Cancers Study, a population-based case-control study of men aged 32 to 60 years from eight population-based cancer registries conducted from 1984 to 1988. Potential chlorophenol exposure was characterized by an industrial hygienist using intensity estimates and confidence ratings, based upon review of verbatim job histories. Cases with substantial chlorophenol exposure had a significantly greater number of years of chlorophenol exposure (median years: cases, 4.0; controls, 2.0; P = 0.046); however, in conditional logistic regression models, the odds ratio for more than 8 years of substantial exposure was 1.51 (95% CI, 0.88 to 2.59). Overall, the findings do not provide strong support for an association with NHL risk. Chlorophenol exposure in this study is not based upon measured values and, therefore, may fail to characterize actual chlorophenol exposures accurately. Because of the large presence of machinists in the potentially chlorophenol-exposed group, these results may be underestimated by exposure misclassification if these subjects were not exposed to chlorophenolic biocides. However, these results are consistent with other findings, which suggest that chlorophenol exposure is not likely to be a strong risk factor for NHL.

The Relationship of Hepatitis History and Pathological Diagnosis of Primary Liver Cancer

During the analysis of risk factors in relation to primary liver cancer, we noticed an association between the confirmed (as opposed to probable) pathologic diagnosis of liver cancer and a positive history of hepatitis. This report pursues the observation using data from the Selected Cancers Study. Study subjects included 168 men who lived in areas covered by eight cancer registries in the U.S., and were pathologically diagnosed with confirmed or probable primary liver cancer during 1984-1988. The results showed that men with confirmed primary liver cancer were six times more likely to have a hepatitis diagnosed within 3 years before liver cancer detection, compared with those with probable primary liver cancer. Further analyses showed that men with a confirmed primary liver cancer or with a recent hepatitis more likely had a tissue specimen obtained from a surgery, and less likely had one from an aspiration. Upon adjustment for type of specimen, the association between pathological confirmation of primary liver cancer and recent hepatitis persisted. The results raised questions whether recent hepatitis and its pathologic changes influence choice of tissue-collecting procedure and ultimate pathological diagnosis of primary liver cancer. Other factors that might be related to the findings also need to be examined in future studies.