Peter Greenwald

Vaginal cancer after maternal treatment with synthetic estrogens.

VAGINAL adenocarcinoma in young women was recently reported by Herbst, Ulfelder and Poskanzer1 as being associated with stilbestrol therapy of the mother during pregnancy. In an accompanying editorial, Dr. Alexander D. Langmuir2 emphasized the scientific and social implications of this observation, and stated the need for confirmatory data. Our findings confirm the association and provide additional information on dose and time relations. The New York State Cancer Registry receives reports of all cancer diagnosed in New York State, exclusive of New York City. During the period 1950 through 1970, five adenocarcinomas of the vagina were reported in women under age .xa0.xa0.

Estimated effect of breast self-examination and routine physician examinations on breast-cancer mortality.

We examined the effects of breast self-examination and breast examination by physicians on the stage of breast cancer at diagnosis. Clinical and pathological-staging information was compared to interview data on method of initial detection of 293 women. Tumors were detected in clinical Stage I 53.8% of the time when the detection method was routine physician examination, 37.7% when it was self-examination and only 27.0% when detection was accidental. Sixty-nine per cent of women practicing self-examination at the time of diagnosis discovered their tumor by this method. Differences were less apparent when pathological stage was considered. Tumors found during routine examination of the breast averaged 6.1 mm smaller in diameter than those discovered accidentally. We estimate that breast-cancer mortality might be reduced by 18.8% to 24.4% through self-examination or routine physician examination, respectively.

Extended epidemic of Hodgkin's disease in high-school students.

Abstract Four students in a high school de Summaryn veloped Hodgkins disease. Inquiry amongst relatives and friends demonstrated an interrelationship of nine cases of Hodgkins disease in more than two decades. The outbreak suggested an infective disease condition with a carrier state and a long incubation period.

TONSILLECTOMY AND HODGKIN'S DISEASE: THE LYMPHOID TISSUE BARRIER

Abstract Tonsillectomy increases the liability to the subsequent development of Hodgkins disease by a factor of 2.9 times. Since appendicectomy has previously been shown to increase the liability to subsequent Hodgkins disease, it seems that surgical ablation of active lymphoid tissue, and perhaps the natural involution in late childhood of the oropharyngeal lymphoid tissue, in some way facilitate the onset of Hodgkins disease. A protective barrier is removed.

Analyzing the Instrumental Use of Relations in the Context of Social Structure

Employing a variation of the Small World technique for tracing social relations in the context of a larger social structure, the instrumental uses of social relations are examined in terms of the prestige and types of relations characteristic of participants m the search process. The results show that successful chains tend to involve participants of higher occupational prestige as the chains progress before dipping down toward the target prestige level at the last link. Also, the successful chains tend to utilize weak and infrequent social relations rather than strong and frequent social relations.

Diagnostic sensitivity bias -- an epidemiologic explanation for an apparent brain tumor excess.

Preliminary data showing over-representation of the Eastman Kodak Company (Rochester) on death certificates of brain tumor patients, and higher risk for older workers when compared to the general population, led to a case-control epidemiologic study. Chemical exposure histories of 56 workers with brain tumors were compared with those of other Kodak employees. No differences were found in exposure to a variety of chemicals. In addition, employees with brain tumors were compared to other upstate New York brain tumor patients; there was no difference in histology. However, the Kodak employees had diagnoses more frequently confirmed by histologic examination and more thorough diagnostic studies. Thus, the apparent initial excess of diagnosed tumors may have resulted from a diagnostic sensitivity bias arising from more complete medical evaluation of Kodak employees.

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.

NATURE OF HODGKIN'S DISEASE AGENT

Abstract It is suggested that Hodgkins disease is due to a virus of low virulence and infectivity which enters via the oral-respiratory tract portal and which is barrier-held by intact, non-involuted lymphoid tissue; that immune-complex material escapes to the lymph-nodes and evokes the distinctive reaction; and that the failure to detect an agent in the nodal lesions may be due to the fact that the agent itself does not get to the lymph-nodes. The habitat of the virus may be the female genital tract.

Cancer among the foreign-born in New York State

Cancer deaths among white, foreign‐born residents of New York State (exclusive of New York City) during the years 1969 through 1971 were analyzed according to country of birth. The largest numbers of immigrants came from Great Britain, Ireland, Germany, Austria, Poland, Italy, USSR, and Canada. Several distinctive features emerged from these data: Irish immigrants have an increased risk of dying from oropharyngeal, gastrointestinal, lung, and prostate cancers. Among all migrant groups studied, contrasting mortality patterns observed for carcinomas of the stomach, colon, and rectum provide further support for the concept that these neoplasms result from different etiologic processes. For the leukemias, lymphomas, and carcinomas of the breast and colon, each of the migrant groups acquired the higher risk common to others in the host country. This rise in risk suggests a major environmental component for cancers of these sites.

HODGKIN'S DISEASE MORTALITY AMONG PHYSICIANS

Abstract The possibility that the physicians might represent a high-risk group for Hodgkins disease was investigated by surveying all teaching hospitals in Upstate New York for deaths due to this disease from 1960 through 1972. The physician-mortality rate observed was statistically significantly higher than those for dentists, general population, and high socio-economic control groups with the same age and sex distribution. The relative risk for physicians was 1·8.