Peter Isacson

Prognostic factors for gastrointestinal and bronchopulmonary carcinoid tumors

Data collected by population‐based cancer registries in Iowa and metropolitan Atlanta were evaluated to determine prognostic factors for gastrointestinal (n = 270) and bronchopulmonary (n = 151) carcinoids. The predictors considered in univariate and multivariate analyses were: age, sex, race, marital status, anatomic subsite, stage, occurrence of other malignancies, and surgery. For surgically treated gastrointestinal tumors, the cumulative percentages of survivors at five years were: appendix, 85.6%; small intestine, 66.0%; and large intestine, 37.7%. The likelihood of death from gastrointestinal carcinoids was found to be related independently to increasing age (P = 0.001), advanced stage (P < 0.0001), location within the large intestine (P < 0.0001), and occurrence of another malignancy (P = 0.02). The overall five‐year survival rate for bronchopulmonary carcinoids was 87.6%, and lack of surgical treatment (P < 0.0001) and advanced stage (P = 0.006) were associated independently with unfavorable prognosis.

Drinking Water Pollutants and Risk of Cancer Incidence

Advances in techniques for measuring environmental contaminants have revealed the widespread occurrence of chlorinated by-products of chlorination (chloroform, other triha1omethanes (THMs)), organic solvents and other industrial chemicals in drinking water. Chloroform is carcinogenic when fed to rats and mice (Page 1976). On addition, there is evidence that higher-molecular-weight halogenated compounds are likely to be carcinogenic (Loper 1980; McCann 1975). Other naturally occurring chemical and radiological constituents in drinking water are known or likely carcinogens.