William S. Burnett

The epidemiology of ophthalmic malignancies in New York State

The epidemiologic characteristics of more than 1400 primary eye cancers (ICD-9, site 190) diagnosed among New York State (NYS) residents between 1975 and 1986 are described. Among NYS male residents, the average annual age-adjusted incidence rate was 7.5 per 1,000,000, and among NYS female residents, the rate was 5.4 per 1,000,000 (male:female rate ratio, 1.39). The majority of ophthalmic malignancies were included within three histologic groupings: melanomas (70.4%), retinoblastomas (9.8%), and squamous cell carcinomas (9.2%). The average annual incidence of retinoblastoma among persons in NYS who were less than 5 years of age was 9.5 per 1,000,000 for boys and 8.7 per 1,000,000 for girls (male:female rate ratio, 1.09). The average annual incidence (age-adjusted) of ocular melanomas was 4.9 per 1,000,000 among men and 3.7 per 1,000,000 among women in NYS (male:female rate ratio, 1.32). Expanded knowledge of the epidemiology of ophthalmic cancers can help to develop a foundation on which to monitor disease patterns and can serve to stimulate further etiologic research involving these rare malignancies.

Genital cancer in wives of penile cancer patients

We identified the wives or ex‐wives of 227 males of the 256 reported with cancer of the penis to the New York State Cancer Registry from Upstate New York from 1960–64. Utilizing the Registry, death certificates, hospital and physician records, we ascertained those wives who developed cancer at any site from 1951–1975. We generated expected numbers of cases of cancer at each site by applying the age‐specific incidence rates experienced by women of a specific age in a specific year designated by the age of the wife of the index case in each year, estimating withdrawals from age‐specific death rates. Thus, our expected numbers are based on the experience of the women in Upstate New York with traits like those of spouses of the men in the same population with cancer of the penis. We found significantly more cases of cancer of the cervix than expected. This was not true for other sites of cancer.

Familial aggregation of bladder cancer stratified by smoking status.

To assess bladder cancer incidence in first-degree relatives of affected probands, bladder cancer patients and matched control probands provided general demographic and smoking information on their first-degree relatives. Bladder cancer incidence was established through information from the New York State Tumor Registry. The risk ratio for relatives of case probands versus relatives of control probands was 1.9; for relatives who smoked, the risk ratio was 2.1, while for nonsmoking relatives, the risk ratio was 1.8. Results from a proportional hazards regression analysis agreed with those above. These results indicate a familial component that is independent of smoking.

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.

Epidemiology of Cancer of the Testis in Upstate New York

We collected data on the 434 individuals reported with cancer of the testis to the New York State Tumor Registry, 1960-64, from upstate New York. We compared these with the 410 members of a random sample of the upstate population interviewed from 1959 to 1962. A high risk of developing cancer of the testis was associated with professional occupations, native-born parentage, rural residence, and having been married, especially while young. These findings paralleled some other studies, as well as our earlier inquiry. Each of these factors carried a higher risk even when considered in the context of the other traits, and risk increased with an increase in the number of characteristics possessed.

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.

A prospective study of the relationship between benign breast diseases and breast carcinoma.

Abstract Using a prospective approach, 747 women diagnosed as having benign breast diseases (BBD) at Roswell Park Memorial Institute in Buffalo, New York, during the period 1957 to 1965 were followed for subsequent breast cancer development. For purposes of comparison, a matched control group was similarly followed. Methods of follow-up included mailed questionnaires to the study subjects and/or their relatives, phone contacts, and searches for cancer registry reports at the New York State Department of Health and for death certificates at various state departments of vital statistics. A total of 86% of the study population was traced using these methods, the percentages being similar in the two groups. The age-adjusted incidence rate of breast cancer was three times higher in the BBD group than in the control group ( P

Morbidity and mortality among recipients of blood from preleukemic and prelymphomatous donors.

The present investigation was designed to test the admittedly speculative hypothesis that a factor involved in the etiology of human lymphatic and hematopoietic neoplasms may be transmitted by blood transfusion prior to the clinical onset of illness in the donor. One hundred and five New York State residents, who received blood from donors who subsequently developed neoplasms of the lymphatic or hematopoietic tissues, were identified and followed for an average period of 7.05 years. No recipient was found to have developed a leukemia or lymphoma following receipt of blood from a preleukemic or prelymphomatous donor. The results of this study should be considered preliminary because the small size of the recipient group might mask even a large increase in risk among the recipients.

Evidence for a spatiotemporal cluster of ovarian cancer cases

Personal and lifestyle factors, rather than environmental factors, have been associated with the occurrence of ovarian cancer. An apparent spatiotemporal cluster of ovarian cancer cases was evaluated by comparing the observed and expected number of cases (1978-1988), examining morphologic data, reviewing medical records, and conducting an environmental survey of the study area. A statistically significant excess of ovarian cancer cases was noted (8 cases observed, 3.4 cases expected; P less than 0.025). Seven of the eight cases resided within 0.75 miles of each other at time of diagnosis; six cases were diagnosed within a 5-year interval. A morphologic review, medical record review, and environmental survey did not provide any possible reasons for this excess. It is hoped that this initial report will stimulate reports of similar observations by clinicians and health researchers in an effort to further elucidate etiologic factors in the development of ovarian cancer.