Cancer in a Montreal suburb: the investigation of a nonepidemic.

In response to an alarming newspaper report of 34 cases of cancer in Chomedey, a suburb of Montreal, an epidemiologic survey was undertaken to determine the incidence of cancer in selected Montreal census tracts during the period 1975-79. Cases of cancer, were ascertained from the Quebec Tumour Registry, then age-standardized incidence ratios (SIRs) were calculated, the expected incidence being based on provincial age-specific rates and 1976 populations. The SIRs were significantly lower for males living in the implicated area (P less than 0.01) and were within expected limits for female residents. Further analysis revealed neither an elevated frequency of any particular tumour type nor a clustering of cases in this area. Following additional ascertainment of cases through the examination of hospital records, the SIRs were recalculated. No significant differences were found between those of the implicated area and those of the most demographically comparable census tract. Finally, an independent inquiry failed to uncover any actual or potential sources of environmental carcinogens.     

The Prevalence and Factors for Cancer Screening Behavior among People with Severe Mental Illness in Hong Kong

Objectives

Screening is useful in reducing cancer incidence and mortality. People with severe mental illness (PSMI) are vulnerable to cancer as they are exposed to higher levels of cancer risks. Little is known about PSMI''s cancer screening behavior and associated factors. The present study examined the utilization of breast, cervical, prostate, and colorectal cancer screening among PSMI in Hong Kong and to identify factors associated with their screening behaviors.

Method

591 PSMI from community mental health services completed a cross-sectional survey.

Results

The percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE); 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening. Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and pap-smear test behavior.

Conclusions

Cancer screening utilization among PSMI in Hong Kong is low. Beliefs about cancer and self-efficacy are associated with cancer screening behavior. Health care professionals should improve the knowledge and remove the misconceptions about cancer among PSMI; self-efficacy should also be promoted.     

Childhood energy intake and adult mortality from cancer: the Boyd Orr Cohort Study.

OBJECTIVE: To examine the relation between energy intake in childhood and adult mortality from cancer. STUDY DESIGN: Cohort study. SETTING: 16 rural and urban centres in England and Scotland. SUBJECTS: 3834 people who took part in Lord Boyd Orr''s Carnegie survey of family diet and health in prewar Britain between 1937 and 1939 who were followed up with the NHS, central register. Standardised methods were used to measure household dietary intake during a one week period. MAIN OUTCOME MEASURES: Cancer mortality. RESULTS: Significant associations between childhood energy intake and cancer mortality were seen when the confounding effects of social variables were taken into account in proportional hazards models (relative hazard for all cancer mortality 1.15 (95% confidence interval 1.06 to 1.24), P = 0.001, for every MJ increase in adult equivalent daily intake in fully adjusted models). This effect was essentially limited to cancers not related to smoking (relative hazard 1.20; 1.07 to 1.34; P = 0.001), with similar effects seen in men and women. CONCLUSION: This positive association between childhood energy intake and later cancer is consistent with animal evidence linking energy restriction with reduced incidence of cancer and the association between height and human cancer, implying that higher levels of energy intake in childhood increase the risk of later development of cancer. This evidence for long term effects of early diet confirm the importance of optimal nutrition in childhood and suggest that the unfavourable trends seen in the incidence of some cancers may have their origins in early life.     

Weight Change in Adult Life and Health Outcomes

Objective: To investigate the relationship between weight change in adult life and subsequent mortality and cancer incidence in women. Research Methods and Procedures: In 1994 to 1995, all women (age range, 42 to 81) still under general practitioner observation in the United Kingdom's Royal College of General Practitioners Oral Contraception Study (n = 12 303) were sent a health survey asking about health and lifestyle issues, including current weight and weight at age 30. The main outcome measures were 6‐year all‐cause mortality and cancer incidence among different weight change deciles. Cox regression was used to calculate hazard ratios that were adjusted for: social class at recruitment, BMI at age 30, and age group, parity, smoking status, and hormone replacement therapy status in 1995. Results: Women who had been obese at age 30 were more likely to die and significantly more likely to develop cancer in the 6 years after the health survey than non‐obese respondents. Women reporting weight gains between age 30 and 1995 were significantly less likely to die during the 6 years after the health survey than those with a stable weight, whereas those with weight loss did not fare any better than those in the stable‐weight group. Discussion: Although obesity at young age was associated with subsequent mortality and cancer incidence, weight gain over a time period of 12 to 51 years appeared to be beneficial when compared with women with stable weight over the same time period. Further research is needed to confirm or refute our findings and to allow detailed examination of potential explanations for them.     

The Link between Knowledge,Attitudes and Practices in Relation to Atmospheric Haze Pollution in Peninsular Malaysia

Transboundary haze episodes caused by seasonal forest fires have become a recurrent phenomenon in Southeast Asia, with serious environmental, economic, and public health implications. Here we present a cross-sectional survey conducted among people in Kuala Lumpur and surrounds to assess the links between knowledge, attitudes, and practices in relation to the transboundary haze episodes. Of 305 respondents, 125 were amateur athletes participating in a duathlon event and the remainder were surveyed in an inner-city shopping mall. Across the whole sample, people who possessed more factual information about the haze phenomenon showed significantly higher levels of concern. Duathletes were more knowledgeable than non-duathletes and also more concerned about the negative effects of haze, especially on health. For all people who regularly practice outdoor sports (including people interviewed at the shopping mall), higher levels of knowledge and concerned attitudes translated into a greater likelihood of engaging in protective practices, such as cancelling their outdoor training sessions, while those with greater knowledge were more likely to check the relevant air pollution index on a daily basis. Our results indicate that the provision of accurate and timely information about air quality to residents will translate into beneficial practices, at least among particularly exposed individuals, such as amateur athletes who regularly practice outdoor sports.     

Cancer screening barriers and facilitators for under and never screened populations: A mixed methods study

BackgroundCancer screening is below targets in Ontario, Canada. Our objective was to identify and quantify the barriers and facilitators for breast, cervical and colorectal cancer screening for under and never screened (UNS) residents living in Ontario between 2011 and 2013.MethodsWe used a multi-phased mixed methods study design. Results from thematic analysis of focus group discussions with health care providers and UNS community members were used to develop an on-line, province-wide, cross-sectional survey to estimate the prevalence of barriers and facilitators for the provincial population. Adjusted prevalence odds ratios and 95% confidence intervals were estimated for UNS compared to regularly screened participants using logistic regression.ResultsFour focus groups were held with health service providers and sixteen with UNS community members. Top barriers and facilitators themed around provider-patient communication, fear and embarrassment, history of physical or sexual abuse, social determinants of health (including low literacy, lack of awareness, and health insurance), symptoms appearing, and family and friends. 3075 participants completed the online survey. Compared to regularly screened participants, UNS had significantly higher odds of reporting: no regular health care provider; not feeling comfortable talking about screening; or the Doctor or Nurse Practitioner not suggesting screening. UNS also had significantly higher odds of reporting the facilitators: the test being less scary/painful or uncomfortable; friend/family insisting on getting screened; starting to have symptoms; or an easier test that could be done at home.ConclusionsInterventions addressing fear through individual, interpersonal and structural facilitators may increase cancer screening.     

Dysregulation of ferroptosis may involve in the development of non-small-cell lung cancer in Xuanwei area

The Xuanwei area of Yunnan Province, China, is one of the regions suffering from the highest occurrence and mortality rate of lung cancer in the world. Local residents tend to use bituminous coal as domestic fuel, which causes serious indoor air pollution and is established as the main carcinogen. After the local government carried out furnace and stove reform work, lung cancer rate including incidence and mortality among residents remains high. We herein wonder if there are specific mechanisms at protein level for the development of non-small-cell lung cancer (NSCLC) in this area. We investigated the changes of protein profiling in tumour of the patients from Xuanwei area. Tandem mass tag (TMT) was employed to screen the differential proteins between carcinoma and para-carcinoma tissues. We identified a total of 422 differentially expressed proteins, among which 162 proteins were significantly up-regulated and 260 were downregulated compared to para-carcinoma tissues. Many of the differentially expressed proteins were related to extracellular matrix (ECM)-receptor interaction, focal adhesion, PI3K/AKT pathway and ferroptosis. Further experiments on the two differential proteins, thioredoxin 2 (TXN2) and haptoglobin (HP), showed that the change of their expressions could make the lung cancer cell lines more resistant to erastin or RSL-induced ferroptosis in vitro, and promote the growth of tumour in nude mice. In conclusion, this study revealed that aberrant regulation of ferroptosis may involve in the development of lung cancer in Xuanwei area.     

Knowledge about Cervical Cancer and Barriers of Screening Program among Women in Wufeng County,a High-Incidence Region of Cervical Cancer in China

Purpose

Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area.

Participants and Methods

A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening.

Results

Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics.

Conclusion

Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.     

我国农村居民生活能源碳排放的时空特征分析

随着生活质量的提高,我国农村居民生活能源消费呈现大幅增长的趋势,成为碳排放增长的新源泉。估算了我国30个省区2001—2013年的农村居民生活能源碳排放,采用碳基尼系数、Arc GIS技术分析了中国省级尺度农村居民生活能源碳排放的时空特征,并利用STIRPAT模型辨明了农村居民生活能源碳排放的主要影响因素。结果表明:(1)2001—2013年农村居民直接生活能源碳排放量和间接生活能源碳排放量分别增长了7.65%、9.16%。(2)东部、中部、西部地区的碳基尼系数呈下降趋势,说明各区域农村居民人均生活能源碳排放量的区域差异总体均呈缩小趋势。(3)2001—2013年间,处于我国农村居民人均直接生活能源碳排放高水平地区的空间格局分布相对较为稳定,而对于人均间接生活能源碳排放来说,处于低水平地区的空间格局分布较为稳定。(4)农村人口规模、农民人均纯收入、农村居民生活消费支出、青壮年人口比重对农村居民生活能源碳排放量具有促进作用,而农村居民能源消费结构对其具有减缓作用,且北方农村居民生活能源碳排放量明显高于南方。(5)从环境Kuznets曲线假说出发,经济发展是促使我国农村居民生活能源碳排放Kuznets曲线存在拐点的重要因素。     

Chromium Supplementation Reduces Resting Heart Rate in Patients with Metabolic Syndrome and Impaired Glucose Tolerance

Mental health problems are a major public health issue worldwide, and zinc may be associated with psychiatric symptoms, but such associations have not been investigated extensively. This study was conducted to evaluate the relationship between serum zinc levels and mental health problems in Korean adults. We used data from the Korean National Health and Nutrition Examination Survey V-1, a cross-sectional survey of Korean civilians. Data from 1748 subjects were analyzed. Serum zinc levels did not differ significantly according to psychiatric symptoms including sleep duration, stress, depressed mood, suicidal ideation, and whether respondents sought psychiatric consultation. The frequencies and odds ratios of psychiatric symptoms according to serum zinc tertiles were not significantly associated after adjusting for age, smoking, alcohol consumption, physical activity, body mass index, total body fat, and renal function and for daily fat, carbohydrate, and protein intake. Serum zinc levels may not be associated with psychiatric symptoms in Korean adults without psychiatric disorders.     

Regional variation of cancer mortality incidence and its relation to selenium levels in China

The epidemiological relationship between selenium level and age-adjusted human cancer mortality (incidence) was studied in 24 regions located in eight provinces of China. Statistically significant inverse correlation was found between age-adjusted total cancer death rates and selenium levels in whole blood from local residents. In the areas with high selenium levels, there was significantly lower mortality in both males and females from cancer of the stomach and esophagus. In addition, an inverse correlation between regional distribution of liver cancer incidence and selenium contents in blood and grains in Qidong county, an area with high risk of hepatoma, was observed. With the intention of providing selenium supplements to residents living in low selenium regions, the selenium content in grains was raised by means of foliar spraying of crops with Na₂SeO₃ solution.     

Cancer Cluster Investigation in Residents Near a Municipal Landfill

While there are several studies of the health status of residents near hazardous waste landfills, relatively few have focused on the health of individuals living near municipal landfills. We assessed whether there were increased incidence rates of 18 cancer types and all cancers combined among residents near the Northampton Regional Landfill in western Massachusetts by conducting analyses for the cities of Northampton and Easthampton, as well as each census tract in these cities, between years 1982 and 2004. We also examined incidence rates within a 1-mile radius of the landfill and examined spatial patterns of all cancer cases in Northampton and Easthampton. The majority of cancer types occurred at, near, or below expected rates. No statistically significant association persisted over time. Within 1 mile of the landfill, all cancers combined occurred at rates comparable to the statewide average (SIR = 94, 95% CI: 69, 120) from 1997 to 2004, as did all individual cancer types analyzed. There were no unusual spatial patterns of cases in the area surrounding the landfill for the entire study period or four individual periods examined. The results do not support the hypothesis that residing near the investigated municipal landfill was associated with increased cancer risk.     

Cancer incidence and mortality in populations living near uranium milling and mining operations in grants, New Mexico, 1950-2004

In a previous cohort study of workers engaged in uranium milling and mining activities near Grants, Cibola County, New Mexico, we found lung cancer mortality to be significantly increased among underground miners. Uranium mining took place from early in the 1950s to 1990, and the Grants Uranium Mill operated from 1958-1990. The present study evaluates cancer mortality during 1950-2004 and cancer incidence during 1982-2004 among county residents. Standardized mortality (SMR) and incidence (SIR) ratios and 95% confidence intervals (CI) were computed, with observed numbers of cancer deaths and cases compared to expected values based on New Mexico cancer rates. The total numbers of cancer deaths and incident cancers were close to that expected (SMR 1.04, 95% CI 1.01-1.07; SIR 0.97, 95% CI 0.92-1.02). Lung cancer mortality and incidence were significantly increased among men (SMR 1.11, 95% CI 1.02-1.21; SIR 1.40, 95% CI 1.18-1.64) but not women (SMR 0.97, 95% CI 0.85-1.10; SIR 1.01, 95% CI 0.78-1.29). Similarly, among the population of the three census tracts near the Grants Uranium Mill, lung cancer mortality was significantly elevated among men (SMR 1.57; 95% CI 1.21-1.99) but not women (SMR 1.12; 95% CI 0.75-1.61). Except for an elevation in mortality for stomach cancer among women (SMR 1.30; 95% CI 1.03-1.63), which declined over the 55-year observation period, no significant increases in SMRs or SIRs for 22 other cancers were found. Although etiological inferences cannot be drawn from these ecological data, the excesses of lung cancer among men seem likely to be due to previously reported risks among underground miners from exposure to radon gas and its decay products. Smoking, socioeconomic factors or ethnicity may also have contributed to the lung cancer excesses observed in our study. The stomach cancer increase was highest before the uranium mill began operation and then decreased to normal levels. With the exception of male lung cancer, this study provides no clear or consistent evidence that the operation of uranium mills and mines adversely affected cancer incidence or mortality of county residents.     

Blood selenium concentration in residents of areas in China having a high incidence of lung cancer

Data concerning the blood selenium level and its relation to the mortality from lung cancer are reported. There were 353 samples of blood collected from workers at the Yannan Tin Mine (Yun-Xi) and 75 samples from Beijing residents for comparison. An inverse correlation between blood selenium levels and lung cancer mortalities was observed. The average selenium concentration in whole blood from Beijing residents (age-adjusted mortality rate from lung cancer for males: 12/100,000) and Yun-Xi miners (age-adjusted mortalty from lung cancer for males: 108/100,000) were 12.3 and 8.8 μg/100 mL, respectively. A similar inverse correlation was also observed among young people of comparable sex and age groups. In Yun-Xi, the tin miners working underground with an average lung cancer death rate of 250/100, 000 for males had lower blood selenium concentrations than those working above ground, where the average lung cancer death rate for males was 42/100,000. Workers frequently exposed to arsenic exhibited lower blood selenium contents. Selenium levels in the blood of patients with lung cancer were lower (6.2 μg/100 mL) than those of healthy controls.     

The Semipalatinsk nuclear test site: a first analysis of solid cancer incidence (selected sites) due to test-related radiation

Since 1956, cancer incidences have been analysed in several rayons of the Semipalatinsk oblast, with cross-sectional analyses being conducted every 5 years. Data on different tumor localizations were recorded within a heavily contaminated so-called main area of nine villages (estimated average effective equivalent dose about 2000 mSv) and a so-called control area (estimated average effective equivalent dose about 70 mSv), each including approximately 10 000 persons. Up to 1970, the excess cancer incidence in the exposed villages was observed to have increased; after 1970, a decrease was noted, followed by a second increase in the late 1980s. The main sites of excess cancer included the esophagus, stomach, and liver. Up to 1970, the esophagus cancer incidence was predominant, but it decreased thereafter, while the incidence of stomach and liver cancers increased. The second peak of excess cancer rates was mainly due to lung, breast, and thyroid carcinomas.     

Biological effects on human health due to radiofrequency/microwave exposure: a synopsis of cohort studies

We evaluated the methods and results of nine cohort studies dealing with the biological effects on human health from exposure to radiofrequencies/microwaves, published between 1980 and 2002. The size of the cohorts varied between 304 (3,362 person years) and nearly 200,000 persons (2.7 million person years). As exposures were defined: dielectric heaters in a plastic manufacturing plant, working with radio devices (professional and amateur), production of wireless communication technologies, radar devices of the Canadian police, radar units used by the military as well as artificially produced electromagnetic pulses similar to those after a nuclear explosion. In all studies (except one that used a qualitative job-exposure-matrix) either the duration of occupational work as an approximation to actual exposure was determined or a simple yes/no differentiation was used based on a definition of high-exposed and/or low-exposed (occupational) groups. Either total mortality, cancer mortality, cancer incidence or other outcomes were estimated. In most of the studies, an increased risk for various types of cancer was found in exposed study participants, although in different organs. The overall results were, however, inconsistent. The most important limitations of the studies were the lack of measurements referring to past and current exposures and, thus, the unknown details on actual exposure, the use of possibly biased data as well as the lack of adjustment for potential confounders and the use of indirect standardization techniques. Due to these limitations and the inconsistencies of the results it has to be concluded that the studies give no evidence of high frequency emissions causing cancer.     

The health of Indians in Canadian cities: a challenge to the health care system

It is well known that Canadian native people living on reserves have high morbidity and mortality rates, but less is known about the health of those who migrated to urban centres. Several studies have shown that these people have high rates of mental health problems, specific diseases, injuries, infant death and hospital admission. In addition, there is evidence that cultural differences create barriers to their use of health care facilities. The low socioeconomic status, cultural differences and discrimination that they find in cities are identified as the primary blocks to good health and adequate health care. More epidemiologic studies need to be done to identify health problems, needs and barriers to health care. Federal, provincial and civic governments along with the appropriate departments of faculties of medicine should begin working with native organizations to improve the health of native people living in Canada''s cities.     

Public perceptions of health care problems. An analysis from Arizona.

Public perception of 17 health problems was assessed by telephone and in-person interviews in Arizona. Drug abuse (64.7%), the costs of health care (62.8%), and drunk driving (60.6%) were considered the most serious health care problems. Elderly and rural residents tended to view drug abuse, drunk driving, teenage pregnancy, and economic aspects of health care as less serious than did the younger and urban respondents, while the poor thought these problems were more serious. Respondents in this survey were less concerned with the lack of specific clinical services for high-risk groups--the old and frail, pregnant women, people with the acquired immunodeficiency syndrome, suicidal teenagers, and abused children.     

Health diary study of Japanese residents in Greater Boston: Variables related to high incidence of health problems

This study was conducted to assess the impact of migration on the incidence of illness episodes and health care seeking behavior among Japanese residents in Greater Boston. Subjects were instructed to keep diaries about illnesses experienced and visits to physicians. A total of 62 problems (0.77 per person) occurred over a four-week period with only 9 problems (15 percent) receiving medical consultation. Residents who were in the U.S. for less than one year had the highest rate of perceived stress and the highest incidence of health problems. The number of people available for support to an individual did not correlate with the occurrence of health problems. Surprisingly no emotional or psychological problems were recorded in the diary in spite of explicit encouragement to note such problems. An increased occasion of family get-togethers compared to that in Japan was perceived as stressful by men, but not by women. This contrasts with the perception of children's educational issues as stressful exclusively by women.     

Stressor or succour? Examining the association between conflict,livestock assets,and farmers’ mental health in Nigeria

Farmers are disproportionately vulnerable to violent attacks in the conflict situation in Nigeria, with potential traumatising effects due to the destruction of agricultural livelihoods. In this study, we conceptualise the links between conflict exposure, livestock assets, and depression, using a cross-sectional nationally representative survey of 3021 Nigerian farmers to quantify the relationships. We highlight three main findings. First, conflict exposure is significantly associated with farmers exhibiting depressive symptoms. Second, holding higher herds of livestock, more cattle, and more sheep and goats while exposed to conflict is associated with higher risk of depression. Third, keeping more poultry is negatively associated with depressive symptoms. Finally, this study accentuates the significance of psychosocial support for farmers in conflict situations. The relationships between different livestock species and farmers’ mental health may interest further research in strengthening the evidence.