Multiple primary cancers in Denmark 1943-80; influence of possible underreporting and suggested risk factors

The risk of developing a second primary cancer was studied among 171,749 men and 208,192 women who were reported to the Danish Cancer Registry between 1943 and 1980. Only those who survived at least two months were included in the analysis, and more than 1.7 million person-years of observation were accrued. Altogether, 15,084 second primary cancers developed, of which 13,231 were in organs other than the initial or adjacent site [relative risk (RR) = 1.01]. Adjustment for possible underreporting of multiple primary cancers increased the RR to 1.24, which stresses the need for detailed knowledge of registration procedures interpreting results from cancer registries. The unadjusted RR for all sites increased with time, from 0.94 during the first decade of follow-up (excluding the first year) to 1.13 among 30-year survivors, whereas the adjusted RR increased from 1.08 to 1.41. Elevated risks were observed for sites thought to have a common etiology. For example, cancers of smoking-related sites were increased in both directions following cancers of the oral cavity, respiratory tract, and urinary organs. For cancers suspected to have a hormone- or dietary fat-related association, significant reciprocal relationships were seen among cancers of the endometrium, ovary, and colon. Cancer treatment probably is an important factor in second cancer development, even when judged indirectly in the present study. For example, radiotherapy may have been responsible for an elevated risk of subsequent cancers of the thyroid, breast, colon, rectum, bladder, and connective tissue in long-term survivors. Chemotherapy may have increased the risk of subsequent leukemias. Our data further indicate that cancer patients have no general susceptibility to develop new malignant tumors, although high rates may be found for particular sites sharing common risk factors. Conversely, the occurrence of one cancer does not appear to protect against developing a new cancer.     

Multiple primary malignant neoplasms in England and Wales, 1971-1981

In the period 1971-81, more than 1.9 million persons were registered with a malignant neoplasm among the 49.2 million population of England and Wales. For 63,536 people, two or more tumor registrations (multiple tumor records) have arisen in that period. Because of the structure of the National Cancer Registration scheme, some errors in registration are inevitable, particularly duplicate registration of a single tumor by adjacent regional cancer registries. A pilot study showed that 61 percent of multiple records would represent true multiple primary malignancy, and that these records could be readily separated from registration errors. After abstraction of identifying codes from each tumor, 129,047 tumors involved in 63,536 multiple records were matched to the national cancer file, and the full data set extracted for successfully matched tumors. Person-years data were extracted for the 1.8 million tumors not involved in a multiple record. Eleven percent of multiple records were not completely matched, and a further 16 percent were excluded on SEER criteria, or as probable registration errors, leaving 46,155 multiple primary tumors for further analysis. Over 3 million person-years at risk of a second tumor were accrued. The overall risk of a second tumor at any site before age 85 was 0.77 for males and 0.80 for females, after exclusion of second tumors observed within 12 months of the first. The risk of a new primary apparently decreased with increasing duration of survival, a trend which may be due in part to under-registration of second tumors in the early 1970s and an improvement in linkage since 1971.     

STAT3, HIF-1alpha, EPO and EPOR - signaling proteins in human primary ductal breast cancers

STAT3 upregulates expression of HIF-1 induced EPO. Receptor EPOR was reported to activate STAT3. Our study was aimed at demonstration of tissue immunoreactivities of those proteins and determination of their relationships in reference to clinicopathological variables of breast cancers. We detected STAT3, HIF-1alpha, EPO and EPOR in specimens of 76 human, female, ductal breast cancers by immunohistochemistry. STAT3 was detected in 38 of 76 cancers (50%). HIF-1alpha was found in 55 cases (72%). EPO positive tumors comprised 89% of all the cancers (68 cases). EPOR was also visualized in 55 cases (72%). Anti-HIF-1alpha and anti-STAT3 stained nuclei and cytoplasm of breast cancer cells in diffuse and finely granular fashion. Strong membranous expressions of EPO and EPOR were distributed in cytoplasmic and membranous granularity or diffuse staining. STAT3 correlated with HIF-1 in general (r=0.4012, p<0.0001) and in different patients' subgroups. STAT3 was significantly associated with EPO and EPOR in all the cancers (r=0.2370, p=0.039 and r=0.3336, p=0.003, respectively). Besides a correlation between STAT3 and EPOR in node negative ones, STAT3 wasn't related to EPO and EPOR in remaining subgroups. HIF-1alpha correlated with EPO and EPOR in most of analyzed groups. Immunoreactivity to EPO generally was associated with EPOR (r=0.3520, p=0.002). Statistically analyzed distributions of the proteins reflected functional dependences among STAT3, HIF-1alpha, EPO and EPOR in cellular signal conduction.     

The UK cardiac surgical register, 1977-82.

Data for 1977-82 obtained from the Cardiac Surgical Register, established by the Society of Thoracic and Cardiovascular Surgeons of Great Britain and Northern Ireland in 1977, were analysed for trends in incidence and mortality of cardiac surgery and regional workload in the United Kingdom. Operative mortality for most types of cardiac operation showed a general decline. The numbers of operations performed for valvular and congenital heart disease had remained unchanged, but a striking increase had occurred in the number of coronary bypass graft operations: 2297 in 1977 to 6008 in 1982. The figure for 1982, representing an annual rate of 107 operations per million population, was still well below that for other countries such as Australia (410 per million in 1982) and the United States (750 per million in 1981). A wide variation was seen in the regional provision of cardiac surgical services within the United Kingdom. This was particularly appreciable for coronary bypass graft surgery, in which there was a 10-fold difference in numbers of operations performed between the various regions. The UK Cardiac Surgical Register provides an important source of information on trends within the specialty that could well be followed by other surgical specialties.     

The American Anthropological Association and the Values of Science, 1935-70

American anthropologists have repeatedly addressed questions about the nature of anthropology as a science and the relationship of anthropology to society. Complex interactions between anthropology and political events in American life have challenged definitions of science, including anthropologists as citizens, scientists, and professionals and the roles they appropriately play. A series of exchanges and events between the 1930s and 1970 are examined in order to shed light on some of the recurrent dilemmas of definition and practice in anthropology as anthropologists have grappled with them in different times and in relation to different contexts. [Keywords: U.S. anthropology, U.S. history, science]     

Trends in parasuicide and unemployment among men in Edinburgh, 1968-82.

Between 1968 and 1982 annual unemployment and annual incidence of parasuicide among men in Edinburgh were positively and highly significantly correlated (r = 0.77). Similarly, they were found to be correlated across the city wards in 1971 (r = 0.76) and, even more strongly, 1981 (r = 0.95). Throughout the period the incidence of parasuicide among the unemployed was nearly always more than 10 times higher than among the employed. Men unemployed for more than a year were at much higher risk than those out of work for shorter periods. These findings were considered to be consistent with the view that unemployment, especially if long term, increases the incidence of parasuicide. The official prediction of an increase in long term unemployment has important implications.