Education and mortality from cancer in São Paulo, Brazil

This study investigated social class differentials in cancer mortality in São Paulo county, Brazil, for the period 1978 to 1982. A measure of socioeconomic status based on education was used, and cancer risk by level of education was estimated by a case-control approach in which other cancers were considered as controls. For most cancers, the socioeconomic differences in risk were similar to those found in western Europe and North America. For lung cancer, however, the highest risk was observed in men and women with the most education. Other cancers related to tobacco--cancer of the larynx, pharynx, and esophagus--showed a negative association with education. The differences between social classes in consumption habits of alcohol and maté and the use of black tobacco are probably responsible for these contrasting patterns. For breast and cervix uteri cancer the social class patterns were similar to those found in developed countries--a positive relationship for breast and a negative one for cervix uteri cancer. The magnitude of the differences observed between social classes for these cancers was frequently greater in South America than in the United States or western Europe.

Cancer risks among European migrants in São Paulo, Brazil

Using both mortality and incidence data, cancer risk in Italian, Spanish and Portuguese migrants to São Paulo were compared with those in the Brazil-born population, and with those in their countries of origin. Italian and Spanish migrants show changes in cancer risks which are rather similar to those observed in migrants of the same origin in other parts of South America: they increase their rates of oropharyngeal, oesophageal, cervical and breast cancers and they decrease their rates of lung cancers. However, for cancer of the oesophagus, the changes are greater in São Paulo, where migrants acquire rates similar to those of the natives. For colon cancer, rates in Italian migrants decrease in the low risk area of São Paulo and increase in the high risk area of Argentina. Changes in Portuguese migrants are less evident: their rates of colorectal cancer remain high, and, as found for Japanese migrants in São Paulo, they also retain their higher risks of stomach cancer.

Ethnicity and cancer risk in São Paulo, Brazil

Data from the São Paulo Cancer Registry (Brazil) for the period 1969-1974 are used to investigate ethnic differentials in cancer risk. Risks for specific cancers were estimated for mulattos and blacks relative to whites, using a case-control approach with other cancers as controls. For both sexes, blacks and mulattos are at higher risk than whites for cancer of the esophagus, stomach, and liver and for myeloma; for prostate cancer in males; and for gall bladder, pancreas, and cervix uteri cancers in females. Blacks and mulattos are at lower risk than whites for cancer of the colon, lung, larynx (males only), bladder, bone, testis, breast, and corpus uteri and for melanoma and leukemia. Except for lung and colon cancers, for which life-style habits are the main risk factors, these ethnic differences are similar to those observed in the United States.

Cancer incidence in Western Samoa

This report presents the first data on cancer incidence in Western Samoa, which has one of the largest Polynesian communities in the world. Incidence estimates are based on a systematic retrospective survey of cancer cases identified in the laboratory of pathology, and from hospital records, for the period January 1980 to June 1988. The overall incidence rates are low in both sexes (age-standardized incidence rates are 93.7 for males and 95.7 per 100,000 for females). Although cases may have been missed, it seems likely that incidence rates among Samoans are substantially lower than those recorded in Polynesian populations elsewhere. It is notable that cancers related to tobacco are responsible for less than 17% of all cancers in males, compared to more than 30% in other Polynesians. Stomach cancer remains the most common cancer in males. In females, breast and cervix are equally common and make up almost 40% of all cancers. Liver cancer occurs more commonly in males, and the rates are slightly lower than those of other Polynesians. The high incidence of thyroid cancer seen in some Pacific Island populations is not seen among Samoans.

Alcohol, beer and cancer of the pancreas

The relationship between total alcohol consumption and intake of beer, wine and spirits and the risk of cancer of the pancreas was re-assessed in a pooled analysis of 3 case-control studies of pancreatic cancer from Italy, France and Switzerland, providing a total data-set of 494 cases and 1,704 controls. Logistic regression was used to obtain relative risks adjusted for study, age, sex, smoking and socio-economic status. Relative to non-drinkers, the risk estimates for subsequent levels of alcohol consumption were close to unity, and there was no evidence of a trend in risk with dose: the point estimate for more than 8 drinks per day was 0.8 (95% Confidence Interval, CI = 0.5-1.3). Likewise, no consistent association was observed for consumption of wine, beer or spirits: the relative risks for the highest consumption levels were 1.0 for wine, 0.9 for beer and 0.9 for spirits. No significant interaction was observed with study centre, sex or smoking habits. Given the large size of the data-set, of the consistency and the replication of findings across the 3 different studies, and of the elevated alcohol consumption of these populations, the present analysis gives reassuring evidence on the alcohol and pancreatic cancer issue in relation to total consumption of alcohol, of beer and of other alcoholic beverages.

Risk factors for male breast cancer: a Franco-Swiss case-control study

In order to evaluate risk factors in male breast cancer, a case-control study of 91 histologically diagnosed cases and 255 cancer controls, matched for age and year of diagnosis, was conducted in Villejuif (France) and Geneva (Switzerland). Factors studied included marital history, occupational exposure, associated diseases, family history of breast cancer, history of radiation exposure and drugs which increase or are suspected of increasing prolactin or estrogen levels. Cases were significantly more likely to be bachelors or to work as butchers than were the controls. Other statistically significant risk factors identified were family history of breast cancer and therapeutic use of digitalis. Elevated risks, although not significant, were observed for individuals with a past history of tuberculosis, hyperthyroidism, liver cirrhosis or gallstone, who had been treated with isoniazid, or who had worked in high environmental temperatures. Further studies are needed to confirm our results particularly as regards hormonal imbalance and genetic factors.

Risk factors for breast cancer according to age at diagnosis in a French case-control study

In a French case-control study of 1010 women with breast cancer and 1950 controls with nonmalignant disease, the variations of the effects of 8 risk factors for breast cancer as a function of age at diagnosis, were analysed by tests of homogeneity and trend. The risks associated with a late age at first full-term pregnancy and with nulliparity were different between age-groups (test of homogeneity: p = 0.03), and the highest risks for these two factors were observed in women 45-54 years old. The risks associated with Quetelet index were also found to vary with age at diagnosis (test for trend: p = 0.008). A high Quetelet index decreased the risk of breast cancer in the younger age-groups; this decrease of risk became progressively less important with advancing age, and no such effect was found in the oldest age-group. Inverse results were observed for a tall stature (test for trend: p = 0.04): a tall stature increased the risk of breast cancer in the younger age-groups, and the figures suggested a reverse effect in the oldest group. No large variation with age was found for the effects of age at menarche, history of breast cancer death in mother or sisters, prior biopsy for benign breast disease, and weight. In conclusion, the relative importance of certain risk factors for breast cancer is closely related to age at diagnosis. Nulliparity and a late age at first birth appear to be major risk factors only for middle-aged women, whereas a low Quetelet index and a tall stature appear to increase the risk of breast cancer only for younger women.

Endometrial cytohistology by the pistol-aspiration technique: clinical applicability

The purpose of this study was to assess the value of the endometrial pistol-aspiration technique as an office procedure for diagnosing corpus uteri cancer in symptomatic and asymptomatic women. Review of 3000 pistol aspirations in symptomatic outpatient women from 1974-1981 confirms that this method, with its high specificity and sensitivity, can be used for such women as a preliminary diagnostic procedure, eliminating risks from anesthesia and curettage as well as the cost of hospitalization. Analysis of resident incident cases shows that 82% were localized to the uterus, and more than 85% of these women were already symptomatic. Older women represent particularly difficult problems, both technical (cervical stenosis) and in recruitment. Because the natural history of the precursor lesions of corpus uteri cancer are not yet well established, use of this method for systematic population screening of asymptomatic women is questionable.

Effects of bopindolol on renal function

The effect of the long-acting beta-blocking agent bopindolol on renal function was assessed in 10 healthy normotensive volunteers and 10 hypertensive patients. The subjects received 1 mg bopindolol at 8 p.m. for 21 days. The following determinations were made at 8 a.m. on recumbent, fasting subjects before day 0 (D0) and 12 h after day 1 (D1) the first dose of bopindolol, and on the 21st day of treatment (D21): blood pressure (diastolic = DBP), glomerular filtration rate (GFR) and renal plasma flow (RPF) as reflected by the plasma disappearance of 51Cr-EDTA and 125I-hippuran, plasma concentrations and 2- and 24-h urinary excretion of electrolytes, creatinine, and proteins and osmolality of the urine. Plasma renin activity was assessed on standing subjects. Following bopindolol administration GFR, RPF, and filtration fraction remained stable, in spite of a fall of DBP from 80 +/- 7 to 76 +/- 4 and to 72 +/- 9 mm Hg in normotensives (p less than 0.05) and from 106 +/- 11-96 +/- 10 and to 91 +/- 8 mm Hg in hypertensives (p less than 0.05) on D1 and D21, respectively. The drops in DBP at D1 correlated weakly with the pretreatment renin levels (p = 0.074, p less than 0.05). All the other variables remained stable, including diuresis, free water clearance, and fractional sodium excretion. It is concluded that in contrast to many other anti-hypertensive drugs including several beta blockers, bopindolol does not reduce renal function during short- or medium-term treatment in normal volunteers or hypertensive patients.