Socioeconomic, environmental, demographic and behavioral factors associated with occurrence of diarrhea in young children in the Republic of Congo

This study is the result of a cross-sectional survey undertaken in five regions of the Republic of Congo. A sample of 612 women having children under 3 years of age was interviewed to determine the socioeconomic, environmental, demographic and behavioral factors associated with the occurrence of diarrhea in young children. Logistic regression analysis was used to determine which variables predict the occurrence of diarrhea in a multivariable context. Most of the statistically significant variables were those suggesting behaviorally mediated modes of transmission. These include: type of weaning food fed to the child, maternal age, sex of the child, maternal sickness and method of refuse disposal. Male children had a more than two-fold odds of experiencing recent diarrhea than did female children among those greater than 1 year of age. Although breastfeeding status was not statistically significantly associated with diarrheal disease, children under 1 year of age who were already weaned had a greater odds of disease than those who were still breasted. Due to the pattern of extended breastfeeding in this population, this relationship was difficult to assess. Urban residence also was highly associated with diarrheal disease occurrence. Urban residence is likely to reflect a host of socioeconomic, environmental and behavioral factors. These findings underscore the potential impact of educational interventions on the occurrence of diarrheal disease among young children.

Difficulty becoming pregnant and family history as interactive risk factors for postmenopausal breast cancer: the Iowa Women's Health Study

We recently provided data from a prospective cohort study of postmenopausal women which suggested that a first livebirth at age 30 or older (cf before age 20) was associated with a twofold increased risk of breast cancer in women without a family history, but a 5.8-fold higher risk in women with a positive family history. To address the question of whether these observations reflect difficulty becoming pregnant or maintaining a pregnancy, we performed additional analyses in which the outcome of each pregnancy was considered. During five years of follow-up, 620 incident cases of breast cancer were identified in the 37,105 women at risk. There was little evidence for an increased risk associated with a history of spontaneous abortion (relative risk [RR] = 1.1; 95 percent confidence interval [CI] = 0.9-1.4), nor was the risk higher among women who reported two or more spontaneous abortions in consecutive pregnancies (RR = 1.0, CI = 0.7-1.4). Although women who reported that they had tried unsuccessfully to become pregnant had only slightly and nonsignificantly elevated risks of breast cancer (RR = 1.1, CI = 0.9-1.3), a more pronounced and statistically significant association was noted in women with a positive family history (RR = 2.1, CI = 1.4-3.2). There was a strong inverse association between failure to become pregnant and parity (P < 0.0001); nearly 50 percent of the nulliparous married women reported having tried and failed to become pregnant, whereas the frequency was only 6.8 percent among married women with five or more livebirths.(ABSTRACT TRUNCATED AT 250 WORDS)

Familial clustering of colon, breast, uterine, and ovarian cancers as assessed by family history

The aggregation of colon, endometrial, ovarian, and possibly breast cancers in families has been described as a "cancer family syndrome" (now called Lynch syndrome II). To determine if the familial clustering of these malignancies was more common in women with cancer than without, we analyzed data from the Iowa Women's Health Study (IWHS), a population-based sample of 41,837 women aged 55-69 years. Self-reported information was collected on history of colon, uterine, ovarian, and breast cancers in female first-degree relatives. A family history of cancer of the breast (odds ratio [OR] = 1.4), colon (OR = 1.3), and uterus (OR = 1.3), but not ovary (OR = 1.2), was significantly more common among women with a personal history of any of these four cancers (all P < 0.05); the pattern of the ORs suggested strongly that the clustering tended to be site-specific. Age-adjusted relative risks (RR) of incident colon cancer over 5 years of follow-up (N = 237) were calculated with regard to family history. Colon cancer incidence was increased among women with a family history of breast (RR = 1.3), uterine (RR = 1.4), colon (RR = 1.5), and ovarian (RR = 1.3) cancers, although none of the risk estimates achieved statistical significance. RR was, however, significantly related to the number of different cancer sites reported among family members (Ptrend = 0.008). These data on a representative sample of postmenopausal women suggest that family histories of colon, breast, uterine, and ovarian cancers are associated with an increased risk of cancer at the same site, but provide little support for the hypothesis that Lynch syndrome II is a non-random occurrence.

Increased risk of breast cancer with alcohol consumption in postmenopausal women

The association between breast cancer incidence and alcohol consumption among postmenopausal women was examined in the Iowa Women's Health Study. In January 1986, a cohort of 41,837 postmenopausal women, aged 55-69 years, completed a questionnaire that included alcohol intake and other information. Through December 1989, 493 incident breast cancer cases were identified. Age-adjusted relative risks of consumption of less than 1.5, 1.5-4.9, 5.0-14.9, and 15.0 g or more of alcohol per day compared with abstention were 1.08, 1.10, 1.08, and 1.28, respectively (p for trend = 0.11). After controlling for age, body mass index, age at first livebirth, age at menarche, and family history of breast cancer, the relative risks were 1.18, 1.20, 1.25, and 1.46 (p for trend = 0.04). Multivariate modeling, using Cox proportional hazards regression, revealed a significant multiplicative interaction between alcohol intake and noncontraceptive estrogen use. The relative risks of breast cancer associated with average daily alcohol consumption of 5.0-14.9 and 15.0 g or more were 1.88 (95% confidence interval 1.30-2.72) and 1.83 (95% confidence interval 1.18-2.85), respectively, among ever-users of estrogen; no association between alcohol and breast cancer was observed among never-users of estrogen.

Alcohol, beer, and lung cancer in postmenopausal women. The Iowa Women's Health Study

There are data to suggest a relationship between alcohol consumption, particularly beer, and lung cancer. This hypothesis was tested on data from a cohort of 41,837 Iowa women aged 55 to 69 years. Women were recruited by mail and provided information on alcohol and tobacco use, physical activity, and education. Compared to a randomly selected group of women without lung cancer (n = 1900), those with lung cancer (n = 109) consumed more alcohol (measured on the Willett food frequency questionnaire) (10.2 versus 3.6 g/d; P = 0.001). The difference was accounted for largely by differences in beer consumption (3.5 versus 0.6 glass/wk; P = 0.003). Liquor consumption by patients was about double that by control subjects (1.7 versus 0.8 glass/wk; P = 0.063). Wine consumption was low and did not differ between those with and those without lung cancer. The relationship between beer consumption and lung cancer risk appeared U-shaped. After adjusting for the other variables (including six categories of pack-years of smoking), beer consumption remained a significant predictor of lung cancer risk. Those drinking 1 or more beers per week had an odds ratio of 2.0 (95% confidence interval, 1.02 to 3.80) compared with those consuming less than 1 glass per week. There was no evidence of interaction with smoking. The association of beer with lung cancer does not appear to be explained solely by confounding with cigarette smoking, although that remains by far the single strongest predictor of risk.

Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews

The authors report the results of a dietary survey of 38,121 Iowa women, 55-69 years of age in 1986, based on a semiquantitative food frequency questionnaire previously tested among Boston-area women aged 34-59 years. The Iowa women, compared with the younger Boston-area women, consumed a similar amount of calories (1,767 vs. 1,844 kcal) and a similar amount of total calories from fat (35 vs. 37%) but had markedly greater intake of the following micronutrients after including supplement use: iron (+18%), calcium (+33%), vitamin A (+43%), riboflavin (+46%), thiamine (+50%), and pyridoxine (+122%). The reproducibility of the questionnaire was examined in two more administrations to 44 of the Iowa women in January and June of 1988. Reproducibility was highest for alcohol (Pearson's r = 0.99), caffeine (r = 0.95), and vitamin E (r = 0.90) and lowest for sucrose (r = 0.53), polyunsaturated fat (r = 0.56), and iron (r = 0.59). Micronutrient intakes were generally more reproducible than macronutrient intakes. The agreement between the June 1988 questionnaire and the average of five 24-hour dietary recalls was also assessed in the 44 subjects. The median correlations of energy-adjusted intake were as follows: for macronutrients, r = 0.45; for micronutrients without supplements, r = 0.33; and for micronutrients with supplements, r = 0.64. This food frequency questionnaire appears to be reasonably reproducible and accurate, so that its use may be extended to epidemiologic studies of older women with a broad range of socioeconomic backgrounds.

Dietary fat and postmenopausal breast cancer

BACKGROUND

Although the results of animal studies and cross-cultural comparisons generally support a role for dietary fat in the etiology of breast cancer, results of analytic epidemiology studies are equivocal.

PURPOSE

The association between dietary fat and subsequent breast cancer was examined in a cohort of 34,388 postmenopausal women from Iowa.

METHODS

Dietary habits were assessed by a food-frequency questionnaire mailed in January 1986. Through December 31, 1989, 459 incident cases of breast cancer occurred in this cohort. Proportional hazards regression was used to examine the dietary fat-breast cancer association while adjusting for potential confounders. The effects on this association of four analytic approaches to adjustment for energy intake were also considered.

RESULTS

After adjustment for known determinants of breast cancer, a modest positive association of total fat intake with risk of breast cancer was seen. Polyunsaturated fat intake was also positively associated with breast cancer (relative risk from lowest to highest intake, 1.0, 1.25, 1.31, and 1.49; P for trend = .052). Different approaches to adjustment for energy intake, however, provided different impressions of the dietary fat-breast cancer association. One method, involving categorization of crude fat intake and inclusion of total energy intake in regression analysis, gave relative risk estimates from low to high fat intake of 1.0, 1.17, 1.25, and 1.38 (P for trend = .18). Another method, based on categorization of fat intake residuals in which the variation in fat due to total energy intake was removed, gave corresponding estimates of 1.0, 1.24, 1.30, and 1.16 (P for trend = .29). The former suggests increasing breast cancer risk with increasing fat intake; the latter suggests no association.

CONCLUSIONS

These results are consistent with other cohort studies that have shown a weak association or no association between dietary fat and breast cancer. They are also consistent with studies suggesting that fat intake is a determinant of breast cancer, particularly after accounting for inaccuracies in dietary assessment. The effects of different energy-adjustment methods may account in part for the varying interpretations of four previous cohort studies of dietary fat and breast cancer.

IMPLICATIONS

Further work is needed to clarify not only the nature of the dietary fat-breast cancer association, but also the impact of different analytic methods used in the investigation of diet-disease associations.

Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer

BACKGROUND

A family history of breast cancer reflects shared cultural factors, genetic predisposition, or both. There is evidence that the estimated risk associated with a family history of breast cancer increases multiplicatively in combination with other risk factors. We examined the combined effect of family history and anthropometric and reproductive factors on the risk of breast cancer in postmenopausal women.

METHODS

Using data from a prospective cohort study, we studied 37,105 women 55 to 69 years of age to determine whether known risk factors for breast cancer are modified by a reported family history at the time of entry into the study.

RESULTS

During the first 4 years of follow-up, 493 new breast cancers were diagnosed. The association of the waist-to-hip ratio (the circumference of the waist divided by that of the hips) with the risk of breast cancer was limited predominantly to women with a family history of breast cancer; the age-adjusted relative risk of breast cancer for the women above the fourth quintile for waist-to-hip ratio as compared with those below the first quintile was 3.2 in women with a family history of breast cancer and 1.2 for women without such a family history. An interaction was observed between a family history of breast cancer and the number of live-born children; the protective effect of higher parity was observed primarily among women with a family history of breast cancer. Similarly, the age-adjusted relative risk of breast cancer associated with a late age at first pregnancy (i.e., greater than or equal to 30 years) was 5.8 for women with a family history of breast cancer and 2.0 for women without such a family history.

CONCLUSIONS

The increase in the risk of breast cancer associated with a high waist-to-hip ratio, low parity, or greater age at first pregnancy is more pronounced among women with a family history of breast cancer. These findings suggest etiologic differences between familial breast cancer and the sporadic form.

Lung cancer detection and prevention: evidence for an interaction between smoking and genetic predisposition

The initiation and promotion of cancer is thought to result from a series of genetic mutations, some of which may be inherited. Our analysis of 337 lung cancer families suggested that, after allowing for an individual's pack-years of tobacco use, the pattern of disease was best explained by Mendelian codominant inheritance of an allele that produced earlier age of onset. Since lung cancer rarely occurs in the absence of exposure to tobacco, differences in the prevalence of smoking across generations could have a profound influence on the fit of genetic models. In the present study, families were partitioned into two groups, based on the birth cohort of the proband, i.e., born before World War I (age at death, greater than or equal to 60 years) or born after World War I (age at death, less than 60 years). This partition was chosen because the year 1915 signaled the start of the dramatic rise in tobacco use in the United States. In younger proband families, in which parents were more likely to smoke, Mendelian codominant inheritance provided the best fit to the data. In older proband families, for whom smoking among parents was less prevalent, the "no major gene" and "environmental" hypotheses were rejected; however, no Mendelian models could be distinguished. If the results on the families with the most homogeneous exposure to tobacco across generations (born after World War I) reflect the true underlying biology, then the influence of genetic factors in the pathogenesis of lung has been underestimated; the cumulative probability of lung cancer at age 80 for a noncarrier of the gene, at the average level of tobacco consumption, is close to zero, implying that virtually all lung cancer occurs among gene carriers. Identification of this putative genetic factor has profound implications for the detection and prevention of lung cancer.

Relation of serum lipoprotein lipids and apolipoproteins to obesity in children: the Bogalusa Heart Study

BACKGROUND

The relationship of serum lipoprotein lipids and apolipoproteins to obesity was studied in a biracial sample of 2,816 children of ages 5-17 in Bogalusa, Louisiana.

METHODS

Two measures of obesity were used: fatness (subscapular skinfold thickness) and fat centrality (the ratio of subscapular to triceps skinfold thickness). Plasma insulin and glucose were included as metabolic markers related to obesity.

RESULTS

The obesity associations were relatively strong with insulin (rs = 0.29, P less than 0.001, skinfold; rs = 0.15, P less than 0.001, skinfold ratio) and triglycerides (rs = 0.25, P less than 0.001, skinfold; rs = 0.19, P less than 0.001, skinfold ratio). The relationships of serum low-density lipoprotein cholesterol (LDL-C) (rs = 0.17, P less than 0.001, skinfold; rs = 0.13, P less than 0.001, skinfold ratio) and apolipoprotein (apo) B (rs = 0.16, P less than 0.001, skinfold; rs = 0.13, P less than 0.001, skinfold ratio) with the obesity measures were of lesser magnitude, but persisted after adjustment for insulin and triglycerides. The inverse association of obesity to serum high-density lipoprotein cholesterol (HDL-C) (rs = -0.13, P less than 0.001, both skinfold and skinfold ratio) and apo A-I (rs = -0.04, P = 0.03, skinfold; rs = -0.05, P = 0.004, skinfold ratio) was significant only before adjustment for insulin and serum triglycerides. Multiple linear regression of obesity measures showed that, like insulin, serum triglycerides had consistently higher standardized coefficients than LDL-C, HDL-C, apo B, and apo A-I. Apo A-I and apo B added only a small amount (less than 2%) of information to the relationship of serum lipoproteins with obesity measures.

CONCLUSION

These results indicate that serum very-low-density lipoprotein (VLDL) levels are directly and independently related to obesity. The well-known inverse association between obesity and serum HDL-C is not independent, but secondary to the elevated VLDL or triglyceride levels associated with obesity. While associations of obesity and lipoprotein cholesterol are found, far fewer occur with apolipoproteins, especially Apo A-I. Interesting race and sex differences in the relationship of obesity to serum lipoproteins and apoproteins are noted, being greater among white children and more consistent in white males.

Lung cancer histologic type and family history of cancer

The authors studied 300 patients with pathologically confirmed cancer of the trachea, bronchus, or lung in a 16-parish (county) area of southern Louisiana. Squamous-cell carcinoma was observed most frequently among these patients (39.3%), with nearly equal numbers of adenocarcinoma (25.0%) and small cell varieties (25.5%). Patients with large cell cancer, the least frequent type (10.3%), were 4.6 years younger on average than those with small cell (P less than 0.05) or squamous cell (P less than 0.05) neoplasias. Squamous cell neoplasia was more frequent among men (45.5%) than women (22.0%) (P less than 0.05). To assess whether family history differed according to the histologic cell type of the index family member, 248 patients were interviewed with regard to a family history of neoplasia. Those with small cell cancer had the highest family-size adjusted mean number of lung cancers per family (0.28). This was 2.2 times greater than the mean number of affected persons among relatives of patients with adenocarcinoma and 1.5 times greater than the mean for the families of patients with large or squamous cell types. However, none of these differences was statistically significant. Similar results were obtained when the total number of cancers at all sites was tabulated. Probands with small cell neoplasia were again most likely to have a positive family history, but the differences between histologic types were small. Although these data suggest an association, a larger study sample is required to determine conclusively whether or not a family history of lung cancer differs according to histologic type.

Effect of cohort differences in smoking prevalence on models of lung cancer susceptibility

Data on 337 lung cancer families were analyzed to determine if known cohort differences in parental cigarette consumption influence parameters from a segregation analysis. Previous results suggested that, after allowing for an individual's pack-years of tobacco exposure, Mendelian codominant inheritance of an allele that produced an earlier age of onset provided a good fit to the data. In the present study, the data were split into two groups of families: probands age 60 and over (born before WWI) and probands younger than age 60. This partition of the data by age of the proband was done to separate families in which there were parents who were less likely to smoke from those with parents more likely to smoke--predicated on the known increase of smoking prevalence after World War I. For the younger proband families (those with parents more likely to smoke), only Mendelian codominant inheritance adequately fit the data. The hypotheses of no major type, environmental transmission, and Mendelian dominant or recessive inheritance were rejected. In contrast to our earlier findings, the estimate of population susceptibility increased from 28% in the total data to 60% in this subset. In the older proband families (those with parents less likely to smoke), the no major type and environmental hypotheses were rejected; further, none of the Mendelian models could be distinguished. Our results demonstrate that cohort differences, probably in exposure to tobacco, can confound parameters of a segregation analysis, and suggest that the genetic component of lung cancer may be greater than previously estimated. It further suggests that susceptibility to lung cancer occurs as a function of susceptibility to the effects of tobacco smoking.

Can dietary intake patterns account for the familial aggregation of disease? Evidence from adult siblings living apart

The familial aggregation of certain chronic diseases is well documented [Perkins, 1986; King et al., 1984; Anderson, 1982]. Dietary data on adult brothers living apart were used to examine whether familial clustering of disease could be explained by nature or nutriture. Intakes of nutrients were strikingly more similar among siblings than expected: when correlations were adjusted for country of residence, 21 of 25 (84%) were statistically significant. Thus, dietary patterns among adult siblings are more alike than could be predicted by their sharing a common culture, as alike as has been described for monozygotic twins, and as alike as described for familial correlations of serum cholesterol. Incorporation of dietary measures in co-twin studies or studies of siblings can improve the estimates of the true genetic effect on disease pathogenesis.

Association of incident lung cancer with family history of female reproductive cancers: the Iowa Women's Health Study

A number of studies have documented the familial aggregation of lung cancer; there is at least one report that female reproductive cancers are also increased in these families. To determine if the risk exists for all reproductive cancer sites, we conducted a nested case-control study of lung cancer incidence in a cohort of 41,837 women ages 55-69 years. Women were recruited by mail and asked to provide information on education, occupation, smoking habits, physical activity, and family history of specific cancer sites among female relatives. Four year follow-up for cancer incidence was conducted using a state-wide tumor registry. Compared to random controls (n = 1900), cases (n = 152) were more likely to have reported at baseline a sister affected with cancer of the uterus [crude odds ratio (OR) = 3.4, 95% Cl = 1.7-7.0, P less than 0.01], cervix (OR = 3.2, 95% Cl 1.2-8.6, P less than 0.05), or cancer at any site (OR = 1.6, 95% Cl 1.1-2.4, P less than 0.05). A family history of an affected mother with a female reproductive cancer was also more common among the cases, but not statistically significant. Cases were less educated, more likely to work in a technical/industrial setting, less physically active, more likely to smoke, and to smoke for a longer period of time than the controls (all P less than 0.01). These differences reduced the magnitude of the family history risk indicators; only the combined category of reproductive cancer at all sites among sisters remained statistically significant. Additional family studies should be done to assess environmental factors in the relatives of the cases and controls to disentangle the influence of shared genes and shared environmental factors in these associations.

Evidence for mendelian inheritance in the pathogenesis of lung cancer

Segregation analyses that allowed for variable age of onset of lung cancer and smoking history were performed on 337 families, each ascertained through a lung cancer proband. Results indicated compatibility of the data with mendelian codominant inheritance of a rare major autosomal gene that produces earlier age of onset of the cancer. Segregation at this putative locus could account for 69% and 47% of the cumulative incidence of lung cancer in individuals up to ages 50 and 60, respectively. The gene was involved in only 22% of all lung cancers in persons up to age 70, a reflection of an increasing proportion of noncarriers succumbing to the effects of long-term exposure to tobacco.

Stepwise oligogenic segregation and linkage analysis illustrated with dopamine-beta-hydroxylase activity

A stepwise oligogenic method is developed that can be used to adjust the phenotype of a quantitative trait for the effects of a previously identified single-locus component. This method assumes that a single-locus component can be adequately identified through the use of segregation and/or linkage analysis under a 1-locus model and that the variation due to that locus can be removed from the phenotype leaving a residual that can be parameterized in terms of an additional single-locus component. Segregation and/or linkage analysis can then be used in an attempt to identify an additional single-locus component in the residual phenotype. This stepwise process can be repeated until no further single-locus effects are identified. The method is illustrated using family data on the specific activity of dopamine-beta-hydroxylase (DBH), which a number of studies have suggested may be due either to the combined effects of single-locus and multifactorial components or to the combined effects of 2 loci.

Rapid post-disaster community needs assessment: a case study of guatemala after the civil strife of 1979-1983

Disaster assessment and assistance activities are often hampered by organizational problems which diminish the effect of these efforts on the people they are intended to help. Inefficient targeting of relief causes reduced coverage of needy populations and inflated costs. In order to ensure that the most needy populations receive appropriate types and amounts of assistance, collection of assessment data must be at the lowest possible administrative unit. In addition, it is essential that disaster assessment be a dynamic process in which follow-up activities monitor possible changes in vulnerability and need in the targeted populations. This paper presents a method for post-disaster rapid needs assessment at the community level. Indigenous numerators are used to collect data with which communities are served and ranked according to need. Qualitative and quantitative methods are incorporated to provide rapidly a centralised database with which relief organizations can accurately target specific communities for assistance.

Familial risk of cancer among randomly selected cancer probands

Several investigators have reported that relatives of lung cancer probands have a greater-than-normal likelihood for developing some form of cancer. To evaluate whether this familial risk is general for probands with cancer at any site or limited to lung cancer probands, we did a case-control study in which probands having cancer affecting any body site were identified and their pedigree data were tabulated. Telephone interviews and a mailed questionnaire were used to obtain cancer histories and environmental exposures on the families of 41 lung cancer probands, 105 probands with cancer other than lung, and 127 spouse families. Cumulative tobacco exposure (P less than .05), occupational hazards (P less than .005), and age of the family relatives (P less than .0001) were found to be statistically significant predictors of cancer risk. With consideration given for these variables, we determined that siblings of lung cancer probands were at slightly greater risk of cancer of any kind (odds ratio [OR] = 1.43, P = .06) than siblings in the control group. Much of the elevated risk was attributable to an excess of lung cancer (OR = 2.49, P = .06). Siblings of non-lung/non-breast cancer probands were also determined to be at increased risk of lung cancer as well (OR = 1.61, P = .06). For parents, the risk was lower, although parental information may have been underreported.

Increased familial risk for non-lung cancer among relatives of lung cancer patients

Reports of two or more anatomically distinct cancer types clustering in families suggest the possible existence of a susceptibility-to-cancer gene. To determine whether a genetic predisposition accounts for such familial aggregation, a retrospective case-control study was conducted in 1976-1979 of 337 southern Louisiana families in each of which a deceased lung cancer patient was used as the proband. A comparison of first-degree relatives of proband families with spouse (control) families revealed a significantly greater overall risk of cancer (odds ratio (OR) = 2.0, p less than 0.0001) in the proband group. Using logistic regression techniques to control for the confounding effects of age, sex, cigarette smoking, and occupational/industrial exposures, relatives of lung cancer probands maintained an increased risk of non-lung cancer (p less than 0.05). The crude odds ratio of a proband family having one family member with cancer was 1.67 compared with control families. Proband families were 2.16 times more likely to have two other family members with cancer. For three cancers and four or more cancers, the risk increased to 3.66 and 5.04, respectively. Each risk estimate was significant at the 0.01 level. The most striking differences in cancer prevalence between proband and control families were noted for cancer of the nasal cavity/sinus, mid-ear, and larynx (OR = 4.6); trachea, bronchus and lung (OR = 3.0); skin (OR = 2.8); and uterus, placenta, ovary, and other female organs (OR = 2.1). These data support the hypothesis of a genetic susceptibility to cancer in families with lung cancer.

Description of a large pedigree with an adverse lipoprotein cholesterol phenotype: the Bogalusa Heart Study

A large pedigree (N = 356) with a high prevalence of heart disease and associated adverse lipoprotein phenotype was studied. The adverse lipoprotein phenotype is characterized by both low levels of high-density-lipoprotein cholesterol (HDL-C) alone (16.3%) and in combination with other adverse lipoprotein levels (12.8%). In all, 44.2% of all pedigree members had at least one adverse lipoprotein level. Analysis of mating types showed that all lipids and lipoproteins possess familial clustering with 25-36% of offspring above median levels when both parents had levels below the median, while 67-83% had levels above the median when both parents had levels above the median. Using adjusted lipid and lipoprotein levels, a statistically significant linear trend was found between the degree of relationship to pedigree members with heart disease, and both the low-density-lipoprotein cholesterol/high-density-lipoprotein cholesterol (LDL-C/HDL-C) ratio (P less than .05), and the very-low-density-lipoprotein cholesterol (VLDL-C; P less than .01) level. A similar analysis using the prevalence of adverse lipoprotein levels as the dependent variable and degree of relationship to heart diseased pedigree numbers as the independent variable showed significant (P less than .05) relationships with VLDL-C and the LDL-C/HDL-C ratio. Further genetic analyses of this pedigree may reveal genetic mechanisms responsible for the familiality of lipoprotein levels in this pedigree.