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Wang F, Tan F, Wu Z, Cao W, Yang Z, Yu Y, Xu Y, Qin C, Zhao L, Ren J, Li J, Chen W, Li N, He J. Lung cancer risk in non-smoking females with a familial history of cancer: a multi-center prospective cohort study in China. JOURNAL OF THE NATIONAL CANCER CENTER 2021. [DOI: 10.1016/j.jncc.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Capps BJ, van der Eijk Y. The tobacco industry, researchers, and ethical access to UK Biobank: using the public interest and public good. Am J Public Health 2014; 104:1833-9. [PMID: 25122018 DOI: 10.2105/ajph.2014.302138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We have asked whether the strategic purpose of the tobacco industry is something that a public resource, such as UK Biobank, should support. Tobacco industry health research has been known to work irreconcilably with the purposes of such institutions, which can be surmised as for the public good and defined to improve the provision, diagnosis, and treatment of illness and the promotion of health throughout society. We have isolated possible conflicts of interest that underlie vested research agendas of the tobacco industry and that may extend to tobacco industry-funded researchers. With respect to research, we find that the tobacco industry is entirely at odds with the purposes of public biobanking.
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Affiliation(s)
- Benjamin James Capps
- Benjamin James Capps and Yvette van der Eijk are with the Centre for Biomedical Ethics, Dean's Office, Yong Loo Lin School of Medicine, National University of Singapore
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Knox SS. From 'omics' to complex disease: a systems biology approach to gene-environment interactions in cancer. Cancer Cell Int 2010; 10:11. [PMID: 20420667 PMCID: PMC2876152 DOI: 10.1186/1475-2867-10-11] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 04/26/2010] [Indexed: 12/24/2022] Open
Abstract
Background Cancer is a complex disease that involves a sequence of gene-environment interactions in a progressive process that cannot occur without dysfunction in multiple systems, including DNA repair, apoptotic and immune functions. Epigenetic mechanisms, responding to numerous internal and external cues in a dynamic ongoing exchange, play a key role in mediating environmental influences on gene expression and tumor development. Hypothesis The hypothesis put forth in this paper addresses the limited success of treatment outcomes in clinical oncology. It states that improvement in treatment efficacy requires a new paradigm that focuses on reversing systemic dysfunction and tailoring treatments to specific stages in the process. It requires moving from a reductionist framework of seeking to destroy aberrant cells and pathways to a transdisciplinary systems biology approach aimed at reversing multiple levels of dysfunction. Conclusion Because there are many biological pathways and multiple epigenetic influences working simultaneously in the expression of cancer phenotypes, studying individual components in isolation does not allow an adequate understanding of phenotypic expression. A systems biology approach using new modeling techniques and nonlinear mathematics is needed to investigate gene-environment interactions and improve treatment efficacy. A broader array of study designs will also be required, including prospective molecular epidemiology, immune competent animal models and in vitro/in vivo translational research that more accurately reflects the complex process of tumor initiation and progression.
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Affiliation(s)
- Sarah S Knox
- Program in Clinical and Population Epigenetics, Dept, of Community Medicine West Virginia University School of Medicine, PO Box 9190, Health Science South Morgantown, WV 26506, USA.
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Rachtan J, Sokołowski A, Niepsuj S, Zemła B, Zwierko M. Familial lung cancer risk among women in Poland. Lung Cancer 2009; 65:138-43. [DOI: 10.1016/j.lungcan.2008.10.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 10/28/2008] [Indexed: 11/30/2022]
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Wu CC, Shete S, Amos CI, Strong LC. Joint effects of germ-line p53 mutation and sex on cancer risk in Li-Fraumeni syndrome. Cancer Res 2007; 66:8287-92. [PMID: 16912210 DOI: 10.1158/0008-5472.can-05-4247] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Germ-line p53 mutations have been identified in most families with Li-Fraumeni syndrome (LFS). For germ-line p53 mutation carriers, there is considerable variability with respect to age of cancer onset and tumor type, suggesting that additional genetic effects influence the clinical severity and tumor spectrum. To identify factors that might contribute to the observed heterogeneity in time to onset, we used segregation analysis to analyze the joint effects of germ-line p53 mutations and risk modifier(s) on cancer incidence. We studied 159 kindreds, ascertained through probands who had been diagnosed with childhood soft-tissue sarcoma before 16 years of age, survived >3 years after diagnosis, and treated at The University of Texas M.D. Anderson Cancer Center (Houston, TX) from 1944 to 1975. This unique cohort has been followed systematically for >20 years and has had germ-line p53 mutation testing in probands and extended family members. The analyses revealed that germ-line p53 mutations and sex had significant effects on cancer risk: men with p53 mutations had 151-fold higher odds of developing cancer than did those without mutations [95% confidence interval (95% CI), 60-380], and women with p53 mutations had 1,075-fold higher odds than did those without mutations (95% CI, 358-3,229) and 7.1-fold higher odds of having cancer than did men with mutations (95% CI, 2.5-20.3). These findings provide quantitative cancer risk assessments for LFS families.
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Affiliation(s)
- Chih-Chieh Wu
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
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Kollárová H, Janout V, Cizek L. Epidemiology of lung cancer. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2002; 146:103-14. [PMID: 12572908 DOI: 10.5507/bp.2002.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This review article presents lung cancer epidemiology, describing main epidemiologic characteristics including epidemiological situation in cancer incidence, mortality and survival in Europe in comparison with situation in the Czech Republic. Influence of environmental and life style risk factors like smoking, passive smoking, risk factors of work environment, ionizing radiation, air pollution, nutrition and genetic and hormonal factors are discussed.
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Affiliation(s)
- Helena Kollárová
- Department of Preventive Medicine, Faculty of Medicine, Palacký University, Hnevotinská 3, 77515 Olomouc
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Sellers TA, Weaver TW, Phillips B, Altmann M, Rich SS. Environmental factors can confound identification of a major gene effect: results from a segregation analysis of a simulated population of lung cancer families. Genet Epidemiol 2000; 15:251-62. [PMID: 9593112 DOI: 10.1002/(sici)1098-2272(1998)15:3<251::aid-gepi4>3.0.co;2-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Proper control of environmental factors can be crucial to the identification of genes that influence susceptibility to a complex trait, especially for a trait such as lung cancer, for which the environmental factor (smoking) accounts for a significant etiologic fraction of the disease. An earlier segregation analysis of 337 Louisiana families, which incorporated direct measure of tobacco consumption, provided evidence for autosomal codominant inheritance of a major gene that influenced age at onset of lung cancer. Subsequent analyses were performed in which the families were stratified into two subsets based on birth cohort of the proband; results suggested the presence of heterogeneity that were postulated to reflect the influence of cohort trends in tobacco consumption. To evaluate this hypothesis further, we simulated a population of three-generation pedigrees in which an autosomal dominant mode of susceptibility to lung cancer was transmitted, but tobacco use varied across generations corresponding to published trends in smoking. A total of 200,000 individuals in families of various sizes, ages, and cigarette smoking habits were simulated from 1900 to 1980. From this population, 324 families (2,405 individuals) with 380 cases of lung cancer were ascertained through 328 lung cancer probands. Complex segregation analysis was performed using the REGTL program of S.A.G.E. in which pack-years of tobacco exposure were incorporated directly into the likelihood calculations. Although the no major gene, environmental, and Mendelian recessive hypotheses were rejected, both dominant and codominant transmission provided a good fit to the data. Thus in a population of simulated families with autosomal dominant susceptibility to lung cancer, intergenerational differences in tobacco consumption led to the detection of autosomal codominant transmission as an acceptable hypothesis. These results underscore the potential danger of segregation analysis of complex traits in which exposure to known environmental influences may differ across generations.
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Affiliation(s)
- T A Sellers
- Division of Epidemiology, School of Public Health, Institute of Human Genetics, University of Minnesota, Minneapolis 55454-1015, USA
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Abstract
Lung cancer has been shown to aggregate in families of nonsmoking lung cancer cases with an earlier age at onset. The current study evaluates whether relatives of nonsmoking lung cancer cases are at increased risk of cancers at sites other than lung. Families were identified through 257 population-based, nonsmoking lung cancer cases and 277 population-based, nonsmoking controls residing in metropolitan Detroit. Data were collected for 2,252 relatives of cases and 2,408 relatives of controls. First-degree relatives of nonsmoking lung cancer cases were at 1.52-fold (95% CI, 1.02-2.27) increased risk of cancer of the digestive system after adjustment for each relative's age, race, sex, and smoking status. Relative risk estimates also were elevated, but not significantly, for tobacco-related cancers (RR = 1.39) and breast cancer (RR = 1.72). Among first-degree relatives of younger probands (age 40-59), risk was non-significantly increased 72% (95% CI 0.95-3.10) for all cancers combined and 3.14-fold for cancers of the digestive system (95% CI 0.76-12.9). Nonsmoking relatives of cases were at increased risk of all cancer sites combined (RR = 1.32; 95% CI 1.003-1.73), cancers other than lung (RR = 1.37; 95% CI 1.03-1.82), and digestive system cancers (RR = 2.01; 95% CI 1.20-3.37). These findings of moderate familial aggregation for cancers of the lung, digestive system, breast, and tobacco-related sites suggest that common susceptibility genes may act to increase risk for a variety of cancers in families.
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Affiliation(s)
- A G Schwartz
- Department of Human Genetics, MCP Hahnemann School of Medicine, Allegheny University of the Health Sciences, Pittsburgh, Pennsylvania, USA
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Abstract
Lung carcinogenesis in humans requires exposure to environmental agents, including the inhalation of tobacco smoke, radioactive compounds, asbestos, heavy metals, and petrochemicals. Tobacco smoking is the risk factor with the highest attributable lung cancer risk worldwide. This article discusses occupational carcinogen exposure and exposure from tobacco use, and the lung-cancer risk associated with these types of exposure.
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Affiliation(s)
- D C Christiani
- Department of Occupational Medicine and Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
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Abstract
Lung cancer risk is thus defined by the balance between metabolic activation and detoxification of xenobiotic compounds and by the efficiency of DNA repair. It is most likely that multiple susceptibility factors must be accounted for to represent the true dimensions of gene-environment interactions. The ability to identify smokers with the highest risks of developing cancer has substantial preventive implications. These subgroups could be targeted for the most intensive screening and smoking cessation interventions and could be enrolled into chemoprevention trials. Studying susceptibility to common cancers and widely prevalent exposures may provide further insights into the basic mechanisms of carcinogenesis. Issues that will need to be addressed in the very near future include risk communication to study subjects and the ethical, legal, and social consequences of such testing.
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Affiliation(s)
- M R Spitz
- Department of Epidemiology, University of Texas M. D. Anderson Cancer Center, Houston, USA
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Abstract
One in ten tobacco smokers develops bronchogenic carcinoma over a lifetime. The study of susceptibility of an individual and a population to lung cancer traditionally has been limited to the study of tobacco smoke dose and family history of cancer. New insights into lung carcinogenesis have made the study of molecular markers of risk possible in human populations in the emerging field of molecular epidemiology. This review summarizes data addressing the relationships of human lung cancer to polymorphisms of phase I procarcinogen-activating and phase II-deactivating enzymes and intermediate biomarkers of DNA mutation, such as DNA adducts, oncogene and tumor suppressor gene mutation, and polymorphisms. These parameters are reviewed as they relate to tobacco smoke exposure, procarcinogen metabolizing polymorphisms, and the presence of lung cancer. Problem areas in biomarker validation, such as cross-sectional data interpretation; tissue source, race, statistical power, and ethical implications are addressed.
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Affiliation(s)
- S D Spivack
- Laboratory of Human Toxicology and Molecular Epidemiology, New York State Department of Health, Albany, NY 12201-0509, USA
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Wu X, Dave BJ, Jiang H, Pathak S, Spitz MR. Lung carcinoma patients with a family history of cancer and lymphocyte primary chromosome 9 aberrations. Cancer 1997; 79:1527-32. [PMID: 9118034 DOI: 10.1002/(sici)1097-0142(19970415)79:8<1527::aid-cncr13>3.0.co;2-#] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Deletion of chromosome 9p has been reported in numerous tumor types. The authors demonstrated in an earlier study that spontaneous chromosome aberrations on chromosome 9 in peripheral blood lymphocytes (PBLs) were a significant risk predictor for lung carcinoma. METHODS The current study evaluated the relationship between self-reported family history of cancer and spontaneous chromosome aberrations in the PBLs of 97 previously untreated lung carcinoma patients. The authors' hypothesis was that individuals exhibiting specific chromosome aberrations might have inherited genetic instability and thus be more likely to report a family history of cancer. For each individual, a personal interview was conducted to construct a detailed family history, and 100 metaphases from PBLs were analyzed for spontaneous aberrations by G-banding. RESULTS The patients reported having 829 first-degree relatives, including 74 (8.9%) with cancer. A significantly elevated odds ratio (OR) of 2.7 was noted in smokers for having chromosome 9 aberrations and a first-degree relative with cancer. When the family history of cancer was dichotomized into lung carcinoma or other cancers, the OR associated with chromosomal aberrations was 8.5 for lung carcinoma but only 2.3 for other cancers. In addition to chromosome 9 aberrations, other spontaneous chromosome aberrations and family history of cancer were also evaluated, but no associations were found. There were no associations between age, gender, ethnicity, or smoking status and the chromosome 9 aberration profile. CONCLUSIONS The findings of this study suggest that chromosome 9 aberrations may be a marker of cancer susceptibility and may be associated with familial aggregation of cancer.
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Affiliation(s)
- X Wu
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Affiliation(s)
- T A Dragani
- Division of Experimental Oncology A, Istituto Nazionale Tumori, Milan, Italy
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Sellers TA, Chen PL, Potter JD, Bailey-Wilson JE, Rothschild H, Elston RC. Segregation analysis of smoking-associated malignancies: evidence for Mendelian inheritance. AMERICAN JOURNAL OF MEDICAL GENETICS 1994; 52:308-14. [PMID: 7810562 DOI: 10.1002/ajmg.1320520311] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Tobacco consumption is an established risk factor for cancer at a number of sites: oral cavity, esophagus, nasopharynx, lung, larynx, pancreas, bladder, kidney, and uterine cervix. These sites also demonstrate familial aggregation. To determine if evidence exists for a major gene controlling susceptibility to smoking-associated cancers, maximum likelihood segregation analyses were performed on 337 families (3,276 individuals) ascertained through a deceased lung cancer proband. Models were fitted that allowed for personal tobacco use and variable age of onset. The hypotheses of environmental transmission and no major gene were rejected (P < 0.005), but none of the Mendelian models could be distinguished. According to Akaike's Information Criterion, Mendelian dominant inheritance of an allele that produces cancer at an earlier age of onset provided the best fit to the data. The model suggests that 62% of the population are susceptible, and that the mean age-of-onset differs for men and women: at the mean level of tobacco exposure, female gene carriers are affected, on average, 24 years earlier than non-carriers (77 vs. 101), while in males the difference was 20 years (71 vs. 91). These findings extend our earlier observations on the genetic epidemiology of lung cancer and suggest that Mendelian factors may influence the risk of cancers that are known to be smoking associated.
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Affiliation(s)
- T A Sellers
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455-1015
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Abstract
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.
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Affiliation(s)
- T A Sellers
- Department of Biometry and Genetics, Louisiana State University Medical Center, New Orleans
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Sellers TA, Bailey-Wilson JE, Potter JD, Rich SS, Rothschild H, Elston RC. Effect of cohort differences in smoking prevalence on models of lung cancer susceptibility. Genet Epidemiol 1992; 9:261-71. [PMID: 1398045 DOI: 10.1002/gepi.1370090405] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
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.
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Affiliation(s)
- T A Sellers
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454
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Söderström M, Hovelius B, Prellner K. Children with recurrent respiratory tract infections tend to belong to families with health problems. ACTA PAEDIATRICA SCANDINAVICA 1991; 80:696-703. [PMID: 1867089 DOI: 10.1111/j.1651-2227.1991.tb11931.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Children (7-11 years of age) who had recurrent respiratory tract infections (RTI) treated with antibiotics as preschoolers (n = 41), and their families were compared with regard to medical and social factors to families with children of comparable age who had had no such infections as preschoolers, or only isolated episodes (controls; n = 29). All the children studied had attended day-care centres as preschoolers. The two groups of children did not differ with regard to socio-economic conditions or age at admission to day-care centres. There was a difference in the two groups with regard to signs noted at physical examination (p less than 0.05), eardrum changes being observed in 34% of the children with recurrent episodes of RTI as preschoolers and in none of the controls (p less than 0.001). Questionnaires answered by parents indicated diseases, particularly cardiovascular diseases, to be significantly more frequent in the families of the children with recurrent RTIs as preschoolers than in those of the controls (p less than 0.01). Parents of the controls were more often satisfied with their own health (p less than 0.05) and reported fewer symptoms of minor illness (p less than 0.05), as compared with parents of the children with recurrent RTIs as preschoolers. Thus, the results of the present study support the idea that children with recurrent bacterial RTIs as preschoolers tend to belong to families with health problems.
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Affiliation(s)
- M Söderström
- Department of Community Health Sciences, Dalby, Sweden
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Sellers TA, Potter JD, Folsom AR. Association of incident lung cancer with family history of female reproductive cancers: the Iowa Women's Health Study. Genet Epidemiol 1991; 8:199-208. [PMID: 1955154 DOI: 10.1002/gepi.1370080306] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
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.
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Affiliation(s)
- T A Sellers
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis
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