An epidemiological study on marital status and cancer incidence

Is psychedelic use associated with cancer?: Interrogating a half-century-old claim using contemporary population-level data

BACKGROUND

In 1967, concerns about the carcinogenic potential of psychedelics arose after a study reported chromosomal damage in human leukocytes following in vitro lysergic acid (LSD) exposure. Worries were further heightened by subsequent reports of leukemia and other cancers in LSD users. Additional investigations of psychedelics' effects on chromosomes were published over the next decade, with the majority suggesting these concerns were unfounded. However, the relationship between psychedelics and cancer has been explored only minimally from an epidemiological perspective.

AIMS

To determine whether associations exist between psychedelic use and either lifetime cancer or hematologic cancer diagnoses.

METHODS

We analyzed data from adult participants in the 2015-2019 administrations of the National Survey on Drug Use and Health for associations between lifetime use of psychedelics and lifetime diagnosis of either any cancer or hematologic cancer.

RESULTS

We identified no associations between lifetime psychedelic use and either lifetime cancer diagnosis or hematologic cancer diagnosis. Sub-analyses of lifetime lysergamide, phenethylamine, and tryptamine use also revealed no associations with lifetime cancer or hematologic cancer diagnosis.

CONCLUSIONS

While laboratory studies and case reports from the 1960s and 1970s generated concerns about psychedelics' carcinogenic potential, this analysis of recent epidemiological data does not support an association between psychedelic use and development of cancer in general or hematologic cancer. Important study limitations to consider include a lack of information about psychedelic dosage, number of lifetime psychedelic exposures, and the temporal relationship between psychedelic use and cancer diagnosis.

The Effect of Dietary Methyl-Donor Intake and Other Lifestyle Factors on Cancer Patients in Hungary

BACKGROUND

Nutrition is essential to life and can have an indisputable influence on health and prevention of disease development including cancer. Methyl-donors are macronutrients that are important in achieving a healthy balance of metabolic processes. Their deficiency can lead to several symptoms and diseases-even to severe SARS-CoV-2 infection. We aimed to explore the potential protective effect of methyl-donor intake in breast, colorectal and pancreatic cancer by patient follow up.

METHODS

A food frequency questionnaire and a diet diary were used to evaluate methyl-donor intake and blood samples were taken to evaluate Il-6 and IL-8 cytokine levels as well as MTHFR (C677T) polymorphism in breast, colorectal and pancreatic cancer patients.

RESULTS

We found that levels around the recommended daily intake of B6 and B9 were effective in supporting the overall survival of breast and colorectal, and a relatively higher level of pancreatic adenocarcinoma, patients. The total intake of methyl-donors significantly and negatively correlated with smoking in pancreatic cancer, while folate as well as betaine intake significantly and positively correlated with IL-8 in colorectal cancer patients.

CONCLUSIONS

Our results suggest that the appropriate intake of methyl-donor can be an adjunct of conventional oncotherapy to improve quality of life. Whether methyl-donor intake supports cancer prevention and patient survival needs further confirmation in large patient cohorts.

Dynamic changes in marital status and survival in women with breast cancer: a population-based study

Marital status proved to be an independent prognostic factor for survival in patients with breast cancer. We therefore strove to explore the impact of dynamic changes in marital status on the prognosis of breast cancer patients. We selected patients meeting the eligibility criteria from the Surveillance, Epidemiology, and End Results cancer database. We then used multivariate Cox proportional hazard regression model to analyze the effect of dynamic changes in marital status on the prognosis of overall survival (OS) and breast cancer-specific special survival (BCSS). Compared with the patients in the Single–Single group and the divorced/separated/widowed–divorced/separated/widowed (DSW–DSW) group, patients in the Married–Married group were significantly associated with better BCSS (HR 1.13, 95% CI: 1.03–1.19, P < 0.001; HR 1.19, 95% CI: 1.14–1.25, P < 0.001, respectively) and OS (HR 1.25, 95% CI: 1.20–1.30, P < 0.001; HR 1.49, 95% CI: 1.45–1.54, P < 0.001, respectively). In contrast to the DSW–DSW group, the Single–Single group and the DSW–Married group showed similar BCSS (HR 0.98, 95% CI: 0.92–1.05, P = 0.660; HR 1.06, 95% CI: 0.97–1.15, P = 0.193, respectively) but better OS (HR 1.14, 95% CI: 1.09–1.19, P < 0.001; HR 1.32, 95% CI: 1.25–1.40, P < 0.001, respectively). Compared with the Single–Single group, the Single–Married group showed significantly better BCSS (HR 1.21, 95% CI: 1.07–1.36, P = 0.003) but no difference in OS (HR 1.08, 95% CI: 0.98–1.18, P = 0.102); In contrast to the Married–DSW group, the Married–Married group exhibited better BCSS (HR 1.11, 95% CI: 1.05–1.18, P < 0.001) and OS (HR 1.27, 95% CI: 1.22–1.32, P < 0.001). Our study demonstrated that, regardless of their previous marital status, married patients had a better prognosis than unmarried patients. Moreover, single patients obtained better survival outcomes than DSW patients. Therefore, it is necessary to proactively provide single and DSW individuals with appropriate social and psychological support that would benefit them.

Effects of marital status on breast cancer survival by age, race, and hormone receptor status: A population-based Study

Introduction

It remains unclear whether marital status could affect the breast cancer‐caused special survival (BCSS) of patients with breast cancer. Therefore, we sought to explore the influence of demographic and pathological factors on prognosis of patients with breast cancer.

Materials and methods

We selected patients meeting the eligibility criteria from the Surveillance, Epidemiology, and End Results (SEER) cancer registry program. We assessed the effect of marital status on overall survival (OS) and BCSS using Kaplan‐Meier curve and multivariate Cox proportional hazards regression.

Results

Compared with divorced/separated/widowed (DSW) patients, the married (AHR 0.7483, 95% CI: 0.729‐0.7682, P < 0.001) and single patients had better BCSS (AHR 0.9096, 95% CI: 0.8796‐0.9406, P < 0.001). Married patients kept better prognosis among all age subgroups, while the better BCSS of single patients occurred only in groups older than 35 years. As for race and hormone receptor status (HRs), the better BCSS of single patients was only observed in white race (AHR 0.881, 95% CI: 0.8457‐0.9177, P < 0.001) and patients with ER+/PR + status (AHR 0.8844, 95% CI: 0.8393‐0.932, P < 0.001).

Conclusion

Our findings demonstrated that married and single patients with breast cancer had better prognosis than their DSW counterparts. Age, race, and HRs could affect the correlation between marital status and BCSS.

Influence of marital status on small intestinal adenocarcinoma survival: an analysis of the Surveillance, Epidemiology, and End Results (SEER) database

Aim

No studies have been published on the relationship between marital status and outcomes in small intestinal cancers. The present study was conducted to explore the influence of marital status on small intestinal adenocarcinoma survival based on the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Data from eligible patients diagnosed with small intestinal adenocarcinoma between 2004 and 2015 were extracted from the SEER database. Patients were categorized into married group (including common law) and unmarried group (including single [never married], widowed, divorced, separated, and unmarried or domestic partner). The primary endpoints were 5-year overall survival (OS) and 5-year cancer-specific survival (CSS). A survival curve was generated by the Kaplan–Meier method, and the survival rate differences were estimated by a log-rank test. A multivariate Cox proportional hazard model was used to evaluate the independent risk factors for survival.

Results

A total of 6,747 small intestinal adenocarcinoma patients were enrolled, including 3,862 married and 2,885 unmarried patients. The 5-year OS and 5-year CSS were significantly greater in married patients than in unmarried patients (27.1 vs 18.8% for OS and 45.7 vs 39.3% for CSS, both P<0.001). After adjusting for age, insurance status, tumor primary site, TNM stage, tumor grade, tumor histology, and surgery, the multivariate Cox proportional hazards model showed that marriage is an independent protective factor for OS (HR =0.789, 95% CI: 0.745–0.836, P<0.001) and CSS (HR =0.794, 95% CI: 0.736–0.857, P<0.001).

Conclusion

Married small intestinal adenocarcinoma patients have better OS and CSS than unmarried patients. Psychological and economic supports from the spouses of married patients may contribute to improvements in survival.

Nomogram for predicting survival in triple-negative breast cancer patients with histology of infiltrating duct carcinoma: a population-based study

Triple-negative breast cancer (TNBC) represents around 15%-20% of newly diagnosed breast cancer and is more aggressive than other breast cancer sub-types. Infiltrating duct carcinoma (IDC) is the most common type of TNBC. Nomogram is a valuable tool for prognosis prediction by integrating different biological and clinical variables. The purpose of current study was to evaluate the prognostic value of clinical factors of TNBC patients with IDC histology type and construct nomograms for their outcome prediction. The cohort was selected from Surveillance, Epidemiology, and End Results (SEER) program. Univariate and multivariate analyses were performed using Cox proportional hazards regression model to evaluate the prognostic value of involved variables. Nomogram was constructed from the multivariate logistic regression model to combine all the prognostic factors to predict the 1-year and 3-year prognosis of TNBC patients with histology of IDC. Internal validation of nomogram was tested by discrimination and calibration. We identified 14,538 patients with the median and max survival time was 28 months and 59 months, respectively. There were 1,592 deaths, accounting for 10.9% of the cohort. Multivariate analyses showed that grade, tumor stage, tumor size, regional nodes positive, marital status, experience of radiotherapy or chemotherapy were independent prognostic factors of IDC of TNBC. Eleven variables were combined to construct 1-year and 3-year nomograms. It was revealed that the C-index of the nomograms was 0.763 and the calibration curves showed good agreement between the nomogram prediction and actual observation. Current study was the first one to construct nomograms of TNBC patients with IDC histology, which could help physicians to identify patients at high risk for intensive treatment or follow-up.

The influence of marital status and race/ethnicity on risk of mortality for triple negative breast cancer

Purpose

To assess the effect of marital status and the role of race/ethnicity on breast cancer specific mortality in women with triple negative breast cancer (TNBC).

Methods

The study utilized the California Cancer Registry to identify 22,812 cases of first primary female TNBC. Unadjusted Kaplan-Meier breast cancer specific survival was computed. Cox Proportional Hazards modeling was used to compute the adjusted risk of breast cancer specific mortality for women who were single, separated, divorced, and widowed when compared with women who were married. Models were adjusted for age, stage, tumor grade, SES, and treatment with surgery, chemotherapy, hormone therapy, and radiation therapy. Hazard ratios (HR) and 95% confidence intervals (CI) were reported.

Results

Separated (HR: 1.45; 95% CI: 1.14–2.01) and widowed (HR: 1.39; 95%CI: 1.23–1.57) white women had a higher risk of mortality than white married women whereas single and divorced white women had the same risk of mortality. For Asian/Pacific Islanders (API), only single (HR: 1.55; 95% CI: 1.17–2.06) and divorced (HR:1.81; 95% CI:1.26–2.60) women had a higher risk of mortality than married women. Marital status had no influence on risk of mortality for either black or Hispanic women.

Conclusions

The risk of mortality associated with marital status is dependent on race/ethnicity. Only white and API women with TNBC have a marital advantage.

Imidazoline and Its Derivatives : An Overview

Imidazoline derivatives, a class of novel cationic surfactants are presently gaining importance in global detergent market due to their wide range of applications. These are extensively used mainly as fabric softeners and antistatic agents. The present communication reviews the preparation, reaction scheme, reaction rates and properties of imidazoline derivatives. The analysis of imidazoline derivatives, its mode of action, their biodegradation and various applications have also been discussed.

Socioeconomic factors and risk of esophageal adenocarcinoma: a nationwide Swedish case-control study

BACKGROUND

The increase in esophageal adenocarcinoma incidence in developed countries remains unexplained. Although low socioeconomic status (SES) is linked to an increased risk of esophageal squamous cell carcinoma (SCC), the relation with adenocarcinoma is uncertain.

METHODS

We addressed the importance of various socioeconomic factors in a Swedish population-based case-control study, where 189 and 262 cases of esophageal adenocarcinoma and the gastric cardia, respectively, 167 cases of esophageal SCC, and 820 control participants underwent personal interviews. Our classification of SES was derived from occupational histories. Relative risks were estimated by odds ratios with 95% confidence intervals (95% CI), derived from conditional logistic regression, in crude and adjusted models.

RESULTS

The risk of both esophageal adenocarcinoma and SCC increased with decreasing SES; unskilled workers had 3.7-fold (95% CI, 1.7-7.7) and 2.1-fold (95% CI, 1.0-4.7) increased risks, respectively, compared with age- and sex-comparable professionals. Adjustment for reflux symptoms, body mass, and tobacco smoking attenuated the excess risk for esophageal adenocarcinoma, whereas adjustment for Helicobacter pylori infection in a subset of the interviewed participants did not influence the results. Life without a partner was associated with a >2-fold increased risk of both histologic types of esophageal cancer, associations that remained even after multiple adjustments.

CONCLUSIONS

Esophageal adenocarcinoma and SCC are both linked to low SES and a life without a partner. These associations are only partly explained by established risk factors.

Why do Black Americans have a higher risk of pancreatic cancer than White Americans?

BACKGROUND

For several decades, the incidence of pancreatic cancer has been 50% to 90% higher among blacks than among whites in the United States. The purpose of this study was to identify risk factors that may contribute to this racial disparity.

METHODS

We conducted a population-based case-control study of pancreatic cancer diagnosed in Atlanta (GA), Detroit (MI), and 10 New Jersey counties from August 1986 through April 1989. In-person interviews were exclusively with subjects (526 cases and 2153 population controls), rather than with next of kin.

RESULTS

The determinants of the higher incidence of pancreatic cancer among blacks than among whites differed by sex. Among men, established risk factors (, cigarette smoking, long-term diabetes mellitus, family history of pancreatic cancer) account for 46% of the disease in blacks and 37% in whites, potentially explaining all but 6% of the excess risk among blacks. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption (>7 drinks per week) and elevated body mass index (above the first quartile). When these less accepted risk factors were combined with the established risk factors, 88% of the disease in black women and 47% in white women were explained, potentially accounting for all of the excess risk among blacks in our female study population.

CONCLUSIONS

Among men, the established risk factors (mainly cigarette smoking and diabetes mellitus) explain almost the entire black/white disparity in incidence. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption and elevated body mass index. In the absence of these factors, pancreatic cancer incidence rates among blacks probably would not exceed those among whites of either sex.

Excess incidence of squamous cell esophageal cancer among US Black men: role of social class and other risk factors

Data from a population-based case-control study were used to evaluate the relation between social class factors and squamous cell esophageal cancer and the extent to which alcohol, tobacco, diet, and low income contribute to the higher incidence among Black men than among White men in the United States. A total of 347 male cases (119 White, 228 Black) and 1,354 male controls (743 White, 611 Black) were selected from three US geographic areas (Atlanta, Georgia, Detroit, Michigan, and New Jersey). Cases were residents of the study areas aged 30-79 years who had been diagnosed with histologically confirmed esophageal cancer between 1986 and 1989. The adjusted odds ratios for subjects with annual incomes less than $10,000 versus incomes of $25,000 or more were 4.3 (95% confidence interval: 2.1, 8.7) for Whites and 8.0 (95% confidence interval: 4.3, 15.0) for Blacks. The combination of all four major risk factors-low income, moderate/heavy alcohol intake, tobacco use, and infrequent consumption of raw fruits and vegetables-accounted for almost all of the squamous cell esophageal cancers in Whites (98%) and Blacks (99%) and for 99% of the excess incidence among Black men. Thus, lifestyle modifications, especially a lowered intake of alcoholic beverages, would markedly decrease the incidence of squamous cell esophageal cancer in both racial groups and would narrow the racial disparity in risk. Further studies on the determinants of social class may help to identify a new set of exposures for this tumor that are amenable to intervention.

Occupation and small bowel adenocarcinoma: a European case-control study

OBJECTIVES

Because of the rarity of small bowel adenocarcinoma (SBA), little is known about the aetiology of this disease. This study aimed to identify occupational clustering of cases SBA as a systematic approach to new hypotheses on the aetiology of this disease.

METHODS

A European multicentre case-control study was conducted in 1995-7, inclusive. Incident cases aged 35-69 years with SBA (n=168) were recruited before acceptance by a pathologist. Altogether 107 cases and 3915 controls were accepted, of which 79 cases, 579 colon cancer controls, and 2070 population controls were interviewed.

RESULTS

The strongest industrial risk factors for SBA taking account of 10 years' exposure lag were dry cleaning, manufacture of workwear, mixed farming (women), and manufacture of motor vehicles (men). A significantly increased risk of SBA (odds ratio (OR) and 95% confidence interval (95% CI)) was found among men employed as building caretakers, OR 6.7 (1.7 to 26.0) and women employed as housekeepers, OR 2.2 (1.1 to 4.9); general farm labourers, OR 4.7 (1.8 to 12.2); dockers, OR 2.9 (1.0 to 8.2); dry cleaners or launderers, OR 4.1 (1.2 to 13.6); and textile workers (sewers or embroiderers), OR 2.6 (1.0 to 6.8). For the last four groups, together with welders OR 2.7 (1.1 to 6.6) (men) an exposure-response pattern was found when calculating the ORs for jobs held 1-5 years and >5 years, with never having held the job as reference. The ORs (95% CIs) for 1-5 years and >5 years were 4.3 (0.4 to 44.0) and 3.5 (0.9 to 13.7), 3.0 (0.3 to 26.2) and 4.3 (0.9 to 21.2), 4.6 (0.4 to 48.1) and 11.0 (2.0 to 60.4), 1.3 (0.2 to 11.0) and 5.8 (2.0 to 17.2), and 2.8 (0.3 to 23.8) and 4.6 (1.3 to 16.6), respectively, for each of these occupations. Among welders, people performing semiautomatic arc welding (MIG/MAG) were identified as a high risk group (OR 5.0 (1.3 to 19.6)).

CONCLUSIONS

This explorative study suggests an increased occurrence of SBA in certain occupations, which needs further evaluation.

Assessing the relationship between marital status and cancer incidence: methodologic considerations

In registry-based population studies on marital status in relation to cancer, incidence rates sometimes have been calculated using marital status-specific populations that have been estimated by interpolation and extrapolation from census data as a denominator. Alternatively, other cancers from the same registry have been used to estimate the proportion of the population in each marital-status category in the calculation of the relative risk (RR) of a given cancer. Using cancer registry data from four United States populations for the years 1979-87, we compared the relative incidence estimated using each of the two methods. For selected cancers diagnosed during 1979-81, the age-adjusted risks of never-married Black persons were 1.5 to 2.2 times those of married persons when the population size was estimated from census data. The corresponding RRs were 0.7 to 1.1 when the 'control' cancers were used. Among Whites, the differences between the two methods were about 20 to 30 percent. For both races, the difference between the methods was greater still for the years for which we relied on extrapolation to estimate the population (1981-87). The differences between the risk estimates from the two methods may be related to underenumeration in the census, inconsistent definitions of marital status between cancer registries and the census, errors in the extrapolation of the population, and/or the possible association of the incidence of 'control' cancers with marital status. In the US, while each method has some potential for bias, we believe that the likelihood of bias is relatively greater using the census-based method.

Excess mortality among the unmarried: a case study of Japan

Recent research has demonstrated that mortality patterns by marital status in Japan are different from corresponding patterns in other industrialized countries. Most notably, the magnitude of the excess mortality experienced by single Japanese has been staggering. For example, estimates of life expectancy for the mid-1900s indicate that single Japanese men and women had life expectancies between 15 and 20 years lower than their married counterparts. In addition, gender differences among single Japanese have been smaller than elsewhere, while those among divorced persons have been unanticipatedly large; and, the excess mortality of the Japanese single population has been decreasing over the past few decades in contrast to generally increasing differentials elsewhere. In this paper, we use a variety of data sources to explore several explanations for these unique mortality patterns in Japan. Undeniably, the traditional Japanese system of arranged marriages makes the process of selecting a spouse a significant factor. Evidence from anthropological studies and attitudinal surveys indicates that marriage is likely to have been and probably continues to be more selective with regard to underlying health characteristics in Japan than in other industrialized countries. However, causal explanations related to the importance of marriage and the family in Japanese society may also be responsible for the relatively high mortality experienced by singles and by divorced men.