The risk of subsequent primary malignant disease after cancers of the colon and rectum: a nationwide cohort study

Article Abstract:

Metachronous cancers are those which occur at different times in the same patient. They are thought to share a common etiology, and may provide clues to the causes of some forms of cancer. Colorectal cancer is a particularly common and serious form of cancer in Western nations, and the long-term survival has not improved in recent decades despite advances in chemotherapy. To obtain insights into the etiology of colorectal cancer, the occurrence of secondary cancers were reviewed in the histories of 61,769 patients with colorectal cancer listed in the Swedish Cancer Registry. Men with either colon or rectal cancer had a risk of developing a second cancer that was 1.3 times that expected (based on statistical calculation), while women with either colon cancer or rectal cancer had a relative risk of 1.4. The increased risk was greatest among younger patients, and decreased with age. A 30 percent increased risk of breast cancer was observed for both colon and rectal cancers, but was statistically significant only for colon cancer. A significant increase in endometrial cancer was also observed for both colon and rectal cancer. Some studies have indicated increased risk for cancer of the prostate, but the present study could only confirm that increase for the first year after the colorectal cancer, an effect which may be due to increased medical surveillance during this period. Cancer of the ovary was also found to occur more often among patients with colorectal cancer, but this finding is suspect. Most of the reported ovarian cancers were adenocarcinomas, which may reflect either an actual association or the misdiagnosis of a metastatic lesion. The question remains to be answered. The present study confirmed published reports of an association between kidney cancer and cancer of the colon, but not cancer of the rectum. However, it also revealed an association between bladder cancer and colon cancer, which is contrary to other reports and contrary to beliefs about the etiology of bladder cancer. Therefore, this result must be considered with caution. The association between colorectal cancer, particularly colon cancer, and secondary cancers appears to be well established, but the common etiologic factors involved remain elusive. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Risk factors, Colorectal cancer

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Nuclear DNA content and survival in medullary thyroid carcinoma

Article Abstract:

The DNA content of tumor cells from 211 patients with medullary thyroid carcinoma was measured to determine whether the chromosomal organization of the tumor can predict prognosis. The DNA content was measured using a DNA-specific stain on tissue sections in combination with image cytometry. Image cytometry, which involves the quantitative analysis of microscopic images, has advantages and disadvantages. It places greater demands on the judgment of the operator than do methods like flow cytometry. The operator, on the other hand, can limit the analysis to tumor cells and not include normal cells existing in the same section. Two different methods were used to evaluate the DNA measurements. One, called P90, determined how many cells in a sample had greater than the 90th percentile of DNA content. The other measure, called ploidy, determined whether the distribution of DNA content was best fit by a normal chromosome complement, i.e. diploid, or an aneuploid chromosome complement. It was found that the P90 value correlated with the chances of dying from medullary thyroid carcinoma. From a statistical standpoint, it is worth noting that some information is lost when a number like the P90 is used to classify patients. In other words, if one classifies the patients into two groups based on P90, for example those over versus those under 70 percent, some of the predictive value will be lost. This is probably the reason why P90 was statistically more reliable than ploidy in predicting survival, as ploidy is intrinsically a classification rather than a quantization. It should be clear, however, that classification is probably necessary for clinical usefulness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Measurement, Cytodiagnosis, Ploidy, Thyroid cancer

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Hormone replacement therapy and the risk for first hip fracture: a prospective, population-based cohort study

Article Abstract:

Hip fractures are a major health problem, particularly among women who have gone through menopause. Thinning of the bone structure (osteoporosis) occurs after menopause because bone cells die and are not replaced, and this, in turn, can lead to bone fracture, particularly of the neck (cervical) and upper portions of the leg bone (femur). A woman undergoes menopause either because her aging ovaries secrete less and less natural female hormones (estrogen), or because her ovaries have been surgically removed (oophorectomy). The latter is often called surgical menopause. Hormone replacement with potent estrogen, the less potent estriols, or a combination of estrogen and progestogen has been suggested as a preventive measure against hip fracture. This prospective study involved 23,246 women 35 years of age and older who had received hormone replacement therapy from April 1977 to March 1980, with follow-up through 1983. The greatest protection against hip fracture was noted in women who received potent estrogens and who were under age 60 when they entered this study, who also had the highest proportion of treatments with a combination of potent estrogen and progestogen. Those treated with less potent estrogens received no protective effect from them. Thus, treatment with potent estrogens, possibly in combination with progestogens, reduces the risk of hip fracture within the first 10 years after the onset of menopause. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Prevention, Drug therapy, Hormone therapy, Menopause, Osteoporosis, Estrogen, Estrogens, Hip joint, Hip fractures

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