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  • Breast neoplasms  (1)
  • Cohort effects  (1)
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  • 1
    ISSN: 1573-7225
    Keywords: Breast neoplasms ; menopausal status ; second primary neoplasms ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: To evaluate predictors of contralateral breast cancer risk, we examined data from a nested case-control study of second primary cancers among a cohort of women in western Washington (United States) diagnosed with breast cancer during 1978 through 1990 and identified through a population-based cancer registry. Cases included all women in the cohort who subsequently developed contralateral breast cancer at least six months after the initial diagnosis, but prior to 1992 (n=234). Controls were sampled randomly from the cohort, matched to cases on age, stage, and year of initial breast cancer diagnosis. Information on potential risk factors for second primary cancer was obtained through medical record abstractions and physician questionnaires. Women who were postmenopausal due to a bilateral oophorectomy (i.e., a surgical menopause) at initial breast cancer diagnosis had a reduction in contralateral breast cancer risk compared with premenopausal women (matched odds ratio [mOR]=0.25, 95 percent confidence interval [CI]=0.09–0.68), whereas no reduction in risk was noted among postmenopausal women who had had a natural menopause (mOR=0.90, CI=0.39–2.09). Among postmenopausal women, there was a suggestion of a lower risk associated with relatively high parity (2+). A family history of breast cancer was associated with an increased risk (mOR=1.96, CI=1.22–5.15) and varied little by menopausal status. Having an initial tumor with a lobular component (c.f. a ductal histology) was not related strongly to risk (mOR=1.47, CI=0.79–2.74). The results of the present and earlier studies argue that we have limited ability to predict the occurrence of a contralateral breast tumor. Better predictors will be required before diagnostic and preventive interventions can be targeted to subgroups of patients with unilateral breast cancer.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Cancer causes & control 4 (1993), S. 93-100 
    ISSN: 1573-7225
    Keywords: Cohort effects ; incidence ; melanoma ; registries ; SEER ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: The incidence of malignant melanoma has been increasing steadily in the United States. The increase may be due to lifestyle changes in subsequent generations or birth cohorts. The nine population-based tumor registries in the Surveillance, Epidemiology, and End Results program (SEER) have been in existence for a sufficient time to begin to investigate cohort trends for the US population. Cases were the 18.787 Caucasians aged 20 to 84 years, who reported to SEER registries with a diagnosis of melanoma in 1974–86. Among men born between 1890 and 1919, each subsequent five-year birth cohort experienced 45 to 57 percent increases in age-adjusted melanoma incidence of the arm and trunk, and 14 to 20 percent increases were experienced across each site (arm, leg, head, and trunk) for the 1920–44 cohorts of men. Among women born between 1890 and 1919, 24 to 29 percent increases were seen for melanoma of the trunk, arms, and legs for each subsequent five-year birth-cohort, followed by six to 29 percent increases in the 1920–44 cohorts. Recent birth cohorts, 1945–64, have shown stabilizing rates, even after an attempt to adjust for the increasing tendency for diagnoses to be made in doctors' offices. Thus, the dramatic birth-cohort effects appear to have ended beginning with those born in 1945. However, melanoma rates will continue to rise until those born after 1945 represent the majority of the population. Furthermore, for the most recent cohorts, the trunk has become the most common site (per square meter of body surface) for men and the second most common site for women. This suggests that some lifestyle change has led to more damaging exposure (e.g., sunburns) of the trunk among recent cohorts than earlier cohorts.
    Type of Medium: Electronic Resource
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