Epidemiologic studies are conducted to identify life-style and environmental risk factors for cancer and to investigate their interrelationships with genetic determinants of these diseases. Case-control studies of cancers of the bladder, prostate, pancreas, esophagus, stomach, lung, brain, and head and neck, as well as non-Hodgkins lymphoma and multiple myeloma, are in progress. A large case-control study of bladder cancer is underway in Spain to identify occupational bladder carcinogens and to evaluate non-occupational exposures including cigarette smoking (black vs. blond tobacco), phenacetin-containing analgesics, dietary factors, and urination frequency and pH. Genetic susceptibility markers also will be evaluated in relation to bladder cancer risk, as well as their interaction with epidemiologic risk factors. A large multi-center investigation is examining risk factors for malignant neoplasms among subjects being screened for cancers of the prostate, lung, colon, rectum, and ovaries. A feasibility study for a large case-control study of bladder cancer in New England is underway to determine the reasons for the persistently elevated bladder cancer mortality and incidence in the northeastern United States. In a case-control study of pancreatic cancer among blacks and whites, risk of developing pancreatic cancer was associated with pre-existing diabetes mellitus and cholecystectomy. These risk factors have been difficult to detect because they are also potential consequences of pancreatic cancer. Elevated pancreatic cancer risk was also associated with having a first-degree relative with cancers of the pancreas, colon, ovary, endometrium and breast, a pattern consistent with the familial predisposition reported for pancreatic cancer and with the array of tumors associated with hereditary non-polyposis colon cancer. An increased pancreatic cancer risk, as well as an increased risk of cancer of the ampulla Vater, was also associated with a cholecystectomy in a nationwide population-based cohort study in Denmark. Findings from a case-control study of prostate cancer among black and white Americans suggested that dietary fat from animal sources was related to prostate cancer among blacks and to advanced prostate cancer among both blacks and whites. Men who reported a history of gonorrhea or syphilis also experienced elevated prostatic cancer risk, but the patterns of risk were similar for blacks and whites. In a prostate cancer case-control study nested within a cohort of Iowa men, risk was associated with a family history of prostate cancer in a father and/or brother, as well as with a family history of breast and/or ovarian cancer in a mother or sister. A descriptive study of the rising incidence of renal cell cancer in the United States indicated that the increasing detection of presymptomatic tumors by imaging procedures, such as ultrasonography, computed tomography, and magnetic resonance imaging, does not fully explain the upward incidence trends of renal cell carcinoma. In a case-control study of stomach cancer in Warsaw, Poland, cigarette smoking was associated with elevated risk, which was estimated to account for approximately 20% of stomach cancers diagnosed among Warsaw residents during the mid-1990s. Stomach cancer risk was also associated with a history of stomach cancer in a first-degree relative. - Human Subjects & Human Tissues, Fluids, Cells, etc.
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