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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A case-control study of the role of induced abortion and other factors on the subsequent occurrence of ectopic pregnancy was undertaken in 1986–1987 in Athens, Greece, where a similar study 20 years ago found a tenfold risk of ectopic pregnancy among women with one or more illegal induced abortions. Seventy women residents of Athens, consecutively admitted to the major state maternity hospital with a diagnosis of ectopic pregnancy, were individually matched with women with a newly diagnosed pregnancy of the same order as the ectopic index pregnancy. Two control women were found for each of 63 cases, but only one control for each of the remaining seven cases. All cases and controls were interviewed by the same qualified obstetrician. Statistical analysis was undertaken with stratification of individual matched triplets and pairs, as well as through conditional multiple regression procedures. The relative risk of recurrence of an ectopic pregnancy was 6.39 with 95% confidence interval (CI) 1.96–21.04. Miscarriages did not increase the risk of ectopic pregnancy. The relative risk for subsequent ectopic pregnancy among women with one or more induced abortion, compared to women without such abortions, was 1.87 (CI 0.84–4.16) controlling only for the matching factors, and 1.71 (CI 0.69–4.27) when marital status (a possible selection factor) was also accounted for in the conditional logistic regression. There was no evidence for increasing risk with increasing number of induced abortions. Past use of an intrauterine device (IUCD) was associated with a relative risk of 3.89 (0.72–21.02); the relative risk increased with the duration of use of the IUCD. Tobacco smoking significantly increased the risk of an ectopic pregnancy, the relative risk being 2.35 (CI 1.19–4.67). Legalized induced abortions, as currently practised in Greece, do not appear to increase the relative risk of ectopic pregnancy to a substantial degree.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1420-911X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le «European Code Against Cancer» (ECAC) a été prodigué à quatre groupes de 50 femmes. Dans le premier groupe, la traduction grecque du programme original a été fournie; dans le second groupe un ensemble d'images explicatives a été fourni en supplément du texte; dans le troisième groupe une version simplifiée du texte a été fournie; enfin, dans la quatrième groupe, le texte était accompagné par un entretien de 15 minutes avec un psychologue. Dans un groupe de comparaison (76 femmes), aucun texte n'était donné. Après un délai de 4 à 7 jours, toutes les femmes remplissaient un questionnaire évaluant la connaissance des participantes sur l'étiologie et la prévention du cancer, la connaissance adéquate et la connaissance exacte. Aucune différence n'a été notée entre les trois groupes de femmes ayant reçu l'information et le groupe de comparaison. En revanche, il y a eu une amélioration substantielle des connaissances chez les femmes ayant reçu le texte plus le conseil par un psychologue. Cette différence porte sur les connaissances correctes aussi bien que sur les connaissances perçues et les connaissances adéquates. L'amélioration était particulièrement importante concernant le dépistage, les cancers liés à l'alimentation; en revanche, il y a eu peu d'amélioration des connaissances concernant le tabagisme et l'exposition aux radiations. Les connaissances concernant la prévention et l'étiologie du cancer étaient positivement corrélées avec les connaissances concernant la contraception et le tabagisme, même chez les femmes de même âge et même niveau d'éducation.
    Abstract: Zusammenfassung Der «European Code Against Cancer» (ECAC) wurde vier Gruppen mit je 50 Frauen vorgelegt. Der ersten Gruppe wurde eine griechische Übersetzung des Originals gegeben; die zweite Gruppe erhielt in Ergänzung zum Code erklärende Cartoons; der dritten Gruppe wurde eine vereinfachte Version des Codes vorgelegt und die vierte Gruppe erhielt neben dem Code eine Betreuung von etwa 15 Minuten durch einen Psychologen. Einer Kontrollgruppe von 76 Frauen wurde der ECAC nicht vorgelegt. Nach 4-7 Tagen erhielten sämtliche Frauen einen Fragebogen mit 78 items zu Ursachen und Prävention von Krebs. Dabei sollte überprüft werden, wieviel Wissen erinnert wurde (perceived knowledge, PK), wieviel Wissen exakt wiedergegeben wurde (accurate knowledge, AK) und wieviel korrektes Wissen (correct knowledge, CK) vorhanden war (Angaben in %). Bezüglich dieser drei Parameter wurde kein Unterschied festgestellt zwischen den beiden Gruppen mit dem modifizierten ECAC ohne Betreuung bzw mit dem ECAC und ergänzenden Cartoons einerseits und der Kontrollgruppe andererseits. Im Unterschied dazu fand sich eine deutlich signifikante Wissensverbesserung bei den Frauen, die neben dem ECAC eine individuelle Betreuung erhalten hatten; diese Differenz im korrekten Wissen (CK) war sowohl auf eine Verbesserung des PK (erinnerliches Wissen) als auch des AK (exakt wiedergegebenes Wissen) zurückzuführen. Eine Wissensverbesserung war besonders deutlich bei Fragen zu Krebsscreening, ernährungs- und arbeitsbedingten Krebsarten, während eine nur geringfügige Verbesserung bei den Aspekten Tabak und Strahlenexposition zu verzeichnen war. Es gab eine positive Korrelation zwischen dem «CK» über Ursachen und Prävention von Krebs einerseits und dem «AK» über Kontrazeption und Nichtrauchen andererseits, auch bei Frauen derselben Altersgruppe und desselben Ausbildungsstandes.
    Notes: Summary The European Code Against Cancer (ECAC) was administered to four groups of women, each comprising about 50 women. In the first group, the Greek translation of the original code was given; in the second group a set of explanatory cartoons was given in addition to the code; in the third group a more simplified version of the code was administered; lastly, in the fourth group the code was administered and in addition, mothers were tutored for about 15 minutes by a psychologist. A comparison group of 76 women were not exposed to ECAC. After 4 to 7 days, all women were given a 78-item questionnaire, probing their perceived knowledge (PK) about cancer etiology and prevention, their accurate knowledge (AK) and eventually their correct knowledge (CK), (all expressed in %). No difference, with respect to any of the above three parameters was noted between the three groups of women who were given the ECAC, the ECAC with cartoons or the modified ECAC without individual tutoring on the one hand and the comparison group on the other. By contrast, there was a substantial and highly significant improvement of knowledge among women who were given the ECAC and who were also individually tutored; this difference in CK was accounted for by improvement in both PK and AK. Improvement was particularly evident in respect to questions dealing with cancer screening, nutritional and occupational cancers, whereas there was little improvement with respect to knowledge concerning some aspects of tobacco smoking and exposure to radiation. CK about cancer etiology and prevention was positively correlated with AK about contraception and nonsmoking status, even among women of the same age and educational status.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7225
    Keywords: Case-control study ; Greece ; pancreatic cancer ; risk factors ; tobacco smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A hospital-based case-control study of pancreatic cancer was conducted in Athens in 1991–92. One hundred and eighty-one patients operated on for cancer of the exocrine pancreas in eight teaching hospitals formed the case series, whereas hospital patient controls and hospital visitor controls formed two independent comparison series. Cases and controls were matched by hospital, gender, and age in 1:1:1 ratio, and every matched triplet was interviewed in person by the same researcher. Results indicate that tobacco smoking increased the risk of pancreatic cancer, whereas neither coffee drinking nor consumption of alcoholic beverages were associated with the disease. Diabetes mellitus, cholelithiasis, and pancreatitis were associated positively with risk of pancreatic cancer, whereas allergic asthma was inversely (but not significantly) related to the disease. There was a suggestion that earlier age at menarche was associated with increased risk of pancreatic cancer and that parous women were at lower risk. No consistent associations were noted with respect to gastrectomy, other medical conditions or operations, birth order, height, weight, broad occupational groups, or other reproductive variables. The two comparison series were remarkably similar with respect to the whole spectrum of the study variables.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Cancer causes & control 2 (1991), S. 95-98 
    ISSN: 1573-7225
    Keywords: Birth order ; breast cancer ; case-control studies ; estrogens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: It has been hypothesized that prenatal exposure to maternal estrogens may be a risk factor for breast cancer in the offspring. In two recent studies, maternal estradiol levels in the first pregnancy have been compared to those in the second, and in both studies levels were higher in the first pregnancy. If both the hypothesis and the reported findings were true, women born as their mother's second child would be expected to have lower risk for breast cancer than first-born women. Data from 1,468 cases of breast cancer and 4,175 hospital controls from three previously published studies were modelled through multiple logistic regression to evaluate this possibility. The size of the woman's sibship was not related to breast cancer risk. On the other hand, second-born women had, as predicted, lower breast cancer risk than first-born women, although the difference was nominally significant only among premenopausal women. The relative risk for breast cancer, contrasting second-born to first-born women, and the corresponding 95 per cent confidence intervals, were 0.71 (0.54–0.94) among premenopausal women, 0.94 (0.76–1.17) among postmenopausal women, and 0.86 (0.73–1.02) among all women, controlling for menopausal status.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7225
    Keywords: bladder neoplasms ; occupation ; risk factors ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: We examined the importance of occupational exposures for bladder cancer in women. Methods: We combined data from 11 case-control studies conducted between 1976 and 1996 in six European countries. The pooled data comprised 700 incident female cases and 2425 population or hospital controls, aged 30–79 years. Lifetime occupational and smoking history were examined using common coding. Results: Excess risks were found in only a few of the occupations previously identified at high risk for bladder cancer. Statistically significant excess risks were observed for metal workers, particularly blacksmiths, toolmakers and machine tool operators (OR: 2.0, 95% CI: 1.1–3.6), tobacco workers (OR: 3.1, 95% CI: 1.1–9.3), field crop and vegetable farm workers (OR: 1.8, 95% CI: 1.0–3.1), tailors and dress makers (OR: 1.4, 95% CI: 1.0–2.1), saleswomen (OR: 2.6, 95% CI: 1.0–6.9), and mail sorting clerks (OR: 4.4, 95% CI: 1.0–19.5). About 8% (95% CI: 3.1–19.9) of all bladder cancers in women could be attributed to occupation after adjusting for smoking. The attributable risk was higher in women aged less than 65 years (12%), compared to older women (4%). Conclusions: The calculation of the attributable risk on the basis of results from this analysis may have caused some overestimation of the proportion of occupational bladder cancer in women. A significant proportion, however, of bladder cancer cases among European women less than 65years is likely to be attributed to occupation. This link between bladder cancer in women and occupational factors has received little recognition, probably because studies addressing these issues have predominantly been done in men.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-7225
    Keywords: Breast neoplasms ; estrogens ; maternal age ; parity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Total estrogens (TE), estradiol (E2), estriol (E3), and human placental lactogen (hPL) were determined by radioimmunoassay in the blood of 126 pregnant women during their 26th and 31st weeks of pregnancy and the results were studied in relation to maternal age and parity. Total estrogens and E2 were lowest among the youngest women (〈20 years) and highest among women aged 20–24 years, whereas older women (25 + years) had, on the average, intermediate values. For E3 the pattern was qualitatively similar to that of TE and E2 but less striking, and no maternal age pattern was evident with respect to hPL. Within maternal age groups, TE and E2 were higher among women in the first, than among those in their second, full-term pregnancy; the difference was about seven percent for TE (P=0.14) and about 14 percent for E2 (P=0.05). No parity patterns were evident with respect to E3 and hPL. There were fairly strong correlations between the determinations of the same hormone in the same woman during the 26th and 31st weeks of pregnancy; Pearson correlation coefficients were 0.60 for TE, 0.78 for E2, 0.60 for E3, and 0.72 for hPL. Since the risk of breast cancer increases apparently monotonically with maternal age at birth, the present data are equivocal with respect to the hypothesis linking levels of pregnancy estrogens to risk of breast cancer in the offspring. However, the data are compatible with hypotheses linking excessive pregnancy-estrogen exposure to conditions more common among first-born individuals, including testicular cancer and cryptorchidism.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1573-7225
    Keywords: bladder cancer ; coffee consumption ; nonsmokers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Coffee consumption has been associated with an excess bladder cancer risk, but results from epidemiological studies are inconsistent. This association has been long debated, in part due to the potential confounding by smoking. We examined the risk associated with coffee consumption in nonsmokers in a pooled analysis of ten European bladder cancer case–control studies. Methods: The pooled data set comprises 564 cases and 2929 hospital or population controls who had never smoked. They were enrolled in ten studies conducted in Denmark, Germany, Greece, France, Italy and Spain. Information on coffee consumption and occupation was re-coded following standard criteria. Unconditional logistic regression was applied adjusting for age, study center, occupation and gender. Results: Seventy-nine percent of the study population reported having drunk coffee, and 2.4% were heavy drinkers, reporting having drunk on average ten or more cups per day. There was no excess risk in ever coffee drinkers (OR = 1.0, 95% CI 0.8–1.3) compared to never drinkers. The risk did not increase monotonically with dose but a statistically significant excess risk was seen for subjects having drunk ten or more cups per day (OR = 1.8, 95% CI 1.0–3.3). This excess was seen in both men and women. There was no evidence of an association of the risk with duration or type of coffee consumption. The pooled results were not dependent on the findings of any specific study, but they depended on the type of controls with an overall excess risk observed only for studies using hospital controls. Conclusion: Nonsmokers who are heavy coffee drinkers may have a small excess risk of bladder cancer. Although these results cannot be attributed to confounding by smoking, the possibility of bias in control selection cannot be discarded. On the basis of these results, only a very small proportion of cancers of the bladder among nonsmokers could be attributed to coffee drinking.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1573-7225
    Keywords: Case-control study ; diet ; Greece ; pancreatic cancer ; nutrient intake
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: In a hospital-based case-control study of pancreatic cancer conducted in Athens (1991–92), 181 patients with histologically confirmed cancer of the exocrine pancreas were compared with hospital patient controls and hospital visitor controls, individually matched to the cases by hospital, age, gender, and interviewer in a 1:1:1 ratio. All interviews were conducted in person in the respective hospitals. Diet was ascertained through a semiquantitative food-frequency questionnaire. Nutrient intakes for individuals were estimated by multiplying the nutrient content of a selected typical portion-size for each specified food-item by the frequency that the food was used per month, and summing these estimates for all food items. Data were analyzed using conditional logistic regression, controlling for tobacco smoking and total energy intake as well as for mutual confounding influences among nutrients. Adjusted odds ratios (rate ratios) for pancreatic cancer, associated with particular nutritional variables, were expressed per increments approximately equal to the standard deviations of (the residual of) the respective nutrients, on a daily basis. The adjusted odds ratios (OR) and 95 percent confidence intervals (CI) compared with other patient and visitor controls respectively, were: for polyunsaturated fat, OR=1.32 (CI=1.07−1.63) and 1.21 (CI=0.98−1.49); and for crude fibre, OR=0.80 (CI=0.64−1.00) and 0.65 (CI=0.50−0.86). No substantial, statistically significant or consistent, independent associations were noted for total energy, total protein, total fat, saturated fat, monounsaturated fat, dietary cholesterol, total carbohydrates, sucrose, vitamin C, vitamin A, riboflavin, or calcium.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1573-7225
    Keywords: Case-control studies ; colorectal neoplasms ; dietary fat ; energy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to examine the effects of the intakeof dietary fat upon colorectal cancer risk in a combined analysis of datafrom 13 case-control studies previously conducted in populations withdiffering colorectal cancer rates and dietary practices. Original datarecords for 5,287 cases of colorectal cancer and 10,470 controls werecombined. Logistic regression analysis was used to estimate odds ratios (OR)for intakes of total energy, total fat and its components, and cholesterol.Positive associations with energy intake were observed for 11 of the 13studies. However, there was little, if any, evidence of anyenergy-independent effect of either total fat with ORs of 1.00, 0.95, 1.01,1.02, and 0.92 for quintiles of residuals of total fat intake (P trend =0.67) or for saturated fat with ORs of 1.00, 1.08, 1.06, 1.21, and 1.06 (Ptrend = 0.39). The analysis suggests that, among these case-control studies,there is no energy-independent association between dietary fat intake andrisk of colorectal cancer. It also suggests that simple substitution of fatby other sources of calories is unlikely to reduce meaningfully the risk ofcolorectal cancer.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1573-7225
    Keywords: Dihydrotestosterone ; estradiol ; Greece ; men ; prostate cancer ; sex hormone-binding globulin ; testosterone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Blood samples were collected from 52 incident cases of histologicallyconfirmed prostate cancer and 52 age- and town of residence-matched healthycontrols in Athens, Greece. Samples were analyzed blindly in Boston,Massachusetts (USA) for testosterone (T), estradiol (E2), sex hormone-bindingglobulin (SHBG), and dihydrotestosterone (DHT). The data were modeled usingmultiple logistic regression with adjustment for age, height, body mass index(wt/ht2), years of schooling, and mutually among hormones. DHT was associatedinversely, significantly, and strongly with the risk of prostate cancer,whereas T was associated marginally positively, and E2 was associatednonsignificantly inversely with the disease. No association was observed inthis study with respect to SHBG.
    Type of Medium: Electronic Resource
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