The clinical characteristics of 183 patients with second primary neoplasms in the head and neck region were compared with those of 20,598 patients with one primary tumor in the same region registered ...during the period 1973 to 1984 in the Surveillance, Epidemiology and End‐Results Program. Second primary head and neck tumors were more likely to be diagnosed in a localized stage (47%) than if diagnosed as a single primary tumor (43%), but this difference was not significant. The tumor grade distribution was comparable in both groups. Using Cox proportional hazards modeling with age, sex, race, and stage as covariates, the median survival of patients with first and second head and neck cancer was identical (50 months). The survival of patients with localized second head and neck cancer was shorter than that of patients with single localized tumors (55 versus 102 months, P less than 0.026). Survival for regional tumors was similar (18 versus 21 months, not significant). The 84 second head and neck cancers in which the first head and neck cancer received radiation therapy (RT) had a median survival of 20 months; the 98 cases without prior RT had a median survival of 35 months. The high incidence of localized second cancers was probably due to the more intense surveillance. The worse survival in this group may be a result of prior RT or biologic characteristics of the tumor.
This is a study of the magnitude and dynamics of lung cancer in the State of Israel. Ten thousand nine hundred and eighty-one cases (10,981), diagnosed between 1962 and 1982 and reported to the ...Israel Cancer Registry were studied. Low incidence rates among Jewish and Arab males (23-34/100,000/year) and females (3-10/100,000/year) as well as lack of the expected increase among the females compared to other Western countries were the major findings of the study. These low rates held true for both European-American and Asian-African born Jews, as did the lack of increase in rates among the females. Jewish males from only a few countries (Iraq, Algier, Turkey, Bulgaria) had somewhat higher rates, in the range of 40-50/100,000/year. An increase in adenocarcinoma in Jewish males and females and a decrease in squamous cell carcinoma in Jewish males were found and are in accordance with data from other Western countries. Smoking data were available only for the country as a whole and not for individual cases, and only from 1963 and onwards. Also, no data were available on various smoking-behavior parameters (quantity, duration, age at initiation, tar content). Keeping these reservations in mind, smoking prevalence was not found to correlate with the low lung cancer rates, but were in accordance with the increase in lung cancer seen among Asian-African Jews and the decrease among the European-American Jews. Other known, less important, risk factors for lung cancer were also not found to contribute to the understanding of the low rates. Although more data are needed regarding smoking habits, it is suggested that a partial explanation to the low incidence rates might be in a lower susceptibility to lung cancer among the Jews. This suggestion draws support from the known role of various genetic markers in lung cancer and the uniqueness of some disease states among Jews.
Data from 29, 845 patients with lymphomas, 981 of whom had lymphoma as a second primary tumor, registered in the Surveillance Epidemiology and End Results (SEER) program in the U.S.A. between 1973 ...and 1986 were analyzed. The characteristics of the 274 patients with lymphoma as a second tumor who had received chemotherapy and/or radiotherapy for their primary tumor (SEP PT) were compared with 675 patients with second primary lymphomas who had no prior treatment (SEP NT) and with patients with single lymphomas (SIP). Patients with SEP PT disease had a significantly higher percentage of intermediate and high-grade tumors (80%) compared to those with SEP NT or SIP tumors (73% and 72%, respectively). The survival of all patients with SIP tumors did not differ from those with SEP tumors, but the median survival of those with SEP PT disease was shorter than for SEP NT disease. This was most probably due to the high percentage of intermediate and high-grade lymphomas in the SEP PT group. This was statistically significant in the group treated by combined chemotherapy and radiotherapy but not in those treated by a single modality alone. These findings relating to a worse prognosis in patients with SEP PT lymphoma are in line with our previous observations of a poor survival in patients with other multiple primary tumors.
Objective: To determine the possible relationship between food and life style habits and bone health in adolescent Israeli females.
Methods: 2,000 adolescent Israeli Jewish and Arab high-school girls ...(mean age 14.5) completed a semi-quantitative food frequency questionnaire and a personal history questionnaire. 27 food components were calculated for each subject. Bone mineral content and density were determined for 112 subjects with calcium intake below 800 mg/day.
Results: Average calcium intake was found to be 1,260 mg/day, but 20% of all girls had a calcium intake below 800 mg/day. All low-energy diets were very low in calcium, as mean calcium intake per 1,000 calories was 411±128 grams. A large percentage of diets with less than 800 mg calcium were also deficient in phosphorus (95.2%), magnesium (84.8%), iron (90.5%) and zinc (100%). Due to differences in food sources, Jewish girls had more phosphorus in their diet, but less magnesium and iron compared to Arab girls. Calcium and zinc deficiencies in Jewish and Arab diets were similar. A negative correlation was found between body mass index (BMI) and age at menarche for all girls in the study. Bone mineral density (BMD) measured for girls with calcium intake below 800 mg/day distributed normally around the average when compared to age matched controls despite their low calcium intake. There was a strong positive correlation between BMD and bone mineral content (BMC) at all sites and body weights.
Conclusions: Low calcium intake, other nutritional deficiencies and delayed menarche due to low-energy diet in the growing period and in adolescence may prevent the formation of healthy bones. There is no evidence of lower bone mass among the low calcium intake group in the study population at this stage. It remains to be documented if the window of opportunity for optimal bone accretion for this group will be missed in the future, possibly leading to increased risk of osteoporosis.
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