Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Statistical evaluation of clinical treatments or preventive medicine has profoundly contributed to decision making in medical fields such as with the acceptance of new treatment methods and health promotion policies. It is crucial in such decision making to find a correct statistical model to treat a surprisingly large variety of patients, or a heterogeneous group of patients, even with the same diagnosis. In diseases such as cancer, cardiovascular disease or diabetes, patients are often followed up to certain endpoints and these data are frequently analyzed by logrank tests or Cox-models to evaluate treatment effects. Although these methods have been widely accepted and extensively studied, we are sometimes faced with problems in applying these methods when the heterogeneity of patients is large and a lot of prognostic factors affecting the endpoints have to be considered. Based on the results of the analyses of survival data from more than 6,000 gastric cancer patients, it is revealed that the stratified logrank test may suffer serious power loss, even though primary prognostic factors are used as stratified factors. A so-called 'piecewise linear Cox regression method' for properly treating the heterogeneity of patients is introduced and extensively studied. This method is shown to be appropriate for patient groups with a high degree of heterogeneity such as the gastric cancer patients. The same method is, in principle, applicable to patients of other diseases, too, using statistical software such as SAS, BMDP and etc.
 ...
PMID:A statistical model that takes into account patient heterogeneity in decision making. 1038 12

With the improvement in survival of cancer patients, the incidence of second primaries has been increasing. Data from the Osaka Cancer Registry showed that the incidence of metachronous second primaries was associated with gender (male), age and calendar year at diagnosis of the first cancer. The 10-year cumulative risk was estimated at around 10% for those who developed their first cancer in their sixties in 1978-83. The observed number (O) of second primaries (including synchronous) was compared with the expected number (E). The O/E ratios among those who developed their first cancer at ages 0-14 and 15-29 years old were much higher than the ratios among all age groups. Patients who had developed cancer of the colon, larynx, lung, bladder, or breast (1978-86) showed a significantly higher than expected risk of developing second primaries during the 1-4 years after diagnosis of the first cancer. Based on the hospital cancer registry data from Osaka Medical Center for Cancer and Cardiovascular Diseases, associations between adjuvant chemo-immunotherapy and the risk of second primaries were examined among 1,925 gastric cancer patients who underwent curative gastrectomy. The sex-, age-, and stage-adjusted hazard rate ratio of second primaries was 1.04 for patients who underwent chemotherapy and 0.70 for patients who underwent chemo-immunotherapy, when compared with the risk for patients who did not receive adjuvant chemo-immunotherapy. Some chemotherapeutic agents appeared to increase the risk of second primaries. Second primaries among 2,824 breast cancer patients were examined and their associations with adjuvant chemo-immuno-radiotherapy were analyzed. The O/E ratio for cancers of all sites was 1.28, significantly higher than 1.0. Cancer of the stomach, colon, lung and ovary were frequently observed as a second primary among them. Among 117 patients who developed second primaries, 4 developed cancer of the corpus uteri. This corresponded to 1.89 times the expected, however, only one of the 4 patients underwent tamoxifen treatment. The O/E ratio for non-Hodgkin's lymphoma was 3.40, significantly higher than 1.0. These results suggest associations between the risk for non-Hodgkin's lymphoma and chemotherapy.
 ...
PMID:[Descriptive and analytical epidemiology of second primaries in Osaka, Japan]. 1058 61

Population groups with a lower socioeconomic status (SES) have a greater risk of disease and mortality. The aim of this study was to investigate the relationship between SES and mortality in the metropolitan area of Rome during the six-year period 1990-1995, and to examine variations in mortality differentials between 1990-92 and 1993-95. Rome has a population of approximately 2,800,000, with 6,100 census tracts (CTs). During the study period, 149,002 deaths occurred among residents. We compared cause-specific mortality rates among four socioeconomic categories (SES) defined by a socioeconomic index, derived from characteristics of the CT of residence. Among men, total mortality and mortality for the major causes of death showed an inverse association with SES. Among 15-44 year old men, the strong positive association between total mortality and low SES was due to AIDS and overdose mortality. Among women, a positive association with lower SES was observed for stomach cancer, uterus cancer and cardiovascular disease, whereas mortality for breast cancer was higher in the groups with higher SES. Comparing the periods 1990-92 and 1993-95, differences in total mortality between socioeconomic groups widened in both sexes. Increasing differences were observed for tuberculosis and lung cancer among men, and for uterus cancer, traffic accidents, and overdose mortality among women. The use of an area-based indicator of SES limits the interpretations of the findings. However, despite the possible limitations, these results suggest that social class differences in mortality in Rome are increasing. Time changes in life style and in the prevalence of risk behaviors may produce differences in disease incidence. Moreover inequalities in the access to medical care and in the quality of care may contribute to an increasing differentials in mortality.
 ...
PMID:[Socioeconomic differences in mortality in Rome, 1990-1995]. 1060 55

Vitamin C, a water-soluble glucose derivative, has considerable antioxidant activity in vitro, in part because of its ease of oxidation and because the semidehydroascorbate radical derived from it is of low reactivity. Vitamin C in vivo is an essential cofactor for a range of enzymes involved in diverse metabolic pathways, but much recent literature has focused on its antioxidant effects. Consumption of foods rich in Vitamin C (fruits and vegetables) is associated with decreased risk of cardiovascular disease, of many types of cancer and possibly of neurodegenerative disease, but the extent to which Vitamin C contributes to these effects is uncertain. Data using biomarkers of oxidative damage to DNA bases have given no compelling evidence to date that ascorbate supplements can decrease the levels of oxidative DNA damage in vivo, except perhaps in subjects with very low Vitamin C intakes. Similarly, there is no conclusive evidence from studies of strand breaks, micronuclei, or chromosomal aberrations for a protective effect of Vitamin C. There is limited evidence that supplements of Vitamin C might have beneficial effects in disorders of vascular function, and that diet-derived Vitamin C may decrease gastric cancer incidence in certain populations, but it is not clear whether it is the antioxidant or other properties of ascorbate that are responsible for these two actions.
 ...
PMID:Vitamin C and genomic stability. 1129 51

A self-reported questionnaire on the health status, life habits, and social background was conducted at baseline in the Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases (JPHC study). This report presents the outcome of the study regarding past or family history of various diseases, medical treatment, life habits such as physical labor or sports, and social background among study participants. In both cohorts I and II, prevalent past and family history included hypertension, stroke, and cancer, whereas the prevalence of coronary heart diseases was historically low. The prevalence of a past history of hypertension and stroke was higher in the northern part of Japan, Ninohe, and Yokote, and lower in Okinawa, compared to the other districts. The prevalence of participants with a history of stomach cancer and liver cancer was higher in Arikawa than in other districts. The frequency of participants who took medication from doctors ranged from 20% to 30%, higher in the Tohoku areas, and lower in Okinawa compared to the other districts. All districts showed a high rate of over 70% for the participation rate for basic health examination conducted by the local government, The rate was particularly high in the Tohoku area where a high prevalence of a history of hypertension was found. The frequency of persons who had a chance to participate in sports or physical exercise was high in Okinawa and Suita subcohort 2, although the mean total physical activity (both at work and for leisure time) was lowest in the latter subcohort. No substantial differences were found in compositions of personality among districts. The frequency of more active and positive persons, however, was relatively higher in urban areas and lower in Okinawa compared to the other districts. The association between the differences of health status, life habits, and social background and the occurrence of various lifestyle-related diseases will be clarified in a follow-up study within the JPHC study.
 ...
PMID:Health status, life habits, and social background among the JPHC study participants at baseline survey. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases. 1176 40

BACKGROUND: Although many trials have been conducted to evaluate the feasibility and effectiveness of adjuvant chemotherapy (ACT) for patients with stomach cancer, the benefits of ACT remain unclear. Moreover, some authors have reported that ACT increased the incidence of second malignancy. The risk of second malignancy was evaluated in patients who underwent treatment for stomach cancer in the past 20 years at Osaka Medical Center for Cancer and Cardiovascular Diseases.METHODS: The study population consisted of 1925 patients who underwent gastrectomies for stomach cancer between the years 1978 and 1992 and who received follow-up examinations to check for second malignancies. They included 1114 patients who underwent surgery only (group A) and 811 who underwent surgery and received chemotherapy (group B). The observed incidence of second malignancy (O) was compared with the expected incidence (E), calculated by the person-year method, using data from the Cancer Registry in Osaka.RESULTS: The average follow-up period was 7.99 years. The total number of patients with a second malignancy was 127 (men, 97; women, 30); 72 patients had the second malignancy in digestive organs; 27 in respiratory organs; and 28 in other organs. The relative risks of a second malignancy in group A and B patients were 1.05 and 1.02 (differences between the two groups were not significant). The relative risks of a second malignancy in patients who received ACT with 5-fluorouracil, Tegafur and Uracil, and FT207 were 0.79, 1.01, and 1.06, respectively (differences between the groups were not significant).CONCLUSION: The risk of second malignancy after chemotherapy for stomach cancer was not high in comparison with the expected incidence. Adjuvant chemotherapy did not increase the risk of a second malignancy.
Gastric Cancer 1999 Dec
PMID:The risk of second malignancy after adjuvant chemotherapy for stomach cancer. 1195 99

Many users of oral contraceptives (OCs) and potential users misunderstand the risks and benefits of OCs. A recent poll in the US revealed that 3 out of 4 women thought the pill carried substantial health risks. Nearly 2/3 of the women surveyed believe using OCs is at least as risky as childbearing. Family Health International (FHI) recently conducted a world survey of perceptions of OCs. It shows that women in many other countries share US womens negative image of the pill. Women believe in pill-related dangers scientists have never even suspected, much less proven, such as an increased risk of stomach cancer. Yet, many women, especially women in developing countries, are unaware of problems such as cardiovascular disease that are related to OC use, and they are ignorant of the proven health benefits of OCs, such as protection against ovarian and endometrial cancer. Despite the persistence of negative perceptions of the pill, research conducted over the past 30 years has shown that the pill is safe for the great majority of women and, in fact, provides significant health benefits for many users. With the contraceptive effectiveness of the pill established through the early tests, drug companies began steadily lowering the hormone dosages. By 1983, more than half of the OCs sold in the US contained less than 0.5 mg estrogen. Many of the combination OCs now sold have only 0.2 to 0.4 mg estrogen. Eventually, pill researchers learned that OCs containing only progestogen, even in comparatively small doses, also could effectively prevent pregnancy, though not as effectively as pills containing estrogen. The first progestogen-only pills received US Food and Drug Administration approval in 1973. Continued research on OCs shows that the increased risks of cardiovascular diseases actually were almost entirely confined to specific groups women who were over 35 or who both were over 30 and smoked. For the great majority of women, studies showed, the risk of cardiovascular disease was increased little by OC use. FHI's recent study of long-term OC risks and benefits, based on previous epidemiological research, demonstrates that OC use has no net effect on life expectancy for most women. Among younger women who do not smoke, life expectancy is slightly increased by OC use, the study shows. This is because OCs provide protection against ovarian and endometrial cancer. In an effort to improve compliance with recommended OC procedures, FHI has initiated a series of studies which will examine the interaction between OC side effects, the information and support given OC users by family planning providers, and OC compliance.
 ...
PMID:The misunderstood pill: thirty years of testing and development have reduced pill's major, minor side effects. 1234 Oct 93

This review summarizes key results of epidemiologic studies published in peer-reviewed journals between April 2003 and March 2004. The prevalence of H. pylori infection continues to vary strongly between developing countries and developed countries, and according to ethnicity, place of birth and socioeconomic factors among people living in the same country. Intrafamilial spread appears to play a central role in transmission of the infection in both developing and developed countries. The role of H. pylori infection in development of noncardia gastric cancer appears to be even much stronger than previously assumed, whereas the lack of an association with cardia cancer and an inverse association with adenocarcinoma of the esophagus could be confirmed. Suggestions for an inverse association of the infection with atopic diseases have recently received further support, whereas evidence concerning the role of the infection (or its eradication) in GERD and a large variety of other extragastric diseases, including cardiovascular disease, remains inconclusive.
 ...
PMID:Epidemiology of Helicobacter pylori infection. 1534 99

Interest in tobacco harm reduction strategies has raised the question of the comparative health risks of cigarette smoking and use of other tobacco products. Although there appears to be a general belief that a unique smokeless tobacco product called Swedish snus has fewer health risks than cigarettes, no one has systematically reviewed the literature and compared the data on health risks in a quantitative manner. We reviewed the literature to identify all analytic epidemiologic studies that provided quantitative risk estimates associated with Swedish snus and cigarette smoking in a single population, using a common reference group. Seven studies were identified that addressed eight health outcomes. Although few in number, these seven studies do provide quantitative evidence that, for certain health outcomes, the health risks associated with snus are lower than those associated with smoking. Specifically, this is true for lung cancer (based on one study), for oral cancer (based on one study), for gastric cancer (based on one study), for cardiovascular disease (based on three of four studies), and for all-cause mortality (based on one study). This review has likely omitted many of the adverse effects of cigarettes, but probably few of the potential health effects of snus. Continued investigation of the reduced health risks of Swedish snus compared to cigarette smoking is warranted.
 ...
PMID:Health risks of smoking compared to Swedish snus. 1619 9

Several studies have evaluated cancer risk associated with occupational and environmental exposure to dichlorodiphenyltrichloroethane (DDT). Results are mixed. To further inquire into human carcinogenicity of DDT, we conducted a mortality follow-up study of 4,552 male workers, exposed to DDT during antimalarial operations in Sardinia, Italy, conducted in 1946 to 1950. Detailed information on DDT use during the operations provided the opportunity to develop individual estimates of average and cumulative exposure. Mortality of the cohort was first compared with that of the Sardinian population. Overall mortality in the cohort was about as expected, but there was a deficit for death from cardiovascular disease and a slight excess for nonmalignant respiratory diseases and lymphatic cancer among the unexposed subcohort. For internal comparisons, we used Poisson regression analysis to calculate relative risks of selected malignant and nonmalignant diseases with the unexposed subcohort as the reference. Cancer mortality was decreased among DDT-exposed workers, mainly due to a reduction in lung cancer deaths. Birth outside from the study area was a strong predictor of mortality from leukemia. Mortality from stomach cancer increased up to 2-fold in the highest quartile of cumulative exposure (relative risk, 2.0; 95% confidence interval, 0.9-4.4), but no exposure-response trend was observed. Risks of liver cancer, pancreatic cancer, and leukemia were not elevated among DDT-exposed workers. No effect of latency on risk estimates was observed over the 45 years of follow-up and within selected time windows. Adjusting risks by possible exposure to chlordane in the second part of the antimalarial operations did not change the results. In conclusion, we found little evidence for a link between occupational exposure to DDT and mortality from any of the cancers previously suggested to be associated.
 ...
PMID:Cancer mortality among men occupationally exposed to dichlorodiphenyltrichloroethane. 1623 Apr 25


<< Previous 1 2 3 4 5 Next >>