Illinois State Cancer Registry Research Articles

Cancer in Illinois construction workers: A study

A series of case-control studies using subjects from the Illinois State Cancer Registry have been conducted. Logistic regression was used to control for age and history of tobacco and alcohol use. Construction workers were consistently found to be younger than other subjects and to have used alcohol and tobacco more often. Significant positive associations between cancer of the stomach and welding (odds ratio [OR] = 2.11, 95% confidence interval [CI] = 1.09, 4.09), lung cancer and employment in the construction industry (OR = 1.18, 95% CI = 1.02, 1.26), and lung cancer and welding (OR = 1.68, 95% CI = 1.03, 2.76) were found. Significant negative associations between cancer of the colon and welding (OR = .54, 95% CI = .29, 1.00), cancer of the prostate and employment in the construction industry (OR = .76, 95% CI = .65, .89), cancer of the prostate and plumbing (OR = .44, 95% CI = .38, .50), cancer of the prostate and metal working (OR = .43, 95% CI = .19, .93), and bladder cancer and employment as an electrician (OR = .60, 95% CI = .36, 1.00) suggests that construction workers did not consistently experience excesses of cancers known to be associated with tobacco use, and an overall excess of sites not known to be related to tobacco use may have occurred.

Age differences in the breast cancer management of rural women.

This article describes the effect of age on the pattern of access to breast cancer care among rural women diagnosed in 1986-1989. Cases were identified by the Illinois State Cancer Registry and information on breast cancer management was obtained through review of hospital records and physician survey. Case follow-back was more than 99% complete. State-of-the-art breast cancer management was defined by the Physician Data Query (PDQ) and included diagnostic evaluation, prognostic evaluation, and stage-specific definitive treatment. The data did not indicate age differences in bilateral diagnostic mammography, performance of hormone receptor assays, radiation therapy, and stage-appropriate treatment. Tumor staging and axillary node dissection did differ by age with significant negative trends in the multivariate model. Also, women younger than 55 years were the most likely to receive separate diagnostic biopsy, limited surgery, and chemotherapy, whereas women 55 to 74 years were most likely to receive hormone therapy. Although rural populations may experience barriers to some aspects of state-of-the-art breast cancer management, age does not always exacerbate them.

Relation between population density and cancer incidence, Illinois, 1986-1990.

Many investigators have examined urbanization gradients in cancer rates. The authors used incidence data for 1986 through 1990 from the Illinois State Cancer Registry, a large, population-based incidence registry, to identify race-specific, urban-rural trends in cancer rates. Using population density, they categorized an urbanization gradient into four groups. Five-year, average annual age-adjusted, site-specific incidence rates were calculated for all sex-race strata within each population density group. Monotonic and statistically significant cancer incidence trends across all race-sex groups were found for cancers of the esophagus, liver, lung, female breast and cervix, male prostate, nervous system, non-Hodgkin's lymphomas, and all cancers combined. No trend was observed for blacks that was not also seen for whites; however, significant trends for cancer of the pancreas and Hodgkin's disease were seen for whites but not for blacks. Colon cancer in males was the only sex-specific trend in cancer that can occur in both sexes. Analytic studies for sites with consistent urban-rural trends across all race-sex groups may be fruitful in identifying the aspect of population density, or other unmeasured factor, that contribute to these trends.

Risk Factors for Lung Cancer Among Nonsmoking Illinois Residents

The purpose of this study was to examine possible risk factors for lung cancer among nonsmokers. The Illinois State Cancer Registry was used to identify all nonsmoking lung cancer cases diagnosed between 1985 and 1987. Subjects were classified as nonsmokers only if their medical record specifically stated that they had never smoked during their lifetime. These cases were compared with nonsmoking colon cancer cases. White male nonsmoking lung cancer cases were more likely to have worked in the construction industry than controls [odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.2–2.3] and to have worked in the bus service and urban transit industry (OR = 2.6, 95% CI = 1.0–6.9), in the trucking service industry (OR = 2.1, 95% CI = 1.3–3.6), and in blast furnaces, steelworks, and rolling and finishing mills (OR = 1.9, 95% Cl = 1.0–3.6). White female cases were more likely to have worked as registered nurses than were the controls (OR = 1.9, 95% Cl = 1.0–3.5). Negative associations between lung cancer and farming were found in both white males (OR = 0.6, 95% CI = 0.5–0.7) and white females (OR = 0.1, 95% CI = 0.01–0.6). Several other less plausible associations between employment and lung cancer were also found. To determine whether urban residence and associated air pollution increased the risk of lung cancer for nonsmokers, rates among nonsmokers in Cook County were compared with those in the remainder of Illinois. Cook County rates of nonsmoking lung cancer were elevated among white females and nonwhite females, but not among males. Residences of the white female and nonwhite female lung cancer cases were mapped to determine whether clustering within Chicago had occurred. The absence of observable clustering suggests that the excess of female lung cancer cases in Cook County is not attributable to pollution.