Squamous Cell Carcinoma In Women Research Articles

Vulvar squamous cell carcinoma in women 80 years and older: Treatment, survival and impact of comorbidities

BackgroundDespite being a disease of mainly older women, little is known about the clinical management of older women with vulvar squamous cell carcinoma (VSCC). We evaluated their daily clinical management compared with younger women, and established the prevalence of comorbidities and its impact on overall survival (OS). MethodsAll Dutch women diagnosed with VSCC from 2015 to 2020 (n = 2249) were selected from the Netherlands Cancer Registry. Women aged ≥80 years (n = 632, 28%) were defined as “older” patients, women <80 years were considered as “younger”. Chi-square tests were performed to evaluate differences in treatment by age group and comorbidities. Differences in OS were evaluated using Kaplan-Meier Curves and log-rank test. ResultsThe vast majority of both older (91%) and younger (99%) patients with FIGO IA VSCC received surgical treatment of the vulva. Older FIGO IB-IV VSCC patients were less likely to undergo groin surgery than younger patients (50% vs. 84%, p < 0.01). Performance of surgical treatment of the vulva and groin(s) was not associated with the number of comorbidities in older patients (p = 0.67 and p = 0.69). Older patients with ≥2 comorbidities did have poorer OS compared to women with one or no comorbidities (p < 0.01). ConclusionThe vast majority of older patients underwent vulvar/local surgery. Older patients less often received groin surgery compared to younger patients. The majority of older patients had at least one comorbidity, but this did not impact treatment choice. The poorer survival in older VSCC patients may therefore be due to death of competing risks instead of VSCC itself.

Body Mass Index, Height, Weight Change, and Subsequent Lung Cancer Risk: The Japan Public Health Center-Based Prospective Study.

Body mass index (BMI) is inversely associated with lung cancer risk, while residual confounding by smoking or weight change is controversial. Evidence on height and lung cancer is scarce. We investigated the associations between anthropometrics, BMI, and height, and incidence of lung cancer among 92,098 study subjects (44,158 men and 47,940 women) in the Japan Public Health Center-based Prospective Study. Cox proportional hazards regression was performed with adjustment for potential confounders and by cancer subtypes and smoking status. Information on weight and height was self-reported at baseline, and validated using measured health check-up data. During follow-up between 1990 and 2013 (average, 19.1 years), a total of 2,152 lung cancer cases were newly diagnosed. In a multivariate regression model, lower BMI was positively associated with overall lung cancer risk [<19 kg/m2 HR = 1.48; 95% confidence interval (CI) = 1.18-1.85 and 19-22.9 kg/m2; HR = 1.19; 95% CI = 1.05-1.35; P trend = <0.001] in men. The risk estimate was also elevated for adenocarcinoma in the BMI <19 kg/m2 category and for squamous cell carcinoma among men in the 19-22.9 kg/m2 BMI category. An association was also observed between low BMI, weight decrease, and squamous cell carcinoma in women. No significant associations were observed for other weight categories, height, weight change and lung cancer, adenocarcinoma, squamous and small cell carcinoma. Our prospective study suggests that lower BMI may be associated with an increased risk of smoking-related lung cancer in Japan, irrespective of gender. This study highlights the association between lower BMI and the risk of lung cancer in men.

Circulating Sex Hormones Are Associated With Gastric and Colorectal Cancers but Not Esophageal Adenocarcinoma in the UK Biobank.

Gastrointestinal cancers show an unexplained male predominance, but few prospective studies have investigated sex hormones and gastrointestinal cancer risk. This study aimed to determine the impact of circulating sex hormones on risk of esophageal, gastric, and colorectal cancers in men and women. We included 219,425 men and 147,180 women from the UK Biobank. Sex hormones were quantified using chemiluminescent immunoassay. Gastrointestinal cancers were identified from cancer registry linkages. Sex hormone concentrations and risk of gastrointestinal cancers were investigated using Cox proportional hazards regression. During the 10 years of follow-up, 376 esophageal adenocarcinoma, 108 esophageal squamous cell carcinoma, and 333 gastric and 2,868 colorectal cancer cases were identified. Increased hazard ratios (HRs) were found for sex hormone-binding globulin (SHBG) and risk of gastric cancer in men (Q4 vs Q1 HR 1.43, 95% confidence interval [CI] 0.95-2.17, Ptrend = 0.01). Free testosterone was inversely associated with esophageal squamous cell carcinoma in women (Q4 vs Q1 HR 0.32, 95% CI 0.11-0.98, Ptrend = 0.05). For colorectal cancer, SHBG was associated with a reduced risk among men (Q4 vs Q1 HR 0.89, 95% CI 0.77-1.03, Ptrend = 0.04) and free testosterone concentrations was associated with a reduction in risk among women (Q4 vs Q1 HR 0.80, 95% CI 0.66-0.97, Ptrend = 0.01). No associations were found for esophageal adenocarcinoma. In this large prospective investigation of prediagnostic sex hormones and risk of gastrointestinal cancers, men with higher SHBG concentrations had higher gastric, yet lower colorectal, cancer risks, whereas women with higher free testosterone levels had a lower risk of esophageal squamous cell carcinoma and colorectal cancer.

Anthropometry, body fat composition and reproductive factors and risk of oesophageal and gastric cancer by subtype and subsite in the UK Biobank cohort.

BackgroundObesity has been positively associated with upper gastrointestinal cancers, but prospective data by subtype/subsite are limited. Obesity influences hormonal factors, which may play a role in these cancers. We examined anthropometry, body fat and reproductive factors in relation to oesophageal and gastric cancer by subtype/subsite in the UK Biobank cohort.MethodsAmong 458,713 UK Biobank participants, 339 oesophageal adenocarcinomas, 124 oesophageal squamous cell carcinomas, 137 gastric cardia and 92 gastric non-cardia cancers were diagnosed during a mean of 6.5 years follow-up. Cox models estimated multivariable hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsBody mass index (BMI), hip circumference, waist circumference, waist-to-hip ratio, waist-to-height ratio, total body fat and trunk fat were positively associated with oesophageal adenocarcinoma (highest vs lowest category: HR = 2.33, 95%-CI:1.65–3.28; HR = 1.56, 95%-CI:1.15–2.13; HR = 2.30, 95%-CI:1.47–3.57; HR = 1.71, 95%-CI:1.01–2.90; HR = 2.87, 95%-CI:1.88–4.38; HR = 1.96, 95%-CI:1.30–2.96; HR = 2.34, 95%-CI:1.70–3.22, respectively). Although there were no statistically significant associations in combined sex analyses, BMI (HR = 1.83, 95%-CI:1.00–3.37), waist circumference (HR = 2.21, 95%-CI:1.27–3.84) and waist-to-hip ratio (HR = 1.92, 95%-CI:1.11–3.29) were associated with gastric cardia cancer in men; however, mutual adjustment attenuated the associations for BMI and waist-to-hip ratio. For oesophageal squamous cell carcinoma, statistically significant inverse associations were observed among women for BMI, hip circumference, waist circumference, waist-to-height ratio, total body fat and trunk fat, although they were based on small numbers. In addition, older age at first (HR = 0.44, 95%-CI:0.22–0.88) and last live birth (HR = 0.44, 95%-CI:0.22–0.87) were inversely associated with oesophageal squamous cell carcinoma and having a stillbirth/miscarriage/termination was positively associated (HR = 1.84, 95%-CI:1.10–3.07).ConclusionsObesity and abdominal obesity specifically may be a risk factor for oesophageal adenocarcinoma and gastric cardia cancer in men. Some reproductive factors may be associated with oesophageal squamous cell carcinoma in women.

Geographical variations in the incidence of oesophageal cancer in Sweden

Background: Geographical variations in the incidence and tumour stage distribution of oesophageal cancer in Sweden are not well characterised.Methods: Using data from the Swedish Cancer Registry over 45 years (1972–2016), we compared the age-standardised incidence rates of oesophageal cancer by histological type across all seven national areas (in five-year periods) and 21 counties (in 15-year periods) in Sweden, and assessed the geographical distribution of tumour stage at diagnosis since 2004.Results: The incidence rate of oesophageal adenocarcinoma increased in all national areas and counties and in both sexes over time, while the rate of oesophageal squamous cell carcinoma decreased from the 1980s onwards. In the latest period (2012– 2016), the incidence rate of adenocarcinoma in men ranged from 3.5/100,000 person-years in West Sweden to 6.2/100,000 person-years in North Middle Sweden. At the county level, the rate of adenocarcinoma in men was lowest in Jämtland (2.7/100,000 person-years) and highest in Gotland (6.2/100 000 person-years) in 2002–2016. The incidence rates of both adenocarcinoma and squamous cell carcinoma in women were below 2/100,000 person-years in all national areas and counties in the latest calendar periods, i.e., 2012–2016 and 2002–2016, respectively. The proportion of patents with tumour stage IV ranged from 22% in Stockholm area to 31% in Middle Norrland, while at the healthcare region level it was lowest in Stockholm healthcare region (23%) and highest in North (30%) and Uppsala-Örebro (29%) healthcare regions.Conclusion: There are considerable geographical variations in the incidence and tumour stage distribution of oesophageal cancer in Sweden.

Having a first-degree relative with melanoma increases lifetime risk of melanoma, squamous cell carcinoma, and basal cell carcinoma

Previous studies have found familial aggregation of melanoma and keratinocyte cancers (KCs). We sought to determine the risk of melanoma and KCs in those with a positive family history of melanoma while controlling for pigmentary and environmental risk factors. We prospectively followed 216,115 participants from the Nurses' Health Study, Nurse's Health Study 2, and Health Professionals Follow-up Study for more than 20years. Cox proportional hazards regression controlling for known risk factors for skin cancer was used to estimate association between family history of melanoma and melanoma and KCs. Compared with those without a family history of melanoma, individuals with a family history of melanoma had a 74% increased risk of melanoma (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.45-2.09), a 22% increased risk of squamous cell carcinoma (HR, 1.22; 95% CI, 1.06-1.40), and a 27% increased risk of basal cell carcinoma (HR, 1.27; 95% CI, 1.12-1.44). Family history of melanoma increased the risk of development of truncal melanoma in both sexes, extremity melanoma in women, and extremity squamous cell carcinoma in women. Limitations of this study include self-reported family history and detection bias. Individuals with a family history of melanoma are at an increased risk of melanoma and KCs.

Incidence of cervical high-grade squamous intraepithelial lesions and squamous cell carcinoma in women with high-risk human papillomavirus and normal cervical cytology: A retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype.

To retrospectively analyse the incidence of high-grade squamous intraepithelial lesions (HSILs) and squamous cell carcinoma (SCC) in women of different ages with high-risk (HR) human papillomavirus (HPV) but with normal cytology test results stratified by age and HPV genotype. In total, 1858 women with HR-HPV infection but with a normal smear who received a colposcopy and biopsy between 2015 and 2016 at our institution were included. The pathological results were retrospectively analysed after stratifying by age and HPV genotype. Among the 1858 cases, the HSIL% in women aged 21-29years (10.54%) was significantly different from that in women aged 40-49years (19.85%; P<0.05), whereas there was no significant difference in the HSIL% among women aged 21-29years and those in the other age groups (P>0.05). In total, 295 cases had single HPV16 infection. The HSIL% in patients with HPV16/18 infection was >15%, and the 40-49-year age group had the highest percentage at 48.48%. For other HR-HPV infections, the HSIL and SCC incidence rate was 10.41%, and there was no significant difference among the age groups; thus, women with other types of viral infections, regardless of age, should be referred to colposcopy. Although HPV16 is the HPV with the highest risk, other HR-HPV infections can also cause a high percentage of HSILs and SCC in women with normal cytology. Therefore, it is necessary to refer HR-HPV-infected women aged ≥21years for colposcopy in a timely manner to exclude potential cervical intraepithelial neoplasia and cervical cancer.

Involvement of myeloperoxidase gene polymorphism 463G>A in development of cervical squamous cell carcinoma.

The myeloperoxidase (MPO) -463G&gt;A (rs2333227) polymorphism has been linked with increased susceptibility to the development of various malignancies. However, the data on the association of the MPO -463G&gt;A transition with cervical cancer remain inconsistent. Using high resolution melting analysis we genotyped this polymorphism in women with cervical squamous cell carcinoma (SCC) (n = 476) and controls (n = 493) from a Polish Caucasian population. Logistic regression analysis was used to adjust for the effect of confounders such as age, parity, oral contraceptive use, tobacco smoking, and menopausal status, and revealed that the MPO -463G&gt;A single nucleotide polymorphism (SNP) was associated with an increased risk of SCC. The adjusted odds ratio (OR) for patients with the A/A genotype versus G/G genotype was 0.718 (95% CI 0.531-0.972, p = 0.0316). Stratified analyses between the MPO -463G&gt;A polymorphism and SCC risks demonstrated a protective role of the MPO -463G&gt;A SNP in patients with a positive history of parity and negative history of tobacco smoking. In patients with a positive history of parity, the age-adjusted OR for the A/A versus G/G genotype was 0.667 (95% CI 0.479-0.929, p = 0.0164). The age-adjusted OR for patients with a negative history of tobacco smoking for the A/A versus G/G genotype was 0.491 (95% CI 0.313-0.770, p = 0.0019). Our study demonstrated that the MPO -463G&gt;A SNP may protect from SCC in women from Polish Caucasian populations.

The increasing incidence of esophageal squamous cell carcinoma in women in Turkey.

This study assessed the trend changes in the histological types of esophageal cancer in a 25-year period in eastern Turkey. We searched all cases of esophageal cancer from 1990 to 2015 according to their histological diagnosis and sex, grouping the patients in 5-year time periods to evaluate time trends. We identified 1462 cases of esophageal cancer. In terms of patient make-up, 742 were male and 720 were female. In general, 75.86% of the patients had squamous cell carcinoma (SCC), 19.56% of the patients had adenocarcinoma (ADC), and the remaining 4.58% patients were found to have other histopathologic disorders. While the SCC to ADC ratio was 1.76 between 1990 and 1994, this rate increased to 8.73 between 2010 and 2014; during these periods, the male to female ratio decreased from 1.43 to 0.86. Between these two periods, statistically significant changes were observed of SCC and the number of female patients (P < 0.001, P = 0.008, respectively). While the incidence of esophagus ADC and the number of male patients increased recently in Western countries, the number of female patients and SCC cases increased in our region in the last 25 years.

The use of corticosteroids in patients with COPD or asthma does not decrease lung squamous cell carcinoma.

BackgroundAsthma and COPD (chronic obstructive pulmonary disease) lead to persistent airway inflammation and are associated with lung cancer. The objective of the study was to assess the relationship between inhaled (ICS) and oral corticosteroid (OCS) use, and risk of lung squamous cell carcinoma (SqCC).MethodsThis study was a nested case–control study. Patients with newly diagnosed asthma or COPD between 2003 and 2010 were identified from the National Health Insurance Database. Cases were defined as patients diagnosed with SqCC after enrollment. For each case, four control individuals who were randomly matched for sex and age and date diagnosis of asthma or COPD were selected.ResultsFrom the 1,672,455 eligible participants, 793 patients with SqCC were matched with 3,172 controls. The odds ratios (ORs) of SqCC in men who received high and low-dose ICS were 2.18 (95 %CI, 1.56–3.04) and 1.77 (1.22–2.57), respectively. Similarly, the ORs were 1.46 (95 %CI, 1.16–1.84) and 1.55 (95 %CI, 1.22–1.98) for men who were placed on low and high dose OCS. However, there was no significant association between cumulative ICS and/or OCS and risk of SqCC in women. Recent dose increase in corticosteriod was significantly associated with risk of SqCC. Specifically, among men, the ORs for SqCC were 8.08 (95 %CI, 3.22–20.30) for high-dose ICS + OCS, 4.49 (95 % CI, 2.05–9.85) for high-dose ICS, and 3.54 (95 % CI, 2.50–5.01) for high-dose OCS treatments, respectively. The OR for SqCC in women who received high-dose OCS was 6.72 (95 %CI, 2.69–16.81).ConclusionCorticosteroid use did not decrease SqCC in patients with asthma or COPD. Recent dose increase in corticosteroids was associated with SqCC.

Murine Double-Minute 2 Homolog Single Nucleotide Polymorphisms 285 and 309 in Cervical Carcinogenesis.

Background and ObjectiveIn Caucasians, the MDM2 single nucleotide polymorphism (SNP) 285 G>C (rs117039649) neutralizes the effect of 309 T>G (rs2279744), which increases MDM2 expression and impairs the p53 pathway. In this study, we examined the distribution of these two SNPs in Polish women with squamous cell carcinoma (SCC) (n = 379), adenocarcinoma (n = 59) and other cervical tumor types (n = 18).MethodsThe polymerase chain reaction-restriction fragment length polymorphism technique and DNA sequencing were employed in our study.ResultsThe P trend value calculated for the MDM2 285 G>C polymorphism was statistically significant (Ptrend = 0.016) for SCC. Using logistical regression analysis adjusted for the effect of age, pregnancy, oral contraceptive use, tobacco smoking, and menopausal status, we observed that the MDM2 285 G>C SNP protected against SCC, with an adjusted odd ratio (OR) for the C carriers versus G/G genotype of 0.536 (P = 0.019). Stratified analyses of MDM2 285 G>C revealed a protective role of the C allele against SCC in women with a positive history of oral contraceptive use (age-adjusted OR 0.413, P = 0.021) and in premenopausal women (age-adjusted OR 0.362, P = 0.022). We also found that the 285GG/309GG vs 285GG/309 TT genotype increased the risk of SCC (adjusted OR 1.890, P = 0.005). However, the 285CC/309GG + 285GC/309GG versus 285GG/309GG genotype reduced the risk of SCC (adjusted OR 0.311, P = 0.004).ConclusionOur results demonstrate that the MDM2 285C gene variant and 285CC/309GG + 285GC/309GG genotypes protect against SCC, most likely by neutralizing the effect of the 309 T>G SNP. The 285GG/309GG genotype increases the risk of SCC possibly due to increased MDM2 expression.Electronic supplementary materialThe online version of this article (doi:10.1007/s40291-015-0153-4) contains supplementary material, which is available to authorized users.

The risk of squamous cell carcinoma in women from exposure to UVA lamps used in cosmetic nail treatment

The use of ultraviolet (UV)A lamps for curing gel nails is widespread in the cosmetic nail industry. A report that two women who had undergone this treatment subsequently developed squamous cell carcinoma (SCC) on the dorsum of hands has prompted some concern about the safety of this procedure. To estimate the number of women who would need to be exposed to UVA nail lamps for one woman to develop SCC on the dorsum of hands, who would not have done so otherwise. A mathematical model that combines age and UV exposure was used to compare the risk of developing SCC due to typical sun exposure with the risk of inducing these cancers from exposure to UVA nail lamps. For typical usage, the analysis indicates that tens or hundreds of thousands of women would need to use a UVA nail lamp regularly for one to go on to develop SCC on the dorsum of the hands as a direct consequence. The risk of inducing an SCC from exposure to UVA nail lamps is very low and one that is likely to be accepted by most women. Even then, the risk can be reduced to virtually zero by wearing fingerless gloves when the hands are being exposed.

Demographic and Tumor Characteristics of Patients Diagnosed with Nonmelanoma Skin Cancer: 13-Year Retrospective Study

The incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) is increasing worldwide; however, this varies by region. To date, there are limited data about trends of nonmelanoma skin cancer (NMSC) in Canada. To determine the demographic and tumor characteristic changes in patients diagnosed with BCC and SCC from 1993 to 2005 in a dermatology practice in Vancouver, British Columbia. A retrospective chart review was conducted on patients with biopsy-confirmed NMSC between 1993 and 2005. Demographic and tumor characteristics were documented for the first two incident BCCs and SCCs per patient, and a descriptive data analysis was undertaken. A total of 1,177 NMSCs were identified from 885 patient charts. The number of BCCs increased from 1993 to 2003 and then decreased until 2005. BCCs and SCCs were generally diagnosed in older people (60+ years); however, an important group of younger patients (20-39 years) was also diagnosed with BCCs. BCCs and SCCs were most commonly seen on the head and neck, but the leg was a common location for SCC in women. NMSC is prevalent in British Columbia. These results highlight the fact that NMSC can affect individuals younger than 40 years old. Prevention strategies are warranted to reduce the burden of NMSC in British Columbia.

Cigarette Smoking and Trends in Lung Cancer Incidence in Lithuania: An Analysis by Histological Type

The aim of this study was to investigate time trends of lung cancer incidence by histological type in Lithuania during the period from 1996 to 2005. The results were evaluated in relation to tobacco smoking trends. The incidence rates of the most common lung cancer cell types (squamous cell carcinoma, adenocarcinoma, small cell carcinoma, other types, and morphologically not specified cases) were studied using data from the Lithuanian Cancer Registry. The world standard population was used for age adjustment. Data on tobacco smoking in Lithuania were obtained from various published sources. Among men, squamous cell carcinoma was the most common type of lung cancer. The age-adjusted rates of squamous cell carcinoma decreased from 25 per 100,000 in 1998-1999 to 19.1 per 100,000 in 2004-2005; the incidence rates for adenocarcinoma and small cell carcinoma rose to around 7 per 100,000 in 2002-2003. Among women, adenocarcinoma was the most common histological type. The incidence rates for adenocarcinoma increased to 1.9 per 100,000 until 2002-2003 and thereafter did not change. The rates of squamous cell carcinoma in women were relatively stable at around 1.1 per 100,000. In 2000, the prevalence of regular smoking among men and women peaked at 51.5% and 15.8%, respectively; there was a significant change from smoking nonfilter cigarettes to filter cigarettes. The decreasing squamous cell carcinoma rates among men and increasing adenocarcinoma rates among men and women are similar to those reported in other European countries and may be due to a shift from nonfilter type cigarettes to filter type.

Lifetime and baseline alcohol intake and risk of cancer of the upper aero‐digestive tract in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Recent alcohol consumption is an established risk factor for squamous cell carcinoma (SCC) of the upper aero-digestive tract. In contrast, the role of lifetime exposure to alcohol with regard to risk of SCC is not well established. Historical data on alcohol use are available in 271,253 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 2,330,381 person years, 392 incident SCC cases (279 men and 113 women) were identified. Cox regression was applied to model sex-specific associations between lifetime alcohol intake and SCC risk adjusting for potential confounders including smoking. Compared to men who drank 0.1-6.0 g/day alcohol at lifetime, the relative risks (RR) for developing SCC were significantly increased for men who drank 30.1-60.0 g/day (RR 1.65, 95% confidence interval:1.00-2.71), 60.1-96.0 g/day (RR 2.20, 95%CI 1.23-3.95), and >96.0 g/day, (RR 4.63, 95% CI 2.52-8.48), and for former drinkers (RR 4.14, 95%CI 2.38-7.19). These risk estimates did not considerably change when baseline alcohol intake was analyzed. Compared to women who drank 0.1-6.0 g/day alcohol intake at lifetime, the RR were significantly increased for women who drank >30 g/d (RR 6.05, 95%CI 2.98-12.3). Applying similar categories, the relative risk for baseline alcohol intake was 3.26 (95%CI 1.82-5.87). We observed a stronger association between alcohol intake at lifetime and risk of SCC in women compared to men (p for interaction = 0.045). The strong dose-response relation for lifetime alcohol use underscores that alcohol is an important risk factor of SCC of the upper aero-digestive tract throughout life.

Incidence of Nonmelanoma Skin Cancer in New Brunswick, Canada, 1992 to 2001

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), collectively referred to as nonmelanoma skin cancer (NMSC), cause significant morbidity and generate a substantial cost to the health care system. Canadian data on the incidence of NMSC are lacking. To study the incidence and characteristics of NMSC in New Brunswick, Canada (population 729,498 people in 2001), by using the Provincial Cancer Registry. Data were obtained from 1992 to 2001 from the New Brunswick Provincial Cancer Registry, to which reporting of all cancers is mandatory. Multiple tumors of a given histologic type are recorded only once in the registry per individual per lifetime. A descriptive analysis of incidence rates of BCC and invasive SCC of the skin was performed in relation to gender, age, and anatomic location. The main outcome measures were the age- and sex-specific incidence rates of BCC and SCC. Age standardization was performed using the Canadian, US, and world standard populations. When adjusted to the world standard population, the age-standardized incidence rates (ASIRs) per 100,000 population for BCC from 1992 through 2001 were 87 for males and 68 for females. For invasive SCC, the ASIRs per 100,000 population were 34 for males and 16 for females. There was an increasing incidence trend for both BCC and invasive SCC over the 10-year study period, with minimal change in the incidence of SCC in women. The overall ratio of BCC to invasive SCC in the population was 2.8 to 1. The approximate lifetime probabilities of developing BCC and invasive SCC were 13% and 5%, respectively. The incidence of NMSC in the province of New Brunswick is similar to that reported from 1973 through 1987 in the province of British Columbia, higher than those reported in most parts of Europe, and lower than all published rates in the United States and Australia. Owing to the inability of the registry to account for tumor multiplicity, the actual annual number of all NMSC lesions in this population is likely much higher.

Physical activity and the risk of lung cancer in Canada.

A population-based case-control study of 2,128 cases with histologically confirmed incident lung cancer and 3,106 population controls aged 20-76 years was conducted to assess the impact of recreational physical activity on lung cancer risk in Canada in 1994-1997. The multivariable-adjusted odds ratios and 95% confidence intervals for the second, third, and fourth quartiles versus the lowest quartile of total recreational physical activity were, respectively, 0.82 (95% confidence interval: 0.68, 0.98), 0.76 (95% confidence interval: 0.63, 0.92), and 0.73 (95% confidence interval: 0.60, 0.89) (p for trend=0.0008). The risk reduction was observed for both men and women and was attributed to both moderate and vigorous activities. A greater risk reduction was found for squamous cell carcinoma in women, small cell carcinoma in men, and other types/unspecified histologic subtypes in both genders. The physical-activity-associated risk reduction was more profound among smokers and those with low and medium body mass indexes. This study provides additional evidence that recreational physical activity reduces lung cancer risk. More studies are needed to confirm the differences between histologic subtypes and between genders and to address the underlying biologic mechanisms.

Estudo de variáveis demográficas, ocupacionais e co-carcinogenéticas no carcinoma espinocelular da base de língua nas mulheres

Avaliar a relação entre carcinógenos e o carcinoma espinocelular no sexo feminino. FORMA DE ESTUDO: Retrospectivo não randomizado. OBJETIVO: Determinar a relação entre carcinógenos (álcool e fumo) e o carcinoma espinocelular no sexo feminino na base da língua. MATERIAL E MÉTODOS: Estudo retrospectivo de 31 pacientes do sexo feminino realizado no Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia do Hospital Heliópolis, Hosphel, São Paulo (1977 a 2000). Foram analisados variáveis como etnia, idade, profissão, tabagismo, etilismo, queixa principal, o intervalo de tempo entre o início da queixa e a procura do médico e o estadiamento clínico. Quanto ao tratamento estatístico, foram utilizados os Testes de Kappa e o de Mc Nemar. RESULTADOS: Houve predomínio da raça branca (58,1%) sobre a negra (35,5%) e a amarela (6,4%), bem como da 6ª décadade vida; sendo profissionais do lar (83,9%) trabalhadoras na agricultura 6,4%). Indústria (3,2%), comércio e liberais (3,2%). Houve mais consumo isolado do tabagismo (48,4%), ambos (45,2%) e nenhum (6,4%). Quanto à sintomatologia, odinofagia (48,4%), nódulo no pescoço (19,3%), disfagia (12,9%); otalgia (9,7%), ferida na língua (6,4%) e rouquidão (3,2%). Quanto ao estadiamento, T3-4 (74,1%), T1-2 (25,8%), N0 (29,0%), N1(29,0%), N2-3 (42,0%). CONCLUSÕES: O carcinoma espinocelular em mulheres predominou na 6ª década, na raça branca, tendo como principais sintomas odinofagia e linfonodo cervical metastático. Houve predomínio do tabagismo sobre o etilismo, em paciente T3-4, sendo que a maioria já portador de metástase linfonodal à 1ª consulta.

High incidence of lichen sclerosus in patients with squamous cell carcinoma of the penis.

There is a well-documented association between lichen sclerosus (LS) and vulval carcinoma in women; however, until recently, there have only been anecdotal reports of penile squamous cell carcinoma (SCC) occurring in men with LS. The incidence of penile carcinoma occurring on a background of LS remains uncertain, and we wished to examine this possible association further. To address this, all the cases (n = 20) of penile SCC held on our pathology database (4 years) were examined. Histology was reviewed, blind to the clinical picture, for evidence of LS, applying strict histological criteria. Subsequently, clinical notes were reviewed for history of LS before the SCC presented, and history of previous circumcision, treatments, node involvement, metastases and death. In eight cases, evidence of LS was found in the excision specimen. Seven of these had well-differentiated SCC. In the 12 cases with no evidence of LS, only three were well differentiated. With case note review, seven had a history of LS (four with histological LS), sometimes preceding the SCC by 10 years. These all had well-differentiated SCC. Ten of the 20 patients are dead, seven from metastatic disease. Four deaths occurred in the 'well-differentiated LS' group, but only one from penile SCC metastatic disease. There appears to be a definite association between SCC of the penis and the presence of LS, similar to that reported between LS and vulval SCC in women. Of the 20 patients with penile SCC studied, 11 had a clinical history and/or histological evidence of LS. However, clinical presentation of the LS or need for circumcision may precede the SCC by many years. As follow-up is impractical, counselling at the time of diagnosis is very important, and it is essential that medical practitioners are aware of this association so that the subsequent risk from SCC is reduced.

“FEMALE LUNG CANCER; STATISTICAL ANALYSIS OF THE CASES SEEN IN A UNIVERSITY HOSPITAL”

In recent years there has been an increase in the incidence of lung cancer in women with the rate of increase exceeding the rate of increase in men. There are some reports of detailed studies of lung cancer in women in the United States of America and European countries, but few in Japan.Fifty nine cases of lung cancer in women were studied in comparison with 225 cases in men by the hospital records. The ratio of female to male cases was 1:3.8. The major characteristic findings of cases admitted to hospital were as follows.1) The age of the peak incidence of lung cancer in women was appeared to be younger than that in men, and the age distribution in adeno carcinoma was also different between both sexes.2) The incidence of squamous cell carcinoma in women was less than in men though there was no difference in the incidence of other histological types.3) The prognosis of women with lung cancer was consistently better than in men without significant difference in any methods of treatment.4) The relationship between cigarette smoking and the increasing tendency of incidence of lung cancer was not demonstrated. However there was remarkable difference in the histological distribution between smokers and non-smokers.