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Purpose This prospective occupation-based cohort study was designed to assess the effects of body mass index (BMI) on mortality by gender and age. Methods Using Cox proportional hazards regression models with age as the time-scale, stratified at baseline for birth cohorts in 5-year intervals, we evaluated mortality risk associated with BMI (based on self-reported weight and height) in 64,733 female and 19,011 male radiologic technologists who responded to a questionnaire administered in 1983 to 1989 and who were free of cancer and myocardial infarction at that time. During an average of 14.7 years of follow-up or 1.25 million person-years, there were 2278 female and 1495 male deaths. The analysis focused on never-smoking subjects, excluding the first 5 years of follow-up, to limit the potential confounding effect of low BMI associated with smoking and illness-related weight loss. Risks were assessed in male and female subjects less than 55 years old and 55 or older. Results Mortality risks were highest in both women and men in the two age groups ( Conclusion In both women and men, all-cause mortality risks appear to increase at a lower BMI in younger than in older adults.

Purpose To explore etiologic clues for endocrine cancers by evaluating risk of multiple cancers in conjunction with thyroid and adrenal cancer. Methods We conducted cohort studies including all 2-month survivors of thyroid and adrenal cancer (excluding neuroblastoma) in the U.S. Surveillance, Epidemiology and End Results (SEER) cancer registries program (1973–2000). Relative risks are expressed as the ratio of observed (O) to expected (E) number of cases. Absolute excess risks (EAR) are expressed as the difference between O and E, divided by the person-years (PY) at risk, and then expressed per 10,000 PY. Results Among 29,456 thyroid cancer survivors, 2214 developed a second cancer (O/E = 1.11, 95% CI = 1.06–1.15, EAR = 7.47/10,000 PY), with the highest risk seen in the first year (26%). Patients less than 40 years at diagnosis of thyroid cancer had a 39% increased risk; older patients had a 6% increased risk. We observed a likely radiotherapy-related excess of leukemia. Consistently increased risks also were observed for cancers of the breast, prostate, and kidney; a decreased risk was observed for lung cancer. Based on small numbers of cases, cancers of the salivary glands, trachea, scrotum, adrenal glands, and brain or CNS occurred in excess. Among 811 survivors of adrenal cancer, a 1.76-fold (95% CI = 1.33–2.27) risk of second cancers was observed (O = 57, EAR = 71.36/10,000 PY). Following adrenal carcinoma excesses, were observed for lung, bladder, and prostate cancer; kidney cancer occurred in excess after pheochromocytoma. Young carcinoma patients ( Conclusion Thyroid cancer survivors are at moderately increased risk of second cancers of many different organs. Enhanced clinical surveillance, radiotherapy, and hormonal and genetic factors likely play a role. Survivors of adrenal carcinoma are at increased risk of cancers of the lung, bladder, and prostate. Second cancer risks among young patients suggest Li–Fraumeni syndrome.

PURPOSE: Few studies have evaluated cancer risk associated with low-dose occupational ionizing radiation exposure to women. We present data on incident cancer risks among a predominantly (77%) female cohort of 73,963 U. S. radiologic technologists followed up from 1983 through 1998. METHODS: Cancer incidence information and data on work history, selected cancer risk factors, personal radiation exposure and other health outcomes were obtained from two mailed questionnaires (administered ~1984 and ~1995). Incident cancers were ascertained from the second survey and supplemented by mortality records. Medical records, obtained for 74% of all self-reported cancers, confirmed the cancer in 85%. We computed standardized incidence ratios (SIR) using cancer incidence rates from the National Cancer Institute's Surveillance Epidemiology and End Results Program. RESULTS: The SIR for all cancers combined in both sexes was 1.04 (95% confidence interval (CI): 1.00, 1.07; n = 3292). The incidence of solid cancers was elevated in women (SIR = 1.06, 95% CI: 1.02, 1.10), but lower than expected among men (SIR = 0.92 , 95% CI 0.85, 0.98). Female technologists had an elevated incidence of breast cancer (SIR = 1.16, 95% CI: 1.09, 1.23). Among both sexes combined, elevated risks were seen for melanoma (SIR = 1.59, 95% CI: 1.38, 1.80) and thyroid cancers (SIR = 1.61, 95% CI: 1.34, 1.88), and decreased risks were observed for buccal cavity/pharynx (SIR = 0.73, 95% CI: 0.55, 0.90), rectum (SIR = 0.62, 95% CI: 0.48, 0.76), and lung (SIR = 0.77, 95% CI: 0.70, 0.85) cancers. CONCLUSION: The elevated risk for breast cancer may be related to occupational radiation exposure. The observed melanoma and thryoid cancer excesses may reflect, at least in part, increased screening among medical workers with easy access to health care.

Between 1977 and 1980, 854 biopsied cases of benign breast disease (BBD) and 755 matched surgical and 723 matched neighborhood controls subjects were interviewed in Israel by using a detailed food frequency questionnaire. Cases were classified according to degree of ductal atypia (Black-Chablon grading system). Women with atypic lesions (grades greater than or equal to 3) reported a higher intake of all types of foods compared with both control series. Further analyses indicated that the increased consumption was due primarily to foods containing greater than or equal to 10% fat. Odds ratios associated with the highest fat consumption quartile were close to 3.0. There was a trend for increasing saturated fatty acid consumption with increasing ductal atypica. After adjusting for hormonal and demographic confounders, the association with fat intake was strengthened. Because atypic BBD has been reported to be a precursor of breast cancer, our findings lend support to the hypothesis that dietary fat is a risk factor for breast cancer.