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To examine the association between serum nutrients and the development of bladder cancer we measured selenium, alpha-tocopherol, lycopene, beta-carotene, retinol, and retinol-binding protein in serum collected from 25,802 persons in Washington County, MD, in 1974. Serum samples were kept frozen at -70 degrees C. In the subsequent 12-year period, 35 cases of bladder cancer developed among participants. Comparisons of serum levels in 1974 among cases and two matched controls for each case showed that selenium was significantly lower among cases than controls (P = 0.03), lycopene was lower among cases at a borderline level of significance (P = 0.07), and alpha-tocopherol was nonsignificantly lower (P = 0.13). For selenium there was a nearly linear increase in risk with decreasing serum levels (P = 0.03). When examined by tertiles, the odds ratio associated with the lowest tertile of selenium compared to the highest tertile was 2.06. Serum levels of retinol, retinol-binding protein, and beta-carotene were similar among cases and controls. These results support a role for selenium in the prevention of bladder cancer.

A total of 4678 persons participated in an Allegheny County, Pennsylvania glaucoma screening program in 1977. Black participants had higher mean intraocular pressures, more frequent pathologic disc changes and more new cases of glaucoma discovered than a sample of white participants matched for sex and age. The same year, in a younger population of 2127 health center employees, the higher prevalence of pathologic disc changes was confirmed, although differences in mean intraocular pressures were variable. Blacks accounted for 23% of hospitalizations for chronic open-angle glaucoma during a three-year period (1975-1977) in 10 Pennsylvania counties, rather than the expected 6.3%. Among those hospitalized for open-angle glaucoma or having anterior chamber surgery, blacks were younger than whites.