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2. Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53297 women with breast cancer and 100239 women without breast cancer from 54 epidemiological studies

Author

Calle, Ee, Heath, Cw, Miraclemcmahill, Hl, Coates, Rj, Liff, Jm, Franceschi, S., Talamini, R., Chantarakul, N., Koetsawang, S., Rachawat, D., Morabia, A., Schuman, L., Stewart, W., Szklo, M., Bain, C., Schofield, F., Siskind, V., Band, P., Coldman, Aj, Gallagher, Rp, Hislop, Tg, Yang, P., Duffy, Sw, Kolonel, Lm, Nomura, Amy, Oberle, Mw, Ory, Hw, Peterson, Hb, Wilson, Hg, Wingo, Pa, Ebeling, K., Kunde, D., Nishan, P., Graham Colditz, Martin, N., Pardthaisong, T., Silpisornkosol, S., Theetranont, C., Boosiri, B., Chutivongse, S., Jimakorn, P., Virutamasen, P., Wongsrichanalai, C., Mcmichael, Aj, Rohan, T., Ewertz, M., Paul, C., Skegg, Dcg, Boyle, P., Evstifeeva, M., Daling, Jr, Malone, K., Noonan, Ea, Stanford, Jl, Thomas, Db, Weiss, Ns, White, E., Andrieu, N., Bremond, A., Clavel, F., Gairard, B., Lansac, J., Piana, L., Renaud, R., Cuevas, Hr, Ontiveros, P., Palet, A., Salazar, Sb, Aristizabel, N., Cuadros, A., Bachelot, A., Le, Mg, Deacon, J., Peto, J., Taylor, Cn, Alfandary, E., Modan, B., Ron, E., Friedman, Gd, Hiatt, Ra, Bishop, T., Kosmelj, J., Primiczakelj, M., Ravnihar, B., Stare, J., Beeson, Wl, Fraser, G., Allen, Ds, Bulbrook, Rd, Cuzick, J., Fentiman, Is, Hayward, Jl, Wang, Dy, Hanson, Rl, Leske, Mc, Mahoney, Mc, Nasca, Pc, Varma, Ao, Weinstein, Al, Moller, Tr, Olsson, H., Ranstam, J., Goldbohm, Ra, Vandenbrandt, Pa, Apelo, Ra, Baens, J., Delacruz, Jr, Javier, B., Lacaya, Lb, Ngelangel, Ca, Lavecchia, C., Negri, E., Marubini, E., Ferraroni, M., Gerber, M., Richardson, S., Segala, C., Gatei, D., Kenya, P., Kungu, A., Mati, Jg, Brinton, La, Hoover, R., Schairer, C., Spirtas, R., Lee, Hp, Rookus, Ma, Vanleeuwen, Fe, Schoenberg, Ja, Gammon, Md, Clarke, Ea, Jones, L., Mcpherson, K., Neil, A., Vessey, M., Yeates, D., Beral, V., Bull, D., Crossley, B., Hermon, C., Jones, S., Key, T., Lewis, C., Reeves, G., Smith, P., Collins, R., Doll, R., Peto, R., Hannaford, P., Kay, C., Roserobixby, L., Gao, Yt, Yuan, Jm, Wei, Hy, Yun, T., Zhiheng, C., Berry, G., Booth, Jc, Jelihovsky, T., Maclennan, R., Shearman, R., Wang, Qs, Baines, Cj, Miller, Ab, Wall, C., Lund, E., Stalsberg, H., Dabancens, A., Martinez, L., Molina, R., Salas, O., Alexander, Fe, Hulka, Bs, Bernstein, L., Haile, Rw, Paganinihill, A., Pike, Mc, Ross, Rk, Ursin, G., Yu, Mc, Adami, Ho, Bergstrom, R., Longnecker, Mp, Newcomb, P., Farley, Tmn, Holck, S., Meirik, O., Calle EE, Heath CW, MiracleMcMahill HL, Coates RJ, Liff JM, Franceschi S, Talamini R, Chantarakul N, Koetsawang S, Rachawat D, Morabia A, Schuman L, Stewart W, Szklo M, Bain C, Schofield F, Siskind V, Band P, Coldman AJ, Gallagher RP, Hislop TG, Yang P, Duffy SW, Kolonel LM, Nomura AMY, Oberle MW, Ory HW, Peterson HB, Wilson HG, Wingo PA, Ebeling K, Kunde D, Nishan P, Colditz G, Martin N, Pardthaisong T, Silpisornkosol S, Theetranont C, Boosiri B, Chutivongse S, Jimakorn P, Virutamasen P, Wongsrichanalai C, McMichael AJ, Rohan T, Ewertz M, Paul C, Skegg DCG, Boyle P, Evstifeeva M, Daling JR, Malone K, Noonan EA, Stanford JL, Thomas DB, Weiss NS, White E, Andrieu N, Bremond A, Clavel F, Gairard B, Lansac J, Piana L, Renaud R, Cuevas HR, Ontiveros P, Palet A, Salazar SB, Aristizabel N, Cuadros A, Bachelot A, Le MG, Deacon J, Peto J, Taylor CN, Alfandary E, Modan B, Ron E, Friedman GD, Hiatt RA, Bishop T, Kosmelj J, PrimicZakelj M, Ravnihar B, Stare J, Beeson WL, Fraser G, Allen DS, Bulbrook RD, Cuzick J, Fentiman IS, Hayward JL, Wang DY, Hanson RL, Leske MC, Mahoney MC, Nasca PC, Varma AO, Weinstein AL, Moller TR, Olsson H, Ranstam J, Goldbohm RA, vandenBrandt PA, Apelo RA, Baens J, delaCruz JR, Javier B, Lacaya LB, Ngelangel CA, LaVecchia C, Negri E, Marubini E, Ferraroni M, Gerber M, Richardson S, Segala C, Gatei D, Kenya P, Kungu A, Mati JG, Brinton LA, Hoover R, Schairer C, Spirtas R, Lee HP, Rookus MA, vanLeeuwen FE, Schoenberg JA, Gammon MD, Clarke EA, Jones L, McPherson K, Neil A, Vessey M, Yeates D, Beral V, Bull D, Crossley B, Hermon C, Jones S, Key T, Lewis C, Reeves G, Smith P, Collins R, Doll R, Peto R, Hannaford P, Kay C, RoseroBixby L, Gao YT, Yuan JM, Wei HY, Yun T, Zhiheng C, Berry G, Booth JC, Jelihovsky T, MacLennan R, Shearman R, Wang QS, Baines CJ, Miller AB, Wall C, Lund E, Stalsberg H, Dabancens A, Martinez L, Molina R, Salas O, Alexander FE, Hulka BS, Bernstein L, Haile RW, PaganiniHill A, Pike MC, Ross RK, Ursin G, Yu MC, Adami HO, Bergstrom R, Longnecker MP, Newcomb P, Farley TMN, Holck S, and Meirik O

Abstract

Background The Collaborative Group on Hormonal Factors in Breast Cancer has brought together and reanalysed the worldwide epidemiological evidence on the relation between breast cancer risk and use of hormonal contraceptives. Methods Individual data on 53297 women with breast cancer and 100 239 women without breast cancer from 54 studies conducted in 25 countries were collected, checked, and analysed centrally. Estimates of the relative risk for breast cancer were obtained by a modification of the Mantel-Haenszel method. All analyses were stratified by study, age at diagnosis, parity, and, where appropriate, the age a woman was when her first child was born, and the age she was when her risk of conception ceased. Findings The results provide strong evidence for two main conclusions. First, while women are taking combined oral contraceptives and in the 10 years after stopping there is a small increase in the relative risk of having breast cancer diagnosed (relative risk [95% CI] in current users 1.24 [1.15-1.33], 2p

Published
1996

3. Breast cancer and hormonal contraceptives: Further results

Author

Calle, Ee, Heath, Cw, Miraclemcmahill, Hl, Coates, Rj, Liff, Jm, Franceschi, S., Talamini, R., Chantarakul, N., Koetsawang, S., Rachawat, D., Morabia, A., Schuman, I., Stewart, W., Szklo, M., Bain, C., Schofield, F., Siskind, V., Band, P., Coldman, Aj, Gallagher, Rp, Hislop, Tg, Yang, P., Duffy, Sw, Kolonel, Lm, Nomura, Amy, Oberle, Mw, Ory, Hw, Peterson, Hb, Wilson, Hg, Wingo, Pa, Ebeling, K., Kunde, D., Nishan, P., Colditz, G., Martin, N., Pardthaisong, T., Silpisornkosol, S., Theetranont, C., Boosiri, B., Chutivongse, S., Jimakorn, P., Virutamasen, P., Wongsrichanalai, C., Mcmichael, Aj, Rohan, T., Ewertz, M., Paul, C., Skegg, Dcg, Spears, Gfs, Boyle, P., Evstifeeva, T., Daling, Jr, Malone, K., Noonan, Ea, Stanford, Jl, Thomas, Db, Weiss, Ns, White, E., Andrieu, N., Bremond, A., Clavel, F., Gairard, B., Lansac, J., Piana, L., Renaud, R., Fine, Srp, Cuevas, Hr, Ontiveros, P., Palet, A., Salazar, Sb, Aristizabel, N., Cuadros, A., Bachelot, A., Le, Mg, Deacon, J., Peto, J., Taylor, Cn, Alfandary, E., Modan, B., Ron, E., Friedman, Gd, Hiatt, Ra, Bishop, T., Kosmelj, K., Primiczakelj, M., Ravnihar, B., Stare, J., Beeson, Wl, Fraser, G., Allen, Ds, Bulbrook, Rd, Cuzick, J., Fentiman, Is, Hayward, Jl, Wang, Dy, Hanson, Rl, Leske, Mc, Mahoney, Mc, Nasca, Pc, Varma, Ap, Weinstein, Al, Moller, Tr, Olsson, H., Ranstam, J., Goldbohm, Ra, Vandenbrandt, Pa, Apelo, Ra, Baens, J., Delacruz, Jr, Javier, B., Lacaya, Lb, Ngelangel, Ca, Lavecchia, C., Eva Negri, Marbuni, E., Ferraroni, M., Gerber, M., Richardson, S., Segala, C., Gatei, D., Kenya, P., Kungu, A., Mati, Jg, Brinton, La, Hoover, R., Schairer, C., Spirtas, R., Lee, Hp, Rookus, Ma, Vanleeuwen, Fe, Schoenberg, Ja, Gammon, Md, Clarke, Ea, Jones, L., Mcpherson, K., Neil, A., Vessey, M., Yeates, D., Beral, V., Bull, D., Crossley, B., Hermon, C., Jones, S., Key, T., Lewis, C., Reeves, G., Smith, P., Collins, R., Doll, R., Peto, R., Hannaford, P., Kay, C., Roserobixby, L., Yuan, Jm, Wei, Hy, Yun, T., Zhiheng, C., Berry, G., Booth, Jc, Jelihovsky, T., Maclennan, R., Shearman, R., Wang, Qs, Baines, Cj, Miller, Ab, Wall, C., Lund, E., Stalsberg, H., Dabancens, A., Martinez, L., Molina, R., Salas, O., Alexander, Fe, Hulka, Bs, Chilvers, Ced, Bernstein, L., Haile, Rw, Paganinihill, A., Pike, Mc, Ross, Rk, Ursin, G., Yu, Mc, Adami, Ho, Bergstrom, R., Longnecker, Mp, Newcomb, P., Farley, Tmn, Holck, S., Meirik, O., Calle EE, Heath CW, MiracleMcMahill HL, Coates RJ, Liff JM, Franceschi S, Talamini R, Chantarakul N, Koetsawang S, Rachawat D, Morabia A, Schuman I, Stewart W, Szklo M, Bain C, Schofield F, Siskind V, Band P, Coldman AJ, Gallagher RP, Hislop TG, Yang P, Duffy SW, Kolonel LM, Nomura AMY, Oberle MW, Ory HW, Peterson HB, Wilson HG, Wingo PA, Ebeling K, Kunde D, Nishan P, Colditz G, Martin N, Pardthaisong T, Silpisornkosol S, Theetranont C, Boosiri B, Chutivongse S, Jimakorn P, Virutamasen P, Wongsrichanalai C, McMichael AJ, Rohan T, Ewertz M, Paul C, Skegg DCG, Spears GFS, Boyle P, Evstifeeva T, Daling JR, Malone K, Noonan EA, Stanford JL, Thomas DB, Weiss NS, White E, Andrieu N, Bremond A, Clavel F, Gairard B, Lansac J, Piana L, Renaud R, Fine SRP, Cuevas HR, Ontiveros P, Palet A, Salazar SB, Aristizabel N, Cuadros A, Bachelot A, Le MG, Deacon J, Peto J, Taylor CN, Alfandary E, Modan B, Ron E, Friedman GD, Hiatt RA, Bishop T, Kosmelj K, PrimicZakelj M, Ravnihar B, Stare J, Beeson WL, Fraser G, Allen DS, Bulbrook RD, Cuzick J, Fentiman IS, Hayward JL, Wang DY, Hanson RL, Leske MC, Mahoney MC, Nasca PC, Varma AP, Weinstein AL, Moller TR, Olsson H, Ranstam J, Goldbohm RA, vandenBrandt PA, Apelo RA, Baens J, delaCruz JR, Javier B, Lacaya LB, Ngelangel CA, LaVecchia C, Negri E, Marbuni E, Ferraroni M, Gerber M, Richardson S, Segala C, Gatei D, Kenya P, Kungu A, Mati JG, Brinton LA, Hoover R, Schairer C, Spirtas R, Lee HP, Rookus MA, vanLeeuwen FE, Schoenberg JA, Gammon MD, Clarke EA, Jones L, McPherson K, Neil A, Vessey M, Yeates D, Beral V, Bull D, Crossley B, Hermon C, Jones S, Key T, Lewis C, Reeves G, Smith P, Collins R, Doll R, Peto R, Hannaford P, Kay C, RoseroBixby L, Yuan JM, Wei HY, Yun T, Zhiheng C, Berry G, Booth JC, Jelihovsky T, MacLennan R, Shearman R, Wang QS, Baines CJ, Miller AB, Wall C, Lund E, Stalsberg H, Dabancens A, Martinez L, Molina R, Salas O, Alexander FE, Hulka BS, Chilvers CED, Bernstein L, Haile RW, PaganiniHill A, Pike MC, Ross RK, Ursin G, Yu MC, Adami HO, Bergstrom R, Longnecker MP, Newcomb P, Farley TMN, Holck S, and Meirik O

Abstract

The Collaborative Group on Hormonal Factors in Breast Cancer has brought together and reanalysed the worldwide epidemiological evidence on breast cancer risk and use oi hormonal contraceptives. Original data from 54 studies, representing about 90% of the information available on the topic, were collected, checked and analysed centrally. The 54 studies were performed in 26 countries and include a total of 53,297 women with breast cancer and 100,239 women without breast cancer. The studies were varied in their design, setting and timing. Most information came from case-control studies with controls chosen from the general population; most women resided in Europe or North America and most cancers were diagnosed during the 1980s. Overall 41% of the women with breast cancer and 40% of the women without breast cancer had used oral contraceptives at some time: the median age at first use was 26 years, the median duration of use was 3 years, the median year of first use was 1968, the median time since first use was 16 years, and the median time since last use was 9 years. The main findings, summarised elsewhere,I are that there is a small increase in the risk of having breast cancer diagnosed in current users of combined oral contraceptives and in women who had stopped use in the past 10 years but that there is no evidence of an increase in the risk more than 10 years after stopping use. In addition, the cancers diagnosed in women who had used oral contraceptives tended to be less advanced clinically than the cancers diagnosed in women who had not used them. Despite the large number of possibilities investigated, few factors appeared to modify the main findings either in recent or in past users. For recent users who began use before age 20 the relative risks are higher than for recent users who began at older ages. For women whose use of oral contraceptives ceased more than 10 years before there was some suggestion of a reduction in breast cancer risk in certain subgroups, with a deficit of tumors that had spread beyond the breast, especially among women who had used preparations containing the highest doses of oestrogen and progestogen. These findings are unexpected and need to be confirmed. Although these data represent most of the epidemiologi cal evidence on the topic to date, there is still insufficient information to comment reliably about the effects of specific types of oestrogen or of progestogen. What evidence there is suggests, however, no major differences in the effects for specific types of oestrogen or of progestogen and that the pattern of risk associated with use of hormonal contraceptives containing progestogens alone may be similar to that observed for preparations containing both oestrogens and progestogens. On the basis of these results, there is little difference between women who have and have not used combined oral contraceptives in terms of the estimated cumulative number of breast cancers diagnosed during the period from starting use up to 20 rears after stopping. The cancers diagnosed in women who have used oral contraceptives are, however, less advanced clinically than the cancers diag nosed in never users. Further research is needed to establish whether the associations described here are due to earlier diagnosis of breast cancer in women who have used oral contraceptives, to the biological effects of the hormonal contraceptives or to a combination of both. Little information is as yet available about the effects on breast cancer risk of oral contraceptive use that ceased more than 20 years before and as such data accumulate it will be necessary to reexamine the worldwide evidence. RI Ranstam, Jonas/A-4386-2009; Colditz, Graham/A-3963-2009

Published
1996

4. Breast cancer and hormonal contraceptives: further results

Author

Calle, EE, primary, Heath, CW, additional, Miracle-McMahill, HL, additional, Coates, RJ, additional, Liff, JM, additional, Franceschi, S, additional, Talamini, R, additional, Chantarakul, N, additional, Koetsawang, S, additional, Rachawat, D, additional, Morabia, A, additional, Schuman, L, additional, Stewart, W, additional, Szklo, M, additional, Bain, C, additional, Schofield, F, additional, Siskind, V, additional, Band, P, additional, Coldman, AJ, additional, Gallagher, RP, additional, Hislop, TG, additional, Yang, P, additional, Duffy, SW, additional, Kolonel, LM, additional, Nomura, AMY, additional, Oberle, MW, additional, Ory, HW, additional, Peterson, HB, additional, Wilson, HG, additional, Wingo, PA, additional, Ebeling, K, additional, Kunde, D, additional, Nishan, P, additional, Colditz, G, additional, Martin, N, additional, Pardthaisong, T, additional, Silpisornkosol, S, additional, Theetranont, C, additional, Boosiri, B, additional, Chutivongse, S, additional, Jimakorn, P, additional, Virutamasen, P, additional, Wongsrichanalai, C, additional, McMichael, AJ, additional, Rohan, T, additional, Ewertz, M, additional, Paul, C, additional, Skegg, DCG, additional, Spears, GFS, additional, Boyle, P, additional, Evstifeeva, T, additional, Daling, JR, additional, Malone, K, additional, Noonan, EA, additional, Stanford, JL, additional, Thomas, DB, additional, Weiss, NS, additional, White, E, additional, Andrieu, N, additional, Brêmond, A, additional, Clavel, F, additional, Gairard, B, additional, Lansac, J, additional, Piana, L, additional, Renaud, R, additional, Fine, SRP, additional, Cuevas, HR, additional, Ontiveros, P, additional, Palet, A, additional, Salazar, SB, additional, Aristizabel, N, additional, Cuadros, A, additional, Bachelot, A, additional, Leê, MG, additional, Deacon, J, additional, Peto, J, additional, Taylor, CN, additional, Alfandary, E, additional, Modan, B, additional, Ron, E, additional, Friedman, GD, additional, Hiatt, RA, additional, Bishop, T, additional, Kosmelj, K., additional, Primic-Zakelj, M, additional, Ravnihar, B, additional, Stare, J, additional, Beeson, WL, additional, Fraser, G, additional, Allen, DS, additional, Bulbrook, RD, additional, Cuzick, J, additional, Fentiman, IS, additional, Hayward, JL, additional, Wang, DY, additional, Hanson, RL, additional, Leske, MC, additional, Mahoney, MC, additional, Nasca, PC, additional, Varma, AO, additional, Weinstein, AL, additional, Moller, TR, additional, Olsson, H, additional, Ranstam, J, additional, Goldbohm, RA, additional, van den Brandt, PA, additional, Apelo, RA, additional, Baens, J, additional, de la Cruz, JR, additional, Javier, B, additional, Lacaya, LB, additional, Ngelangel, CA, additional, La Vecchia, C, additional, Negri, E, additional, Marbuni, E, additional, Ferraroni, M, additional, Gerber, M, additional, Richardson, S, additional, Segala, C, additional, Gatei, D, additional, Kenya, P, additional, Kungu, A, additional, Mati, JG, additional, Brinton, LA, additional, Hoover, R, additional, Schairer, C, additional, Spirtas, R, additional, Lee, HP, additional, Rookus, MA, additional, van Leeuwen, FE, additional, Schoenberg, JA, additional, Gammon, MD, additional, Clarke, EA, additional, Jones, L, additional, McPherson, K, additional, Neil, A, additional, Vessey, M, additional, Yeates, D., additional, Beral, V, additional, Bull, D, additional, Crossley, B, additional, Hermon, C, additional, Jones, S, additional, Key, T, additional, Reeves, Clewis G, additional, Smith, P, additional, Collins, R, additional, Doll, R, additional, Peto, R, additional, Hannaford, P, additional, Kay, C, additional, Rosero-Bixby, L, additional, Yuan, J-M, additional, Wei, HY, additional, Yun, T, additional, Zhiheng, C, additional, Berry, G, additional, Booth, J Cooper, additional, Jelihovsky, T, additional, Maclennan, R, additional, Shearman, R, additional, Wang, Q-S, additional, Baines, CJ, additional, Miller, AB, additional, Wall, C, additional, Lund, E, additional, Stalsberg, H, additional, Dabancens, A, additional, Martinez, L, additional, Molina, R, additional, Salas, O, additional, Alexander, FE, additional, Hulka, BS, additional, Chilvers, CED, additional, Bernstein, L, additional, Haile, RW, additional, Paganini-Hill, A, additional, Pike, MC, additional, Ross, RK, additional, Ursin, G, additional, Yu, MC, additional, Adami, HO, additional, Bergstrom, R, additional, Longnecker, MP, additional, Farley, TMN, additional, Holck, S, additional, and Meirik, O, additional

Published
1996
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6. Increased risk of salivary gland tumors after low-dose irradiation.

Author

Modan B, Chetrit A, Alfandary E, Tamir A, Lusky A, Wolf M, Shpilberg O, Modan, B, Chetrit, A, Alfandary, E, Tamir, A, Lusky, A, Wolf, M, and Shpilberg, O

Abstract

Objective: To assess the risk of neoplastic development among persons exposed to scalp irradiation.Study Design: Historical cohort study initially; prospective follow-up subsequently.Method: Two control groups--population and siblings--matched for age, sex, ethnic origin, and year of immigration. Follow-up from time of irradiation (1950s) until the end of 1991. Linkage with nationwide cancer registry.Results: A 4.5-fold incidence of cancer (P < .01) and a 2.6-fold increase of benign tumors were noted. The mean length of latency period until tumor development was 11 years for malignant tumors and 21.5 years for benign. A clear dose response effect for both cancer and benign tumors was demonstrated.Conclusions: The study confirms the role of radiation in salivary gland carcinogenesis. It indicates a need for better awareness, a comprehensive examination, and long-term follow-up of patients who have been subjected to head and neck radiation. [ABSTRACT FROM AUTHOR]

Published
1998

7. A nationwide study of breast disease.

Author

Black, Maurice M., Modan, Baruch, Lubin, Flora, Triffleman, Elisa, Cuckle, Howard, Rosen, Nehama, Kwon, C. Stephen, Peretz, Michal, Alfandary, Esther, Black, M M, Modan, B, Lubin, F, Triffleman, E, Cuckle, H, Rosen, N, Kwon, C S, Peretz, M, and Alfandary, E

Published
1988
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10. Increased risk of breast cancer after low-dose irradiation.

Author

Modan, B, Chetrit, A, Alfandary, E, and Katz, L

Subjects
*AGE distribution, *BREAST tumors, *COMPARATIVE studies, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *RADIATION doses, *RADIATION carcinogenesis, *RESEARCH, *TINEA capitis, *EVALUATION research
Abstract

A significant increase in the risk of breast cancer has been found for the most recent 5-year period of a long-term follow-up study of children subjected to scalp irradiation, in whom a carcinogenic effect was previously only apparent in the head and neck. This increased risk was found among women aged 5 to 9 years at exposure. The breast had been exposed to a low radiation dose of approximately 16 mGy. [ABSTRACT FROM AUTHOR]

Published
1989
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11. The role of nutritional habits during gestation and child life in pediatric brain tumor etiology.

Author

Lubin F, Farbstein H, Chetrit A, Farbstein M, Freedman L, Alfandary E, and Modan B

Subjects
Adolescent, Brain Neoplasms epidemiology, Brain Neoplasms pathology, Child, Child, Preschool, Eating, Female, Humans, Infant, Male, Multivariate Analysis, Pregnancy, Brain Neoplasms etiology, Diet, Maternal Behavior, Nutritional Status
Abstract

Our aim was to evaluate the role of maternal nutritional habits during the period of gestation and of children subsequent diet in the etiology of pediatric brain tumors. All cases of incident nervous system tumors under age 18, diagnosed between 1984 and 1993 (n = 300) in Israel were identified. Two matched population controls per case were selected (n = 574). Personal interviews, using a semi-quantified three-step food frequency questionnaire, were performed. Univariate analysis showed that increased child consumption of vegetable fat [p trend 0.01; 95% confidence interval (CI) 1.1-3.2], carbohydrates (p trend 0.05; CI 1.0-5.9), and vitamin E (p trend 0.05; CI 1.0-3.3), were significantly associated with brain tumor risk. No associations were found with nitrate, nitrite or vitamin C. A significant positive association with potassium consumption (p trend 0.01; CI 1.1-3.7) was noted during gestation. Results of multivariate analysis showed that the only persisting associations were with vegetable fat (OR = 1.36; CI 1.06-1.73) in the child diet and potassium intake during gestation (OR = 1.44; CI 1.04-1.99). In conclusion, nutritional associations with pediatric brain tumor etiology, remain unsubstantiated.

Published
2000
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12. Cancer risk following radiotherapy for infertility or menstrual disorders.

Author

Ron E, Auvinen A, Alfandary E, Stovall M, Modan B, and Werner A

Subjects
Adult, Amenorrhea radiotherapy, Brain radiation effects, Breast Neoplasms epidemiology, Cohort Studies, Colon radiation effects, Colonic Neoplasms epidemiology, Confidence Intervals, Female, Genital Neoplasms, Female epidemiology, Humans, Incidence, Israel epidemiology, Ovary radiation effects, Pituitary Gland radiation effects, Risk Assessment, Risk Factors, Infertility, Female radiotherapy, Menstruation Disturbances radiotherapy, Neoplasms epidemiology, Radiotherapy adverse effects
Abstract

A cohort of 968 Israeli women treated with radiotherapy for infertility was followed up for cancer incidence. The majority of the subjects were irradiated to both the ovaries and the pituitary gland. Mean doses to the brain, colon, ovary and bone marrow were 0. 8, 0.6, 1.0 and 0.4 Gy, respectively. More than 10 years after radiation treatment, 60 cancers were observed compared with 74.5 expected based on national cancer incidence rates (standardized incidence ratio 0.81, 95% confidence interval 0.61-1.04). No statistically significant excess or deficit was seen for any individual type of cancer; however, a non-significant 60% increased risk of colon cancer was observed. Risk of colon cancer was higher among women with 2 or more treatments and increased with length of follow-up. A decreased risk of breast cancer was suggested. Neither age at exposure nor attained age modified subsequent cancer risk. No clear excess of any cancer site was observed among women at organ doses above the median compared with subjects at doses below the median, except a slight increase in colon cancer. No significant excess incidence of cancer was demonstrated in this small cohort of patients treated with radiotherapy for infertility. Our results are consistent with those from an earlier study of cancer mortality among women receiving radiotherapy for infertility conducted in New York City. Int. J. Cancer 82:795-798, 1999. Published 1999 Wiley-Liss, Inc.

Published
1999
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13. In vitro radiosensitivity of fibroblasts from thyroid and skin cancer patients treated with X-rays for tinea capitis.

Author

Ron E, Tarone RE, Modan B, Chaki R, Alfandary E, Parry DM, Makar M, Setlow N, Mulvihill JJ, and Miller RW

Subjects
Ataxia Telangiectasia epidemiology, Ataxia Telangiectasia genetics, Bias, Biopsy, Case-Control Studies, Cell Survival, Cells, Cultured, Cohort Studies, Colony-Forming Units Assay, Female, Fibroblasts cytology, Heterozygote, Humans, Israel epidemiology, Jews genetics, Male, Middle Aged, Neoplasms, Radiation-Induced epidemiology, Neoplasms, Radiation-Induced genetics, Radiation Dosage, Radiotherapy Dosage, Risk Factors, Skin Neoplasms epidemiology, Skin Neoplasms genetics, Thyroid Neoplasms epidemiology, Thyroid Neoplasms genetics, Fibroblasts radiation effects, Neoplasms, Radiation-Induced etiology, Neoplasms, Radiation-Induced pathology, Radiation Tolerance, Skin Neoplasms etiology, Skin Neoplasms pathology, Thyroid Neoplasms etiology, Thyroid Neoplasms pathology, Tinea Capitis radiotherapy
Abstract

To investigate the hypothesis that persons who developed thyroid or skin cancer subsequent to scalp irradiation for tinea capitis are particularly sensitive to radiation, possibly because of a high frequency of ataxia-telangiectasia, we used an in vitro cell survival assay to evaluate radiosensitivity of their fibroblast cell strains. Study subjects were selected from a cohort of 10,834 Israelis irradiated during childhood for tinea capitis. Skin fibroblasts were obtained from thyroid and skin cancer patients (cases) as well as a sample of subjects who did not have cancer (controls). Fibroblasts were cultured and then loss of colony-forming ability as a result of acute X-irradiation was evaluated. Comparison of survival curve parameters (mean inverse of the slope and the dose needed to reduce colony survival to 10%) between 12 thyroid cancer and 12 control strains showed no differences (P > 0.5). A slightly increased radiation sensitivity of the skin cancer cases compared with their controls was observed. Although based on few subjects (14 cases and 11 controls), the findings were similar whether the mean inverse of the slope (P = 0.06) or the dose needed to reduce colony survival to 10% (P = 0.05) was evaluated. However, because of the small size of the study and potential errors inherent in survival assays, our finding that cell strains derived from patients who developed skin cancer exhibit enhanced radiosensitivity should be viewed as preliminary and interpreted cautiously.

Published
1994

14. Factors affecting the development of skin cancer after scalp irradiation.

Author

Modan B, Alfandary E, Shapiro D, Lusky A, Chetrit A, Shewach-Millet M, and Movshovitz M

Subjects
Adolescent, Alopecia etiology, Child, Female, Head, Heliotherapy, Humans, Male, Neck, Radiation Injuries, Radiodermatitis, Radiotherapy Dosage, Risk Factors, Neoplasms, Radiation-Induced epidemiology, Scalp radiation effects, Skin Neoplasms epidemiology
Abstract

A nested case control study of persons who developed skin cancer after scalp irradiation in childhood revealed two risk factors for the appearance of radiation-induced skin cancer: (a) an apparently higher radiation dose delivered inadvertently, manifested by a higher prevalence of alopecia and radiation dermatitis (RR = 3.4; CI 1.3-8.8); (b) a more frequent exposure to the sun, manifested by summer sunbathing (RR = 2.6; CI 1.1-6.1). These findings may have certain implications with regard to the understanding of radiation-induced cancer, after low-dose radiation exposure, in general.

Published
1993

15. Radiation-induced skin carcinomas of the head and neck.

Author

Ron E, Modan B, Preston D, Alfandary E, Stovall M, and Boice JD Jr

Subjects
Adolescent, Age Factors, Carcinoma, Basal Cell epidemiology, Carcinoma, Basal Cell etiology, Child, Child, Preschool, Female, Head and Neck Neoplasms etiology, Humans, Infant, Israel epidemiology, Male, Melanoma epidemiology, Melanoma etiology, Neoplasms, Radiation-Induced etiology, Retrospective Studies, Risk, Sex Factors, Skin Neoplasms etiology, Head and Neck Neoplasms epidemiology, Neoplasms, Radiation-Induced epidemiology, Radiotherapy adverse effects, Scalp radiation effects, Skin Neoplasms epidemiology, Tinea Capitis radiotherapy
Abstract

Radiation exposures to the scalp during childhood for tinea capitis were associated with a fourfold increase in skin cancer, primarily basal cell carcinomas, and a threefold increase in benign skin tumors. Malignant melanoma, however, was not significantly elevated. Overall, 80 neoplasms were identified from an extensive search of the pathology logs of all major hospitals in Israel and computer linkage with the national cancer registry. Radiation dose to the scalp was computed for over 10,000 persons irradiated for ringworm (mean 7 Gy), and incidence rates were contrasted with those observed in 16,000 matched comparison subjects. The relative risk of radiogenic skin cancer did not differ significantly between men or women or by time since exposure; however, risk was greatest following exposures in early childhood. After adjusting for sex, ethnic origin, and attained age, the estimated excess relative risk was 0.7 per Gy and the average excess risk over the current follow-up was 0.31/10(4) PY-Gy. The risk per Gy of radiation-induced skin cancer was intermediate between the high risk found among whites and no risk found among blacks in a similar study conducted in New York City (Shore et al., Radiat. Res. 100, 192-204, 1984). This finding suggests the role that subsequent exposure to uv radiation likely plays in the expression of a potential radiation-induced skin malignancy.

Published
1991

16. Thyroid neoplasia following low-dose radiation in childhood.

Author

Ron E, Modan B, Preston D, Alfandary E, Stovall M, and Boice JD Jr

Subjects
Adolescent, Africa ethnology, Child, Child, Preschool, Female, Humans, Infant, Israel, Male, Middle East ethnology, Neoplasms, Radiation-Induced epidemiology, Risk, Sex Characteristics, Thyroid Neoplasms epidemiology, Neoplasms, Radiation-Induced etiology, Radiotherapy adverse effects, Thyroid Neoplasms etiology, Tinea Capitis radiotherapy
Abstract

The thyroid gland is highly sensitive to the carcinogenic effects of ionizing radiation. Previously, we reported a significant increase of thyroid cancer and adenomas among 10,834 persons in Israel who received radiotherapy to the scalp for ringworm. These findings have now been extended with further follow-up and revised dosimetry. Overall, 98 thyroid tumors were identified among the exposed and 57 among 10,834 nonexposed matched population and 5392 sibling comparison subjects. An estimated thyroid dose of 9 cGy was linked to a fourfold (95% Cl = 2.3-7.9) increase of malignant tumors and a twofold (95% Cl = 1.3-3.0) increase of benign tumors. The dose-response relationship was consistent with linearity. Age was an important modifier of risk with those exposed under 5 years being significantly more prone to develop thyroid tumors than older children. The pattern of radiation risk over time could be described on the basis of a constant multiplication of the background rate, and an absolute risk model was not compatible with the observed data. Overall, the excess relative risk per cGy for thyroid cancer development after childhood exposure is estimated as 0.3, and the absolute excess risk as 13 per 10(6) PY-cGy. For benign tumors the estimated excess relative risk was 0.1 per cGy and the absolute risk was 15 per 10(6) PY-cGy.

Published
1989

17. Tumors of the brain and nervous system after radiotherapy in childhood.

Author

Ron E, Modan B, Boice JD Jr, Alfandary E, Stovall M, Chetrit A, and Katz L

Subjects
Adolescent, Brain radiation effects, Brain Neoplasms epidemiology, Child, Child, Preschool, Dose-Response Relationship, Radiation, Female, Follow-Up Studies, Glioma epidemiology, Glioma etiology, Head and Neck Neoplasms epidemiology, Humans, Infant, Male, Meningioma epidemiology, Meningioma etiology, Neurilemmoma epidemiology, Neurilemmoma etiology, Risk Factors, Tinea Capitis radiotherapy, Brain Neoplasms etiology, Head and Neck Neoplasms etiology, Neoplasms, Radiation-Induced epidemiology, Radiotherapy adverse effects
Abstract

We investigated the relation between radiotherapy in childhood for tinea capitis and the later development of tumors of the brain and nervous system among 10,834 patients treated between 1948 and 1960 in Israel. Benign and malignant tumors were identified from the pathology records of all Israeli hospitals and from Israeli national cancer and death registries. Doses of radiation to the neural tissue were retrospectively estimated for each patient (mean, 1.5 Gy). Sixty neural tumors developed in the patients exposed as children, and the 30-year cumulative risk (+/- SE) was 0.8 +/- 0.2 percent. The incidence of tumors was 1.8 per 10,000 persons per year. The estimated relative risk as compared with that for 10,834 matched general-population controls and 5392 siblings who had not been irradiated was 6.9 (95 percent confidence interval, 4.1 to 11.6) for all tumors and 8.4 (confidence interval, 4.8 to 14.8) when the analysis was restricted to neural tumors of the head and neck. Increased risks were apparent for meningiomas (relative risk, 9.5; n = 19), gliomas (relative risk, 2.6; n = 7), nerve-sheath tumors (relative risk, 18.8; n = 25), and other neural tumors (relative risk, 3.4; n = 9). A strong dose--response relation was found, with the relative risk approaching 20 after estimated doses of approximately 2.5 Gy. Our study confirms that radiation doses on the order of 1 to 2 Gy can significantly increase the risk of neural tumors.

Published
1988
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