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Background: There are very limited data on cancer among U.S. Hispanics. The data that are available seldom appear outside individual registry reports. Without coalescing and assessing such information, the epidemiology of cancer among Hispanics cannot be understood., Purpose: This article presents an overall view of the epidemiology of cancer among Hispanic populations in the United States., Methods: Major types of cancer were reviewed from geographic areas with 1) large Hispanic/Latino populations and 2) population-based cancer registries that cover 68% of the U.S. Hispanic population. Age-standardized rates, standardized rate ratios, and ranks of the top cancers are presented for Hispanics and non-Hispanics by sex., Results: Hispanic men had consistently lower rates of cancers of the lung, prostate, colon, rectum, and oral cavity as well as of melanoma and non-Hodgkin's lymphoma than non-Hispanic men. Among Hispanic men, higher rates were observed for cancers of the stomach, liver, and gallbladder. Compared with the rates in non-Hispanic women, Hispanic women had consistently lower rates of cancers of the breast, colon, rectum, endometrium, lung, ovary, and oral cavity, non-Hodgkin's lymphoma, and melanoma and higher rates of cancers of the uterine cervix, stomach, liver, and gallbladder. Perhaps more importantly, however, was that, within U.S. Hispanic populations, the top five sites of cancer for women were breast, colon, lung, cervix, and uterine corpus. For men, the top sites were usually prostate, lung, colon, stomach, and rectum. Furthermore, some geographic areas showed differences in the order of importance within these five sites, while in other areas, the top five cancers for Hispanic men included kidney and bladder cancers, liver cancer, and non-Hodgkin's lymphomas. For women, other leading cancers mentioned were ovarian cancer, non-Hodgkin's lymphoma, and gallbladder cancer., Conclusions: Hispanics had consistently lower rates of breast, lung, prostate, and colon cancers than non-Hispanics. In some geographic regions, however, differences in cancer incidence rates with respect to specific sites existed between the heterogenous Hispanic populations. Furthermore, the rankings demonstrated that, even if Hispanics have lower rates of the most common cancers than non-Hispanics, such sites are still the most important cancers among Hispanic populations., Implications: Cancer is a major problem among U.S. Hispanic populations. The information given in this article can be used to develop etiologic studies and cancer control interventions. Data limitations and recommendations for improving data quality are presented.

Epidemiologic data on the average daily human dietary intake of the trace elements nickel, cadmium, molybdenum and silicon are scarce, worldwide, primarily because foods consumed vary widely over days and seasons. Available full year food allocation records for farmers in rural areas of China provide an unique opportunity to estimate dietary trace elements. In 1988, we measured the concentration of zinc, copper, iron, cadmium, nickel, molybdenum, silicon and selenium in different foods by using food samples collected from 232 villages (distributed among 21 communes). These measurements, combined with the food consumption information from existing food allocation records in each commune for an entire year, allowed us to estimate the average daily consumption of these trace elements by Chinese farmers. With one exception (an association of zinc and esophageal cancer), the variation of dietary trace elements did not show any association with mortality from several common diseases. The estimates for some of the dietary trace elements from some subpopulations were either less or more than current recommendations. No increases in mortality were found, however, from diseases normally associated with either dietary deficiencies or excesses of these elements.

In 1985, residents of a suburban community in South Florida became concerned when several young women were diagnosed with breast cancer. First as individuals, then through a community-based effort, they attempted to gain attention and action on what they believed to be a cluster of breast cancer. Through their efforts to find out whether some agent or toxic exposure existed in the community that might have caused breast cancer, the women formed a community-based organization. This paper describes the activism of the women to resolve the issue through an epidemiologic study of the breast cancer occurrence in their community. Furthermore, it substantiates the need and role of rational community response in resolving community threats and concerns.

In 1970 a questionnaire was sent to 97,300 married women aged 25-50 years residing in eastern Massachusetts information was requested on use of oral contraceptives (OC), education, and gynecologic and reproductive histories. Subsequent questionnaires were sent in 1973 and 1979 to a subset of the original cohort (37,000) to obtain recent information. Surveillance of 34 hospitals disclosed 622 cases of breast cancer among respondents diagnosed in a 6 1/2-year period. The rate ratio of breast cancer associated with any use of OC was 0.84 (95% confidence limits: 0.7, 1.1). Although certain subgroups users experienced significantly lower rates of hospitalization for breast cancer than did nonusers (including users aged 25-29, those for whom less than or equal to 5 yr had passed since first use, women with ages at birth of first child either before 25 or after 30, and women who first used OC after the birth of the first child), the risk of breast cancer OC after the birth of the first child), the risk of breast cancer was not consistently lower among users of OC. Among nulliparous women, the rate ratio associated with use of OC was 2.1 (0.9, 5.0).

The relationship between oral contraceptive (OC) use and occurrence of fibrocystic breast disease (FBD) of different histologic classifications was evaluated with data from a cohort study. Biopsy specimens from 232 women with FBD were classified into different atypia categories. In 96 matched pairs of OC users and nonusers, atypia scores were lower in users than in nonusers. Women without breast diseases (500 OC users and 500 nonusers) were sampled from the original cohort to form a two-stage "anamorphic" study with the 232 cases of FBD. The previously shown inverse association between OC use and FBD occurrence was present and increased with increased length of OC use. However, the "protective effect" of OC use did not vary for different histologic classifications of FBD. The findings from both paired and anamorphic analyses of the data are not consistent with the hypothesis that the use of OC is associated with decreased frequency only of FBD with minimal epithelial atypia.

A prospective cohort study of approximately 97 300 women was conducted in eastern Massachusetts. Information on use of oral contraceptives, and on gynaecological and reproductive histories was sought through mailed questionnaires, while newly diagnosed cases of cancer of the endometrium were identified from records of 34 area hospitals. Oral contraceptive (OC) use was associated with some increase in endometrial cancer rates (standardized rate ratio = 1.4; 95% confidence interval = 0.9-2.4), although the risk did not vary consistently by length of use, years since first use, or age at initial use. Although some subgroups of users had rates of disease higher than among nonusers, there was little to suggest a consistent association between OC use and incidence of endometrial cancer.

We describe our experience at Jackson Memorial Hospital in Miami, Florida, with 172 children who were given diagnoses of perinatally acquired infection with human immunodeficiency virus type 1 (HIV-1). The 146 mothers of the children acquired HIV-1 through heterosexual contact (69 percent), intravenous drug use (30 percent), or blood transfusion (1 percent). The children presented with symptomatic disease at a median age of eight months; only 21 percent presented after the age of two years. The most common first manifestations of disease were lymphoid interstitial pneumonia (in 17 percent), encephalopathy (in 12 percent), recurrent bacterial infections (in 10 percent), and candida esophagitis (in 8 percent), for which the median survival times from diagnosis were 72, 11, 50, and 12 months, respectively. Nine percent of the children had Pneumocystis carinii pneumonia at a median age of five months and had a median survival of only one month. The median survival for all 172 children was 38 months from the time of diagnosis. Mortality was highest in the first year of life (17 percent), and by proportional-hazard analysis the probability of long-term survival is low. In multivariate analyses, early age at diagnosis and the first identifiable pattern of clinical disease were found to be independently related to survival. We conclude that children with perinatally acquired HIV-1 infection have a very poor prognosis and that most become symptomatic before one year of age. Early diagnosis is important, since there is only a short interval in which to initiate prophylactic or antiviral treatment before progressive disease begins.

The relation between age at first birth and the occurrence of fibrocystic breast disease of different atypia subtypes was evaluated using data from a cohort study of the health effects of oral-contraceptive use. Multivariate case-control analysis was performed on 218 parous women with biopsied fibrocystic disease and 928 parous controls. Fibrocystic breast disease, as a whole and as atypia subtypes, was found to be unrelated to age at first birth. Furthermore, the estimated effect of age at first birth did not vary from one atypia subtype to another. Women with high parity were found to be at decreased risk of fibrocystic breast disease compared to those with low parity. Age at completion of education, used as an indicator of socioeconomic status, was found to be moderately associated with fibrocystic breast disease. The estimated effect of parity and age at completion of education also did not vary among subtypes. More epidemiologic studies specific to histopathologic classifications of benign breast disease are called for.

The relationship between estrogen replacement therapy (ERT) and the risk of benign breast disease (BBD) was examined among 929 postmenopausal cases and 846 postmenopausal controls identified through a large breast cancer screening program. Prior use of ERT among postmenopausal women was associated with an increased risk of both fibrocystic breast disease [odds ratio (OR) = 1.4; 95% confidence interval (Cl) = 1.1-1.8] and fibroadenoma (OR = 1.6; Cl = 0.8-3.5). The risk of all BBD rose with increasing years of use (OR = 1.9 for greater than or equal to 15 yr of total use) and with years since initial use (OR = 1.6 for greater than or equal to 15 yr since first use). Among users of the conjugated estrogen Premarin, increased risks were found at all but the lowest dose. Finally, risks associated with ERT were higher in women with a bilateral oophorectomy than in other postmenopausal women. These results suggested, overall, an increased risk of BBD associated with ERT.