Record-Linkage Studies of Cancer

来自瑞典、丹麦和美国退伍军人医院的人口普查和出院数据，与癌症、死亡率和可用的人口登记的随访相关联，用于评估具有特定医疗和职业暴露的个人的癌症风险。瑞典糖尿病患者的死亡率在所有主要死因中都有所上升，特别是循环系统、呼吸系统、消化系统、生殖-泌尿系统和恶性肿瘤。年龄最小的糖尿病患者因各种原因导致的死亡率增幅最大。肥胖的瑞典患者患消化道、尿道、女性生殖器官和结缔组织癌症的风险增加。瑞典血色素沉着症患者在9年后患肝癌的累积风险为10%。瑞典乳糜泻患者患上消化道淋巴瘤和癌症的风险增加。瑞典牛皮癣患者与酒精和烟草消费相关的几种癌症的风险增加，但他们患恶性黑色素瘤的风险没有增加。瑞典和丹麦肢端肥大症患者患多种癌症的风险增加，包括小肠癌和大肠癌、直肠癌、脑癌、甲状腺癌、肾癌和骨癌。可能涉及到几种可能的机制，例如这些患者体内IGF-1水平升高。在丹麦和美国退伍军人医院的数据中，我们调查了炎症性肠病（溃疡性结肠炎和克罗恩病）、阑尾切除术和癌症之间的联系。我们没有发现丹麦患者或美国退伍军人阑尾切除术后溃疡性结肠炎风险降低的证据。除妊娠期绒毛膜癌外，未发现有磨牙妊娠的丹麦妇女患任何癌症的风险增加。因淋病住院的丹麦妇女患宫颈癌前瘤变的风险增加，但浸润性宫颈癌或任何其他癌症的风险没有增加。患有神经性厌食症的丹麦妇女随后患癌症的风险没有显著降低，这与能量限制可以减少肿瘤发展的理论是一致的。从事柴油机排放的职业的瑞典男性和女性患呼吸系统和消化系统癌症的风险增加，女性患宫颈癌的风险也增加。从事纸包装、绘图、干洗、电报和电话工作的瑞典妇女患卵巢癌的风险增加。1960年和1970年，从事久坐工作的瑞典男性前列腺癌发病率上升，但死亡率没有上升。一项针对瑞典建筑工人的研究发现，即使体重或血压轻微超标，也会增加患肾细胞癌的风险，而血压的降低则与癌症风险的降低有关。今年启动了一项大型新研究，以评估自身免疫性疾病和淋巴增生性恶性肿瘤（LP）的家族性聚集性。我们将研究5万例瑞典和1万例丹麦的LP病例，相似数量的非癌症对照，以及他们所有亲属的计算机化医疗数据（癌症和医院诊断）。

Census and hospital discharge data from Sweden and Denmark and U.S. Veterans hospitals, linked for follow-up to cancer, mortality, and population registries where available, were used to assess cancer risk among individuals with specific medical and occupational exposures. Mortality among diabetics in Sweden was elevated for all major causes of death, particularly circulatory, respiratory, digestive, genito-urinary, and malignancies. The youngest diabetics had the greatest increased mortality from all causes. Obese Swedish patients were at increased risk of cancers of the digestive tract, urinary tract, female reproductive organs and connective tissue. Swedish patients with hemochromatosis had a cumulative risk of hepatic cancer of 10% after about nine years. Swedish Celiac patients had an increased risk of lymphoma and cancers of the upper digestive tract. Swedish psoriasis patients were at increased risk of several cancers associated with alcohol and tobacco consumption, but they had no increase in malignant melanoma. Swedish and Danish acromegaly patients were at increased risk of several cancers, including cancers of the small and large intestine, rectum, brain, thyroid, kidney and bone. Several possible mechanisms could be involved, such as the elevated levels of IGF-1 in these patients. In Danish and U.S. Veterans hospital data, we investigated the link between inflammatory bowel diseases (ulcerative colitis and Crohn's disease), appendectomy and cancer. We found no evidence of a reduced risk of ulcerative colitis subsequent to appendectomy in either Danish patients or U.S. veterans. Danish women with molar pregnancy were not found to be at increased risk of any cancer other than gestational choriocarcinoma. Danish women hospitalized with gonorrhea were at increased risk of cervical pre-neoplasia, but not invasive cervical cancer or any other cancers. Danish women with anorexia nervosa had a non-significantly reduced risk of subsequent cancer, which is consistent with the theory that energy restriction may decrease tumor development. Swedish men and women employed in occupations exposed to diesel engine emissions showed increased risks of respiratory and digestive cancers, and also cervical cancer among women. Swedish women employed in paper packaging, graphic work, dry cleaning, telegraph and telephone work were at increased risk of ovary cancer. Prostate cancer incidence, but not mortality, was elevated for Swedish men employed in sedentary occupations in 1960 and 1970. A study of Swedish construction workers found that even small excesses in weight or blood pressure were associated with increased risk of renal cell cancer, and reduction in blood pressure was associated with reduced cancer risk. A large new study was initiated this year to assess familial aggregation of autoimmune diseases and lymphoproliferative malignancies (LP). We will study 50,000 Swedish and 10,000 Danish cases of LP, a smiliar number of non-cancer controls, and all their relatives' computerized medical data (cancers and hospital diagnoses).