The most probable interpretation of these trends is that therapeutic improvements--including more widespread and timely surgery, introduction of less invasive techniques, such as transurethral prostatectomy, and possibly the development of medical treatments--have had a favourable and substantial impact on BPH mortality. There are, however, areas of the world, including several countries of western Europe and South America, where rates are still very high.

Epidemiological data on occupational exposure and personal use of hair dyes was reviewed with specific focus on bladder cancer and lymphoid neoplasms. At least seven cohort and 11 case-control studies included data on occupational exposure to hair dyes by hairdressers, barbers and beauticians, and their subsequent bladder cancer risk. The relative risk (RR) estimate was 1.4 (183 observed vs 129 expected) for cohort studies, and in several case-control studies the RRs were somewhat above unity. These results are compatible with some moderate association between past professional exposure to hair dyes and subsequent bladder cancer risk, but also with errors and biases in observational epidemiological studies, particularly since allowance for smoking was lacking or inadequate in most studies. An open question is whether current occupational exposure to modern hair dyes is still related to some excess bladder cancer risk. Five case-control studies included information on personal use of hair dyes and bladder cancer risk. There was no evidence of any association. Nine cohort and eight case-control studies considering occupational exposure to hair dyes and lymphoid neoplasms were reviewed. In the cohort studies, a total of 100 lymphoid neoplasms was observed compared with 84.4 expected (RR 1.2). The RR estimates were 1.5 for non-Hodgkin's lymphomas (NHL, 17 observed vs 11.2 expected) and 1.1 for multiple myeloma (MM, 19 observed cases vs 16.8 expected). Interpretation of case-control studies of occupational exposure is seriously hampered by the small number of exposed cases. Five case-control studies considered personal use of hair dyes and the risk of lymphoid neoplasms. Of these, three reported some association, particularly with NHL and MM. However, the RR estimates were only moderately above unity, and inadequate allowance was made for potential confounding factors, including social class and greying hair, which could be correlates of both hair dye use and lymphoid neoplasms. Further, there is little information on the biodistribution and bioavailability of potential carcinogens in hair dyes, particularly their concentrations in lymphoid tissue. These findings, therefore, require further research, particularly since they may be influenced by selective publication of positive findings (publication bias). None of the other neoplasms extensively studied, including breast, skin and lung was related to hair dye use.

The relationship between treatment with histamine-2 (H2)-receptor antagonists (cimetidine and ranitidine) and subsequent risk of gastric cancer was analyzed with data of a case-control study conducted in northern Italy between 1983 and 1991 on 628 incident cases of gastric cancer and 1776 control subjects who had been hospitalized for acute, nonneoplastic, non-digestive-tract disorders, with a specific focus on time-risk relationships and analysis of covariates. Previous use of H2-receptor antagonists was reported by 45 (7.2%) cancer patients and 68 (3.8%) control subjects; the corresponding multivariate relative risk (RR) was 2.1 (95% confidence interval [CI] 1.4-3.8). A significantly elevated risk, however, was evident only among individuals (27 patients and 23 control subjects) who had started using the drug less than 5 yr before diagnosis (RR 3.8, 95% CI 2.1-6.1). The risk estimate declined to 2.1 (95% CI 1.0-4.2) for use starting 5-9 yr before diagnosis and to 0.4 (95% CI 0.2-1.2) for use starting greater than or equal to 10 yr before diagnosis. When the relationship between use of H2-receptor antagonists and gastric cancer risk was examined across strata of sex, age, and other selected covariates (educational level, tobacco use, and alcohol and coffee consumption), all RRs were greater than unity for use starting less than 5 yr before diagnosis, but there was no evidence of any consistent association for use starting in the more distant past. Furthermore, there was no evidence of heterogeneity in the RRs for H2-receptor antagonist use and gastric cancer across strata of the covariates examined.(ABSTRACT TRUNCATED AT 250 WORDS)

Hysterectomy approximately halves the risk of ovarian cancer, possibly because of altered ovarian blood flow or the opportunity that hysterectomy provides for examining the ovaries.

We considered, by means of a multivariate approach, trends in survival from cutaneous malignant melanoma in relation to patient and tumor characteristics, using data from the Cancer Registry of the Swiss Canton of Vaud. Between 1980 and 1994, 1,229 cases of incident cutaneous malignant melanoma were registered. There was a decline in the proportion of neoplasms in the head and neck and lower limbs, and a rise in those of the trunk and upper limbs, an increase in superficial spreading melanoma and in tumors of limited thickness, mostly in females. Five-year crude survival was 0.68 for males and 0.82 for females, and relative survival of 0.79 for males and 0.89 for females, corresponding to a multivariate hazard ratio (HR) of 0.63 for females vs. males. Survival was inversely related to age, with 5-year relative survival of 0.92 at age 15-44 years, 0.85 at age 45-64 years, and 0.79 at age > or = 65 years. With reference to histological type, no significant difference was observed in males, but in females nodular melanoma showed reduced survival. Compared with melanoma of the limbs, the HR was 1.46 for melanoma of the trunk, and 1.23 for those in the head and neck, and the difference was greater in females. A strong relation, in both sexes, was observed between survival and tumor thickness, with an HR of 3.96 for tumors > or = 4 mm vs. those < 1.50 mm. After allowance for all other factors considered, most recent calendar period of diagnosis was associated with improved survival in both sexes (HR = 0.72), but mostly in females. Although differences in survival tended to be larger during the first 2 years after diagnosis, the pattern was similar for most prognostic factors considered up to 10 years after diagnosis.

The authors report trends in the incidence of colorectal carcinomas and polyps over an 18-year period (1979-1996), based on data from the Cancer Registry of the Swiss Canton of Vaud. The increase in ascending colon neoplasms is compatible with the impact of newer diagnostic techniques, which seems to have leveled off in recent years.

Problems of infertility or difficulties in conception, history of pelvic inflammatory disease/salpingitis, and abdominal surgery are the main risk factors for ectopic pregnancy in this Italian study. Sexual habits also appear to have some independent effect.

Mortality trends of breast, colorectal, ovarian and prostate cancer in Spain, Italy, Greece, Yugoslavia, and England and Wales are presented. Figures are discussed with regard to patterns of consumption of fat-containing foods in these countries. An increase of all cancer site mortality is shown in southern European countries, whereas in England and Wales a decrease in ovarian and colorectal cancer among women is observed. Consumption of milk, meat and animal fat products increased in all Mediterranean countries but decreased in England and Wales. Some differences regarding cancer mortality and food consumption patterns among southern European countries are pointed out. This markedly divergent fat consumption pattern between northern and southern Europe appears to antedate and be associated with their substantial differences in ovarian and colorectal cancer mortality trends, and to a lesser extent with breast cancer.