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We sought to study the association between intrauterine device (IUD) use and endometrial cancer.A comprehensive search of literature published through April 2007 was conducted, studies reviewed, and data abstracted. Data from ten studies were pooled and analyzed using both fixed- and random-effects models to examine the association of ever use of an IUD and endometrial cancer.Based on the random effects model, a protective crude association between IUD use and endometrial cancer was observed (odds ratio [OR] = 0.39; 95% confidence interval [CI] = 0.29-0.51; heterogeneity p0.001) with a pooled adjusted risk of OR = 0.54 (95% CI, 0.47-0.63; heterogeneity p = 0.40). A decreased risk of endometrial cancer also was seen for increased years of IUD use (OR for 5 years of use 0.88; 95% CI = 0.84-0.92; n = 5; heterogeneity p = 0.14), increased years since last IUD use (OR for 5 years of use 0.91; 95% CI, 0.86-0.95; n = 4; heterogeneity p = 0.02), and increased years since first IUD use (OR for 5 years of use 0.89; 95% CI, 0.83-0.95; n = 4; heterogeneity p = 0.04).Our results suggest that nonhormonal IUD use may be associated with a decreased risk for endometrial cancer; however, the exact mechanism for this association is unclear. Future investigations should address the difference in the proposed association by specific type of IUDs.

Purpose This study was designed to determine the occupational risk factors associated with voice disorders among schoolteachers, a high-risk population for developing voice problems. Methods Telephone interviews were completed by 1243 teachers from Utah and Iowa. Response rates were 98% and 95%, respectively. Bivariate analyses were computed and assessed using chi-square test and Cochran-Mantel-Haenszel test, and logistic regression analyses were performed and resulting odds ratios assessed using 95% confidence intervals. Results Teachers of vocal music, drama, other performing arts and chemistry were at significantly greater risk of having a voice disorder (OR = 2.2, 95% CI: 1.2–4.0; OR = 2.1, 95% CI: 0.9–4.8; OR = 1.6, 95% CI: 1.0–2.4; OR = 2.0, 95% CI: 1.1–3.4), while teachers of special and vocational education had a significantly lower risk (OR = 0.5, 95% CI: 0.3–0.7; OR = 0.6, 95% CI: 0.4–0.9). When adjusted for the intensity of vocalization, only teachers of chemistry were significantly at risk (OR = 2.0, 95% CI: 1.1–3.5) while teachers of special education continued to have less of a risk (OR = 0.5, 95% CI: 0.4–0.8). Chronic voice disorders were more prevalent among teachers of vocal music (OR = 4.1, 95% CI: 2.2–7.9) and less prevalent among teachers of vocational education (OR = 0.29, 95% CI: 0.09–0.95). Conclusions These findings suggest that teachers of specific courses are at greater risk of developing a voice disorder.

PURPOSE: This study investigated the association between detection of HPV DNA among current and past HRT users compared to never HRT users, duration of HRT use, and type of HRT (estrogen, estrogen/progestin). METHODS: Postmenopausal women (n = 390) were recruited from a university hospital and completed a questionnaire regarding 1) HRT use, duration, and type, 2) reproductive and sexual history, 3) smoking and alcohol use, and 4) HPV-related diseases. Cervical specimens were obtained for Pap smears, and for the presence of HPV using PCR/dot blot and DNA sequencing, and Southern blot or SSCP. Age-adjusted odds ratios (OR), 95% confidence intervals (CI), and logistic regression examined the association between HRT use and risk of HPV detection. RESULTS: The frequency of HPV was 10%, with 2.8% oncogenic types. Compared to Never Users, Current (adj. OR = 1.50, 95% CI = 0.55, 4.07) and Past (OR = 1.96, CI = 0.56, 6.86) HRT users had an elevated risk of HPV detection. Although HRT duration among Current Users was not statistically significant (OR = 1.01, 95% CI = 0.95, 1.07), duration among Past Users was significantly associated with an increased risk of HPV detection (OR = 1.30, CI = 1.06, 1.61). In addition, Past Users of estrogen/cyclic progestin HRT regimens were significantly more likely to be detected with HPV (OR = 1.82, CI = 1.11, 2.97) compared to Never Users. CONCLUSIONS: These findings indicate that risk of HPV detection is increased among users of HRTs, particularly among Past Users associated with longer duration and among those taking HRT regimens that included a progestin. Results suggest a latency or duration effect may be important in elevating the risk. They also support previous in vitro studies of progestin effects on HPV gene regulation.

ENVIRONMENTAL/OCCUPATIONAL PURPOSE: Determine occupational exposures associated with salivary gland cancer mortality. METHODS: We conducted a death certificate-based case-control study, including African American (168 cases, 672 controls) and white (2237 cases, 8748 controls) men and women in 24 states during 1984-89. Controls were frequency matched by 5-year age group, sex, race, and geographic region, excluding infectious causes of death. A job exposure matrix based on occupation/industry code (1980 US Census) at time of death was used to estimate exposure probability and intensity. Race and sex-stratified multiple logistic regression models estimated adjusted Odds Ratios (aOR: age, socio-economic (SES) and marital status adjustment). RESULTS: A higher proportion of African American cases were under age 50, compared with white cases (20.8% versus 8.8%, respectively; p 0.001). Among white men, higher SES was associated with higher mortality risk in a dose-dependent fashion (p trend 0.05). Ionizing radiation exposure was associated with increased mortality (aOR 1.7; 95% CI: 1.05-2.80), but only among white men. Occupations with moderate physical activity were associated with a 20% reduced mortality risk among men in both groups, compared with sedentary occupations (aOR 0.8; 95% CI: 0.61-0.99, white; aOR 0.8; 95% CI; 0.19-3.69, African American). Formaldehyde, solvents, ultraviolet radiation, and animal contact were associated with elevated risk among white men (p 0.05). Among African American women, formaldehyde, solvents, benzene, and animal contact exposures were suggestive, but not statistically significant. CONCLUSION: These findings provide supporting evidence for an association with occupational radiation exposure and suggest new avenues for investigation including SES and racial/ethnic differences.