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Objectives. THe purpose of this study was to identify behaviors associated with change in body mass index or with weight gain at the waist. Methods. A cohort of 79 236 White, non-Hispanic, healthy adults was questioned in 1982 and 1992 about diet and 10 physical activities. Estimates were made of the mean effects of stable behaviors on 10-year change m body mass index and on odds ratios for gain at the waist. Results. Ten-year change in body ass index was associated positively with meat consumption and smoking cessation and inversely with vegetable consumption, vitamin E supplementation, continued smoking and some vigorous activities (e.g., jogging/running). Women's body mass index decreased with walking 4 or more hours per week and with regular alcohol intake, but these behaviors had a smaller effect on men's body mass index. Waist gain was inversely associated with high vegetable consumption, walking 4 or more hours per week, and jogging/running 1 to 3 hours per week but not with less demanding physical activities. Conclusions. Simple description of behaviors associated with weight loss or reduced abdominal obesity may enhance programs designed to prevent obesity and chronic diseases. (Am J Public Health. 1997; 87:747-754)

Lung cancer may have become the leading cause of death among smokers, with a special emphasis on women. Researchers compared death rates from major diseases among non-smokers and smokers collected by the American Cancer Society during the 1960s and the 1980s. This white middle-class population included more than 200,000 current cigarette smokers and more than 400,000 non-smokers. Cause of death shifted from heart disease and stroke to lung cancer in the 1980s. Per 100,000 smokers, lung cancer death rates increased from 26 to 155 among women and from 187 to 341 among men over a period of 20 years. In addition, the overall death rates from smoking of women smokers rose from 16.7% to 47.4% during the same period. Younger smokers died less frequently from lung cancer in the recent study compared to patterns seen in the 1960s. The death rates of men and non-smokers, on the other hand, did not vary much over time.

The authors examined the association between main lifetime occupation and subsequent breast cancer mortality in a large prospective study of US adults. After 9 years of follow-up, 1,780 cases of fatal breast cancer were observed among 563,395 women who were cancer-free at interview in 1982. Main lifetime occupation was derived based on self-reports of current and former occupational titles and was classified into 14 broad occupational groups and 16 more narrowly defined occupational titles. Results from Cox proportional hazards models, adjusted for breast cancer risk factors, revealed little variability in breast cancer mortality by occupation. Two significant associations were observed: In comparison with housewives, women in ‘administrative support, including clerical” occupations were at a small increased risk (rate ratio (RR) = 1.14, 95% confidence interval (Cl) 1.01–1.31), and an increased risk was seen for “executives” (RR = 1.93, 95% Cl 1.03–3.62), based on 10 breast cancer deaths. No significant increases in risk were observed for teachers and librarians (RR = 0.89), nurses (RR = 0.84), managers (RR = 0.89), or women employed in sales (RR = 0.88) or service (RR = 0.84) occupations. When analyses were limited to women who had worked in their occupation for 10 or more years, the results for each occupational title were virtually unchanged. These results offer little support for an association between occupation and breast cancer mortality in general or for particular occupational titles, including teachers and nurses. Am J Epidemiol 1998;148:191–7. [ABSTRACT FROM AUTHOR]

The authors examined the relation of hypertension, use of diuretics, and use of antihypertensive medications to the risk of fatal renal cell cancer in a prospective cohort study of 998,904 adult Americans followed for 7 years (1982–1989). Analysis included 335 renal cell cancer deaths (123 in women and 212 in men). Cox proportional hazards modeling was used to calculate rate ratios. Increased rate ratios were present for cigarette smoking in men and for elevated body mass index in both sexes. Significantly increased age-matched rate ratios, independent of smoking and body mass index, were present for hypertension, use of diuretics, and use of hypertension medications, but only for women. Multivariate testing confined these risks to hypertensive women who were using hypertension medications alone (rate ratio = 2.2, 95% confidence interval 1.4–3.5) or with diuretics (rate ratio = 2.5, 95% confidence interval 1.5–4 3). Risk was not significantly increased for either men or women who had untreated hypertension or who used diuretics alone with or without hypertension. These findings partly support those of earlier studies suggesting that medications related to treatment of hypertension, or the seventy of hypertension itself, may contribute to the etiology of renal cell cancer. [ABSTRACT FROM AUTHOR]

The authors examined the relation between smoking and the risk of fatal prostate cancer in a large prospective mortality study of 450, 279 men who were cancer free at enrollment in 1982. During 9 years of follow-up, 1, 748 deaths occurred from prostate cancer. Cox proportional hazards modeling was used to adjust for other risk factors Current cigarette smoking was associated with fatal prostate cancer (rate ratio = 1.34, 95% confidence interval (Cl) 1.16–1.56). The rate ratio was greater at younger ages, decreasing from 1.83 (95% Cl 1.04–3.24) among men below the age of 60 years to 1 11 (95% Cl 079–1.58) among men aged 80 years and above (p for trend = 0.16). No trend in nsk was observed with the number of cigarettes per day or with the duration of smoking among current smokers at baseline, and no increased nsk was found among former smokers. Race did not significantly modify the association between cigarette smoking and fatal prostate cancer. These data, together with those of three other large prospective studies that find higher death rates from prostate cancer in current cigarette smokers, and inconsistent findings in incidence studies suggest that smoking may adversely affect survival in prostate cancer patients Am J Epidemiol 1997; 145: 466-75. [ABSTRACT FROM AUTHOR]

Several studies suggest that tubal sterilization may decrease the risk of ovarian cancer. Data from the Cancer Prevention Study II were analyzed to examine the relation between tubal ligation and ovarian cancer mortality in a large prospective study. A total of 396,114 women who had not had hysterectomies and who had no prior history of cancer (except nonmelanoma skin cancer) were followed prospectively for approximately 9 years from 1982 to 1991. During this time, 799 ovarian cancer deaths were observed. Tubal ligation was significantly associated with a decreased risk of ovarian cancer mortality in an age- and race-adjusted Cox proportional hazards model (hazard ratio (HR) = 0.64, 95% confidence interval (Cl) 0.42–0.96), and the results were essentially unchanged when controlling for potential ovarian cancer risk factors (HR = 0.68, 95% Cl 0.45–1.03). The protective effect appeared to be greater in the first 20 years after the procedure (HR = 0.49, 95% Cl 0.24–0.99) than later (HR = 0.80, 95% Cl 0.48–1.34). No interactions between ever having had a tubal ligation and other covariates were observed. These data suggest that tubal ligation reduces the risk of fatal ovarian cancer. Am J Epidemiol 1997; 145: 349–57. [ABSTRACT FROM AUTHOR]

The authors examined the association between the use of diethylstilbestrol during pregnancy and the risk of subsequent fatal breast cancer in a large prospective study of US adults. After 9 years of follow-up, 1,574 cases of fatal breast cancer were observed among 501,536 gravid women who reported no prior history of cancer in 1982. Results from Cox proportional hazards models showed a positive association between a history of diethylstilbestrol exposure (reported by 3.9% of all women) and fatal breast cancer (adjusted rate ratio = 1.34,95% confidence interval 1.06–1.69). This excess risk did not increase over time; women who were exposed more than 35 years ago (rate ratio = 1.35,95% confidence interval 0.97–1.87) were not at greater risk than women who were exposed within the past 35 years (rate ratio = 1.39,95% confidence interval 1.01–1.93). The positive association was not observed in women who used diethylstilbestrol before age 25 years but was seen at all other ages. The age of study participants did not modify the association between exposure and breast cancer, and there were no significant interactions between ever use of diethylstilbestrol and any of the other potential risk factors included in the analysis. These findings are consistent with those of several other studies of diethylstilbestrol exposure and breast cancer. Am J Epidemiol 1996;144:645–52. [ABSTRACT FROM AUTHOR]