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Data on occupations and life styles of patients with cancer have been collected since 1983. To investigate cancer patterns and risks in farmers in Alberta, all farmers were abstracted and compared with nonfarmers in the data base, using case-control analysis. Controls were patients with cancer at any site except the index site. Significantly elevated odds ratio (OR), adjusted for age and smoking, were found among the farmers for cancers of the lip (OR = 3.22, 95% confidence interval [CI] = 2.14 to 4.84) and prostate (OR = 1.31, 95% CI = 1.11 to 1.55). Crude risk for lung cancer was significantly lower in farmers, but statistical significance disappeared when risk was adjusted for smoking (OR = 0.81, 95% CI = 0.65 to 1.02). Farmers were at considerably lower risk of malignant melanoma of the skin, compared with nonfarmers (OR = 0.57, 95% CI = 0.36 to 0.91).

Study Objective: The aim of the study was to evaluate the role of the general practitioner as a source of information for a cancer registry., Design: The study involved a random sample of respondents to a letter inviting participation which was sent to all general practitioners in a specific area. Participating doctors were visited to maximise cooperation. Data collection consisted of setting up a retrospective (prevalence) registry of cancer patients diagnosed over a 20 month period, and a prospective (incidence) register over a subsequent 12 month period. The general practitioner cancer file was then linked to the total cancer registry data base to estimate missed cases., Setting: The study took place in the catchment area of the Comprehensive Cancer Centre Middle-Netherlands (IKMN)., Participants: Of 448 general practitioners in the IKMN region, 152 were willing to participate and of these 52 were randomly selected to take part (11% of all general practitioners in the region)., Measurements and Main Results: A total of 1637 tumours were identified from the general practitioners, of which 252 (15.4%) were not included in the cancer registry. Of these, only 22 (1.3%) were not included in the registry because they had tumours diagnosed clinically in outpatients and therefore had been omitted from the usual sources of information available to the cancer registry (pathology reports, hospital discharge letters). The missed cases were mostly older patients with digestive tract tumours., Conclusions: On cost-benefit grounds it was not considered feasible to initiate an active cancer registration system among general practitioners, provided that notification of pathological examinations to the registry is complete. Limited under-registration will occur when death certificates cannot be used as an additional source of information.

The patterns of cancer risk by religion in the large multidenominational population of Los Angeles County were examined with the method of proportional incidence. Risk estimates for individual cancers by religion were screened and those extreme but stable estimates found were reexamined in light of relative socioeconomic class, nativity, and ethnicity. Within Protestant denominations, gradients which can still best be attributed to religious preference were observed for leukemia, stomach, and cervix cancer. Roman Catholics tend to have high risks of stomach and gallbladder and a low risk of prostate cancer, whereas Eastern Orthodox women trade high risk of stomach cancer for low risk of endometrial and lung cancer. The most extreme pattern of risk, that for Jews, is comprised of lowered risk for cervical cancer and for most sites usually associated with smoking, plus consistently higher risk for lymphomas, thyroid cancer, and bladder cancer among males. Like Jews, Seventh-Day Adventists experience high risk for lymphoma and low risk for cervical and respiratory cancers. Risk to Mormons in Los Angeles differs from that of the standard Protestant population in only minor and inconsistent ways. Neither Mormons nor Adventists showed the previously reported deficits of colorectal or breast cancer. Although the method of proportional incidence may be partly responsible for our failure to confirm previous findings, nonreligious cultural or methodologic factors in the original investigations also provide plausible explanations. More generally, associations of the modest magnitude observed between cancer risk and religion in American populations should probably not be attributed to religious life-style, unless extraordinary circumstances permit the exclusion of other determinants.

In 1985 the regional cancer registry in the IKMN area started. Pathology reports are used as the primary source of information for the registry. In order to evaluate the completeness of the registry, the registry database was compared with the discharge diagnosis register of the participating hospitals (LMR). In 1986 a total of 3546 tumours were registered by the registry, using the pathology reports as the primary source. The comparison with the LMR revealed that 616 patients were included in the cancer registry but not in the LMR. On the other hand 376 patients, in 180 of whom the diagnosis was confirmed by pathological examination while in 196 the diagnosis was based on clinical grounds only, were missing in the registry. Specifically, tumours of the central nervous system, liver, gallbladder, bile ducts and pancreas were missed in a high percentage. It is concluded that--even with an optimal pathology notification system--the LMR check is necessary to avoid underregistration. Omitting this check results in a 5% underregistration.