Encourage men age 45 to 79 years to use aspirin when the potential benefit of a reduction in myocardial infarctions outweighs the potential harm of an increase in gastrointestinal hemorrhage. (A recommendation) Encourage women age 55 to 79 years to use aspirin when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage. (A recommendation) Evidence is insufficient to assess the balance of benefits and harms of aspirin for cardiovascular disease prevention in men and women 80 years or older. (I statement) Do not encourage aspirin use for cardiovascular disease prevention in women younger than 55 years and in men younger than 45 years. (D recommendation).
The findings of a case‐control study of cancer of the pancreas, which was conducted in the Baltimore metropolitan area, are reported. Two hundred one patients with pancreatic cancer were matched on age (±5 years), race, and sex to hospital and non‐hospital controls, the latter selected by random‐digit‐dialing (RDD). All subjects were interviewed regarding diet, beverage consumption, occupational and environmental exposures, and medical and surgical history. Significantly decreased risks were associated with consumption of raw fruits and vegetables and diet soda, and significantly increased risks were associated with consumption of white bread when cases were compared with hospital and RDD controls. A significantly reduced risk was associated with consumption of wine when cases were compared to RDD controls. Risk ratios for consumption of coffee were not significantly different from one, although there appeared to be a dose‐response relationship in women. A moderate but statistically nonsignificant increase in relative odds was found for cigarette smoking, and cessation of smoking was associated with a marked reduction in risk. No significant associations were found with particular occupational exposures. Tonsillectomy was associated with a significantly reduced risk, a finding that has been observed for other cancers as well. The current evidence indicates that pancreatic cancer is likely to result from a complex interaction of factors and suggests that the study of its etiology requires a multidisciplinary approach involving both laboratory and epidemiologic components.
An exploratory case-control study was conducted in 15 hospitals in the Baltimore, MD, SMSA of possible etiologic factors associated with brain tumors in children. Eighty-four children with brain tumors were compared to normal children and to children with other malignancies. Parents of these children were interviewed about a variety of possible etiologic factors. The findings included: 1) children with brain tumors as well as children with other cancers had a greater tendency than normal children to have been first births and to have had higher birth weights; 2) more children with brain tumors had a sibling with epilepsy or seizures than did normal children, and several of the mothers of children with brain tumors had themselves had epilepsy or a stroke at a relatively young age; 3) there were no significant differences between the groups with regard to several maternal characteristics, including smoking during pregnancy and prior radiation exposure; 4) more children with brain tumors and children with other cancers were found to have had exposures to insecticides than had normal children; 5) fewer children with brain tumors or with other cancers were reported to have had tonsillectomies than normal children; and 6) more of the children with brain tumors as well as the children with other malignancies were reported to have been exposed to farm animals and to sick pets. This exploratory study is one of the first case-control studies of the epidemiology of brain tumors in children, and the results suggest directions for future epidemiologic studies in this relatively uncharted field.
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