Adenocarcinoma of the oesophagus has been increasing in incidence in most developed countries in the last two decades (Powell and McConkey, 1990;Blot et al, 1991). The incidence of this condition in British women is among the highest in the world, with half of all cases in Europe occurring in the UK (Black et al, 1997). Previous studies, which had predominantly included men, had identified obesity, diet low in fruit and vegetables, and smoking as the main risk factors (Brown et al, 1995;Vaughan et al, 1995;Gammon et al, 1997;Chow et al, 1998;Lagergren et al, 1999). Little is known about the causes of this cancer in women. Here we report a multi-centre, population-based case-control study among British women together with an estimate of the overall population attributable risk of important risk factors in a multivariate fashion. This population-based case-control study was conducted in the former Regional Health Authorities (RHA) of East Anglia and Oxford, part of Trent RHA and Eastern Scotland covering the Health Boards of Highland, Grampian, Tayside, Fife, Lothian and Forth Valley. Ethical approval was given by all the local research ethics committees.Cases comprised all women aged under 75 years of age (80 years in Trent) resident in the study areas at the time of their diagnosis with oesophageal cancer. Results on adenocarcinoma only are reported here. Cases were identified through pathology departments, treating clinicians and cancer registries and all tumours were histologically confirmed. Care was taken to exclude tumours established as arising in the cardia of the stomach but a small number of cases of those arising at the gastro-oesophageal junction may be included.Cases were accrued over a 2-year period in each study region between 1993 and 1996. A single female control was matched to each case by age (within 5 years) and general practice. Potential controls were randomly selected using the Family Health Service Authority (FHSA) or Health Board primary care registers. Eligible controls who declined to take part were replaced.Women were approached with consultant or General Practitioner (GP) permission and asked for a personal interview. Trained interviewers used a standard form to conduct interviews either in hospital or at home. Information was collected on sociodemographic characteristics, smoking, alcohol, tea and coffee consumption, diet, previous medical and obstetric histories, and a number of other factors, including weight, height and use of vitamin supplements. Smoking was measured in pack years and total years of smoking whilst units of alcohol were categorized by average weekly and total lifetime consumption. A dietary questionnaire was used to obtain information for recent diet (3 years prior to interview) and at age 30 years. Consumption of fresh fruit, salad and vegetables was assessed by questions on food frequency. Categories for analysis were based on quartiles of the frequency of consumption per week among all controls (including those for cases of other histological diagnoses)...

Against the background of the increasing incidence of many immune mediated childhood conditions, this study aimed to identify recent time trends and ethnic patterns of childhood nephrotic syndrome. A population-based cohort of children (0-15 years) diagnosed according to strict criteria with nephrotic syndrome (NS) was ascertained within the northern UK region of Yorkshire between 1987 and 1998. South Asian ethnicity was assigned based on the child's full name using a dedicated computer algorithm and expert individual checks. NS was diagnosed in 194 children, 170 (88%) of whom were steroid sensitive. The incidence of steroid sensitive NS was 2.0/100,000 pyrs (95% CI 1.7-2.3), peaking in 1-4 year olds (4.1/100,000 pyrs). Over the 12-year study period incidence rates of steroid sensitive NS were fairly stable although south Asian children displayed significantly higher rates than non-south Asians (P<0.01). The size of our population-based series reflects the relative rarity of paediatric nephrotic syndrome but is nonetheless recent and includes larger numbers than previous reports. The absence of any increase in incidence over the last decade contrasts with other paediatric immune mediated conditions such as asthma and diabetes.

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The United Kingdom Childhood Cancer Study was designed to examine the relation between childhood cancer and preceding exposure to infectious diseases. The authors analyzed the relation between diagnosis (1991-1996) of acute lymphoblastic leukemia (ALL) at ages 2-5 years and clinically diagnosed infections in infancy. Almost all study children (96% of both cases and controls) were taken to a general practitioner for a non-immunization-associated visit at least once before their first birthday. Children diagnosed with ALL had significantly more clinically diagnosed infectious episodes in infancy than did controls; the average number of episodes was 3.6 (95% confidence interval (CI): 3.3, 3.9) versus 3.1 (95% CI: 2.9, 3.2). This case-control difference was most apparent in the neonatal period (< or =1 month); 18% of controls and 24% of ALL cases were diagnosed with at least one infection (odds ratio = 1.4, 95% CI: 1.1, 1.9; p < 0.05). Cases who had more than one neonatal infectious episode tended to be diagnosed with ALL at a comparatively young age; the mean age at ALL diagnosis was 37.7 months for cases with two or more episodes versus 45.3 months for cases with only one episode or none (p < 0.01). These findings support the hypothesis that a dysregulated immune response to infection in the first few months of life promotes transition to overt ALL later in childhood.

The incidence of childhood IDDM was associated with environmental factors including population density and overcrowded homes. A possible inference from these data is that patterns of infection are involved in the occurrence of IDDM. Analytical epidemiological studies will be needed to investigate these ideas further.