The First National Health and Nutrition Examination Survey (NHANESI), conducted in 1971-1975, included a cohort of 6913 adults for whom history of smoking, allergies, and other factors was obtained. These persons were traced (with 93% success) approximately 10 years later by the NHANESI Epidemiologic Followup Survey, and incidence of malignancy in the interim period was determined. Primary allergy variables were physician-diagnosed asthma, hay fever, hives, food allergy, or other allergies. Excluded were persons with a prior history of cancer and cases of nonmelanoma skin cancer. After adjustment by logistic regression for age, sex, race, and smoking history, allergic history was found to increase the risk of subsequent malignancy (risk odds ratio = 1.40, 95% confidence interval = 1.10-1.77). The specific allergy type with the strongest cancer risk was hives. The cancer group with the strongest allergy association was lymphatic-hematopoietic (leukemia, lymphoma, myeloma). The risk odds ratio of developing leukemia, lymphoma, or myeloma for persons with hives history was 7.89 (95% CI = 3.13-19.89). These findings suggest that a history of allergy does not protect against subsequent cancer, and may be a risk factor. The possibility is raised that a history of hives may be a particular risk factor for lymphatic-hematopoietic malignancies.

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Adult asthma has been the subject of relatively few epidemiologic studies; separation from chronic obstructive pulmonary disease (COPD) has been difficult. Utilizing a cohort of 14,404 subjects, 25 to 74 yr of age, from the First National Health and Nutrition Survey (NHANESI, 1971-75) traced by the NHANESI Epidemiologic Followup Survey (1982-84), we investigated prevalence, incidence, predictors, and consequences of adult asthma. Cases were based on subject reports of active doctor-diagnosed asthma (without COPD). Differentiation of asthma from COPD was partially successful, as suggested by correlations with smoking status and pulmonary symptoms, but was imperfect, as suggested by subsequent hospital experience. Followup interview underestimated interim hospital diagnosis of asthma by 28%. Prevalence of active asthma at NHANESI among U.S. adults was estimated at 2.6%, and followup incidence of new-onset asthma at 2.1/1,000/yr. Low income was the strongest independent predictor of asthma; the higher rates seen in blacks were largely explained by their lower income. Males and females had equal prevalence rates, but females had higher incidence rates. Asthma prevalence and incidence were independent of age and cigarette smoking. Asthmatics were often hospitalized with various lung conditions in the followup period, but unlike those with COPD, did not have a significantly increased risk of death.

The relation between race, type of initial treatment, and survival with breast cancer were investigated using 36,905 cases reported to nine registries in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute in the years 1978-82 and followed for survival through 1984. Using the crude treatment categories of surgicallnonsurgical/untreated, Blacks were found to have received less aggressive therapy. They were more likely than Whites to be treated nonsurgically (OR = 1.4; 95%

Colorectal cancers of histologic varieties other than adenocarcinoma have distinctive epidemiologic and clinical traits.