| Biostatistics Branch
Diet and Risk of Esophageal Cancer in White Men and Black Men
Food frequency questionnaires from a population-based case-control study
of white men and black men were analyzed for dietary factors related to
risk of squamous cell esophageal cancer. Cases consisted of 114 whites
and 219 blacks, and controls consisted of 681 whites and 557 blacks. Protective
effects were associated with increasing categories of raw fruit and vegetable
consumption and with vitamin supplements (especially vitamin C) in both
racial groups, with consumption being greater among white than black control
subjects. Elevated risks were associated with high intake of red meat
(particularly for black men) and processed meat, with levels of consumption
being greater among black than white control subjects. These differences
in dietary patterns may contribute to the fivefold higher incidence of
squamous cell esophageal cancer among black men than white men in the
United States. (Brown LM, Swanson CA, Gridley G, Swanson
GM, Silverman DT, Greenberg RS, Hayes RB, Scohenberg JB, Pottern LM, Schwartz
AG, Liff JM, Hoover R, Fraumeni JF Jr. Dietary factors and the risk of
squamous cell esophageal cancer among black and white men in the United
States. Cancer Causes Control 1998;9:467-474)
Gastric Cancer in Two Counties of China
Linqu County in Shandong Province of northeast China has a gastric cancer
rate 15 times higher than Cangshan County in Shandong Province, even though
these counties are within 200 miles of each other. With use of endoscopy
to evaluate the rate of precancerous gastric lesions, the prevalence of
intestinal metaplasia and dysplasia was found to be 30 percent and 15
percent, respectively, among 3,400 adults in Linqu compared to 8 percent
and 6 percent among 224 adults in Cangshan. Within these histologic categories,
advanced grades were found more often in Linqu than in Cangshan, supporting
the role of intestinal metaplasia and dysplasia in the multistep process
of gastric carcinogenesis. (You WC, Zhang L, Gail MH,
Li JY, Chang YS, Blot WJ, Zhao GL, Liu WD, Li HQ, Ma JL, Hu YR, Bravo
JC, Correa P, Xu GW, Fraumeni JF Jr. Precancerous lesions in two counties
of China with contrasting gastric cancer risk. Int J Epidemiol 1998;27:945-948)
In Cangshan County, the prevalence of Helicobacter pylori
infection was lowest among those with normal gastric mucosa, rising steadily
to 35 percent for superficial gastritis, 56 percent for chronic atrophic
gastritis, 80 percent for intestinal metaplasia, and 100 percent for dysplasia.
In a comparison of H. pylori-positive precancerous lesions with
normal histology, the odds ratio (OR) was elevated for chronic atrophic
gastritis (OR=4.2) and intestinal metaplasia-dysplasia (OR=31.5). After
adjustment for H. pylori infection, alcohol consumption was a risk
factor for chronic atrophic gastritis (OR=3.2) and intestinal metaplasia-dysplasia
(OR=7.8). Garlic consumption showed nonsignificant protective effects
and was inversely associated with H. pylori infection. These findings
provide further evidence for the etiologic role of H. pylori infection
in gastric carcinogenesis and the protective role of garlic consumption.
(You WC, Zhang L, Gail MH, Ma JL, Chang YS, Blot WJ, Li
JY, Zhao CL, Liu WD, Li HQ, Hu YR, Bravo JC, Correa P, Xu GW, Fraumeni
JF Jr. Helicobacter pylori infection, garlic intake and precancerous lesions
in a Chinese population at low risk of gastric cancer. Int J Epidemiol
1998;27:941-944) 
Environmental Epidemiology
Branch
Estrogen Replacement Therapy and Breast Cancer Survival
Survival of women with postmenopausal breast cancer was examined in a
screening study of 2,614 patients according to estrogen hormone replacement
therapy (HRT) status at time of diagnosis. Patients were followed an average
of 14.1 years after diagnosis. Among patients with node-negative disease,
the hazard-rate ratios for breast cancer mortality associated with current
HRT use compared with nonuse were 0.5 until 12 years after diagnosis and
2.2 thereafter. Mortality was not statistically lower in past HRT users.
The cumulative probabilities of breast cancer mortality at the end of
follow-up were 0.14 (nonusers), 0.14 (past users), and 0.09 (current users).
Among women with node-positive disease, the hazard-rate ratios associated
with current and past use were both 0.5 until 4 years after diagnosis
and thereafter 1.1 and 1.8, respectively. The cumulative probabilities
of breast cancer mortality were 0.32 (nonusers), 0.39 (past users), and
0.27 (current users). Thus, patients who were HRT users at the time of
diagnosis experienced reduced breast cancer mortality, which waned with
time from diagnosis. (Schairer C, Gail M, Byrne C, Rosenberg
PS, Sturgeon SR, Brinton LA, Hoover RN. Estrogen replacement therapy and
breast cancer survival in a large screening study. J Natl Cancer Inst
1999;91:264-270)
Smoking and Breast Cancer Risk among Younger Women
Data from a population-based case-control study were used to evaluate
the relation between cigarette smoking and risk of breast cancer among
young women. A modest inverse relation with current (OR=0.82) but not
past smoking was found among women under age 45 years. Risk decreased
for current smokers who began smoking at an early age (OR=0.59) or continued
smoking for long periods (OR=0.70 for more than 21 years). In subgroup
analyses, reduced risk was observed for current smokers who had used oral
contraceptives, were in the lowest quartile of adult body mass, or never
or infrequently drank alcohol. Among women aged 45 to 54 years, there
was little evidence for any association with smoking. These results suggest
a modest reduction in breast cancer risk among women under age 45 who
are current smokers, particularly among those who are long-term smokers
and those who began smoking at an early age. The reduction in risk may
be related to anti-estrogenic properties associated with cigarette smoking.
(Gammon MD, Schoenberg JB, Teitelbaum SL, Brinton LA,
Potischman N, Swanson CA, Brogan DJ, Coates RJ, Malone KE, Stanford JL.
Cigarette smoking and breast cancer risk among young women. Cancer
Causes Control 1998;9:583-590)
Alcohol Consumption and Risk of Breast Cancer
The role of light alcohol consumption and alcoholic beverage type on
breast cancer risk was examined using data from the Framingham Study.
Among the 2,764 women in the original cohort followed for more than 40
years (from 1948 to 1993) and the 2,284 women in the offspring cohort
followed for up to 24 years (from 1971 to 1993), there were 221 and 66
cases of incident breast cancer, respectively. Breast cancer risk decreased
from 3.60 per 1,000 person-years to 2.47, 2.30, and 2.33 in increasing
categories of average alcohol consumption in the original cohort, and
from 3.07 to 1.26, 1.24, and 2.22 in the offspring cohort. When the two
cohorts were combined, risk in successively increasing categories of alcohol
consumption was 1.0 (nondrinkers), 0.8, 0.7, and 0.7. Changes in risk
were not associated with wine, beer, or spirits consumption when each
beverage was analyzed individually. The findings suggest that light consumption
of alcohol or of any type of alcoholic beverage is not associated with
an increased risk of breast cancer. (Zhang YQ, Kreger BE, Dorgan JF, Splansky
GL, Cupples LA, Ellison RC. Alcohol consumption and risk of breast cancer:
The Framingham Study revisited. Am J Epidemiol 1999;149:93-101)
Diet and Risk of Prostate Cancer in China
A case-control study was conducted to evaluate the role of dietary factors
in the etiology of prostate cancer in a low-risk population in China.
Interview data were analyzed from 133 histopathologically confirmed cases
of prostate cancer diagnosed between 1989 and 1992 and 265 neighborhood
controls. Cases were more likely than controls to consume food with high
fat and from animal sources (p < 0.01). Daily fat intake and the percentage
of energy from fat were higher among cases than among controls (p < 0.01).
When the lowest and highest quartiles of intake were compared, the adjusted
odds ratio was 3.6 for total fat, 2.9 for saturated fat, and 3.3 for unsaturated
fat. These findings suggest that dietary fat –– both saturated and unsaturated
–– is associated with an increased risk of prostate cancer in a low-risk
population. (Lee MM, Wang R-T, Hsing AW, Gu F-L, Wang
T, Spitz M. Case-control study of diet and prostate cancer in China. Cancer
Causes Control 1998;9:545-552)
Genetic Epidemiology Branch
Breast Cancer Survival in Ashkenazi Jewish BRCA1 and BRCA2
Mutation Carriers
An analysis of a community-based study of Jewish volunteers of Ashkenazi
origin was carried out to investigate the effect of three founder mutations
in the BRCA1 and BRCA2 genes on survival among patients with breast or
ovarian cancer. Blood samples from 5,318 participants were tested for
the 185delAG and 5382insC mutations in BRCA1 and the 6174delT mutation
in BRCA2. A novel extension of the kin-cohort method (Wacholder S, Hartge
P, Struewing JP, Pee D, McAdams M, Brody L, Tucker M. The kin-cohort study
for estimating penetrance. Am J Epidemiol 1998;148:623-630) was
used to estimate survival differences in the affected relatives according
to mutation carrier status. Fifty mutation carriers reported 58 first-degree
relatives with breast cancer and 10 with ovarian cancer, and 907 noncarriers
reported 979 first-degree relatives with breast cancer and 116 with ovarian
cancer. No statistically significant difference was found between median
survival after breast cancer for relatives of carriers (16 years) and
noncarriers (18 years). There was also no difference in survival time
between first-degree relatives with ovarian cancer. In addition, no survival
difference was found between patients with breast or ovarian cancer who
were inferred carriers of BRCA1 or BRCA2 mutations versus noncarriers.
These findings suggest that carriers of BRCA1 and BRCA2 mutations have
approximately the same survival prognosis as noncarriers. (Lee
JS, Wacholder S, Struewing JP, McAdams M, Pee D, Brody LC, Tucker MA,
Hartge P. Survival after breast cancer in Ashkenazi Jewish BRCA1 and BRCA2
mutation carriers. J Natl Cancer Inst 1999;91:259-263)
Comparison of Merkel Cell (Skin) Carcinoma and Melanoma
Using data from the Surveillance, Epidemiology, and End Results (SEER)
program, Merkel cell carcinoma (MCC) of the skin was compared with cutaneous
malignant melanoma. From 1986 to 1994, 425 of cases of MCC were reported;
the annual age-adjusted incidence per 100,000 was 0.23 for whites and
0.01 for blacks. Among whites, the ratio of melanoma to MCC was about
65 to 1. Only 5 percent of MCC occurred before age 50, unlike the lifelong
risk of nodular and superficial spreading melanoma. The geographic incidence
of MCC and melanoma increased similarly with increasing exposure to sun.
Both MCC and melanoma increased in frequency and aggressiveness after
immunosuppression, organ transplantation, or B-cell neoplasia. Six patients
with both MCC and melanoma were identified in the SEER data, and in five
of these cases, melanoma occurred first. Overall, MCC and melanoma are
etiologically linked to ultraviolet exposure and immunosuppression, but
differ markedly in their distributions by age, race, and anatomic site,
especially the face. (Miller RW, Rabkin CS. Merkel cell
carcinoma and melanoma: Etiological similarities and differences. Cancer
Epidemiol Biomark Prev 1999;8:153-158)
Screening for Wilms’ Tumor in Children
A case series analysis was undertaken to assess the value of sonography
screening in preventing late-stage (III or IV) Wilms' tumor in children
with Beckwith-Wiedemann syndrome and idiopathic hemihypertrophy (BWS/HH).
Fifteen screened patients, who had sonograms at intervals of 4 months
or less, were compared with 59 unscreened patients. None of the 12 screened
children who developed Wilms’ tumor had late-stage disease, whereas 25
(42%) of the unscreened children had late-stage disease. Three of the
screened children were operated on for suspected Wilms' tumor, but the
lesions proved to be renal cysts or nephroblastomatosis. These results
suggest that children with BWS/HH may benefit from screening sonograms
at intervals of 4 months or less, although false-positive findings may
result in unnecessary surgery. (Choyke PL, Siegel MJ,
Craft AW, Green DM, DeBaun MR. Screening for Wilms tumor with Beckwith-Wiedemann
syndrome or idiopathic hemihypertrophy. Med Pediatr Oncol 1999;32:
196-200)
p53 Mutation Status and Genetic Polymorphisms in Non-small Cell
Lung Cancer
Mutation status of p53 was analyzed in relation to DNA polymorphisms
of GSTM1, CYP1A1, and CYP2E1 from 105 cases of surgically
resected non-small cell lung cancer. The analysis was adjusted for demographic
factors, smoking, occupation, family history, and tumor histology, grade,
and stage. The p53 mutations were overrepresented among CYP1A1
variants. Mutations in exon 8 and transitions at CpG sites in the p53
gene were favored in this subset. No relation was found between individual
gene polymorphisms or p53 mutations and disease-free survival.
The finding of excess CYP1A1 heterozygotes among persons with p53
mutations after adjustment for smoking suggests that CYP1A1 activation
contributes to lung cancer through p53 inactivation. (Przygodzki
RM, Bennett WP, Guinee DG Jr, Khan MA, Freedman A, Shields PG, Travis
WD, Jett JR, Tazelaar H, Pairolero P, Trastek V, Liotta LA, Harris CC,
Caporaso NE. p53 mutation spectrum in relation to GSTM1, CYP1A1 and CYP2E1
in surgically treated patients with non-small cell lung cancer. Pharmacogenetics
1998;8:503-511)
Nutritional Epidemiology
Branch
Is Colonoscopy Needed for Nonadvanced Adenoma?
The Polyp Prevention Trial, a multicenter dietary intervention study,
evaluated the need for colonoscopy in patients with a single nonadvanced
tubular adenoma identified in a screening program using sigmoidoscopy.
Of the 981 patients with distal adenomas, 46.9 percent had one or more
that was pathologically advanced and 21.5 percent had proximal adenomas,
4.3 percent of which were advanced. Approximately 5.9 percent of patients
with advanced distal adenomas, but only 2.9 percent with nonadvanced distal
adenomas, also had advanced proximal adenomas (odds ratio=2.1). Without
colonoscopy in patients with nonadvanced distal adenomas, 36 percent of
advanced proximal adenomas would have been missed. These findings suggest
that colonoscopy may be an important follow-up procedure to detect advanced
proximal adenomas among patients found to have nonadvanced distal adenomas
by sigmoidoscopy. (Schoen RE, Corle D, Cranston L, Weissfeld
JL, Lance P, Burt R, Iber F, Shike M, Kikendall JW, Hasson M, Lewin KJ,
Appelman HD, Pakett E, Selby J, Lanza E, Schatzkin A. Is colonoscopy needed
for the non-advanced adenoma found on sigmoidoscopy? Gastroenterology
1998;115:533-541)
Meat Consumption and Risk of Lung Cancer in Women
A population-based case-control study among smoking and nonsmoking women
was conducted in Missouri to investigate the role of meat intake and cooking
practices in relation to risk of lung cancer. Food frequency questionnaires
were analyzed from 593 cases and 623 matched controls. When the 90th and
10th percentiles were compared, risk of lung cancer increased for total
meat consumption (OR=1.6), red meat (OR=1.8), well-done red meat (OR=1.5),
and fried red meat (OR=1.5). The ORs comparing the 5th and 1st quintiles
using categorical variables for well-done red meat and fried red meat
were essentially the same as with percentiles, although the increase in
risk was associated mainly with the 5th quintile. These results suggest
an increased risk of lung cancer related to high consumption of all meat
and red meat, as well as to cooking practices associated with the production
of compounds that are carcinogenic in laboratory animals. (Sinha
R, Kulldorff M, Curtin J, Brown CC, Alavanja M, Swanson CA. Fried, well-done
red meat and risk of lung cancer in women (United States). Cancer Causes
Control 1998;9:621-630)
Occupational Epidemiology
Branch
Cytogenetic Changes in Lymphocytes of Chinese Workers Exposed to
Benzene
Two common cytogenetic changes in therapy- and chemical-related leukemia
are loss and long-arm deletion of chromosomes 5 and 7. The detection of
these aberrations in lymphocytes of persons exposed to potential leukemogens
may serve as biomarkers of increased risk of leukemia. A novel fluorescence
in situ hybridization (FISH) procedure was used to determine if specific
aberrations in chromosomes 1, 5, and 7 occurred at elevated rates in lymphocytes
of workers exposed to benzene, a known leukemogen. Forty-three healthy
workers exposed to a wide range of benzene levels (median 31 ppm, 8-hour
time-weighted average) were compared with 44 unexposed controls in Shanghai,
China. Benzene exposure was associated with increases in rates of monosomy
5 and 7 but not monosomy 1, and with increases in trisomy and tetrasomy
of all three chromosomes. In the exposed workers, long-arm deletion of
chromosomes 5 and 7 was increased up to 3.5-fold in a dose-dependent fashion.
These results show that leukemia-related changes in chromosomes 5 and
7 are detectable by FISH in peripheral blood of otherwise healthy benzene-exposed
workers, and that these changes may be useful biomarkers of early biological
effects of benzene exposure. (Zhang L, Rothman N, Wang
Y, Hayes RB, Li G, Dosemeci M, Yin S, Kolachana P, Titenko-Holland N,
Smith MT. Increased aneusomy and long arm deletion of chromosomes 5 and
7 in the lymphocytes of Chinese workers exposed to benzene. Carcinogenesis
1998;19:1955-1961)
Occupation and Risk of Pancreatic Cancer in China
A large population-based case-control study was conducted in Shanghai,
China, to assess occupational risks of pancreatic cancer. Among men, increased
risk was associated with employment as an electrician (OR=7.5), with a
threefold elevation observed for those with the highest exposure level
to electromagnetic fields. However, women with heavy exposure to electromagnetic
fields were not at excess risk of pancreatic cancer. Elevated risks were
also found for men employed as metal workers (OR=2.1), toolmakers (OR=3.4),
plumbers or welders (OR=3.0), and glass formers, potters, painters, or
construction workers (OR=2.6). Among women, textile workers were at increased
risk (OR=1.4). These results suggest that increased risk of pancreatic
cancer may be associated with work as an electrician and in occupations
associated with exposures to metal and textile dusts. (Ji
BT, Silverman DT, Dosemeci M, Dai Q, Gao YT, Blair A. Occupation and pancreatic
cancer risk in Shanghai, China. Am J Ind Med 1999;35:76-81)
Gallstones and Cholecystectomy and Risk of Cancers of the Liver,
Biliary Tract, and Pancreas
A population-based cohort study in Denmark was carried out to examine
the association between gallstones and cholecystectomy and risk of liver,
biliary tract, and pancreatic cancers. A total of 60,176 patients hospitalized
for gallstones between 1977 and 1989 were followed for cancer incidence
until the end of 1993. Among patients without cholecystectomy and with
5 years or more of follow-up, risk was significantly elevated for cancers
of the liver (standardized incidence ratio [SIR]=2.0) and gallbladder
(SIR=2.7). Excess risk of liver cancer was seen only among patients with
a history of hepatic disease. Among cholecystectomy patients, risk was
significantly elevated for cancers of ampulla of Vater (SIR=2.0) and pancreas
(SIR=1.3) but not for cancers of the liver or extrahepatic bile duct.
These findings confirm that gallstone disease increases risk of gallbladder
cancer and that cholecystectomy increases risk of cancers of ampulla of
Vater and pancreas. (Chow WH, Johansen C, Gridley G, Mellemkjaer
L, Olsen JH, Fraumeni JF Jr. Gallstones, cholecystectomy and risk of cancers
of the liver, biliary tract and pancreas. Br J Cancer 1999;79:640-644)
Diabetes Mellitus and Risk of Renal Cell Cancer
A population-based retrospective cohort study was carried out in Sweden
to investigate the relation between diabetes mellitus and risk of renal
cell cancer. Using national registry data, 153,852 patients diagnosed
with diabetes mellitus between 1965 and 1983 were identified and followed
through 1989. After exclusion of the first year of observation, 267 incident
cases of renal cell cancer occurred in diabetic patients, compared with
182.4 expected. Increased risk was observed for both women (SIR=1.7) and
men (SIR=1.3) throughout the period of follow-up. Risk of kidney cancer
mortality was higher in women than men. These results indicate that patients
with diabetes mellitus are at increased risk of renal cell cancer. (Lindblad
P, Chow WH, Chan J, Bergstrom A, Wolk A, Gridley G, McLaughlin JK, Nyren
O, Adami HO. The role of diabetes mellitus in the aetiology of renal cell
cancer. Diabetologia 1999;42:107-112)
Diet and Risk of Prostate Cancer
Prostate cancer is the most common malignancy in men in the United States,
with substantially higher rates among blacks than whites. A population-based
case-control study in three geographic areas was carried out to evaluate
the reasons for the racial disparity. Dietary factors were evaluated through
interviews with 449 black men and 483 white men with prostate cancer and
1,201 control subjects. Increased intake of foods high in animal fat was
linked to prostate cancer among black men but not white men. However,
the risk of advanced prostate cancer was higher in both racial groups
with increasing consumption categories of foods high in animal fat. Increased
intake of animal fat as a proportion of total caloric intake also showed
positive but weaker associations with advanced prostate cancer. Thus,
the greater risk of prostate cancer among blacks than whites may be related
to the differential effects of animal fat in these populations. (Hayes
RB, Ziegler RG, Gridley G, Swanson C, Greenberg RS, Swanson GM, Schoenberg
JB, Silverman DT, Brown LM, Pottern LM, Liff J, Schwartz AG, Fraumeni
JF Jr, Hoover RN. Dietary factors and risks for prostate cancer among
blacks and whites in the United States. Cancer Epidemiol Biomarkers
Prev 1999;8:25-34)
Familial Cancer History and Risk of Prostate Cancer
Within a population-based cohort study in Iowa, the cancer history of
parents and siblings of 101 incident cases of prostate cancer was evaluated
to assess risk of this malignancy in relation to family cancer history.
After adjustment for major confounders (age, alcohol intake, and dietary
factors), increased risk was associated with having a family history of
prostate cancer, with risk being greater for a brother (relative risk
[RR]=4.5) than a father (RR=2.3) having had prostate cancer. Increased
risk was also associated with having a family history of breast or ovarian
cancer in a mother or sister (RR=1.7) and with a history of both prostate
and breast or ovarian cancers (RR=5.8). No association was found with
a family history of colon cancer. These results confirm that a family
history of prostate cancer is a strong risk factor for this malignancy
and indicate that a family history of breast or ovarian cancer may also
increase risk. (Cerhan JR, Parker AS, Putnam SD, Chiu
BCH, Lynch CF, Cohen MB, Torner JC, Cantor KP. Family history and prostate
cancer risk in a population-based cohort of Iowa men. Cancer Epidemiol
Biomarkers Prev 1999;8:53-60)
Radiation Epidemiology Branch
Pooled Analysis of Case-control Studies of Thyroid Cancer
A pooled analysis of 14 case-control studies was carried out to evaluate
major risk factors involved in the etiology of thyroid cancer. Although
the pooled population was composed of 2,725 cases (2,247 females and 478
males) and 4,776 controls (3,699 females and 1,077 males), analyses were
limited to study populations having relevant data. Analysis of menstrual
status found slight elevations in risk associated with natural (OR=1.33)
and artificial menopause (OR=1.84) compared with premenopause. Parity,
spontaneous or induced abortions, and history of infertility were not
associated with thyroid cancer risk. Later age at first birth was associated
with a small increased risk (OR=1.14). No relation was seen between risk
and oral contraceptive (OC) use, including duration of use, age at first
use, or use before first birth. Increased risk was found for current OC
users (OR=1.45), but declined with increasing time since stopping (OR=1.06
for at least 10 years). Risk was not increased with use of hormone replacement
therapy, but was slightly elevated for use of fertility drugs (OR=1.57)
and for lactation suppression treatment (OR=1.48). These findings indicate
generally weak associations between risk of thyroid cancer and menstrual
status, reproductive factors, or OC use. (Negri E, Ron
E, Franceschi S, Dal Maso L, Mark SD, Preston-Martin S, McTiernan A, Kolonel
L, Kleinerman R, Land C, Fan J, Wingren G, Galanti MR, Hallquist A, Glattre
E, Lund E, Levi F, Linos D, Braga C, La Vecchia C. A pooled analysis of
case-control studies of thyroid cancer. Parts I, II, III. Cancer Causes
Control 1999;10:131-166)
Viral Epidemiology Branch
Adult T-cell Leukemia/Lymphoma Incidence in Central Brooklyn
A pilot surveillance program was established to identify cases of adult
T-cell leukemia/lymphoma (ATL), a rare outcome of infection with human
T-lymphotropic virus (HTLV-I), in seven hospitals in central Brooklyn.
Twelve incident cases of ATL were reported, all among persons of Afro-Caribbean
descent, giving an annual incidence in this community of about 3.2 per
100,000 person-years and a female-to-male ratio of 3:1. These results
provide evidence that HTLV-I infection and ATL are endemic in central
Brooklyn, where a large Caribbean migrant community is located, and suggest
the need for disease surveillance and intervention efforts. (Levine
PH, Dosik H, Joseph EM, Felton S, Bertoni MA, Cervantes J, Moulana V,
Miotti AB, Goberdhan LJ, Lee SL, Daouad A, DaCosta M, Jaffe ES, Axiotis
CA, Cleghorn FR, Kahn A, Welles SL. A study of adult T-cell leukemia/lymphoma
incidence in Central Brooklyn. Int J Cancer 1999;80:662-666)
Comparison of Predictive Models of HIV-disease Progression in Gay
Men
The performance of HIV-I RNA models, based on human leukocyte antigen
(HLA), was compared in predicting the rate of HIV-1 disease progression
by using both linear regression and neural network models across two cohorts
of homosexual men. A total of 139 seroconverters from an AIDS cohort study
was used as the training set, and a total of 97 seroconverters from a
cohort of gay men was used to assess the reliability of the predictive
models. Both viral load (p < 0.0001) and HLA markers (p = 0.001) were
strongly predictive of disease progression. Consideration of both HLA
markers and viral load offered no significant predictive advantage over
viral load alone in most cases. Viral load, HLA scores, and rapid disease
progression were moderately correlated. Viral load is a stronger predictor
of disease progression than are previously developed HLA models, but neural
network methods and further refined HLA models may offer additional prognostic
information, especially for cases of rapid progression. (Ioannidis
JPA, Goedert JJ, McQueen PG, Enger C, Kaslow RA. Comparison of viral load
and human leukocyte antigen statistical and neural network predictive
models for the rate of HIV-1 disease progression across two cohorts of
homosexual men. J Acquir Immune Defic Syndr Hum Retrovirol 1999;20:129-136)
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