[Program contents of undergraduate teaching of epidemiology to medical students and its evaluation]. / Zalozenla programowe nauczania przeddyplomowego epidemiologii w Collegium Medicum Uniwersytetu Jagiellonskiego wraz z jego ocena przez studentów.

The importance of epidemiology in modern medicine increased rapidly during the last years. Now each physician should know basic epidemiological definitions and epidemiological strategy for studies on health and disease. The course of epidemiology, as a separate subject for medical students, was introduced to curriculum of Medical Faculty in 1970. At present, the course covers 4 lecture units and 16 exercise units. It is conducted on 4th year of the Medical Faculty. The evaluation of the course carried out in 1995 showed that a great majority of medical students considers it as interesting and useful subject to be taught.

[Occupational exposure and histologic differentiation of lung cancer. Retrospective assessment in Cracow]. / Ekspozycja zawodowa a zróznicowanie histologiczne raka pluca. Badanie retrospektywne w Krakowie.

A population-based case-control study was performed in Cracow, Poland. Male cases and controls were identified from the Cracow Death Register. Information were obtained by mailed questionnaire from next-of-kin on smoking, occupational branch, occupational exposures and other pertinent variables. Response rates were 73.5% in cases and 72.0% in controls. For cases that underwent a bronchial biopsy or surgical excision the histological diagnosis of the tumor was obtained from clinical records. The case group contained 343 subjects with squamous cell carcinomas, 151 small cell carcinomas and 106 adenocarcinomas. 27 cases showed other histological types (large cell carcinoma and not classifiable). Analysis was performed separately by histological type for occupational exposure variables adjusted for smoking. Long-term exposure to mineral dust and metal dust (20 years or more) was found to be a significant risk factor for small cell and squamous cell carcinoma. The effect was more pronounced if the analysis was restricted to the age groups "less than 70 years". The highest relative risk due to occupational exposures was found for squamous cell carcinoma and mineral dust exposure for more than 20 years (RR = 2.45, 95% CI 1.43-4.19). The estimated effect of mineral dust on small cell carcinoma and adenocarcinoma was slightly lower (RR = 2.29, 95% CI 1.16-4.53 and RR = 2.04, 95% CI 0.89-4.64, respectively). The effect of metal dust and fumes appeared to be about the same for squamous and small cell carcinoma.

Effect of occupational air pollutants on various histological types of lung cancer: a population based case-control study.

A population based case-control study was performed in Cracow, Poland, to determine the effect of occupational air pollutants on various histological types of lung cancer. Male cases and controls were identified from the Cracow Death Register. Information was obtained by mailed questionnaire from next of kin on smoking, occupational branch, occupational exposures, and other pertinent variables. Response rates were 73.5% in cases and 72.0% in controls. For cases that underwent a bronchial biopsy or surgical excision the histological diagnosis of the tumour was obtained from clinical records. The case group contained 343 subjects with squamous cell carcinomas, 151 with small cell carcinomas, and 106 with adenocarcinomas. Twenty seven cases showed other histological types (large cell carcinoma and not classifiable). Analysis was performed separately by histological type for occupational exposure variables adjusted for smoking. Long term exposure to mineral dust and metal dust (20 years or more) was found to be a significant risk factor for small cell and squamous cell carcinoma. The effect was more pronounced if the analysis was restricted to those aged less than 70 years. The highest relative risk (RR) due to occupational exposures was found for squamous cell carcinoma and exposure to mineral dust for more than 20 years (RR = 2.45, 95% CI 1.43-4.19). The estimated effect of mineral dust on small cell carcinoma and adenocarcinoma was smaller (RR = 2.29, 95% CI 1.16-4.53 and RR = 2.04, 95% CI 0.89-4.64 respectively). The effect of metal dust and fumes seemed about the same for squamous and small cell carcinoma. No specific agent could be identified as particularly important for a specific histological type; it rather seemed that the effects of the substances considered were similar for lung cancers in general.

Effect of tobacco smoking on various histological types of lung cancer.

In a population-based case/control study the differential lung cancer risk patterns due to tobacco smoking habits of various histological types have been investigated. The cases were 1432 deaths from lung cancer in the years 1980-1987, of which the histological type was known for 627 individuals. There was 54% squamous cell carcinoma, 24% small-cell carcinoma and 17% adenocarcinoma. Controls were 1343 deaths from other causes. Next-of-kin interviews were performed. The results of the study confirmed that cigarette smoking is associated with all histological types of lung cancer; however, the dose/response relationship between smoking and adenocarcinoma differed clearly from that observed in squamous and small-cell carcinomas. In the latter histological types the gradient of risk was much stronger as the number of cigarettes smoked or duration of smoking increased. The overall relative risk for smoking in small-cell and squamous cell carcinoma was 15.4 and 13.5 respectively, whereas that for adenocarcinoma was weaker (relative risk = 3.1). An interesting difference between squamous and small-cell carcinomas was found also for patients who gave up smoking. The effect of stopping was more pronounced in squamous cell carcinoma. The attributable risks for smoking in squamous and small-cell carcinoma were much higher (90% and 88% respectively) than for adenocarcinoma (64%). The data suggest that adenocarcinoma is likely to be related to other factors than tobacco smoking to a greater extent than are squamous or small cell carcinoma. Possible sources of bias, such as missing histological diagnoses, are discussed in detail.

[Effect of smoking on the development of various histological types of lung cancer]. / Wplyw palenia tytoniu na powstawanie róznych typów histologicznych raka pluca.

The aim of this clinically controlled trial was to assess the effect of different smoking patterns on development of different histological types of lung cancer. The study group consisted of 1,432 subjects that died due to lung cancer in the years 1980-1987. 627 of these had the histological type of the cancer determined; 54% had squamous cell cancer, 24% small cell lung cancer (SCLC), 17% adenocarcinoma. The control group consisted of 1,343 subjects that died due to other causes. Medical and social history was taken from the families of the deceased. The results of the analysis demonstrate that lung cancer development is related to smoking although differences were seen in the different types of cancer. The calculated risk of a smoker developing lung cancer-squamous cell and SCLC was respectively 15.4 and 13.5 while for adenocarcinoma it was much lower--3.1. Important differences were seen in ex-smokers developing squamous cell lung cancer and SCLC. The risk of developing squamous cell lung cancer and SCLC in this group was 89% and 88%, and adenocarcinoma only 64%. This suggests that adenocarcinoma is related more to environmental factors than the other two types of lung cancer.

A case-control study of lung cancer with special reference to the effect of air pollution in Poland.

STUDY OBJECTIVE: The aim of the study was to assess the affect of inhaled pollutants on lung cancer risk. DESIGN: The study was a retrospective case-control survey of lung cancer deaths over a six year period (1980-1985). Information on occupation, smoking habits, and residency was collected from next of kin. Classification of exposure to community air pollution was based on measured levels of total suspended particular matter and sulphur dioxide. SETTING: Cases and controls had been resident in the city of Cracow, Poland. PARTICIPANTS: Cases were male (n = 901, questionnaire response rate 70.7%) and female (n = 198, response rate 65.1%) lung cancer deaths; controls were deaths from other causes, excluding other respiratory diseases, and frequency matched by age and sex (males n = 875, response rate 73.5%; females n = 198, response rate 64.0%). MAIN RESULTS: Lung cancer risk was found to depend strongly on total cigarette consumption, on age at starting to smoke, and on time since stopping smoking. Relative risk estimates for occupational exposure in iron and steel foundries or in other industries were significantly increased in males. Relative risk in men for highest air pollution level was 1.48 (95% confidence interval 1.08-2.01), while in women the increase was not significant. The joint action of the risk facts of smoking, occupational exposure, and air pollution was found to fit almost perfectly into a multiplicative model. CONCLUSIONS: Under conditions found in Cracow, air pollution may increase lung cancer risk, acting multiplicatively with known risk factors such as smoking and industrial exposure.

[Combined effects of tobacco smoking, occupational factors and atmospheric air pollution as risk factors of bronchial carcinoma. Results of retrospective studies in Cracow]. / Laczny wplyw palenia tytoniu, czynników zawodowych i zanieczyszczen powietrza atmosferycznego na ryzyko raka oskrzela. Wyniki badan retrospektywnych w Krakowie.

A case-control study was conducted in order to assess the combined effect of smoking, occupation and air pollution on lung cancer risk. Cases were male and female residents of Cracow whose deaths occurred within a 6 years period (1980-1985) and were attributed to primary lung cancer. The control series were selected by frequency matching to cases by sex and age (+/- 5 years) from the subjects who died of other causes than cancer or respiratory diseases. Through a mailed simple questionnaire data were collected on demographic variables, occupation, smoking habits and residency. Estimates of adds ratio were found to increase with the amount of prior cigarette consumption expressed in pack-years. In men the odds ratio estimates for suspected occupational exposure in men lasting longer than 20 years was 1.72 (1.39-2.17); for job category (manual vs nonmanual) 1.27 (1.01-1.62). Both occupational variable did not reach significance level in women. The standardized odds ratio for the highest air pollution level in men was 1.47 (1.08-2.01), while for women found to be insignificant.