[Methodologic and organizational principles of selective screening for cervical, endometrial and ovarian carcinoma].

Data are presented on screening for cervical (CC), endometrial (UC) and ovarian (OC) carcinoma carried out in the Republic of Belarus as well as a discussion of logistic and methodologic aspects of the problem. Local "centers for prevention and early diagnosis of reproductive organ tumors" form the backbone of the national system. They operate on the basis of the existing guidelines about such matters as screening staging, sites, examination procedures used at each stage and suitable distribution of medical personnel (obstetricians, doctor's assistants, gynecologists). A comparison of data on selective screening for CC, UC and OC with those of mass prophylactic examinations and cytological screening for CC showed that selective detection rates for cervical dysplasia were 14 times, and in situ cervical carcinoma--4 times higher. That was followed by lower incidence of invasive CC and absence of advanced cases. Consequently, the share of endometrial hyperplasia cases rose 3.5-fold, uterine myoma--3-fold and adenomyosoma--1.5-fold. identified atypical endometrial hyperplasia, in situ cancer and endometrial stage I in "clinically healthy" women. The rates of detection of such tumor-like ovarian formations as follicular, lutein, endometrioid and para-ovarian cysts increased 2.3-fold, benign tumors--2.2-fold and polycystosis--twofold.

A case-case analysis of factors related to overexpression of p53 in endometrial cancer following breast cancer.

We studied 54 patients diagnosed with endometrial cancer between 1981 and 1994 following a diagnosis of breast cancer. We used a case-case analysis, comparing tumors with and without overexpression of the p53 gene product to evaluate the association of putative p53 mutations with tamoxifen use and other risk factors for endometrial cancer. Twenty-four % of the tumors showed strong positive staining for the p53 gene product. Tumors in a more advanced stage (stage 2, 3, or 4, compared to stage 1) were more likely to overexpress p53 [odds ratio (OR) = 4.2; 95% confidence interval (CI), 1.1-16.2], as were tumors with serous or clear cell, compared to endometrioid, histology (OR = 5.8; 95% CI, 1.3-26.5). There was a small association between p53 overexpression and treatment with tamoxifen for breast cancer (OR = 2.6; 95% CI, 0.69-9.8). There was a strong relationship between overexpression of p53 and having a first-degree relative with breast cancer (OR = 12.3; 95% CI, 2.6-57.4) and between overexpression of p53 and having an additional cancer, i.e., at sites other than breast or endometrium (OR = 7.9; 95% CI, 1.6-40.1). In this group of women, genetic predisposition to cancer, as reflected in family history of breast cancer and personal history of an additional primary cancer, was strongly associated with overexpression of p53 in endometrial tumors. The results suggest that use of tamoxifen may be associated with an increase in tumors that overexpress p53, although the results could be due to chance.

Working life tables for females in Canada, 1971.

PIP: This paper attempts to construct some working life tables (WLTs) for females in Canada, 1971. Attention is directed to methodological problems in female WLT construction, a suggested methodology, and loss due to mortality. The working life expectancy (WLE), which refers to the average number of years that a person is likely to spend in the labor force during his/her lifetime, reveals the extent of his/her contribution to the national economy. Although working life tables have been prepared for Canadian males, no attempt has been made previously to develop a WLT for the Canadian females. In some countries, such as Canada, the long census questionnaire collects additional pieces of information on labor force participation (LFP), even though the coverage is only on a part (but sizable) of the population. It is suggested that the information on "weeks worked" (Canadian Census wording) can be used to smooth out the bimodality problem in the female LFP. If a working woman works for an entire year, i.e., 52 weeks inclusive of paid holidays and vacation, she is said to contribute 1 woman year of working (or economically active) life to the economy. On the basis of this concept of a woman year of working life, all females who are working full time, part time, and not working can be considered in regard to their respective contributions of working lives to the national economy. An age limit is not indicated in the definition. The number of hours worked per day cumulated for the year and scaled down to the base of 1 woman year of working life would make the analysis more realistic. If the census data on weeks worked are tabulated by single years of age, or age groups for the female population, the average number of weeks worked specific for the various age categories can be computed. Those who are unemployed are taken as contributing zero weeks worked in the computation of the mean. Then the age specific participation rate is obtained as the percent of the average number of weeks worked by females in a given age group to the total number of weeks in a year. From these age specific rates, the probabilities of LFP at an age interval is worked out by averaging 2 consecutive age specific rates. Employing the notion of woman years of working life and utilizing the average number of weeks worked from the 1971 Census of Canada PUST data, a set of age specific participation rates for the Canadian females was developed. With these participation rates, the WLT for the Canadian females is constructed. The WLE for a female in Canada in 1971 attains a maximum of 38.7 years at age 15 and declines with increases in age. A comparison with the males showed that the female WLE was higher in the latter and lower in the early years of life.^ieng