[Cancer in the parents of children with cancer]. / Cancer hos foraeldre til børn med cancer.

Certain types of cancer in children and young adults have been linked with an increased risk of cancer in close relatives. However, the relation between childhood cancer and familial risk remains to be fully assessed in population-based studies. We conducted a nationwide study in Denmark of 11,380 parents of children with cancer. The children were identified from records in the Danish Cancer Registry; their parents were identified from population registers. The occurrence and rate of cancer in the parents were determined with use of the Cancer Registry's files and compared with national incidence rates for various categories of tumour. Overall, 1445 cancers were diagnosed in the parents, as compared with 1496 expected from national incidence rates, to yield standardized incidence ratios of 0.97 (95 percent confidence interval, 0.92 to 1.02) for all parents, 0.99 for mothers, and 0.94 for fathers. The lower rate of cancer among fathers reflected their lower standardized incidence ratio for lung cancer (0.76; 95 percent confidence interval, 0.63 to 0.91), as calculated from 114 observations. Genetic determinants are important in several types of childhood cancer, but the genetic susceptibility to tumours does not generally extend to the parents of children with cancer, not do the patterns of incidence point to the influence of shared environmental factors. Thus, cancer in children should not be viewed as a general marker for an increased risk of cancer in the patient's parents.

[Ataxia telangiectasia]. / Ataxia telangiectasia.

Ataxia telangiectasia is a genetically determined multi-system disorder in which senile skin changes are at an early stage. The patients have progressive neurological disability, cellular and humoral immunodeficiencies and increased cancer incidence. Heterozygous carriers of the gene, estimated to comprise about 1% of the general population, have an increased risk of cancer. We have initiated an identification of a cohort of patients and their relatives in order to evaluate their cancer risk.

[Survival of patients with severe alpha 1-antitrypsin deficiency]. / Overlevelse for patienter med svaer alpha 1-antitrypsinmangel.

Previous estimates of survival of patients with alpha-1-antitrypsin deficiency (alpha 1ATD) have been based on selected patients. In this paper we have compared the survival of 397 patients with severe alpha-1-antitrypsin deficiency either ascertained because of pulmonary impairment (index cases) or ascertained through family studies (non-index cases). The patients were drawn from the nationwide Danish alpha 1ATD register. The overall median survival was 54.5 years with no significant difference between males and females. Survival for index cases was less than for the non-index cases regardless of smoking history (49.4 years and 69.3 years respectively). When we analyzed index cases and non-index cases separately there was no difference between the survival of smokers and never-smokers in the index group. In the non-index group smokers had a shorter survival than never-smokers. The survival of non-index never-smokers was similar to the survival of the normal Danish population. We conclude that the prognosis of severe alpha 1ATD is better than previously assumed, and that although smoking is a major risk factor the development of emphysema in patients with severe alpha 1ATD is multifactorial.

[Factitious disorder--an iatrogenic disease?]. / Uaegte sygdom--en iatrogen lidelse?

The case of a woman aged 31 years with numerous contacts with the health care system is reported. The patient presented an extremely varied pattern of complaints with pain as one of the most frequently recurring reasons for admission. During the past 12 to 13 years, the patient was admitted to inpatient units on numerous occasions and was submitted to numerous examinations, most of which revealed normal findings. This article lists a number of possible background causes which might permit a career like this to develop. Measures for prevention of similar "case-stories" in future are discussed.