Geographic assessment of breast cancer screening by towns, zip codes, and census tracts.

Early detection is the primary way to control breast cancer, and mammography screening can reduce breast cancer mortality 30 to 40 percent among women aged 50 years and older. Geographic areas with a high proportion of cases with late-stage diagnoses may reflect gaps in screening efforts. We used a spatial scan statistic, adjusting for the multitude of possible region locations and sizes, to test whether any particular region of Massachusetts had statistically significant excesses of late-stage diagnoses during the period 1982 to 1986. The novel geographic analysis technique utilized here can also be used in the control of other types of cancer.

A case-control study of testicular cancer using Connecticut tumour registry data.

This case-control study was designed to determine whether males who were exposed to diethylstilboestrol (DES) in utero are at increased risk of testicular cancer. Questionnaires were completed for 79 residents of Connecticut, who were diagnosed with primary cancer of the testes between 1945 and approximately six months into 1980. An equal number of matched controls drawn from birth certificate records available from the Connecticut State Department of Health Services also submitted questionnaires. Information included data on past medical conditions of subjects and obstetrical history of mothers. The major finding of this study was a statistically significant elevated risk for premature birth for the testicular cancer cases. The study failed to show that DES increased the risk for testicular cancer. However, in view of the findings from previous human and animal studies of such abnormalities as undescended and hypoplastic testes as well as the consideration that only the earliest exposed birth cohort has reached the age of substantial cancer risk, it would seem prudent for any male who has been prenatally exposed to DES to seek medical follow-up.