[Endometrial cancer and tamoxifen. Discussion apropos of a series of cases].

Tamoxifen is widely used nowadays in the management of breast cancer, having established its efficacy in this indication, especially for postmenopausal patients with ER-positive breast tumours. However, tamoxifen has recently been recognized as carcinogenic for the human endometrium, probably with an effect of duration of treatment. Moreover, this drug may be associated with the occurrence of endometrial cancers of unusual histological types and/or of a more aggressive nature.

[Cancer prevention by general practitioners in the Rhône area: a declarative survey].

A telephone questionnaire on primary prevention and cancer screening practices of general practitioners in the Rhône was administered to a sample of 191 general practitioners, 129 of which had been randomly sampled. Questions concerned primary prevention (tobacco, alcohol, diet, exposure to sunlight, occupation) and cancer screening (uterine cervix, breast, colo-rectum, prostate, other cancers). In addition, physicians were also interviewed on difficulties encountered in their practice, and about their initial and further medical training in this field.

[Screening of undifferentiated carcinoma of the nasopharynx].

Screening for nasopharyngeal carcinoma (NPC) is being conducted as a quasi-experiment in the south east of the People's Republic of China using serological markers of the Epstein-Barr virus. Several studies are available but the efficacy of screening in terms of impact on mortality from NPC has not yet been demonstrated. Valid experimental studies should be carried out before implementing population-based screening programmes in Chinese or North African populations which are known for their high risk of NPC.

[Medical adverse effects of chemoprevention: the example of tamoxifen].

Tamoxifen, a synthetic antiestrogen widely used for the treatment of breast cancer, is also being proposed for the prevention of this cancer among women at high risk for the disease. Such an approach requires an objective and accurate evaluation, not only of the expected beneficial effects, but also of the potential iatrogenic side effects which could result from the administration of this drug to a population of healthy women. The present article summarizes our present knowledge which results from studies, all carried out on women with breast cancer: we review the side effects on the female genital apparatus, the ovarian and non ovarian endocrine side effects, the effects on cardio-vascular and thromboembolic risks, on bone metabolism and on ocular and hepatic side effects.

[Epidemiology and prevention of cancer: reflections on the ethics of public health measures].

About 5 million cancer deaths occur each year in the world, and many more cancer incident cases arise. It is estimated that at least 80% of these cancers could be avoided, based upon currently available epidemiological knowledge. Such a result could be achieved through modification of life-style and, to a much lesser extent, of the general environment.

[Identification of human carcinogenic risks in IARC monographs].

For more than twenty years, the IARC has been evaluating the carcinogenic risk to humans of chemicals, groups of chemicals, complex mixtures, occupational exposures, behavioral and life-style exposures, biological agents, such as bacteria and viruses, and physical agents, such as radiation, on the basis of published studies of carcinogenicity in humans and laboratory animals. This paper includes the list established by IARC of substances carcinogenic to humans.

Hepatitis C virus among blood donors: follow-up study.

Background: The exact significance of antibodies to hepatitis C virus (HCV) in blood donors remains unknown. Confirmatory tests of anti-HCV-reactive serum and HCV RNA by polymerase chain reaction (PCR) are used to refute a large proportion of false-positive results.

Study Design And Methods: Ninety-two blood donors who were anti-HCV reactive in a first-generation enzyme-linked immunosorbent assay (ELISA) were reevaluated 10 months later with a second-generation ELISA (ELISA-2) as well as with second-generation recombinant immunoblot assay (RIBA-2) and by PCR.

[Smoking and social class in France 1974-1991].

We examined trends in cigarette smoking behaviour in France from 1974 to 1991 separately for men and women as well as according to social class indicators. Overall, cigarette smoking prevalence has declined among men but has increased among women over the 18-year period which was taken into consideration. Analysis by social class groupings shows, among men, that the decrease is greater among higher level executives, professionals and academics and occurred as early as 1983.

[Genetic predisposition to cancer: familial forms of medullary thyroid cancer and breast cancer].

Most cancers appear to be sporadic. However, 5 to 10% of cancers occur in genetically predisposed individuals. This inherited genetic risk is observed in syndromes such as familial polyendocrinopathies or phacomatosis such as neurofibromatosis, but also in familial aggregations of frequent cancers such as breast or colon cancers.

[Iatrogenic risk and screening: the example of mammography].

Iatrogenic risk is a necessary component of any curative medical intervention in medicine. By contrast, its existence is often ignored in public health programmes. The example of breast cancer screening by means of mammography is studied here to describe the type and importance of risks linked to the screening examination itself, but also to the ensuing complementary procedures in order to evaluate the global impact on women's health in the general population.

Variable morphology of human immunodeficiency virus-associated lymphomas with c-myc rearrangements. The French Study Group of Pathology for Human Immunodeficiency Virus-Associated Tumors, I.

Burkitt lymphoma (BL) and immunoblastic lymphoma (IL) are the most frequent lymphoid tumors encountered in human immunodeficiency virus (HIV)-infected patients. Tumors with a morphology intermediate between BL and IL, and the existence of Burkitt's type translocations in some IL cases makes the classification of these tumors sometimes unclear. We have studied 14 cases of BL and IL in HIV-seropositive individuals with regard to clonality, Epstein-Barr virus (EBV) association, and the presence of c-myc rearrangement.

[Consequences of tobacco use on mothers and children].

The effects of smoking on female reproductive life are clear, with a longer time-lapse necessary for conception, alterations in hormonal and placental functions and an increased risk of extra-uterine pregnancy, prematurity and low birth-weight. The effects of passive smoking among children, irrespective of source, are linked to an increased risk of sudden infants death syndrome, as well as a higher frequency of otitis and respiratory ailments. Some authors have also found an increased risk of cancer in children and a negative impact on physical and psychological development.

[Epidemiological trends of primary lung cancers].

Due to a dramatic increase in the present century, lung cancer is now undoubtedly the most frequent cancer in the world. Their principal risk factor for lung cancer is active smoking, but passive smoking is also responsible. Eighty to 90% of lung cancer cases in men and 50 to 75% in women are caused by tobacco smoke.

[Epidemiology of acute lymphoid leukemia].

Acute lymphocytic leukaemia (ALL) has a bimodal age incidence. It constitutes the majority of leukaemias diagnosed in childhood but less than 5% of adult leukaemia. Distinction between lymphocytic and myeloid forms of acute leukaemia in routine statistics has only been possible since 1968.

[Epidemiology of breast cancer in men].

Incidence data for male breast cancer from 34 selected cancer registries in different parts of the world are presented. The geographic variation in incidence is similar to that observed for female breast cancer, resulting in a strong correlation between their respective rates, although certain populations have higher rates for male breast cancer than expected from the female incidence, notably Israeli Jews and blacks in the United States. It seems that both environmental factors (acting by the intermediary of endogenous oestrogens excess) and genetic predisposition play a role in determining the epidemiological profile of male breast cancer, as they do for cancer of the female breast.

[Genetics of neurofibromatosis: recent progress and prospects].

Two forms of neurofibromatosis are currently described. Von Reckinghausen Neurofibromatosis (NF 1) is the classic and common form, recently localised to chromosome 17. Neurofibromatosis type 2 (NF 2) or bilateral acoustic Neurofibromatosis, formerly the "central form" of von Reckinghausen disease, is characterized by multiple brain tumors, most often bilateral acoustic neuromas.

[Current development of smoking in young people in France].

Two sets of data, collected independently, have been analysed to study the recent evolution of tobacco smoking in France among young people. For the first time a trend towards a reduction of this habit has been observed.

[Role of junctional intercellular communication in hepatic carcinogenesis in rats].

Two major alterations in gap junctional intercellular communication (GJIC) during experimental carcinogenesis have been seen: a decrease of its capacity during tumor promotion and a selective loss of intercellular communication between transformed cells and surrounding normal counterparts. These data, first discovered in our laboratory on mouse fibroblasts (BALB/c 3T3), were partly confirmed in rat liver epithelial cells. In such cells, the decreased GJIC was related to their level of transformation.

[Geographic distribution of cancer of the larynx and hypopharynx by anatomic subsite].

Incidence data from many cancer registries throughout the world are presented for the major sub-sites of laryngeal and hypopharyngeal cancers. Correlations between glottic (161.0) supra-glottic (161.

[Incidence of cancer in children throughout the world].

The International Agency for Research on Cancer has coordinated a worldwide study of the incidence of cancer in childhood. Contributors from over 50 countries have provided data. This paper presents a summary of some of the major results.