Document 82YLG1eYrQapgmgEJDZ1GVqN5
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Cancer ana
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JL be cancer maps pubbshed 1 y the Nationaj Cancer
Institute have given Louisiana tl e dubious distinction of displaying some of the highe it cancer ratei in `the nation.1, * This excess is only t ue for males, is mostly
concentrated in the southern pc rtion of the state and is especially prominent for the n spiratory organs. Ageadjusted death rates for respirato for 1950-1968 have been calculated for each of the 3,056
counties of the United States. rThe top 18 in that list include the following 10 Louisiana parishes: St. Bernard, Tensas,\ Terrebone, Cancordia, Drleans, Jefferson, Ibe ria, St. Martin, Evangeline and SCharles.3 More recent data on death rates for Louisian a parishes (prepared by Thomas Ballinger, Department of Health and Human Resources) show the following ra ik order for the parishes with highest lung cancer death rates in white males, 1960-1976^ Evangeline, West C irroll, Bossier, St. Ber
nard, Assumption, Acadia, St. K\ artin, Richland, Tensas,
Iberia, Franklin, Terrebone, S . Mary, St. Tammany,
Washington and Orleans.
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Lifestyle is one of the (acton suspected to; be linked
with cancer causation! The run li north of Lou:
has
respiratory cancer rates which t re Approximately^ h*lf of
those of the more industrialized south. As a first approx
imation to investigate' the possi >le link between Icancer risk and lifestyle, we conducted isuWeyfofourfcJutfrern
and five northern Louisiana p^ isbes whose death ptcs from respiratory cancer are sbo m inTablel.'*A rirndom
sample ofall males ov^r 30 year ofage wps ^lepfod from
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From the Department of Pathology ad Biometry, Louts! aa Sute
i Vnlv^uity Mescal Canter, New Orlei is, La. 1
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T PELAYO CORREA, h D )VILUAM D. JOHNSOj*
New prler
holders ofdriver's licenses with addresses in the \ selected. With the help of die American Cancer__ volunteers, a questionnaire was mailed to them inqu about their lifestyle. The positive results are summaairiced in Table 2. All responses to the questionnaire are expressed in terms of the age-adjusted percent oi'the re-
i-: -1 J TABLE 1
^GE-ADJUSTED MALE DEATH RATES PER 100,OdO ,FOR RESPIRATORY CANCER FOR 1950-1969 IN SELECTED PARISHES FROM NORTH AND
' ' SOUTH LOUISIANA*
South
Iberia Lafourche St. Terrebone
White 62
, 58 61 69
Black 42 S3 53 41
Average
63 47
'I r
Bienville \ *', Natchitoches.1-I,
fled River M'
Sabine : ft',
North
35 32 37 23 33
10 19 10 19 26
32 17 [ X
,# race-location category.Response re-
t l^to ipods/^h^ drinks showing any inter-groups di fer-
' shown kj Table 3. 1 . ^Li'Tesult^ jydipate (hat the differences'll) thi<[ life! tyle
r rhshleDtjqfareAj with 'cbnxrastijng lung cancer trial sin
\.x- riling,.: I ,>
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Vh * j$'i
Ma-chl983-YoL 125, M.3
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TABLE 2
RESPONSES TO LIFE STYLE QUESTIONNAIRE FROM MALES OF NORTH AND SOUTH LOUISIANA
> - - - - - -
- - - - - - - - - - - - - -L
1 i1 ,
White
South
North
Black !
South
Nort .
Number of responses % college graduates % current smokers % smokers starting after age 20 % smokers using filter cigarettes % whose father smokes % whose mother smokes % employed in
offshore oil inland oil refinery petro-chemica]
other chemicals ship building fishery construction farming sawmill white collar % drinking water from: river
private well % spraying home for insects
daily or weekly
l
1 777 ,
680
' 92
! 137
i
15.5 19.9
5.3
6. 1
38.7 34.7 54.0
46. i
17.4 20.2 19.3
19.
75.9
S4.9 73.8
74.
!
39.3 ,
28.0
29.7
28. T
6.5 .
5.2 1
3.9
5.9
1
10.7 ' ' 4.0
9.7
1.7
1 1
3.7 3.4
0 0.
11
3.5 ;
0.8
12.8
; i.
0.7 0.8 1.2
0.
1.8 1.3 1.1
O'
4.6 0 3.0
0
6.0 0 1.1 0.6
10.0 12.5 16.3 8.2 9.5 19.0
515. 4
12.
1.4 17.9 1.8 21.8
17.3 13.2
I4.3 6. 0 '
24.0
1.7 17.1
12. )
9.6 45.2 10.1
12. $T
t12.1 13.6 36.6 41.
| `
] $
'
TABLE 3 AVERAGE CONSUMPTION OF SELECTED FOODS AND BEVERAGES BY NORTH AND SOUTH LOUISIANA MA^ES
;
White
Black
!
i
South
North
South
North
Mean number of times per month
shellfish -
pork
beef
Mean units (glasses or cups) drunk per month
coffee
I
tea
beer
wine other alcohol
4.4 4.0 14.7
106 15 35 5 99
1.3 6.5 15.4
103 30 14
2
, 67
32 4.1 0.7
59 6
35 18 93
1
L9 6.1! n.o
i
41 i 12 23 6 66
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I TABLE 4
PERCENT OF CIGARETTE SMOKERS AMONG SUBJECTS INTERVIEWED ACCORDING TO THE l SMOK1NC HABITS OF THEIR PARENTS, BY RACE
White subject smokes Yes No
Black subject smokes Yes No
March 1983 - Vol. 135, No. 3
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Father Smokes Yes No
43.7 56.3
. ,
t ' 26.9 73,1
,: i 6L7 j t3. 1
44.4 i 55.6
: , :
Mother Smokes ! Yes No
46.5 53.5
56.8 [ 43.2
j 1
35.1 64.9
47,4 52.6 -------1-------
!5
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i 1* Louisiana are multiple, One pfthe more marked differ ences refers to the occupation; about one-thiid the
white labor force in the southern parishes und?r study works in oil and shipbuilding industries while! farming and sawmill predominate in tjie north. Fishery also pre
dominates in the south. Moje river water is used for drinking purposes in the south and more private weljs in
the north. The proportion of smokers, the proportion using non-filter cigarettes and the proportion starting to smoke before age 20 are higher in the south. In Whites, a remarkable excess of parents who smoked is repotted from the south, apparently indicating that the habit has been more widespread in the south for severa^ genera tions, It appears that the smoking habits of the,parents influence the smoking habits of their children, as shi>wn
in Table 4. A greater proportion of smokers is found among subjects whose father or mother smoke as com pared to those whose father or mother did not smoke. The difference is higher in whites than in blacks. Lifestyle features apparently related to race rather than geography are; education, spraying of home for insects, work in farming, construction and white collar occupations and consumption of coffee.
This type of correlation study does not allow definitive
causal inferences but does serve as a basis for further scientific inquiry. An association between lung cancer and certain occupations has been suggested.3 The inter
pretation of such correlations should take into account existing differences in smoking habits between occupa tion categories.4-8 In our survey we found a higher pro portion of smokers among workers of certain industries: while the average proportion of smokers for all industries was 41 percent, the corresponding figure for fishery workers was 48 pprcent and for offshore oil workers 47 percent. More in-depth studies of the lifestyle of cancer patients and controls are underway.
I
References
1. .Burbank F: Patterns in cancer mortality in the United States:
1950-1967. Nat Cancer Inst. Monograph No. 33. P.H.S. U. S. Govt.
Printing Office, Washington, 1971
2. Muon T gpd McKay FW: U. S. Cancer mortality by county
1950-1969, DHEW Publication No. (NIH)74-615. U. S. Govt. Printing
Office, Washington, 1974
1
5- Blot WJ, Davies J^, Brown LM, NordwallCW, Buiatt K, Ng A and
Fraumeni JF: Occupation and high risk of lung cancer in northeast
Florida. Cancer 50:364.371, 1982
4. Covey L$ and Wynder EL: Smoking habits and occupatlpnal
Itatpa. J.Occup Med 23:537-542. 1981
(,
:5-j^Vpinberg CE, Kuller LH and Redmond CK: The relationship
between1 the geographic distribution of king cancer incidence and
cigarette; smoking In Allegheny County, Pennsylvania.1 Am J Epid
1982 f',,. |j I ' ! j'| ' .
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*! Acknowledgment
work was supported by a grant froomm the America^' Cancer
Society, Louisiana Division.
.4March 1983 - Voi
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