M J Schoemaker

Publications of M J Schoemaker

• The Breakthrough Generations Study: design of a long-term UK cohort study to investigate breast cancer aetiology.

  Authors: A J Swerdlow, M E Jones, M J Schoemaker, J Hemming, D Thomas, J Williamson, A Ashworth

  British journal of cancer. 09/2011; 105(7):911-7.

  The rationale, design, recruitment and follow-up methods are described for the Breakthrough Generations Study, a UK cohort study started in 2003, targeted at investigation of breast cancerThe rationale, design, recruitment and follow-up methods are described for the Breakthrough Generations Study, a UK cohort study started in 2003, targeted at investigation of breast cancer aetiology. Cohort members have been recruited by a participant referral method intended to assemble economically a large general population cohort from whom detailed questionnaire information and blood samples can be obtained repeatedly over decades, with high completeness of follow-up and inclusion of large numbers of related individuals. 'First-generation' recruits were women contacted directly, or who volunteered directly, to join the study. They nominated female friends and family, whom we contacted, and those who joined ('second generation') nominated others, reiterated for up to 28 generations. The method has successfully been used during 2003-2011 to recruit 112,049 motivated participants with a broad geographic and socioeconomic distribution, aged 16-102 years, who have completed detailed questionnaires; 92% of the participants gave blood samples at recruitment. When eligible, 2½ years after recruitment, >98% completed the first follow-up questionnaire. Thirty percent are first-degree relatives of other study members. The 'generational' recruitment method has enabled recruitment of a large cohort who appear to have the commitment to enable long-term continuing data and sample collection, to investigate the effects of changing endogenous and exogenous factors on cancer risk.

• Determinants of age at menarche in the UK: analyses from the Breakthrough Generations Study.

  Authors: D H Morris, M E Jones, M J Schoemaker, A Ashworth, A J Swerdlow

  British journal of cancer. 11/2010; 103(11):1760-4.

  Early menarche increases breast cancer risk but, aside from weight, information on its determinants is limited. Age at menarche data were collected retrospectively by questionnaire from 81,606 womenEarly menarche increases breast cancer risk but, aside from weight, information on its determinants is limited. Age at menarche data were collected retrospectively by questionnaire from 81,606 women aged 16-98, resident in the UK and participating in the Breakthrough Generations Study. Menarche occurred earlier in women who had a low birthweight (P(trend)<0.001), were singletons (P<0.001), had prenatal exposure to pre-eclampsia (P<0.001) or maternal smoking (P=0.01), were not breastfed (P(trend)=0.03), were non-white (P<0.001), were heavy (P(trend)<0.001) or tall (P(trend)<0.001) compared with their peers at age 7 and exercised little as a child (P(trend)<0.001). Menarcheal age increased with number of siblings (P<0.001) independently of birth order, and had an inverse association with birth order after adjustment for sibship size (P<0.001). In a multivariate model, birthweight, ethnicity, weight, height, exercise, sibship size and birth order remained significant, and maternal age at birth became significant (positive association, P<0.001). Age at menarche was influenced by both pre- and post-natal factors, and these factors may affect breast cancer risk through this route.

• Cancer risk in patients with constitutional chromosome deletions: a nationwide British cohort study.

  Authors: A J Swerdlow, M J Schoemaker, C D Higgins, A F Wright, P A Jacobs

  British journal of cancer. 07/2008; 98(12):1929-33.

  The finding of increased risks of specific cancers in individuals with constitutional deletions of chromosomes 11p and 13q led to the discovery of cancer predisposition genes at these locations, butThe finding of increased risks of specific cancers in individuals with constitutional deletions of chromosomes 11p and 13q led to the discovery of cancer predisposition genes at these locations, but there have been no systematic studies of cancer risks in patients with constitutional deletions, across the chromosome complement. Therefore, we assessed cancer incidence in comparison with national cancer incidence rates in a follow-up of 2561 patients with constitutional autosomal chromosome deletions diagnosed by microscopy or fluorescence in situ hybridisation in Britain during the period 1965-2002. Thirty cancers other than non-melanoma skin cancer occurred in the cohort (standardised incidence ratio (SIR)=2.4, 95% confidence interval (CI) 1.6-3.5). There were significantly increased risks of renal cancer in persons with 11p deletions (SIR=1869, 95% CI 751-3850; P=4 x 10(-21)), eye cancer with 13q deletions (SIR=1084, 95% CI 295-2775; P=2 x 10(-11)), and anogenital cancer with 11q deletions (SIR=305, 95% CI 63-890; P=3 x 10(-7)); all the three latter cancers were in the 11 subjects with 11q24 deletions. The results strongly suggest that in addition to suppressor genes relating to Wilms' tumour risk on 11p and retinoblastoma on 13q, there are suppressor genes around 11q24 that greatly affect anogenital cancer risk.

• History of allergic disease and risk of meningioma.

  Authors: M J Schoemaker, A J Swerdlow, S J Hepworth, M van Tongeren, K R Muir, P A McKinney

  American journal of epidemiology. 03/2007; 165(5):477-85.

  Epidemiologic studies have consistently shown inverse associations of allergic disease with risk of glioma, but it is unclear whether this association also applies to meningioma. The authorsEpidemiologic studies have consistently shown inverse associations of allergic disease with risk of glioma, but it is unclear whether this association also applies to meningioma. The authors conducted a pooled analysis of meningioma risk in relation to a history of allergic disease based on data from two population-based, case-control studies with 475 cases and 1,716 controls in the United Kingdom (2001-2004). Meningioma risk was significantly reduced in relation to self-reported, physician-diagnosed allergic disease (odds ratio = 0.76, 95% confidence interval (CI): 0.61, 0.96) but was nonsignificantly reduced for individual conditions: asthma (odds ratio = 0.85, 95% CI: 0.61, 1.18), hay fever (odds ratio = 0.81, 95% CI: 0.62, 1.06), and eczema (odds ratio = 0.72, 95% CI: 0.51, 1.02). Risk reductions were greatest for asthma (odds ratio = 0.43, 95% CI: 0.21, 0.89) and hay fever (odds ratio = 0.50, 95% CI: 0.25, 1.00) with an early age at onset (<10 years) and for eczema (odds ratio = 0.46, 95% CI: 0.21, 1.07) with an onset at ages 10-19 years; they were near unity for onset in adulthood. This study suggests an inverse association between a history of allergies and meningioma risk, but with smaller risk reductions than for glioma. The reasons for this association need clarification, as well as an etiologic explanation. Consideration also needs to be given to confounding or bias.

• Medical history, cigarette smoking and risk of acoustic neuroma: an international case-control study.

  Authors: M J Schoemaker, A J Swerdlow, A Auvinen, H C Christensen, M Feychting, C Johansen, L Klaeboe, S Lönn, T Salminen, T Tynes

  International journal of cancer. Journal international du cancer. 02/2007; 120(1):103-10.

  Acoustic neuroma (vestibular schwannoma) is a benign tumor of the vestibulocochlear nerve. Its recorded incidence is increasing but risk factors for this tumor have scarcely been investigated. WeAcoustic neuroma (vestibular schwannoma) is a benign tumor of the vestibulocochlear nerve. Its recorded incidence is increasing but risk factors for this tumor have scarcely been investigated. We conducted a population-based case-control study of risk factors for acoustic neuroma in the UK and Nordic countries, including 563 cases and 2,703 controls. Tumor risk was analyzed in relation to medical history and cigarette smoking. Risk of acoustic neuroma was significantly raised in parous compared with nulliparous women (OR = 1.7, 95% CI: 1.1-2.6), but was not related to age at first birth or number of children. Risk was not associated with a history of allergic disease, past head injury, past diagnosis of a neoplasm or birth characteristics, but was significantly raised for past diagnosis of epilepsy (OR = 2.5, 95% CI: 1.3-4.9). Tumor risk was significantly reduced in subjects who had ever regularly smoked cigarettes (OR = 0.7, 95% CI: 0.6-0.9), but the reduction applied only to current smokers (OR = 0.5, 95% CI: 0.4-0.6), not ex-smokers (OR = 1.0, 95% CI: 0.8-1.3). The reduced risk of acoustic neuroma in smokers and raised risk in parous women might relate to sex hormone levels, or smoking might suppress tumor growth, but effects of parity and smoking on timing of diagnosis of the tumor are also a potential explanation. The raised risk in relation to past diagnosis of epilepsy might be a surveillance artefact or imply that epilepsy and/or antiepileptic medication use predispose to acoustic neuroma. These findings need replication by other studies and possible mechanisms need to be clarified.

• Mobile phone use and risk of acoustic neuroma: results of the Interphone case-control study in five North European countries.

  Authors: M J Schoemaker, A J Swerdlow, A Ahlbom, A Auvinen, K G Blaasaas, E Cardis, H Collatz Christensen, M Feychting, S J Hepworth, C Johansen, L Klaeboe, S Lönn, P A McKinney, K Muir, J Raitanen, T Salminen, J Thomsen, T Tynes

  British journal of cancer. 11/2005; 93(7):842-8.

  There is public concern that use of mobile phones could increase the risk of brain tumours. If such an effect exists, acoustic neuroma would be of particular concern because of the proximity of theThere is public concern that use of mobile phones could increase the risk of brain tumours. If such an effect exists, acoustic neuroma would be of particular concern because of the proximity of the acoustic nerve to the handset. We conducted, to a shared protocol, six population-based case-control studies in four Nordic countries and the UK to assess the risk of acoustic neuroma in relation to mobile phone use. Data were collected by personal interview from 678 cases of acoustic neuroma and 3553 controls. The risk of acoustic neuroma in relation to regular mobile phone use in the pooled data set was not raised (odds ratio (OR) = 0.9, 95% confidence interval (CI): 0.7-1.1). There was no association of risk with duration of use, lifetime cumulative hours of use or number of calls, for phone use overall or for analogue or digital phones separately. Risk of a tumour on the same side of the head as reported phone use was raised for use for 10 years or longer (OR = 1.8, 95% CI: 1.1-3.1). The study suggests that there is no substantial risk of acoustic neuroma in the first decade after starting mobile phone use. However, an increase in risk after longer term use or after a longer lag period could not be ruled out.

• Lung cancer after Hodgkin's disease: a nested case-control study of the relation to treatment.

  Authors: A J Swerdlow, M J Schoemaker, R Allerton, A Horwich, J A Barber, D Cunningham, T A Lister, A Z Rohatiner, G Vaughan Hudson, M V Williams, D C Linch

  Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 04/2001; 19(6):1610-8.

  PURPOSE: To investigate the causes of the raised risk of lung cancer in patients who have had Hodgkin's disease, and in particular the relationship to treatment. PATIENTS AND METHODS: A nestedPURPOSE: To investigate the causes of the raised risk of lung cancer in patients who have had Hodgkin's disease, and in particular the relationship to treatment. PATIENTS AND METHODS: A nested case-control study was conducted within a cohort of 5,519 patients with Hodgkin's disease treated in Britain during 1963 through 1993. For 88 cases of lung cancer and 176 matched control subjects, information on treatment and other risk factors was extracted from hospital case-notes, and odds ratios for lung cancer in relation to these factors were calculated. RESULTS: Risk of lung cancer was borderline significantly greater in patients treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy than those who did not receive this treatment (relative risk [RR] = 1.66; 95% confidence interval [CI], 0.99 to 2.82), and increased with number of cycles of MOPP (P =.07). Exclusion of lung cancers for which histologic confirmation was not available strengthened these associations (RR = 2.41; 95% CI, 1.33 to 4.51; P =.004 for any MOPP and P =.007 for trend with number of cycles of MOPP). Risks were not raised, however, after chlorambucil, vinblastine, procarbazine, and prednisone treatment. There was evidence that the raised risk of lung cancer occurring in relation to radiotherapy was restricted to histologies other than adenocarcinoma. CONCLUSION: The results suggest that MOPP chemotherapy may lead to elevated risk of lung cancer, at least in certain subgroups of patients. The role of chemotherapy in the etiology of lung cancer after Hodgkin's disease deserves further investigation.

• Predictors of first nonfatal occupational injury following employment in a Brazilian steelworks.

  Authors: S M Barreto, A J Swerdlow, M J Schoemaker, P G Smith

  Scandinavian journal of work, environment & health. 01/2001; 26(6):523-8.

  OBJECTIVES: This study investigated the influence of sociodemographic and occupational factors on the risk of 1st injury among Brazilian steelworkers. METHODS: Workers 1st employed between 1 JanuaryOBJECTIVES: This study investigated the influence of sociodemographic and occupational factors on the risk of 1st injury among Brazilian steelworkers. METHODS: Workers 1st employed between 1 January 1977 and 31 December 1985 and still employed on 1 December 1983 were followed from the date of hire until 30 October 1992. Occupational injuries were ascertained from a database. Kaplan-Meier curves for time to 1st injury were calculated for the total cohort and for different subgroups. A multivariate analysis of risk factors for 1st injury was carried out using the Cox proportional hazards regression model. RESULTS: Forty-one percent of the workers had > or = 1 occupational injuries, and 39% of 1st injuries occurred in the 1st year of employment. Lacerations, contusions, penetration by foreign bodies, bums, sprains, and fractures constituted the main diagnostic groups. Injuries to the hands, eyes, feet, arms, and legs dominated. Over 5% of the injured workers were on temporary disability leave (cumulative total 10,660 days). The probability for an occupational injury was 16% for the 1st year, rising to 25% in the 2nd year. The risk of nonfatal injury was highest for laborers [hazard ratio (HR) 1.76, 95% confidence interval (95% CI) 1.35-2.29] and employees in the steel mill (HR 1.40, 95% CI 1.21-1.63), and inversely related to worker age and educational level. The risk of injury decreased significantly with calendar period of employment. CONCLUSIONS: Substantial reductions in nonfatal injuries may reflect changes in work organization, increased automation, and improved safety standards. Knowledge of predictors of work-related injury may contribute to injury prevention strategies, especially among newly employed workers.

• Non-fatal work related injuries in a cohort of Brazilian steelworkers.

  Authors: M J Schoemaker, S M Barreto, A J Swerdlow, C D Higgins, R G Carpenter

  Occupational and environmental medicine. 09/2000; 57(8):555-62.

  OBJECTIVES: Workers in the steel industry are exposed to various severe hazards. This study investigated risk factors for non-fatal injury occurring in the workplace and during travel to and fromOBJECTIVES: Workers in the steel industry are exposed to various severe hazards. This study investigated risk factors for non-fatal injury occurring in the workplace and during travel to and from work in steelworkers in Brazil. METHODS: Non-fatal work related injuries during employment from January 1977 to September 1992 were analysed in a cohort of 21 732 male workers in the steel plant of USIMINAS, Brazil. RESULTS: There were 14 972 non-fatal injuries during follow up, with 10 891 injuries in the workplace and 4081 during travel to and from work (travel to work injury). The rate of injury in the workplace was 5.6/100 person-years and that of travel to work injury was 2.1/100 person-years. The most common injuries were to hands, arms, and eyes, with 90% of the eye injuries caused by a foreign body. Both rates of workplace and travel to work injury increased significantly with the number of injuries previously experienced, and decreased with number of years in employment and calendar period. The rates of travel to work injury also seemed to decrease with age, but age was not an independent predictor of workplace injury when we controlled for duration of employment. The rate of workplace injury was increased eightfold for workers who had experienced more than six previous injuries compared with those with no previous workplace injuries after adjusting for duration of employment and calendar period. Labourers were most at risk of workplace injury, with about eight injuries per 100 person-years. Travel to work injury was most common among support workers, with nearly half of the travel to work injuries affecting the eyes. CONCLUSION: The rate of injury was high in these steelworks, both for workplace and travel to work injuries. Characteristics of the work areas and the employees can identify high risk groups; protective measures, safety, health training, and injury programmes should concentrate particularly on these groups. Prevention of eye injury needs special attention in steelworks.

• Reply: Mobile phone use and acoustic neuroma in five North European countries

  Authors: M J Schoemaker, A J Swerdlow, A Auvinen, E Cardis, M Feychting, C Johansen, P A McKinney, T Tynes

• Lung cancer after Hodgkin’s disease: a nested case-control study of the relation to treatment

  Authors: A J Swerdlow, M J Schoemaker, R Allerton, A Horwich, J A Barber, D Cunningham, T A Lister, A Z S Rohatiner, G Vaughan Hudson, M V Williams, D C Linch

  Swerdlow, A.J. and Schoemaker, M.J. and Allerton, R. and Horwich, A. and Barber, J.A. and Cunningham, D. and Lister, T.A. and Rohatiner, A.Z.S. and Vaughan Hudson, G. and Williams, M.V. and Linch, D.C. (2001) Lung cancer after Hodgkin’s disease: a nested case-control study of the relation to treatment. Journal of Clinical Oncology, 19 (6). pp. 1610-1618. ISSN 0732183X.

  Purpose: To investigate the causes of the raised risk of lung cancer in patients who have had Hodgkin’s disease, and in particular the relationship to treatment. Patients and Methods: A nestedPurpose: To investigate the causes of the raised risk of lung cancer in patients who have had Hodgkin’s disease, and in particular the relationship to treatment. Patients and Methods: A nested case-control study was conducted within a cohort of 5,519 patients with Hodgkin’s disease treated in Britain during 1963 through 1993. For 88 cases of lung cancer and 176 matched control subjects, information on treatment and other risk factors was extracted from hospital case-notes, and odds ratios for lung cancer in relation to these factors were calculated. Results: Risk of lung cancer was borderline significantly greater in patients treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy than those who did not receive this treatment (relative risk [RR] = 1.66; 95% confidence interval [CI], 0.99 to 2.82), and increased with number of cycles of MOPP (P = .07). Exclusion of lung cancers for which histologic confirmation was not available strengthened these associations (RR = 2.41; 95% CI, 1.33 to 4.51; P = .004 for any MOPP and P = .007 for trend with number of cycles of MOPP). Risks were not raised, however, after chlorambucil, vinblastine, procarbazine, and prednisone treatment. There was evidence that the raised risk of lung cancer occurring in relation to radiotherapy was restricted to histologies other than adenocarcinoma. Conclusion: The results suggest that MOPP chemotherapy may lead to elevated risk of lung cancer, at least in certain subgroups of patients. The role of chemotherapy in the etiology of lung cancer after Hodgkin’s disease deserves further investigation.