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The Puerto Rican Nation on the Move: Identities on the Island and in the United States

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We cannot exclude that the elevated B12 level may have prompted some physicians to look for underlying cancer in patients of the EE and EN groups, but this limitation is imbalanced by the prolonged follow-up (3.2 [1.55.2] years in the whole population, with a longer follow-up in the NN group), which could have enabled detection of cancers that have not been actively searched initially

For chronic heavy users, the detection time can be extended