Trends in smoking-related cancer incidence in Tarragona, Spain, 1980–96

Objectives: To analyze recent trends (1980–96) in the incidence of smoking-related cancers among men and women in Tarragona, Spain. Methods: Data were obtained from a population-based cancer registry. Age-standardized incidence rates were computed. Secular trends, between 1980 and 1996, were estimated using a Poisson regression model. From these figures, age, period, and cohort effects were assessed using the method proposed by Holford. Results: The incidence of all smoking-related cancers combined increased significantly in both sexes. The annual increase was 3.0% in men and 4.5% in women. By sites the annual increase was 4.3% in oral cavity, 5.1% in pancreas, 2.5% in lung, 3.2% in bladder, and 7.7% in kidney cancers among men. Among women the corresponding increments were 7.0% in oral cavity, 7.3% in pancreas, 3.1% in lung, 2.1% in bladder, and 6.9% in kidney cancers. The increasing incidence of lung cancer in women was mostly due to the adenocarcinoma histological type. No increase was observed in esophagus and larynx cancer either in men or women. It was not possible to determine whether the increases are due to a period or cohort effect since the curvature analysis was found to be non-significant. Conclusions: All smoking-related cancers combined, except larynx and esophagus, are increasing in both sexes. The effect of tobacco, alcohol, and occupational exposure to carcinogens could explain the high rates of larynx, bladder, and upper digestive tract cancer in men. The rising incidence rates of lung cancer observed in younger women indicate a change in recent trends that is consistent with changes observed in smoking prevalence. Unless recent upward smoking trends in young women can be reversed, lung cancer in women will rise rapidly in the next few years. New smoking prevention strategies aimed at Spanish women, especially in the younger age groups, should be developed.     

Trends in endometrial cancer incidence and mortality in Sweden, 1960–84

Trends in incidence of and mortality from invasive endometrial cancer in Sweden in 1960–84 were analyzed. The study was based on virtually all 20,371 patients given this diagnosis and 4,887 patients who died of the disease in that period. Only minor changes occurred in age-standardized incidence in pre-menopausal women, in whom the rates declined consistently during the last 15 years, especially in the youngest age groups. Among post-menopausal women, an early increase was followed by stable rates in women over 60 and decreasing rates at ages 50–59 years. In contrast, mortality rates decreased consistently over the study period. Multivariate regression analyses indicated that birth cohort was a more important determinant of incidence and mortality than was time period. The relative risk of developing endometrial cancer increased by about 20 percent in women born around 1900 as compared with 1880, and by an additional 40 percent from the 1910 cohort to the maximum risk attained in those born around 1930. In successively younger birth cohorts, the risk markedly and continuously declined. These strong birth-cohort effects after 1910 may be reasonably explained by the change from the risk-increasing estrogen-only replacement therapy introduced in the 1960s to the less harmful use, starting about 10 years later, of combined estrogen—progestogen regimens; and further, by the protective exposure of a large proportion of pre-menopausal women to oral contraceptives. Mortality, however, decresed steadily in successive cohorts from those born in 1890, indicating that the increase in incidence was referable mainly to non-lethal cancers.Dr Persson is with the Department of Obstetrics and Gynecology, University Hospital, S-751 85 Uppsala, Sweden. Drs Schmidt and Pettersson are in the Department of Gynecologic Oncology at the University Hospital. Dr Adami is with the Department of Surgery, Unit of Cancer Epidemiology at the University Hospital. Mr Sparén is in the Department of Statistics, Uppsala University. Address correspondence to Dr Persson. This work was supported by grants from the Swedish Cancer Society and the Cancer Fund at the University Hospital in Uppsala.     

Trends in childhood cancer incidence in the U.S. (1992-2004)

BACKGROUND: The etiology of most pediatric neoplasms remains elusive. Examination of population-based incidence data provides insight regarding etiology among various demographic groups and may result in new hypotheses. The objective of the current study was to present updated information regarding childhood cancer incidence and trends in the U.S. overall and among demographic subgroups, including Asian/Pacific Islanders and Hispanics, for whom to the authors' knowledge trends have not been previously examined. METHODS: Data obtained by 13 registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program were evaluated to assess incidence and trends of common primary cancers diagnosed between 1992 and 2004 among children aged birth to 19 years. Frequencies, age-adjusted incidence rates, and joinpoint regression results, including annual percent change (APC) in incidence rates (and 95% confidence intervals [95% CI]), were calculated. RESULTS: Between 1992 and 2004, a modest, nonsignificant increase in the average annual incidence rate (APC, 0.4%; 95% CI, -0.1%-0.8%) was observed for all pediatric cancer diagnoses combined. There was a suggestion of an increase in leukemia (APC, 0.7%; 95% CI, -0.1%-1.5%), and acute lymphoblastic leukemia in particular (APC, 0.8%; 95% CI, -0.4%-1.9%), whereas rates for central nervous system tumors overall were stable (APC, -0.1%; 95% CI, -1.1%-1.0%); 2 joinpoints were observed for astrocytoma. Rate increases were noted for hepatoblastoma (APC, 4.3%; 95% CI, 0.2%-8.7%) and melanoma (APC, 2.8%; 95% CI, 0.5%-5.1%). Differences by demographic group (sex, age, and race/ethnicity) are also described. CONCLUSIONS: The observed trends reinforce an ongoing need for population-based surveillance and further etiologic studies.     

广州市2004-2013年原发性肝癌流行现况和趋势分析

目的 原发性肝癌是危害人群健康的常见恶性肿瘤,在我国发病位居所有恶性肿瘤第3位,其发病变化趋势全球不同.本研究通过分析广州市肿瘤登记处数据,了解原发性肝癌流行现况及其变化趋势.方法 根据广州市肿瘤登记处收集的2004-01-01-2013-12-31广州市原发性肝癌的病例资料,计算粗发病率、世界标化率(世标率)和年度变化百分比(annual percentage change,APC),标化率的计算采用Segi's世界标准人口.结果 2004-01-01-2013-12-31广州市居民肝癌新发病例22 135例,男17 875例,女4 260例,男女比为4.20∶1,粗发病率、世标率分别为28.34/10万和21.29/10万,粗发病率和世标率的APC分别为-0.91％(95％CI为-2.80％～1.00％)和-2.97％(95 ％CI为-4.60％～-1.30％);除≥75岁年龄组外其余各组均呈现下降趋势;男女患者肝癌发病均从40岁开始迅速增加,80～84岁达高峰.结论 广州市2004-2013年肝癌发病标化率呈下降趋势,但仍处于高发状态,应加强肝癌的防治研究.     

浙江省肿瘤登记地区2000～2009年女性乳腺癌流行趋势

[目的]了解浙江省登记地区女性乳腺癌的发病和死亡的变化趋势。[方法]根据浙江省6个肿瘤登记处上报的数据,计算并分析浙江省肿瘤登记地区女性乳腺癌的发病率和死亡率等指标。2000~2009年女性乳腺癌发病率和死亡率变化趋势釆用年度变化百分比（APC）估计。[结果]浙江省肿瘤登记地区女性乳腺癌发病率为39.24/10万,构成比16.59%,居女性恶性肿瘤发病的第1位。2000~2009年女性乳腺癌发病率呈上升趋势,APC为5.36%（95%CI：2.88~7.91）。浙江省肿瘤登记地区女性乳腺癌的死亡率为6.42/10万,构成比5.72%,居女性恶性肿瘤死亡的第5位。2000~2009年死亡率无统计学意义的变化,APC为1.42%（95%CI：-0.24~3.10）。[结论]浙江省肿瘤登记地区女性乳腺癌发病率和死亡率低于全国平均水平,但发病率增长趋势比较明显,应该进一步加强乳腺癌的防治。     

Decline in breast cancer incidence after decrease in utilisation of hormone replacement therapy

Hormone replacement therapy (HRT) has been implicated as a risk factor for breast cancer and the use of HRT has decreased substantially in general population over the last years. Recently, there are first indications that breast cancer incidence has started declining. We examined recent breast cancer incidence and actual data on HRT utilisation in Schleswig-Holstein, Germany, to find out population based evidence on decreasing breast cancer incidence and its possible relationship with reduced HRT usage. Breast cancer incidence is taken from the population based cancer registry of Schleswig-Holstein. HRT data was extracted from a cohort of 102,000 women taking part in a quality assurance project in breast cancer diagnosis for the years 2001–2005. The annual percentage change in incidence of breast cancer and HRT utilisation was measured by linear regression. There is a linear decline in HRT utilisation among less than 50 years group, 50–69 years group and all age group women between the years 2001 and 2005. Breast cancer incidence decreased between the years 2001 and 2005 for more than 50 years old and all age group, but not in the younger than 50 years women. The decline of breast cancer incidence started about two years after the HRT decline. Breast cancer incidence decline and decreased HRT utilisation showed a high correlation. A drastic change in age-incidence relationship in breast cancer has taken place, the change is likely to continue and in future it has to be monitored closely with HRT use and other possible explanations.     

Trends in the epidemiology of larynx and lung cancer in south-east England, 1985�C2004

We analysed data on 8987 larynx and 174060 lung cancer patients diagnosed between 1985 and 2004, of which 17.3% of larynx and 35.5% of lung cancers were in females. The age-standardised rates for each cancer declined in both sexes, but since the 1990s, the rates in females over 70 years of age have been diverging.     

Changing trends in incidence of lung cancer by histologic type in Scotland

Lung cancer is a major public health concern worldwide. Our study aims to examine trends in incidence of lung cancer in Scotland during 1959-97 and by histologic type for 1975-97. In Scotland, lung cancer is the most commonly diagnosed cancer in men and is the second most commonly diagnosed cancer in women. Due to poor survival rates, trends in incidence and mortality display similar patterns. Within the United States and many parts of Europe, falls in the incidence of squamous cell carcinoma have occurred whilst the incidence of adenocarcinoma has increased. Data were extracted from the Scottish Cancer Registry. Trends in incidence were examined by standardising rates to the World Standard Population. Age-specific rates were examined by year of diagnosis and mid year of birth. In Scotland the incidence of lung cancer in men has fallen since the late 1970s, whereas incidence in women has continued to increase. Incidence rates of adenocarcinoma have increased over time but squamous cell carcinoma remains the predominant type of lung cancer in Scotland. The quality of lung cancer registration data has improved over time, although a large proportion of lung cancers (>20%) are not microscopically verified. Changes in histologic types are unlikely to be solely due to diagnostic advances. Rates of adenocarcinoma have increased steadily over time, and this may be due to changes in cigarette design during the 1950s.     

2009—2019年江苏省肿瘤登记地区胃癌发病趋势及年龄特征分析

摘 要：［目的］ 分析2009—2019年江苏省肿瘤登记地区人群胃癌发病趋势及年龄变化情况。［方法］ 基于2009—2019年江苏省16个符合质量控制标准、数据连续的肿瘤登记处资料,提取胃癌发病数据进行分析。分性别、城乡和年龄组计算发病率,人口标准化参照2000年中国标准人口结构（中标率）。采用Joinpoint软件对发病趋势进行分析,计算平均年度变化百分比（average annual percentage change,AAPC）。构建出生队列模型,计算1929—2019年出生的男性和女性胃癌发病率,分析其发病趋势。计算并比较2009年和2019年江苏省胃癌发病年龄构成。［结果］ 2009—2019年江苏省肿瘤登记地区胃癌发病率和标化发病率无论男女或城乡,均呈显著下降趋势,其中男性下降幅度（AAPC=-1.28%,P<0.001）高于女性（AAPC=-1.17%,P=0.030）,城市下降幅度（AAPC=-1.66%,P<0.001）高于农村（AAPC=-0.72%,P<0.001）。不同年龄发病趋势结果显示,2009—2019年全省肿瘤登记地区40~79岁各年龄组胃癌发病率均呈显著下降趋势,AAPC在-6.75%~-3.54%之间（P均＜0.05）。出生队列分析结果显示,不同出生年份的40~79岁年龄段人群的胃癌发病率均随着出生年份增加呈现下降趋势。2009—2019年江苏省人群胃癌平均发病年龄每年上升0.27岁（95%CI：0.24~0.29）,调整人口结构后,平均每年上升0.13岁（95%CI：0.10~0.16）。2009—2019年60岁以上人群的胃癌标化发病构成每年增加0.63%（95%CI：0.46%~0.81%）。［结论］ 2009—2019年江苏省肿瘤登记地区胃癌发病率呈现下降趋势,平均发病年龄呈现后移趋势,60岁以上老年人群标化发病比重增加。