Trends in childhood cancer incidence and mortality in Catalonia, Spain, 1975-1998.

Childhood cancer mortality has sharply declined in most economically developed countries over the last years, whereas no substantial changes in the incidence have been observed. In Catalonia (Spain), childhood cancer mortality showed a considerable decline until 1992, but incidence trends have not been analysed in this population. To assess both recent incidence and mortality trends in this population, we analysed childhood (0-14 years) cancer data from the population-based Tarragona Cancer Registry and from the Mortality Registry of Catalonia (Spain) from 1980 to 1998. All cancer mortality decreased by -2.6% annually in boys (95% confidence interval, 95% CI -3.7, -1.6) and -3.7% in girls (95% CI -4.9, -2.5). Mortality due to leukaemia decreased annually -3.0% in boys (95% CI -4.7, -1.4) and -4.4% in girls (95% CI -6.3, -2.4). Mortality for brain tumours showed a reduction of -3.2% in boys (95% CI -5.5, -0.9) and of -4.4% in girls (95% CI -6.3, -2.4). No significant trend in incidence rates, either in boys or in girls, was observed (annual per cent of change for all cancers -0.5%, 95% CI -3.5, 2.7, in boys and 1.7%, 95% CI -1.9, 5.5, in girls). These results suggest an improvement in both childhood cancer diagnosis and treatment, which may explain current higher childhood cancer survival rates.     

Trends in the incidence of adenocarcinoma of the oesophagus and cardia in the Netherlands 1989-2003

Over the 15-year period 1989-2003, the incidence of oesophagus-cardia adenocarcinoma in the Netherlands rose annually by 2.6% for males and 1.2% for females. This was the net outcome of annual increases in the incidence of adenocarcinoma of the oesophagus (ACO) of 7.2% for males and 3.5% for females and annual declines in the incidence of adenocarcinoma of the gastric cardia (AGC) of more than 1% for both genders. Nonlinear cohort patterns were found in females with ACO and for both genders in AGC; a nonlinear period pattern was observed only in males with AGC. These differing epidemiological patterns for ACO and AGC do not support a common aetiology. Proposed underlying factors for the rise in ACO incidence appear to have little effect on AGC incidence. This and the secular decline in smoking among males may have led to the decline in AGC incidence.     

Trends of cutaneous squamous cell carcinoma in the Netherlands: increased incidence rates, but stable relative survival and mortality 1989-2008

BackgroundIncidence rates of cutaneous squamous cell carcinoma (SCC) are increasing in many countries, though detailed information is scarce.ObjectivesTo describe detailed trends in incidence rates, relative survival and estimate mortality rates of SCC in the Netherlands.MethodsInformation on newly diagnosed SCC patients between 1989 and 2008 was obtained from the Netherlands Cancer Registry (NCR). Information of non-melanoma skin cancer (NMSC) mortality was obtained from Statistics Netherlands. European Standardised Rates (ESR) and Estimated Annual Percentage Change (EAPC) were calculated. Incidence rates were fitted to two different models and predicted by the best fitted model. Cohort-based and multivariate survival analyses were performed to assess changes over time.ResultsThe ESR increased from 22.2 to 35.4 per 100,000 inhabitants for males and from 7.8 to 20.5 for females. The EAPC was 6.9% (95% confidence interval: 5.8–8.7) for males and 9.2% (95% CI: 7.5–11.0) for females. Incidence rates increased for all body sites, except for the lips, where a decreasing trend for males was observed. The predicted ESR in 2020 is 46.9 per 100,000 inhabitants for males and 28.7 for females. The 5-year relative survival rate was 92.0% (95% CI: 91.3–92.8) for males and 94.9% (95% CI: 94.0–95.7) for females and remained stable over time. Overall relative survival was better for females, but females with advanced disease had a 30.4 relative excess risk of dying compared to those in stage I. This difference was 9.9 for men. The estimated mortality rate decreased with –1.9% (95% CI: –3.1% to –0.7%) annually.ConclusionsIncidence rates of SCC increased rapidly. Relative survival was high, as most SCCs were diagnosed in stage I. Nevertheless, the number of newly diagnosed patients may exceed 11,000 by 2020, emphasising the need to improve methods to prevent skin cancer.     

Trends in survival of prostate cancer in southeastern Netherlands, 1971-1989

The increase in the incidence of prostate cancer observed over the past 2 decades is suggested to be largely due to increased detection of insignificant tumors. To explore this assumption, we investigated trends in survival of prostate cancer patients in southeastern Netherlands, an area with almost 1 million inhabitants, where the age-adjusted incidence of prostate cancer increased by 53% between 1971 and 1989, i.e., before the introduction of prostate-specific antigen testing. Survival was calculated for all patients registered in the Eindhoven Cancer Registry between 1971 and 1989 (n = 2,562). In spite of earlier diagnosis, survival barely changed during this time period. Five-year relative survival improved slightly from 53% [95% confidence interval (CI) 47%, 59%] in 1975-1979 to 56% (CI 51%, 61%) in 1985-1989. Stratified analyses suggested an improvement since 1980 for patients below 75 years with localized tumors but, despite possible stage migration, decreased survival for those with metastasized and/or poorly differentiated tumors. Patients below 75 years whose tumors were diagnosed unexpectedly during transurethral resection of the prostate (TURP) exhibited a relative survival of 85% 5 years and 68% 10 years after diagnosis. Less extensive application of TURP in The Netherlands might explain why our findings do not agree with those in Sweden and the United States. Inference from country-specific trends in survival appears not to be necessarily generalizable to other countries with a similar increase in the incidence of prostate cancer. We conclude from our results that earlier diagnosis of prostate cancer between 1971 and 1989 may be accompanied by an increased incidence of an aggressive variant.     

Breast cancer incidence and mortality in the Nordic capitals, 1970-1998. Trends related to mammography screening programmes

The aim of the present study was to relate the time trends in breast cancer incidence and mortality to the introduction of mammography screening in the Nordic capitals. Helsinki offered screening to women aged 50-59 starting in 1986. The other three capitals offered screening to women aged 50-69 starting in 1989 in Stockholm, 1991 in Copenhagen, and 1996 in Oslo. Prevalence peaks in breast cancer incidence depended on the age groups covered by the screening, the length of the implementation of screening, and the extent of background opportunistic screening. No mortality reduction following the introduction of screening was visible after seven to 12 years of screening in any of the three capitals where significant effects of the screening on the breast cancer mortality had already been demonstrated by using other analytical methods for the evaluation. No visible effect on mortality reduction was expected in Oslo due to too short an observation period. The study showed that the population-based breast cancer mortality trend is too crude a measure to detect the effect of screening on breast cancer mortality during the first years after the start of a programme.     

Trends in breast cancer incidence and mortality in Denmark, 1943-1982

The trend in breast cancer incidence and mortality was examined using data from the Danish Cancer Registry and the national mortality statistics respectively. The study population comprised 65,870 incident cases and 33,817 deaths from breast cancer in Denmark between 1943 and 1982. The incidence rate remained almost constant up to around 1960, whereafter it rose steadily. Comparatively little change was observed in mortality. Possible explanations for the differing trends in incidence and mortality include under-reporting of breast cancer from death certificates and improvement in survival. A multivariate statistical analysis showed that the increase in incidence was due mostly to a cohort effect, though calendar time may have had a slight effect as well.     

Stable incidence of childhood and adult glioma in The Netherlands, 1989-2003

Time trends in the incidence of glioma may reflect changes in the prevalence of environmental risk factors for glioma. We therefore investigated trends in the incidence of childhood and adult glioma in the Netherlands from 1989 to 2003. We used population-based incidence data from the Netherlands Cancer Registry. We calculated European standardised incidence rates for glioma, and stratified for age, gender and glioma subgroups. Changes in the incidence were estimated by calculating the Estimated Annual Percentage Change. Similar to other countries, the overall incidence of glioma was fairly stable in the Netherlands during the period 1989 to 2003, for both children and adults. In adult astrocytic glioma, a significantly increasing incidence of high-grade astrocytoma was balanced by simultaneous decreases of low-grade astrocytoma, astrocytoma with unknown malignancy grade and glioma of uncertain histology. Most of these time trends can be explained by improving detection and diagnostic precision. Stable incidence rates of adult and childhood glioma suggest that no major changes in environmental risk factors have occurred, which influenced the incidence of glioma in the studied period.     

Trends in breast cancer aggressiveness before the introduction of mass screening in southeastern Netherlands 1975-1989

Objective. The increased incidence of breast cancer in the southeastern Netherlands was accompanied by markedly improved relative survival and stable mortality. We investigated whether the average aggressiveness of tumors changed over time in a population-based study, before the introduction of mass screening. Methods. The mitotic activity index (MAI) was determined retrospectively for 1051 consecutive patients diagnosed with invasive, non-metastatic breast cancer in 1975, 1981, 1988, and 1989. Trends over time, and effects of age, tumor size and lymph node status were examined by univariate and multivariate regressions. Results. Age-adjusted incidence of low MAI tumors changed from 35/100,000 in 1975 to 45/100,000 in 1988–89, an increase of 30% (P=0.01), the incidence of tumors with a high MAI increased about 20% (P=0.28), from 25 to 29/100,000. For small tumors (T1) the odds for a high MAI was lower in 1981 (OR: 0.80; 95% CI: 0.37–1.73) and 1988–89 (OR: 0.66; 95% CI: 0.35–1.23) compared to 1975. Among T3 and T4 tumors the odds increased to 2.03 (95% CI: 0.71–5.86) in 1981 and 2.16 (0.76–6.18) in 1988–89. Conclusion. Although the incidence of tumors with low aggressive potential increased, the incidence of high MAI tumors also increased. Stable breast cancer mortality rates in the face of increasing incidence rates during the period 1975–89 cannot be attributed solely to changes in tumor aggressiveness; early diagnosis and better treatment may also have contributed.     

Trends in cancer incidence and mortality in Vaud, Switzerland, 1974-1993

BACKGROUND:: Comparing incidence of and mortality from cancer within a givenpopulation yields several benefits. One of these is the opportunity,when trends in incidence differ from those in mortality, toderive inferences about the potential role of improved diagnosisin the rise of incidence rates, and about therapeutic advancementsin reducing mortality. MATERIALS AND METHODS:: Trends in incidence of and mortality from various cancers orgroups of cancers (comprising 55,682 new malignant tumours and26,528 certified cancer deaths) over the period 1974–1993were compared using, respectively, data from the Cancer Registryof the Swiss Canton of Vaud (with about 600,000 inhabitants)and those provided by the Swiss Federal Statistical Office. RESULTS:: The overall cancer incidence increased by 10% to 30% in bothsexes and various age groups, whereas mortality remained approximatelythe same. The sites primarily responsible for these divergenttrends were breast, prostate and colorectal, three sites wherecancers have been less frequently diagnosed since the adventof certain technical advancements and the introduction of screening.Other contributors to the divergent trends were testicular cancer,Hodgkin's disease and leukaemias, i.e., the sites for whichthe most substantial therapeutic advancements have been achieved. CONCLUSIONS:: These data are fairly reassuring, since they are inconsistentwith an ongoing cancer epidemic in this European population.However, they are also incompatible with the presence of majoradvancements in the prevention and treatment of cancer. cancer, epidemiology, incidence, mortality, registry, time trends     

Trends in cancer incidence,survival and mortality in northern sweden 1960-1986

The impact of cancer on a population may be measured in several ways. Incidence, relative survival and mortality are frequently utilized for this purpose. Incidence and relative survival are, however, often influenced by changes in the diagnostics of incident cancer, particularly by an altered rate of detection of non-fatal cancer. Mortality, as traditionally studied, is often influenced by changes of death causes diagnostics or of cocling routines. In an attempt to overcome some of these difficulties, the concept of excess mortality was suggested, which is independent of death cause diagnoses or cocling routines, as well as of the rate of detection of non-fatal cancer. In order to elucidate time trends in the overall effects of cancer we analysed incidence, survival and mortality from all cancer in the northern region of Sweden 1960—1986. An increasing age-adjusted cancer incidence was paralleled by an improvement in relative survival, whereas age-adjusted cancer mortality was mainly unchanged, at least when studied as excess mortality. We interpreted these finclings as due mainly to an increased detection of non-fatal cancer, and to an unchanged occurrence rate of fatal cancer.     

Oesophageal cancer in The Netherlands: increasing incidence and mortality but improving survival

AimOesophageal cancer is highly lethal with a 5-year relative survival of 10–15%. An increasing incidence has been reported for several parts of the Western world. We studied time trends in incidence, mortality and survival for oesophageal cancer in the Netherlands during 1989–2003.MethodsData on incidence and survival were obtained from the Netherlands Cancer Registry and mortality data from Statistics Netherlands.ResultsThe age standardised incidence increased by 3.4% (p < 0.001) and 1.9% (p = 0.003) per year for males and females, respectively. This increase was almost exclusively caused by oesophageal adenocarcinomas. Age standardised mortality increased 2.5% (p < 0.001) per year among males and 1.7% (p = 0.002) per year among females. Relative survival improved significantly from 8.1% in 1989–1993 to 12.6% in 1999–2003 (p < 0.001). Adjusted for age, stage, tumour location and surgery, the excess risk of death decreased by 22%.ConclusionOesophageal carcinoma incidence is rising in the Netherlands. Mortality increased at a slightly lower pace due to improving survival.     

Trends in skin cancer incidence in Vaud: an update, 1976-1998.

Trends of skin cancer incidence by histotype in the Swiss Canton of Vaud (608,000 inhabitants) between 1976 and 1992 were updated on the basis of 6720 further skin cancers registered over the period 1993-1998. Trends in the last period were downwards for squamous cell carcinoma in both sexes, still on the rise for basal cell carcinoma, and levelled off for malignant melanoma in females.     

Trends in cancer incidence, survival and mortality in northern Sweden 1960-1986.

The impact of cancer on a population may be measured in several ways. Incidence, relative survival and mortality are frequently utilized for this purpose. Incidence and relative survival are, however, often influenced by changes in the diagnostics of incident cancer, particularly by an altered rate of detection of non-fatal cancer. Mortality, as traditionally studied, is often influenced by changes of death causes diagnostics or of coding routines. In an attempt to overcome some of these difficulties, the concept of excess mortality was suggested, which is independent of death cause diagnoses or coding routines, as well as of the rate of detection of non-fatal cancer. In order to elucidate time trends in the overall effects of cancer we analysed incidence, survival and mortality from all cancer in the northern region of Sweden 1960-1986. An increasing age-adjusted cancer incidence was paralleled by an improvement in relative survival, whereas age-adjusted cancer mortality was mainly unchanged, at least when studied as excess mortality. We interpreted these findings as due mainly to an increased detection of non-fatal cancer, and to an unchanged occurrence rate of fatal cancer.     

2006～2015年哈尔滨市南岗区恶性肿瘤发病与死亡趋势分析

目的 分析2006 ～2015年恶性肿瘤发病率和死亡率,预测未来5年发病率和死亡率水平.方法 搜集哈尔滨市南岗区2006～ 2015年恶性肿瘤发病死亡登记数据,计算发病率/死亡率、调整发病率/调整死亡率,利用JoinPoint分析10年间恶性肿瘤发病/死亡趋势,年龄-时期-队列的贝叶斯模型预测2016 ～ 2020年发病率/死亡率.结果 2006～2015年男性和女性恶性肿瘤发病率分别为266.71/10万和254.06/10万,中标率分别为191.56/10万和172.47/10万.10年间男性和女性恶性肿瘤死亡率分别为214.21/10万和140.92/10万,中标率分别为150.36/10万和88.95/10万.10年间恶性肿瘤发病率和死亡率均呈上升趋势,男性发病率年度变化百分比(annual-percentage-changes,APC)为3.2％(95％ CI:2.5％ ～ 4.0％;),女性为5.4％(95％CI:4.4％～6.4％);男性死亡率APC为2.9％(95％ CI:1.2％ ～4.7％),女性为2.9％ (95％CI:1.0％ ～4.0％).基于年龄-时期-队列的贝叶斯模型预测2020年发病率和死亡率,男性和女性发病率和死亡率将分别达到335.77/10万、364.82/10万和250.84/10万、152.62/10万.结论 南岗区恶性肿留发病率和死亡率呈逐年增长趋势,女性发病率增长趋势快于男性.预测未来5年发病率和死亡率仍呈增长趋势.     

Trends in colorectal cancer incidence and mortality in the Israeli Jewish ethnic populations

Background: Ashkenazi Jews, as compared to non-European Jews and non-Jews, are at increased risk for colorectal cancer (CRC), this is attributed to genetic susceptibility and/or lifestyle. Aims: To follow Israeli long-term trends in CRC incidence and mortality and their associations with ethnicity. Methods: All Israeli CRC data accumulated 1970–2001 was used, age standardized rates (adjusted to world standard population) was computed by cancer site, US Surveillance, Epidemiology and End Results Program (SEER) Stage and ethnic group (continent of birth: Europe–America, Asia, Africa, Israel). Results: From 1970, CRC incidence increased 190% in males and 140% in females; mainly colon cancer (270% and 185% respectively) (P < 0.01), while rectal cancer incidence decreased and is now stable. Stage 3 CRC increased while stage 4 decreased significantly (P < 0.01 for both). In 2001, CRC incidence per 100,000 in European–American-born males was 48.3, Asian and African born 35.5 and Israeli born 32.7 (relative risk (RR) 1.36, P=0.03), while European–American female rates were 35 and all the others 26 (RR 1.35, P < 0.01). Overall survival increased 9% over 30 years (P 0.01), 5 years survival since 1988–1996 for European–American born was 43.1%, Asian 46.7%, African 47.5% and Israeli 55.8%. Stage-2 CRC 5 years survivals for 1970–1996 (most had no post surgical treatment) for European–American born were 41.7%, Asian and African 44.8% and Israeli 53.4% (P < 0.05). Stage-3 CRC survivals (most received adjuvant therapy in addition to surgery) for European–American born was 38.8%, Asian and African 43.3% and Israeli 45.1% (P < 0.01). Conclusions: Colon cancer has increased in Israel, mainly in males and European–American born. Israeli-born Jews (of 20 to 60% mixed ethnicity and lifestyle habits) have the lowest incidence and best survival data for stages-2 and -3 CRC. There is evidence of ethnic survival advantage and possibly in response to adjuvant oncological therapy.