Ovarian cancer histology-specific incidence trends in Canada 1969-1993: age-period-cohort analyses.

This study examined histology-specific incidence trends of ovarian cancer in Canada, 1969-1993. The impact of age, period and cohort effects on these trends were studied by means of age-period-cohort analysis. Age-standardized incidence rates of serous, endometrioid, clear cell and germ cell tumours increased significantly and the rates of sex cord-stromal and other classified epithelial ovarian tumours decreased considerably. The rates of mucinous and NOS/unclassified tumours remained unchanged. Cohort effect has a major impact on incidence trends of serous, endometrioid, germ cell, sex cord-stromal and other classified epithelial ovarian tumours but no meaningful impact on trends of mucinous, clear cell, or NOS/unclassified ovarian tumours. Various cohort patterns by histology subtypes were observed: the risk of developing serious tumours increased markedly among birth cohorts of 1895-1930, stabilized thereafter and decreased among young cohorts of 1950-1960; the risk of germ cell tumours increased significantly among young cohorts of 1965-1980; and the risk of sex cord-stromal tumours dropped constantly among cohorts 1910-1950. Various period patterns by histology subtypes observed in this study suggested changes in histology classification criteria over the period. Further studies need to consider the various etiologies and the classification criteria changes according to histology subtypes.     

Trends in incidence of cutaneous malignant melanoma in a Swedish population 1976-1994

The incidence of cutaneous malignant melanoma has been increasing in Sweden for several decades. In the Stockholm-Gotland area educational activities for healthcare professionals were started in the late 1970s and public primary and secondary prevention campaigns were initiated in the mid-1980s. Melanoma incidence trends have been studied in Sweden, with special reference to trends in the Stockholm-Gotland area where these prevention campaigns were first started. During 1976-1994 the average annual increase of age-standardized incidence in the Stockholm-Gotland area was about 5%, the increase being associated mainly with thin tumors and melanoma in situ. During the 1990s, the incidence among males leveled off. In contrast, no such shift in trend was observed among females, or among males or females residing outside the Stockholm-Gotland area. The campaigns may have contributed to a trend towards earlier diagnosis but there is still no clear effect of the primary prevention efforts.     

Folate intake and stomach cancer incidence in a prospective cohort of Swedish women.

BACKGROUND: Experimental and epidemiologic evidence suggests that folate may play a role in the development of some cancers. Case-control studies and one prospective cohort study on folate intake in relation to stomach cancer risk have yielded inconsistent results. METHODS: We prospectively investigated the relation between folate intake and the incidence of stomach cancer among 61,433 women in the Swedish Mammography Cohort. Participants completed a food frequency questionnaire at baseline (1987-1990) and again in 1997. During follow-up through December 2004, 156 incident stomach cancer cases were diagnosed. Cox proportional hazards models were used to calculate multivariate-adjusted hazard ratios. RESULTS: There was no association between dietary folate intake (i.e., folate from food sources) and the risk of stomach cancer. The multivariate hazard ratio for the highest compared with the lowest category of updated average dietary folate intake was 1.04 (95% confidence interval, 0.61-1.86; P(trend) = 0.91). The relation between dietary folate intake and stomach cancer did not vary significantly by intake of alcohol, methionine, or caffeine. CONCLUSION: Results from this prospective study do not support an association between dietary folate intake and risk of stomach cancer.     

Temporal trends in the incidence rate of childhood cancer in Germany 1987-2004

The German Childhood Cancer Registry regularly presents graphs of childhood cancer incidence rates by period, but no systematic analysis. The Automated Childhood Cancer Information System-project found an increasing trend in Europe. Against this background we present the first detailed trend analysis of childhood (aged under 15) malignancies in Germany. We examined incidence rates separately in western Germany 1987-2004 and eastern Germany 1991-2004. We analyzed all malignancies, all main diagnostic groups and relevant subsets using an age-period-cohort model. Additionally we fitted fractional polynomials to assess the linearity of the drift. All malignancies combined (excluding Central Nervous System-tumors and neuroblastoma) show a significant trend: +0.7% in western and +1.1% per year in eastern Germany. The overall trend in Germany is mostly due to the significant increase in lymphoid leukemia, which increased significantly in western Germany (+0.7% per year) and significantly nonlinearly in eastern Germany (+3.3% per year until 1998, +0.8% since 1998), catching up from a level 20% below western Germany. This could be due to life style changes since the reunification in eastern Germany influencing early immune system training. We found no trends for acute non-lymphocytic leukemia and non-Hodgkin lymphoma. Hodgkin's disease shows a cohort effect in western Germany after reunification. Improved registration of CNS tumors led to an increase. Neuroblastoma yielded a period effect in western Germany due to screening. With the exception of germ cell tumors, further observations for solid tumor entities are in agreement with those reported for Europe.     

Continued surveillance of cancer incidence among Swedish smelter workers.

A cohort study of workers at a smeltery in northern Sweden showed an excess mortality, mostly due to deaths in cancer (especially in the respiratory organs) and circulatory diseases. Further follow-up of the cohort showed a decreasing trend in lung cancer incidence and mortality. The cohort studied has now been expanded and comprises 6,334 blue-collar workers first employed 1928-1979. They were followed in the cancer register up to 1987-01-01 and in the cause-of-death register up to 1988-01-01. The decreasing trend in lung cancer incidence and mortality continued but there was still an elevated lung cancer incidence among the workers when compared with Swedish males. The cumulative occurrence of lung cancer since time of first employment was analyzed by different employment cohorts and a higher occurrence of lung cancer was found among those earlier employed.     

Cancer incidence in the Hmong of Central California, United States, 1987-94

The Hmong are an ethnic minority in China, some of whom migrated tothe mountainous areas of North Vietnam, Laos, and Thailand in the 19th and20th centuries. Because of their support for the United States during theVietnam war, many Laotian Hmong fled to Thailand and eventually werere-settled in the US after the end of that conflict. Approximately100,000Hmong currently live in the US, of whom about half reside in theCentral Valley of California. The purpose of this study was to measure cancerincidence in this unique new immigrant population. Using the resources of theCancer Registry of Central California (CRCC), a population-based cancerregistry, cancer incidence in the Hmong was evaluated by calculatingage-adjusted incidence rates as well as by calculating proportional incidenceratios. Compared with all races combined, elevated rates of cancer in theHmong were observed for the following sites: nasopharynx, stomach, liver,pancreas, leukemia, and non-Hodgkins lympho ma. Cervical cancer incidenceoverall was elevated, but more noteworthy, invasive cervix cancer rates weremuch higher than expected. Lower cancer rates were found for breast,prostate, and colorectal cancer. Hmong also experienced advanced stage andgrade of disease at diagnosis for many cancer sites in addition to cervicalcancer, which may be explained by cultural factors, including avoidance ofWestern medical care and low rates of participation in screening programs.This population should be followed closely and monitored for patterns ofcancer incidence in the future since it provides a natural laboratory forstudies of cancer etiology as this population gradually becomes acculturatedto the Western lifestyle.     

Cancer incidence and survival among American Indians registered for Indian health service care in Montana, 1982-1987.

BACKGROUND: Cancer incidence and cancer survival estimates in American Indians are quite limited. PURPOSE: Our purpose was to estimate cancer incidence and survival in American Indians who were registered for Indian Health Service (IHS) care in Montana. METHODS: We linked databases from the IHS and the Montana Central Tumor Registry (MCTR) to ascertain cases for the time period from January 1, 1982, through December 31, 1987. To calculate survival rates, we used a relative survival method that incorporated age-specific risks for noncancer deaths among American Indians. RESULTS: We identified 344 cases that were compatible with the National Cancer Institute (Surveillance, Epidemiology, and End Results Program) surveillance definition of cancer. Of these cases, 249 (72%) were listed in both the MCTR and the IHS databases; 56 (16%) and 39 (11%) were listed in only the MCTR or the IHS database, respectively. Compared with the overall cancer incidence in U.S. White men, the overall cancer incidence in Montana American Indian men was markedly lower, as was the incidence for colorectal and bladder cancers and for non-Hodgkin's lymphoma. The overall cancer incidence for Montana American Indian women differed less markedly, however, from the overall incidence in U.S. White women. Compared with the cancer incidence in U.S. White women, the incidence in Montana American Indian women was significantly higher for cervical cancer but was significantly lower for colorectal, breast, and uterine cancers. Survival rates from cancer were also examined for the first time in this population. For those sites examined, the survival rates were much lower in Montana American Indians than in U.S. Whites. CONCLUSIONS: We conclude that it is feasible to develop state-specific cancer incidence and survival estimates for American Indians in at least some states in different regions of the United States. Collaboration between the IHS and a state tumor registry is likely to improve the case ascertainment achieved by either agency alone.     

The incidence of HPV in a Swedish series of invasive cervical carcinoma

The incidence of HPV was studied in 71 invasive squamous carcinomas of the cervix using PCR technique. We used primers, which presumably recognize all types of HPV (consensus primers), and also type-specific primers.In situ hybridization was carried out in 24 of the cases. The overall incidence of HPV was 53/71 (75 %) of which 5 cases were positive with the consensus primers only. However, 21/71 cases (30%) were negative for the consensus primers but positive for one of the type-specific primer pairs. This finding indicates that subgenomic deletions may have occurred in the viral genome upon integration in the human DNA.In situ hybridization was positive in 14/24 cases (58 %), showing excellent correlation with PCR results. The HPV types detected were, in descending order of frequency: type 16 (52 %), 31 (23 %), 18 (13 %), 33 (12 %). No cases of HPV type 6 or 11 were found in this series of invasive carcinomas.     

Correlations between U.S. county annual cancer incidence and population density

Population density implicitly involves specific distances between living individuals who exhibit biophysical forces and energies. Objective was to investigate major data bases of cancer incidence and population data to help understand the emergent properties of diseases that become apparent only when large populations and areas are considered. Correlation analyses of the annual incidence (years 2007 to 2011) of cancer in counties (2,885) of the U.S. and population densities were convergent with these quantitative predictions and suggested an inflection threshold around 50 people per square mile. The potential role of subtle or even “non-local” factors coupled to averaged population density in the viability and mortality of the human species may serve as alternative explanations to the attribution of malignancy to “chance” factors. Calculations indicated average distances between the electric force dipole of the brains or bodies of human beings generate forces known to affect DNA extension and when distributed over the Compton wavelength of the electron could produce energies sufficient to affect the binding of base nucleotides. An inclusive science of human ecology might benefit from considering subtle forces and energies associated with the individual members within the habitat that could determine the probability of cellular anomalies.     

Correlations between cancer incidence rates from the Canadian National Cancer Incidence Reporting System, 1969-78

Incidence rates for 19 cancers in females and 16 cancers in males have been computed from data reported by 8 Canadian provinces to the National Cancer Incidence Reporting System between 1969 and 1978. The rates, very similar in absolute and relative magnitude to those reported by the U.S. Third National Cancer Survey, have been used to examine patterns of correlation between various cancers within the 8 provinces. There is strong evidence of positive associations between a number of cancers, including a number of associations that have been reported in other similar correlational studies. Correlations that may be of particular interest in suggesting etiologic factors in common include clusters of smoking-related cancers (buccal cavity with pharynx, larynx, lung, and bladder), female sexual cancers (breast, corpus uteri, and ovary), and a group of cancers that have shown correlation in other studies (i.e., cancers of the pancreas and kidney, leukemias, lymphomas, and cancer of the prostate gland). Organs in the gastrointestinal tract (esophagus, stomach, colon, and rectum) anatomically close to each other show a high positive correlation in both females and males, but the further apart the organs are the lower is the correlation; these observations are consistent with other evidence of varying dietary etiologies. Two individual correlations of particular interest are those between female brain tumors and female bladder cancer (two cancers for which little is known of the etiology for a large percentage of them) and those between female breast cancer and female lung cancer. This study, the largest correlational study of incidence data reported to date, demonstrates the utility of such simple correlational analyses.     

Breast screening, prognostic factors and survival--results from the Swedish two county study.

The results of the Swedish two-county study are analysed with respect to tumour size, nodal status and malignancy grade, and the relationship of these prognostic factors to screening and to survival. It is shown that these factors can account for much of the differences in survival between incidence screen detected, interval and control group cancers but to a lesser extent for cancers detected at the prevalence screen where length bias is greatest. Furthermore, examination of the relationships among the prognostic factors and mode of detection indicates that malignancy grade, as a measure of inherent malignant capacity, evolves as a tumour grows. The proportion of cancers with poor malignancy grade is several fold lower for cancers of diameter less than 15 cm than for cancers greater than 30 cm, independent of the length bias of screening. The implications of these findings for screening frequency are briefly discussed.     

Cancer in Circumpolar Inuit 1969-1988

The results of an international, collaborative study of cancer in Circumpolar Inuit in Greenland, Canada, Alaska and Russia are summarized. A total of 3 255 incident cancers were diagnosed from 1969 to 1988 among 85 000-110 000 individuals. Indirect standardization (SIR) based on comparison populations in Connecticut (USA), Canada and Denmark showed excess risk of cancer of the lung, nasopharynx, salivary glands, gallbladder and extrahepatic bile ducts in both sexes, of liver and stomach cancer in men, and renal and cervical cancer in women. Low risk was observed for cancer of the bladder, breast, endometrium and prostate, and for non-Hodgkin lymphoma, Hodgkin's disease, leukaemia, multiple myeloma and melanoma. Age-standardized incidence rates (ASRs) of cancer of lung, cervix, nasopharynx and salivary glands among Inuit were among the world's highest as were rates in women of oesophageal and renal cancer. Regional differences in ASRs within the Circumpolar area were observed for cancer of the cervix, lung, colon and rectum, liver, gallbladder and breast. The differences in the Inuit cancer incidence pattern to some extent reflect known variations in lifestyle, diet and other exposures, as well as implementation of cancer control measures. Future research addressing possible individual differences are needed to evaluate environmental and genetic factors in etiology and evaluate intervention studies.     

Trends in cancer mortality in 15 industrialized countries, 1969-1986.

BACKGROUND: Assessing trends in cancer provides a means for gauging progress against the disease, estimating future demands for care and treatment, and suggesting clues about shifting causal factors that may account for the more recent changes. PURPOSE: This study was designed to evaluate trends in the major sites of cancer associated with high mortality rates in 15 industrialized countries. To highlight differences among regions, we grouped these countries into six geographic areas: United States, Eastern Europe, Western Europe, East Asia, Oceania, and Nordic countries. In addition, cancer mortality trends in these regions were compared with incidence patterns in the United States. METHODS: Data provided by the World Health Organization were used to evaluate age-specific mortality trends from 1969 through 1986 for lung, breast, prostate, stomach, and colorectal cancers and for all other sites considered as a group. We also assembled and analyzed data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute for the same sites and age groups from 1973 through 1986. RESULTS: Over the period 1969 through 1986, recorded cancer mortality in persons aged 45 years and older in the six regions studied has increased for lung, breast, and prostate cancers in most age groups, while the decline in stomach cancer mortality is substantial. The increase in lung cancer deaths in men aged 45-54 years has slowed greatly or reversed in all areas except Eastern Europe and East Asia. Trends for intestinal cancer vary by age and region. For all other sites considered as a group, increases have occurred for persons older than 64 years in most regions. In Eastern Europe, there are disturbingly high rates and rapid increases for several of the major forms of cancer in persons aged 45-54 years. In general, trends for cancer incidence in the United States parallel those for mortality. For intestinal cancer, however, incidence has increased while mortality has declined. CONCLUSIONS: The trends we report cannot be explained solely by changes in cigarette smoking or aging. Other causes of changes in cancer incidence and mortality need to be determined. IMPLICATIONS: The increasing and decreasing trends in mortality from and incidence of cancer that we found are important for health care planning and may also suggest opportunities for research in cancer prevention.     

江阴市2002年-2006年恶性肿瘤发病情况调查分析

目的：了解江阴市近年恶性肿瘤发病情况及人群分布。方法：采用回顾性调查方法，对2002年1月1日-2006年12月31日期间发病并确诊为恶性肿瘤或白血病的患者进行回顾性调查分析。结果：2002年-2006年江阴市恶性肿瘤标化总发病率为194．92／10万，其中男性220．35／10万、女性132．45／10万；发病率顺位依次为：胃癌、食管癌、大肠癌、肺癌、肝癌、乳腺癌、宫颈癌、鼻咽癌、卵巢癌、白血病；发病率随年龄增大而升高，不同性别组恶性肿瘤发病率均由45岁起迅速上升。结论：江阴市的恶性肿瘤发病率呈逐年上升趋势，预防控制应以中老年人群为重点。     

Breast Cancer in Circumpolar Inuit 1969-1988

Breast cancer was studied over a 20-year period in Inuit populations in the Circumpolar region. A total of 193 breast cancers were observed in women. The incidence increased from 28.2 per 100000 in 1969-1973 to 34.3 per 100 000 in 1984-1988. However, the incidence is low, about half what could be expected based on the rates in Denmark, Canada and Connecticut (USA). The low incidence could be explained by the Inuit diet and other lifestyle factors. These benefits should be preserved, in particular in the young, to maintain a low breast cancer incidence.     

Testicular Lymphoma - The Need for a New Approach

Thirteen cases of malignant lymphoma of the testis were referred to the Queensland Radium Institute between 1975 and 1989. The age varied from 43 years to 84 years and the histology was intermediate to high grade in all cases. Seven patients had Stage I/II and 6 had Stage III/IV. The 4 year survival was only 16%. Half of the relapses were systemic, 1 was in the paraaortic nodes (unirradiated) and 2 were in the opposite testicle. Adjuvant radiotherapy to paraaortic nodes and mild chemotherapy have produced disappointing results. A new approach using aggressive combination chemotherapy and adjuvant scrotal irradiation is proposed for early stage disease.