Showing papers by "Donald Maxwell Parkin published in 1994"

At least one in seven cases of cancer is caused by smoking. Global estimates for 1985

Abstract: Tobacco smoking is accepted as a major cause of cancers of the lung, larynx, oral cavity and pharynx, oesophagus, pancreas, kidney and bladder. The proportions of these cancers that are due to smoking were estimated for the year 1985 for 24 areas of the world. Fifteen percent--1.1 million new cases per year--of all cancer cases are attributed to cigarette smoking, 25% in men and 4% in women. In developed countries, the tobacco burden is estimated at 16% of all annual incident cases. In developing countries, the corresponding figure is 10%. In total, 85% of the 676,000 cases of lung cancer in men are attributable to tobacco smoking. The highest attributable fractions (AF: 90-93%) are estimated in areas where the habit of cigarette smoking in men has been longest established: North America, Europe, Australia/New Zealand and the former USSR. Among the other 6 cancer sites considered in this analysis, those with the largest fractions of tobacco-related cases are the larynx, mouth and pharynx (excluding nasopharynx) and oesophagus. In regions where males have smoked for several decades, 30 to 40% of all cancers in this sex are attributable to tobacco. Unless tobacco-control efforts in developing countries are strengthened, the massive rise in cigarette consumption over the last few decades will produce a comparable rise in cancer in these countries within the next 20 to 30 years.

Cancer in developing countries.

Abstract: The developing countries are represented by incidence and mortality datasets from 16 populations. Trends are studied using age specific data from six cancer registries (three in Asia, three in Latin America) and national mortality datasets from Central and South America (three), the Caribbean (two), Asia (two) and Mauritius. In Africa, three cancer registries (in Nigeria, Uganda and Zimbabwe) provide time series of 15 years or more. Systematic examination of time trends is confined to five major sites (stomach, lung, breast, cervix uteri and colon-rectum), with a comment on observed trends in the other important cancers of developing countries (mouth/pharynx, oesophagus and liver). Although uniformity is not to be expected in such diverse material, some overall patterns emerge. Stomach cancer, as in the developed world, appears to be declining in importance. Lung cancer rates are rising, although in males, the increases are most marked in the elderly, with more recent birth cohorts in several populations showing a decline in risk. Breast cancer incidence and mortality rates are rising in most populations, with changes usually more marked in younger women. Conversely, cervix cancer, at present the most common cancer of women in developing countries, shows declines in incidence and mortality in the majority of populations studied, although Africa is clearly an exception. Cancer of the large bowel is becoming more frequent, although there are exceptions (eg Bombay, Mauritius and Trinidad). In the highest risk population (Uruguay), mortality seems to have peaked around 1965 and has since declined.

Cancer in developing countries.

Abstract: Cancer is a major cause of mortality in developing countries, accounting for 13 percent of the annual deaths in adults. As the population increases and ages, the number of new cases of cancer is expected to increase dramatically. This article presents epidemiologic information on the principal cancers in developing countries and outlines the increasing challenge for the control of cancer in developing countries.

Cancer patterns and risk factors in the African population of southwestern Zimbabwe, 1963-1977.

Abstract: The incidence of cancer and the importance of some selected risk factors in its etiology were estimated from the data collected in the cancer registry of Bulawayo, Zimbabwe, during the period 1963-1977. Cancer cases were interviewed with a standard questionnaire, and more than 71% of these were complete. In men, the most frequent cancer sites were liver, esophagus, and lung, while in women, cervical cancer was the dominant malignant tumor, followed by cancers of the liver, breast, and bladder. Risk factors of cancer cases were estimated by case-control analysis in which other cancers (excluding tobacco-related cancers in men and hormone-related cancers in women) were considered as controls. In men, tobacco smoking was associated with increased risk of lung cancer (odds ratio OR2, 5.2) and esophagus cancer (OR, 5.6) in the highest consumption category (15 g of tobacco per day) compared to nonsmokers. Copper (OR, 1.5), gold (OR, 1.5), and nickel (OR, 2.6) miners had an increased risk of lung cancer, but no increase was found among asbestos miners (OR, 0.7). There was no independent effect of alcohol consumption on the risk of esophagus cancer. The presence of schistosomiasis was associated with a significantly increased risk of bladder cancer (OR, 3.9). The risk of invasive cervical cancer increased with number of children--the estimated odds ratio was 1.8 in women with six or more births--but no consistent association was found for first intercourse. In postmenopausal women, the risk of breast cancer increased with age at first pregnancy (but not in the highly fertile) and decreased with high parity, if age at first pregnancy was 19 or more.

International variations in the incidence of childhood soft-tissue sarcomas.

Abstract: Summary. In the study of international childhood cancer incidence coordinated by the International Agency for Research on cancer, soft-tissue sarcomas comprised between 4 and 8% of all cancers between 0 and 14 years of age. Among predominantly white populations, the age-standardised annual incidence rate (ASR) for all soft-tissue sarcomas was between 5 and 9 per million. The most common histological subtypes were rhabdomyosarcoma (ASR 4–7 per million) and fibrosarcoma, including other malignant fibromatous tumours (ASR 1–2 per million). In the United States the incidence of rhabdomyosarcoma for black girls was only half that for white girls, while the rates for boys were similar in the two ethnic groups; fibrosarcoma had a higher incidence among black people than white people for both sexes. Throughout most of Asia, soft-tissue sarcomas almost invariably had a total ASR below 6 per million, rhabdomyosarcoma and fibrosarcoma again being the most common histological types. In Africa, incidence rates could not generally be calculated, but there were substantial numbers of registrations for rhabdomyosarcoma and fibrosarcoma. The majority of cases of Kaposi's sarcoma were in African children, and in eastern and southern Africa where Kaposi's sarcoma is endemic among adult men it comprised 25–50% of soft-tissue sarcomas and 2–10% of all childhood cancers; the sex ratio (M/F) was 2.2:1, in contrast to the overwhelming male predominance among adults. Variations between ethnic groups in the incidence of rhabdomyosarcoma and fibrosarcoma, together with their occurrence in a number of heritable syndromes, suggest that genetic predisposition is important in their aetiology. There was little evidence for an environmental aetiology in rhabdomyosarcoma and fibrosarcoma but an infectious agent may be responsible for childhood Kaposi's sarcoma.

Cancer mortality among Chinese and South-East Asian migrants in France.

Abstract: The cancer risk in migrants from China and South-east Asia (Vietnam, Laos and Cambodia) resident in France has been compared to that observed in the local-born population, using mortality data from the period 1979-1985 and population data from the 1982 French census. Risks were adjusted for important confounding factors such as social standing and area of residence. Compared to local-born, South-east Asian migrants of one sex or of both sexes combined have higher risks of cancer of the nasopharynx, stomach, liver, gallbladder, lung (in females only), and cervix. On the other hand, South-east Asian migrants have lower risks of cancer of the oral cavity, other pharynx, colon, rectum, larynx, lung (among males only), bladder, nervous system, breast and prostate. Within this group, the risks are quite similar for Vietnamese, Laotians and Cambodians. Results for Chinese-born migrants are quite similar, for most sites, to those found among South-east Asian migrants, although, because of smaller numbers, few of the estimates are statistically significant. These results are consistent with other studies on Chinese migrants around the world, and with the 3 other previous studies on Vietnamese migrants, in England and Wales, Los Angeles and Australia.