Showing papers by "Donald Maxwell Parkin published in 2002"

Cancer patterns in eastern India: The first report of the Kolkata cancer registry

Abstract: There are no population-based data available for the cancer patterns in Eastern India This is the first report of cancer incidence in the region from the population-based cancer registry in Kolkata (Calcutta), the capital city of the state of West Bengal, India, for the period 1998-1999 The cancer registry collects data on all new cases of cancer diagnosed in the resident population of Kolkata Since cancer is not a notifiable disease in India, registration is carried out by active data collection by the registry staff The cancer registry staff visits 50 data sources comprising cancer hospitals, secondary and tertiary care hospitals, nursing homes, diagnostic laboratories and death registration offices; scrutinizes medical records and collects details on incident cancer cases A customized version of CanReg-3 software was used for data entry and analysis A total of 11,700 cases were registered during the 2-year period from 1 January 1998 to 31 December 1999 The overall age-adjusted (world population) incidence rates were 1021 per 100,000 males and 1146 per 100,000 females The most frequently reported malignancies in males were lung cancer (163%), followed by cancers of the oral cavity (71%), pharynx (57%) and larynx (57%) In females, the most frequently reported malignancies were breast (227%) followed by uterine cervix (175%), gallbladder (64%) and ovary (58%) The data reported by the Kolkata cancer registry provide information on the cancer profile in Eastern India for the first time The highest incidence rate of lung cancer in males in India is reported from Calcutta A high risk of gallbladder cancer is observed in women The observed cancer patterns indicate that tobacco-control measures and early detection of head and neck, breast and cervical cancers are of importance for cancer control in this population

The epidemiology of conjunctival squamous cell carcinoma in Uganda

Abstract: As part of a larger investigation of cancer in Uganda, we conducted a case–control study of conjunctival squamous cell carcinoma in adults presenting at hospitals in Kampala. Participants were interviewed about social and lifestyle factors and had blood tested for antibodies to HIV, KSHV and HPV-16, -18 and -45. The odds of each factor among 60 people with conjunctival cancer was compared to that among 1214 controls with other cancer sites or types, using odds ratios, estimated with unconditional logistic regression. Conjunctival cancer was associated with HIV infection (OR 10.1, 95% confidence intervals [CI] 5.2–19.4; P<0.001), and was less common in those with a higher personal income (OR 0.4, 95% CI 0.3–1.2; P<0.001). The risk of conjunctival cancer increased with increasing time spent in cultivation and therefore in direct sunlight (χ2 trend=3.9, P=0.05), but decreased with decreasing age at leaving home (χ2 trend=3.9, P=0.05), perhaps reflecting less exposure to sunlight consequent to working in towns, although both results were of borderline statistical significance. To reduce confounding, sexual and reproductive variables were examined among HIV seropositive individuals only. Cases were more likely than controls to report that they had given or received gifts for sex (OR 3.5, 95% CI 1.2–10.4; P=0.03), but this may have been a chance finding as no other sexual or reproductive variable was associated with conjunctival cancer, including the number of self-reported lifetime sexual partners (P=0.4). The seroprevalence of antibodies against HPV-18 and -45 was too low to make reliable conclusions. The presence of anti-HPV-16 antibodies was not significantly associated with squamous cell carcinoma of the conjunctiva (OR 1.5, 95% CI 0.5–4.3; P=0.5) and nor were anti-KSHV antibodies (OR 0.9, 95% CI 0.4–2.1; P=0.8). The 10-fold increased risk of conjunctival cancer in HIV infected individuals is similar to results from other studies. The role of other oncogenic viral infections is unclear. British Journal of Cancer (2002) 87, 301–308. doi:10.1038/sj.bjc.6600451 www.bjcancer.com © 2002 Cancer Research UK

Practical implications of imposing a new world standard population.

Abstract: Objective: The World Health Organization (WHO) has recently introduced a new world standard population for the production of age-standardized rates. In this study we compare cancer rates standardized to this population with those computed using reference populations in current practice, particularly the world standard of Segi (1960), in order to evaluate their adequacy as estimators of relative risk in diverse population groups and over time. Methods: Incidence and mortality rates standardized using these reference populations were calculated and compared for various cancers. Standardized rate ratios were compared with more efficient methods of approximating relative risk, the Mantel & Haenszel and maximum-likelihood estimators. The differences were tested by taking a synthesis of the relative risks and by taking into account whether effects were homogeneous across age strata or not. Results: There were no statistically significant differences between the relative risk estimates based on direct standardization and those obtained using Mantel & Haenszel (p 0.99), regardless of whether the Segi or the WHO world population was used as the standard. Conclusions: Ratios of rates age-standardized using the world standard of Segi approximate relative risk as precisely as the WHO standard. For this, and important practical reasons, it is considered unnecessary to replace the Segi standard population for comparisons between cancer rates.

Body mass index, tobacco chewing, alcohol drinking and the risk of oral submucous fibrosis in Kerala, India

Abstract: Objective: While chewing areca nut is considered a risk factor for oral submucous fibrosis, the effects of cigarette smoking, alcohol drinking, and body mass index (BMI) have not been examined; nor are they well established In this study we investigated the association between BMI, smoking, drinking, and the risk of oral submucous fibrosis Methods: We conducted a case-control study within the framework of an ongoing randomized oral cancer screening trial in Kerala, India Trained health workers conducted interviews with structured questionnaires and oral visual inspections to diagnose oral premalignant lesions A total of 170 oral submucous fibrosis cases (139 women and 31 men) and 47,773 controls were identified The odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression in SAS Results: The adjusted OR for ever-tobacco chewing was 441 (95% CI = 220-882) An inverse dose-response relationship was seen between BMI and the risk of oral submucous fibrosis when both genders were combined (p for trend = 00010), with an OR of 05 (95% CI = 03-09) for the highest BMI quartile compared to the lowest Alcohol drinking may possibly be associated with the risk of oral submucous fibrosis; the adjusted OR for ever drinking was 21 (95% CI = 10-44) Cigarette smoking did not appear to be a risk factor for women or for men Both smoking and drinking were rare habits among women Conclusion: This study suggested, for the first time, that BMI was inversely associated with the risk of oral submucous fibrosis for both genders when potential confounding factors were adjusted Our results indicated that alcohol drinking might be a moderate risk factor and confirmed the previous observation that chewing tobacco was a strong risk factor for oral submucous fibrosis

Reduction of Death Certificate Only (DCO) Registrations by Active Follow Back.

Abstract: Summary Death certificates are an important source of information for cancer registries that help to improve completeness of case finding. In many countries where routine mortality data are considered of poor quality, this source is often regarded as being of little value. We evaluated the contribution of death certificates to the total number of registrations in the years 1993-1997, in the Manila Cancer Registry (MCR). We compared the “standard” practice of retrieving clinical information if the death certificate was completed in a hospital, with active search of additional information from the deceased's relatives when the death was certified at home.The standard procedure allowed us to reduce the proportion of cases registered from a death certificate by 5%. The improvement varied significantly among the most common sites with a reduction of 10% for lymphomas to less than 1% for cancers of the cervix.The proportion of liver cancers registered from a death certificate only (DCO), originally 47%, was reduced to 29% by contacting relatives of the deceased patients. In countries with limited investment in information systems, death certificates, even when recognised as being of poor quality, are an important source of information for cancer registries.