Showing papers by "Donald Maxwell Parkin published in 2005"

Global cancer statistics, 2002.

Abstract: Estimates of the worldwide incidence, mortality and prevalence of 26 cancers in the year 2002 are now available in the GLOBOCAN series of the International Agency for Research on Cancer. The results are presented here in summary form, including the geographic variation between 20 large "areas" of the world. Overall, there were 10.9 million new cases, 6.7 million deaths, and 24.6 million persons alive with cancer (within three years of diagnosis). The most commonly diagnosed cancers are lung (1.35 million), breast (1.15 million), and colorectal (1 million); the most common causes of cancer death are lung cancer (1.18 million deaths), stomach cancer (700,000 deaths), and liver cancer (598,000 deaths). The most prevalent cancer in the world is breast cancer (4.4 million survivors up to 5 years following diagnosis). There are striking variations in the risk of different cancers by geographic area. Most of the international variation is due to exposure to known or suspected risk factors related to lifestyle or environment, and provides a clear challenge to prevention.

Cancer occurrence in Iran in 2002, an international perspective.

Abstract: For almost 30 years no population-based cancer statistics have been available with which to estimate the cancer burden in Iran. In 2002 and 2003 two separate reports of population based cancer registries were published from Iran and the cancer incidence rates from these sources have permitted informed estimates of cancer incidence and mortality to be prepared. They suggest that more than 51,000 cases of cancer are diagnosed and 35,000 deaths due to cancer occur each year. The 5 most common cancers in males (by ASR) are stomach (26.1 per 10 5 ), esophagus (17.6 ), colon-rectum (8.3), bladder (8.0) and leukemia (4.8), and in females are breast (17.1), esophagus (14.4), stomach (11.1), colon-rectum (6.5) and cervix uteri (4.5). The incidence rates of esophageal and stomach cancer in Iran are high, well above the world average, while the incidence of lung cancer is very low. Breast cancer, although the most common cancer of females in Iran, has rates that are low by world standards, especially those observed in Europe and USA. Similarly, the incidence of cervix cancer in Iran is very low, even lower than such low risk countries as China, Kuwait and Spain. Comparing these rates with the data of 30 years ago, the incidence of esophageal cancer has decreased dramatically, but gastric cancer has increased about two fold.

A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India.

Abstract: The impact of screening by visual inspection with acetic acid (VIA), cytology or HPV testing on cervical cancer incidence and mortality is investigated in a cluster randomized controlled trial in India. We report findings after the screening phase, when 52 clusters, with a total of 142,701 women aged 30-59 years in Osmanabad District, India, were randomized into 4 arms for a single round of screening by trained midwives with either VIA, cytology or HPV testing as well as a control group. All laboratory tests were done locally. Test-positive women underwent investigations (colposcopy/biopsy) and treatment in the base hospital. Data on participation, test positivity, positive predictive value and detection rates of cervical neoplasia were analyzed using cluster design methodology. Of the eligible women, 72-74% were screened. Test positivity rates were 14.0% for VIA, 7.0% for cytology and 10.3% for HPV. The detection rate of high-grade lesions was similar in all intervention arms (0.7% for VIA, 1.0% for cytology and 0.9% for HPV testing) (p = 0.06, Mann-Whitney test). While the detection rate for VIA dropped to 0.5% with declining test positivity during the course of the study, it remained constant for cytology and HPV testing. Over 85% of women with high-grade lesions received treatment. Our results show that a high level of participation and good-quality cytology can be achieved in low-resource settings. VIA is a useful alternative but requires careful monitoring. Detection rates obtained by HPV testing were similar to cytology, despite higher investments.

Geographic pathology revisited : Development of an atlas of cancer in India

Abstract: Information on 217,174 microscopically diagnosed cancers diagnosed in 2001-2002 was collected from pathology laboratories in 68 districts across India. Data collection took place primarily via the Internet. Average annual age-adjusted incidence rates for microscopically diagnosed cases (MAAR) by gender and site were calculated for each of the 593 districts in the country. The rates were compared to those from established population based cancer registries (PBCR). In 82 districts, the MAAR for 'all cancer sites' was above a "completeness" threshold of 36.2/100,000 (based on results of a rural PBCR). The results confirmed some known features of the geography of cancer in India, and brought to light new ones. Cancers of the mouth and tongue are particularly frequent in both genders in the southern states. Very high rates of nasopharynx cancer were found in the northeastern states (Nagaland, Manipur). There was clear geographic correlation between the rates of cervical and penile cancer, and a high rate of stomach and lung cancer (in both genders) in many districts of Mizoram State. The area of high risk for gallbladder cancer seems larger than suspected previously, involving a wide band of northern India. There is a belt of high incidence of thyroid cancer in females in southwest coastal districts. Other than identifying possible existence of high-risk areas of specific cancers, our study has recognized places where PBCR could be established. The study was remarkably cost-effective and the electronic data-capture methodology provides a model for health informatics in the setting of a developing country.

Cancer survival in Kampala, Uganda.

Abstract: Epidemiological data on the occurrence of cancer in sub-Saharan Africa are sparse, and population-based cancer survival data are even more difficult to obtain due to various logistic difficulties The population-based Cancer Registry of Kampala, Uganda, has followed up the vital status of all registered cancer patients with one of the 14 most common forms of cancer, who were diagnosed and registered between 1993 and 1997 in the study area We report 5-year absolute and relative survival estimates of the Ugandan patients and compare them with those of black American patients diagnosed in the same years and included in the SEER Program of the United States In general, the prognosis of cancer patients in Uganda was very poor Differences in survival between the two patient populations were particularly dramatic for those cancer types for which early diagnosis and effective treatment is possible For example, 5-year relative survival was as low as 83% for colorectal cancer and 177% for cervical cancer in Uganda, compared with 542 and 639%, respectively, for black American patients The collection of good-quality follow-up data was possible in the African environment The very poor prognosis of Ugandan patients is most likely explained by the lack of access to early diagnosis and treatment options in the country On the policy level, the results underscore the importance of the consistent application of the national cancer control programme guidelines as outlined by the World Health Organization

Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay Cohort Study

Abstract: Results The adjusted relative risk was 1.37 (95% CI 1.23–1.53) for (men) cigarette smokers and 1.64 (95% CI 1.47–1.81) for bidi smokers, with a significant dose–response relationship for number of bidis or cigarettes smoked. Women were essentially smokeless tobacco users; the adjusted relative risk was 1.25 (95% CI 1.15–1.35). The risk of deaths from respiratory diseases (RR 2.12, 95% CI 1.57–2.87), tuberculosis (RR 2.30, 95% CI 1.68–3.15), and neoplasms (RR 2.60, 95% CI 1.78–3.80) were significantly high in male smokers than never tobacco users. Conclusions Bidi is no less hazardous than cigarette smoking, and smokeless tobacco use may also result in significantly increased mortality.

International uveal melanoma incidence trends in view of a decreasing proportion of morphological verification

Abstract: The introduction of eye-preserving therapies for uveal melanoma in the 1970s complicates time trend analyses of the uveal melanoma incidence because the proportion of morphologically verified uveal melanoma has been decreasing over the decades. We carried out incidence trend analyses, based on data from internationally accredited population-based cancer registries throughout the world that take missing data on topography, morphology and basis of diagnosis of eye tumours into account. We selected incidence data of cancer registries that were included in Cancer Incidence In 5 Continents, Volumes VI-VIII covering a registration period of at least 15 years (usually 1983 to 1997) and classified each eye cancer as morphologically verified uveal melanoma, clinically diagnosed uveal melanoma, uveal melanoma identified as DCO case (Death certificate only), possibly uveal melanoma, other eye tumour or unclassifiable eye tumour and calculated age-standardized incidence rates by 3-year calendar periods using the World Standard Population as the reference. The uveal melanoma incidence decline in the United States SEER Caucasian population is due mainly to an incidence decline in the early registration period (from 1974-76 to 1986-88). The data from France and Italy suggest a recent increase in incidence. Uveal melanoma diagnosed clinically increasingly contribute to the overall uveal melanoma incidence over time. Combining all registries, the proportion of morphologically verified uveal melanoma decreased from 82% in 1983-87 to 75% in 1993-97. Uveal melanoma incidence rates remained quite stable during the period 1983-97. The interpretation of uveal melanoma incidence trends is complicated by missing data on topography within the eye, morphology and basis of diagnosis.

A prospective study of diet, lifestyle, and genetic factors and the risk of cancer in Khon Kaen Province, northeast Thailand: description of the cohort.

Abstract: Cohort studies are the preferred design in observational epidemiology, but few involving the general population have been performed in Asia, and most concern affluent urban populations. The Khon Kaen study has recruited about 25,000 subjects, aged mainly 35-64, from villages in the relatively underdeveloped north-east of Thailand. All subjects underwent simple physical examination, completed an interviewer-administered questionnaire (including sections on lifestyle, habits, and diet) and donated specimens of blood, which were processed and stored in a biological bank at -20 degrees C. Female subjects (about 16,500) were offered screening by Pap smear, and specimens of cells from the cervix were stored at -20 degrees C. This paper describes the methodology of the study, and the characteristics of the participants. Almost all subjects are peasant farmers, with low annual income and body mass, although 14.6% of women had a BMI in the obese range (>30 kg/m(2)). Smoking was common among men (78% regular smokers, most of whom used home-produced cigarettes), but rare among women. Fertility levels were relatively high, with a more than half the women having four or more live births. 23.4% of subjects were infected with the liver fluke Opisthorchis viverrini, known to be highly endemic in this region. Follow-up of the cohort is by record-linkage to the provincial cancer registry. By 2003, 762 cancer cases had occurred, the most common being cancers of the liver (363 cases) and cervix uteri (44 cases). The antecedents of these cancers are being investigated using a nested case-control approach. The cohort will yield increasing numbers of cancers for study in the next decade, giving important information on the relative importance of dietary and lifestyle factors in a rural population, undergoing gradual transition to a more westernised lifestyle.

Statistics on cancer in China: cancer registration in 2002.

Abstract: The objective of this study was to determine how many population-based cancer registries exist in China, what methods are being used, and the statistical data that are available from them, and to identify future needs with respect to technical support. A two-stage survey was conducted in 2002 at provincial and cancer registry level. Based on the questionnaire used in these two stages, the basic distribution and descriptive information on population-based cancer registry practices in China are addressed. There are 48 cancer registries in China, covering 73 million people (5.7% of the total population of China in 2000). The oldest three registries are LinZhou, ShangHai and QiDong. There are marked variations in practice between registries, with respect to data collection, data management and coding. Differences are also found in administrative aspects and sources of financial support. In conclusion, this first national survey of Chinese cancer registry practice provides a benchmark against which development and standardization can be evaluated in the future. The survey suggests that lack of qualified personnel, insufficient funding support and lack of stability of the population are major problems in carrying out registration work in China. It also indicates several ways in which registry practice, and hence availability and quality of incidence and survival data can be improved.

Mortality time trends and the incidence and mortality estimation and projection for lung cancer in China

Abstract: Background and objective Using the most comprehensive available data on lung cancer incidence and mortality in China, the mortality time trends were described and the incidence and mortality profile in 2000 and 2005 were estimated and projected, so as to provide evidence and reference for clinic, basic research and making prevention and control strategy for lung cancer in China. Methods The Joinpoint model was used to analyze the lung cancer mortality trends during 1987--1999, based on data reported to WHO from the Ministry of Health in China. Combined with the data from the second national mortality survey in 1990--1992 and the lung cancer incidence and mortality data from several cancer registries in China which involved in Cancer Incidence in Five Continents, the 8th version, using the log-linear model （based on Poisson distribution）, the incidence and mortality profile for lung cancer in 2000 and 2005 in China were estimated and projected. Results The age-standardized mortality rates increased during the study period, especially in rural areas （the expected annual percentage changes were 2.7% in men and 3.6% for women, both were statistically significant） and showed among almost all age groups （above age 15）. From 2000 to 2005, there would be 0.101 million more lung cancer deaths （from 327643 in 2000 to 428936 in 2005） and 0.116 million more new incident cases （from 381487 in 2000 to 497908 in 2005）. Conclusion Due to the double effects from both changes in the risk factors for the disease and the population growth and aging, lung cancer is becoming one of the most common and increasing malignant neoplasmin China . The prevention and control for this disease will be theemphasis for future cancer control strategy of China in which tobacco control is critically important . DOI: 10.3779/j.issn.1009-3419.2005.04.05

Consistency of cytology diagnosis for cervical cancer between two laboratories.

Abstract: The principal approach to the prevention of cancer of the cervix uteri has been through screening programmes, using the cervical smear (Pap test) to detect precursor lesions. The sensitivity and specificity of Pap smears depend on the skill of the observer in recognizing and classifying a variety of cellular abnormalities. We have studied the reproducibility of cytological diagnosis, according the Bethesda classification, made by cytologists in Khon Kaen, north-east Thailand, and in Helsinki, Finland, on smears taken from rural women undergoing screening during 1994-2001. A total of 313 slides were reviewed. The prevalence of abnormalities was relatively high, since the series included smears judged abnormal in Khon Kaen or from women who developed cancer during follow-up, as well as a group whose smears were negative. In general, the reviewing cytologist in Finland evaluated more slides as abnormal than in the initial report. The level of agreement between the two observers was evaluated by calculating the coefficient of concordance (Kappa). The kappa score depended upon the degree of detail in the diagnosis; it was 0.43 for the presence or not of an epithelial abnormality (the General Categorization of the Bethesda system), and rather higher (0.5) for separating low grade from high grade (HSIL or worse) abnormalities or glandular lesions. Agreement was only fair (0.37) when the more detailed Bethesda categories (seven) were used. The reproducibility of cervical cytology evaluations is critical to the success of screening programmes, and in this programme in a moderate-high risk population of women in rural Thailand, we found that agreement between skilled observers, at the level of tests requiring diagnostic follow-up or not, was only moderate. The women in this study are being traced to evaluate the true sensitivity of screening in terms of the lesions found on histology, during a prolonged follow up of 4 or more years.