This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21660

Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.

Viral hepatitis in all its forms is a major public health problem throughout the world, affecting several hundreds of millions of people. Viral hepatitis is a cause of considerable morbidity and mortality both from acute infection and chronic sequelae which include, in the case of hepatitis B, C and D, chronic active hepatitis and cirrhosis. Hepatocellular carcinoma, which is one of the 10 commonest cancers worldwide, is closely associated with hepatitis B and, at least in some regions of the world, with hepatitis C virus. This timely monograph is a distillation of knowledge of hepatitis B, C and D, based on a review of 1000 studies by a small group of scientists. (It is interesting to note in passing that some 5000 papers on viral hepatitis are published annually in the world literature.) The epidemiological, clinical and experimental data on the association between infection with hepatitis B virus and primary liver cancer in humans are reviewed in a readable and succinct format. The available information on hepatitis C and progression to chronic infection is also evaluated and it is concluded (perhaps a little prematurely) that hepatitis C virus is carcinogenic. However, it is concluded that hepatitis D virus, an unusual virus with a number of similarities to certain plant viral satellites and viroids, cannot be classified as a human carcinogen. There are some minor criticisms: there are few illustrations and some complex tabulations (for example, Table 6) and no subject index. A cumulative cross index to IARC Monographs is of little value and occupies nearly 30 pages. This small volume is a useful addition to the overwhelming literature on viral hepatitis, and the presentation is similar to the excellent World Health Organisation Technical Reports series on the subject published in the past. It is strongly recommended as a readable up-to-date summary of a complex subject; and at a cost of 65 Sw.fr (approximately £34) is excellent value. A J ZUCKERMAN

https://jcp.bmj.com/content/jclinpath/48/7/691.1.full.pdf

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans

Prospective Cohort Study

2 1 The innovative transport systems and the CityMobil project 10 1.1 The research questions 10 2 The state of art in the field of automatic transport systems 12 2.1 Case studies and demand studies for innovative transport systems 12 3 The design and implementation of surveys 14 3.1 Definition of experimental design 14 3.2 Questionnaire design and delivery 16 3.3 First analyses on the collected sample 18 4 Calibration of Logit Multionomial demand models 21 4.1 Methodology 21 4.2 Calibration of the “full” model. 22 4.3 Calibration of the “final” model 24 4.4 The demand analysis through the final Multinomial Logit model 25 5 The analysis of interaction between the demand and socioeconomic attributes 31 5.1 Methodology 31 5.2 Application of Mixed Logit models to the demand 31 5.3 Analysis of the interactions between demand and socioeconomic attributes through Mixed Logit models 32 5.4 Mixed Logit model and interaction between age and the demand for the CTS 38 5.5 Demand analysis with Mixed Logit model 39 6 Final analyses and conclusions 45 6.1 Comparison between the results of the analyses 45 6.2 Conclusions 48 6.3 Answers to the research questions and future developments 52

The European commission

Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012

Effects of occupation on risks of avoidable cancers in the Nordic countries

To identify high and low risk groups for laryngeal cancer in Denmark, all individuals aged 30-74 in the 1970 census were followed up over 10 years. Census data were linked with the Central Population Register to identify persons who died or emigrated during the follow up, and with the Danish Cancer Register to identify cases of laryngeal cancer. Individuals were categorised according to sex, age, and sociodemographic characteristics as declared on the census forms. A multivariate analysis was carried out by means of multiplicative Poisson models. The study showed that the risk of laryngeal cancer was strongly related to sociodemographic factors. The risk for skilled workers living in Copenhagen (relative risk (RR) 4.76, 95% confidence interval (CI) 3.61-6.28) was estimated to be almost five times higher than the risk for men self employed in agriculture and living in rural areas. The variation in the risk of laryngeal cancer is not fully explained by known variations in tobacco and alcohol consumption, and this study highlights additional risk factors particularly related to occupation and marital state.

https://oem.bmj.com/content/oemed/47/7/473.full.pdf

Laryngeal cancer in Denmark: a nationwide longitudinal study based on register linkage data.

Increased occurrences of malignancies of the lymphatic and haematopoietic tissues have been reported from industries in which employees are potentially exposed to styrene. The aim of the study reported here was to describe cancer incidence in the reinforced plastics industry in Denmark. A total of 64,000 employees of 552 Danish companies assessed to have produced reinforced plastics at any time since the 1960s were identified from a public administrative registry of all Danish employers and wage earners. Cancer incidence in the population was compared with similar rates for the population at large. No excess risk for all neoplasms was observed. Among male employees, increased risks were found for cancer of the lung (396 cases; relative risk [RR], 1.15; 95% confidence interval, 1.04-1.27), of the pleura (20 cases; RR, 2.33; 1.42-3.60), of the nasal cavities (nine cases; RR, 1.55; 0.71-2.94), of non-Hodgkin's lymphoma (61 cases; RR, 1.27; 0.97-1.63) and for leukaemia (61 cases; RR, 1.15; 0.88-1.48). Among female employees, a reduced risk for non-Hodgkin's lymphoma was observed (one case; RR, 0.16; 0.00-0.88). Some support was thus found for previous reports of increased risk for respiratory cancers and for malignancies of the lymphatic and haematopoietic tissues. The results must be interpreted with caution, however, owing to shortcomings in the design of the study.

Cancer incidence in the Danish reinforced plastics industry.

INTRODUCTION Tobacco smoking is an important cause of premature death and morbidity in Denmark. It is therefore important to monitor tobacco consumption. In this paper, tobacco consumption in Denmark is illustrated by two methods: sale of tobacco products and smoking habit surveys. MATERIAL AND METHODS Data on sale of tobacco products in Denmark were available for the 1920-2010-period. National smoking habit surveys were found through grey-zone literature, a PubMed search and a report on the Danish population's smoking habits. Ten smoking habit surveys were identified from the 1953-2010-period, three of which have data from multiple years and annual surveys from 1969 onwards. RESULTS The changes in tobacco consumption found by the two methods were not parallel. Furthermore, there were significant differences between the proportions of smokers found in smoking habit questionnaires from the same year. This difference may be due to changes in cross-border trade, smuggling, smokers' willingness to participate in smoking habit studies, recognition of own smoking and actual tobacco consumption, and differences in the composition of participants in the smoking habit studies both over time and between different studies. CONCLUSION Both sales statistics and surveys have advantages and disadvantages. It may therefore be important to use both when estimating tobacco consumption.

Nationwide tobacco surveys and sales data in Denmark from 1920 to 2010.

Breast cancer is the leading cancer among women, and early diagnosis is essential for future prognosis. Evidence from mainly cross-sectional US studies with self-reported exposure and outcome found positive association of body mass index (BMI) with non-participation in mammographic screening, but hardly addressed the influence of potential effect-modifiers. We studied the association between objective measures of BMI and participation in mammographic screening in a Danish prospective cohort, and explored the influence of menopausal status, hormone therapy (HT), previous screening participation, and morbidities on this relationship. A total of 5,134 women from the Diet, Cancer, and Health cohort who were invited to population based mammographic screening in Copenhagen were included in analysis. Women were 50–64 years old at inclusion (1993–97) when their height and weight were measured and covariates collected via questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) for the association between BMI and mammographic screening participation were estimated by logistic regression, adjusted for other breast cancer risk factors and morbidities. Effect modification was evaluated by an interaction term and tested by Wald test. Underweight (BMI < 18.5 kg/m2, OR: 95% CI; 2.24: 1.27-3.96) and obese women of class II (BMI 35–40 kg/m2, 1.54: 0.99-2.39) and III (BMI ≥ 40 kg/m2, 1.81: 0.95-3.44) had significantly higher odds of non-participation than women with normal weight. This association was limited to postmenopausal women (Wald test p = 0.08), with enhanced non-participation in underweight (2.83: 1.52-5.27) and obese women of class II and III (1.84: 1.15-2.95; 2.47: 1.20-5.06) as compared to normal weight postmenopausal women. There was no effect modification by HT, previous screening participation, or morbidities, besides suggestive evidence of enhanced non-participation in diabetic overweight and obese women. Underweight and very obese postmenopausal women were significantly less likely to participate in mammographic screening than women with normal weight, while BMI was not related to screening in premenopausal women. Effect of BMI on mammographic screening participation was not significantly modified by HT, previous screening participation, or morbidities.

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Elsebeth Lynge

Papers

Effects of occupation on risks of avoidable cancers in the Nordic countries

Laryngeal cancer in Denmark: a nationwide longitudinal study based on register linkage data.

Cancer incidence in the Danish reinforced plastics industry.

Nationwide tobacco surveys and sales data in Denmark from 1920 to 2010.

Body mass index and participation in organized mammographic screening: a prospective cohort study.