Showing papers by "Freddie Bray published in 2003"

Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia.

Abstract: We analyzed time trends in incidence of and mortality from malignant cutaneous melanoma in European populations since 1953. Data were extracted from the EUROCIM database of incidence data from 165 cancer registries. Mortality data were derived from the WHO database. During the 1990s, incidence rates were by far highest in northern and western Europe, whereas mortality was higher in males in eastern and southern Europe. Melanoma rates have been rising steadily, albeit with substantial geographic variation. In northern Europe, a deceleration in these trends occurred recently in persons aged under 70. Joinpoint analyses indicated that changes in these trends took place in the early 1980s. In western Europe, mortality rates have also recently leveled off [estimated annual percentage change (EAPC) from -13.6% (n.s.) to 3.3%], whereas in eastern and southern Europe both incidence and mortality rates are still increasing [incidence EAPCs 2.3-8.9%, mortality EAPCs -1.8% (n.s.) to 7.2%]. Models including the effects of age, period and birth cohort were required to adequately describe the rising incidence trends in most European populations, with a few exceptions. Time trends in mortality were adequately summarized on fitting either an age-cohort model (with the leveling off of rates starting in birth cohorts between 1930 and 1940) or an age-period-cohort model. The most plausible explanations for the deceleration or decline in the incidence and mortality trends in recent years in northern (and to a lesser extent western) Europe are earlier detection and more frequent excision of pigmented lesions and a growing public awareness of the dangers of excessive sunbathing.

Lung cancer in Europe in 2000: epidemiology, prevention, and early detection.

Abstract: Lung cancer is the most common cancer in the world. In men, the highest incidence rates are seen in Europe (especially eastern Europe) and North America. In women, high incidence rates are found in North America and in Europe, particularly in northern and western Europe. It is estimated that there were about 375000 cases of lung cancer in Europe in 2000; 303000 in men and 72000 in women. The number of resulting deaths was about 347000 (280000 in men and 67000 in women). Tobacco smoking is well established as the main cause of lung cancer and about 90% of cases are thought to be tobacco related. There is a clear dose-response relation between lung-cancer risk and the number of cigarettes smoked per day, degree of inhalation, and age at initiation of smoking. Someone who has smoked all their life has a lung-cancer risk 20-30 times greater than a non-smoker. However, risk of lung cancer decreases with time since smoking cessation. Recently, there has been renewed interest in screening because spiral computerised tomography can detect small asymptomatic lesions more effectively than conventional radiography. Although cure rates for such lesions are very good, there is to date no evidence for effectiveness of mass-screening strategies.

Pleural mesothelioma incidence in Europe: evidence of some deceleration in the increasing trends.

Abstract: Objective: To summarize the geographical and temporal variations in incidence of pleural mesothelioma in Europe, using the extensive data available from European general cancer registries, and consider these in light of recent trends in asbestos extraction, use and import in European countries. Material and methods: The data were extracted from the European Cancer Incidence and Mortality database (EUROCIM). The inclusion criteria was acceptance in Volume VII of Cancer Incidence in Five Continents. Truncated age-standardized rates per 100,000 for the ages 40–74 were used to summarise recent geographical variations. Standardized rate ratios and 95% confidence intervals for the periods 1986–1990 and 1991–1995 were compared to assess geographical variations in risk. To investigate changes in the magnitude of most recent trends, regression models fitted to the latest available 10-year period (1988–1997) were compared with trends in the previous decade. Fitted rates in younger (40–64) and older adults (65–74) in the most recent period were also compared. Results: There was a great deal of geographical variation in the risk of mesothelioma, annual rates ranging from around 8 per 100,000 in Scotland, England and The Netherlands, to lower than 1 per 100,000 in Spain (0.96), Estonia (0.85), Poland (0.85) and Yugoslavia, Vojvodina (0.56) among men. The rank of the rates for women was similar to that observed for men, although rates were considerably lower. Between 1978 and 1987, rates in men significantly increased in all countries (excepting Denmark). In the following 10 years, there was a deceleration in trend, and a significant increase was detectable only in England and France. In addition, the magnitude of recent trends in younger men was generally lower than those estimated for older men, in both national and regional cancer registry settings. Conclusions: While mesothelioma incidence rates are still rising in Europe, a deceleration has started in some countries. A decrease may begin in the next few years in certain European populations considering the deceleration of observed trends in mesothelioma and asbestos exposure, as well as the recent ban on its use.

The comprehensive cancer monitoring programme in Europe.

Abstract: Background: There continue to be major public health challenges arising from the increasing cancer burden in Europe. Drawing upon expertise from other European centres and networks, the Comprehensive Cancer Monitoring Programme in Europe project (CaMon) provides a central information resource of the cancer profile in European populations. Methods: The cancer indicators fundamental to disease monitoring in Europe are illustrated in terms of definitions and availability. Where necessary data are supplemented by estimates, in order to make available cancer data to individuals and institutions in all Member and Applicant countries of the European Union (EU). The relevant methodologies are discussed. Finally, a major ongoing project examining time trends of cancer incidence and mortality in 38 European countries is described. Results: In the European Union, there were approximately 1.6 million new cases of cancer according to the latest year available, and approximately, one million cancer deaths. About 2.6 million new cases of cancer, and 1.6 million deaths were estimated in Europe. Lung cancer is the most common cancer in Europe and together with cancers of the colon and rectum and female breast represent approximately 40% of new cases in Europe. Conclusion: The statistics generated by the project on cancer incidence, mortality, survival and prevalence, together with time trends and projections will be regularly updated and made available to a European Commission, and to a Community-wide audience via the CaMon website and via other means of dissemination, such as peer-reviewed journals.