Showing papers by "Isabelle Soerjomataram published in 2018"

Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Abstract: This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions There will be an estimated 181 million new cancer cases (170 million excluding nonmelanoma skin cancer) and 96 million cancer deaths (95 million excluding nonmelanoma skin cancer) in 2018 In both sexes combined, lung cancer is the most commonly diagnosed cancer (116% of the total cases) and the leading cause of cancer death (184% of the total cancer deaths), closely followed by female breast cancer (116%), prostate cancer (71%), and colorectal cancer (61%) for incidence and colorectal cancer (92%), stomach cancer (82%), and liver cancer (82%) for mortality Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality) Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts CA: A Cancer Journal for Clinicians 2018;0:1-31 © 2018 American Cancer Society

Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States

Abstract: Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer-associated infections). The numbers of cancer cases were obtained from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute; the numbers of deaths were obtained from the CDC; risk factor prevalence estimates were obtained from nationally representative surveys; and associated relative risks of cancer were obtained from published, large-scale pooled analyses or meta-analyses. In the United States in 2014, an estimated 42.0% of all incident cancers (659,640 of 1570,975 cancers, excluding nonmelanoma skin cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) were attributable to evaluated risk factors. Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% and 6.5%, respectively) and alcohol intake (5.6% and 4.0%, respectively). Lung cancer had the highest number of cancers (184,970 cases) and deaths (132,960 deaths) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). These results, however, may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal. Nevertheless, these findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures. CA Cancer J Clin 2018;68:31-54. © 2017 American Cancer Society.

The global cancer burden and human development: A review:

Abstract: Aims: This review examines the links between human development and cancer overall and for specific types of cancer, as well as cancer-related risk-factors and outcomes, such as disability and life ...

Status of implementation and organization of cancer screening in the European Union Member States - summary results from the second European screening report

Abstract: The second report on the implementation status of cancer screening in European Union (EU) was published in 2017. The report described the implementation status, protocols and organization (updated till 2016) and invitation coverage (for index year 2013) of breast, cervical and colorectal cancer screening in the EU. Experts in screening programme monitoring (N=80) from the EU Member States having access to requisite information in their respective countries provided data on breast, cervical and colorectal cancer screening through online questionnaires. Data was collected for screening performed in the framework of publicly mandated programmes only. Filled in questionnaires were received from 26 Member States for all three sites and from one Member State for breast cancer only. Substantial improvement in screening implementation using population-based approach was documented. Among the age-eligible women, 94.7% were residents of Member States implementing or planning population-based breast cancer screening in 2016, compared to 91.6% in 2007. The corresponding figures for cervical cancer screening were 72.3% and 51.3% in 2016 and 2007 respectively. Most significant improvement was documented for colorectal cancer screening with roll-out ongoing or completed in 17 Member States in 2016, compared to only five in 2007. So the access to population-based screening increased to 72.4% of the age-eligible populations in 2016 as opposed to only 42.6% in 2007. The invitation coverage was highly variable, ranging from 0.2%-111% for breast cancer, 7.6%-105% for cervical cancer and 1.8%-127% for colorectal cancer in the target populations. In spite of the considerable progress, much work remains to be done to achieve optimal effectiveness. Continued monitoring, regular feedbacks and periodic reporting are needed to ensure the desired impacts of the programmes. This article is protected by copyright. All rights reserved.

Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012.

Abstract: Ultraviolet radiation (UVR) is a strong and ubiquitous risk factor for cutaneous melanoma, emitted naturally by the sun but also artificial sources. To shed light on the potential impact of interventions seeking to reduce exposure to UVR in both high and low risk populations, we quantified the number of cutaneous melanomas attributable to UVR worldwide. Population attributable fractions and numbers of new melanoma cases in adults due to ambient UVR were calculated by age and sex for 153 countries by comparing the current melanoma burden with historical data, i.e., the melanoma burden observed in a population with minimal exposure to UVR. Secondary analyses were performed using contemporary melanoma incidence rates in dark-skinned African populations with low UVR susceptibility as reference. Globally, an estimated 168,000 new melanoma cases were attributable to excess UVR in 2012, corresponding to 75.7% of all new melanoma cases and 1.2% of all new cancer cases. This burden was concentrated in very highly developed countries with 149,000 attributable cases and was most pronounced in Oceania, where 96% of all melanomas (representing 9.3% of the total cancer burden) were attributable to excess UVR. There would be approximately 151,000 fewer melanoma cases worldwide were incidence rates in every population equivalent to those observed in selected low-risk (dark-skinned, heavily pigmented) reference populations. These findings underline the need for public health action, an increasing awareness of melanoma and its risk factors, and the need to promote changes in behavior that decrease sun exposure at all ages.

Changing geographical patterns and trends in cancer incidence in children and adolescents in Europe, 1991–2010 (Automated Childhood Cancer Information System): a population-based study

Abstract: Summary Background A deceleration in the increase in cancer incidence in children and adolescents has been reported in several national and regional studies in Europe. Based on a large database representing 1·3 billion person-years over the period 1991–2010, we provide a consolidated report on cancer incidence trends at ages 0–19 years. Methods We invited all population-based cancer registries operating in European countries to participate in this population-based registry study. We requested a listing of individual records of cancer cases, including sex, age, date of birth, date of cancer diagnosis, tumour sequence number, primary site, morphology, behaviour, and the most valid basis of diagnosis. We also requested population counts in each calendar year by sex and age for the registration area, from official national sources, and specific information about the covered area and registration practices. An eligible registry could become a contributor if it provided quality data for all complete calendar years in the period 1991–2010. Incidence rates and the average annual percentage change with 95% CIs were reported for all cancers and major diagnostic groups, by region and overall, separately for children (age 0–14 years) and adolescents (age 15–19 years). We examined and quantified the stability of the trends with joinpoint analyses. Findings For the years 1991–2010, 53 registries in 19 countries contributed a total of 180 335 unique cases. We excluded 15 162 (8·4%) of 180 335 cases due to differing practices of registration, and considered the quality indicators for the 165 173 cases included to be satisfactory. The average annual age-standardised incidence was 137·5 (95% CI 136·7–138·3) per million person-years and incidence increased significantly by 0·54% (0·44–0·65) per year in children (age 0–14 years) with no change in trend. In adolescents, the combined European incidence was 176·2 (174·4–178·0) per million person-years based on all 35 138 eligible cases and increased significantly by 0·96% (0·73–1·19) per year, although recent changes in rates among adolescents suggest a deceleration in this increasing trend. We observed temporal variations in trends by age group, geographical region, and diagnostic group. The combined age-standardised incidence of leukaemia based on 48 458 cases in children was 46·9 (46·5–47·3) per million person-years and increased significantly by 0·66% (0·48–0·84) per year. The average overall incidence of leukaemia in adolescents was 23·6 (22·9–24·3) per million person-years, based on 4702 cases, and the average annual change was 0·93% (0·49–1·37). We also observed increasing incidence of lymphoma in adolescents (average annual change 1·04% [0·65–1·44], malignant CNS tumours in children (average annual change 0·49% [0·20–0·77]), and other tumours in both children (average annual change 0·56 [0·40–0·72]) and adolescents (average annual change 1·17 [0·82–1·53]). Interpretation Improvements in the diagnosis and registration of cancers over time could partly explain the observed increase in incidence, although some changes in underlying putative risk factors cannot be excluded. Cancer incidence trends in this young population require continued monitoring at an international level. Funding Federal Ministry of Health of the Federal German Government, the European Union's Seventh Framework Programme, and International Agency for Research on Cancer.

Occupational exposures and cancer: a review of agents and relative risk estimates.

Abstract: Objectives The contribution of occupational exposures to the cancer burden can be estimated using population-attributable fractions, which is of great importance for policy making. This paper reviews occupational carcinogens, and presents the most relevant risk relations to cancer in high-income countries using France as an example, to provide a framework for national estimation of cancer burden attributable to occupational exposure. Methods Occupational exposures that should be included in cancer burden studies were evaluated using multiple criteria: classified as carcinogenic or probably carcinogenic by the International Agency for Research on Cancer (IARC) Monographs volumes 1–114, being a primary occupational exposure, historical and current presence of the exposure in France and the availability of exposure and risk relation data. Relative risk estimates were obtained from published systematic reviews and from the IARC Monographs. Results Of the 118 group 1 and 75 group 2A carcinogens, 37 exposures and 73 exposure-cancer site pairs were relevant. Lung cancer was associated with the most occupational carcinogenic exposures (namely, 18), followed by bladder cancer and non-Hodgkin’s lymphoma. Ionising radiation was associated with the highest number of cancer sites (namely, 20), followed by asbestos and working in the rubber manufacturing industry. Asbestos, bis(chloromethyl)ether, nickel and wood dust had the strongest effect on cancer, with relative risks above 5. Conclusions A large number of occupational exposures continues to impact the burden of cancer in high-income countries such as France. Information on types of exposures, affected jobs, industries and cancer sites affected is key for prioritising policy and prevention initiatives.

Cancer prevention policy in the EU: Best practices are now well recognised; no reason for countries to lag behind

Abstract: Through the application of science to public health practice, National Cancer Control Programmes provide the framework for the development of policies on cancer control, with the ultimate goal of reducing cancer morbidity and mortality, and improving quality of life. In the last decade, a substantial number of Member States in the European Union (EU) have formulated and/or updated their National Cancer Control Programmes, Plans or Strategies including primary prevention (health promotion and environmental protection), secondary prevention (screening and early detection), integrated care and organization of services, and palliative care as main elements. Although tobacco control and population-based screening policies are examples of best practices that are gradually being implemented in most of the EU countries, there are still large regional differences in cancer burden arising from the wide variety of social determinants and other epidemiological factors, along with gaps in the policy and practical articulation of cancer control within the health systems. On the other hand, few quantitative assessments are available with regard to evaluating the success or failure of the implementation of these programmes, especially in terms of reducing cancer incidence or mortality. An EU framework to better assess of the effectiveness of cancer prevention policies and the factors triggering shortfall in best practices implementation seems imperative.

New cancer cases in France in 2015 attributable to infectious agents: a systematic review and meta-analysis

Abstract: To provide an assessment of the burden of cancer in France in 2015 attributable to infectious agents. A systematic literature review in French representative cancer cases series was undertaken of the prevalence of infectious agents with the major associated cancer types. PubMed was searched for original studies published up to September 2016; random-effects meta-analyses were performed. Cancer incidence data were obtained from the French Cancer Registries Network, thereby allowing the calculation of national incidence estimates. The number of new cancer cases attributable to infectious agents was calculated using population-attributable fractions according to published methods. Of the 352,000 new cancer cases in France in 2015, 14,336 (4.1% of all new cancer cases) were attributable to infectious agents. The largest contributors were human papillomavirus (HPV) and Helicobacter pylori, responsible for 6333 and 4406 new cancer cases (1.8 and 1.3% of all new cancer cases) respectively. Infectious agents caused a non-negligible number of new cancer cases in France in 2015. Most of these cancers were preventable. The expansion of vaccination (i.e., for hepatitis B virus and HPV) and screen-and-treat programs (for HPV and hepatitis C virus, and possibly for H. pylori) could greatly reduce this cancer burden.

Cancers attributable to tobacco smoking in France in 2015

Abstract: Background The evidence on the carcinogenicity of tobacco smoking has been well established. An assessment of the population-attributable fraction (PAF) of cancer due to smoking is needed for France, given its high smoking prevalence. Methods We extracted age- and sex-specific national estimates of population and cancer incidence for France, and incidence rates of lung cancer among never smokers and relative risk (RR) estimates of smoking for various cancers from the American Cancer Prevention Study (CPS II). For active smoking, we applied a modified indirect method to estimate the PAF for lung and other tobacco smoking-related cancer sites. Using the RR estimates for second-hand smoking, the proportion of never smokers living with an ever-smoking partner derived from survey, and marital status data, we then estimated the PAF for lung cancer attributable to domestic passive smoking. Results Overall in France in 2015, 54 142 and 12 008 cancer cases in males and females, respectively, were attributable to active smoking, accounting for 28 and 8% of all cancer cases observed among adult (30+ years) males and females. Additionally, 36 and 142 lung cancer cases, respectively among male and female never smokers, were attributable to second-hand smoke resulting from their partner's active smoking, corresponding to 4.2 and 6.7% of lung cancer cases which occurred in never smoker males and females, respectively. Conclusions Tobacco smoking is responsible for a significant number of potentially avoidable cancer cases in France in 2015. More effective tobacco control programmes are critical to reduce this cancer burden.

New cancer cases in France in 2015 attributable to different levels of alcohol consumption

Abstract: Background and aims Alcohol consumption increases the risk of cancer. Thus, to inform policy decisions, this study estimated the number of new cancer cases in France in 2015 attributable to alcohol consumption generally and to light (< 20 g per day (g/day) among women; < 40 g/day among men), moderate (20 to < 40 g/day among women; 40 to < 60 g/day among men) and heavy drinking (≥ 40 g/day among women; ≥ 60 g/day among men), and the number of cancer cases that would have been prevented assuming a previous 10% decrease in alcohol consumption. Design New cancer cases attributable to alcohol were estimated using a population-attributable fraction methodology, assuming a 10-year latency period between exposure and diagnosis. Setting and participants Population of France, 2015. Measurements Alcohol consumption was estimated by coordinating data from the Barometre sante 2005, a national representative survey (n = 30 455), with data from the Global Information System on Alcohol and Health. Relative risks were obtained from meta-analyses. Cancer data were estimated based on data from the French Cancer Registries Network. Uncertainty intervals (UI) were estimated using a Monte Carlo procedure. Findings In France in 2015, an estimated 27 894 (95% UI = 24 287–30 996) or 7.9% of all new cancer cases were attributable to alcohol. The number of alcohol-attributable new cancer cases was similar for both men and women, with oesophageal squamous cell carcinomas having the largest attributable fraction (57.7%). Light, moderate, heavy and former alcohol drinking were responsible for 1.5, 1.3, 4.4 and 0.6% of all new cancer cases, respectively. Lastly, if there had been a previous 10% reduction in alcohol consumption, 2178 (95% UI = 1687–2601) new cancer cases would have been prevented. Conclusions Alcohol consumption in France appears to cause almost 8% of new cancer cases, with light and moderate drinking contributing appreciably to this burden. A 10% drop in drinking in France would have prevented more than 2000 (estimated) new cancer cases in 2015.

Cutaneous melanoma in France in 2015 attributable to solar ultraviolet radiation and the use of sunbeds.

Abstract: Background Exposure to solar ultraviolet radiation (UVR) and the use of UV-emitting tanning devices are associated with cutaneous malignant melanoma occurrence. Objective The aim of this study was to quantify the proportion and number of melanoma cases attributable to solar UVR exposure and sunbed use in France in 2015. Methods Population attributable fractions (PAFs) and numbers of melanoma cases attributable to solar UVR exposure were estimated by age and sex using the incidence rates of a 1903 birth cohort as the primary reference. Further analyses were performed using the following: (i) contemporary melanoma incidence rates in low-incidence regions within France and (ii) national melanoma incidence rates for the year 1980, as additional references. Assuming a 15-year lag period, PAF and melanoma cases attributable to sunbed use were calculated using prevalence estimates from a cross-sectional population survey and published relative risk estimates. Results In 2015, an estimated 10 340 melanoma cases diagnosed in French adults were attributable to solar UVR exposure, corresponding to 83% of all melanomas and 3% of all cancer cases in that year. PAFs for melanoma were highest in the youngest age group (30-49 years) and higher in men than in women (89% vs. 79%). A total of 382 melanoma cases occurring in French adults in 2015 were attributed to the use of sunbeds, equivalent to 1.5% and 4.6% of all melanoma cases in men and women, respectively. Conclusions A considerable proportion of melanoma cases in France in 2015 were attributable to solar UVR exposure, suggesting that targeted prevention strategies need to be implemented.

Tobacco‐attributable burden of cancer according to socioeconomic position in France

Abstract: Smoking is a major preventable cause of cancers and is increasingly concentrated among the most deprived individuals leading to increasing socioeconomic inequalities in the incidence of cancers linked to smoking. We aimed to estimate the tobacco-attributable cancer burden according to socioeconomic position in France. The analysis was restricted to cancer sites for which tobacco smoking was recognized as a risk factor. Cancer cases by sex, age group and European Deprivation Index (EDI) among people aged 30-74 between 2006 and 2009 were obtained from cancer registries covering ∼20% of the French population. The tobacco-attributable burden of cancer according to EDI was estimated applying the population attributable fraction (PAF) computed with the Peto-Lopez method. The PAF increased from 56% in the least deprived EDI quintile to 70% in the most deprived EDI quintile among men and from 26% to 38% among women. In total, 28% of the excess cancer cases in the four most deprived EDI quintiles in men and 43% in women could be prevented if smoking in these 4 EDI quintiles was similar to that of the least deprived EDI quintile. A substantial smoking-attributable burden of cancer by socioeconomic position was observed in France. The results highlight the need for policies reducing tobacco consumption. More comprehensive interventions integrating the various dimensions of health determinants and proportionate according to socioeconomic position may essentially contribute to the reduction of socioeconomic inequalities in cancer.

The Future Burden of Colorectal Cancer Among US Blacks and Whites

Abstract: Although overall colorectal cancer (CRC) incidence rates in the United States are declining, rates among younger persons (age < 55 years) are increasing, particularly among US whites. We assessed how these trends will impact the future burden (up to 2040) of CRC among US blacks and whites using an age-period-cohort model. Over the last four decades (1973 to 2014), CRC incidence rates for all ages (both sexes) have dropped by 6.6% and 33.9% in US blacks and whites, respectively. Yet we predict an upward turn in CRC cancer incidence rates over the next quarter century, particularly among US whites. The age-standardized rates of CRC were 55.4 and 43.2 per 100 000 among US blacks and whites in 2014, respectively, and are projected to be 49.5 and 43.1 in 2040, respectively. Future interventions are needed to reduce the striking differences in CRC incidence between blacks and whites.

Population attributable fractions continue to unmask the power of prevention

Abstract: The population attributable fraction is a critical driver of evidence-based cancer prevention. With an increasing recognition of the need for high-level investment in cancer control, there is an overwhelming need for a new generation of descriptive studies that globally promote the long-term public health and economic benefits of cancer prevention.

New cancer cases attributable to diet among adults aged 30-84 years in France in 2015.

Abstract: This study aimed to estimate the number of new cancer cases attributable to diet among adults aged 30-84 years in France in 2015, where convincing or probable evidence of a causal association exists, and, in a secondary analysis, where at least limited but suggestive evidence of a causal association exists. Cancer cases attributable to diet were estimated assuming a 10-year latency period. Dietary intake data were obtained from the 2006 French National Nutrition and Health Survey. Counterfactual scenarios of dietary intake were based on dietary guidelines. Corresponding risk relation estimates were obtained from meta-analyses, cohort studies and one case-control study. Cancer incidence data were obtained from the French Network of Cancer Registries. Nationally, unfavourable dietary habits led to 16 930 new cancer cases, representing 5·4 % of all new cancer cases. Low intake of fruit and dietary fibre was the largest contributor to this burden, being responsible for 4787 and 4389 new cancer cases, respectively. If this is expanded to dietary component and cancer pairs with at least limited but suggestive evidence of a causal association, 36 049 new cancer cases, representing 11·6 % of all new cancer cases, were estimated to be attributable to diet. These findings suggest that unfavourable dietary habits lead to a substantial number of new cancer cases in France; however, there is a large degree of uncertainty as to the number of cancers attributable to diet, including through indirect mechanisms such as obesity, and therefore additional research is needed to determine how diet affects cancer risk.

The risk of cancer attributable to diagnostic medical radiation: Estimation for France in 2015

Abstract: Introduction Although diagnostic medical ionizing radiation (IR) has clear clinical benefits, it is also an established carcinogen. Although the individual IR dose usually delivered from medical diagnostic procedures is small, the number of people undergoing these procedures is large. In France exposure to diagnostic medical IR represented 35% of the French total non-therapeutic IR exposure, being one of the highest exposures to diagnostic medical IR in Europe. This study quantifies the number of new cancer cases in France in 2015 attributable to lifetime IR exposure from medical imaging procedures. Methods The cancer incidence attributable to medical diagnostic IR was estimated using cumulative exposure, risk of cancer for a given dose, and cancer incidence by site. We used national frequencies of medical diagnostic examinations by sex and age reported in 2007 to estimate the lifetime cumulative organ dose exposure adjusted for changes in use of diagnostic procedures over time. The Biological Effects of Ionizing Radiation (BEIR) VII risk models were used to estimate the excess cancer risk due to IR; alongside we used cancer incidence data from the French Cancer Registries Network, FRANCIM. A minimum latency period of 10 years was assumed. Exposures from both external (X-rays, CT scans and interventional radiology) and internal sources (nuclear medicine) were considered. Results Of the 346,000 estimated new cancer cases in adults in France in 2015, 2100 cases (800 among men and 1300 among women) were attributable to diagnostic IR from external sources, representing 0.6% of all new cancer cases (0.4% for men and 0.8% for women). Furthermore, 220 new cancer cases, representing 0.1% of all cases, were attributable to diagnostic IR from internal sources. Overall, the leading cancers attributable to diagnostic medical IR in France were female breast (n = 560 cases), lung cancers (n = 500), colon (n = 290) and bladder (n = 250) cancers. In the sensitivity analyses, we found that the largest differences with the main model were observed when changing the dose-rate effectiveness. Assuming an over- or under-estimation of the dose by 30% also modified the attributable fraction. Using the UNSCEAR model instead of the BEIR VII model increased attributable fraction for all nine considered cancer sites. Conclusion The contribution of diagnostic medical IR to the cancer burden in France is small compared to other risk factors, and the benefits largely outweigh its harms quantified here. However, some of these IR-associated cancer cases may be preventable through dose optimization and more enhanced justification thorough diagnostic examination.

The impact of historical breastfeeding practices on the incidence of cancer in France in 2015.

Abstract: The purpose of the study was to estimate the number of new breast cancer cases in France in 2015 attributable to breastfeeding for durations below recommendations (at least 6 months per child), and cases prevented through historical breastfeeding. As a secondary analysis, the corresponding numbers for ovarian cancer were estimated. Historical breastfeeding data were obtained from population surveys. Duration of breastfeeding data were obtained from the French Epifane cohort study. Relative risks were obtained from meta-analyses, cohort, and case–control studies. Cancer incidence data were obtained from the French Network of Cancer Registries. A 10-year latency period was assumed. Among parous women 25 years of age and older, 14.1% breastfed for at least 6 months per child born before 2006. As a result, 1,712 new breast cancer cases (3.2% of all new breast cancer cases) were attributable to breastfeeding for < 6 months per child, while actual breastfeeding practices prevented 765 breast cancer cases. Furthermore, 411 new ovarian cancer cases (8.6% of all new ovarian cancer cases) may be attributable to breastfeeding for < 6 months per child, with breastfeeding preventing 163 ovarian cancer cases. The historically low breastfeeding prevalence and duration in France led to numerous avoidable cancer cases.

Incidence trends and age-period cohort effect on ovarian cancer in high-income countries

Abstract: Background Ovarian cancer is the seventh most common cancer worldwide. Historically, the incidence of ovarian cancer in Europe and North America had been higher compared to other regions of the world. Among European countries, the incidence of ovarian cancer has steadily declined over the years, nevertheless, countries in Europe continues to have the highest incidence of ovarian cancer. The aim of the study is to provide an overview of ovarian cancer incidence trends for high-income countries that are currently part of the Cancer Survival in High-Income Countries (SURVMARK-2) project. These countries include Norway, Denmark, Ireland, the United Kingdom, Canada, Australia and New Zealand. In addition, an age-period-cohort (APC) analysis was also conducted utilizing data from population-based cancer registries from these seven countries. Methods Ovarian cancer incidence rates were calculated using data from three sources, namely, SURVMARK-2, the Cancer Incidence in Five Continents database (CI5plus), and the European cancer registries (EUREG) database. The study contains all available years included in the databases until 2014, with Norway and Denmark having the longest study periods (1953–2014). The overall age-standardized incidence rates for ovarian cancer in women aged 20 and above were computed per year. SURVMARK-2 was utilized to calculate the incidence rates from 1995 to 2014. Incidence rates prior to 1995 were then derived from the CI5plus and the EUREG databases. Additionally, the estimated annual percent change (EAPC) between 1999 and 2013 was calculated for all women age 20 and above, women age 25–49 years and 50–74 years. Lastly, the data was grouped into 5-year age groups starting with 20–24 through 70–74 years, and APC analysis was performed to examine the effects of birth cohort and period. In addition, the goodness-of-fit of the models were assessed and the likelihood ratio test was used for APC model comparison. Results In general, Norway, Denmark, Ireland and the United Kingdom, consistently had higher incidence of ovarian cancer compared to non-European countries. Nevertheless, the incidence trends revealed decreasing incidence trends of ovarian cancer in all countries evaluated. Additionally, in the last 15-year period of the study, the overall incidence rate of ovarian cancer has generally been stable. Between 1999 and 2013 the highest decline of ovarian incidence rate was observed in Norway (EAPC: −1.9, 95% CI: −4.0, 0.4). Incidences of ovarian cancer in 25–49 years and 50–74 years age groups have also declined for most countries. Notably, among the age group 25–49 years, a statistically significant decline of ovarian cancer incidence rate was observed in Norway (EAPC: −4.2, 95% CI: −7.7, −0.6). In contrast, a modest increase of incidence rate in Canada (EAPC: 1.8, 95% CI: −2.2, 5.9) was observed in this age group. Moreover, the United Kingdom (EAPC: −1.8, 95% CI: −3.3, −0.3) had statistically significant decline of incidence rates among women 50–74 years. In addition, the APC analysis yielded the full APC model as the best fitting model for all countries. After adjusting for the period effect, a statistically significant cohort effect (P Conclusion In summary, a gradual decline of ovarian cancer was observed for all countries in the study. The birth cohort effect observed in the study may be linked to the changes in the prevalence of ovarian cancer risk factors, such as the use of oral contraceptive pill. In the other hand, the period effect observed may be explained partly by changes in disease classifications and cancer registry practices.

Epidemiological patterns of leukemia in 184 countries: A population-based study

Abstract: Introduction Leukaemia is a heterogeneous group of haemopoietic cancers that comprises a number of diverse and biologically distinct subgroups. We examine the leukaemia burden worldwide and highlight the distinct incidence patterns in order to elucidate explanatory factors that may support preventive measures and health resource planning. We aimed to estimate the global burden of leukaemia incidence according to the four major subtypes stratified by age and sex. Methods In this population-based study, we assessed leukaemia incidence for the major subtypes using the Cancer Incidence in Five Continents Volume X (CI5-X), which includes data from 290 cancer registries in 68 countries covering the diagnostic period 2003–07, for all ages and both sexes. We then extracted counts and incidence rates in 184 countries for the year 2012 from IARC's GLOBOCAN database of national estimates. We calculated age-specific incidence rates per 100,000 person-years and age-standardised rates (ASRs) using the world standard population by country, sex, age group, and where applicable, by major subtypes. We excluded from all analyses registries for which the total number of leukaemia cases was less than 100 or the proportion of microscopically verified (MV%) cases was less than 80% (2572 cases). Results A total of 717,863 cases between 2003–07 were included in this analysis. More than 350,000 new leukaemia cases were estimated in 2012. We observed substantial variation in incidence between and within world regions. The highest leukaemia incidence rates for both sexes were estimated in Australia and New Zealand (ASR per 100,000 11·3 in males and 7·2 in females), Northern America (10·5 in males and 7·2 in females), and western Europe (9·6 in males and 6·0 in females), and the lowest was in western Africa (1·4 in males and 1·2 in females). Rates were generally higher in males than females with an overall male to female ratio of 1·4. In children, acute lymphoblastic leukaemia was the main subtype in all studied countries in both sexes and characterised by a bimodal age-specific pattern. The subtype distribution was more diverse in adults, with a relatively higher proportion of chronic lymphocytic leukaemia in most European and North American countries, whereas rates of acute lymphoblastic leukaemia remained relatively high among adults in selected South American, Caribbean, Asian, and African populations. Conclusion Geographical disparities in leukaemia might partly be explained by quality of, and access to, health systems linked to resource levels, although there is probably a role for aetiological factors, including gene–environment interactions. The observed bimodal pattern could be due to different risk factors affecting different ages and might include a genetic component.

Author's reply to: Cancer screening policy in Hungary.

Abstract: 1 Screening Group, International Agency for Research on Cancer, Lyon, France 2 CPO Piemonte and University Hospital “Citt a della Salute e della Scienza,” Turin, Italy 3 Mass Screening Registry/Finnish Cancer Registry, Helsinki, Finland 4 Departamento de Tocoginecologia, Divis~ao de Oncologia, Universidade Estadual de Campinas, Brazil 5 Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France 6 Institute of Oncology Ljubljana, Ljubljana, Slovenia 7 Swedish Cervical Screening Registry, Stockholm, Sweden 8 Regionalt cancercentrum Stockholm-Gotland, Stockholm, Sweden 9 Cancer Registry of Norway, Oslo, Norway; Finnish Cancer Registry, Helsinki, Finland 10 Research Triangle Institute, International-India, Commercial Tower, Pullman Hotel Aerocity, New Delhi, India

Author's reply to: Implementation and organization of cancer screening in France.

Abstract: Screening Group, International Agency for Research on Cancer, Lyon, France CPO Piemonte and University Hospital “Città della Salute e della Scienza”, Turin, Italy Mass Screening Registry/Finnish Cancer Registry, Helsinki, Finland Departamento de Tocoginecologia, Divisão de Oncologia, Universidade Estadual de Campinas, Brazil Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France Institute of Oncology Ljubljana, Ljubljana, Slovenia Swedish Cervical Screening Registry, Stockholm, Sweden Regionalt cancercentrum Stockholm-Gotland, Stockholm, Sweden Cancer Registry of Norway, Oslo, Norway Finnish Cancer Registry, Helsinki, Finland Research Triangle Institute, International-India, Commercial Tower, Pullman Hotel Aerocity, New Delhi, India