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.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/canjclin.55.2.74

Global cancer statistics, 2002.

background The influence of excess body weight on the risk of death from cancer has not been fully characterized. methods In a prospectively studied population of more than 900,000 U.S. adults (404,576 men and 495,477 women) who were free of cancer at enrollment in 1982, there were 57,145 deaths from cancer during 16 years of follow-up. We examined the relation in men and women between the body-mass index in 1982 and the risk of death from all cancers and from cancers at individual sites, while controlling for other risk factors in multivariate proportional-hazards models. We calculated the proportion of all deaths from cancer that was attributable to overweight and obesity in the U.S. population on the basis of risk estimates from the current study and national estimates of the prevalence of overweight and obesity in the U.S. adult population. results The heaviest members of this cohort (those with a body-mass index [the weight in kilograms divided by the square of the height in meters] of at least 40) had death rates from all cancers combined that were 52 percent higher (for men) and 62 percent higher (for women) than the rates in men and women of normal weight. For men, the relative risk of death was 1.52 (95 percent confidence interval, 1.13 to 2.05); for women, the relative risk was 1.62 (95 percent confidence interval, 1.40 to 1.87). In both men and women, body-mass index was also significantly associated with higher rates of death due to cancer of the esophagus, colon and rectum, liver, gallbladder, pancreas, and kidney; the same was true for death due to non-Hodgkin’s lymphoma and multiple myeloma. Significant trends of increasing risk with higher body-mass-index values were observed for death from cancers of the stomach and prostate in men and for death from cancers of the breast, uterus, cervix, and ovary in women. On the basis of associations observed in this study, we estimate that current patterns of overweight and obesity in the United States could account for 14 percent of all deaths from cancer in men and 20 percent of those in women. conclusions Increased body weight was associated with increased death rates for all cancers combined and for cancers at multiple specific sites.

/pdf/overweight-obesity-and-mortality-from-cancer-in-a-3whc0l70ow.pdf

Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.

The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Hepatocellular Carcinoma: Epidemiology and Molecular Carcinogenesis

CA : A Cancer Journal for Clinicians

Smoking increases the risk of peptic ulcer disease and also adversely affects its course.1 Both pharmacological and surgical treatments will lead to a relief from the symptoms of the disease.23 We analysed to what extent such potential relief would affect the subsequent risk of lung cancer in patients who had had a vagotomy for peptic ulcer disease, compared with patients with the disease who were treated without surgery.

https://www.bmj.com/content/bmj/316/7130/518.full.pdf

Relation of vagotomy to subsequent risk of lung cancer: population based cohort study

Objective:To investigate the validity and reproducibility of a newly developed internet-based self-administered hearing test using clinical pure-tone air-conducted audiometry as gold standard.Study Design:Cross-sectional intrasubject comparative study.Setting:Karolinska University Hospital, Solna, S

An internet-based hearing test for simple audiometry in nonclinical settings: preliminary validation and proof of principle.

AIM: To assess the natural course of screening-detected oral leukoplakia (OL) among non-consulting individuals. METHODS: A cohort of 555 individuals with OL, confirmed in 1973‐1974 during a population-based survey, were followed through January 2002 via record linkages with nationwide and essentially complete registers. A sample of 104 drawn from the 297 surviving cohort members who still were living in the area in 1993‐1995 was invited to a re-examination. Sixty-seven of them attended. RESULTS: At the time of re-examination OL had disappeared in 29 (43%) individuals. There was a statistically significant association between cessation of/no smoking habits in 1993‐1995 and the disappearance of OL. Never/ previous daily smokers were thus over-represented among individuals whose OL had disappeared compared to those with persisting OL [n ¼ 23 (82%) vs. n ¼ 18 (47%), P < 0.01]. Eighteen (78%) of the twenty three nonsmokers with disappearing OL had quit after the initial examination. One man and two women developed oral cancer during follow-up while 0.7 and 0.07, respectively, were expected. CONCLUSION: Smoking cessation was associated with an increased disappearance of OL. Hence, at least one-fourth had lesions that could be classified as tobaccorelated. Small observed and expected numbers prohibited firm conclusions about a possible excess risk of developing oral cancer. J Oral Pathol Med (2007) 36: 78–82

A long-term follow-up study on the natural course of oral leukoplakia in a Swedish population-based sample.

Although some studies have linked excess of Hodgkin's disease (HD) to tonsillectomy, the findings have not been consistent. In particular, risk of HD by age at tonsillectomy has not been fully evaluated, despite the notable change in immunologic function of the tonsils between childhood and adulthood. To evaluate the risk of HD and other lymphomas, associated with tonsillectomy according to age at surgery, a population-based cohort study was conducted. Using nationwide Swedish hospitalization records, 55,169 patients undergoing tonsillectomy with/without adenoidectomy (T/A) were identified during the period 1964-1983. By linkage with the nationwide Total Population, Migration, Cancer and Causes-of-Death registries, these patients were followed up for as long as 25 years. After exclusion of the first post-operative year, a total of 533 first primary-cancer cases was identified between 1965 and 1989. Small excess risk was observed for HD (20 cases, SIR = 1.4, 95% CI 0.9-2.2). HD risk was more pronounced among patients tonsillectomized before age 12 (7 observed vs. 1.7 expected, SIR = 4.1, 95% CI 1.6-8.4), but declined significantly with older ages at T/A. While our data suggest a small increase in HD among all patients undergoing T/A and a significant excess for those under age 12 at surgery, we cannot exclude the possibility that the excess may be due to factors underlying the disorders that led to surgery.

Risk of Hodgkin's disease subsequent to tonsillectomy : A population-based cohort study in Sweden

Dialysis has been used in the treatment of patients with end-stage renal disease since the 1960s. Recently, several large observational studies have been conducted to assess whether early initiation of dialysis prolongs survival, as compared with late initiation. However, these studies have used analytic approaches which are likely to suffer from either lead-time bias or immortal-time bias. In this paper, the authors demonstrate that recently developed methods in the causal inference literature can be used to avoid both types of bias and accurately estimate the ideal time for dialysis initiation from observational data. This is illustrated using data from a nationwide population-based cohort of patients with chronic kidney disease in Sweden (1996-2003).

Olof Nyrén

Papers

Relation of vagotomy to subsequent risk of lung cancer: population based cohort study

An internet-based hearing test for simple audiometry in nonclinical settings: preliminary validation and proof of principle.

A long-term follow-up study on the natural course of oral leukoplakia in a Swedish population-based sample.

Risk of Hodgkin's disease subsequent to tonsillectomy : A population-based cohort study in Sweden

Comparing Different Strategies for Timing of Dialysis Initiation Through Inverse Probability Weighting