Showing papers by "Cancer Epidemiology Unit published in 2004"

Testicular cancer incidence in eight northern European countries: secular and recent trends.

Abstract: Objective: Striking geographic variation and marked increasing secular trends characterize the incidence of testicular cancer. However, it is not known whether these patterns have attenuated in recent years and whether they are similar for seminomas and nonseminomas, the two main histologic groups of testicular cancer. Method: Cancer registry data, including 27,030 testicular cancer cases, were obtained from Denmark, Estonia, Finland, Latvia, Lithuania, Norway, Poland, and Sweden. Between 57 (Denmark) and 9 (Poland) years of registration were covered. Country-specific temporal trends were estimated, with focus on the last decade and seminomas and nonseminomas. Data from the Nordic countries were further analyzed using an age-period-cohort approach. Results: Age-standardized incidence rates increased annually by 2.6% to 4.9% during the study period, with marginal differences between seminomas and nonseminomas. In the last decade, the increasing trend attenuated only in Denmark (annual change, −0.3%; 95% confidence interval, −1.5 to 0.9). In 1995, the highest and the lowest age-standardized incidence rates (per 105) were 15.2 in Denmark and 2.1 in Lithuania. Incidence rates (i.e., for all cancers and for seminomas and nonseminomas, separately) depended chiefly on birth cohort rather than on calendar period of diagnosis (although both birth cohort and period determined the Danish incidence rates). Conclusions: Testicular cancer incidence is still increasing, with the exception of Denmark, and a large geographic difference exists. The increasing trend is mainly a birth cohort phenomenon also in recent cohorts. Temporal trends for seminomas and nonseminomas are similar, which suggests that they share important causal factors.

Trends in mortality from major cancers in the European Union, including acceding countries, in 2004.

Abstract: BACKGROUND In May 2004, 10 additional countries joined the European Union (EU), including a total of 75 million inhabitants. Most of these were from central and eastern European countries with comparably high cancer mortality rates and with relatively unfavorable trends. Therefore, it is important to provide updated mortality data regarding major cancers in various countries and to analyze trends for the current population of the EU. METHODS The authors considered mortality rates (directly standardized to the world standard population) for all cancers and for 8 major cancer sites in the year 2000 in the 25 countries of the EU and analyzed corresponding trends since 1980 using data derived from the World Health Organization data base. RESULTS For men, overall cancer mortality in the year 2000 varied by a factor > 2 between the highest rate of 258.5 per 100,000 men in Hungary and the lowest rate of 122.0 per 100,000 men in Sweden. Central and Eastern European accession countries had the highest rates not only for lung and other tobacco-related cancers but also for gastrointestinal cancers and leukemias. The geographic pattern was different and the range of variation was smaller for women, i.e., between 136.7 per 100,000 women in Denmark and 76.4 per 100,000 women in Spain in the year 2000. In the EU as a whole, lung cancer mortality in men peaked at 55.4 per 100,000 men in 1988 and declined thereafter to 46.7 per 100,000 men in 2000. Gastric cancer steadily declined from 19.7 per 100,000 men in 1980 to 10.1 per 100,000 men in 2000. Other major sites showed moderately favorable trends over the last few years. In women, breast cancer peaked at 21.7 per 100,000 in 1989 and declined to 18.9 per 100,000 in 2000. Mortality from gastric, (cervix) uterus, and intestinal cancers demonstrated steady decreases, but lung cancer increased from 7.7 per 100,000 women in 1980 to 11.1 per 100,000 women in 2000. The increase in lung cancer mortality in women age < 55 years was 38% between 1990 and 2000 (from 2.16 per 100,000 women to 2.99 per 100,000 women), reflecting the spread of tobacco smoking among women in the EU over the last few decades. CONCLUSIONS The priority for further reduction of cancer mortality in the EU remains tobacco control together with more widespread availability of modern diagnostic and treatment procedures for neoplasms that are amenable to treatment. Cancer 2004. © 2004 American Cancer Society.

International trends in prostate-cancer mortality: the decrease is continuing and spreading.

Abstract: Objective: To measure recent changes in prostate-cancer mortality across 24 developed countries. Methods: Mortality data for men aged 50–79 years were obtained from the World Health Organisation mortality database and we assessed trends in age-standardised mortality rates using joinpoint regression models. Results: Significant reductions in prostate-cancer mortality were observed in United Kingdom, United States, Austria, Canada, Italy, France, Germany, Australia and Spain, and downward trends were also observable in the Netherlands, Ireland and Sweden. Conclusions: Mortality declines for prostate cancer are now evident in 12 out of the 24 developed countries considered in this analysis. Increases in PSA screening and better treatment of early-stage disease, possibly acting in combination, remain plausible hypotheses.

International comparison of performance measures for screening mammography: can it be done?

Abstract: Objective: Published screening mammography performance measures vary across countries. An international study was undertaken to assess the comparability of two performance measures: the recall rate and positive predictive value (PPV). These measures were selected because they do not require identification of all cancers in the screening population, which is not always possible.Setting: The screening mammography programs or data registries in 25 member countries of the International Breast Cancer Screening Network (IBSN).Methods: In 1999 an assessment form was distributed to IBSN country representatives in order to obtain information on how screening mammography was performed and what specific data related to recall rates and PPV were collected. Participating countries were then asked to provide data to allow calculation of recall rates, PPV and cancer detection rates for screening mammography by age group for women screened in the period 1997–1999.Results: Twenty-two countries completed the assessment for...

Infections and immune factors in cancer: the role of epidemiology

Abstract: An infective, mostly viral, basis has been found in an increasing number of different human cancers In all cases, the neoplasm is a rare response to the relevant infection, which is usually present in persistent form, and requiring specific cofactors for malignancy to develop In some cases, epidemiological evidence of infectivity preceded and promoted identification of the specific infection involved and even the discovery of the microbe itself, as in Burkitt's lymphoma and cervix cancer In other cases, the discovery of the agent came first as in stomach and nasopharynx cancers, and epidemiology has been concerned mainly with confirming the relationship, measuring the size of the risk and identifying cofactors Infection-linked cancers include some of the commonest malignancies in certain large world regions, amounting to over 20% of all cancer in the developing countries In addition to these cancers are others such as childhood leukaemia that show features indicative of an infective basis though no underlying agent has been identified Advances in this field invite speculation about possible future discoveries and how these might be promoted However, in that majority of cancers that are unrelated to sexual behaviour, there will be nothing even at the population level to suggest an infective basis because what is transmitted from one individual to another is not the neoplasm itself, but the underlying, often silent, infection to which the malignancy is an uncommon response The increasing prevalence of immune impairment in human populations, as a result of the use of immunosuppressive drugs with organ transplants and the spread of HIV infection, has produced marked effects on cancer incidence in the affected groups including increases, of skin cancers, non-Hodgkin's lymphoma and Kaposi's sarcoma and to a lesser extent of many other cancers, in some cases at least due to the release from immunological control of incipient infection-based malignancies

Population mixing and childhood leukaemia: Fallon and other US clusters.

Abstract: Cancer clusters – distinctive geographical groupings of cases – have always attracted attention and none more so than those involving childhood leukaemia. The public, however, has often found the approach of epidemiologists to these clusters disappointing. For the frequent uncertainty about the genuineness of a cluster in reflecting a raised underlying risk, and its treatment only as generating a hypothesis, with consequently greater interest in possible future cases than in the (seemingly definite) recent past, can all appear unhelpful. The fact remains that the choice of boundaries in space and time greatly influences the magnitude of observed excesses; and tests of significance are strictly inappropriate without a prior hypothesis, since a chance would inevitably from time to time generate extreme fluctuations in disease occurrence, which, in the absence of further information, cannot be distinguished from a genuinely raised risk. The population mixing hypothesis of childhood leukaemia (Kinlen, 1988) moved attention away from aggregations attracting notice and on to a possible cause; if correct, it should reveal significant excesses even when these were previously unsuspected.

Leveling of prostate cancer mortality in Western Europe.

Abstract: BACKGROUND Mortality from prostate cancer (CaP) has increased throughout Europe until the early 1990s. Trends in 24 European countries, the European Union (EU), six selected Central and Eastern European countries, and the Russian Federation have been updated to 1999. METHODS Cancer death certification data for CaP were abstracted from the World Health Organization database. RESULTS In the EU, the peak rate (15.7/100,000) was reached in 1993, followed by a leveling off and a decline to 14.1/100,000 in 1999. Age-standardized analysis for each subsequent age group of men aged 50 or over showed larger absolute falls in the elderly. CaP rates were lower in Central and Eastern European countries providing data, but showed a rise from 9.7/100,000 in 1980 to 11.3 in 1996, and leveled off thereafter. Rates were originally lower, but the rises larger in the Russian Federation (from 5.1/100,000 in 1980 to 8.1/100,000 in 1999). In the late 1990s, there was a threefold difference between the highest rates of 22/100,000 in Norway and those of 7.7 in Russia or 7.3 in Ukraine. Such a difference was, however, restricted to the elderly, since at age 35–64 the Russian rate (6.7/100,000) was the same as that of Norway, and only Greece and Italy had appreciably lower rates. CONCLUSION The pattern of trends in CaP rates observed across Europe is consistent with a favorable role of improved diagnosis, but mainly of advancements of therapy (including more widespread adoption of radical prostatectomy and androgen blockage) on CaP mortality in Western Europe. © 2004 Wiley-Liss, Inc.

Ret/PTC Activation in Benign and Malignant Thyroid Tumors Arising in a Population Exposed to Low-Dose External-Beam Irradiation in Childhood

Abstract: Ionizing radiation is the strongest risk factor known for the development of thyroid neoplasia. Although ret/PTC rearrangements have been identified in both spontaneous and radiation-induced papillary thyroid cancer, they seem more frequent among radiation-associated tumors. We studied the frequency of ret/PTC activation in a group of sporadic and radiation-induced thyroid carcinomas (n = 49) and adenomas (n = 13) among 44 individuals treated for Tinea Capitis with low-dose external irradiation as well as in 18 nonirradiated subjects. Total RNA recovered from paraffin-embedded thyroid cancer surgical specimens was analyzed for ret/PTC 1, 2, and 3 mutations using RT-PCR with Southern blotting to maximize detection sensitivity. Ret/PTC rearrangements were identified in 42.9% of thyroid carcinoma and 46.2% of adenoma subjects. Among the positive carcinoma specimens, three were follicular carcinomas. Ret/PTC 1, the predominant rearrangement, was more prevalent in nonirradiated compared with irradiated carcinomas (66.7 vs. 27.0%; P = 0.04). Ret/PTC activation was associated with male gender. The strengths of this study included analysis of age-, gender-, and ethnicity-matched groups; molecular analysis using two techniques; and a complete blinding of laboratory analysis from clinical features. The differences seen between these and other published results may be related to differences in radiation doses to the thyroid, latency period between time of radiation exposure and development of clinically apparent thyroid cancer, and ethnic background of the study populations.

Low socioeconomic status and risk for infection with human herpesvirus 8 among HIV-1 negative, South African black cancer patients.

Abstract: Between January 1994 and October 1997, we interviewed 2576 black in-patients with newly diagnosed cancer in Johannesburg and Soweto, South Africa. Blood was tested for HIV-1 and HHV-8 antibodies and the study was restricted to 2191 HIV-1 antibody-negative patients. We examined the relationship between infection with HHV-8 and sociodemographic and behavioural factors using unconditional logistic regression models. Of the 2191 HIV-1 negative patients who did not have Kaposi's sarcoma, 854 (39.1%) were positive for antibodies against the latent nuclear antigen of HHV-8 encoded by orf73 in a immunofluorescence assay. Infection with HHV-8 was independently associated with increasing age (P trend = 0.02). For females, independent risk factors also included working in a paid domestic capacity (OR 1.63, 95% CI 1.09-2.44, P = 0.02), defining occupational status as economically non-active unemployed (OR 1.70, 95% CI 1.06-2.72, P = 0.03), having a state pension or being on a disability grant (OR 1.49, 95% CI 1.05-2.11, P = 0.02), using oral contraceptives (OR 1.43, 95% CI 1.03-1.99, P = 0.03) and having a delayed age at menarche (P trend = 0.04). The relationship between these variables and HHV-8 antibody status requires further, prospective study.

Early deaths from childhood cancer. A report from the Childhood Cancer Registry of Piedmont, Italy, 1967-1998.

Abstract: The population-based Childhood Cancer Registry of Piedmont (CCRP) has collected data on incidence since 1967. The occurrence of early death (i.e. within 30 days of diagnosis) was investigated in 3006 cases of childhood cancer diagnosed during the period 1967–1998. The proportion of early deaths (178 of the 3006 cases) was analysed by period of diagnosis (three decennial periods), age group, major diagnostic group and hospital category, with univariate statistics and logistic regression. The proportion of children with cancer who died within 1 month of diagnosis was 10.8%, 5.3% and 1.8% for cases diagnosed during 1967–1978, 1979–1988 and 1989–1998, respectively. This trend may reflect earlier diagnosis, improved diagnosis, more effective therapy or more frequent referral to specialised centres. The risk factors for early death were: age <1 year and diffuse disease at diagnosis, diagnosis during 1967–1978, a diagnosis of acute non lymphocytic leukaemia, non-Hodgkin lymphoma, central nervous system tumour or hepatic tumour. Early death was not related to the sex of the child. Care in an extra-regional specialised centre was associated with lower risk of early death. Conclusion:no temporal changes in early mortality were found among children with acute non lymphocytic leukaemia diagnosed in the first, second or third decade of activity of the CCRP, the percentages of children dying within 1 month being 12.8%, 10.7% and 12.8%, respectively. This pattern clearly differed from the corresponding trend for acute lymphoid leukaemia (6.4%, 2.0%, 0.4%).

Time trends of childhood cancer mortality rates: a report from the Childhood Cancer Registry of Piedmont, Italy, 1971-1998.

Abstract: Time changes in mortality rates can be used to suggest future trends in the prognosis of childhood cancer. Estimates provided from recent studies led to divergent previsions of future trends. In this study we used data from the population-based Childhood Cancer Registry of Piedmont (CCRP) in order to measure the decrease in mortality. The study included 1,060 deaths in the period 1971–1998. Analyses were carried out using Poisson regression models and considered separately the total tumours, acute lymphoblastic leukaemia (ALL) and tumours of the central nervous system (CNS). We observed a progressive decline in the mortality rates: for all tumours the estimated annual percentage change was −3.6% (P < 0.05), for ALL it was −5.2%, (P < 0.05) and for CNS tumours it was −3.8% (P < 0.05). The statistical test for effect modification due to age at death was not significant. For all cancer types, the Poisson model fits the data well, corresponding to an exponential decrease of mortality rates and leading to the conclusion that current therapies, despite their proven effectiveness, are not sufficient to cure all cases of childhood cancer. Pediatr Blood Cancer 2004;43:788–791. © 2004 Wiley-Liss, Inc.

Incidence of anal carcinoma in Vaud, Switzerland, 1979-2001.

Abstract: Substantial rises in anal cancer incidence have been registered over the last few decades in the USA and a few Nordic countries. Incidence trends in the Swiss population of Vaud (about 602,000 inhabitants) over the period 1979-2001 were considered. Rates were around 0.3-0.5 per 100,000 men (age-standardized, world population) and 1.1-1.4 per 100,000 women, in the absence of any consistent trend over time. The epidemiology of anal cancer appears therefore different in this Swiss population as compared with North America and northern Europe.

Trends in survival for both histologic types of esophageal cancer in Switzerland.

Abstract: Fabio LEVI*, Van-Cong TE, Lalao RANDIMBISON and Carlo LA VECCHIA Cancer Epidemiology Unit and Cancer Registry of Vaud, Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland Cancer Registry of Neuchâtel, Neuchâtel, Switzerland Laboratory of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri,” Milano, Italy Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milano, Italy