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Journal ArticleDOI

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

01 Nov 2018-CA: A Cancer Journal for Clinicians (American Cancer Society)-Vol. 68, Iss: 6, pp 394-424
TL;DR: 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.
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
Topics: Cancer registry (78%), Cancer (72%), Breast cancer (63%), Skin cancer (60%), Stomach cancer (58%)
Citations
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Journal ArticleDOI
Abstract: 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.

4,049 citations


Journal ArticleDOI
Christina Fitzmaurice1, Christina Fitzmaurice2, Christina Fitzmaurice3, Tomi Akinyemiju4, Faris Lami, Tahiya Alam1, Reza Alizadeh-Navaei5, Christine Allen1, Ubai Alsharif6, Nelson Alvis-Guzman7, Erfan Amini8, Benjamin O. Anderson3, Olatunde Aremu9, Al Artaman10, Solomon Weldegebreal Asgedom11, Reza Assadi12, Tesfay Mehari Atey11, Leticia Avila-Burgos, Ashish Awasthi, Huda Omer Ba Saleem, Aleksandra Barac13, James R. Bennett1, Isabela M. Benseñor14, Nickhill Bhakta15, Hermann Brenner16, Lucero Cahuana-Hurtado, Carlos A Castañeda-Orjuela17, Ferrán Catalá-López18, Ferrán Catalá-López19, Jee-Young Jasmine Choi20, Jee-Young Jasmine Choi21, Devasahayam J. Christopher22, Sheng-Chia Chung23, Maria Paula Curado, Lalit Dandona24, Lalit Dandona1, Rakhi Dandona24, Rakhi Dandona1, José Neves25, Subhojit Dey, Samath D Dharmaratne26, David Teye Doku27, David Teye Doku28, Tim Driscoll29, Manisha Dubey30, Hedyeh Ebrahimi8, Dumessa Edessa31, Ziad El-Khatib32, Ziad El-Khatib33, Aman Yesuf Endries34, Florian Fischer35, Lisa M. Force15, Kyle J Foreman36, Kyle J Foreman1, Solomon Weldemariam Gebrehiwot37, Sameer Vali Gopalani, Giuseppe Grosso, Rahul Gupta38, Bishal Gyawali39, Randah R. Hamadeh40, Samer Hamidi41, James D. Harvey1, Hamid Yimam Hassen42, Roderick J. Hay43, Simon I. Hay44, Simon I. Hay1, Behzad Heibati45, Molla Kahssay Hiluf, Nobuyuki Horita46, H. Dean Hosgood47, Olayinka Stephen Ilesanmi, Kaire Innos48, Farhad Islami49, Mihajlo Jakovljevic3, Mihajlo Jakovljevic50, Sarah Charlotte Johnson1, Jost B. Jonas51, Amir Kasaeian8, Tesfaye Dessale Kassa11, Yousef Khader52, Ejaz Ahmad Khan53, Gulfaraz Khan54, Young-Ho Khang55, Young-Ho Khang21, Mohammad Hossein Khosravi56, Mohammad Hossein Khosravi57, Jagdish Khubchandani58, Jacek A. Kopec59, G Anil Kumar24, Michael Kutz1, Deepesh Lad60, Alessandra Lafranconi61, Qing Lan, Yirga Legesse11, James Leigh29, Shai Linn62, Raimundas Lunevicius63, Raimundas Lunevicius64, Azeem Majeed36, Reza Malekzadeh8, Deborah Carvalho Malta65, Lorenzo G. Mantovani61, Brian J. McMahon66, Toni Meier67, Yohannes Adama Melaku11, Yohannes Adama Melaku68, Mulugeta Melku69, Peter Memiah70, Walter Mendoza71, Tuomo J. Meretoja72, Haftay Berhane Mezgebe11, Ted R. Miller73, Ted R. Miller74, Shafiu Mohammed75, Shafiu Mohammed51, Ali H. Mokdad1, Mahmood Moosazadeh5, Paula Moraga76, Seyyed Meysam Mousavi8, Vinay Nangia, Cuong Tat Nguyen77, Vuong Minh Nong77, Felix Akpojene Ogbo29, Andrew T Olagunju78, Andrew T Olagunju68, Andrew T Olagunju79, Padukudru Anand Mahesh80, Eun-Kee Park81, Tejas Patel, David M. Pereira25, Farhad Pishgar8, Maarten J. Postma82, Maarten J. Postma83, Farshad Pourmalek59, Mostafa Qorbani, Anwar Rafay, Salman Rawaf36, David Laith Rawaf23, David Laith Rawaf36, Gholamreza Roshandel84, Gholamreza Roshandel8, Saeid Safiri85, Hamideh Salimzadeh8, Juan Sanabria86, Juan Sanabria87, Milena M Santric Milicevic13, Benn Sartorius88, Benn Sartorius89, Maheswar Satpathy90, Sadaf G. Sepanlou8, Katya Anne Shackelford1, Masood Ali Shaikh, Mahdi Sharif-Alhoseini8, Jun She91, Min-Jeong Shin92, Ivy Shiue93, Ivy Shiue67, Mark G. Shrime33, Abiy Hiruye Sinke, Mekonnen Sisay31, Amber Sligar1, Mu'awiyyah Babale Sufiyan75, Bryan L. Sykes94, Rafael Tabarés-Seisdedos18, Gizachew Assefa Tessema69, Gizachew Assefa Tessema68, Roman Topor-Madry95, Roman Topor-Madry96, Tung Thanh Tran77, Bach Xuan Tran97, Bach Xuan Tran98, Kingsley N. Ukwaja, Vasiliy Victorovich Vlassov99, Stein Emil Vollset1, Elisabete Weiderpass, Hywel C Williams100, Nigus Bililign Yimer, Naohiro Yonemoto101, Mustafa Z. Younis102, Christopher J L Murray1, Mohsen Naghavi1 
Institute for Health Metrics and Evaluation1, Fred Hutchinson Cancer Research Center2, University of Washington3, University of Alabama at Birmingham4, Mazandaran University of Medical Sciences5, Charité6, University of Cartagena7, Tehran University of Medical Sciences8, Birmingham City University9, University of Manitoba10, Mekelle University11, Mashhad University of Medical Sciences12, University of Belgrade13, University of São Paulo14, St. Jude Children's Research Hospital15, German Cancer Research Center16, National University of Colombia17, University of Valencia18, Ottawa Hospital Research Institute19, Seoul National University Hospital20, Seoul National University21, Christian Medical College & Hospital22, University College London23, Public Health Foundation of India24, University of Porto25, University of Peradeniya26, University of Tampere27, University of Cape Coast28, University of Sydney29, International Institute for Population Sciences30, Haramaya University31, Karolinska Institutet32, Harvard University33, Arba Minch University34, Bielefeld University35, Imperial College London36, College of Health Sciences, Bahrain37, West Virginia University38, Aarhus University39, Arabian Gulf University40, Hamdan bin Mohammed e-University41, Mizan–Tepi University42, King's College London43, University of Oxford44, Iran University of Medical Sciences45, Yokohama City University46, Albert Einstein College of Medicine47, National Institutes of Health48, American Cancer Society49, University of Kragujevac50, Heidelberg University51, Jordan University of Science and Technology52, Health Services Academy53, United Arab Emirates University54, New Generation University College55, Education and Research Network56, Baqiyatallah University of Medical Sciences57, Ball State University58, University of British Columbia59, Post Graduate Institute of Medical Education and Research60, University of Milano-Bicocca61, University of Haifa62, University of Liverpool63, National Health Service64, Universidade Federal de Minas Gerais65, Alaska Native Tribal Health Consortium66, Martin Luther University of Halle-Wittenberg67, University of Adelaide68, University of Gondar69, University of West Florida70, United Nations Population Fund71, University of Helsinki72, Curtin University73, Pacific Institute74, Ahmadu Bello University75, Lancaster University76, Duy Tan University77, University of Lagos78, Lagos University Teaching Hospital79, JSS Medical College80, Kosin University81, University Medical Center Groningen82, University of Groningen83, Golestan University84, University of Maragheh85, Marshall University86, Case Western Reserve University87, University of KwaZulu-Natal88, South African Medical Research Council89, Utkal University90, Fudan University91, Korea University92, University of Edinburgh93, University of California, Irvine94, Jagiellonian University Medical College95, Wrocław Medical University96, Hanoi Medical University97, Johns Hopkins University98, National Research University – Higher School of Economics99, University of Nottingham100, Kyoto University101, Jackson State University102
01 Nov 2018-JAMA Oncology
Abstract: Importance The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, −1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. Conclusions and Relevance Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

3,484 citations


Journal ArticleDOI
TL;DR: The sources and methods used in compiling the cancer statistics in 185 countries are reviewed, and uncertainty intervals are now provided for the estimated sex‐ and site‐specific all‐ages number of new cancer cases and cancer deaths.
Abstract: Estimates of the worldwide incidence and mortality from 36 cancers and for all cancers combined for the year 2018 are now available in the GLOBOCAN 2018 database, compiled and disseminated by the International Agency for Research on Cancer (IARC). This paper reviews the sources and methods used in compiling the cancer statistics in 185 countries. The validity of the national estimates depends upon the representativeness of the source information, and to take into account possible sources of bias, uncertainty intervals are now provided for the estimated sex- and site-specific all-ages number of new cancer cases and cancer deaths. We briefly describe the key results globally and by world region. There were an estimated 18.1 million (95% UI: 17.5-18.7 million) new cases of cancer (17 million excluding non-melanoma skin cancer) and 9.6 million (95% UI: 9.3-9.8 million) deaths from cancer (9.5 million excluding non-melanoma skin cancer) worldwide in 2018.

3,021 citations


Cites methods from "Global cancer statistics 2018: GLOB..."

  • ...A complete assessment of the geographic variability observed across 20 world regions is provided elsewhere.(4) This paper reviews the sources and methods used in compiling cancer incidence and mortality estimates for 2018 in 185 countries or territories worldwide....

    [...]


Journal ArticleDOI
01 Aug 2019-Annals of Oncology
TL;DR: This work presents the results of a meta-analysis conducted at the 2016 European Oncology and Radiotherapy Guidelines Working Group (ESMO) workshop on breast cancer diagnosis and prognosis of women with atypical central giant cell granuloma (CGM) who have previously had surgery.
Abstract: E. Senkus1, S. Kyriakides2, F. Penault-Llorca3,4, P. Poortmans5, A. Thompson6, S. Zackrisson7 & F. Cardoso8,9, on behalf of the ESMO Guidelines Working Group* Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland; Europa Donna Cyprus, Nicosia, Cyprus; Department of Pathology, Centre Jean Perrin, Clermont-Ferrand; EA 4677 Universite d’Auvergne, Clermont-Ferrand, France; Institute Verbeeten, Tilburg, The Netherlands; Dundee Cancer Centre, University of Dundee, Dundee, UK; Diagnostic Radiology, Lund University, Malmo, Sweden; European School of Oncology, Milan, Italy; Breast Cancer Unit, Champalimaud Centre Center, Lisbon, Portugal

1,803 citations


Journal ArticleDOI
01 Jul 2016-Medicine
TL;DR: According to the analysis, old men plus gastric fundus or antrum of CFB were strongly suggested to perform ESD if precancerous lesions were found and young women with low-grade intraepithelial neoplasia could select regular follow-up.
Abstract: Conventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN) and adenocarcinoma of gastric epithelium. The aim of this study was to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD).Four hundred forty-four patients who finally undertook ESD in our hospital were enrolled from Jan 1, 2009 to Sep 1, 2015. We retrospectively assessed the characteristics of pathological results of CFB and ESD.The concordance rate between CFB and ESD specimens was 68.92% (306/444). Men showed a lower concordance rate (63.61% vs 79.33%; P = 0.001) and concordance patients were younger (P = 0.048). In multivariate analysis, men significantly had a lower concordance rate (coefficient -0.730, P = 0.002) and a higher rate of pathological upgrade (coefficient -0.648, P = 0.015). Locations of CFB did not influence the concordance rate statistically.The concordance rate was relatively high in our hospital. According to our analysis, old men plus gastric fundus or antrum of CFB were strongly suggested to perform ESD if precancerous lesions were found. And young women with low-grade intraepithelial neoplasia could select regular follow-up.

1,567 citations


Cites background from "Global cancer statistics 2018: GLOB..."

  • ...There were an estimated 572,034 cases of esophageal cancer in 2018.([1]) The most common histological subtypes of esophageal...

    [...]


References
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Journal ArticleDOI
TL;DR: A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination, and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake.
Abstract: The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.

51,138 citations


Journal ArticleDOI
TL;DR: A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests.
Abstract: Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The occurrence of cancer is increasing because of the growth and aging of the population, as well as an increasing prevalence of established risk factors such as smoking, overweight, physical inactivity, and changing reproductive patterns associated with urbanization and economic development. Based on GLOBOCAN estimates, about 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide. Over the years, the burden has shifted to less developed countries, which currently account for about 57% of cases and 65% of cancer deaths worldwide. Lung cancer is the leading cause of cancer death among males in both more and less developed countries, and has surpassed breast cancer as the leading cause of cancer death among females in more developed countries; breast cancer remains the leading cause of cancer death among females in less developed countries. Other leading causes of cancer death in more developed countries include colorectal cancer among males and females and prostate cancer among males. In less developed countries, liver and stomach cancer among males and cervical cancer among females are also leading causes of cancer death. Although incidence rates for all cancers combined are nearly twice as high in more developed than in less developed countries in both males and females, mortality rates are only 8% to 15% higher in more developed countries. This disparity reflects regional differences in the mix of cancers, which is affected by risk factors and detection practices, and/or the availability of treatment. Risk factors associated with the leading causes of cancer death include tobacco use (lung, colorectal, stomach, and liver cancer), overweight/obesity and physical inactivity (breast and colorectal cancer), and infection (liver, stomach, and cervical cancer). A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests.

21,062 citations


Journal ArticleDOI
TL;DR: 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.
Abstract: 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.

17,254 citations


Journal ArticleDOI
17 Jul 2002-JAMA
TL;DR: Overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2-year follow-up among healthy postmenopausal US women, and the results indicate that this regimen should not be initiated or continued for primary prevention of CHD.
Abstract: Context Despite decades of accumulated observational evidence, the balance of risks and benefits for hormone use in healthy postmenopausal women remains uncertain Objective To assess the major health benefits and risks of the most commonly used combined hormone preparation in the United States Design Estrogen plus progestin component of the Women's Health Initiative, a randomized controlled primary prevention trial (planned duration, 85 years) in which 16608 postmenopausal women aged 50-79 years with an intact uterus at baseline were recruited by 40 US clinical centers in 1993-1998 Interventions Participants received conjugated equine estrogens, 0625 mg/d, plus medroxyprogesterone acetate, 25 mg/d, in 1 tablet (n = 8506) or placebo (n = 8102) Main outcomes measures The primary outcome was coronary heart disease (CHD) (nonfatal myocardial infarction and CHD death), with invasive breast cancer as the primary adverse outcome A global index summarizing the balance of risks and benefits included the 2 primary outcomes plus stroke, pulmonary embolism (PE), endometrial cancer, colorectal cancer, hip fracture, and death due to other causes Results On May 31, 2002, after a mean of 52 years of follow-up, the data and safety monitoring board recommended stopping the trial of estrogen plus progestin vs placebo because the test statistic for invasive breast cancer exceeded the stopping boundary for this adverse effect and the global index statistic supported risks exceeding benefits This report includes data on the major clinical outcomes through April 30, 2002 Estimated hazard ratios (HRs) (nominal 95% confidence intervals [CIs]) were as follows: CHD, 129 (102-163) with 286 cases; breast cancer, 126 (100-159) with 290 cases; stroke, 141 (107-185) with 212 cases; PE, 213 (139-325) with 101 cases; colorectal cancer, 063 (043-092) with 112 cases; endometrial cancer, 083 (047-147) with 47 cases; hip fracture, 066 (045-098) with 106 cases; and death due to other causes, 092 (074-114) with 331 cases Corresponding HRs (nominal 95% CIs) for composite outcomes were 122 (109-136) for total cardiovascular disease (arterial and venous disease), 103 (090-117) for total cancer, 076 (069-085) for combined fractures, 098 (082-118) for total mortality, and 115 (103-128) for the global index Absolute excess risks per 10 000 person-years attributable to estrogen plus progestin were 7 more CHD events, 8 more strokes, 8 more PEs, and 8 more invasive breast cancers, while absolute risk reductions per 10 000 person-years were 6 fewer colorectal cancers and 5 fewer hip fractures The absolute excess risk of events included in the global index was 19 per 10 000 person-years Conclusions Overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 52-year follow-up among healthy postmenopausal US women All-cause mortality was not affected during the trial The risk-benefit profile found in this trial is not consistent with the requirements for a viable intervention for primary prevention of chronic diseases, and the results indicate that this regimen should not be initiated or continued for primary prevention of CHD

13,961 citations


Book
31 Dec 1997-
TL;DR: The aim of this study was to establish a database of histological groups and to provide a level of consistency and quality of data that could be applied in the design of future registries.
Abstract: 1. Techniques of registration 2. Classification and coding 3. Histological groups 4. Comparability and quality of data 5. Data processing 6. Age-standardization 7. Incidence data by site and sex for each registry 8. Summary tables presenting age-standardized rates 9. Data on histological type for selected sites

10,051 citations


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