Showing papers on "Relative survival published in 2005"

A 10-year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum.

Abstract: Most studies examining mucinous or signet-ring cell colorectal cancers are single institution reports. This study used a national cancer registry to analyze the epidemiology and survival outcomes of these two subtypes of colorectal cancer compared with adenocarcinoma tumors. All patients diagnosed with mucinous (n = 16,991), signet-ring cell (n = 1,522), or adenocarcinoma (n = 146,115) colorectal cancer in the Surveillance, Epidemiology, and End Results database (1991–2000) were evaluated. Analyses were performed to obtain age-adjusted incidence rates, stage at presentation, tumor grade, and five-year relative survival for each subtype. Mucinous were slightly more common in females (53.4 percent). Incidence rates per 100,000 persons were: mucinous, 5.5; signet-ring cell, 0.6; and adenocarcinoma 46.6. The annual percent change during ten years was stable for mucinous, increased for signet-ring cell (4.8 percent; P < 0.05), and decreased for adenocarcinoma (−1.1 percent; P < 0.05). Fewer mucinous (18 percent) and signet-ring cell (21 percent) tumors were located in the rectum compared with adenocarcinoma (29 percent). Signet-ring cell presented at later stage (III/IV, 80.9 percent) more often than mucinous (52.8 percent) and adenocarcinoma (49.5 percent), and also had worse tumor grade (high grade: signet-ring cell, 73.5 percent; mucinous, 20.9 percent; adenocarcinoma, 17.5 percent). Relative five-year survival was worse for signet-ring cell than mucinous or adenocarcinoma. We present a large population-based review of colorectal cancer subtypes by analyzing national data from the past decade. Although the incidence of colorectal adenocarcinoma is decreasing in the United States, mucinous and signet-ring cell subtypes are stable and increasing, respectively. Importantly, it seems that the signet-ring cell subtype has worse outcomes, whereas survival rates for mucinous tumors are similar to adenocarcinomas.

Improved Survival of Follicular Lymphoma Patients in the United States

Abstract: Purpose Despite several new treatment options, single- and multi-institution analyses have not clarified whether survival patterns in follicular lymphoma (FL) patients have changed in recent decades. We undertook a study using a large population-based registry to analyze survival patterns among patients with FL. Patients and Methods Surveillance, Epidemiology, and End Results morphology codes were used to identify 14,564 patients diagnosed with FL between 1978 and 1999. Observed median survival times, Kaplan-Meier survival curves, proportional death hazard ratios, and relative survival rates were calculated. Joinpoint regression analysis was used to identify trends in annual adjusted death hazard ratios. Results An improvement in survival of all patients with FL was observed between each of three diagnosis eras (1978 to 1985, 1986 to 1992, and 1993 to 1999) by log-rank tests. Among patients with stage-specific data, the median survival time improved from 84 months (95% CI, 81 to 88 months) in the 1983 to ...

Malignancies of the Appendix: Beyond Case Series Reports

Abstract: A comprehensive analysis was performed for five histologic types of appendiceal tumors to compare incidence, clinicopathologic features, survival, and appropriateness of surgery. All patients diagnosed with mucinous adenocarcinoma (n = 951), adenocarcinoma (n = 646), carcinoid (n = 435), goblet (n = 369), and signet-ring cell (n = 113) in the Surveillance, Epidemiology, and End Results database (1973–2001) were analyzed. Evaluation of incidence, stage, and five-year relative survival were determined for each histology. The appropriateness of the operative procedure (i.e. , appendectomy vs. colectomy) was examined by tumor type and size. Tumor incidence, patient demographics, survival outcomes, and appropriateness of surgery varied significantly among the different appendiceal tumor histologies. The most common appendiceal tumors were mucinous. With regard to patient demographics, carcinoids presented at an earlier mean age of 41 years and 71 percent were female (P 2 cm, we found that 30 percent of noncarcinoids underwent appendectomy. Similarly, 28 percent of carcinoids >2 cm under-went appendectomy, which is a lesser resection than is indicated. This study provides a population-based analysis of epidemiology, tumor characteristics, survival, and quality of care for appendiceal carcinomas. This characterization provides a novel description of the presentation and outcomes for malignancies of the appendix and highlights that a substantial number of patients with appendiceal tumors may not be receiving appropriate surgical resection.

Mortality trends for cervical squamous and adenocarcinoma in the United States. Relation to incidence and survival.

Abstract: BACKGROUND In the United States, detection of squamous carcinoma in situ (CIS) by screening has led to reduced rates for invasive squamous carcinoma and lower mortality. Adenocarcinoma in situ (AIS) rates also have increased, but invasive cervical adenocarcinoma rates have not declined similarly. To make inferences about the effectiveness of screening, the authors assessed mortality trends for squamous and adenocarcinoma in relation to incidence of these tumors, incidence of their precursors and survival. METHODS Using data from the Surveillance, Epidemiology, and End Results program (SEER), the authors tabulated incidence per 105 woman-years for invasive carcinomas (1976–2000) and for CIS and AIS (1976–1995) by age (< 50 years, ≥ 50 years) and race (whites, blacks). Cumulative relative survival rates were tabulated for 1976–1995 and mortality rates were estimated for 1986–2000. RESULTS Among all groups, CIS rates approximately doubled whereas rates for invasive squamous carcinoma declined. Among younger whites, mortality declined from 1.12 to 0.93, and for older whites, mortality decreased from 5.02 to 3.82. Among younger blacks, mortality for squamous carcinoma decreased from 2.69 to 1.96. Among older blacks, the mortality rates declined from 14.88 to 9.15. Although AIS rates have increased dramatically among whites (all ages) and younger blacks, adenocarcinoma incidence and mortality rates have not changed greatly. Survival for patients did not change greatly within these age-race groups. CONCLUSIONS The authors concluded that increases in CIS seemed disproportionately large compared with improvements in mortality rates for squamous carcinoma. Despite increased reporting of AIS, declines in mortality for cervical adenocarcinoma have not been demonstrated conclusively. However, future analyses are required to evaluate these trends more completely. Cancer 2005. Published 2005 by the American Cancer Society.

Cancer survival in Kampala, Uganda.

Abstract: Epidemiological data on the occurrence of cancer in sub-Saharan Africa are sparse, and population-based cancer survival data are even more difficult to obtain due to various logistic difficulties The population-based Cancer Registry of Kampala, Uganda, has followed up the vital status of all registered cancer patients with one of the 14 most common forms of cancer, who were diagnosed and registered between 1993 and 1997 in the study area We report 5-year absolute and relative survival estimates of the Ugandan patients and compare them with those of black American patients diagnosed in the same years and included in the SEER Program of the United States In general, the prognosis of cancer patients in Uganda was very poor Differences in survival between the two patient populations were particularly dramatic for those cancer types for which early diagnosis and effective treatment is possible For example, 5-year relative survival was as low as 83% for colorectal cancer and 177% for cervical cancer in Uganda, compared with 542 and 639%, respectively, for black American patients The collection of good-quality follow-up data was possible in the African environment The very poor prognosis of Ugandan patients is most likely explained by the lack of access to early diagnosis and treatment options in the country On the policy level, the results underscore the importance of the consistent application of the national cancer control programme guidelines as outlined by the World Health Organization

Survival differences between European and US patients with colorectal cancer: role of stage at diagnosis and surgery

Abstract: Background: Population based colorectal cancer survival among patients diagnosed in 1985–89 was lower in Europe than in the USA (45% v 59% five year relative survival). Aims: To explain this difference in survival using a new analytic approach for patients diagnosed between 1990 and 1991. Subjects: A total of 2492 European and 11 191 US colorectal adenocarcinoma patients registered by 10 European and nine US cancer registries. Methods: We obtained clinical information on disease stage, number of lymph nodes examined, and surgical treatment. We analysed three year relative survival, calculating relative excess risks of death (RERs, referent category US patients) adjusted for age, sex, site, surgery, stage, and number of nodes examined, using a new multivariable approach. Results: We found that 85% of European patients and 92% of US patients underwent surgical resection. Three year relative survival was 69% for US patients and 57% for European patients. After adjustment for age, sex, and site, the RER was significantly high in all 10 European populations, ranging from 1.07 (95% confidence interval 0.86–1.32) (Modena, Italy) to 2.22 (1.79–2.76) (Thames, UK). After further adjustment for stage, surgical resection, and number of nodes examined (a determinant of stage), RERs ranged from 0.77 (0.62–0.96) to 1.59 (1.28–1.97). For some European registries the excess risk was small and not statistically significant. Conclusions: US-Europe survival differences in colorectal cancer are large but seem to be mostly attributable to differences in stage at diagnosis. There are wide variations in diagnostic and surgical practice between Europe and the USA.

The effect of changes in tumor size on breast carcinoma survival in the U.S.: 1975–1999

Abstract: BACKGROUND Temporal comparisons of case survival are commonly used to assess improvement in cancer treatment at the population level. However, such comparisons may be confounded by secular trends in disease prognosis, even within conventional stage categories. The objective of the current study was to characterize within-stage migration of tumor size in breast carcinoma, and to estimate the effect of this shift on reported breast carcinoma survival. METHODS Population-based Surveillance, Epidemiology, and End Results (SEER) cancer registry data were used to evaluate secular trends in tumor size at the time of diagnosis and relative survival among localized and regional invasive breast carcinoma patients diagnosed between 1975–1999. Outcomes were stage-specific tumor size distribution, 5-year relative survival, relative survival standardized to the tumor size distribution of the cohort diagnosed between 1975–1979, and the percentage of improvement in relative survival attributable to shifts in tumor size distribution. RESULTS Within each stage category, the proportion of smaller tumors increased significantly over time. Comparing patients diagnosed between 1995–1999 with those diagnosed between 1975–1979, within-stage migration of tumor size accounted for 61% and 28%, respectively, of the relative survival increases noted in localized and regional breast carcinoma. CONCLUSIONS The tumor size distribution of incident breast carcinomas in SEER has shifted toward smaller tumors. A substantial fraction of the improvement in breast carcinoma survival noted since 1975 may be attributable to within-stage migration of tumor size. Cancer 2005. © 2005 American Cancer Society.

Ethnic Inequalities in Cancer Survival in New Zealand: Linkage Study

Abstract: We explored the contribution of stage at diagnosis to ethnic disparities in cancer survival in New Zealand. We linked 115811 adult patients with invasive cancer registered on the cancer registry (1994 to 2002) to mortality data. Age-standardized, 5-year relative survival rates were lowest for Maori, intermediate for Pacific people (otherwise known as Pacific Islanders), and highest for non-Maori/non-Pacific people for many cancers. Stage at diagnosis accounted for only part of these differences. Possible factors responsible for ethnic inequalities might include access to specialized cancer services and the quality of care received.

Esophageal cancer epidemiology in blacks and whites: racial and gender disparities in incidence, mortality, survival rates and histology.

Abstract: BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease.

Comparative changes in adult vs. juvenile survival affecting population trends of African ungulates

Abstract: Summary 1 Among large mammalian herbivores, juvenile survival tends to vary widely and may thus have a greater influence on population dynamics than the relatively constant survival rates typical of adults. However, previous studies yielding stage-specific survival rates have been mostly on temperate zone ungulates and in environments lacking large predators. 2 Annual censuses coupled with assessments of population structure enabled annual survival rates to be estimated for the juvenile, yearling and adult segments of nine ungulate species in South Africa's Kruger National Park. Four of these populations persisted at high abundance after initial increases (zebra, wildebeest, impala and giraffe), while five showed progressive declines during the latter part of the study period (kudu, waterbuck, warthog, sable antelope and tsessebe). 3 The magnitude of the reduction in adult survival between periods showing contrasting population trends was similar to or greater than the corresponding change in juvenile survival for five of the nine species. Accordingly alterations in population phase, from increasing to stable or stable to declining, were brought about mostly through reduced survival within the adult segment. Elevated predation risk may have been responsible. 4 Estimates were derived of the relative survival rates of juveniles, yearlings and adult segments associated with zero population growth, and the survival differential between adult males and females, for all nine species. Stage-specific survival rates appeared dependent on body mass, but with some anomalies. The sex difference in adult survival showed no obvious relation with sexual size dimorphism. 5 For large mammalian herbivores, assessments of relative elasticities of stage-specific survival rates on population growth are problematic for several reasons. Sensitivity to corresponding increments in either survival or mortality rates provides a better basis for ecological or adaptive interpretation. Survival rates of adults seem to vary more over multiyear periods compared with mainly annual fluctuations in juvenile survival. More studies are needed on tropical species and in environments retaining large predators to support generalizations about factors influencing ungulate life-history patterns.

Long-Term Survival Rates of Patients With Prostate Cancer in the Prostate-Specific Antigen Screening Era: Population-Based Estimates for the Year 2000 by Period Analysis

Abstract: Purpose In the era of widespread prostate specific antigen (PSA) screening, a large proportion of older men have to live with a diagnosis of prostate cancer. In this study, we applied a new method for up-to-date analysis of long-term survival to evaluate if and to what extent these patients still have any excess mortality compared to the general population. Methods Five- and 10-year absolute and relative survival rates for the year 2000 were derived from the 1973 to 2000 database of the Surveillance, Epidemiology and End Results Program using the recently introduced period analysis methodology. Results Overall, 5- and 10-year relative survival rates were approximately 99% and 95%; that is, excess mortality compared with the general population was as low as 1% and 5% within 5 and 10 years following diagnosis, respectively. Two-thirds of patients were diagnosed with well or moderately differentiated localized/regional prostate cancer, and among these patients, 5- and 10-year relative survival rates were above 100% (indicating the lack of any excess mortality) at all ages. Conclusion While the value of PSA screening for lowering mortality due to prostate cancer remains to be shown by randomized clinical trials, the majority of patients diagnosed with prostate cancer in the PSA screening era do not have excess mortality compared to the general population under current patterns of medical care. This information may be important for both clinical management of, and for patients’ coping with, the disease. J Clin Oncol 23:441-447. © 2005 by American Society of Clinical Oncology

Additive and multiplicative covariate regression models for relative survival incorporating fractional polynomials for time-dependent effects.

Abstract: Relative survival is used to estimate patient survival excluding causes of death not related to the disease of interest. Rather than using cause of death information from death certificates, which is often poorly recorded, relative survival compares the observed survival to that expected in a matched group from the general population. Models for relative survival can be expressed on the hazard (mortality) rate scale as the sum of two components where the total mortality rate is the sum of the underlying baseline mortality rate and the excess mortality rate due to the disease of interest. Previous models for relative survival have assumed that covariate effects act multiplicatively and have thus provided relative effects of differences between groups using excess mortality rate ratios. In this paper we consider (i) the use of an additive covariate model, which provides estimates of the absolute difference in the excess mortality rate; and (ii) the use of fractional polynomials in relative survival models for the baseline excess mortality rate and time-dependent effects. The approaches are illustrated using data on 115 331 female breast cancer patients diagnosed between 1 January 1986 and 31 December 1990. The use of additive covariate relative survival models can be useful in situations when the excess mortality rate is zero or slightly less than zero and can provide useful information from a public health perspective. The use of fractional polynomials has advantages over the usual piecewise estimation by providing smooth estimates of the baseline excess mortality rate and time-dependent effects for both the multiplicative and additive covariate models. All models presented in this paper can be estimated within a generalized linear models framework and thus can be implemented using standard software.

Trends in the management and survival of digestive tract cancers among patients aged over 80 years.

Abstract: Summary Background: Advances have occurred in the management of digestive tract cancers, but it is not known how much they have benefited the elderly. Aims: To determine trends in treatment, stage at diagnosis and prognosis of digestive tract cancers among patients aged ≥80 years in two well-defined French populations. Design: Time trends were studied in three age classes and in 5 four-year time intervals. A multivariate relative survival analysis was performed to estimate the independent effect of both age and period on prognosis. Results: Five-year relative survival rates were 1.9% for oesophageal cancer, 12% for stomach cancer, 41% for colon cancer and 37% for rectal cancer. The survival rates improved between the first and the fifth period for all cancer sites except for oesophageal cancer. This improvement remained significant after adjustment for age, sex, site and treatment. It was associated with an increase in the proportion of patients who underwent curative resection. Very few patients received adjuvant chemotherapy. The use of adjuvant radiotherapy for rectal and oesophageal cancers did not significantly increase over time. Conclusions: Except for oesophageal cancers, substantial advances in the care of digestive tract cancers in the elderly have been achieved. Surgery should not be restricted on the basis of age alone. Further improvements can be made in particular to enhance adjuvant therapy whenever possible.

Breast cancer survival in South Asian women in England and Wales

Abstract: Study objectives: To estimate ethnic and socioeconomic differences in breast cancer incidence and survival between South Asians and non-South Asians in England and Wales, and to provide a baseline for surveillance of cancer survival in South Asians, the largest ethnic minority. Setting: 115 712 women diagnosed with first primary invasive breast cancer in England and Wales during 1986–90 and followed up to 1995. Methods/design: Ethnic group was ascribed by a computer algorithm on the basis of the name. Incidence rates were derived from 1991 census population denominators for each ethnic group. One and five year relative survival rates were estimated by age, quintile of material deprivation, and ethnic group, using national mortality rates to estimate expected survival. Main results: Age standardised incidence was 29% lower among South Asian women (40.5 per 100 000 per year) than among all other women (57.4 per 100 000). Five year age standardised relative survival was 70.3% (95%CI 65.2 to 75.4) for South Asian women and 66.7% (66.4 to 67.0) for other women. For both ethnic groups, survival was 8%–9% higher for women in the most affluent group than those in the most deprived group. In each deprivation category, however, survival was 3%–8% higher for South Asian women than other women. Conclusions: This national study confirms that breast cancer incidence is substantially lower in South Asians than other women in England and Wales. It also provides some evidence that South Asian women diagnosed up to 1990 had higher breast cancer survival than other women in England and Wales, both overall and in each category of deprivation.

Variation in survival after diagnosis of breast cancer in

Abstract: Background: Survival after diagnosis of cancer is a key criterion for cancer control. Major survival differences between time periods and countries have been reported by the EUROCARE studies. We investigated whether similar differences by period and region existed in Switzerland. Methods: Survival of 11 376 cases of primary invasive female breast cancer diagnosed between 1988 and 1997 and registered in seven Swiss cancer registries covering a population of 3.5 million was analysed. Results: Comparing the two periods 1988–1992 and 1993–1997, age-standardized 5 year relative survival improved globally from 77% to 81%. Furthermore, multivariate analysis adjusting for age, tumour size and nodal involvement identified regional survival differences. Survival was lowest in the rural parts of German-speaking eastern Switzerland and highest in urbanised regions of the Latin- and German-speaking northwestern parts of the country.

Socio-economic factors and health care system characteristics related to cancer survival in the elderly. A population-based analysis in 16 European countries (ELDCARE project)

Abstract: The ELDCARE study aims to investigate, at the ecological level, the relationships between socio-economic variables and cancer survival in patients aged 65 years and over. Survival data for patients diagnosed during the period 1985-1989 and followed up to 1994 were provided by 43 European Cancer Registries in 16 countries participating in the EUROCARE 2 project. Relative survival was computed by Hakulinen's methods. Data on socio-economic factors were collected by national statistics offices for the years around 1991. Pearson's correlation was used to study the relationships between cancer survival and socio-economic factors. We selected four groups of variables. The first group included macro-economic variables (such as Gross Domestic Product, GDP; Total Health Expenditure, THE); the second, the main characteristics of national health care systems; the third, demographic factors; and the fourth, variables on labour market organisation. The countries with the largest proportions of elderly populations, in Northern and Western Europe, spent more on health than the less affluent countries of Eastern Europe. GDP was strongly related to THE but a very high variability in Computed Tomography Scanners (CTS) among countries with similar THE was observed. Indeed, those countries with THE around US 1500 dollars per capita had survival rates for breast cancer ranging from 67 to 82%. Cancer survival in elderly patients in Europe was most strongly related to GDP and THE, especially for good prognosis cancers. Survival was strongly correlated with health care technologies, particularly CTS, but not with health employment. Survival was positively correlated with proportion of married elderly people (and negatively with widowed elderly), suggesting a role played by social support in influencing the prognosis of elderly patients. These results highlight how health outcomes in the elderly are a complex phenomenon, not determined only by GDP and THE, but affected by social organisation and life habits as well as economic development conditions.

Regional differences in breast cancer survival despite common guidelines.

Abstract: PURPOSE: Despite a uniform regional breast cancer care program, breast cancer survival differs within regions. We therefore examined breast cancer survival in relation to differences in diagnostic activity, tumor characteristics, and treatment in seven Swedish counties within a single health care region. METHODS: We conducted a population-based observational study using a clinical breast cancer register in one Swedish health care region. Eligible women (n = 7,656) ages 40 to 69 years diagnosed with primary breast cancer between 1992 and 2002 were followed up until 2003. The 7-year relative survival ratio was used to estimate breast cancer survival. Excess mortality was modeled using Poisson regression to study differences in survival between counties. RESULTS: The 7-year relative survival for breast cancer patients was significantly lower (up to 7% in absolute risk difference) in one county (county A) compared with the others. This difference existed only among women diagnosed before 1998, ages 50 to 59 years, and was strongest among stage II breast cancer patients. Adjustment for amount of diagnostic activity eliminated the survival differences among the counties. The amount of diagnostic activity was also lower in county A during the same time period. After county A, during 1997-1998, began to adhere strictly to the regional breast cancer care program, neither any survival differences nor diagnostic activity differences were observed. INTERPRETATIONS: Markers of diagnostic activity explained survival differences within our region, and the underlying mechanisms may be several. Low diagnostic activity may entail later diagnosis or inadequate characterization of the tumor and thereby missed treatment opportunities. Strengthening of multidisciplinary management of breast cancer can improve survival.

An individual measure of relative survival

Abstract: Summary. Relative survival techniques are used to compare survival experience in a study cohort with that expected if background population rates apply. The techniques are especially useful when cause-specific death information is not accurate or not available as they provide a measure of excess mortality in a group of patients with a certain disease. Whereas these methods are based on group comparisons, we present here a transformation approach which instead gives for each individual an outcome measure relative to the appropriate background population. The new outcome measure is easily interpreted and can be analysed by using standard survival analysis techniques. It provides additional information on relative survival and gives new options in regression analysis. For example, one can estimate the proportion of patients who survived longer than a given percentile of the respective general population or compare survival experience of individuals while accounting for the population differences. The regression models for the new outcome measure are different from existing models, thus providing new possibilities in analysing relative survival data. One distinctive feature of our approach is that we adjust for expected survival before modelling. The paper is motivated by a study into the survival of patients after acute myocardial infarction.

The National Prostate Cancer Register in Sweden 1998-2002: trends in incidence, treatment and survival

Abstract: OBJECTIVES: To provide a descriptive review of the establishment of the National Prostate Cancer Register (NPCR) in Sweden, to present clinical characteristics at diagnosis and to calculate the relative survival of different risk groups after 5 years. MATERIAL AND METHODS: Since 1998, data on all newly diagnosed prostate cancers, including TNM classification, grade of malignancy, prostate-specific antigen (PSA) level and treatment, have been prospectively collected. For the 35,223 patients diagnosed between 1998 and 2002, relative survival in different risk groups has been calculated. RESULTS: Between 1998 and 2002, 96% of all prostate cancer cases diagnosed in Sweden were registered in the NPCR. The number of new cases increased from 6137 in 1998 to 7385 in 2002. The age-standardized rate rose in those aged 100 ng/ml) decreased by 17%. The proportion of patients receiving curative treatment doubled. Patients with N1 or M1 disease or poorly differentiated tumours (G3 or Gleason score 8-10) had a markedly reduced relative 5-year survival rate. CONCLUSIONS: It is possible to establish a nationwide prostate cancer register including basic data for assessment of the disease in the whole of Sweden. The introduction of PSA screening has increased the detection of early prostate cancer in younger men and, to a lesser extent, decreased the incidence of advanced disease. The effect of these changes on mortality is obscure but the NPCR in Sweden will serve as an important tool in such evaluation.

Long-term preservation of human saphenous vein by green tea polyphenol under physiological conditions.

Abstract: This paper reports on cases of malignant melanoma of the skin diagnosed in Finland between 1963 and 1968. Sufficient data for estimating the survival was obtained in 691 cases. The ten-year relative survival rate for the entire series was 41% for males and 53% for females. This sex difference remained constant throughout the various divisions of the material. The ten-year relative survival rate of males with tumour in stage I was 52% and that of females 59%. The highest survival rate of stage I tumour in males was for the tumours of the lower extremities (77%) and in females for those in the head and neck (79%). The relative survival of patients with tumour of the trunk in stage I was lowest in both sexes (males 49%, females 45%). The ten-year relative survival rate of patients with a local recurrence was 33% in males and 27% in females. The relative ten-year survival rates of patients with superficial melanoma were 130% in males and 92% in females.