Patterns of inpatient surgeries for the top four cancers in the United States, National Hospital Discharge Survey, 1988–95

Background: At a time when the population is aging and medical practices are rapidly changing, ongoing surveillance of surgical treatments for cancer is valuable for health services planning. Methods: We used data from the National Hospital Discharge Survey for patients with discharge diagnoses of lung, prostate, female breast, and colorectal cancer during 1988–95 to estimate population-based rates and numbers of inpatient surgical procedures. Results: In 1988–91, rates of lobectomy for lung cancer were significantly higher in males than females. By 1994–95, the male/female differences had largely disappeared due to increasing trends among females and decreasing trends among males. During 1988–95, surgeries on the large intestine for colorectal cancer, including right hemicolectomy and sigmoidectomy, decreased significantly, as did abdominoperineal resections of the rectum. Anterior resections of the rectum increased significantly. Radical prostatectomies for prostate cancer increased from 34,000 in 1988–89 to 104,000 in 1992–93 and then decreased to 87,000 in 1994–95; rates followed a similar pattern. Finally, the number and rates of inpatient mastectomies for female breast cancer decreased over the study period (from 219,000 to 180,000 and from 78.8 to 61.5 per 100,000, respectively). Conclusion: These trends in inpatient surgeries for the major cancers in the US probably reflect changes in disease occurrence and modified treatment recommendations.     

Cancer incidence and mortality in Ontario First Nations, 1968-1991 (Canada)

Objective: To determine cancer incidence and mortality rates in Ontario First Nations (FN) people (native Indians) during 1968–1991 and to compare these with rates in the Ontario population. Methods: A cohort of 141,290 Ontario FN was created from registration files maintained by the Canadian government. Cancers and deaths were ascertained by linkage to the provincial cancer registry and mortality file, which also provided general population comparison data. Results: Cancer incidence was significantly lower in FN compared to the general population for all cancer (rate ratio (RR) = 0.72 for females; 0.62 for males), breast cancer (RR = 0.54), lung cancer in men (RR = 0.68), prostate cancer (RR = 0.57) and colorectal cancer (RR = 0.58 and 0.57 in men and women, respectively). Rates were significantly higher in FN for cervical cancer (RR = 1.73) and gallbladder cancer (2.05 and 2.20 in men and women, respectively). Incidence rates increased significantly in FN people between 1968–1975 and 1984–1991 for all cancer and for the major cancers (breast, lung, prostate and colorectal). Colorectal cancer rate ratios were significantly higher in 1984–1991 than in 1968–1975, indicating converging incidence rates. Patterns of cancer mortality were similar. Conclusions: These trends are compatible with a population in epidemiologic transition to the Euro-American disease pattern which is dominated by chronic diseases.     

Trends in the Incidence of 15 Common Cancers in Hong Kong, 1983-2008

Background: The objective of this study WAS to describe cancer incidence rates and trends among THE HongKong population for the period 1983-2008. Methods: Incident cases and population data from 1983 to 2008 wereobtained from the Hong Kong Cancer Registry and the Census and Statistics Department, respectively. Agestandardizedincidence rates (ASIR) were estimated and joinpoint regression was applied to detect significantchanges in cancer morbidity. Results: For all cancers combined, the ASIR showed declining trends (1.37%in men, 0.94% in women), this also being the case for cancers of lung, liver, nasopharynx, stomach, bladder,oesophagus for both genders and cervix cancer for women. With cancer of thyroid, prostate, male colorectal,corpus uteri, ovary and female breast cancer an increase was evident throughout the period. The incidence forleukemia showed a stable trend since early 1990s, following an earlier decrease. Conclusions: Although overallcancer incidence rates and certain cancers showed declining trends, incidence trends for colorectal, thyroid andsex-related cancers continue to rise. These trends in cancer morbidity can be used as an important resource toplan and develop effective programs aimed at the control and prevention of the spread of cancer amongst theHong Kong population. It is particularly useful in allowing projection of future burdens on the society with theincrease in certain cancer incidences.     

Survival patterns for the top four cancers in Canada: the effects of age, region and period.

This study examined the variations in survival rates (1989-1991) and the trends (1969-1991), by sex, age and province, for patients diagnosed with breast, colorectal, lung or prostate cancer in Canada and compared the Canadian rates with those of nine American SEER registries. Five-year age-standardized relative survival rates (ASRs) were calculated, and the trends were estimated from variance-weighted linear regression of the ASRs for five periods of diagnosis (1969-1973, 1974-1978, 1979-1983, 1984-1988 and 1989-1991). In 1989-1991, the ASR varied among provinces for each cancer except female colorectal cancer. The lowest survival rates were observed in the youngest patients (15-44) for breast and prostate cancers, and in the oldest patients (75-99) of both sexes for lung and colorectal cancers. Over the five periods, a major trend toward improved survival was observed for breast, prostate and colorectal cancers (P<0.008), whereas no changes were seen for lung cancer. The ASRs in the western region were higher than in the Atlantic region over time (P<0.02) for each cancer. From the third period onward, the ASRs for Canadian patients with lung cancer were similar to those for the US patients and lower than for Canadian patients with breast, prostate or colorectal cancer. The observed increases in ASR for breast and prostate cancer are likely due to the increased use of screenings and the improved treatment modalities.     

石家庄市区户籍人口2012年恶性肿瘤发病分析

目的:研究石家庄市区户籍人口2012年恶性肿瘤发病情况。方法:2012年石家庄市区237 万户籍人口医疗保险覆盖率达99% 以上。将2012年1 月1 日至12月31日于石家庄市医保中心首次报销的住院恶性肿瘤个案经与医院数据核对后作为分子,市公安局2012年中户籍人口数作为分母,计算发病率,分析性别、年龄别和部位别肿瘤的发病特点。结果:2012年石家庄市区户籍人口恶性肿瘤粗发病率为237.53/10万,中国人口年龄调整发病率（中调率）为129.86/10万,世界人口年龄调整发病率（世调率）为167.71/10万。发病率随年龄增加而增加,男女均于75~79岁组达到高峰,分别为1 729.42/10万和867.35/10万。男性前10位的恶性肿瘤依次为肺癌、胃癌、结直肠癌、肝癌、食管癌、肾癌、前列腺癌、白血病、膀胱癌、淋巴瘤;女性分别为乳腺癌、肺癌、结直肠癌、胃癌、宫颈癌、子宫体癌、卵巢癌、淋巴瘤、食管癌及肝癌。石家庄市区户籍人口男性恶性肿瘤的粗发病率、世调率分别为269.05/10万、187.52/10万,女性分别为207.57/10万、150.44/10万。与全国31个城市2009年的世调率相比,男性肺癌、胃癌、结直肠癌与全国水平相近,女性乳腺癌高于全国水平;与北京市相比,石家庄市区男性胃癌、食管癌世调率分别约为北京市男性的2倍,但北京市男性胰腺癌、前列腺癌,女性甲状腺癌的世调率分别是石家庄市区的2 倍。结论:石家庄市区户籍人口2012年主要恶性肿瘤如肺癌、胃癌、结直肠癌、乳腺癌的世调率与全国31个城市2009年的水平相当;与北京市相比,食管癌、胃癌高发,但甲状腺癌、前列腺癌、胰腺癌低发。      

Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities

In this article, the American Cancer Society provides the estimated number of new cancer cases and deaths for blacks in the United States and the most recent data on cancer incidence, mortality, survival, screening, and risk factors for cancer. Incidence data are from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, and mortality data are from the National Center for Health Statistics. Approximately 189,910 new cases of cancer and 69,410 cancer deaths will occur among blacks in 2016. Although blacks continue to have higher cancer death rates than whites, the disparity has narrowed for all cancers combined in men and women and for lung and prostate cancers in men. In contrast, the racial gap in death rates has widened for breast cancer in women and remained level for colorectal cancer in men. The reduction in overall cancer death rates since the early 1990s translates to the avoidance of more than 300,000 deaths among blacks. In men, incidence rates from 2003 to 2012 decreased for all cancers combined (by 2.0% per year) as well as for the top 3 cancer sites (prostate, lung, and colorectal). In women, overall rates during the corresponding time period remained unchanged, reflecting increasing trends in breast cancer combined with decreasing trends in lung and colorectal cancer rates. Five‐year relative survival is lower for blacks than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Progress in reducing cancer death rates could be accelerated by ensuring equitable access to prevention, early detection, and high‐quality treatment. CA Cancer J Clin 2016;66:290‐308. © 2016 American Cancer Society     

Race, socioeconomic status and stage at diagnosis for five common malignancies

Background: African-Americans are more likely than Caucasians to be diagnosed at an advanced stage of colorectal, lung, breast, cervical, and prostate cancers. This study explores if racial differences in stage at diagnosis can be explained by socioeconomic status (SES) differences. Previous studies investigating this association have used aggregate SES indicators from census tract of residence; we used census block-group data, representing a smaller, potentially more homogenous group. Methods: We included all African-American and Caucasian invasive cancers of the colon and rectum, lung and bronchus, female breast, cervix uteri, and prostate that were diagnosed between January 1, 1988 and December 31, 1992 in the Detroit area. Stage of disease at diagnosis was grouped as local or non-local. An SES value was calculated for each case using aggregate 1990 US Census data for education, poverty status, and occupation specific to each case's census block-group. Logistic regression analysis was used to model the probability of non-local stage using SES, race, age group, and sex as covariates. Results: SES was an independent predictor of stage at diagnosis for each cancer site, with cases from the highest SES block-group more likely to present with local stage disease than those from the lowest SES group. Race independently predicted stage only for breast and prostate cancers; African-Americans presented with more advanced stage than Caucasians. Conclusions: Based on census block-group aggregate data, SES is an important predictor of stage at diagnosis, most likely accounting for much of the disparity in stage between African-Americans and Caucasians for colorectal, lung, and cervical cancers. Biological factors may play a role in racial disparities for breast and prostate cancer stage at diagnosis.     

Population-based cancer incidence analysis in Beijing, 2008-2012

Objective: To analyze the incidence of cancer during 2008-2012 in Beijing, China, and compare the cancer spectrum with that during 1998-1999.Methods: Data from the Beijing Cancer Registry(BCR), which covered 12 million residents and 16 administrative regions in Beijing, were checked and evaluated on basis of the criteria of data quality from the National Central Cancer Registry(NCCR) of China. Incidences were calculated stratified by cancer type, sex, areas(urban/rural), and age. The Chinese census population in 1982 and the world Segi’s population were used for calculating the age-standardized incidences.Results: A total of 177,101 new cancer cases were diagnosed in Beijing between 2008 and 2012. The crude incidence rate(CR) of all cancers was 282.64/100,000(290.71/100,000 in males and 274.45/100,000 in females). The age-standardized rates by Chinese standard population(ASR-China) and by world standard population(ASR-world) were 124.46/100,000 and 161.18/100,000, respectively. Female breast cancer was the most common cancer, followed by lung cancer, colorectal cancer, liver cancer, and stomach cancer, with the CR of 59.87/100,000, 59.21/100,000, 32.49/100,000, 19.81/100,000 and 17.96/100,000, respectively. In urban areas, female breast cancer(68.50/100,000) was still the most common cancer, followed by lung cancer(61.23/100,000), colorectal cancer(37.23/100,000), prostate cancer(20.49/100,000) and stomach cancer(20.07/100,000). In rural areas, lung cancer(55.94/100,000) was the most common cancer, followed by female breast cancer(45.87/100,000), colorectal cancer(24.77/100,000), liver cancer(20.68/100,000) and stomach cancer(14.52/100,000). Great changes of the cancer spectrum were found from the period of 1998-1999 to the period of 2011-2012 in Beijing.Conclusions: The cancer burden in Beijing was heavier than the national average level. Cancer prevention and control strategies, especially for lung, colorectal, prostate and female thyroid cancers, should be enhanced.     

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

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.     

Age- and time-dependent changes in cancer incidence among immigrants to Sweden: colorectal, lung, breast and prostate cancers

To examine the role of gender, age at immigration and length of stay on incidence trends of common cancers, we studied risk of colorectal, lung, breast and prostate cancers in immigrants to Sweden from 1958 to 2008. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios for common cancers among immigrants compared to Swedes. Immigrants were classified into "high-risk" countries when their risk was increased, into "low-risk" when their risk was decreased and into "other" when their risk was nonsignificant. Among those who immigrated at younger age (<30 years), we found an increasing trend for colorectal cancer risk in low-risk men and high-risk women. Among those who immigrated at older age (≥ 30 years), a decreasing lung cancer risk in high-risk men and an increasing breast cancer risk in low-risk women were observed. The increasing trend of prostate cancer risk was independent of age at immigration. The risk trends for "other" immigrants were between the risks of low- and high-risk countries. The gender-specific shifts in cancer risks in immigrants toward the risk in natives indicate a major role of sex, age at immigration and environmental exposures in colorectal and lung cancers risks. In contrast, the unchanged trend of breast cancer among those who immigrated at younger ages and an increasing trend for those who migrated at older ages may suggest a limited effect for environmental exposures, especially at younger age. Our study points out a role of age at immigration on the risk trend of cancer.     

Serum total thiol levels and the risk of lung,colorectal, breast and prostate cancer: A prospective case–cohort study

Free thiol groups of intra and extracellular molecules are considered to be antioxidative and to protect cells from damage caused by free radicals. However, the associations of serum total thiol levels (TTL) with the incidences of the four most frequent cancer sites have not yet been investigated in a large population-based, prospective study. TTL was measured in case–cohort design in a sample from the population-based, Norwegian Tromsø 3 study (cancer cases: n = 941; random subcohort: n = 1,000) and was repeatedly measured at Tromsø 5. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by weighted multivariable-adjusted Cox regression with time-dependent modeling of TTL for incident lung, colorectal, breast and prostate cancer. High serum TTL were associated with a reduced risk of all four major cancers. The associations with lung (top vs. bottom tertile: HR, 0.64; 95% CI, 0.41, 0.99) and breast cancer (top vs. bottom tertile: HR, 0.64; 95% CI, 0.42, 0.96) were statistically significant, whereas associations with colorectal (top vs. bottom tertile: HR, 0.79; 95% CI, 0.54, 1.16) and prostate cancer (top vs. bottom tertile: HR, 0.79; 95% CI, 0.53, 1.17) were not statistically significant but pointed in the same protective direction. These findings from a large, prospective Norwegian cohort study suggest a preventive role of thiols against the development of the four most frequent cancers. Whereas associations with breast and lung cancer could be shown with statistical significance, larger studies are needed to corroborate potential associations of TTL with colorectal and prostate cancer.     

Risk of prostate, breast and colorectal cancer after skin cancer diagnosis

Ultraviolet radiation is the major cause of skin cancer, but promotes vitamin D synthesis, and vitamin D has been inversely related to the risk of several common cancers including prostate, breast and colorectum. We therefore computed the incidence of prostate, breast and colorectal cancer following skin cancer using the datasets of the Swiss cancer Registries of Vaud and Neuchatel. Between 1974 and 2005, 6,985 histologically confirmed squamous cell skin cancers, 21,046 basal cell carcinomas and 3,346 cutaneous malignant melanomas were registered, and followed up to the end of 2005 for the occurrence of second primary cancer of the prostate, breast and colorectum. Overall, 680 prostate cancers were observed versus 568.3 expected (standardized incidence ratio (SIR) = 1.20; 95% confidence interval (CI): 1.11-1.29), 440 breast cancers were observed versus 371.5 expected (SIR = 1.18; 95% CI: 1.08-1.30) and 535 colorectal cancers were observed versus 464.6 expected (SIR = 1.15; 95% CI: 1.06-1.25). When basal cell, squamous cell and skin melanoma were considered separately, all the SIRs for prostate, breast and colorectal cancers were around or slightly above unity. Likewise, the results were consistent across strata of age at skin cancer diagnosis and location (head and neck versus others), and for male and female colorectal cancers. These findings, based on a population with a long tradition of systematic histologic examination of all surgically treated skin lesions, do not support the hypothesis that prostate, breast and colorectal cancer risk is decreased following skin cancer.     

Breast and cervical cancer screening and disease incidence and stage in New Mexico

Objective: Data on the health impact of breast and cervical cancer screening programs for low-income women are limited. We sought to determine whether a statewide program to provide breast and cervical cancer screening services influenced trends in disease incidence and stage. Methods: We assessed trend data regarding breast and cervical cancer incidence and stage gathered by the New Mexico Tumor Registry and the Surveillance, Epidemiology, and End Results Program before (1975 through 1990) and during (1991 through 1998) implementation of the New Mexico Breast and Cervical Cancer Screening Program. Results: The incidence of cervical carcinoma in-situ increased rapidly in 1991. The incidence per 100,000 population for in-situ breast cancer (2.9 in 1975–1982, 8.5 in 1983–1990, and 16.8 in 1991–1998) and local breast cancer (39.9 in 1975–1982, 46.5 in 1983–1990, and 61.3 in 1991–1998) also increased during the program operation. Notably, a significant increase in incidence per 100,000 population for regional and distant breast cancer from 1975–1982 (31.5) to 1983–1990 (36.0) declined during the 1991–1998 (33.2) period of program operation. Conclusions: The statewide screening program improved detection of breast and cervical cancer and helped reduce the incidence of advanced stages of breast cancer in a relatively short time period.     

Joint Spatio-temporal Shared Component Model with an Application in Iran Cancer Data

Background: Among the proposals for joint disease mapping, the shared component model has become morepopular. Another advance to strengthen inference of disease data is the extension of purely spatial models to includetime aspect. We aim to combine the idea of multivariate shared components with spatio-temporal modelling in a jointdisease mapping model and apply it for incidence rates of seven prevalent cancers in Iran which together account forapproximately 50% of all cancers. Methods: In the proposed model, each component is shared by different subsetsof diseases, spatial and temporal trends are considered for each component, and the relative weight of these trends foreach component for each relevant disease can be estimated. Results: For esophagus and stomach cancers the Northernprovinces was the area of high risk. For colorectal cancer Gilan, Semnan, Fars, Isfahan, Yazd and East-Azerbaijanwere the highest risk provinces. For bladder and lung cancer, the northwest were the highest risk area. For prostate andbreast cancers, Isfahan, Yazd, Fars, Tehran, Semnan, Mazandaran and Khorasane-Razavi were the highest risk part.The smoking component, shared by esophagus, stomach, bladder and lung, had more effect in Gilan, Mazandaran,Chaharmahal and Bakhtiari, Kohgilouyeh and Boyerahmad, Ardebil and Tehran provinces, in turn. For overweightand obesity component, shared by esophagus, colorectal, prostate and breast cancers the largest effect was found forTehran, Khorasane-Razavi, Semnan, Yazd, Isfahan, Fars, Mazandaran and Gilan, in turn. For low physical activitycomponent, shared by colorectal and breast cancers North-Khorasan, Ardebil, Golestan, Ilam, Khorasane-Razavi andSouth-Khorasan had the largest effects, in turn. The smoking component is significantly more important for stomachthan for esophagus, bladder and lung. The overweight and obesity had significantly more effect for colorectal than ofesophagus cancer. Conclusions: The presented model is a valuable model to model geographical and temporal variationamong diseases and has some interesting potential features and benefits over other joint models.     

The hospital burden of disease associated with bone metastases and skeletal‐related events in patients with breast cancer,lung cancer,or prostate cancer in Spain

POCKETT R.D., CASTELLANO D., MCEWAN P., OGLESBY A., BARBER B.L. & CHUNG K. (2010) European Journal of Cancer Care 19 , 755–760
The hospital burden of disease associated with bone metastases and skeletal‐related events in patients with breast cancer, lung cancer, or prostate cancer in Spain Metastatic bone disease (MBD) is the most common cause of cancer pain and of serious skeletal‐related events (SREs) reducing quality of life. Management of MBD involves a multimodal approach aimed at delaying the first SRE and reducing subsequent SREs. The objective of the study was to characterise the hospital burden of disease associated with MBD and SREs following breast, lung and prostate cancer in Spain. Patients admitted into a participating hospital, between 1 January 2003 and 31 December 2003, with one of the required cancers were identified and selected for inclusion into the study. The index admission to hospital, incidence of patients admitted and hospital length of stay were analysed. There were 28 162 patients identified with breast, lung and prostate cancer. The 3 year incidence rates of hospital admission due to MBD were 95 per 1000 for breast cancer, 156 per 1000 for lung cancer and 163 per 1000 for prostate cancer. For patients admitted following an SRE, the incidence rates were 211 per 1000 for breast cancer, 260 per 1000 for lung cancer and 150 per 1000 for prostate cancer. This study has shown that cancer patients consume progressively more hospital resources as MBD and subsequent SREs develop.     

Annual report to the nation on the status of cancer, 1975-2004, featuring cancer in American Indians and Alaska Natives

BACKGROUND: The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate annually to provide updated information on cancer occurrence and trends in the U.S. The 2007 report features a comprehensive compilation of cancer information for American Indians and Alaska Natives (AI/AN). METHODS: Cancer incidence data were available for up to 82% of the U.S. population. Cancer deaths were available for the entire U.S. population. Long-term (1975 through 2004) and fixed-interval (1995 through 2004) incidence and mortality trends were evaluated by annual percent change using regression analyses (2-sided P < .05). Cancer screening, risk factors, socioeconomic characteristics, incidence data, and stage were compiled for non-Hispanic whites (NHW) and AI/AN across 6 regions of the U.S. RESULTS: Overall cancer death rates decreased by 2.1% per year from 2002 through 2004, nearly twice the annual decrease of 1.1% per year from 1993 through 2002. Among men and women, death rates declined for most cancers. Among women, lung cancer incidence rates no longer were increasing and death rates, although they still were increasing slightly, were increasing at a much slower rate than in the past. Breast cancer incidence rates in women decreased 3.5% per year from 2001 to 2004, the first decrease observed in 20 years. Colorectal cancer incidence and death rates and prostate cancer death rates declined, with colorectal cancer death rates dropping more sharply from 2002 through 2004. Overall, rates for AI/AN were lower than for NHW from 1999 through 2004 for most cancers, but they were higher for cancers of the stomach, liver, cervix, kidney, and gallbladder. Regional analyses, however, revealed high rates for AI/AN in the Northern and Southern Plains and Alaska. For cancers of the breast, colon and rectum, prostate, and cervix, AI/AN were less likely than NHW to be diagnosed at localized stages. CONCLUSIONS: For all races/ethnicities combined in the U.S., favorable trends in incidence and mortality were noted for lung and colorectal cancer in men and women and for breast cancer in women. For the AI/AN population, lower overall cancer incidence and death rates obscured important variations by geographic regions and less favorable healthcare access and socioeconomic status. Enhanced tobacco control and cancer screening, especially in the Northern and Southern Plains and Alaska, emerged as clear priorities.     

2015年上海市恶性肿瘤流行特征分析

背景与目的：恶性肿瘤严重威胁着居民健康，已成为重大的公共卫生问题。本研究旨在描述和分析2015年上海市恶性肿瘤流行特征。方法：根据上海市恶性肿瘤病例报告登记系统收集的恶性肿瘤发病和死亡资料，按地区、性别分层，分别计算恶性肿瘤发病与死亡粗率、标化率、前10位恶性肿瘤发病与死亡顺位和构成等，并应用Joinpoint统计软件分析2002—2015年上海市肺癌发病和死亡趋势，估算总体和分阶段的年度变化百分比（annual percent change，APC）。采用Segi’s世界标准人口年龄构成计算标化率。结果：2015年上海市共报告恶性肿瘤新发病例71 610例，死亡病例38 445例。病理学诊断比例（percentage of morphologically verified cases，MV%）为78.42%，只有死亡医学证明书比例（percentage of death certifications only，DCO%）为0.21%，死亡发病比（mortality to incidence ratio，M/I）为0.55。上海市恶性肿瘤粗发病率为497.33/10万，标化发病率为228.82/10万，男性标化发病率低于女性，市区低于郊区。恶性肿瘤发病在40岁以后快速上升，在80~84岁年龄组达到高峰。全市发病前10位恶性肿瘤依次为肺癌、结直肠癌、甲状腺癌、胃癌、乳腺癌、肝癌、前列腺癌、胰腺癌、脑和中枢神经系统肿瘤以及膀胱癌，前10位恶性肿瘤占全部恶性肿瘤发病的76.59%。全市恶性肿瘤粗死亡率为267.00/10万，标化死亡率为95.99/10万，男性标化死亡率高于女性，市区和郊区基本持平。死亡率在45岁以后快速上升，在≥85岁年龄组达到高峰。死亡前10位恶性肿瘤依次为肺癌、结直肠癌、胃癌、肝癌、胰腺癌、乳腺癌、食管癌、胆囊癌、前列腺癌以及脑和中枢神经系统肿瘤，前10位恶性肿瘤占全部恶性肿瘤死亡的78.07%。截至2016年12月31日，上海市共有399 027例现患肿瘤病例，现患率为2.77%。市区现患率为3.07%，郊区为2.55%。乳腺癌是现患病例中最常见的恶性肿瘤，占15.33%。现患病例生存达5年的占50.90%。肺癌是上海市发病和死亡均位居第1位的恶性肿瘤。Joinpoint趋势分析显示，2011年男性和女性肺癌发病率均出现拐点。男性肺癌发病率在2002—2011年期间显著下降，APC为-1.34%（P<0.001），自2011年起显著上升，APC为3.30%（P<0.001）；女性肺癌发病率在2002—2011年期间无明显变化趋势，较为平稳，2011—2015年期间呈快速上升趋势，APC达15.25%（P<0.001）。与发病率变化不同，2002—2015年间上海市男性肺癌死亡率呈缓慢持续下降趋势，APC为-0.72%（P=0.03），女性无明显变化趋势。与2002年相比，2015年男性和女性肺癌诊断时期别为Ⅰ期的病例比例和腺癌比例均明显上升。男性肺癌诊断时期别Ⅰ期比例由2002年的3.96%上升到2015年的11.08%，女性由3.72%上升至23.57%。男性腺癌比例由2002年的15.81%上升到2015年的34.46%，女性由28.76%上升至66.08%。结论：肺癌、消化系统恶性肿瘤、甲状腺癌和女性乳腺癌仍是威胁上海市居民健康的主要癌种。乳腺癌是现患病例中最常见的恶性肿瘤。自2011年开始，男性和女性肺癌发病率显著上升，提示与低剂量螺旋CT广泛应用有一定关系，但需更多数据和研究支持。     

Trends in UK regional cancer mortality 1991–2007

Background:

Until 1990, there was an upward trend in mortality from breast, lung, prostate, and colon cancers in the United Kingdom. With improvements in cancer treatment there has, in general, been a fall in mortality over the last 20 years. We evaluate regional cancer mortality trends in the United Kingdom between 1991 and 2007.

Methods:

We analysed mortality trends for breast, lung, prostate, and colon cancers using data obtained from the EUREG cancer database. We have described changes in age-standardised rates (using European standard population) per 100 000 for cancer mortality and generated trends in mortality for the 11 regions using Joinpoint regression.

Results:

Across all regions in the United Kingdom there was a downward trend in mortality for the four most common cancers in males and females. Overall, deaths from colon cancer decreased most rapidly and deaths from prostate cancer decreased at the slowest rate. Similar downward trends in mortality were observed across all regions of the United Kingdom with the data for lung cancer exhibiting the greatest variation.

Conclusions:

Mortality from the four most common cancers decreased across all regions of the United Kingdom; however, the rate of decline varied between cancer type and in some instances by region.     

Annual cancer incidence rates for Hispanics in the United States: surveillance, epidemiology, and end results, 1992-1996

BACKGROUND: The expansion of the Surveillance, Epidemiology, and End Results (SEER) program and the determination of annual population estimates by county level for different racial/ethnic groups since 1990 allow the calculation of annual cancer incidence rates for Hispanics. METHODS: Incidence rates were calculated for 11 SEER areas representing 25% of the Hispanic population. Standard regression analyses of log-transformed rates were used to determine the trends of the rates. RESULTS: An important measure of the cancer burden among Hispanics is the rank order of their cancers. For Hispanic males, the five major cancers (in declining order) are prostate, lung and bronchus, colon/rectum, non-Hodgkin lymphoma, and stomach cancers. For Hispanic females, the top five cancers are breast, colon/rectum, lung and bronchus, cervix, and endometrial cancers. Another measure of cancer burden is their rates relative to white non-Hispanics. Hispanic males have rates greater than white non-Hispanic males for stomach (1.6 times greater) and liver and IBD cancers (2.2), whereas Hispanic females have greater rates for cervix (2.2 times greater), liver and IBD (2.0), stomach (2.1), and gallbladder cancers (3.3). Other measures of cancer burden include the trends in Hispanic rates. Hispanic males have significant declining trends for all sites, prostate cancer, and urinary bladder cancer, and an increasing trend for liver and IBD cancers. Hispanic females have significant declining trends for cervix and urinary bladder cancers. CONCLUSIONS: The SEER cancer incidence rates and trends provide a general overview of the cancer burden among Hispanics residing in the SEER sites. This type of information is critical for determining interventions to reduce the cancer burden among Hispanics in the United States.     

Incidence and Mortality of Prostate Cancer in Canada during 1992–2010

In Canada, prostate cancer is the most common reportable malignancy in men. We assessed the temporal trends of prostate cancer to gain insight into the geographic incidence and mortality trends of this disease. Three independent population-based cancer registries were used to retrospectively analyze demographic data on Canadian men diagnosed with prostate cancer and men who died of prostate cancer between the years of 1992 and 2010. The incidence and mortality rates were calculated at the provincial, city, and forward sortation area (FSA) postal code levels by using population counts that were obtained from the Canadian Census of Population. The Canadian average incidence rate was 113.57 cases per 100,000 males. There has been an overall increasing trend in crude prostate cancer incidence between 1992 and 2010 with three peaks, in 1993, 2001, and 2007. However, age-adjusted incidence rates showed no significant increase over time. The national mortality rate was calculated to be 24.13 deaths per 100,000 males per year. A decrease was noted in crude and age-adjusted mortality rates between 1992 and 2010. Several provinces, cities, and FSAs had higher incidence/mortality rates than the national average. Several of the FSA postal codes with the highest incidence/mortality rates were adjacent to one another. Several Canadian regions of high incidence for prostate cancer have been identified through this study and temporal trends are consistent with those reported in the literature. These results will serve as a foundation for future studies that will seek to identify new regional risk factors and etiologic agents.