Correction for under-ascertainment in cancer cases in the very elderly (aged 75+): external reference method

OBJECTIVE: Any fall-off in the age-specific cancer incidence curve in oldest age groups may be suggestive of under-ascertainment. This article introduces a correction method for under-ascertainment of cancer cases in the very elderly (aged 75+). METHODS: Corrected age-specific rates for a certain cancer are calculated by summing the age-specific rates of that cancer for two lower age groups multiplied by a corresponding coefficient from an external reference cancer registry (sex-, site-, and age-specific coefficients from the Finnish Cancer Registry, a nation-wide population-based registry with high data validity). In order to examine this new method, Lithuanian Cancer Registry data for the period 1993-97 was chosen as an example. RESULTS: Age-specific incidence curves of cancers in both sexes and most of cancer sites in Lithuania demonstrated the presence of under-ascertainment in the oldest age groups (over 75). Comparison of the corrected incidence rates for 1995 with the original ones showed that without correction for under-ascertainment, crude rates (and consequently number of new cases) were underestimated by around 10%. Underestimation for the year 2050 in Lithuania was approximately 20%. Depending on cancer site and sex, the percentage of underestimation varied substantially. CONCLUSION: In many cancer registries, after correction for under-ascertainment in elderly age groups, the estimates of number of new cases and incidence rates increase. With respect to prepare future projections of incidence, when the effects of an aging population need to be taken into account, accurate age-specific rates in the upper age groups are important. Without correction, cancer occurrence measures may be substantially underestimated, which may lead to inadequate resource allocations for cancer control.     

Increased risk of cancer after Bell’s palsy: a 5-year follow-up study

Reactivation of latent herpes simplex virus (HSV) type I or varicella-zoster virus (VZV) has been recognized as the most common pathomechanism underlying Bell??s palsy. There is also increased reactivation of HSV or VZV in patients with immunosuppressed states and in cancer patients. The purpose of this study was to investigate the risk for cancer during a 5-year follow-up period after diagnosis of Bell??s palsy by using a population-based dataset in Taiwan. We used data from the ??Longitudinal Health Insurance Database??. We identified 2,618 patients with Bell??s palsy as the study cohort and randomly selected 13,090 patients to be used as a comparison cohort. Cox proportional hazards regression was performed to compare the 5-year risk of subsequent cancer between the study and comparison cohorts. We found that the incidence of cancer was 1.55 (95?% CI 1.35?C1.78) per 100 person-years for patients with Bell??s palsy and 1.09 (95?% CI 1.02?C1.18) per 100 person-years for comparison patients. After censoring cases that died from non-cancer causes during the follow-up period and adjusting for urbanization, monthly income, geographic region, and diabetes, the hazard ratio (HR) for cancer during the 5-year follow-up period for patients with Bell??s palsy was 1.43 times that for comparison patients (95?% CI 1.22?C1.73). There was a particularly increased risk of oral cancer (HR?=?2.49; 95?% CI 1.54?C4.03) for patients with Bell??s palsy compared with the other patients. We conclude that patients with Bell??s palsy were at significant risk of cancer during a 5-year follow-up period after diagnosis.     

Cancer Prevalence in Aichi,Japan for 2012: Estimates Based on Incidence and Survival Data from Population-Based Cancer Registry

Background: Cancer is the leading cause of death among both men and women in Japan. Monitoring cancer prevalence is important because prevalence data play a critical role in the development and implementation of health policy. We estimated cancer prevalence in 2012 based on cancer incidence and 5-year survival rate in Aichi Prefecture using data from a population-based cancer registry, the Aichi Cancer Registry, which covers 7.4 million people. Methods: The annual number of incident cases between 2008 and 2012 was used. Survival data of patients diagnosed in 2006–2008 and followed up until the end of 2012 were selected for survival analysis. Cancer prevalence was estimated from incidence and year-specific survival probabilities. Cancer prevalence was stratified by sex, cancer site (25 major cancers), and age group at diagnosis. Results: The estimated prevalence for all cancers in 2012 was 68,013 cases among men, 52,490 cases among women, with 120,503 cases for both sexes. Colorectal cancer was the most incident cancer with 6,654 cases, accounting for 16.0% of overall incident cases, followed by stomach cancer with 5,749 cases (13.8%) and lung cancer with 5,593 cases (13.4%). Prostate cancer was the most prevalent among men, accounting for 21.5%, followed by colorectal and stomach cancers. Breast cancer was the most prevalent among women, accounting for 28.6%, followed by colorectal, stomach, and uterine cancers. Conclusion: This study provides cancer prevalence data that could serve as useful essential information for local governments in cancer management, to carry out more practical and reasonable countermeasures for cancer.     

Collaborative modeling of the impact of obesity on race-specific breast cancer incidence and mortality

Obesity affects multiple points along the breast cancer control continuum from prevention to screening and treatment, often in opposing directions. Obesity is also more prevalent in Blacks than Whites at most ages so it might contribute to observed racial disparities in mortality. We use two established simulation models from the Cancer Intervention and Surveillance Modeling Network (CISNET) to evaluate the impact of obesity on race-specific breast cancer outcomes. The models use common national data to inform parameters for the multiple US birth cohorts of Black and White women, including age- and race-specific incidence, competing mortality, mammography characteristics, and treatment effectiveness. Parameters are modified by obesity (BMI of ??30?kg/m²) in conjunction with its age-, race-, cohort- and time-period-specific prevalence. We measure age-standardized breast cancer incidence and mortality and cases and deaths attributable to obesity. Obesity is more prevalent among Blacks than Whites until age 74; after age 74 it is more prevalent in Whites. The models estimate that the fraction of the US breast cancer cases attributable to obesity is 3.9?C4.5?% (range across models) for Whites and 2.5?C3.6?% for Blacks. Given the protective effects of obesity on risk among women <50?years, elimination of obesity in this age group could increase cases for both the races, but decrease cases for women ??50?years. Overall, obesity accounts for 4.4?C9.2?% and 3.1?C8.4?% of the total number of breast cancer deaths in Whites and Blacks, respectively, across models. However, variations in obesity prevalence have no net effect on race disparities in breast cancer mortality because of the opposing effects of age on risk and patterns of age- and race-specific prevalence. Despite its modest impact on breast cancer control and race disparities, obesity remains one of the few known modifiable risks for cancer and other diseases, underlining its relevance as a public health target.     

Epidemiological Patterns of Cancer Incidence in Southern China: Based on 6 Population-based Cancer Registries

Background: The epidemiological patterns of cancer incidence have been investigated widely in westerncountries. Nevertheless, information is quite limited in Jiangxi province, southern China. Materials and Methods:All data were reported by 6 population-based cancer registries in Jiangxi Province. The results were presentedas incidence rates of cases by site (ICD-10), sex, crude rate (CR), age-standardized rates (ASRs) and truncatedincidence rate (TR) per 100,000 person-years, using the direct method of standardization to the world population.Results: 8,765 new cancer cases were registered in our study during the period 2009-2011. Diagnosis of cancerwas based on histopathology in 61.0%, clinical or radiology findings in 4.87% and death certificate only (DCO)in 3.0% of the cases. The median age at diagnosis was 62.0 years (mean, 61; standard deviation, 15). The ASRswere 170.8 per 100,000 for men and 111.2 for women. The ASRs for all invasive cancers from the urban areas(145.7 per 100,000) was higher than that of rural areas (137.1). Incidence rates for lung cancer were higher inrural (35.8) than in urban areas (27.0). Similarly, relatively high rates were observed for stomach cancer in rural(20.1) relative to urban areas (15.5). Conclusions: Our results reveal that the most common cancers were breastand lung in women and lung and liver in men. Interestingly, this study suggested a higher incidence rates forlung and stomach cancer in rural males than in urban population, which may suggest other potential causes,such as over-consumption of smoked meats and high prevalence of Helicobacter pylori infection, respectively.Public education and the promotion of healthy lifestyles should be actively carried out.     

Cancer risk following primary hemochromatosis: A population-based cohort study in Denmark

A population-based cohort of 120 Danish men, discharged with a hospital diagnosis of primary hemochromatosis from 1977 to 1989, was followed up to 1989 for subsequent cancer risk. Nineteen subjects (including 6 with primary liver cancers) were excluded from the analysis, either because they died within the same month of hemochromatosis diagnosis or because they had cancer prior to diagnosis of hemochromatosis. Among the 101 remaining subjects, 4 primary liver cancers occurred one year or more after the diagnosis of hemochromatosis, far surpassing the expected number based on incidence rates from the Danish population (standardized incidence ratio 92.9, 95% confidence interval 25.0 to 237.9). The excess of liver cancer was associated with cirrhosis and included cholangiocarcinoma as well as hepatocellular carcinoma. Significantly elevated risks were also observed for non-hepatic cancers (13 cases; SIR 3.5, 95% CI 1.9 to 6.0), notably esophageal cancer (2 cases; SIR 42.9, 95% CI 4.8 to 154.9) and skin melanoma (2 cases; SIR 27.8, 95% CI 3.1 to 100.3). The results of this population-based study are in accordance with the hypothesis that patients with primary hemochromatosis have a substantial risk of primary liver cancer. Further studies of hemochromatosis may be useful in clarifying the relation of non-hepatic malignancies to body iron stores in the general population. © 1995 Wiley-Liss, Inc.     

Population-based Mammography Screening and Breast Cancer Incidence in New South Wales, Australia

Objective To analyse breast cancer incidence trends in New South Wales (NSW), Australia, in relation to population-based mammography screening targeting women aged 50 to 69 years. Methods Trends in age-specific incidence of invasive breast cancers in NSW women aged ≥40 years were examined in relation to mammography screening rates and screening cancer detection rates. Results Incidence of invasive breast cancer in NSW women increased in all age-groups over 1972 to 2002. The incidence trend for women aged 50 to 69 years showed that the steepest rise was associated with increased participation in population-based mammography screening, which was implemented from 1988 and achieved state-wide coverage in 1995. The elevated incidence of invasive cancer significantly exceeded pre-screening levels, and persisted after rates of initial screens declined. This elevated incidence was sustained by the contribution of cancers diagnosed through subsequent screening, and resulted from increased cancer detection rates in subsequent screens. Conclusions The recent increase in invasive breast cancer incidence in NSW is associated with mammography screening, and occurred mostly in the target age-group women. Persistence of higher incidence after 1994 was not explicable by inflation of cancer incidence due to detection of prevalent screen cases, but was associated with a trend of increased cancer detection rates in subsequent screening rounds, probably consequent to quality improvements in mammography screening diagnosis.     

Incidence, prevalence and survival of patients with rare epithelial digestive cancers diagnosed in Europe in 1995-2002

Background and aimsLittle is known about the epidemiology of rare epithelial digestive cancers. The aim of this study was to report on their incidence, prevalence and survival across Europe.MethodsThe analysis was carried out on 50,646 cases diagnosed from 1995 to 2002 within a population of 162,000,000 in 21 European countries. Age-standardised incidence rates were computed using the European standard population. Prevalence rates, relative survival and period survival indicators for the years 2000–2002 were calculated. The expected number of new cases per year and of prevalent cases in Europe was estimated.ResultsThere were large variations in gallbladder epithelial cancer incidence rates: the incidence in Eastern Europe was 7 times higher than in the UK &; Ireland. Differences between incidence rates were smaller for the other sites. The estimated number of new epithelial cancers arising in the EU each year was estimated to be 11,050 for extrahepatic bile duct cancer, 10,713 for gallbladder cancer, 5427 for anal cancer and 3595 for small intestine cancer. The corresponding estimated number of total prevalent cases was 18,483, 15,620, 40,589 and 13,276. There was also a large variation in the 5-year relative survival rate. For epithelial cancer of the anal canal, this varied between 66% (Central Europe) and 44% (Eastern Europe). The corresponding rates for small intestine cancers were 33% and 20%, for extrahepatic bile duct cancers, 17% and 12% and for gallbladder cancer 13% and 10%.ConclusionThere are large variations within Europe in the incidence and survival of rare digestive cancers according to geographic area.     

Accounting for Immigrant Status when Calculating Cancer Incidence Rates for Bangkok

Objective: Cancer-registry data are crucial for definingcancer incidence rates for use in setting service prioritiesand monitoringservice effects. This applies in Thailand where cancer is the leading cause of death and service needsare high. The Bangkok Cancer Registry (population-based) was established in 1990to determine cancer incidence ratesfor Bangkok. This proved difficult, however, because the Bangkokpopulation (>8million) fluctuates with numbers oftemporary visitors, many of whom visit Bangkok temporarily for services. If these visitors are mis-categorized asusual residents, cancer incidence rateswould be inflated. During 2013-2015, residential addresses on the Registrywere cross-checked against official addresses on the National Civil Registration records of the Ministry of Interior.The effectsof this cross-checking on incidence rates are discussed. Methods: Residential addresses recorded onthe Registry for cancer diagnoses in 2013-2015 were corrected using official Ministry data. Effects on numbers ofrecorded cancers and crude and directly age-standardized rates (World Population) were determined. Results: Of 44,813cancer casesdiagnosed and recorded on the Registryduring 2013-2015, 36,327 (81.1%) had an official Bangkokaddress. When limiting analyses to these cases, the crude incidencefor all cancer sites combined reduced by 18.9%(19.7% for males and 18.3% for females). Corresponding reductions in age-standardized incidence rates were 20.0%for males and 18.8% for females. These reductions varied for common cancer sites:in males,from 14.8% for lung to25.9% for colorectal cancer; and in females, from 12.9% for lung to 24.0% for cervical cancer. Conclusions: Thesedifferences are considered sufficient in magnitude to justifyroutine use of official residential data when calculatingcancer incidence rates for Bangkok. If these rates are to be compared with comparable rates for other Asian citiesthatserve broader populations, equivalent methodologies for determining residential status would be needed for all cities.     

Patterns of Cancer Incidence and Mortality in North- Eastern India: The First Report from the Population Based Cancer Registry of Tripura

Background: There is, till date no population-based data regarding cancer patterns in North- Eastern India, dictating the need to understand the epidemiology of cancer in this population for its effective management. Methods: This is the first report of the Population Based Cancer Registry (PBCR) in Tripura (2010-2014). The protocol involves active collection of data on all cancer cases from Tripura through staff visit in more than 150 sources of incident and mortality registration, government and private hospitals, municipal corporation, etc. and scrutiny, corroboration with existing records. Data was analyzed statistically to understand cancer trends in terms of incidence and mortality across different sites, age groups affected and gender. Results: A total of 10,251 cases were registered during the period, with overall age-adjusted incidence rates of 75.7 and 54.9 per 100,000 males and females respectively. Crude Incidence Rate (CR) and Age- Adjusted Rate (AAR) was among the lowest reported in India, probably due to associated socio-economic factors. The most prevalent cancers were lung (18.1%), esophageal (8.3%) for men and cervix uteri (17.6%), breast (13.8%) for females. Gall bladder cancer in females was one of the highest in the country. Rate of cancer mortality in the population was quite high and significantly increased with time, probably accounting for dearth in early detection and feasible treatment alternatives. Conclusion: The data suggests that high cancer incidence and mortality are prevalent in the population of Tripura, dictating the need of active tobacco control measures, early detection and awareness drives for effective cancer control.     

Cancer survival in Chiang Mai, Thailand, 1993-1997

The Chiang Mai tumour registry was established in 1978 as a hospital-based cancer registry, and population-based cancer registration started in 1986, with retrospective data collection on cancer incidence and mortality since 1983. Registration of cases is done by active methods. Data on survival for 36 cancer sites or types registered during 1993-1997 are reported here. Follow-up has been carried out predominantly by active methods, with median follow-up ranging between 1-39 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 28-100%; death certificate only (DCO) cases comprised 0-56%; 33-92% of total registered cases were included for survival analysis. Complete followup at five years ranged from 59-100% for different cancers. The 5-year age-standardized relative survival rates was the highest for Hodgkin lymphoma (70%) followed by thyroid (65%), cervix (57%), breast (56%) and corpus uteri (49%). The 5-year relative survival by age group showed either an inverse relationship or was fluctuating. An overwhelmingly high proportion of cases were diagnosed with a regional spread of disease, ranging between 44-82% for different cancers and survival decreased with increasing extent of disease for all cancers studied.     

Trends in the incidence of cancer in the Sousse region,Tunisia, 1993–2006

In this article, we analyzed trends in incidence rates of the major cancer sites for a 14‐year period, 1993–2006, in the Sousse region localized in the centre of Tunisia. Five‐year age‐specific rates, crude incidence rates (CR), world age‐standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. A total of 6,975 incident cases of cancer were registered, with a male to‐female sex ratio of 1.4:1. ASRs showed stable trends (?0.1% in males, and +1.0% in females). The leading cancer sites in rank were lung, breast, lymphoma, colon‐rectum, bladder, prostate, leukemia, stomach and cervix uteri. For males, the incidence rates of lung, bladder and prostate cancers remained stable over time. While, cancers of colon‐rectum showed a marked increase in incidence (APC: +4.8%; 95% CI: 1.2%, 8.4%) and non‐Hodgkin's lymphoma (NHL) showed a notable decline (APC: ?4.4%; 95% CI: ?8.2, ?0.6). For females, cancers of the breast (APC: +2.2%; 95% CI: 0.4%, 4.0%) and corpus uteri (APC: +7.4%; 95% CI: 2.8%, 12.0%) showed a marked increase in incidence during the study period, while the cervix uteri cancer decreased significantly (APC: ?6.1%; 95% CI: ?9.2%, ?3.0%). The results underline the increasing importance of cancer as a cause of mortality and morbidity in Tunisia. Our findings justify the need to develop effective program aiming at the control and prevention of the spread of cancer amongst Tunisian population.     

上海市区女性生殖系统恶性肿瘤发病趋势分析

目的对1972～1999年上海市区常见的女性生殖系统恶性肿瘤的发病率进行统计,分析其发病趋势及变化原因,为防治措施的制定提供依据.方法根据上海市肿瘤发病登记处收集的1972～1999年的上海市区卵巢癌、宫颈癌、宫体癌和不明部位子宫癌的病例资料和相应年份的人口资料,分别计算各年龄组的年龄别发病率.并采用直接法计算世界人口标化发病率,对数线性回归法计算标化率的年变化率(Annual percentage change,APC),并对病例数进行加权计算.结果1972～1999年上海市肿瘤登记处共登记卵巢癌6106例、宫颈癌8063例,宫体癌3 933例和不明部位子宫癌1 312例.28年来,宫体癌和卵巢癌的标化发病率呈上升趋势,分别从1972～1974年的2.49/10万和4.77/10万上升至1996～1999年的4.75/10万和6.88/10万,年增长率分别为3.0%和2.0%.同期宫颈癌的标化发病率从26.66/10万快速下降至2.18/10万,年下降率达10.5%.不明部位子宫癌的标化发病率亦呈下降趋势(P＜0.01).宫体癌以55～64和65～74岁组发病率上升最快,年增长率分别为2.5%和3.3%.卵巢癌各年龄组的发病率均有上升趋势,年变化率都在1.0%以上.宫颈癌发病率下降最快的年龄组是45～54和55～64岁组,25～34和35～44岁组的发病率在近几年有升高趋势.结论上述肿瘤的发病率及年龄别发病率的变化趋势提示,上海女性生活方式和环境因素的改变可能是导致这种变化的重要原因.     

Cancer in the Gambia: 1988-97

We describe the incidence of cancer in The Gambia over a 10-year period using data collected through the Gambian National Cancer Registry. Major problems involved with cancer registration in a developing country, specifically in Africa are discussed. The data accumulated show a low overall rate of cancer incidence compared to more developed parts of the world. The overall age standardized incidence rates (ASR) were 61.0 and 55.7 per 100 000 for males and females, respectively. In males, liver cancer was most frequent, comprising 58% of cases (ASR 35.7) followed by non-Hodgkin lymphoma, 5.4% (ASR 2.4), lung 4.0%, (ASR 2.8) and prostate 3.3% (ASR 2.5) cancers. The most frequent cancers in females were cervix uteri 34.0% (ASR 18.9), liver 19.4% (ASR 11.2), breast 9.2% (ASR 5.5) and ovary 3.2% (ASR 1.6). The data indicate that cancers of the liver and cervix are the most prevalent cancers, and are likely to be due to infectious agents. It is hoped that immunization of children under 1 year against hepatitis B will drastically reduce the incidence of liver cancer in The Gambia.     

Cancer prevalence in European registry areas.

BACKGROUND: Information on cancer prevalence is of major importance for health planning and resource allocation. However, systematic information on cancer prevalence is largely unavailable. MATERIALS AND METHODS: Thirty-eight population-based cancer registries from 17 European countries, participating in EUROPREVAL, provided data on almost 3 million cancer patients diagnosed from 1970 to 1992. Standardised data collection and validation procedures were used and the whole data set was analysed using proven methodology. The prevalence of stomach, colon, rectum, lung, breast, cervix uteri, corpus uteri and prostate cancer, as well as of melanoma of skin, Hodgkin's disease, leukaemia and all malignant neoplasms combined, were estimated for the end of 1992. RESULTS: There were large differences between countries in the prevalence of all cancers combined; estimates ranged from 1170 per 100000 in the Polish cancer registration areas to 3050 per 100000 in southern Sweden. For most cancers, the Swedish, Swiss, German and Italian areas had high prevalence, and the Polish, Estonian, Slovakian and Slovenian areas had low prevalence. Of the total prevalent cases, 61% were women and 57% were 65 years of age or older. Cases diagnosed within 2 years of the reference date formed 22% of all prevalent cases. Breast cancer accounted for 34% of all prevalent cancers in females and colorectal cancer for 15% in males. Prevalence tended to be high where cancer incidence was high, but the prevalence was highest in countries where survival was also high. Prevalence was low where general mortality was high (correlation between general mortality and the prevalence of all cancers = -0.64) and high where gross domestic product was high (correlation = +0.79). Thus, the richer areas of Europe had higher prevalence, suggesting that prevalence will increase with economic development. CONCLUSIONS: EUROPREVAL is the largest project on prevalence conducted to date. It has provided complete and accurate estimates of cancer prevalence in Europe, constituting essential information for cancer management. The expected increases in prevalence with economic development will require more resources; allocation to primary prevention should therefore be prioritised.     

Biliary tract cancer incidence in the United States—Demographic and temporal variations by anatomic site

We evaluated incidence patterns of biliary tract cancers (gallbladder, extrahepatic bile duct, ampulla of Vater and not otherwise specified) to provide potential insight into the etiology of these cancers. Data were obtained from the population‐based Surveillance, Epidemiology and End Results program. Rates for cases diagnosed during 1992–2009 were calculated by racial/ethnic, gender and age groups. Temporal trends during 1974–2009 and annual percentage changes (APC) during 1992–2009 were estimated. Age‐adjusted rates by site were higher among American Indian/Alaska Natives, Hispanics (white) and Asian/Pacific Islanders (Asian/PI) and lower among whites and blacks. Gallbladder cancer was more common among women in all ethnic groups (female‐to‐male incidence rate ratio [IRR] ranged from 1.24 to 2.86), but bile duct and ampulla of Vater cancers were more common among men (female‐to‐male IRR 0.57 to 0.82). Gallbladder cancer rates declined among all racial/ethnic and gender groups except blacks (APC ?0.4% to ?3.9%). In contrast, extrahepatic bile duct cancer rates rose significantly in most female racial/ethnic groups; the APCs among whites were 0.8 among females and 1.3 among males, both significant. Rates for ampulla of Vater cancer decreased among Asian/PI females (APC ?2.7%) but remained stable for the other groups. In addition to confirming that biliary tract cancer incidence patterns differ by gender and site and that the gallbladder cancer incidence rates have been declining, our study provides novel evidence that extrahepatic bile duct cancer rates are rising. These observations may help guide future etiologic studies.     

Cancer in the european population of harare,Zimbabwe, 1990–1992

The data presented from the population-based cancer registry in Harare, Zimbabwe, represent the first information on the incidence of cancer in a population of European origin living in Southern Africa for over 30 years. Their cancer pattern is more or less typical of white populations of high socio-economic status living in Europe or North America, with elevated incidence rates of breast cancer, large-bowel cancer and, in women, lung cancer. However, there are also several unusual features, with extremely high incidence rates of skin cancers, including melanomas, and higher rates of liver and bladder cancer than normally seen in white populations.     

Trends in the incidence of cancer in Qidong, China, 1978-2002

A population-based cancer registry was established in Qidong, Jiangsu Province, China, in 1972, and the trends in incidence rates of the major cancer sites have been analyzed for a 25-year period, 1978-2002. Five-year age-specific rates, crude incidence rates, world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size, and estimates of its age structure. The indices of histological verification of diagnosis, death certificate only and proportion of mortality to incidence were employed for assessing the registration quality. A total of 51,933 incident cases of cancer were registered in Qidong from years 1978 to 2002, with a male-to-female sex ratio of 1.9:1. Crude incidence increased markedly over the 25-year period (PC and APC of +55.6% and +2.1%, respectively), but ASR showed a slight decrease (-0.4% in males, and -0.3% in females), indicating that the major part of this is due to population ageing. The leading cancer sites in rank were liver (average ASR = 50.8 per 100,000), stomach (26.7), lung (22.7), colon-rectum (8.9), oesophagus (7.4) and breast (5.4). Cancers of liver, lung, colon-rectum and female breast all showed increases in incidence during the study period, with APCs (ASR) of +0.1%, +1.7% and +1.4% for males, and +0.2%, +0.9%, +1.9% and +1.1% for females, while the cancers of stomach (APC: -3.2% in male, and --2.4% in female) and cervix (APC: -4.7%) showed notable declines. Examination of age-specific rates showed declining trends in the younger generations for liver cancer, but increases for cervix cancer. The results underline the increasing importance of cancer as a cause of mortality and morbidity in a population that is ageing and undergoing profound changes in socioeconomic development and lifestyle. The cancers of high lethality that have been common in the Chinese population (liver, stomach, oesophagus) are showing some evidence of decline, at least in younger generations, but they remain major problems. At the same time, the cancers associated with economically "developed" societies -- lung, colon-rectum and female breast -- are showing increases. The population-based cancer registry is an indispensable tool for providing data for planning and evaluation of programmes for cancer control in all societies.     

Cancer incidence and incidence rates in Japan in 2006: based on data from 15 population-based cancer registries in the monitoring of cancer incidence in Japan (MCIJ) project

The Japan Cancer Surveillance Research Group estimated the cancer incidence in 2006 as part of the Monitoring of Cancer Incidence in Japan (MCIJ) project, on the basis of data collected from 15 of 32 population-based cancer registries. The total number of incidences in Japan for 2006 was estimated as 664 398 (C00-C96). The leading cancer site was stomach for men and breast for women. Age-standardized incidence rates remained at almost the same level as for the previous 3 years.     

Age-specific interval breast cancers in Japan: estimation of the proper sensitivity of screening using a population-based cancer registry

The age-specific sensitivity of a screening program was investigated using a population-based cancer registry as a source of false-negative cancer cases. A population-based screening program for breast cancer was run using either clinical breast examinations (CBE) alone or mammography combined with CBE in the Miyagi Prefecture from 1997 to 2002. Interval cancers were newly identified by linking the screening records to the population-based cancer registry to estimate the number of false-negative cases of screening program. Among 112 071 women screened by mammography combined with CBE, the number of detected cancers, false-negative cases and the sensitivity were 289, 22 and 92.9%, respectively, based on the reports from participating municipalities. The number of newly found false-negative cases and corrected sensitivity when using the registry were 34 and 83.8%, respectively. In detected cancers, the sensitivity of screening by mammography combined with CBE in women ranging from 40 to 49 years of age based on a population-based cancer registry was much lower than that in women 50-59 and 60-69 years of age (40-49: 18, 71.4%, 50-59: 19, 85.8%, 60-69: 19, 87.2%). These data suggest that the accurate outcome of an evaluation of breast cancer screening must include the use of a population-based cancer registry for detecting false-negative cases. Screening by mammography combined with CBE may therefore not be sufficiently sensitive for women ranging from 40 to 49 years of age.