温州市鹿城区2005年肿瘤发病分析

[目的]了解温州市鹿城区居民恶性肿瘤发病情况与流行特征．[方法]分析温州市2005年恶性肿瘤新发病例报告资料，计算发病率、标化发病率、35～64岁标化截缩率、0～74岁累积率等指标。[结果]2005年温州市鹿城区恶性肿瘤发病率369．09／10万，标化发病率281．20／10万。男性以肺癌、肝癌、胃癌、大肠癌、食管癌、膀胱癌多见，女性以乳腺癌、大肠癌、肺癌、甲状腺癌、胃癌、宫颈癌为主．[结论]温州市恶性肿瘤防治工作的重点应放在40岁以上人群，加强肺癌、肝癌、乳腺癌、甲状腺癌防治研究具有重要意义。     

绍兴市区1996年～2000年居民恶性肿瘤发病分析

[目的]了解绍兴市区1996年—2000年恶性肿瘤发病情况，为防治工作提供依据。[方法]调查人员经培训后，对市区居民展开全面调查登记，根据ICD-9进行恶性肿瘤分类统计，计算发病率、标化发病率。[结果]绍兴市区恶性肿瘤年平均发病率213．92／10万，标化发病率为153．7／10万。男性标化发病率居前5位的是：肺癌、胃癌、肝癌、大肠癌、食管癌；女性标化发病率居前5位的是：肺癌、乳腺癌、胃癌、大肠癌、肝癌，总标化发病率居前5位的是：肺癌、胃癌、大肠癌、肝癌、乳腺癌。[结论]绍兴市区恶性肿瘤以肺癌和消化系统肿瘤为主，应作为防治重点。     

田湾核电站周围居民2001～2004年恶性肿瘤发病分析

[目的]分析田湾核电站运行前30km范围内居民恶性肿瘤发病情况，为评估核电站辐射对人群的影响提供科学依据。[方法]登记报告田湾核电站30km范同内的常住人口恶性肿瘤病例，并补充开展恶性肿瘤回顾性调查。计算发病率、标化发病率、累积发病率、标化截缩率等指标。[结果]恶性肿瘤发病率为155．78／10万，标化发病率为133．27／10万，男性所患恶性肿瘤前5位是肺癌、胃癌、食管癌、肝癌和膀胱癌；女性前5位是乳腺癌、肺癌、胃癌、卵巢癌、食管癌。白血病、甲状腺恶性肿瘤、乳腺癌等与核辐射相关疾病发病率依次为6．63／10万、3．11／10万，33．49／10万。[结论]核电站运行前该地区恶性肿瘤以肺癌和消化道恶性肿瘤为主，白血病、甲状腺恶性肿瘤、乳腺癌发病率高于2004年江苏省内监测点数据，需在该地区持续开展恶性肿瘤监测，以评估核电站对恶性肿瘤的影响。     

温州市鹿城区2003～2005年新发肿瘤发病分析

目的了解温州市鹿城区居民恶性肿瘤发病情况与流行特征。方法对2003~2005年恶性肿瘤新发病例报告资料进行分析,计算发病率、标化发病率、标化截缩率(是指35~64岁截缩人口标化率)等。结果2003~2005年鹿城区恶性肿瘤年平均发病率为368.68/10万,标化发病率为243.05/10万,≥40岁恶性肿瘤发病率为211.88/10万,以肺癌、肝癌和胃癌多见,女姓以乳腺癌、肺癌和大肠癌为主。结论恶性肿瘤防治工作的重点应放在≥40岁人群,男性肺癌发病水平高,而乳腺癌对中壮年女性的生命健康危害大。加强肺癌等主要肿瘤危险因素研究,开展女性乳腺癌筛查具有重要意义。     

杭州市2004～2005年恶性肿瘤发病状况分析

[目的]了解杭州市恶性肿瘤的发病及分布情况。[方法]利用2004～2005年杭州肿瘤登记处报告资料，分析肿瘤粗发病率和中国人口标化发病率。[结果]杭州市恶性肿瘤粗发病率为244．44/10万，其中男、女性粗发病率分别为273．68／10万和208．02／10万。杭州市恶性肿瘤中国人口标化率为178．52／10万；其中男、女性中国人口标化率分别为194．96／10万和159．32／10万。前5位恶性肿瘤为肺癌、胃癌、肝癌、乳腺癌、直肠癌。市区发病率295．12／10万，郊县发病率158．28／10万。[结论]恶性肿瘤是威胁杭州市居民健康的重要因素．预防和控制恶性肿瘤的发生是当前卫生工作的重要任务。     

上海市静安区2002～2005年恶性肿瘤发病数据分析

[目的]探讨上海市静安区居民恶性肿瘤发病特征。[方法]利用上海市肿瘤登记系统,对静安区2002～2005年肿瘤发病情况进行分析。[结果]2005年,静安区男性恶性肿瘤世界标化发病率203．14／10万,中国标化发病率为169．99／10万：女性世界标化发病率为226．12／10万,中标发病率为192．49／10万。2002～2005年,男性常见肿瘤主要为气管、支气管和肺癌,胃癌,结肠癌等：女性主要为乳腺癌：常见恶性肿瘤年龄别发病率呈现随年龄增长而上升的趋势。[结论]在35岁以上的人群中开展恶性肿瘤早诊早洽,是较为积极有效地方法;加强肺癌、乳腺癌以及消化系统癌症的大众宣传教育显得较为重要。     

兰州市2005年恶性肿瘤发病率分析

[目的]了解兰州市2005年恶性肿瘤发病状况。[方法]利用兰州市2005年恶性肿瘤登记数据库资料及人口资料．分析粗发病率、中国标化发病率（中标率）、世界标化发病率（世标率）、累积率和截缩率。[结果]2005年兰州市恶性肿瘤发病率为193．0／10万,中标率为156．9／10万．世标率为206．6／10万．35～64岁截缩率为295．8／10万,0—64岁和0～74岁累计率分别为10．6％和25．7％。兰州市五区恶性肿瘤发病率以西固区为最高,发病率为208．5／10万,中标率为167．0／10万：男性前五位癌种分别为肺癌、胃癌、肝癌、食管癌、直肠癌;女性前五位癌种分别为乳腺癌、肺癌、宫颈癌、胃癌和肝癌;男性明显高于女性,高出37．15％,男性、女性发病率均在30岁年龄组开始缓慢上升,70—75岁组达到发病高峰。[结论]恶性肿瘤已成为影响兰州市居民健康的主要疾病,肺癌、乳腺癌、胃癌、肝癌、宫颈癌应作为兰州市肿瘤防治工作的重点,男性和中老年人应为癌症预防的高危人群,尤其应该加强对肺癌、乳腺癌防治研究。     

1999年～2001年重庆市主城区居民恶性肿瘤发病分析

[目的]了解重庆市城市居民恶性肿瘤发病特征与流行情况。[方法]对1999年－2001年恶性肿瘤新发病例报告资料进行分析，计算发病率、标化发病率等指标。[结果]3年恶性肿瘤平均发病率为141.26/10万，标化发病率为123.86/10万。男性标化截缩率及累积率均以肺癌最高，女性累积率肺癌居首位，而标化截缩率以乳腺癌最高。[结论]重庆市区恶性肿瘤发病（特别是男性）以肺癌为主，而乳腺癌是危害中青年女性生命健康的重要原因。加强社区肿瘤防治工作及环境治理是控制和降低恶性肿瘤发病率的有效途径。     

广州市2000～2002年肺癌发病率与死亡率分析

[目的]分析广州市肺癌发病率和死亡率，为广州市肺癌的防治研究提供科学依据。[方法]收集广州市肿瘤登记处2000～2002年肺癌的发病资料和死亡资料．统计和分析肺癌发病数和死亡病例数、粗发病率和死亡率、中国标化发病率和死亡率、世界标化发病率和死亡率等指标。[结果]广州市2000—2002年肺癌粗发病率和死亡率分别为51．8／10万（其中男性68．8／10万，女性33．7／10万）和45．4／10万（其中男性60．6／10万，女性29．2／10万）。男性肺癌的发病率居所有恶性肿瘤之首，女性居第二位。男女肺癌的死亡率均居所有恶性肿瘤的第一位。[结论]广州市肺癌的发病率和死亡率较高，应加强防治研究。     

2006年兰州市恶性肿瘤发病率分析

[目的]分析2006年兰州市恶性肿瘤发病率。[方法]利用2006年兰州市恶性肿瘤登记数据库资料和人口资料,分析粗发病率、中国标化发病率（中标率）、世界标化发病率（世标率）和累积率（0—74岁）。[结果]2006年兰州市恶性肿瘤发病率为213．00／10万,中标率为173．70／10万,世标率为228．80／10万,累积率（0～74岁）为27．80％。男性发病率高出女性44．89％,五区中以西固区为最高（188．29／10万）。发病第1位的是肺癌,其次为胃癌、结直肠癌、肝癌、乳腺癌,前10位占全部恶性肿瘤发病的73．00％。男性发病第1位的是肺癌,女性发病第1位的是乳腺癌;男女性发病随年龄的增长而升高,80～岁年龄组处于最高水平。[结论]兰州市预防控制重点癌种在肺癌、乳腺癌、胃癌、肝癌和宫颈癌的基础上,也应对结直肠癌、胆囊癌、膀胱癌、前列腺癌加以重视,重点防控35岁以上人群。在人群中积极开展高发癌种病因学研究和早期筛查应为肿瘤防治的工作重点。     

Trends in Breast Cancer Mortality, Incidence, and Survival, and Mammographic screening in Tuscany, Italy

Objective: The study describes breast cancer mortality trends in Tuscany (period 1970–97), comparing Florence with the rest of Tuscany (Florence excluded), and, for Florence, incidence (period 1985–94) and survival (1985–86 versus 1991–92) trends, taking into account the diffusion of screening. Methods: Mortality and incidence rates, age-adjusted on the European population, and 95% confidence intervals (95% CI). Five-year relative survival rates and estimates of risk of dying provided by the Cox model. Results: Mammographic screening, started at the beginning of the 1970s in some municipalities, largely involved the Florence area after 1990 (mammograms/years: from 8000–9000 to 28,000–29,000, respectively, before and after 1990). In the same period no population-based screenings were ongoing in the rest of Tuscany. A significant mortality drop was observed in Tuscany (–3.7%/year), starting at the beginning of the 1990s and observed for ages 74 (especially ages 40–49: –11.2%/year). The drop was similar in Florence and in the rest of Tuscany. In ages 50–69, incidence, increasing between 1985–87 and 1988–90 (+6.5%), rose sharply in 1991–94 (+17.0%); it was stable in other ages. Local disease increased more markedly in ages 50–69 (globally: +88.3%), but also in other ages (+20–30%). Regional and metastatic cancers decreased. A significantly better 5-year survival was observed among cases diagnosed in 1991–92, persisting after adjustment by extent of disease. Conclusion: Even if the causes of breast cancer mortality trends are not easy to clarify in an observational study, our data suggest that the drop in mortality observed in Tuscany at the beginning of the 1990s could be largely explained by both earlier detection, outside of an organized screening program, and by better treatments. The increase in incidence and the shift in stage distribution that occurred before the enlargement of the screening area and in age groups not involved in the program, supports the role of a `spontaneous' widespread earlier detection. The better survival of the period 1991–92, only partly explained by the shift in stage at diagnosis, indirectly supports the role of improvement in therapy.     

Etoposide, dexamethasone, cytarabine, and cisplatin in vincristine, doxorubicin, and dexamethasone-refractory myeloma

Based on remarkable activity in refractory lymphomas, a combination of etoposide, cisplatin (both administered by 4-day continuous infusions), cytarabine (Ara-C), and dexamethasone (EDAP) was evaluated in 20 patients with advanced myeloma refractory to standard melphalan and prednisone (MP) and/or vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and dexamethasone (VAD) and even to high doses of melphalan (HDM) (seven patients). Forty percent of patients responded regardless of previously recognized risk factors (eg, duration of drug resistance, tumor mass, and serum lactic dehydrogenase [LDH] level). While the median survival was only 4.5 months, patients with good performance (Zubrod less than 2) and low or intermediate tumor stage survived more than 14 months compared with only 2 months for the remaining group. EDAP could be readily administered in the outpatient clinic, but neutropenic fever prompted hospital admission in 80% of patients, half of whom developed penumonia and sepsis, a fatal outcome in four patients. Severe myelosuppression was of short duration, so that subsequent cycles could be administered every 3 to 4 weeks. No serious extramedullary toxicity, including renal toxicity, was encountered. Marrow toxicity and hence infectious complications may be reduced by elimination of Ara-C without compromising treatment efficacy. We conclude that the lack of cross-resistance with VAD and even HDM makes EDAP or a similar combination an attractive regiment to be formally explored in an alternating sequence with VAD in high-risk myeloma.     

Mate drinking, alcohol, tobacco, diet, and esophageal cancer in Uruguay

A case-control study was conducted in Uruguay to investigate the role of mate drinking, alcohol, tobacco, and certain dietary factors in the etiology of esophageal cancer. The study included 261 patients with squamous cell carcinoma of the esophagus and 522 hospital controls matched by sex and age. A strong association with a clear dose-response relationship was observed with the amount of mate drunk daily and duration of the habit. The relative risk for those drinking over 2.5 liters of mate per day was 12.2 (95% confidence interval, 3.8-39.6) after adjusting for the effects of age, area of residence, alcohol, and tobacco. Strong associations were also observed with tobacco smoking and alcohol drinking which appear to act in a multiplicative way. The relative risk for those who smoke and drink heavily compared to that of light smokers and drinkers was 22.6. The risk associated with black tobacco was about three times higher than that associated with blond tobacco. A clear protective effect was found for the consumption of fruits and vegetables but a dose-response relationship was present only for fruits. Finally, an increased risk was also found for those eating barbecued meat daily.     

Trends in cancer incidence in esophagus, stomach, colon, rectum and liver in males in India.

Time trends in cancers of the esophagus, stomach, colon, rectum and liver cancers among the male population in five Indian urban population based cancer registries (Mumbai, Bangalore, Chennai, Delhi, and Bhopal) were examined over the period of the last two decades. The model applied fits data to the logarithm of Y=ABx. This Linear Regression method showed decreasing trends in age-adjusted incidence rates for cancers of the stomach and esophagus, especially in Bjopal, and increasing trends for colon and rectum and liver, throughout the entire period of observation in most of the registries. The five cancers together constitute more than 80% of the total gastro intestinal cancers and are serious diseases in both sexes. To understand the etiology of these cancers in depth, analytic epidemiological studies should be planned in the near future on a priority basis.     

Socio-demographic variation in stage at diagnosis of breast,bladder, colon,endometrial, lung,melanoma, prostate,rectal, renal and ovarian cancer in England and its population impact

Background Stage at diagnosis strongly predicts cancer survival and understanding related inequalities could guide interventions.Methods We analysed incident cases diagnosed with 10 solid tumours included in the UK government target of 75% of patients diagnosed in TNM stage I/II by 2028. We examined socio-demographic differences in diagnosis at stage III/IV vs. I/II. Multiple imputation was used for missing stage at diagnosis (9% of tumours).Results Of the 202,001 cases, 57% were diagnosed in stage I/II (an absolute 18% ‘gap’ from the 75% target). The likelihood of diagnosis at stage III/IV increased in older age, though variably by cancer site, being strongest for prostate and endometrial cancer. Increasing level of deprivation was associated with advanced stage at diagnosis for all sites except lung and renal cancer. There were, inconsistent in direction, sex inequalities for four cancers. Eliminating socio-demographic inequalities would translate to 61% of patients with the 10 studied cancers being diagnosed at stage I/II, reducing the gap from target to 14%.Conclusions Potential elimination of socio-demographic inequalities in stage at diagnosis would make a substantial, though partial, contribution to achieving stage shift targets. Earlier diagnosis strategies should additionally focus on the whole population and not only the high-risk socio-demographic groups.Subject terms: Oncology, Health policy