Trends in cancer mortality in the Americas, 1970-2000.

BACKGROUND: Data and statistics on cancer mortality over the last decades are available for most developed countries, while they are more difficult to obtain, in a standardized and comparable format, for countries of Latin America. PATIENTS AND METHODS: Age standardized (world population) mortality rates around the year 2000, derived from the WHO database, are presented for 14 selected cancers and total cancer in 10 countries of Latin America, plus, for comparative purposes, Canada and the USA. Trends in mortality are also given over the period 1970-2000. RESULTS: In 2000, the highest total cancer mortality for males was observed in Argentina and Chile, with rates comparable to those of Canada and the USA, i.e. about 155/100,000. For women, Chile and Cuba had the highest rates in Latin America (114 and 103/100,000, respectively), again comparable to those of North America (around 105/100,000). These reflect the comparatively high mortality from cancer of the stomach (for Chile), lung and intestines (for Argentina) in men, and of stomach and uterus (for Chile), intestines and lung (for Cuba) in women. Colombia, Ecuador and Mexico had the lowest total cancer mortality for men, due to low mortality from stomach, colorectal and lung cancer. For women, the lowest rates were in Brazil and Puerto Rico, reflecting their low stomach and cervical cancer rates. In Argentina, Chile, Colombia, Costa Rica and Venezuela cancer mortality rates tended to decline, particularly in men. Rates were stable in Ecuador and Puerto Rico, and were increasing in Mexico and Cuba. CONCLUSIONS: Mortality from some common cancers (including colorectal and lung) is still low in Latin America compared with Canada and the USA, and decreasing trends have been observed in the last decades for some cancer sites (including stomach, uterus, lung and other tobacco-related cancers) in several countries. However, mortality from female lung and breast cancers has been increasing in most countries of Latin America, and several countries still show an extremely elevated mortality from cancer of the cervix. Selected neoplasms amenable to treatment, including testis and leukemias, also show unsatisfactory trends in Latin America.     

Cancer mortality predictions for 2019 in Latin America

We estimated mortality figures for 2019 in seven Latin American countries, with focus on breast cancer. We retrieved cancer death certification and population data from the WHO and PAHO databases. We obtained mortality statistics for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela for 1970–2015. We predicted current death numbers and age-standardised (world population) mortality rates using joinpoint regression models. Total cancer mortality is predicted to decline in all countries and both sexes, except Argentinian women. Cuba had the highest all cancer rates for 2019, 136.9/100,000 men and 90.4 women, while Mexico showed the lowest ones, 63.8/100,000 men and 61.9 women. Stomach cancer showed favourable trends over the whole period, while colorectal cancer only recently. Lung cancer rates declined in men, while in women they decreased slightly over the most recent years, only. In Cuban women, lung cancer rates overtook breast cancer ones. Breast cancer showed overall favourable trends, but rates are rising in young women. Prostate and uterine cancer had favourable trends. Pancreas, ovary, bladder and leukaemias showed slightly decreasing trends. Between 1990 and 2019, mortality from all neoplasms is predicted to fall by about 18% in Argentina, 26% in Chile, 14% in Colombia, 17% in Mexico and 13% in Venezuela, corresponding to almost 0.5 million avoided cancer deaths. No decline was observed in Brazil and Cuba. Of concern, the persisting high rates of (cervix) uterus cancer, the high lung cancer rates in Cuba, the possible increases in breast cancer in young women, and the lack of overall declines in Brazil, Cuba and Venezuelan men.     

The burden of cancer in Austria.

The aim of this study was to assess the overall progress against cancer in Austria by analysing changes in age-adjusted mortality rates from 1970 to 1996. For the years 1970 to 1996, age-adjusted rates for all malignant neoplasms and for selected sites were calculated for men and women, according to year, age and sex. The number of cancer deaths were obtained from the Austrian Central Statistical Office--age-adjusted mortality rates of all malignant neoplasms decreased in men between 1971 and 1996 by 13% (from 289.1 to 251.4 deaths per 100,000), and in women between 1970 and 1996 by 19.1% (from 276.6 to 223.7 deaths per 100,000). Among older people (> or = 55 years) the mortality decreased by 13% in men and by 17% in women; among younger people (< 55 years) by 12% and 30%, respectively. The decrease in total cancer mortality is promoted by three tumour sites (the leading causes of cancer deaths in 1970). In both sexes, the decrease of stomach cancer mortality had the major impact, followed by colorectal cancer in women and by lung cancer in men. The observed changes in mortality are primarily related to changing incidence and early detection, rather than improvements in treatment. Unfortunately, there is evidence that prevention is losing ground in Austria. The implementation of the well-established knowledge of cancer prevention and the strengthening of preventative research is urgently needed.     

Trends in cancer mortality in Switzerland, 1980-2001.

Trends in cancer mortality in Switzerland were analysed over the period 1980-2001, on the basis of the World Health Organization database. Appropriately developed correction factors were utilized for the period before 1995, to allow for spurious trends introduced by the change between the 8th and the 10th revisions of the ICD. Steady declines in cancer mortality were observed, particularly from the mid-1980s onwards. Over the last decade, the fall in overall age-standardized (world standard) cancer mortality was 11.1% in men (from 158.1 in 1990-1991 to 140.6/100,000 in 2000-2001) and 7.6% in women (from 91.6 to 84.7/100,000), and the decline was larger in truncated rates from 35 to 64 years (-18.0 and -9.7%). In men, all major tobacco and alcohol neoplasms have declined until the late 1990s but have levelled off over the last few years, reflecting recent trends in alcohol and tobacco consumption. The fall in male lung cancer mortality was 20% over the last decade (from 42.9 to 34.3/100,000). In contrast, lung cancer mortality in women has steadily increased by 38% between 1981 and 1991 and by 47% between 1991 and 2001, to reach 10.7/100,000 at all ages and 18.3 at age 35 to 64, due to increased prevalence of smoking in subsequent generations of Swiss women. Other sites showing substantial declines include stomach and colorectum in both sexes, (cervix) uteri and breast in women. Likewise, prostate cancer showed modest favourable trends after 1995. Steady declines were observed for leukaemias, Hodgkin's disease and testicular cancer, namely, the neoplasms most influenced by therapeutic improvements, while trends in lymphomas and myeloma showed no clear pattern.     

Cancer in the very elderly Dutch population

BACKGROUND: Cancer incidence and mortality rates rarely are studied in people age > 85 years. Usually, patients ages 65 years, 75 years, and 85 years of age are combined into 1 group because of small numbers. The number of people age > or = 85 years in the Netherlands increased from 99,000 in 1976 to 203,000 in 1995 (an increase of 105%). The growth of the total population in this period was only 13%. This study addressed cancer incidence and mortality rates among the very elderly in the Netherlands. METHODS: Cancer mortality data (1976-1995) and population data were obtained from Statistics Netherlands, whereas cancer incidence data (1989-1995) were provided by the Netherlands Cancer Registry. Cancer incidence and mortality rates were calculated and trends in cancer mortality were studied. RESULTS: Total cancer incidence rates were highest in the age group 85-94 years, in men and women (3466/100,000 person-years and 1604/100,000 person-years, respectively). Prostate carcinoma was the most frequent cancer in men ages 85-94 years, followed by colorectal carcinoma. In women ages 85-94 years, colorectal carcinoma was most frequent, closely followed by breast carcinoma. In the 95+ years age group squamous cell skin carcinoma was the most frequent cancer in both men and women, followed by prostate carcinoma in men and breast carcinoma in women. Cancer mortality rates increased with increasing age to nearly 3700/100,000 person-years in men age 95+ years and 2500/100,000 person-years in women age 95+ years. In men, lung carcinoma was the most frequent cancer-related cause of death in patients age < or = 85 years, whereas in older men this applied to prostate carcinoma. In women, breast carcinoma was the most frequent cancer-related cause of death in all age groups > 55 years. Cancer as a cause of death became less prominent with increasing age. Over the period 1991-1995, 42% of deaths in men ages 55-64 years were attributed to cancer versus 52% of deaths in women (total population); these proportions in the 95+ years age group were 11% and 7%, respectively. CONCLUSIONS: Peak incidence rates of major cancers were found in the very elderly population in the Netherlands. Different trends in age specific mortality rates of individual cancer sites were found, with stable rates in the middle age groups and increasing rates in the oldest age groups. This may reflect a real increase caused for instance by changes in mortality from other diseases and/or an artifactual increase caused by increased cancer detection rates in the (very) elderly.     

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.     

Trends in mortality from major cancers in the Americas: 1980–2010

BackgroundBetween the 1970s and 2000 mortality in most of Latin America showed favorable trends for some common cancer sites, including stomach and male lung cancer. However, major concerns were related to mortality patterns from other cancers, particularly in women. We provide an up-to-date picture of patterns and trends in cancer mortality in Latin America.MethodsWe analyzed data from the World Health Organization mortality database in 2005–2009 for 20 cancer sites in 11 Latin American countries and, for comparative purposes, in the USA and Canada. We computed age-standardized (world population) rates (per 100 000 person-year) and provided an overview of trends since 1980 using joinpoint regression models.ResultsCancer mortality from some common cancers (including colorectum and lung) is still comparatively low in Latin America, and decreasing trends continue for other cancer sites (including stomach, uterus, male lung cancers) in several countries. However, there were upward trends for colorectal cancer mortality for both sexes, and for lung and breast cancer mortality in women from most countries. During the last decade, lung cancer mortality in women rose by 1%–3% per year in all Latin American countries except Mexico and Costa Rica, whereas rises of about 1% were registered for breast cancer in Brazil, Colombia and Venezuela. Moreover, high mortality from cancer of the cervix uteri was recorded in most countries, with rates over 13/100 000 women in Cuba and Venezuela. In men, upward trends were registered for prostate cancer mortality in Brazil and Colombia, but also in Cuba, where the rate in 2005–2009 was more than twice that of the USA (23.6 versus 10/100 000).ConclusionsTobacco control, efficient screening programs, early cancer detection and widespread access to treatments continue to be a major priority for cancer prevention in most Latin American countries.     

Biliary-tract cancer in Chile

This epidemiological study in Chile shows a marked increase in biliary-tract cancer based on mortality data, from an age-adjusted rate (1970 world population) of 5.1 per 100,000 in 1970 to 12.0 per 100,000 in 1988. There is an increased risk of this cancer in all age groups but especially in young adults (15-44 years). The female ratio of 3:1 persists. The increase in biliary-tract cancer in 1970-1985 was particularly important for young women but occurred in all female age groups whereas in men it was mostly in the elderly (65 years and more) and less in the middle-aged (45-64 years); no changes were observed in young men. Regional differences have begun to be appreciated. One of the factors which may account for this impressive and unexpected increase is the remarkable decrease in cholecystectomy rates. Less than 20% of the 154% increase in biliary-tract cancer mortality in the period 1970-1985 could be attributed to population aging. Improvements in diagnostic methods did not appear to be an important contributing factor. Other factors that could affect this increase in the incidence to epidemic levels include: an increase in the prevalence of cholelithiasis, an increase in the number of typhoid carriers and possible environmental carcinogens.     

Cancer mortality predictions for 2017 in Latin America

BackgroundFrom most recent available data, we predicted cancer mortality statistics in selected Latin American countries for the year 2017, with focus on lung cancer.Materials and methodsWe obtained death certification data from the World Health Organization and population data from the Pan American Health Organization database for all neoplasms and selected cancer sites. We derived figures for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela. Using a logarithmic Poisson count data joinpoint model, we estimated number of deaths and age-standardized (world population) mortality rates in 2017.ResultsTotal cancer mortality rates are predicted to decline in all countries. The highest mortality rates for 2017 are in Cuba, i.e. 132.3/100 000 men and 93.3/100 000 women. Mexico had the lowest predicted rates, 64.7/100 000 men and 60.6/100 000 women. In contrast, the total number of cancer deaths is expected to rise due to population ageing and growth. Men showed declines in lung cancer trends in all countries and age groups considered, while only Colombian and Mexican women had downward trends. Stomach and (cervix) uteri rates are predicted to continue their declines, though mortality from these neoplasms remains comparatively high. Colorectal, breast and prostate cancer rates were predicted to decline moderately, as well as leukaemias. There was no clear pattern for pancreatic cancer. Between 1990 and 2017 about 420 000 cancer deaths were avoided in 5 of the 7 countries, no progress was observed in Brazil and Cuba.ConclusionCancer mortality rates for 2017 in seven selected Latin American countries are predicted to decline, though there was appreciable variability across countries. Mortality from major cancers—including lung and prostate—and all cancers remains comparatively high in Cuba, indicating the need for improved prevention and management.     

Trends in laryngeal cancer mortality in Europe

After a steady increase since the 1950s, laryngeal cancer mortality had tended to level off since the early 1980s in men from most European countries. To update trends in laryngeal cancer mortality in Europe, age-standardized (world standard) mortality rates per 100,000 were derived from the WHO mortality database for 33 European countries over the period 1980-2001. Jointpoint analysis was used to identify significant changes in mortality rates. In the European Union (EU) as a whole, male mortality declined by 0.8% per year between 1980 and 1989, by 2.8% between 1989 and 1995, by 5.3% between 1995 and 1998, and by 1.5% thereafter (rates were 5.1/100,000 in 1980-1981 and 3.3/100,000 in 2000-2001). This mainly reflects a decrease in rates in men from western and southern European countries, which had exceedingly high rates in the past. Male laryngeal mortality rose up to the early 1990s, and leveled off thereafter in several countries from central and eastern Europe. In 2000-2001 there was still a 10-15-fold variation in male laryngeal mortality between the highest rates in Croatia (7.9/100,000) and Hungary (7.7/100,000) and the lowest ones in Sweden (0.5/100,000) and Finland (0.8/100,000). Laryngeal cancer mortality was comparatively low in women from most European countries, with stable rates around 0.3/100,000 in the EU as a whole over the last 2 decades. Laryngeal cancer trends should be interpreted in terms of patterns and changes in exposure to alcohol and tobacco. Despite recent declines, the persistence of a wide variability in male laryngeal cancer mortality indicates that there is still ample scope for prevention of laryngeal cancer in Europe.     

Projections of alcohol- and tobacco-related cancer mortality in Central Europe

Central European mortality rates for cancer sites related to tobacco and alcohol have increased rapidly in recent decades. From a public health point of view, it is of considerable interest to know whether these past increases in cancer mortality will continue into the future. Cancer mortality rates for the period 1965-1994 in Bulgaria, Czech Republic and Slovakia (analysed together), Hungary, Poland, and Romania were analysed for cancers of the larynx, oral cavity and pharynx, oesophagus, bladder, kidney, and pancreas. Using a Bayesian age-period-cohort approach, we have calculated smoothed observed rates. The effects of period and cohort were extrapolated to estimate mortality projections for 1995-99, 2004-09, and 2005-09. Mortality rates for all sites are projected to increase in most countries. Hungary has the highest projected rates for most sites, and particularly rapid increases are expected for cancers of the oral cavity and pharynx and of the larynx in Hungarian men. The smoothed 1990-94 male mortality rates for these two sites of 16. 32/100,000 and 8.70/100,000, respectively, are projected to reach 35. 17/100,000 for cancer of the oral cavity and pharynx and 14.12/100, 000 for cancer of the larynx by the period 2000-04. For kidney cancer, former Czechoslovakia has the highest observed and projected mortality rates. The smoothed 1990-94 rate of 8.37/100,000 is expected to increase 24% to 10.38/100,000 by 2000-04. Our results indicate that further increases may be expected on top of the already high cancer mortality levels in Central Europe. Policies to reduce alcohol consumption and prevent smoking in younger generations are necessary to reduce mortality as these cohorts age.     

Trends in lung cancer among young European women: the rising epidemic in France and Spain

Lung cancer mortality in young women in the European Union (EU) has steadily increased until the mid 1990 s and has levelled off thereafter, but trends have been heterogeneous in various countries. We analyzed therefore age-standardized trends in lung cancer mortality in young women (20-44) for the 6 major European countries, using joinpoint regression. In the early 1970s the highest lung cancer mortality in young women was in the UK (2.1/100,000). UK rates, however, steadily declined and in 2000-2004 they were the lowest of all 6 major EU countries (1.2/100,000). The second lowest rate in 2000-2002 was in Italy, whose rates remained around 1.1/100,000 between 1970 and 1994, and increased to 1.4 thereafter. In Germany and Poland, lung cancer rates in young women rose from 0.8-1.0/100,000 in the early 1970s to 1.7-1.9 in the mid 1990 s and levelled off during the last decade. Major rises over recent years were observed in France (from 0.8/100,000 in 1985-1989 to 2.2 in 2000-2003) and in Spain (from 0.8 in the 1985-1989 to 1.7 in 2000-2004). Thus, France showed both the highest rate observed over the last 3 decades and the largest rise over the last 2 decades. Since recent trends in the young give relevant information to the likely future trends in middle age, the female lung cancer epidemic is likely to expand in southern Europe from the current rates of 5.0/100,000 in Spain and 7.7 in France to approach 20/100,000 within the next 2-3 decades. Urgent interventions for smoking cessation in women are therefore required.     

Diagnostic changes as a reason for the increase in papillary thyroid cancer incidence in Geneva,Switzerland

Objective: Several studies have reported upward incidence trends of papillary thyroid cancer. It is unclear whether these trends reflect a real risk increase, by some attributed to iodine supplementation, or an artificial one, due to increased diagnostic activity or changed histological criteria. This study examines if these artificial factors explain the increased papillary thyroid cancer incidence in the Swiss canton of Geneva. Methods: All thyroid carcinomas (n = 436) recorded between 1970 and 1998 at the Geneva Cancer Registry were considered. European age-adjusted incidence trends were estimated using linear regression analysis. For papillary cancers we evaluated diagnostic modalities and way of presentation (in particular microcarcinoma < 1 cm or silent carcinoma). In addition, we reviewed the histological slides of follicular carcinomas. Results: Papillary thyroid cancer incidence increased significantly from 0.7 to 1.8/100,000 for men and from 3.1 to 4.3/100,000 for women between 1970–74 and 1995–98. The proportion of microcarcinomas and silent carcinomas increased from 17% to 24% between 1970–79 and 1990–98. At histological review, follicular cancers were more often reclassified as papillary cancer for cases diagnosed between 1970 and 1979 than for cases diagnosed between 1990 and 1998 (45% vs 25%, p = n.s.). Conclusions: The increasing papillary thyroid cancer incidence seems mainly due to changes in histological diagnostic criteria and, to a lesser extent, to increased diagnostic activity. If confirmed, the results of this study indicate that fears of increasing incidence rates of papillary thyroid cancer should not prevent implementation of adequate programs of iodine supplementation in the many areas where iodine deficiency still prevails.     

Decreasing rates of cervical cancer among American Indians and Hispanics in New Mexico (United States)

Minority women in New Mexico (United States)—including American Indian and Hispanic women—have shown disproportionately high incidence rates of invasive cervical cancer during the 1960s and 1970s. Several public health programs in New Mexico were directed toward early detection of cervical cellular abnormalities, particularly targeting the state's minority women. To evaluate the effectiveness of these programs, we examined the New Mexico Surveillance, Epidemiology, and End Results (SEER) data collected from 1969–92, and calculated average annual, age-specific, and age-adjusted incidence rates by ethnic group (American Indian, Hispanic, and non-Hispanic White) for five-year time intervals. We also calculated age-adjusted mortality rates for cervical cancer in the same ethnic groups using state vital records. Age-adjusted incidence rates for invasive cervical cancer show substantial temporal decreases, especially for minority women in the state. The age-adjusted incidence rate decreased by 66 percent, from 30.3 to 10.3 per 100,000 for American Indian women, and by 61 percent, from 26.1 to 10.2 per 100,000 for Hispanic women. A stage shift to earlier stages of cervical neoplasia occurred over the study period, with a substantially higher proportion of in situ compared with invasive cancers diagnosed in the most recent cf the most remote time period. The ratio of incidence rates of in situ to invasive cancers changed dramatically for both American Indian and Hispanic women. Cervical cancer mortality rates decreased steadily among Hispanic women from 1958 to 1992; the decrease among American Indian women was less stable and fluctuated due to small numbers. Ongoing targeted sceening programs should help to reduce cervical cancer incidence and mortality further in New Mexico.Drs Chao, Becker, Jordan, Darling, Gilliland, and Key are with the New Mexico Tumor Registry/Epidemiology and Cancer Control Program, Albuquerque, NM, USA. Dr Jordan and also Dr Key are with the Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM. Address correspondence to Dr Chao, New Mexico Tumor Registry, University of New Mexico Cancer Research and Treatment Center, 900 Camino de Salud NE, Albuquerque, NM, 87131-5306, USA.     

Hodgkin's lymphoma mortality in the Americas, 1997–2008: Achievements and persistent inadequacies

Although therapeutic advancements have made Hodgkin's lymphoma (HL) a largely curable disease, trends in HL mortality have been variable across countries. To provide updated information on HL mortality in the Americas, overall and 20–44 years age‐standardized (world population) mortality rates from HL were derived for the 12 Latin American countries providing valid data to the World Health Organization database and with more than two million of inhabitants. For comparative purpose, data for the United States and Canada were also presented. Trends in mortality over the 1997 to 2008 period are based on joinpoint regression analysis. Declines in HL mortality were registered in all Latin American countries except in Venezuela. In most recent years, HL mortality had fallen to about 0.3/100,000 men and 0.2/100,000 women in Argentina, Brazil, Chile, Colombia, Ecuador and Guatemala, that is, to values similar to North America. Despite some declines, rates remained high in Cuba (1/100,000 men and 0.7/100,000 women), Costa Rica and Mexico as well as in Venezuela (between 0.5 and 0.6/100,000 men and between 0.3 and 0.5/100,000 women). In young adults, trends were more favorable in all Latin American countries except Cuba, whose rates remained exceedingly high (0.8/100,000 men and 0.6/100,000 women). Thus, appreciable declines in HL mortality were observed in most Latin America over the last decade, and several major countries reached values comparable to North America. Substantial excess mortality was still observed in Cuba, Costa Rica, Mexico and Venezuela, calling for urgent interventions to improve HL management in these countries.     

Cancer mortality in Italy: an overview of age-specific and age-standardised trends from 1955 to 1984

Number of certified deaths, age-specific and age-standardised rates and percentages of all cancer deaths from 30 cancers or groups of cancers (plus total cancer mortality) for each five-year calendar period between 1955 and 1984 in Italy are presented in tabular form. From these data, three graphs are derived, including trends in age-standardised rates, age-specific rates centered on birth cohorts and maps plotted in different shades of grey to represent the surfaces defined by the matrix of various age-specific rates. These analyses quantified the rises in overall cancer mortality in males (from 137 to 192/100,000 world standard), chiefly due to increases in lung and other tobacco-related neoplasms. Overall cancer mortality was stable in females (around 100/100,000). Appreciable cohort effects were evident for tobacco related neoplasms, but also for other major cancer sites, such as intestines or breast, whose rates, after earlier rises, are now stable in earlier middle age. Since the early 1970's, cancer mortality rates have been declining in all age groups below 40 in males and below 55 in females. These declines reflect improvements in therapy for leukemias, lymphomas and germ cell tumors, and general improvements in food availability and storage, hygiene and early diagnosis, which have led to the declines in stomach and cervical cancer. Although moderate in absolute terms and smaller than in other western countries where tobacco-related neoplasms have also been falling in more recent cohorts, these declines are encouraging for the indication they provide on the most likely patterns over the next decades in the same and subsequent generations.     

Childhood cancer mortality in America,Asia, and Oceania, 1970 through 2007

BACKGROUND:

Over the last 4 decades, childhood cancer mortality declined in most developed areas of the world. However, scant information is available from middle‐income and developing countries. The authors analyzed and compared patterns in childhood cancer mortality in 24 developed and middle‐income countries in America, Asia, and Oceania between 1970 and 2007.

METHODS:

Childhood age‐standardized annual mortality rates were derived from the World Health Organization (WHO) database for all neoplasms, bone and kidney cancer, non‐Hodgkin lymphoma (NHL), and leukemias.

RESULTS:

Since 1970, rates for all childhood cancers dropped from approximately 8 per 100,000 boys to 3 per 100,000 boys and from 6 per 100,000 girls to 2 per 100,000 girls in North America and Japan. Latin American countries registered rates of approximately 5 per 100,000 boys and 4 per 100,000 girls for 2005 through 2007, similar to the rates registered in more developed areas in the early 1980s. Similar patterns were observed for leukemias, for which the mortality rates were 0.81 per 100,000 boys and 0.55 per 100,000 girls in North America, 0.86 per 100,000 boys and 0.68 per 100,000 girls in Japan, and 1.98 per 100,000 boys and 1.65 per 100,000 girls in Latin America for 2005 through 2007. Bone cancer rates for 2005 through 2007 were approximately 2‐fold higher in Argentina than in the United States. During the same period, Mexico registered the highest rate for kidney cancer and Colombia registered the highest rate for NHL, whereas the lowest rates were registered by Japan for kidney and by Japan and the United States for NHL.

CONCLUSIONS:

Improvements in the adoption of current integrated treatment protocols in Latin American and other lower‐ and middle‐income countries worldwide would avoid a substantial proportion of childhood cancer deaths. Cancer 2010;. © 2010 American Cancer Society.     

Trends in cancer mortality in Italy, 1955-1978

Trends in age-specific and age-standardized cancer death certification rates in Italy from 1955 to 1978 were analyzed. In males total cancer mortality rates increased in all age groups. However, when respiratory and other tobacco-related neoplasms were excluded, death certification rates were roughly stable up to age 64. Moderate decreases in overall cancer mortality have been apparent at younger ages (35-44) since the early 1970's. In females, all the age-specific and the age standardized, under-65 death certification rates decreased; the downward trends were more pronounced (-18.5%) in the younger age group considered (35-44 years). Respiratory cancer mortality increased sharply in males: lung cancer death rates reached a plateau in the early 1970's in the 35-44-year age group, but increased at all subsequent ages. In females, the increase in lung cancer mortality was about 50% in the 45-54 and 55-64-year age groups, but no upward trend was evident in younger women. Other tobacco-related cancers (mouth or pharynx, larynx, esophagus, pancreas, kidney and bladder) also rose considerably. In both sexes, gastric cancer mortality dropped about 50% below age 65, but mortality rates from cancer of the stomach were still considerably higher than in other Western countries. Likewise, mortality from cancer of the (cervix) uteri decreased markedly, mostly in younger age groups. Upward trends in death certification rates were evident for cancers of the bowel (colon and rectum, about 50% in males, and 35% in females below age 65), and of the breast in females. However, these trends have levelled off since the late 1960's, at least in the younger age groups. Certified death rates from cancer of the skin (melanoma) increased over all the periods considered in the young of both sexes. Cancer mortality rates showed marked increases in older (greater than or equal to 65) males, but this can be partially explained in terms of better case ascertainment and more accurate death certification.     

Increasing incidence of colon and rectal cancer among Hispanics and American Indians in New Mexico (United States), 1969-94

Objectives: This study evaluates time trends in colon and rectal cancer incidence and mortality among the three major race/ethnic groups (Hispanics, American Indians, and non-Hispanic Whites) in New Mexico (United States). Methods: We used data from the New Mexico Tumor Registry (NMTR) and computed average annual age-standardized incidence and mortality rates. Colon cancer incidence rates were further examined by anatomical subsite. Estimated annual percent change (EAPC) in incidence and mortality over time were computed using Poisson regression. Results: Invasive colorectal cancer incidence rates increased from 1969-89 in all three race/ethnic groups, but decreased among non-Hispanic Whites in 1990-94, while rates continued to increase among minority populations, especially among minority men. Over the 26-year period, EAPC in colon cancer incidence among men was 3.6 percent for Hispanics, 4.7 percent for American Indians, and 0.7 percent for non-Hispanic Whites. Right-sided colon cancers were more common among American Indian women, and among all women aged 65 years and older. Mortality rates decreased steadily among non-Hispanic Whites over the study period, especially among women. Conclusions: Studies are needed to identify important modifiable risk factors and to develop strategies to increase the use of colorectal cancer screening-procedures among the minority populations.