Occupational risks for pleural mesothelioma in Sweden, 1961-79

From national population-based registries linking cancer incidence from 1961 to 1979 with 1960 census data on industry and occupation for all employed individuals in Sweden, a systematic assessment was made of pleural mesothelioma occurrence according to occupational and industrial classifications. There were 318 cases of pleural mesothelioma recorded during the 19-year follow-up period among males employed in 1960, with significant variation by industrial and occupational categorizations. The observed number of pleural mesotheliomas for men employed in the sugar refining, cellulose, wood and pulp, shipbuilding, and railroad equipment manufacturing industries was more than three times the number expected. Occupations with at least twofold excess of mesotheliomas included the craftsman categories of plumbers, mechanics and repairmen, electricians, painters, tire makers, and stationary equipment operators. Our findings are consistent with available data relating mesothelioma to occupational asbestos exposure in other countries, although unexpected associations were found that deserve further epidemiologic study.     

启东1972年～1991年胃癌生存率分析

[目的]分析启东市1972年～1991年全人群胃癌患者的观察生存率和相对生存率。［方法〕观察生存车用Kaplan－Meier法。相对生存率为观察生存率与同期同性别同年龄组人群寿命表中生存概率之比。（结果〕对启东市1972年～1991年胃癌患者7112例（男性4555例,女性2557例）作生存率统计。1982年-1991年的3年至10年生存率显著高于1972年~1981年。5年胃癌观察生存率和相对生存率随年龄增长而下降。男性1、3、5年观察生存率和相对生存率略高于女性。胃癌1、3、5年观察生存率和相对生存率显著高于肝癌。启东5年相对生存率与其它地区比较亦有差异。[结论]胃癌生存率与时期、年龄、性别及地区等存在联系,胃癌生存率还与社会条件和诊治水平等有关。     

Cancer survival in Karunagappally, India, 1991-1997

The rural cancer registry of Karunagappally was established in 1990 to study cancer occurrence due to high natural background radiation in the coastal area of Kerala state. Cancer registration was done by active methods. The registry contributed data on survival for 22 cancer sites or types registered during 1991-1997. Follow-up has been carried out predominantly by active methods, with median follow-up time ranging between 3-57 months for various cancers. The proportion of histologically verified diagnosis for different cancers ranged between 39-100%; death certificates only (DCOs) comprised 0-25%; 75-100% of total registered cases were included for survival analysis. The 5-year age-standardized relative survival rates for common cancers were lung (6%), breast (45%), cervix (55%), mouth (42%), oesophagus (14%) and tongue (31%). Five-year relative survival by age group showed no distinct pattern or trend for most cancers. A majority of cases are diagnosed with a regional spread of disease among cancers of the tongue (48%), oral cavity (66%), hypopharynx (54%), larynx (46%), cervix (61%) and breast (53%); survival decreases with increasing extent of disease.     

Cancer survival in Bhopal, India, 1991-1995

The Bhopal population-based cancer registry was established in 1986 under the national cancer registry programme to investigate the after-effect of a gas leak in 1984. Cancer registration is done entirely by active methods. The registry is contributing data on survival for 16 cancer sites or types registered during 1991-1995. Follow-up of cases was done by active methods with median follow-up time ranging between 8-44 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged between 61-100%; death certificates only (DCOs) comprised 0-2%; 50-92% of total registered cases were included for survival analysis. The 5-year age-standardized relative survival rates for common cancers were mouth (34%), cervix (31%), breast (25%), tongue (12%), oesophagus (3%) and lung (1%). The 5-year relative survival by age group showed that survival was the highest in the youngest age group (45 years and below) for a majority of cancers. A decreasing survival with increasing clinical extent of disease was noted for most cancers studied.     

Cancer survival in Tianjin, China, 1991-1999

The Tianjin cancer registry was established in 1978, and registration of cases is done by the active method. The registry contributed data on 51 cancer sites or types registered during 1991-1999 for this survival study. Follow-up has been a mixture of both active and passive methods, with median follow-up ranging from 5-77 months. The proportion with histologically verified diagnosis for various cancers ranged from 21-95% and 97-100% of total registered cases were included for survival analysis. The top-ranking cancers by 5-year age-standardized relative survival (%) were renal pelvis (101%), lip (99%), corpus uteri (91%), penis and nonmelanoma skin (90%) and thyroid (89%). The corresponding survival for common cancers were lung (31%), stomach (41%), Liver (25%) and breast (82%). The 5-year relative survival by age group reveals an inverse relationship for a few cancers and fluctuated for most cancers. Period survival closely predicted the survival experience of cancer cases diagnosed in that period, with the 5-year relative survival in 1991-1995 by period approach being more or less similar to survival by cohort approach in 1996-1999 for most cancers.     

Metastatic Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia Over Three Decades

Background: Registry data from four major public hospitals indicate trends over three decades from 1980to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stageIV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards modelsfor investigating disease-specific survival and multiple logistic regression analyses for indicating first-roundtreatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses.Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancerdeath approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumourdifferentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggestingreasonable equity in service provision. About 74% of cases were treated surgically and this proportion increasedover time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61%for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of thecases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemictherapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportionshaving: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46%respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offeredtherapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and amongrectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases insurvivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies andsurgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns ofchange accord with clinical guideline recommendations.     

Survival in Women Diagnosed With Breast Cancer During Pregnancy

IntroductionPregnancy rarely coincides with breast cancer, but when it does, uncertainties remain about how survival is affected. In a nation-wide study, we investigated survival in women diagnosed with breast cancer during pregnancy.Materials and MethodsThrough health registries, we identified women with breast cancer at ages 15-44 years from 1973-2016 in Denmark and included 156 who were pregnant at diagnosis and 11,110 who were not. We compared overall mortality in pregnant and non–pregnant women using multivariate Cox regression stratified by time since cancer: <2 and ≥2 years.ResultsDuring the first 2 years after diagnosis, the hazard ratio of overall death was 2.28 (95% CI: 1.48-3.52) for pregnant versus non–pregnant breast cancer patients after adjustment for age and calendar period and 1.62 (95% CI: 1.05-2.50) after further adjustment for extent of disease. Adjusting for additional tumor characteristics, the hazard ratio was still significantly increased. Beyond the first 2 years, there was no excess mortality.ConclusionOur study identifies the early period after breast cancer as a period of particular interest in future studies on survival after breast cancer in pregnancy. We found no evidence that survival is affected by pregnancy when 2 or more years have passed since diagnosis.     

Cancer Mortality Trends in Sweden 1960-1986

Time-related trends in age-standardized cancer mortality have been suggested to be the best single measure of the progress—or lack of progress—in cancer control measures. the paper presents data on trends in Sweden during 1960-1986. From the middle of the 1970s, total cancer mortality decreased significantly among both males and females. the estimated annual decrease between 1975 and 1986 was 0.5-1.2%. Current Swedish trends are thus in keeping with the goal stated in the European Community's action programme 'Europe against cancer': a 10-15% decrease in total age-standardized cancer mortality by the year 2000. This goal might even be too conservative, because most of the cancer control measures in 'Europe against cancer' will not be able to enhance the current downward trends until the early 1990s.     

Colorectal Cancer Mortality Characteristics and Predictions in China, 1991-2011

Background: To identify the epidemiological characteristics of colorectal cancer mortality in China during the period of 1991-2011, and forecast the future five-year trend. Materials and Methods: Mortality data for colorectal cancer in China from 1991 to 2011 was used to describe epidemiological characteristics in terms of age group, gender, and rural/urban residence. Trend surface analysis was performed to analyze the geographical distribution of colorectal cancer. Four models including curve estimation, time series modeling, gray modeling and joinpoint regression were applied to forecast the trends for the future five years. Results: Since 1991 the colorectal cancer mortality rate increased yearly, and our results showed that the trend would continue to increase in the ensuing 5 years. The mortality rate in males was higher than that of females and the rate in urban areas was higher than in rural areas. The mortality rate was relatively low for individuals less than 60 years of age, but increased dramatically afterwards. People living in the northeastern China provinces or in eastern China had a higher mortality rate for colorectal cancer than those living in middle or western China provinces. Conclusions: The steadily increasing mortality of colorectal cancer in China will become a substantial public health burden in the foreseeable future. For this increasing trend to be controlled, further efforts should concentrate on educating the general public to increase prevention and early detection by screening. More effective prevention and management strategies are needed in higher mortality areas (Eastern parts of China) and high-risk populations (60+ years old).     

Cancer Patient Survival - Patterns, Comparisons, Trends: A Population-based Cancer Registry Study in Finland

The effects of primary site, sex, age, stage and histological type on cancer patient survival were analysed on the basis of the population-based material of the Finnish Cancer Registry from 1985 to 1994. In addition, trends in survival were constructed for the period 1955-1994. Detailed site-specific data are published as Supplement 12 to Vol. 38 of Acta Oncologica. Within a given site, the survival differences by gender were not large. However, because of different site distributions, the average prognosis for female patients, all sites taken together, was superior to that of males: the 5-year relative survival rates (RSR) were 58% and 43%, respectively. In general, older patients had a poorer outcome compared with younger patients (partly because of different stage and histology distributions). Stage was a strong determinant of patient survival. In some cancers with a poor average prognosis the 5-year RSR for localized tumours was reasonable, e.g. 61% for stomach cancer, males, 34% for gallbladder cancer, females, and 29% for lung cancer, males. Most of the survival rates clearly increased over time. In addition to improvements in cancer treatment, changes over time in several other factors affect the trends, such as changes in the stage distribution (early diagnosis as a result of health education, improved diagnostic methods, screening, etc.) and in the composition of the patient material because of changing definitions of cancer (e.g. papilloma versus papillary carcinoma of the bladder, occult carcinoma of the thyroid, and early prostate cancer). The large Cancer Registry material (466000 patients) enabled accurate estimates of the survival rates of cancer patients in Finland. These rates reflect the effectiveness of the healthcare system as a whole and are useful for planning and evaluation purposes. However, the estimated survival rates are based on grouped data, and cannot be directly applied for predicting the prognoses of individual patients, although they can be used as guidelines.     

Cervical Cancer Mortality Trends in China, 1991-2013, and Predictions for the Future

Background: To analyze cervical cancer mortality trends in China from 1991-2013 and forecast the mortalitydistribution in future five years (2014-2018), and provide clues for prevention and treatment. Materials andMethods: Mortality data for cervical cancer in China from 1991 to 2013 were used to describe the epidemiologicalcharacteristics and distribution, including the trend of the standardized mortality rate, urban-rural differences,and age variation. Trend-surface analysis was used to analyze the geographical distribution of mortality. Curveestimation, time series, gray modeling, and joinpoint regression were performed to predict and forecast mortalitytrends. Results: In recent years, the mortality rate of cervical cancer has increased, and there is also a steadyincrease in the incidence from 2003 to 2013 in China. Mortality rates in rural areas are higher than in urbanareas. The mortality dramatically increases in the 40+ yr age group, reaching a peak in the >85 yr age group.In addition, geographical analysis showed that the cervical cancer mortality increased from the southwestto west-central and from the southeast to northeast of the country. Conclusions: The incidence rate and themortality rate are increasing from 1991 to 2013, and the predictions show this will continue in the future. Thus,implementation of prevention and management programs for cervical cancer are necessary in China, especiallyfor rural areas, young women in urban areas, and high risk regions (the west-central).     

Survival of Thyroid Cancer and Social Determinants in Iran, 2001-2005

Background: Thyroid cancer is the most common endocrine system malignancy in the world, being the 7thmost common cancer in females, 14th in males and 11th in both sexes in the Iranian population. The presentstudy aimed to determine survival of thyroid cancers in Iran based on sex, age group, pathology and geographicallocation. Methods: The patients selected for this study were 602 out of 5,759 cases listed in the cancer registrysystem between 2001 and 2005. The Kaplan-Meier method was used for survival estimation and Cox’s proportionalhazard model for calculating hazard ratios according to demographic and risk variables. Results: The overall5-year survival rate was 88.0%. There was a significant difference between survivals of the two sexes. Thebest and worst survival were in the age groups under 40 and over 60 years old, respectively. The best survivalwas for papillary type, with the anaplastic type demonstrating the worst survival. The best survival was in thesouthwest (Khuzestan) and the worst in the northwest (Azarbaijan). Conclusion: Size of young population andsocial determinants may be important effective elements for differences in survival, which should be taken moreinto consideration in managing chronic disease such as thyroid cancer.     

Survival of Stomach Cancer Cases in Khon Kaen,Thailand 2000-2012

Background: Stomach cancer is an aggressive malignancy that is difficult to detect at an early stage and therefore is characterized by poor survival rates. Over the last two decades, there has been no report of gastric cancer survival in Khon Kaen province, Thailand. The aim of this retrospective cohort study was to provide up-to-date information about the survival of gastric cancer patients in this province. Materials and Methods: Data from Khon Kaen population-based cancer registry, Faculty of Medicine, Khon Kaen University were newly obtained on 650 patients who were diagnosed with stomach cancer during the period 1 January, 2000 to 31 December, 2012. These were then followed up until death or the end of the study (31 December 2014). We calculated the observed survival with the actuarial life table method, and relative survival, defined as the ratio of observed survival in the group of the stomach cancer patients to the expected survival in the entire Thai population from the estimated generation life tables for Thailand of five-year birth cohorts from 1900 - 2000. Results: The 5 year observed and 5 year relative survival rates were 17.2 % (95% CI: 13.54-21.14) and 18.2 % (95% CI: 14.3-22.4), respectively. The highest 5 year relative survival rates were demonstrated among patients aged 45-65, with stage I or II lesions, with adenocarcinomas, with a body of stomach location, well differentiated and receiving surgery and/or chemotherapy. Conclusions: The observed and relative survival rates were close to each other. Our findings provide basic information beneficial to development of an effective treatment system and appropriately improved population-based cancer registration.     

Melanoma and other tumors of the skin among office, other indoor and outdoor workers in Sweden 1961-1979

Through a record linkage of the 1960 Swedish Population Census and the 1961-79 Cancer Registry it was possible to analyse the occurrence of melanoma and other skin tumours by occupations, classified as either outdoor, office or other indoor work. Office work as compared to other indoor work was associated with risk of melanoma of the covered, but not the uncovered, parts of the body. It is shown that social class is a confounding factor in such analysis, but the elevated risk of melanoma of covered parts of the body among office workers is not entirely due to their higher social class.