Population-based incidence and mortality cancer trends (1986-1997) from the network of Italian cancer registries.

The objective of this study was to analyse incidence and mortality cancer trends in the Italian Network of Cancer Registries (about 8,000,000 inhabitants) during the period 1986-1997. Included were 525,645 newly diagnosed cancers and 269,902 cancer deaths (subjects > 14 years). Joinpoints (points in time where trend significantly changes from linearity) were found and estimated annual percentage changes (EAPC) used to summarize tendencies. Overall cancer incidence increased in both sexes and cancer mortality significantly decreased (since 1991 among men). Lung cancer showed significantly decreasing incidence (EAPC = -1.4%) and mortality (EAPC = -1.6%) among men and increasing trends among women. In women, breast cancer incidence significantly increased (EAPC= +1.7%) and mortality decreased since 1989 (EAPC= -2.0%). Stomach cancer incidence and mortality decreased in both sexes. Prostate incidence sharply increased since 1991 and mortality decreased. Colon cancer incidence increased and rectum mortality decreased significantly in both sexes. Significant increases in incidence were also found for kidney (up to 1991 among men), urinary bladder, skin epithelioma, melanoma, liver (up to 1993 among men), pancreas, mesothelioma, Kaposi's sarcoma (up to 1995 among men), testis, thyroid, non-Hodgkin's lymphomas and multiple myeloma. Mortality significantly decreased for cancers of the oral cavity and pharynx, oesophagus, liver (women), larynx (men), bone, cervix (since 1990), central nervous system, urinary bladder, thyroid, Hodgkin's lymphomas and leukaemias (men). Non-Hodgkin's lymphoma mortality increased in both sexes. In conclusion, most of the changes seen can be explained as the effect of changes in smoking habits and of the extension of secondary prevention activities. The Italian health care system will also have to cope with growing cancer diagnostic and therapeutic needs due to population ageing.     

A trend analysis of breast cancer incidence rates in the United States from 2000 to 2009 shows a recent increase

Recent reports have shown that the breast cancer incidence rate in the US stabilized after a sharp reduction in 2002 and 2003. It is important to continue monitoring breast cancer incidence rates according to age group, race/ethnicity, estrogen receptor (ER) status, and tumor stage. Age-standardized breast cancer incidence rates were calculated using data from the surveillance, epidemiology, and end results 18 registries from 2000 to 2009, for 677,774 female breast cancer patients aged 20 and above. Jointpoint regression models were used to fit a series of joined straight lines on a log scale to annual age-standardized rates. The incidence rates of all breast cancer significantly increased for non-Hispanic blacks from 2005 to 2009 (annual percentage change, APC = 2.0 %, p = 0.01) and Asian/Pacific Islanders from 2000 to 2009 (APC = 1.2 %, p = 0.02). Since 2004, incidence rates in women aged 40–49 years significantly increased for most racial/ethnic groups (overall APC = 1.1 %, p = 0.001). The incidence rate of carcinoma in situ significantly increased in all racial/ethnic groups, with an APC range from 2.3 to 3.0 % (p < 0.005). The localized breast cancer incidence significantly increased in non-Hispanic blacks (APC = 1.3 %, p = 0.004) and Asians (APC = 1.2 %, p = 0.03). ER-positive breast cancer significantly increased in almost all age/race sub-groups after 2005 (APC by race: non-Hispanic whites 1.5 %, non-Hispanic blacks 4.3 %, Asian/Pacific Islanders 1.7 %, and Hispanics 1.8 %; all p values <0.05), while ER-negative breast cancer decreased in most sub-groups (APC by race: non-Hispanic whites—3.9 %, non-Hispanic blacks—3.7 %, Asian/Pacific Islanders—1.5 %, and Hispanics—4.3 %; all p values <0.05). Recently the incidence of breast cancer appears to be increasing in certain subgroups, including ER-positive, early-stage breast cancers, in particular among non-Hispanic blacks and Asian/Pacific Islanders. Further studies are warranted to examine possible reasons for these changes, such as changes in mammography screening methods and risk factors prevalence.     

Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data

BACKGROUND: Traditional cancer-survival analyses provide data on cancer management at the beginning of a study period, and are often not relevant to current practice because they refer to survival of patients treated with older regimens that might no longer be used. Therefore, shortening the delay in providing survival estimates is desirable. Period analysis can estimate cancer survival by the use of recent data. We aimed to apply the period-analysis method to data that were collected by European cancer registries to estimate recent survival by country and cancer site, and to assess survival changes in Europe. We also compared our findings with data on cancer survival in the USA from the US SEER (Surveillance, Epidemiology, and End Results) programme. METHODS: We analysed survival data for patients diagnosed with cancer in 2000-02, collected from 47 of the European cancer registries participating in the EUROCARE-4 study. 5-year period relative survival for patients diagnosed in 2000-02 was estimated as the product of interval-specific relative survival values of cohorts with different lengths of follow-up. 5-year survival profiles for patients diagnosed in 2000-02 were estimated for the European mean and for five European regions, and findings were compared with US SEER registry data for patients diagnosed in 2000-02. A 5-year survival profile for patients diagnosed in 1991-2002 and a 10-year survival profile for patients diagnosed in 1997-2002 were also estimated by the period method for all malignancies, by geographical area, and by cancer site. FINDINGS: For all cancers, age-adjusted 5-year period survival improved for patients diagnosed in 2000-02, especially for patients with colorectal, breast, prostate, and thyroid cancer, Hodgkin's disease, and non-Hodgkin lymphoma. The European mean age-adjusted 5-year survival calculated by the period method for 2000-02 was high for testicular cancer (97.3% [95% CI 96.4-98.2]), melanoma (86.1% [84.3-88.0]), thyroid cancer (83.2% [80.9-85.6]), Hodgkin's disease (81.4% [78.9-84.1]), female breast cancer (79.0% [78.1-80.0]), corpus uteri (78.0% [76.2-79.9]), and prostate cancer (77.5% [76.5-78.6]); and low for stomach cancer (24.9% [23.7-26.2]), chronic myeloid leukaemia (32.2% [29.0-35.7]), acute myeloid leukaemia (14.8% [13.4-16.4]), and lung cancer (10.9% [10.5-11.4]). Survival for patients diagnosed in 2000-02 was generally highest for those in northern European countries and lowest for those in eastern European countries, although, patients in eastern European had the highest improvement in survival for major cancer sites during 1991-2002 (colorectal cancer from 30.3% [28.3-32.5] to 44.7% [42.8-46.7]; breast cancer from 60% [57.2-63.0] to 73.9% [71.7-76.2]; for prostate cancer from 39.5% [35.0-44.6] to 68.0% [64.2-72.1]). For all solid tumours, with the exception of stomach, testicular, and soft-tissue cancers, survival for patients diagnosed in 2000-02 was higher in the US SEER registries than for the European mean. For haematological malignancies, data from US SEER registries and the European mean were comparable in 2000-02, except for non-Hodgkin lymphoma. INTERPRETATION: Cancer-service infrastructure, prevention and screening programmes, access to diagnostic and treatment facilities, tumour-site-specific protocols, multidisciplinary management, application of evidence-based clinical guidelines, and recruitment to clinical trials probably account for most of the differences that we noted in outcomes.     

Comparison of cancer mortality (rectal cancer) in five countries: France, Italy, Japan, UK and USA from WHO mortality database (1960-2000)

Overall males have higher age-standardized mortality rates (ASRs)compared with females, although long-term trends in ASRs differsubstantially between countries. In males from France and theUK a steady decreasing trend is observed, while Italy and theUSA exhibit a bottoming out after a decreasing trend over thestudy period. Japan exhibits an     

Phosphorus NMR study of the response of a murine tumour to hyperthermia as a function of treatment time and temperature

Evaluating the response of tumours to therapy promises to become one of the major applications of in vivo phosphorus (³¹P) nuclear magnetic resonance spectroscopy. Decreases in the levels of organic phosphates in favour of inorganic phosphate (Pi) as occur in murine tumours after hyperthermia treatment, can be quantified by the ratio ATP/Pi. In this study the relationship between the time of heating (15, 30 and 60 min) and the temperature (43 and 44°C) was investigated in mice with NU-82 tumours by considering the changes in ATP/Pi ratio as a function of both variables. After 30 min treatment at 43 °C the percentage decrease in ATP/Pi ratio was similar to that observed after 15 min at 44°C (42 ±9 vs. 48 ±9); after 60 min at 43°C the decrease was similar to that after 30 min at 44°C (75 ±7 vs. 74±4). These results give further evidence for the validity of a current working definition of thermal dose: thermal dose= ± 2^T-43 dt. In addition this study shows that in vivo ³¹P NMR spectroscopy can be a useful means for assessment of thermal dose.     

Phosphorus NMR study of the response of a murine tumour to hyperthermia as a function of treatment time and temperature

Evaluating the response of tumours to therapy promises to become one of the major applications of in vivo phosphorus (31P) nuclear magnetic resonance spectroscopy. Decreases in the levels of organic phosphates in favour of inorganic phosphate (Pi) as occur in murine tumours after hyperthermia treatment, can be quantified by the ratio ATP/Pi. In this study the relationship between the time of heating (15, 30 and 60 min) and the temperature (43 and 44 degrees C) was investigated in mice with NU-82 tumours by considering the changes in ATP/Pi ratio as a function of both variables. After 30 min treatment at 43 degrees C the percentage decrease in ATP/Pi ratio was similar to that observed after 15 min at 44 degrees C (42 +/- 9 vs. 48 +/- 9); after 60 min at 43 degrees C the decrease was similar to that after 30 min at 44 degrees C (75 +/- 7 vs. 74 +/- 4). These results give further evidence for the validity of a current working definition of thermal dose: thermal dose = t integral of 0 2T-43 dt. In addition this study shows that in vivo 31P NMR spectroscopy can be a useful means for assessment of thermal dose.     

Comparison of cancer mortality (lung cancer) in five countries: France, Italy, Japan, UK and USA from the WHO Mortality Database (1960-2000)

Lung cancer mortality age-standardized rates (ASRs; using 1985Japanese standard population) are shown for Japan, USA, UK,France, and Italy (Fig 1). For men (Fig. 1, left), all fivecountries experienced a rapid increase in ASRs of lung cancersince the 1960s. During the 1960s and 1970s, ASRs of lung cancerfor men in the UK and USA were much higher compared with     

Paired tumour infiltrating lymphocyte (TIL) and tumour cell line from bladder cancer: a new approach to study tumour immunology in vitro

This paper reports the first example of tumour infiltrating lymphocytes (TILs) and a tumour cell line from the same individual and analyses their characteristics. The tumour cell line (CAT), derived from a patient with well-differentiated (G3pTa) TCC, has been in culture for 24 months and subcultured more than 100 times. Epithelial origin was established by electronmicroscopy and use of a range of monoclonal antibodies (Mabs) against cytokeratins. The TILs isolated from the same tumour expressed all the phenotypic characteristics of normal activated T cells and demonstrated low levels of cytotoxicity against the autologous tumour line (CAT). Comparison of cell surface molecules of these cells revealed the loss of HLA-B7, B44 and Bw6 from the CAT cells whilst maintaining HLA-A2, A3 and Bw4. Karyotypic analysis demonstrated three rearranged chromosomes (between chromosomes 4 and 11, 10 and 13, 11 and 17) on CAT cells. The potential that study of paired autologous tumour cells and TILs in culture offers for studying the role of MHC antigens in tumour rejection and the impact of different approaches to correcting the defect are reviewed.     

Primary central nervous system lymphoma - A hospital based study of incidence and clinicopathological features from India (1983-2003)

Over the last two decades, an increase in the incidence of PCNSL cases has been reported in the West, both among immunosuppressed and immunocompetent patients. The present study was undertaken to assess the trend of incidence of PCNSL cases in India. To the best of our knowledge, only a single such report is available from India. All biopsy proven PCNSL cases obtained from the Neurosurgical databases of two large referral hospitals, one in Northern India (AIIMS, New Delhi) and another in Southern India (NIMHANS, Bangalore) from the period 1980 to 2003, were reviewed. Immunophenotyping was done and relevant clinical details collected. Appropriate statistical analysis was done to assess any change in trend of incidence or age at presentation. PCNSL cases constituted 0.95% and 0.92% of the total intracranial neoplasms at AIIMS and at NIMHANS, respectively. The mean age for cases diagnosed at AIIMS was 44.35 years, while that for NIMHANS was 39.51 years. Statistical analysis to evaluate any change in trend either of incidence or of age at presentation, over the study period, did not reveal any significant change. All the cases occurred in immunocompetent patients, except one case of HIV positive at NIMHANS, and one case of renal transplant at AIIMS. Frontal lobe was the most common site of involvement. Majority of the cases were diffuse, high grade, large cell lymphoma, B-cell immunophenotype. Thus, this multicentric hospital based study did not reveal any increase in incidence of PCNSL cases in India over the past 24 years. Further, in contrast to the West, majority of the cases in this Indian study were immunocompetent and a decade younger than in the West. The association of PCNSL with HIV/AIDS has been low in India, possibly due to early death in AIDS on account of opportunistic infections.This revised version was published online in April 2005 with corrections to the article title.     

A clinical study of CA-50 as a tumour marker for monitoring of colorectal cancer

Using a radioimmunoassay we have determined serum levels of the carcinoma-associated antigen CA-50 in 266 patients with colorectal cancer. Elevated CA-50 levels were found in Dukes' A (15%), Dukes' B (43%), Dukes' C (31%) and Dukes' D (65%). Patients who had developed a recurrence had 66% elevated levels. 25% of resected patients with no evidence of disease also had elevated CA-50 levels. From 139 patients operated on for a Dukes' A-C, a rise in CA-50 levels from the pre- to the 6-9 month post-operative sample was demonstrated in 12 cases in the absence of any clinical evidence for a recurrence. On follow-up, a recurrence later developed in all these cases with lead times of CA-50 titre rises ranging from 5 to 40 months. A rise in CA-50 levels after resection of a Dukes' A-C is indicative of a recurrence and may precede any clinical evidence of disease by several months or years. Data is also presented from 552 cases with colorectal cancer analysed with a immunoradiometric assay.     

A multicenter study of primary brain tumor incidence in Australia (2000-2008)

There are conflicting reports from Europe and North America regarding trends in the incidence of primary brain tumor, whereas the incidence of primary brain tumors in Australia is currently unknown. We aimed to determine the incidence in Australia with age-, sex-, and benign-versus-malignant histology-specific analyses. A multicenter study was performed in the state of New South Wales (NSW) and the Australian Capital Territory (ACT), which has a combined population of >7 million with >97% rate of population retention for medical care. We retrospectively mined pathology databases servicing neurosurgical centers in NSW and ACT for histologically confirmed primary brain tumors diagnosed from January 2000 through December 2008. Data were weighted for patient outflow and data completeness. Incidence rates were age standardized and trends analyzed using joinpoint analysis. A weighted total of 7651 primary brain tumors were analyzed. The overall US-standardized incidence of primary brain tumors was 11.3 cases 100 000 person-years (±0.13; 95% confidence interval, 9.8-12.3) during the study period with no significant linear increase. A significant increase in primary malignant brain tumors from 2000 to 2008 was observed; this appears to be largely due to an increase in malignant tumor incidence in the ≥65-year age group. This collection represents the most contemporary data on primary brain tumor incidence in Australia. Whether the observed increase in malignant primary brain tumors, particularly in persons aged ≥65 years, is due to improved detection, diagnosis, and care delivery or a true change in incidence remains undetermined. We recommend a direct, uniform, and centralized approach to monitoring primary brain tumor incidence that can be independent of multiple interstate cancer registries.     

A study of 9-nitrocamptothecin (RFS-2000) in patients with advanced pancreatic cancer

This ongoing study evaluates the efficacy of oral 9-nitrocamptothecin (9NC), or RFS-2000, in the treatment of advanced pancreatic cancer. Patients received 9NC orally for 5 days/week; 8 weeks of therapy is required to achieve minimum effective dose. Starting dose was 1.5 mg/m2/day, with adjustments made as necessary. Patients were analyzed for changes in tumor size by CT scan, changes in serum CA 19-9 tumor marker levels, quality of life, and survival. 107 consecutive patients with advanced adenocarcinoma of the pancreas were enrolled before November 3, 1997. Of this group, 47 patients did not receive the minimum 2 courses of treatment necessary to induce response, leaving 60 evaluable patients. Primary dose-limiting toxicities were myelosuppression and interstitial cystitis. No deaths were attributed to 9NC. Median survival was 6.5 months for the 107 total patients and 8.7 months for the 60 evaluable patients, with one patient surviving at 44+ months. Of the 60 evaluable patients, 31.7% were responders (median survival 18.6 months; range 6.5-44.7+ months), 31.7% were stable (median survival 9.7 months), and 36.6% were non-responders (median survival 6.8 months). Fifty-seven previously untreated patients had a median survival of 7.3 months compared to 4.7 months for the 50 previously treated patients. Thirty-three patients who failed gemcitabine therapy prior to 9NC treatment had a median survival of 4.7 months. 9NC is safe and efficacious as first-line therapy for the treatment of advanced pancreatic cancer. It also shows some modest success as second-line therapy in treating gemcitabine failures.     

Comparison of pancreatic cancer mortality in five countries: France, Italy, Japan, UK and USA from WHO mortality database (1960-2000)

Pancreatic cancer mortality age-standardized rates (ASRs; using1985 Japanese standard population) are shown for Japan, USA,UK, France, and Italy (Fig. 1). ASRs of pancreatic cancer forboth males and females are quite similar for four decades inthese countries. After     

非典型脊柱结核误诊脊柱肿瘤19例术后分析

目的探讨非典型脊柱结核误诊脊柱肿瘤的原因.方法对误诊脊柱肿瘤的19例非典型脊柱结核患者的临床表现,病史采集,影像学及实验室检查特点进行回顾性分析.结果由于本组病例临床表现的不典型,采集病史的不详细,对影像学检查的误区及实验室检查的非特异性,使本组19例非典型脊柱结核患者误诊为脊柱肿瘤.结论只有正确认识非典型脊柱结核的临床表现,认真仔细的采集病史,提高自身对影像学知识的学习,充分了解非典型脊柱结核实验室检查的特点,才能减少误诊的发生.     

Pro-gastrin-releasing peptide (31-98) as a tumour marker of small-cell lung cancer: comparative evaluation with neuron-specific enolase.

We attempted to clarify whether serum levels of a carboxy-terminal fragment of ProGRP, ProGRP(31-98), could serve as a more accurate tumour marker in patients with SCLC than neuron-specific enolase (NSE). ProGRP(31-98) and NSE were measured retrospectively in 101 newly diagnosed untreated patients with SCLC, 111 with non-small-cell lung cancer (NSCLC) and 114 patients with non-malignant lung diseases. ProGRP(31-98) and NSE levels were determined using a sandwich enzyme-linked immunosorbent assay. Sensitivity in SCLC patients was 72.3% for ProGRP(31-98) and 62.4% for NSE. Comparing the area under curve (AUC) of ''receiver operator characteristics'' of ProGRP(31-98) with that of NSE, ProGRP(31-98) was the more powerful marker in the diagnosis of SCLC (P = 0.0001). Serum levels of ProGRP(31-98) were higher in the 40 patients with extensive disease than in the 61 patients with limited disease (P = 0.0082). ProGRP(31-98) was significantly higher in patients with pure small-cell carcinoma than in patients with mixed small-cell/large-cell carcinoma (P = 0.02). In serial measurement in 16 patients responding to treatment, a high degree of correlation was noted between the decrease in serum ProGRP(31-98) levels and clinical response during the second week after treatment (P = 0.0045). These results indicate that the determination of serum ProGRP(31-98) levels plays an important role in the diagnosis and treatment of SCLC patients.