启东市1972~2011年乳腺癌发病趋势分析

[目的]探讨启东市1972-2011年乳腺癌发病变化趋势,为乳腺癌预防控制提供依据。[方法]根据启东市1972-2011年癌症发病登记数据库,对乳腺癌发病率作年龄、时间趋势分析,计算指标包括粗发病率、中国人口标化率（中标率）、世界人口标化率（世标率）、35-64岁截缩率、0-74岁累积率、累积风险、变化百分比（PC）及年均变化百分比（APC）等。[结果]1972-2011年启东男女性乳腺癌共发病3452例,粗发病率为7.68/10万,占全部癌症发病的3.72%,位居癌症发病第6位。中标率和世标率分别为4.65/10万和6.13/10万;35-64岁截缩发病率为15.31/10万;0-74岁累积发病率为0.64%;乳腺癌发病的累积风险为0.64%。男女性乳腺癌发病性别比为1∶62.93。女性乳腺癌位居女性癌症发病的第4位,粗率、中标率和世标率分别为14.94/10万、9.00/10万和11.78/10万。女性乳腺癌的发病率随年龄的增加而升高,35-岁组进入增长期,50-岁组达到发病率高峰,为37.10/10万。40年间女性乳腺癌发病的粗率、中标率和世标率的变化百分比（PC）分别为269.74%、73.80%和81.48%,年均变化百分比（APC）分别为3.38%、1.21%和1.31%。各时期女性乳腺癌发病率显示25-34岁年龄组的升降趋势不明显,35-岁以后各年龄组的发病率均有上升趋势。年龄-出生队列方法分析女性乳腺癌,显示40-岁以后各年龄组的发病率均呈上升趋势。[结论]启东近40年来女性乳腺癌发病率有上升趋势,40岁以上的女性是乳腺癌防治的重点。     

Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

The effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Cancer Registry provided detailed data on breast cancer incidence in 1989-1997 by tumour stage, age and region. Annual age-adjusted incidence rates of all breast cancers and advanced cancers, defined as large tumours T2+ with lymph node and/or distant metastases, were compared with rates in 1989. In general, breast cancer incidence rose strongly in the early 1990s, especially in the age category 50-69 years (estimated annual percentage change (EAPC) 4.25; 95% CI 1.70, 6.86). The increase was mainly due to the increase in small T1 cancers and ductal carcinoma in situ. However, in women aged 50-69, advanced cancer incidence rates showed a significant decline by 12.1% in 1997 compared with 1989 (EAPC -2.14, 95% CI -3.47, -0.80), followed by a breast cancer mortality reduction of similar size after approximately 2 years. We confirm that breast cancer screening initially leads to a temporary strong increase in the breast cancer incidence, which is followed by a significant decrease in advanced diseases in the women invited for screening. It is evident that breast cancer screening contributes to a reduction in advanced breast cancers and breast cancer mortality.     

Time trends in cancer incidence in Osaka

Changes in environments and life styles in Japan have caused the recent changes in the time trends of cancer incidence for various sites. Using the data from the Osaka Cancer Registry, time trends during 1966-80 were analysed for cancer incidence of the leading 5 sites: stomach, lung, liver, uterus and breast. Age-adjusted incidence rates of cancers of the stomach (both sexes) and uterus (invasive cancer) decreased to 75% and 64% respectively between the two periods of 1966-68 and 1978-80 while cancers of the lung, liver, and breast reached 163%, 140%, and 143 % during the same period. Decrease of stomach cancer incidence was observed in all age-groups under 79, however, not in the 25-44 age-groups among females. Analyzing the histological data in the registry, it was noticed that estimated incidence of the intestinal type of stomach carcinoma had decreased more rapidly than the diffuse type. In the 30-49 age-groups among females, no decrease was observed of the diffuse type of carcinoma. Concerning lung cancer, a marked increase was observed over 60 years of age. The age-specific incidence curves by birth cohort showed no or very small cohort effects for the population born 1920-29. Among males, percentages of adenocarcinoma and undifferentiated carcinoma have increased and that of epidermoid carcinoma decreased. The change was more marked in the age-groups younger than 59. Liver cancer showed the 3rd highest incidence rate among males and 6th among females. A rising trend in recent years was noticeable over 45 years of age among males. For the invasive uterine carcinoma, the incidence rate has been decreasing in all ages. Comparing these figures with those of whites in Connecticut or of Japanese in Hawaii, the former was higher than the latter and the difference was larger in age-groups over 40. The recent age incidence curve of breast cancer in Osaka came to be close to that in Iceland in 1930-49 when the curve had kept a constant level for age-groups after menopause. Birth cohort effect was observed for in these age classes.     

Breast Cancer in Iraq,Incidence Trends from 2000-2009

Background: Breast cancer is the most frequent malignancy of women worldwide. In Iraq, breast cancer ranksfirst among cancers diagnosed in women but no studies have been conducted on incidence trends. The presentstudy of breast cancer in the country during 2000-2009 was therefore performed. Materials and Methods: Theregistered data for breast cancer cases were collected from the Iraqi Cancer Registry/Ministry of Health. Thesignificance of incidence rate trends during 2000-2009 was tested using Poisson regression. Age-standardizedrates (ASR), and age-specific rates per 100,000 population were calculated. Results: A total of 23,792 incidentbreast cancer cases were registered among females aged ≥15 years, represented 33.8% of all cancers in femalesregistered during 2000-2009. It ranked first in all the years. The median age at diagnosis was 49 and the mean agewas 52 years. The incidence rate of all female breast cancer in Iraq (all ages) increased from 26.6 per 100,000 in2000 to 31.5 per 100,000 in 2009 (APC=1.14%, p<.0001). The incidence in age groups (40-49), (50-59) and (70+)increased in earlier years and has recently (2005-2009) become stable. The incidence in age group (60-69) didnot decline since 2003, while the incidence rates in the age group (15-39) started to decline in 2004. Conclusions:With the Iraqi Cancer Registry data during the period 2000-2009, the incidence of all female breast cancer inIraq (all ages) has risen. We found rapid increase in the age specific incidence rate among age group 60-69.However, breast cancer among Iraqi women still affects younger age groups than their counterparts in developedcountries. Further epidemiological research is needed to examine possible causes and prevention measures.     

Coffee consumption and the risk of colorectal cancer: a prospective cohort study in Japan

An inverse association between coffee consumption and the risk of colorectal cancer has been reported in several case-control studies, but results from prospective cohort studies have been inconclusive. We conducted a prospective cohort study among a Japanese population to clarify the association between coffee consumption and the risk of colorectal cancer incidence. We used data from the Miyagi Cohort Study for this analysis. Usable self-administered questionnaires about coffee consumption were returned from 22,836 men and 24,769 women, aged 40-64 years, with no previous history of cancer. We used the Cox proportional-hazard regression model to estimate hazard ratios and 95% confidence intervals. During 11.6 years of follow-up (425,303 person-years), we identified 457 cases of colorectal cancer. Coffee consumption was not associated with the incidence of colorectal, colon or rectal cancer. The multivariate-adjusted hazard ratio (95% confidence interval) of colorectal cancer incidence for 3 or more cups of coffee per day as compared with no consumption was 0.95 (0.65-1.39) for men and women (p for trend = 0.55), 0.91 (0.56-1.46) for men (p for trend = 0.53) and 1.16 (0.60-2.23) for women (p for trend = 0.996). Coffee consumption was also not associated with incidence of either proximal or distal colon cancer. We conclude that coffee consumption is not associated with the incidence risk of colorectal cancer in the general population in Japan.     

Randomized trial of fenretinide to prevent second breast malignancy in women with early breast cancer.

BACKGROUND: Fenretinide, a vitamin A analogue, has been shown to inhibit breast carcinogenesis in preclinical studies. We determined the efficacy of fenretinide in preventing a second breast malignancy in women with breast cancer. METHODS: We randomly assigned 2972 women, aged 30-70 years, with surgically removed stage I breast cancer or ductal carcinoma in situ to receive for 5 years either fenretinide orally (200 mg/day) or no treatment. The primary end point was the incidence of contralateral breast cancer or ipsilateral breast cancer 7 years after randomization. Other end points considered post hoc were the same outcomes stratified by menopausal status, incidence of distant metastases, overall mortality, and tumors in other organs. The hazards of breast cancer occurrence were determined by Cox proportional hazards regression analysis. Statistical tests were two-sided. RESULTS: At a median observation time of 97 months, there were no statistically significant differences in the occurrence of contralateral breast cancer (P =.642) or ipsilateral breast cancer (P =.177) between the two arms. However, an interaction was detected between fenretinide treatment and menopausal status in both outcomes (P for interaction in both outcomes =.045), with a possible beneficial effect in premenopausal women (contralateral breast cancer: adjusted hazard ratio [HR] = 0.66, and 95% confidence interval [CI] = 0.41-1.07; ipsilateral breast cancer: adjusted HR = 0.65, and 95% CI = 0.46-0. 92) and an opposite effect in postmenopausal women (contralateral breast cancer: adjusted HR = 1.32, and 95% CI = 0.82-2.15; ipsilateral breast cancer: adjusted HR = 1.19, and 95% CI = 0.75-1. 89). There were no statistically significant differences between the two arms in tumors in other organs, incidence of distant metastasis, and all-cause mortality. CONCLUSIONS: Fenretinide treatment of women with breast cancer for 5 years appears to have no statistically significant effect on the incidence of second breast malignancies overall, although a possible benefit was detected in premenopausal women. These studies, particularly the post hoc analyses, are considered exploratory and need to be confirmed.     

上海市金山区2002～2013年恶性肿瘤发病时间趋势分析

[目的]了解近年来上海市金山区恶性肿瘤发病变化趋势,为政府部门制定肿瘤防治策略和措施提供参考依据.[方法]利用基于居民健康档案的肿瘤登记报告系统采集辖区居民肿瘤发病个案信息,并计算2002～2013年金山区不同性别、不同年龄组及不同类别恶性肿瘤的粗发病率、标化发病率和年度变化百分比(APC)等指标.[结果]2002～2013年,金山区男性恶性肿瘤粗发病率APC=4.58％ (P＜0.01),标化发病率APC=0.98％(P＞0.05).女性恶性肿瘤粗发病率APC=7.06％ (P＜0.01),标化发病率APC=4.38％ (P＜0.01);男性除65岁及以上年龄组外,其余0～14岁组、15～44岁和45～64岁组肿瘤发病率均随时间呈上升趋势(APC=1 1.03％、3.47％、1.54％,P＜0.05),女性则除0～14岁组外,其余年龄段肿瘤发病率也呈上升趋势(APC=8.77％、4.56％、3.54％,P＜0.01).12年间,男性肺癌、胃癌、膀胱癌、脑肿瘤、白血病标化发病率无明显变化趋势(APC=-0.22％、-1.55％、-0.93％、-1.42％和1.13％,P＞0.05),结直肠癌、胰腺癌和前列腺癌标化发病率呈上升趋势(APC=4.94％、4.08％和8.96％,P＜0.05),肝癌标化发病率则呈下降趋势(APC=-3.70％,P＜0.01).同期,女性乳腺癌、肺癌、甲状腺癌、子宫癌、脑肿瘤标化发病率随时间呈上升趋势(APC=5.34％ 、4.17％、20.75％、10.12％和5.59％,P＜0.05),肝癌标化发病率则呈下降趋势(APC=-4.86％,P＜0.01),结直肠癌、胃癌、胰腺癌和胆囊癌则随时间未呈现出明显变化趋势(APC=2.66％、-2.07％、1.66％和-1.97％,P＞0.05).[结论]上海市金山区不同性别、年龄组人群和各类肿瘤发病变化趋势各有特点,应根据不同特征人群、不同类别肿瘤的发病趋势特点制定相应的肿瘤防控策略与措施.     

Increased incidence of invasive breast cancer after the introduction of service screening with mammography in Sweden

Screening with mammography has been shown to substantially reduce mortality from breast cancer. The incidence of invasive cancer will increase as screening starts, and it is desirable that it gradually returns to the same level as before screening. Age-specific incidence of invasive breast cancer in 11 Swedish counties, including 463,000 women aged 40-74 years, was analysed before and after the start of service screening with mammography. Incidence, as observed on average during 12.8 years from screening start, was compared to expected incidence based on the incidence during a 15-year period preceding screening start. The height of the incidence peak during the first screening round was increasing with increasing age, compatible with the accumulation in the population of slowly growing tumours by age. All analysed age groups showed an increased ratio between observed stabilised incidence 7-14 years after screening start and expected incidence. When relative risks were adjusted for lead time, the estimates were 1.54 (95% confidence interval [CI] 1.33-1.79) and 1.21 (95% CI 1.04-1.41) for the age groups 50-59 and 60-69 years, respectively. In the age groups 40-49 and 70-74, no change was observed. The findings were further confirmed by the observation of a disappearance in the screened population of the notch in the increasing trend of age-specific breast cancer incidence for the ages after menopause. This notch could indicate hormone-related retardation in tumour growth around menopause. It appears that many of these clinically insignificant, retarded tumours are detected with screening mammography.     

Breast cancer incidence and mortality in a Caribbean population: comparisons with African-Americans

We describe breast cancer incidence and mortality in the predominantly African-origin population of Barbados, which shares an ancestral origin with African-Americans. Age-standardized incidence rates were calculated from histologically confirmed breast cancer cases identified during a 45-month period (July 2002-March 2006). Mortality rates were estimated from death registrations over 10-years starting January 1995. There were 396 incident cases of breast cancer for an incidence rate of 78.1 (95% confidence interval (CI) 70.5-86.3), standardized to the US population. Breast cancer incidence in African-Americans between 2000 and 2004 was 143.7 (142.0-145.5) per 100,000. Incidence peaked at 226.6 (174.5-289.4) per 100,000 among Barbadian women aged 50-54 years, and declined thereafter, a pattern in marked contrast to trends in African-American women, whose rates continued to increase to a peak of 483.5 per 100,000 in those aged 75-79 years. Incidence rate ratios comparing Barbadian and African-American women showed no statistically significant differences among women aged>or=55 years (p相似文献   

Cancer risk in women prenatally exposed to diethylstilbestrol

Prenatal diethylstilbestrol (DES) exposure is associated with excess risks of clear cell adenocarcinoma (CCA), and breast cancer in older women. Whether overall cancer risk is also elevated is unclear. Total and site-specific cancer risks were evaluated in the DES Combined Cohort Follow-up Study using age- and calendar-year specific standardized incidence rate ratios (SIR), and age-adjusted incidence rate ratios (RR) comparing DES exposed and unexposed women. A total of 143 and 49 cancer cases occurred in 97,831 and 34,810 person-years among the exposed and unexposed, respectively. There was no overall excess risk among exposed women when compared with external rates (SIR 1.01; 95% confidence interval [CI] 0.86-1.2). The overall RR comparing exposed with unexposed women was 1.32 (95% CI 0.94-1.8). Breast cancer risk was elevated only among women over 40 years (RR 1.83; 95% CI 1.1-3.2). The CCA SIR among exposed women was nearly 40, and the estimated attack rate through age 39 was 1.6/1,000 women. CCA incidence decreased by over 80% after age 25 when compared with 20-24 years. Excluding CCA and breast cancer, the overall RR was 1.21 (95% CI 0.74-2.0). DES was not associated with excess risks of either endometrial or ovarian cancer. These data suggest that the DES associated increase in CCA incidence remains elevated through the reproductive years. There was no consistent evidence of risk excesses for cancers other than CCA, and breast cancer in older women. Given that the population is still young, continued follow-up is necessary to assess the overall carcinogenic impact of prenatal DES exposure.     

Cervical cancer in the Netherlands 1989-1998: Decrease of squamous cell carcinoma in older women, increase of adenocarcinoma in younger women

Cervical cancer is a preventable disease, occurring in relatively young women. In the Netherlands, population-based cervical screening aims at women aged 30-60 years. We performed a population-based study of the incidence of invasive cervical cancer in the Netherlands to evaluate trends, with emphasis on age at time of diagnosis. Histologic diagnosis was retrieved from the Netherlands Cancer Registry for all women residing in the Netherlands with invasive cervical cancer between January 1, 1989, and December 31, 1998. In this 10-year period, the incidence rate of squamous cell carcinoma decreased significantly from 7.1/100,000 to 6.1/100,000 (p < 0.001), with the greatest decrease in women aged 60-74 (-5.5%). While the overall incidence rate of adenocarcinoma remained stable, it increased in women aged 15-29 (+15.8%) and in women aged 30-44 (+2.5%), though the number of cases was small. For squamous cell carcinoma, the incidence of stage II at diagnosis decreased most (-2.7%). There was no change in stage at diagnosis for adenocarcinoma. Most cases of cervical cancer, 60.5%, were detected between ages 30 and 60 years, i.e., the Dutch screening age interval. Cervical cancer in women below age 30 contributed 5.0% to the total incidence, with 3.0% occurring between ages 27 and 29. Thus, screening for cervical cancer in the Netherlands is associated with a decrease in the incidence of squamous cell carcinoma and adenocarcinoma incidence appears to be increasing in younger women.     

上海市金山区2002-2013年肺癌发病及死亡分析

目的 了解2002—2013年金山区肺癌发病与死亡特征,为制订有针对性肺癌防控措施提供依据。方法 通过肿瘤登记信息系统采集2002—2013年肺癌发病和死亡病例,计算粗发病率、粗死亡率、标化率、截缩率、累积率、潜在减寿年、潜在减寿率和标化减寿率。结果 2002—2013年,金山区肺癌粗发病率为70.79/10万,中标发病率为36.90/10万,世标发病率为36.65/10万,肺癌粗死亡率为62.53/10万,中标死亡率为32.30/10万,世标死亡率为31.99/10万,男性发病率和死亡率均高于女性。12年间,男性中标发病率无明显变化趋势(APC=-0.36%,P=0.632),女性中标发病率呈上升趋势(APC=4.42%,P＜0.001),同期男性肺癌中标死亡率呈下降趋势(APC=-1.70%,P=0.033),女性中标死亡率无明显变化趋势(APC=0.02%,P=0.980)。2002—2013年,金山区居民肺癌所致潜在减寿率为7.21‰,标化减寿率为4.18‰。12年间,男性标化减寿率呈下降趋势(APC=-2.58%,P=0.025),女性标化减寿率无明显升降趋势(APC=2.16%,P=0.143)。结论 肺癌是对金山居民健康威胁最大的恶性肿瘤之一。人口老龄化是造成金山区肺癌发病率和死亡率升高的重要因素。     

Development in incidence of breast cancer in non-screened Danish women, 1973-2002--a population-based study

The authors report on the incidence rates of breast cancer overall and by histology in a population of unscreened women constituting approximately 80% of the total population of women in Denmark from 1973-2002, utilizing the files of the nationwide Danish Cancer Registry. The age-specific incidence rates of breast cancer increased throughout the period, and further, marked changes in the age-specific incidence pattern were observed, where the plateau and change of slope around the age of 46-48 in 1973-1981 shifted to around age 64-66 years in 1994-2002. Age-period-cohort modeling indicated that these changes were not attributable to a birth cohort effect. Although lobular breast cancer incidence increased more than ductal breast cancer incidence, this was only observed in the first decade after the introduction of the ICD-O system in Denmark and probably is attributable to this, whereas we observed no disproportionate changes by histology in any age group from 1988-2002. Thus, previous reports of a disproportionate increase in lobular breast cancer could not be confirmed in a non-screened population, whereas important changes over the past decade in the age-specific incidence pattern of breast cancer particular around the time of menopause were indicated.     

The decline in the incidence of stomach cancer in Sweden 1960-1984: a birth cohort phenomenon

Trends in the incidence of stomach cancer among 52,604 patients notified to the National Swedish Cancer Registry in 1960 through 1984 were analysed. Age-standardized incidence rates declined throughout the period, from 47.1 to 24.6 per 10(5) in males and from 23.8 to 12.7 per 10(5) in females. Among males the decline in incidence was more pronounced in younger age strata, 35-54 years, while in females it reached a maximum at ages 70-74 years. In a multivariate analysis the age-cohort model adequately represented the data and there was no reason to separate the effects of the full age-period-cohort model. Compared with the cohort born in 1876-1884, the relative risk of developing stomach cancer was 0.46 (95% CI:0.44-0.48) in males and 0.39 (95% CI:0.37-0.42) in females born in 1906-1914. This supports the view that the declining incidence is due to a change in the exposure of the population to aetiological factors of stomach cancer and not to refinement of the diagnosis and classification of abdominal tumours. The results also imply that exposure to aetiological factors early in life together with a long induction period is of importance in the development of stomach cancer.     

Diverging trends in incidence and mortality of testicular cancer in Denmark, 1943-1982

Between 1943 and 1982, 5,140 new cases of testicular cancer were diagnosed in Denmark. The age-standardized incidence rate more than doubled in the period. Striking variations is seen in the age-relationship over time with a four-fold increase in incidence for men aged 15-24 years while no increment was observed for those above 65 years of age. The increase with time in the risk could be accounted for by a cohort effect. The mortality rate did not parallel the incidence rate and a 50% decrease in mortality rate appeared in the period 1978-1982. Introduction of combination chemotherapy including cis-platinum is one of the main factors responsible for this beneficial development. The observed pattern of diverging trends in incidence and mortality of testicular cancer implies that mortality rates do not reflect the incidence and will accordingly be unsuited as a basis for aetiological considerations based on trends. The brisk increase in the risk of testicular cancer, especially among young men is in accordance with trends in other western countries, and prompts an enforced search for suspected or new risk factors.     

甲状腺癌的临床诊治特点及治疗效果比较分析

目的 探讨甲状腺癌的临床诊治特点及治疗效果.方法 收集甲状腺癌的病患420例,对其按时间段进行分组,7年为1个时间段,研究甲状腺癌的临床特点变化,并分析影响其治疗效果的因素.结果 2001-2007年与2008-2014年两个时间段甲状腺癌患者的年龄分布在相对应的年龄上发病率没有明显差异,无统计学意义(P>0.05),但在每个时间段中,甲状腺癌的发病率集中在41~50岁上,差异具有统计学意义(P<0.05).2001-2007年和2008-2014年2个时间段的甲状腺癌的发病率在性别上均为女性多于男性,差异具统计学意义(P<0.05).2001-2007年和2008-2014年2个时间段的甲状腺癌在发病年龄、病灶的单发与多发以及肿瘤直径上差异不具统计学意义(P>0.05).但是2组患者无论从性别、年龄、病灶的多寡还是肿瘤直径以及淋巴结清扫阳性率上均具有统计学差异(P<0.05).甲状腺癌全切手术组和次全切手术组对比发现,全切手术组在术中出血量、手术时间以及术后低钙血症发生率上与次全切手术组存在差异,具有统计学意义(P<0.05).甲状腺癌全切手术和次全切手术2种手术方式在甲状旁腺损伤(10.00%/6.00%)、喉返神经损伤(10.00%/8.00%)以及喉上神经损伤(5.00%/7.00%)的发生率上差异不具有统计学意义(P>0.05).结论 甲状腺癌的发生率近年来呈上升趋势,且存在多种危险因素影响其发生发展,不同手术方式影响到甲状腺癌预后,应根据具体情况选择合理的手术方式.     

启东市1972~2011年胃癌发病趋势分析

[目的]探讨启东市1972-2011年胃癌发病率变化趋势。[方法]基于启东市1972-2011年癌症发病登记数据库,对胃癌发病率作性别、年龄别、时间趋势分析,计算指标包括粗发病率、中国人口标化率（中标率）、世界人口标化率（世标率）、35-64岁截缩率、0-74岁累积率、累积风险、变化百分比（PC）及年均变化百分比（APC）等。[结果]1972-2011年启东胃癌发病15 401例（男性9804例,女性5597例）,粗发病率为34.26/10万,占全部癌症发病的16.60%,位居癌症发病第2位。中标率和世标率分别为16.25/10万和25.59/10万;35-64岁截缩发病率为40.03/10万;0-74岁累积发病率为3.15%,累积风险为3.10%。40年间胃癌发病的粗率、中标率和世标率的变化百分比（PC）分别为＋21.90%、-55.32%与-51.20%,年均变化百分比（APC）分别为＋0.49%、-2.12%、-2.06%。各时期胃癌发病率显示25-74岁各年龄组的发病率有下降趋势。年龄—出生队列方法分析显示,25-79岁各年龄组出生队列发病率有下降趋势。[结论]启东胃癌40年粗发病率总体维持在较高水平,但标化发病率已呈下降趋势。启东人群中胃癌的进一步下降,是可以预期的。     

Cancer of mouth, pharynx and nasopharynx in Asian and Chinese immigrants resident in Thames regions

Studies on migrants can generate important clues on the etiology of cancer. The purpose of the present study was to determine the relationship between ethnic origin and the incidence of oral and pharyngeal cancers among residents of the Thames regions in southern England. Records from the Thames Cancer Registry during the period 1986-91 were examined and south Asians and Chinese ethnic immigrants flagged using their place of birth and names. Computation of relative incidence among head and neck cancers (n = 7222) showed that oral cancer was significantly higher among Asians (95/232 = 40.9%) and nasopharyngeal cancer among Chinese (45/67 = 67.2%). Some differences in the intra-oral site of cancer and ethnic origin were noted. The ethnic migrants were significantly younger (Asians 51.6 +/- 34.8 years, Chinese 47.6 +/- 14.8 years) compared to the rest of the population (64.8 +/- 15.6 years) at the time of cancer diagnosis (p = 0.0) but no significant differences were found for the stage of presentation. The mean survival period for a cancer of the head and neck was 2.2 years and significant differences in cumulative rates of survival were noted among the three groups studied (p = 0.003). A strong correlation was noted between the incidence of oral cancer and local authorities with a high percentage of Asian residents. The south Asian and Chinese ethnic minorities constitute important high risk groups for oral and nasopharyngeal cancer, for whom targeted prevention is indicated.     

Trends in childhood cancer incidence and mortality in Catalonia, Spain, 1975-1998.

Childhood cancer mortality has sharply declined in most economically developed countries over the last years, whereas no substantial changes in the incidence have been observed. In Catalonia (Spain), childhood cancer mortality showed a considerable decline until 1992, but incidence trends have not been analysed in this population. To assess both recent incidence and mortality trends in this population, we analysed childhood (0-14 years) cancer data from the population-based Tarragona Cancer Registry and from the Mortality Registry of Catalonia (Spain) from 1980 to 1998. All cancer mortality decreased by -2.6% annually in boys (95% confidence interval, 95% CI -3.7, -1.6) and -3.7% in girls (95% CI -4.9, -2.5). Mortality due to leukaemia decreased annually -3.0% in boys (95% CI -4.7, -1.4) and -4.4% in girls (95% CI -6.3, -2.4). Mortality for brain tumours showed a reduction of -3.2% in boys (95% CI -5.5, -0.9) and of -4.4% in girls (95% CI -6.3, -2.4). No significant trend in incidence rates, either in boys or in girls, was observed (annual per cent of change for all cancers -0.5%, 95% CI -3.5, 2.7, in boys and 1.7%, 95% CI -1.9, 5.5, in girls). These results suggest an improvement in both childhood cancer diagnosis and treatment, which may explain current higher childhood cancer survival rates.     

Analysis of Esophageal Cancer Time Trends in China, 1989-2008

National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in orderto provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophagealcancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008.Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent changeestimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer wasfound to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardizedincidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 inall areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annualdecrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreasedwith 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer agestandardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is stilla big issue and efforts for control should be continuously enhanced. Cancer registration is playing an importantrole in cancer control with the number of registries increasing and data quality improving in China.