Epidemiological profile of cancer for Grand Bahama residents: 1988-2002

This retrospective and observational study is based on a review of data from the pathology ledgers and clinical records of the Rand Memorial Hospital, of diagnoses and deaths from cancer from 1988 to 2002 (15 years). The aim was to determine the cancer incidence, mortality, survival rates and the trends for the island of Grand Bahama, Bahamas. The records indicated at least 545 (males: 187; females: 358) new cancer diagnoses giving an approximate age-standardized annual incidence rate of 167.7 per 100,000. The most frequent cancers were, in males (except for skin keratinocytic cancers) prostate 21.9%, colon/rectum 12.8% and lung 6.4%; and in females: breast 45.3%, cervix uteri 16.8% and colon/rectum 6.4%. Of these cancers, 443 (81.3%) were diagnosed in the pathology department of the hospital with the median age at diagnosis of all persons being 52 years. This comprised 119 males and 324 females. Whereas the majority of breast and cervical cancers were histologically diagnosed locally, those of prostate and lung were not. During the period, 359 (males: 181; females: 178) persons had died from cancer; an annual age-standardized mortality rate of 114.8 per 100,000, with breast 19.2%, prostate 14.5% and colon/rectum 9.5% being the most frequent. The overall median period of survival was one year (range 0-14 years). The median survival for persons with cervix uteri was five years; for breast cancer, three years; colorectal cancer, 2 years; prostate, one year; and less than a year for lung cancer. The data on cancer were not easily obtained and this may be improved if a cancer registry is established on this second most populated island of The Bahamas.     

中国上海人群肺癌发病的时间趋势及预后因素

目的了解上海肺癌发病的时间趋势及影响生存的预后因素。方法由上海全死因登记报告系统所获得的2002至2004年恶性肿瘤患者死亡个案资料,按国际癌症登记协会（IACR）的肿瘤登记计算指南进行计算。分别按粗率和标率计算1972年至2004年的年度变化百分比（APC）,对上海市发病时间趋势进行估计。采用Cox比例风险模型对影响生存的多因素进行分析,参数包括性别、年龄、居住区域、病理类型、临床分期、首诊医院级别。结果自1972年以来的32年,上海市中心区男性肺癌发病粗率APC增加1．723％,而女性增加2．036％,均呈逐渐增高趋势（P均〈0．01）;但男性肺癌的标化发病率APC为-0．605％,呈下降趋势（P〈0．01）,而女性为-0．136％,呈平稳趋势（P〉0．05）。上海市肺癌发病患者中Ⅲ、Ⅳ期占大多数,分别占35．6％和42．2％。上海市女性肺癌的3年生存率为17．05％,中位生存期（MST）为0．83年,均高于男性的14．01％和0．77年（P均〈0．01）,对各期肺癌的不同性别亚组的生存期分析显示女性生存期均较男性为高（P〈0．05）。Cox多因素分析结果提示性别、年龄、居住区域、病理类型、期别、首诊医院级别对肺癌生存有影响（P均〈0．01）;其中女性、年轻、居住市中心区、鳞癌、早期、高级别医院可能对生存有益,而男性、老年、居住郊区、小细胞癌、晚期、低级别医院这些因素可能对肺癌患者不利。结论上海市肺癌的发病水平逐渐接近欧美国家。女性、年轻、市中心区居住、鳞癌、早期、高级别医院治疗对肺癌的生存有益。各期别女性肺癌的预后均优于男性,但原因尚不清楚。     

An attempt to measure burden of disease using disability adjusted life years for Sri Lanka

INTRODUCTION: Disability adjusted life years (DALY) is a measure of burden of disease (BOD) that assesses the years of healthy life lost due to disease or illness. OBJECTIVE: The main objective of the study was to develop a draft measure of the BOD in Sri Lanka, using DALY. METHODS: Computation was done for 100 disease categories identified to reflect the disease pattern in Sri Lanka. Factors that were considered for the calculation of DALY were incidence, degree of disability, duration of the illness and age of onset. RESULTS: Injuries, ischaemic heart disease, asthma, disease of the pulmonary circulation and burns contribute to 55% of BOD in Sri Lanka. CONCLUSION: The highest burden was due to non-communicable diseases, as their duration and degree of disability are high. Diseases such as malaria, which are short term illnesses with low disability, although affecting large numbers, did not give a high value for DALY.     

广东地区近20年大肠癌临床特征的变化趋势

目的了解近20年来广东地区大肠癌临床流行病学特征的变化规律和趋势。方法总结分析广州南方医院和广东惠州市中心人民医院1985-2004年经病理确诊的大肠癌3870例资料。将20年资料按每5年为一时期进行统计分析。结果1985-1989年段与2000-2004年段比较，大肠癌收治率增加102．0％，平均每年上升5．1％；发病中位年龄从50．2岁上升至58．6岁，上升了8．4岁；男女比例逐渐下降，从1．50下降到1．35；发病部位直肠癌比例从64．8％下降到49．7％，右半结肠癌比例则从18．0％上升到28．7％；组织学类型中，中高分化者占的比例从70．1％上升到80．6％，低未分化者比例则从29．9％下降到19．4％；诊断Dukes A期的大肠癌比例从3．2％上升到9．8％。结论近20年来广东地区大肠癌的发病率上升；发病中位年龄上升；男女比例下降；直肠癌比例下降，右半结肠癌上升；组织学类型高中分化者占的比例上升，低未分化者下降；诊断Dukes A期的比例上升。     

An observational study of staghorn calculi in south Sri Lanka

OBJECTIVES: To ascertain patient characteristics, management strategies and outcome of patients with staghorn calculi in southern Sri Lanka. METHODS: All patients with staghorn calculi seen at the urology unit in a teaching hospital during a period of eighteen months were included in this prospective study. Data in relation to patient demography, investigations, treatment and postoperative complications were collected. RESULTS: There were 60 patients with a mean age of 54 years. Eight (13%) of them were female. Urine pH was less than 7.0 in 52 (87%) patients. Urine culture was positive for bacteria in four (7%) patients. 58 patients underwent open surgery, and two patients were managed non-operatively. Seven (12%) patients developed postoperative complications. CONCLUSIONS: Staghorn calculi elsewhere are usually commoner in females and associated with alkaline urine. But in our study there was a clear male preponderance (M:F = 6.5:1), and urine pH was alkaline in 8 (13%) patients only. Hence the aetiological factors for staghorn calculi in Sri Lanka appear to be different. Although open surgical procedures which form the mainstay of treatment of staghom calculi in Sri Lanka can be performed safely and effectively, there is a necessity to provide minimal access surgical facilities.     

Anti-tuberculosis drug inducd hepatitis - a Sri Lankan experience

OBJECTIVE: To assess the incidence of anti-tuberculosis (TB) drug induced hepatitis (AIH) in Sri Lankan patients, determine risk factors of AIH, and to address management options in AIH. DESIGN: A prospective study. SETTING: Chest Hospital, Welisara, Sri Lanka, from April 2001 to April 2002. PATIENTS: Seven hundred and eighty three patients with a confirmed diagnosis of TB and resident in the Colombo and Gampaha districts who presented to Chest Hospital, Welisara, Sri Lanka. METHODS: WHO recommended treatment was commenced in all cases. AIH was diagnosed when patients complained of decreased appetite with nausea or vomiting and elevated serum bilirubin (SB; >1.1 mg/dL) or elevated serum alanine transferase (ALT; > 3 times upper limit of normal). RESULTS: Of 783 enrolled patients, 74 (9.5%) developed AIH, the majority (58%) developing AIH within the first 2 weeks of the intensive phase of treatment. AIH was more common among patients over 60 years (p = 0.018), who developed pulmonary TB (p = 0.028), and in patients weighing 33-55 kg (p = 0.004). Age, weight and rifampicin overdosage were significant predictors of AIH. Of the 74 AIH patients, standard treatment was restarted in 60, treatment modified in six, two defaulted and six died. CONCLUSIONS: The incidence of AIH in Sri Lanka is 9.5% in treated patients. AIH was associated with age, low body weight and rifampicin overdosage.     

Cancer incidence and mortality in Zhejiang Province,Southeast China, 2016: a population-based study

Backgrounds:Cancer is one of the main causes of death worldwide, seriously threatening human health and life expectancy. We aimed to analyze the cancer incidence and mortality rates during 2016 in Zhejiang Province, Southeast China.Methods:Data were collected from 14 population-based cancer registries across Zhejiang Province of China. Cancer incidence and mortality rates stratified by sex and region were analyzed. The crude rate, age-standardized rate, age-specific and region-specific rate, and cumulative rate were calculated. The proportions of 10 common cancers in different groups and the incidence and mortality rates of the top five cancers in different age groups were also calculated. The Chinese national census of 2000 and the world Segi population was used for calculating the age-standardized incidence and mortality rates.Results:The 14 cancer registries covered a population of 14,250,844 individuals, accounting for 29.13% of the population of Zhejiang Province. The total reported cancer cases and deaths were 55,835 and 27,013, respectively. The proportion of morphological verification (MV%) was 78.95% of the population, and percentage of incident cases identified through death certificates only (DCO%) was 1.23% with a mortality-to-incidence ratio (M/I ratio) of 0.48. The crude incidence rate in Zhejiang cancer registration areas was 391.80/10⁵; the age-standardized incidence rate of the Chinese standard population (ASIRC) and the age-standardized incidence rate of the world standard population (ASIRW) were 229.76/10⁵ and 220.96/10⁵, respectively. The incidence rate in men was higher than that in women. The incidence rate increased rapidly after 45 years of age and peaked in individuals aged 80 to 84 years. The top 10 incidence rates of cancers were lung cancer, female breast cancer, thyroid cancer, colorectal cancer, stomach cancer, liver cancer, prostate cancer, cervical cancer, esophageal cancer, and pancreatic cancer (from highest to lowest). The crude mortality rate in Zhejiang cancer registration areas was 189.55/10⁵; the age-standardized mortality rate of the Chinese standard population (ASMRC) and the age-standardized mortality rate of the world standard population (ASMRW) were 94.46/10⁵ and 93.42/10⁵, respectively. The mortality rate in men was higher than that in women, and the male population in rural areas was higher than that in urban areas. The cancer mortality rate increased rapidly after 50 years of age and peaked in individuals aged 85+ years. The top 10 mortality rates of cancers were lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, esophageal cancer, female breast cancer, prostate cancer, lymphoma, and leukemia (from highest to lowest).Conclusions:Lung cancer, female breast cancer, thyroid cancer, colorectal cancer, prostate cancer, liver cancer, and stomach cancer were the most common cancers in Zhejiang Province. Effective prevention and control measures should be established after considering the different characteristics of cancers in urban and rural areas.     

Gender differences in undergraduate medical examination results in Sri Lanka

OBJECTIVE: To identify possible gender related differences in performance at undergraduate medical examinations in Sri Lanka. STUDY DESIGN AND METHODS: Results of examinations conducted by the faculty of medicine, University of Kelaniya in 1997 and 1998, and data published by the University Grants Commission (UGC) on final examinations conducted by 4 other Sri Lankan medical faculties (in the Universities of Colombo, Peradeniya, Ruhuna and Jaffna) in 1996 and 1997, were analysed for sex related differences. RESULTS: The proportion of women in each batch of students who sat for 8 examinations conducted at the faculty of medicine, University of Kelaniya in 1997 and 1998, ranged from 40.7 to 48.4% (average 44.3%). Among students sitting for the final MBBS examinations in other medical faculties in 1996 and 1997, the proportion of women ranged from 37.3% in Peradeniya to 53.7% in Jaffna. The proportions of women who obtained "classes" were higher than that of men in 12/15 examinations, with statistically significant differences in four. Higher proportions of men were referred or failed in all 8 examinations analysed; the differences were statistically significant in two. CONCLUSIONS: Women appear to do marginally better than men in undergraduate medical examinations in Sri Lanka.     

Age-specific incidence of cancer in Kingston and St. Andrew, Jamaica, 2003-2007

A total of 4981 cancers were recorded in Kingston and St. Andrew during the period 2003-2007: 2536 in males and 2445 in females. Age standardized rates per 100,000 per year (ASR) were 188.8 and 144.2 for males and females respectively, and are relatively unchanged, compared to the previous report (188.6 for males and 144.2 for females, 1998-2002). In males, the leading sites for cancer were prostate, bronchus and large bowel, while in females, they were breast, cervix uteri and large bowel. The leading sites for both genders have been maintained in the same order as in the previous report, but for males, there were increases in the incidence of prostate (ASR 65.5 vs. 78.1 per 100,000 per year) and colorectal (ASR 13.7 vs. 17.2 per 100,000 per year) cancers and a decrease in the incidence of cancer of the bronchus (ASR 22.8 vs. 18.6 per 100,000 per year). For females, there was a modest decrease in incidence of cervical cancer (ASR 19 vs. 17.4 per 100,000 per year) while the incidence of cancers of the breast and large bowel remained relatively stable (ASR 40.1 vs. 43 per 100,000 per year for breast and ASR 13 vs. 12.8 per 100,000 per year for colorectal cancer). These data support the need for urgent institution of formal programmes for prevention and control of cancers of the breast and large bowel in the Jamaican population. Malignancies of unknown primary site were common in both genders and require further investigation.     

2005—2015年中国0~14岁儿童恶性肿瘤流行特征研究

背景 恶性肿瘤已经成为我国儿童主要死亡原因之一,给社会及家庭带来极大经济负担。因此掌握儿童恶性肿瘤的流行规模和趋势具有重要意义。 目的 分析2005—2015年中国0~14岁儿童恶性肿瘤的流行病学特征,为我国儿童恶性肿瘤防控战略的制订和卫生资源的合理分配提供参考。 方法 收集2008—2018年"中国肿瘤登记年报"中0~14岁儿童恶性肿瘤的发病和死亡等数据,利用2010年全国人口构成计算标化发病率、死亡率,并通过Joinpoint模型计算年度变化百分比（annual change percentage,APC）来反映时间趋势。 结果 （1）2005—2015年中国0~14岁儿童恶性肿瘤的中位粗发病率为9.35/10万,中位粗死亡率为3.91/10万,其中0~4岁组中位粗发病率、死亡率均高于5~9岁组和10~14岁组（P<0.05）。（2）2005—2015年中国0~14岁男童中位粗发病率和死亡率均高于女童（发病率：10.21/10万vs 8.91/10万,P<0.05;死亡率：4.18/10万vs 3.47/10万,P<0.05）。（3）2005—2015年中国0~14岁城市儿童恶性肿瘤中位粗发病率和死亡率均高于农村儿童（发病率：10.87/10万vs 7.20/10万,P<0.05;死亡率：4.08/10万vs 3.54/10万,P<0.05）。（4）2005—2015年中国0~14岁儿童恶性肿瘤的中位粗死亡率呈上升趋势（APC=1.01%,P<0.05）,其中0~4岁组中位粗死亡率随时间呈下降趋势（APC=-1.19%,P<0.05）;5~9岁组中位粗死亡率随时间呈上升趋势（APC=2.50%,P<0.05）;10~14岁组中位粗死亡率为随时间呈稳定状态（APC=0.64%,P>0.05）。（5）2005—2015年中国农村0~14岁儿童恶性肿瘤的发病率与死亡率均呈上升趋势（APC分别为7.73%和2.22%,P<0.05）。（6）2005—2015年中国0~14岁儿童恶性肿瘤发病与死亡前六位分别为白血病、脑癌、淋巴癌、骨癌、肾癌、肝癌。 结论 中国儿童恶性肿瘤发病和死亡在时间、人群、地区方面呈现出特定的分布特点,今后应将农村地区、5~9岁年龄组以及脑癌、白血病癌种的儿童作为重点防控对象。 该文的微信推文请扫描下方二维码查看！     

Gynaecologic cancer incidence, Kingston and St Andrew, Jamaica, 1973-1997, and gynaecologic cancer mortality, Jamaica, 1999

The incidence of gynaecologic cancers in women from Kingston and St Andrew for the period 1973-1997 were reviewed by analyzing data previously published by the Jamaica Cancer Registry. Gynaecologic cancer-related mortality statistics for the entire island for 1999 were compiled from data obtained from the Registrar General's Department (RGD) and the Statistical Institute of Jamaica (STATIN). Data were compared to gynaecologic cancer statistics for women from the United States of America for 1973-1997. A total of 2862 gynaecologic cancers were registered for the years 1973-1997, which represents 26.8% of all female cancers from Kingston and St Andrew. Cervical cancer accounted for 62% of these gynaecologic cancers. The 268 cancer-related deaths (168 due to cervical cancer) registered in Jamaican women for 1999 represent approximately 15% of all female cancer-related deaths. The present incidence (27.9 per 100,000) and mortality rate (15.8 per 100,000) of cervical cancer are much higher than that documented for American women--both African Americans and Caucasians--and signify the limited success, to date, of efforts to decrease the incidence and mortality of cervical cancer by the implementation of cervical cancer screening programmes. For the time period reviewed, an increase was noted in the incidence of cancer of the corpus uteri while decreases were recorded for the incidence of choriocarcinoma, ovarian cancer and cancers arising from the vulva, vagina and fallopian tube.     

江苏省启东地区1973至2002年肝癌发病率长期趋势的评价

目的评价江苏省启东肝癌高发现场30年肝癌发病率的长期趋势.方法采用启东1973至2002年肿瘤登记报告资料,计算肝癌粗发病率、世界人口调整率（WASR）、35～64岁截缩调整率、0～74岁累积发病率、变化百分比（PC）及年度变化百分比（APC）,并作时期、年龄和队列发病率比较分析。结果启东肝癌30年平均粗发病率为59．28／10万,其中男为91．65／10万,女为27．64／10万,男女发病率性别比例为3．32：1WASR为58．71／10万,其中男为93．32／10万,女为26．46／10万。35～64岁肝癌截缩调整率为143．61／10万,0～74岁累积发病率为6．07％？粗发病率的PC为＋30．90％,APC为＋1．58％;调整率的PC为＋12．33％,APC为＋0．41％。资料显示后15年肝癌总体发病率上升,但35岁以F年龄组发病率有显著的下降。时期趋势分析也显示35岁以下各年龄组发病率均已下降;出生队列分析则显示1963年以后出生队列发病率的下降趋势。结论启东肝癌高发现场30年粗发病率总体呈上升趋势,可能与中老年人口的增加有关;但现场多年的防治工作,已对青年人的肝癌发病率产生影响,并出现下降趋势。     

Colorectal cancer in Alexandria, Egypt;clinical profile,epidemiological characteristics,trend,and survival

Objective:During the past decades,the incidence of colorectal cancer was increased all around the world.In Egypt,colorectal cancer is the 7th most common cancer.The purpose of this study is to study the problem of colorectal cancer in Alexandria:trend,and survival.Methods:Two methodological strategies were adopted:Record reviewing for estimation of the annual incidence rates of colorectal cancer,and a retrospective cohort study to calculate the 5-year survival rates of colorectal cancer.Results:The annual incidence rates of CRC in Alexandria in 2007-2008 were 6.33 and 6.45 respectively per 100000 mid-year Alexandria population.The overall 5-years cumulative survival rate for CRC cases was 28.0%.Conclusion:This increase in incidence and mortality rates points toward a failed early detection and prevention strategy as well as failure to address lifestyle and dietary challenges of urbanization that affect most of the globe including Egypt.     

大肠癌及正常肠黏膜组织中金属硫蛋白阳性表达的临床意义

目的:检测金属硫蛋白(MT)在大肠癌及正常肠黏膜组织中的表达,探讨MT在大肠癌组织中表达的临床意义。方法:对12例大肠癌新鲜标本采用RT-PCR方法检测MT在大肠癌及正常肠黏膜中的表达。对53例存档大肠癌石蜡组织标本采用免疫组化SABC法染色,结果按不同大肠癌肿块大小、组织分级、浸润深度及临床分期进行比较。所有病例随访6-48个月,分析MT表达与大肠癌患者生存、复发和远处转移的关系。结果:MT在大肠癌和正常肠黏膜组织中均有表达。MT阳性表达与大肠癌肿瘤大小、组织分级、浸润深度均无显著相关(P>0.05)。阳性表达者3年总生存率较阴性表达者低(62.5%比87.3%),但无统计学差异(P>0.05)。将37例完成术后辅助化疗者分为阳性表达与阴性表达两组比较,两组无病生存率(52.9%比64.7%)和无远处转移生存率(86.9%比91.3%)有显著性差异(均为P<0.05)。结论:大肠癌MT阳性表达与不良预后相关,可能与术后辅助化疗相对不敏感有关。     

结直肠癌合并泌尿系统疾病的临床分析

目的:探讨结直肠癌累及泌尿系统或合并泌尿系统多原发癌的临床特点、诊断和治疗方法。方法:对2010-2019年我院收治的75例结直肠癌累及泌尿系统或合并泌尿系统多原发癌患者的临床病理资料进行回顾性分析。结果:16例结直肠癌累及一个或多个泌尿系统器官,其中16例全部累及膀胱,同时累及输尿管1例;59例同时或异时性合并泌尿系肿瘤,其中33例单纯合并膀胱癌,17例单纯合并前列腺癌,3例单纯合并输尿管癌,1例单纯合并肾盂癌,1例合并膀胱癌及肾癌,1例合并输尿管癌及前列腺癌,3例合并膀胱癌及输尿管癌。Dukes分期 （以病理分期最晚的一个为准）:A期0例,B期46例,C期21例,D期8例。75例中伴有淋巴结转移者29例。结直肠癌累及膀胱的16例中,结直肠癌根治联合膀胱部分切除14例,其余2例因肿瘤累及膀胱三角区行全膀胱切除及尿流改道。结直肠癌累及膀胱及输尿管的1例行膀胱部分切除、受累输尿管切除、输尿管吻合术。同时性多重癌7例,异时性多重癌52例,与原发癌间隔时间半年至 19年,其中小于2年者 15 例,2～5年者 7例,大于5年者 30 例。54例异时性多原发癌的初发癌均行根治性手术,14例二重癌和2例三重癌均行根治性切除术。同时性多原发结直肠癌和异时性多原发癌初发癌根治术后5年生存率分别为65％和70％。结论:结直肠癌合并泌尿系统疾病的患者,应利用膀胱镜、电子结肠镜及腹部强化CT进行仔细检查,避免漏诊或误诊,行根治性手术切除结直肠及泌尿系统肿瘤可能使患者生存获益。     

PCR detection and typing of human papilloma virus DNA in squamous carcinoma of the cervix in a cohort of Sri Lankan women

OBJECTIVE: To determine the prevalence of human papilloma virus (HPV) types 16 and 18 in squamous carcinomas of the cervix in Sri Lanka. DESIGN: Case control study. SETTING: One gynaecological unit at the Cancer Institute, Maharagama, Sri Lanka. PATIENTS: 15 patients with squamous carcinoma of the cervix, and 15 age matched controls with histologically normal cervices. MEASUREMENTS: DNA was extracted from paraffin embedded cervical biopsies. Polymerase chain reaction was performed on extracted DNA employing primers specific for HPV types 16 and 18. RESULTS: HPV 16 DNA was detected in 11 out of 15 cervical cancer biopsies (73.3%), in comparison with 3 out of 15 normal controls (20%). HPV 18 was detected in 3 out of 15 cervical cancer biopsies, but not in a single control biopsy. CONCLUSION: Despite the limited number of cases in this cohort, this study supports the strong association between HPV 16 and squamous cancer of the cervix.     

Trend Analysis of Cancer Mortality in the Jinchang Cohort,China, 2001-2010

Objective To describe the baseline data of cancers in the Jinchang Cohort, this paper examined trends in cancer mortality among adults investigated in Jinchang, Gansu province from 2001 to 2010.
Methods Mortality data were collected from company departments through administrative documents, death certificates, etc. Trend analyses of cancer mortality were performed on the basis of 925 cancer deaths between 2001 and 2010.
Results The crude mortality rate of cancer continuously increased from 161.86 per 100,000 in 2001 to
315.32 per 100,000 in 2010, with an average increase of 7.69%per year in the Jinchang Cohort (16.41%in females compared to 6.04% in males), but the age-standardized mortality rate increased only in females. Thirteen leading cancers accounted for 92.10%of all cancer deaths. The five leading causes of cancer mortality in males were lung, gastric, liver, esophageal, and colorectal cancer, whereas those in females were lung, liver, gastric, breast, and esophageal cancer.
Conclusion The overall cancer mortality rate increased from 2001 to 2010 in the Jinchang Cohort, with greater rate of increase in females than in males. Lung, breast, and gastric cancer, in that order, were the leading causes of increased cancer mortality in females.     

Clinical features,risk factors and efficacy of cryotherapy in cutaneous leishmaniasis in Sri Lanka

INTRODUCTION: The first autochthonus case of cutaneous leishmaniasis in Sri Lanka was reported in 1992. Several case reports from different parts of the island have been documented. The case incidence has increased in the recent past. OBJECTIVES: To determine the clinical patterns, risk factors and efficacy of cryotherapy for cutaneous leishmaniasis in Sri Lanka. PATIENTS: Sixty-five patients with cutaneous leishmaniasis. DESIGN: Prospective study. SETTING: Department of Parasitology, Faculty of Medicine, Colombo. METHODS: Direct smears prepared from lesion aspirates or punch biopsies were stained and examined for Leishmania sp. All patients with positive smears were included in the study. A pre-designed questionnaire was completed based on clinical evaluation, and the patients were treated and followed up regularly. Investigations were repeated on day 14 and day 90 depending on the response to treatment. RESULTS: Lesions were non-tender, non-itchy papules (early lesions), scaling single nodules or dry crust forming single or multiple ulcers. Young adult males with outdoor behavioural characteristics were mostly affected. Other risk factors were close proximity to jungles, potential reservoir hosts in the environment, lack of awareness and inadequate knowledge and use of preventive measures. Compliance rate for cryotherapy was 40%. The need for frequent hospital visits, the long course of treatment, limited availability and undesirable side effects were identified as reasons for poor compliance. Smear positive rate on day 14 after treatment was 89%. CONCLUSIONS: Cutaneous leishmaniasis is now an established disease in Sri Lanka. Raising public awareness, early diagnosis, definite species identification, availability of proper treatment methods and vector studies are important for its effective control.     

1990~2016年云南省宣威市肺癌死亡流行特征分析

目的 描述1990~2016年云南省宣威市肺癌死亡流行趋势,为宣威肺癌防控提供科学依据。方法 数据来源包括1990~1992年及2004~2005年宣威市死因回顾调查数据、2011~2013年及2014~2016年宣威市死因监测数据,其中,针对不同时期的死因监测数据进行了相应的漏报校正,并计算以上4个时期不同特征肺癌粗死亡率、标化死亡率及其95%CI。结果 1990~1992年、2004~2005年、2011~2013年和2014~2016年宣威市肺癌粗死亡率分别为34.0/10 万、89.8/10 万、102.3/10 万和87.2/10 万。自2004 年起,宣威市肺癌标化死亡率呈现下降趋势,但仍然维持在较高水平;各年龄组肺癌死亡率也大多呈现递减趋势,自2014 年起40 岁以下年龄组开始下降且有统计学意义;高发区除龙场外,其余各乡镇肺癌标化死亡率均呈现下降趋势。结论 宣威市肺癌死亡虽然仍维持在较高水平,但自2004 年以后肺癌标化死亡率已经呈现出逐步降低趋势。自2014 年以后,40 岁以下人群肺癌死亡率下降具有统计学意义。