中国2009年白血病发病和死亡资料分析

[目的]评估中国肿瘤登记地区2009年白血病发病与死亡情况.[方法]按照全国肿瘤登记中心制定的审核方法和评价标准,对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算白血病发病率、死亡率、构成、累积率;人口标准化率根据全国1982年人口普查的人口结构和Segi’s世界人口结构为标准.[结果]2009年72个登记地区共覆盖人口85 470 522人(其中城市57 489 009人,农村27 981 513人),白血病新发病例4 853例,死亡病例3 661例.白血病总体MV％为93.72％、DCO％为1.50％、M/I比例为0.75,其中城市地区分别为94.38％、1.45％和0.71,农村地区分别为91.68％、1.68％和0.88.全国肿瘤登记地区白血病发病率为5.68/10万(男性6.35/10万,女性4.99/10万),中标率为4.34/10万,世标率为4.92/10万,累积率(0～74岁)为0.44％,占全部恶性肿瘤发病的1.99％;城市地区发病率为6.37/10万,中标率4.85/10万,世标率5.53/10万;农村地区发病率为4.25/10万,中标率为3.41/10万,世标率为3.76/10万.全国肿瘤登记地区白血病死亡率为4.28/10万(男性5.00/10万,女性3.55/10万),中标率为2.88/10万,世标率为3.35/10万,累积率(0～74岁)为0.31％,占全部恶性肿瘤死亡的2.37％;城市地区死亡率为4.56/10万,中标率2.91/10万,世标率3.43/10万;农村地区死亡率为3.72/10万,中标率2.82/10万,世标率3.14/10万.白血病发病率、死亡率均为城市高于农村,男性高于女性.髓样白血病发病率、死亡率远高于淋巴样白血病.[结论]积极开展白血病病因学研究,制定有效的干预措施,以期降低白血病发病率和死亡率.     

中国2009年宫颈癌发病与死亡分析

[目的]评估中国肿瘤登记地区2009年宫颈癌发病与死亡情况。[方法]按照全国肿瘤登记中心制定的审核方法和评价标准,对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算宫颈癌发病率、死亡率、累积率、截缩率、构成比;人口标准化率根据全国1982年人口普查的人口结构和Segi’s世界人口结构为标准。[结果]2009年72个登记地区宫颈癌新发病例5473例,死亡病例1387例。72个肿瘤登记地区宫颈癌发病率为12.96/10万,中标率为7.42/10万,世标率为8.97/10万,累积率(0～74岁)为0.89%。城市地区宫颈癌发病率为13.35/10万,中标率为7.58/10万;农村地区发病率为12.14/10万,中标率为7.18/10万。72个肿瘤登记地区宫颈癌死亡率为3.28/10万,中标率为1.64/10万,世标率为2.13/10万。城市地区宫颈癌的死亡率为3.21/10万,而农村地区死亡率为3.42/10万。宫颈癌发病率和死亡率均随着年龄的增加而增加。[结论]宫颈癌严重威胁妇女健康,应成为女性重点预防的恶性肿瘤。     

中国2009年喉恶性肿瘤发病和死亡分析

[目的]评估中国肿瘤登记地区2009年喉恶性肿瘤的发病与死亡情况.[方法]按照全国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,分别计算喉恶性肿瘤的发病率、死亡率、构成、中国人口标化率(中标率)、世界人口标化率(世标率)、累积率、截缩率.[结果] 2009年新发喉恶性肿瘤病例1 673例,喉恶性肿瘤死亡病例870例.MV％为76.69％,DCO％为2.93％,M/I为0.52,UB％为1.08％.全部地区喉恶性肿瘤发病率为1.96/10万(男性3.51/10万,女性0.37/10万),中标率0.98/10万,世标率1.31/10万,累积率(0～74岁)为0.16％,截缩率(35～64岁)为2.31/10万.城市地区发病率为2.33/10万,中标率1.12/10万,农村地区发病率为1.19/10万,中标率0.67/10万.全部地区喉恶性肿瘤死亡率为1.02/10万(男性1.75/10万,女性0.27/10万),中标率0.47/10万,世标率0.64/10万,累积率(0～74岁)为0.07％,截缩率(35～64岁)为0.81/10万.城市地区死亡率为1.10/10万,中标率0.47/10万.农村地区死亡率为0.85/10万,中标率0.46/10万.[结论]我国喉恶性肿瘤的发病率和死亡率均处于较低水平,男性明显高于女性,城市地区发病率明显高于农村地区,死亡率城乡之间无明显差异.无论是城市地区还是农村地区,男性发病率和死亡率明显高于女性.     

中国2009年胃癌发病与死亡分析

[目的]评估中国肿瘤登记地区2009年胃癌的发病与死亡情况.[方法]按中国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算胃癌的发病率、死亡率、顺位、构成、累积率;根据全国1982年人口普查的人口结构和Segi's世界人口结构的标准计算人口标准化率.[结果]2009年胃癌新发病例30 949例,死亡病例22 120例.病理学诊断比例为76.14％,只有死亡医学证明书比例为2.95％,死亡/发病比为0.71.全部地区胃癌发病率为36.21/10万(男性49.61/10万.女性22.50/10万),中标率为17.85/10万,世标率为23.93/10万,累积率(0～74岁)为2.94％.城市地区发病率为30.20/10万,中标率为14.15/10万;农村地区发病率为48.57/10万,中标率为26.31/10万.全部地区胃癌死亡率为25.88/10万(男性34.64/10万,女性16.91/10万),中标率为11.86/10万,世标率为16.38/10万,累积率(0～74岁)为1.89％.城市地区死亡率为21.15/10万,中标率为9.07/10万.农村地区死亡率为35.60/10万,中标率为18.25/10万.[结论]胃癌是威胁我国居民健康的主要癌症之一,其在男性、女性和城乡地区之间存在明显差异,应根据实际情况有重点地开展防治工作.     

中国2009年肾及泌尿系统其他癌发病和死亡分析

[目的]根据2009年全国各肿瘤登记处恶性肿瘤登记数据资料,分析我国肿瘤登记地区肾癌的发病与死亡情况.[方法]以入选的72个肿瘤登记处的数据为依据,采用一般性描述方法分析肾癌的发病和死亡流行情况.[结果] 2009年全国肾癌新发病例4 916例,死亡1 619例.M/I为0.33,MV％为76.61％,DCO％为1.22％,UB％为0.69％.登记地区肾癌发病率为5.75/10万(男性7.07/10万,女性4.40/10万),中标率为3.03/10万,世标率为3.95/10万,累积率(0～74岁)为0.45％;死亡率为1.89/10万(男性2.37/10万,女性1.41/10万),中标率为0.88/10万,世标率为1.21/10万,累积率(0～74岁)为0.12％.[结论]我国肾癌的发病率和死亡率城市明显高于农村,男性高于女性.在不同地区、不同性别中,随年龄的增长肾癌发病率和死亡率均呈上升趋势.     

中国2010年卵巢癌发病与死亡分析

[目的]估计2010年中国肿瘤登记地区卵巢癌的发病与死亡情况.[方法]根据全国肿瘤登记中心指定的审核方法和评估标准,对全国219个肿瘤登记处上报的2010年肿瘤登记数据进行评估,最终145个肿瘤登记处的数据纳入分析.将纳入的登记处按城乡、地区(东部、中部和西部地区)以及性别分层,计算各层卵巢癌的年龄别发病(死亡)率、结合全国人口,估计全国卵巢癌的发病(死亡)率、标化发病(死亡)率、构成比、累积发病(死亡)率.中国人口标化率(简称中标率)采用2000年全国普查标准人口年龄构成,世界人口标化率(简称世标率)采用Segi's世界标准人口年龄构成.[结果]2010年入选年报的145个登记处(城市63个,农村82个),共覆盖人群158 403 248人(其中城市92 433 739人,农村65 969 509人),卵巢癌的M/I比例为0.45,MV％为81.18％,DOC％为1.71％,UB％为0.30％.据估计,2010年全国卵巢癌新发病例约4.15万例,死亡病例约1.76万例.卵巢癌发病率为6.47/10万,中标率为5.22/10万,世标率为4.97/10万,累积率(0～74岁)为0.53％.城市地区分别为7.73/10万、6.01/10万、5.73/10万、0.62％;农村地区分别为5.19/10万、4.32/10万、4.09/10万、0.42％.全国卵巢癌合计死亡率约为2.74/10万,中标率为2.08/10万,世标率为2.04/10万,累积率(0～74岁)为0.23％.城市地区分别为3.52/10万、2.51/10万、2.45/10万、0.28％;农村地区分别为1.94/10万、1.57/10万、1.54/10万、0.17％.[结论]2010年我国女性卵巢癌发病率和死亡率并不高,但因其较高的病死率严重威胁妇女的健康,应成为女性重点防治的恶性肿瘤之一.     

中国2009年脑瘤发病与死亡分析

[目的]评估中国肿瘤登记地区2009年脑瘤的发病与死亡情况。[方法]按照全国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算脑瘤发病率、死亡率、累积率、截缩率、构成比;人口标准化率根据全国1982年人口普查的人口结构和Segi’s世界人口结构为标准。[结果]2009年72个登记地区共覆盖登记人口85470522人（其中城市57489009人,农村27981513人）,脑瘤新发病例5509例,死亡病例3311例。病理诊断比例为51.01%,只有死亡证明书比例为3.41%,死亡发病比为0.60。全国肿瘤登记地区脑瘤发病率6.45/10万,中标率为4.11/10万,世标率为4.88/10万,累积率（0～74岁）为0.50%。全国肿瘤登记地区脑瘤死亡率为3.87/10万,中标率为2.29/10万,世标率为2.81/10万,累积率（0～74岁）为0.29%。[结论]脑瘤在我国已成为严重危害人民健康的重要肿瘤,应加强脑瘤的预防与控制工作。     

中国2009年膀胱癌发病和死亡资料分析

[目的]评价我国肿瘤登记地区膀胱癌的发病与死亡情况.[方法]对全国104个登记处上报的2009年膀胱癌登记数据进行评估,共72个登记处的数据入选,计算膀胱癌的发病率、死亡率、构成、累积率,人口标准化率根据全国1982年人口普查的人口结构和Segi's世界人口结构为标准.[结果] 2009年登记地区共覆盖登记人口85 470 522人(其中城市57 489 009人,农村27 981 513人),新发膀胱癌病例5 647例,膀胱癌死亡病例2 223例.全部地区膀胱癌发病率为6.61/10万(男性9.78/10万,女性3.35/10万),中国人口标准化(中标)发病率3.03/10万,世界人口标准化(世标)发病率4.14/10万,累积率(0～74岁)为0.47％.城市地区发病率为8.11/10万,中标发病率3.55/10万,农村地区发病率为3.52/10万,中标发病率1.82/10万.全部地区膀胱癌死亡率为2.60/10万(男性3.88/10万,女性1.29/10万),中标死亡率0.97/10万,世标死亡率1.49/10万,累积死亡率(0～74岁)为0.13％.城市地区膀胱癌死亡率为3.06/10万,中标死亡率1.07/10万.农村地区膀胱癌死亡率为1.65/10万,中标死亡率0.74/10万.[结论]随着工业化、城镇化、老龄化的加速和吸烟人口的增加,我国膀胱癌的发病率将逐渐上升,应充分重视.     

湖南省肿瘤登记地区2009~2012年恶性肿瘤发病及死亡资料分析

[目的]了解湖南省2009～2012年肿瘤登记地区恶性肿瘤发病死亡情况,为肿瘤防治提供参考数据.[方法]对湖南省2009～2012年肿瘤登记地区恶性肿瘤发病死亡数据进行分析,计算主要肿瘤的发病率、死亡率、顺位、0～74岁累积率等指标,中标率的标准人口采用2000年中国人口普查的人口构成,世标率的标准人口使用的是Segi's世界人口构成.[结果]2009～2012年湖南省6个肿瘤登记点人口人年数1 011.3867万人年,共收集新发病例19 695例,死亡病例12 466例.病理诊断率72.16％,只有死亡证明书比例3.20％,死亡发病比为0.63.全省恶性肿瘤发病率为194.73/10万,中标率为153.62/10万,世标率为149.26/10万,0～74岁累积率为17.37％.城市地区恶性肿瘤发病率为198.22/10万,而农村为193.36/10万(x2=0.06,P＞0.05),城市农村粗发病率比较无统计学差异,但标化率城市高于农村.男性恶性肿瘤发病率为219.18/10万,而女性为168.60/10万(x2=6.46,P＜0.05).男性发病前5位的是肺癌、肝癌、胃癌、结直肠肛门癌、鼻咽癌;女性发病前5位的是肺癌、乳腺癌、宫颈癌、肝癌、结直肠肛门癌.2009～2012年湖南省肿瘤登记地区居民恶性肿瘤死亡率为123.26/10万,中标率为95.10/10万,世标率为92.84/10万,0～74岁累积率为10.97％.城市地区恶性肿瘤死亡率为121.78/10万,农村为123.84/10万,城市死亡率和农村比较相差不大(x2=0.02,P＞0.05),但中标率和世标率城市高于农村.男性恶性肿瘤死亡率为154.11/10万,高于女性的90.28/10万(x2=16.81,P＜0.01).男性死亡率前5位为肺癌、肝癌、胃癌、结直肠癌、鼻咽癌,女性死亡前5位为肺癌、肝癌、胃癌、乳腺癌、结直肠肛门癌.[结论]肺癌、肝癌、胃癌、结直肠肛门癌、鼻咽癌及女性乳腺癌、宫颈癌等是湖南省发病率、死亡率较高的恶性肿瘤,应作为湖南省恶性肿瘤防治的主要癌种.     

广西柳州市市区2009 年恶性肿瘤发病与死亡资料分析

[目的]分析2009年柳州市市区恶性肿瘤发病与死亡的流行病学特征,为恶性肿瘤防控策略提供依据.[方法]通过对柳州市肿瘤登记处2009年肿瘤登记数据进行统计分析,计算恶性肿瘤发病/死亡率、年龄别发病/死亡率、标化率、构成比和累积率等指标.[结果]2009年柳州市市区居民恶性肿瘤粗发病率为234.54/10万,中标率为130.51/10万,世标率为168.00/10万,累积发病率(0～74岁)为18.95％.2009年柳州市市区居民恶性肿瘤粗死亡率为130.71/10万,中标率为69.96/10万,世标率为92.31/10万,累积死亡率(0～74岁)为10.44％.肺癌、肝癌、结直肠癌、乳腺癌和胃癌居恶性肿瘤发病前5位.肺癌、肝癌、结直肠癌、胃癌和白血病居恶性肿瘤死亡前5位.[结论]柳州市市区居民恶性肿瘤防控的重点是肺癌、乳腺癌和消化系统肿瘤.     

Trends in in-patient Hospital Utilization and Surgical Procedures for Breast,Prostate, Lung and Colorectal Cancers in Canada

Objective: To analyse population-based trends of in-patient surgical procedures for breast (female), prostate, lung and colorectal cancers. Methods: The Hospital Morbidity Files supplied hospital data and the Canadian Cancer Registry, incidence data. Age-adjusted rates were standardized to the 1991 Canadian population. Results: All four cancers showed major changes in trends of surgical procedures. For breast cancer, the rate of in-patient breast conservation surgery (BCS) increased from 1981 to the early 1990s while the rate of mastectomy decreased. Because day surgery was not included, the subsequent in-patient BCS rate stayed level. For prostate cancer, the rate of transurethral prostatectomy was initially high but decreased after 1990, while the rate of radical prostatectomy increased rapidly, only minimally affected by the PSA-related peak in incidence. The lung cancer lobectomy rate in men remained at 10/100,000 after 1986, but in women rose from 3/100,000 to 7/100,000, reflecting increasing lung cancer incidence. For colorectal cancer, right hemicolectomies and anterior resections increased, especially in men. Conclusions: Surgery trends reflected changes in incidence and treatment preferences. Canadian trends were generally similar to US trends, although the timing of some of the changes differed. Canadians tended to use less invasive procedures such as BCS and anterior resection.     

Processed meat consumption and risk of cancer: a multisite case–control study in Uruguay

Background:

The role of processed meat in the aetiology of several cancers was explored in detail.

Methods:

In the time period 1996–2004, a multisite case–control study was conducted in Montevideo, Uruguay. The study included 6 060 participants (3 528 cases and 2 532 controls) corresponding to cancers of the oral cavity, pharynx, oesophagus, stomach, colon, rectum, larynx, lung, female breast, prostate, urinary bladder, and kidney (renal cell carcinoma only).

Results:

The highest odds ratios (ORs) were positively associated with cancers of the colon, rectum, stomach, oesophagus, and lung. With the exception of renal cell carcinoma, the remaining cancer sites were significantly associated with elevated risks for processed meat consumption. Furthermore, mortadella, salami, hot dog, ham, and salted meat were strongly associated with risk of several cancer sites.

Conclusion:

It could be concluded that processed meat intake could be a powerful multiorgan carcinogen.     

Cancer surveillance behaviors and psychosocial factors among long‐term survivors of breast cancer

BACKGROUND:

Little is known about cancer surveillance (mammography, clinical breast examination, and pelvic examination) behaviors in long‐term (9‐16 years) breast cancer survivors. This report describes the relation of these behaviors to demographic and clinical characteristics, psychological symptoms, body satisfaction, and social support.

METHODS:

Survivors who had participated in Cancer and Leukemia Group B treatment Trial 8541 completed a survey that included questions on breast cancer surveillance and pelvic examination, psychological well being, body satisfaction, and social support.

RESULTS:

The participation rate was 78% and included 245 breast cancer survivors. Survivors (n = 107; 44%) reported completing breast cancer surveillance (mammography and clinical breast examination) and completing pelvic examination (n = 162; 68%) within recommended guidelines. There were no significant associations between breast cancer surveillance and breast cancer anxiety, depression, stressful life events, body satisfaction, social support, or demographic characteristics. Survivors within recommended guidelines for pelvic examinations were younger (P = .05), married (P = .003), had health insurance (P = .004), and had lower depression scores (P = .005) than survivors who underused or overused pelvic examination. In addition, survivors within recommended pelvic examination guidelines had significantly lower levels of breast cancer anxiety (P = .03) compared with survivors who underused pelvic examination.

CONCLUSIONS:

Many long‐term breast cancer survivors were not within recommended cancer surveillance guidelines. Private health insurance was associated with following recommendations for pelvic examinations, although such a relation did not exist for breast cancer surveillance. The results of this study have implications for the development of educational programs to improve cancer surveillance among the growing population of long‐term breast cancer survivors. Cancer 2009. © 2009 American Cancer Society.     

Rationale and design of the National Program of Cancer Registries' breast, colon, and prostate cancer patterns of care study

Background: Investigators from the Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR), are collaborating with public health professionals from seven states and the District of Columbia to conduct the Patterns of Care study to assess the quality of cancer data and to determine whether stage-specific treatments are being carried out. Methods: To assess the quality and completeness of cancer care data in the United States, trained staff from the Patterns of Care study are abstracting medical records to obtain detailed clinical data on treatment, tumor characteristics, stage at diagnosis, and demographics of representative samples of patients diagnosed with breast, colon, and prostate cancer. Altogether staff from each of the eight participating cancer registries will abstract 500 cases of breast, prostate, and colon/rectum/anus cancer for the CONCORD study and an additional 150 cases of localized breast cancer, 100 cases of stage III colon cancer, and 100 cases of localized prostate cancer for the Patterns of Care study. Chi-square tests will be used to compare routine registry data with re-abstracted data. The investigators will use logistic regression techniques to describe the characteristics of patients with localized breast and prostate cancer and stage III colon cancer. Age, race, sex, type of insurance, and comorbidity will be examined as predictors of the use of those treatments that are consistent with consensus guidelines. The investigators plan to use data from the CONCORD study to determine whether treatment factors are the reason for the reported differences between relative survival rates in the United States and Europe. Conclusions Results from the methodology used in the Patterns of Care study will provide, for the first time, detailed information about the quality and completeness of stage and treatment data that are routinely collected by states participating in the NPCR. It will add significantly to our understanding of factors that determine receipt of treatment in compliance with established guidelines. As part of the CONCORD study, it will also examine differences in survival among cancer patients with breast, prostate, and colon/rectum/anus cancers in the United States and Europe.     

Conundrums in screening for cancer

Screening for cancer has to be carefully organized for maximum effectiveness, and introduced in full understanding of the natural history of the disease. There are major potential harms as well as benefits from screening. The current state of art for breast, cervix and prostate cancer screening is reviewed, only for breast and cervix are policies of screening in the population justified.     

Decreasing the cancer burden in developing countries: concerns and recommendations

Although the close of the 20th century witnessed advances in cancer detection and treatment, cancer morbidity and mortality rates steadily increase across the globe within the 21st century. The majority of this cancer burden can be found in underdeveloped and developing countries. A growing concern can be seen regarding this issue, with the research community as well as governmental and non-governmental organizations considering efforts that need to be developed and implemented. In this article, we propose several strategies to reduce cancer burden in developing countries that involve not only governmental and non-governmental organizations in such developing countries but also the research community. Such measures may prove helpful in gaining a better understanding of cancer burden and assist in clinical decision making and the design of prevention strategies for developing countries.     

Clinical delivery of intensity modulated conformal radiotherapy for relapsed or second-primary head and neck cancer using a multileaf collimator with dynamic control

Background and purpose: Concave dose distributions generated by intensity modulated radiotherapy (IMRT) were applied to re-irradiate three patients with pharyngeal cancer.

Patients, materials and methods: Conventional radiotherapy for oropharyngeal (patients 1 and 3) or nasopharyngeal (patient 2) cancers was followed by relapsing or new tumors in the nasopharynx (patients 1 and 2) and hypopharynx (patient 3). Six non-opposed coplanar intensity modulated beams were generated by combining non-modulated beamparts with intensities (weights) obtained by minimizing a biophysical objective function. Beamparts were delivered by a dynamic MLC (Elekta Oncology Systems, Crawley, UK) forced in step and shoot mode.

Results and conclusions: Median PTV-doses (and ranges) for the three patients were 73 (65–78), 67 (59–72) and 63 (48–68) Gy. Maximum point doses to brain stem and spinal cord were, respectively, 67 Gy (60% of volume below 30 Gy) and 32 Gy (97% below 10 Gy) for patient 1; 60 Gy (69% below 30 Gy) and 34 Gy (92% below 10 Gy) for patient 2 and 21 Gy (96% below 10 Gy) at spinal cord for patient 3. Maximum point doses to the mandible were 69 Gy for patient 1 and 64 Gy for patient 2 with, respectively, 66 and 92% of the volume below 20 Gy. A treatment session, using the dynamic MLC, was finished within a 15-min time slot.