Vulvar cancer in high‐income countries: Increasing burden of disease

The aim of this study was to assess trends in the age‐specific incidence of vulvar cancer in 13 high‐income countries satisfying a priori conditions regarding the availability of cancer registry data over a 20‐year period; these were Canada, the United States, nine European countries, Australia and Japan. Five‐yearly incidence and population at risk were obtained from the International Agency for Research on Cancer's Cancer Incidence in Five Continents for the years 1988–1992 (Volume 7) to 2003–2007 (Volume 10). The 5‐yearly average percent change (AvPC) over the period and standardised rate ratios (SRRs) for 2003–2007 versus 1988–1992 were used to assess changes in the age‐standardised incidence rates of vulvar cancer for all ages, and for <60 years and 60+ years. During the study period, the 5‐yearly AvPC across the 13 countries increased by 4.6% (p = 0.005) in women of all ages, and 11.6% (p = 0.02) in those <60 years. No change was observed in women aged 60+ years (5‐yearly AvPC = 0.1%, p = 0.94). The SRR for 2003–2007 versus 1988–1992 was significantly elevated in women <60 years of age (SRR = 1.38, 95% CI: 1.30–1.46), but not in women of 60+ years (SRR = 1.01, 95% CI: 0.97–1.05). The increase in incidence in women <60 years of age drove a significant increase in the overall SRR in women of all ages (SRR = 1.14, 95% CI: 1.11–1.18). Some differences in the specific findings at the individual country level were observed. The findings are consistent with changing sexual behaviours and increasing levels of exposure to human papillomavirus (HPV) in cohorts born around/after about 1950, but younger cohorts offered HPV vaccination are likely to receive some protection against developing vulvar cancer in the future.     

Increased risk of hepatocellular carcinoma in patients with diabetes mellitus: a systematic review and meta-analysis of cohort studies

In recent years, increasing evidence has suggested a strong association between diabetes mellitus (DM) and hepatocellular carcinoma (HCC). To provide a quantitative assessment of this association, we performed a systematic review and meta-analysis of cohort studies. We collected studies through a literature search of Medline from January 1, 1966 and EMBASE from January 1, 1974, through July 31, 2010. Summary relative risks (SRRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model. A total of 25 cohort studies that met our inclusion and exclusion criteria were included in our analysis. Among these, 18 studies showed that DM was associated with an increased incidence of HCC (SRRs = 2.01, 95% CI: 1.61-2.51), compared with individuals without DM. There was a statistically significant heterogeneity among these studies (Q = 136.68, p < 0.001, I(2) = 87.6%). Analyses subgrouped by controlling confounders revealed that the increased incidence of HCC was independent of geographic location, alcohol consumption, history of cirrhosis, or infections with hepatitis B (HBV) or hepatitis C virus (HCV). In addition, DM was also positively associated with HCC mortality (SRR = 1.56; 95% CI: 1.30-1.87), with no significant evidence of heterogeneity among studies (Q = 1.16, p = 0.56, I(2) =0%). There were no significant publication bias (p = 0.79 for Egger's regression asymmetry test). These findings strongly support a positive association between DM and increased risk of HCC in both males and females.     

Cancer trends among Hispanic men in South Florida, 1981-1998

BACKGROUND: Hispanics now represent a majority of residents in Miami-Dade County, Florida. In this report, the authors present new cancer incidence and mortality data for South Florida's Hispanic men for the period 1990-1998 and compare them with data from a previous report from the 1980s. Periodic updating of cancer incidence data, reflecting current population distribution, lifestyle, and environmental risk factors, is necessary to inform cancer prevention and control activities optimally. METHODS: The study population consisted of all incidents of cancer (1981-1998) occurring in males from Miami-Dade County, as determined from the Florida Cancer Data System data base; patients were divided into two 9-year periods for analysis. Age-standardized incidence and mortality rates were computed for 14 common cancer sites, and rates for Hispanic men were compared with the rates for non-Hispanic white men as standardized rate ratios (SRRs) with 95% confidence intervals (95% CIs). Incidence and mortality trends were determined using linear regression analysis. RESULTS: Nearly 70,000 incident cancer cases were analyzed. For 1990-1998, the top five incident cancers for both race/ethnic groups were the same. The overall decreased cancer risk for Hispanic men (SRR, 0.80; 95% CI, 0.79-0.82), compared with non-Hispanic white men, remained essentially constant over the two study periods. Cancer incidence increased similarly for the two race-ethnic groups; cancer mortality decreased, with a sharper decrease for non-Hispanic white men, resulting in apparent convergence of mortality trends recently. CONCLUSIONS: Differences in cancer risk for South Florida's Hispanic men have not attenuated over the past 20 years. With cancer incidence significantly less for Hispanic men, their mortality rate approaches that of non-Hispanic white men, and cancer prevention and control strategies targeted for this ethnic group become increasingly important.     

Pesticide use and colorectal cancer risk in the Agricultural Health Study

We investigated the relationship between agricultural pesticides and colorectal cancer incidence in the Agricultural Health Study. A total of 56,813 pesticide applicators with no prior history of colorectal cancer were included in this analysis. Detailed pesticide exposure and other information were obtained from self-administered questionnaires completed at the time of enrollment (1993-1997). Cancer incidence was determined through population-based cancer registries from enrollment through December 31, 2002. A total of 305 incident colorectal cancers (212 colon, 93 rectum) were diagnosed during the study period, 1993-2002. Although most of the 50 pesticides studied were not associated with colorectal cancer risk, chlorpyrifos use showed significant exposure response trend (p for trend = 0.008) for rectal cancer, rising to a 2.7-fold (95% confidence interval: 1.2-6.4) increased risk in the highest exposure category. Aldicarb was associated with a significantly increased risk of colon cancer (p for trend = 0.001), based on a small number of exposed cases, with the highest exposure category resulting in a 4.1-fold increased risk (95% confidence interval: 1.3-12.8). In contrast, dichlorophenoxyacetic acid showed a significant inverse association with colon cancer but the association was not monotonic. Our findings should be interpreted cautiously since the literature suggesting that pesticides are related to colorectal cancer is limited. Nonetheless the possibility of an association between exposure to certain pesticides and incidence of colorectal cancer among pesticide applicators deserves further evaluation.     

Cancer mortality and morbidity among workers at the Sellafield plant of British Nuclear Fuels.

The mortality of all 14,282 workers employed at the Sellafield plant of British Nuclear Fuels between 1947 and 1975 was studied up to the end of 1988 and cancer incidence was examined from 1971 to 1986. This updates a previous report on mortality only up to the end of 1983. Ninety-nine per cent of the workers were traced satisfactorily. Cancer mortality was 4% less than that of England and Wales [standardised mortality ratio (SMR) = 96; 95% confidence interval (CI) = 90,103] and the same as that of Cumbria (SMR = 100: Cl = 94,107). Cancer incidence was 10% less than that of England and Wales [standardised registration ratio (SRR) = 90; Cl = 83.97] and 18% less than that of Northern Region (SRR = 82; Cl = 75.88). Cancer mortality rates were significantly in excess of national rates for cancers of the pleura (nine observed, 2.6 expected; P = 0.001), thyroid (six observed, 1.8 expected; P = 0.01) and ill defined and secondary sites (53 observed, 39.2 expected; P = 0.02). There were significant deficits of cancers of the liver and gall bladder, larynx and lung. Among radiation workers there were significant positive correlations between accumulated radiation dose and mortality from cancers of ill-defined and secondary sites (10 year lag: P = 0.01) and for leukaemia (2 year lag: P = 0.009), but not for cancers of the pleura and thyroid cancer. Previous findings of such associations with multiple myeloma and bladder cancer were less strong. There was a significant excess of incident cases of cancer of the oesophagus (P = 0.01), but this was not associated with accumulated radiation dose. For cancers other than leukaemia, the dose-response risk estimates were below those of the adult atomic bomb survivors, but the 90% confidence interval included risks of zero and of 2-3 times higher. For leukaemia (12 deaths, excluding CLL), under an excess relative risk model, the risk estimate derived for the Sellafield workers was about four times higher than that for the adult atomic bomb survivors with a confidence interval ranging from a half to nearly 20 times that of the atomic bomb survivors. Overall, however, there was no excess of leukaemia among the workers compared with national rates.     

Familiality in breast cancer: a case-control study in a Sweden population.

1330 consecutively diagnosed breast-cancer patients, and an equal number of paired aged-matched controls without breast cancer, were investigated for a familial history of breast cancer. Patients and controls received identical questionnaires. One relative or more with breast cancer was reported by 18.6% of the patients and by 12.3% of the controls, giving a standardized relative risk (SRR) of 1.6 (P < 0.01). One or more first-degree relatives with breast cancer were reported by 11.2% of the patients and by 6.8% of the controls, with an SRR of 1.7 (P < 0.01). For second-degree relatives the SRR was 1.5 (P < 0.05). Of the patients, 3.9% had mothers with breast cancer compared to 2.7% of the controls (SRR = 1.4, N.S.). One or more sisters with breast canceer were reported by 10.1% of the patients and by 5.1% of the controls (SRR = 2.0, P < 0.01). No distinct difference in familiality between the different age groups was found.     

Cancer incidence among pesticide applicators exposed to metolachlor in the Agricultural Health Study

Metolachlor is one of the most widely used herbicides in the United States. We evaluated the incidence of cancer among pesticide applicators exposed to metolachlor in the Agricultural Health Study, a prospective cohort study of licensed pesticide applicators in Iowa and North Carolina. A total of 50,193 pesticide applicators were included. Detailed information on pesticide exposure and lifestyle factors was obtained from self-administered enrollment questionnaires completed between 1993 and 1997; average length of follow-up was 7.33 years. Two metolachlor exposure metrics were used : (i) lifetime days personally mixed or applied metolachlor and (ii) intensity-weighted lifetime days (lifetime days x an intensity level). Poisson regression analysis was used to estimate relative risks (RR) and 95% confidence intervals (95%CI) for cancer subtypes by tertiles of metolachlor exposure. No clear risk for any cancer subtype was found for exposure to metolachlor. A significantly decreased RR was found for prostate cancer in the highest category of lifetime days exposure (RR = 0.59; 95%CI, 0.39-0.89) and in the second highest category of intensity-weighted lifetime days exposure (RR = 0.66; 95%CI, 0.45-0.97); however, the test for trend was not significant for either exposure metric. A nonsignificantly increased risk was found for lung cancer with lifetime days exposure in the highest category (RR = 2.37; 95%CI, 0.97-5.82, p-trend = 0.03) but not with intensity-weighted lifetime days. Given the widespread use of metolachlor and the frequent detection of metolachlor in both surface and ground water, future analyses of the AHS will allow further examination of long-term health effects, including lung cancer and the less common cancers.     

Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis

Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60–3.53) and 1.64 (95% CI 1.02–2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63–1.13) for CM and 1.03 (95% CI 0.95–1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.     

Age at first birth, parity and risk of breast cancer in a Swedish population.

A case-control study was conducted over a period of 11 months in an area containing one-third of the Swedish population. One thousand and one patients participated, constituting 94% of all women newly diagnosed as having breast cancer within the area. They were compared with 1,001 age-matched, non-hospitalized controls without breast cancer, selected by paired sampling from a population register. The risk of breast cancer was slightly, but significantly, related to parity, the standardized relative risk (SRR) being 1.35 for nulliparous women as compared to ever parous. In the different parity groups a risk significantly lower than that for nulliparous women was found only for women with more than 2 children (SRR = 0.59) but the trend with parity was highly significant (P less than 0.001). Age at first birth was not found to be an important risk factor for breast cancer. SRR was lower than for nulliparous women in all groups of women with their first birth before the age of 35 years, but the difference was significant (P less than 0.05) only for those with the first birth between 20 and 24 (SSR = 0.69) and 25 and 29 (SRR = 0.69) years of age. The trend with age at first birth (P less than 0.05) disappeared after stratification for parity, suggesting that it was a confounding factor.     

2006-2015年重庆市结直肠肛门癌发病趋势分析

目的:了解重庆市结直肠肛门癌发病趋势变化。方法:采用国际疾病分类(ICD-10)与国际肿瘤学分类（ICD-0-3）整理分析重庆市11个肿瘤登记点2006至2015年结直肠肛门癌发病资料,数据采用SPSS 19.0统计分析发病率、中国标化发病率（中标率）、年度变化百分比(APC)、截缩率与累积危险度,趋势变化采用曲线估计指数分布回归模型进行判别。结果:重庆市结直肠肛门癌发病率由2006年的14.15/105上升至2015年的28.32/105,中标率与世界标化发病率（世标率）均呈上升的趋势,APC分别为7.68%、4.08%与3.77%,差异有统计学意义（P＜0.05）。结直肠肛门癌男性发病率高于女性（t=6.99,P＜0.001）,城市发病率高于农村(t=5.48,P＜0.001)。结直肠肛门癌45岁前发病率低于20/105,45岁后发病率呈现快速上升,80～＜85岁年龄组达到高峰。60～＜65岁、65～＜70岁、70～＜75岁年龄组发病率呈上升的趋势,年度变化百分比（APC)分别为6.29%、5.76%与4.60%,差异有统计学意义（P＜0.05）。重庆市结直肠肛门癌35~64岁截缩率从2006年的13.94/105上升至2015年的25.77/105,APC为4.60%,差异有统计学意义（P＜0.05）。累积率与累积危险度分别由2006年的1.37%、1.36%上升至2015年的2.10%与2.08%,变化趋势差异有统计学意义（P＜0.05）。结论:重庆市结直肠肛门癌发病率处于全国的平均水平,并呈上升的趋势,应尽早开展结直肠肛门癌的三级预防。     

Abdominal obesity and the risk of colorectal adenoma: a meta-analysis of observational studies

Inconsistent results regarding the association between abdominal obesity and the risk of colorectal adenoma (CRA), the precursor of colorectal cancer (CRC), have been reported. To provide a quantitative assessment of this relationship, we summarized the evidence from observational studies in categorical, linear dose-response meta-analyses. We searched MEDLINE and EMBASE for studies of waist circumference (WC) and/or waist-hip ratio (WHR) and CRA risk published until the end of October 2011. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were summarized using a random-effects model. Between-study heterogeneity was assessed using the Cochran's Q and I statistics. A total of 21 studies (four case-control studies, 12 cross-sectional studies, and five cohort studies) were included in this meta-analysis. Overall, the SRRs of CRA were 1.39 (95% CI: 1.24-1.56) for the highest versus the lowest level of WC and 1.22 (95% CI: 1.10-1.35) for WHR (P-value for heterogeneity 0.013 and 0.458, respectively). In linear dose-response analysis, a 10-cm increase in WC was related to an increased risk of CRA (SRR, 1.19; 95% CI, 1.13-1.26) and a 0.1-unit increment in WHR gave 1.16 (95% CI: 1.06-1.26). Subgroup analyses revealed that the increased risk of CRA in abdominally obese individuals was independent of geographic location, design, sex, and confounders: alcohol use, smoking status, and family history of colorectal cancer. However, BMI may be a confounder for the association between WC and CRA risk. These results suggest that abdominally obese individuals, both men and women, may have an increased risk of CRA.     

Lung cancer in an urban area in Northern Italy near a coke oven plant

Coke ovens are well-known sources of potentially carcinogenic air pollutants, but studies on resident populations are still poor. This study investigates the incidence of lung cancer near a coke oven in Cornigliano, a district of the Genoa municipality in Northern Italy. Genoa proper and one district similar to Cornigliano as regards socio-economic deprivation were selected as referents. Incidence data were drawn from the Ligurian Cancer Registry for 1986-1997 calendar period. Concentrations of pollutants related to the industrial activity (namely benzene, benzo[a]pyrene, PM(10), CO, NO(2) and SO(2)) were collected in selected locations before and after the coke oven closing. Spatial trend around the plant was assessed by Stone's test, while the pattern of risk across Cornigliano was evaluated via disease mapping in a Bayesian model. A gradient of air pollutants was observed around the coke oven, which disappeared after its closing. In Cornigliano, 158 lung cancer cases were observed in males and 28 in females. Only a marginal excess risk was observed versus the two selected referents, while a gradient in the areas close to the plant emerged among females. Disease mapping revealed another cluster of risk for both sexes in the Eastern part of the district, where a foundry was operative until the early 1980s. The excess risk for females is consistent with pollution measurements and with other epidemiological evidence. The geographic pattern of incidence suggests a role of industrial air pollution as a risk factor for lung cancer.     

Incidence,survival, and mortality of cancer in children and young adolescents in Belgium and the Netherlands in 2004–2015: A comparative population-based study

International comparisons of cancer surveillance measures may provide insight into inequalities in registration practices, etiological factors, and treatment strategies. This study aimed to compare incidence, survival, and mortality of cancer in children and young adolescents between Belgium and the Netherlands. All children (0–14 years) and young adolescents (15–17 years) diagnosed with cancer between 2004 and 2015 were selected from the population-based cancer registries of Belgium (N = 4739) and the Netherlands (N = 7322). Differences in incidence and mortality were expressed as standardized rate ratios (SRR; BE/NL). Five-year observed survival was calculated using the Kaplan–Meier method. During 2004–2015, the overall cancer incidence among children and young adolescents was similar in both countries. Incidence of neuroblastoma was significantly higher in Belgian children (2010–2015: SRR = 1.3, 95% CI 1.0–1.6). Five-year survival of all malignant cancers was comparable in 2010–2015, exceeding 80% in both age groups. Remarkable differences in survival existed in children for malignant central nervous system (CNS) tumors in 2004–2009 (BE = 62%, NL = 45%), for acute myeloid leukemia (BE = 68%, NL = 78%) and rhabdomyosarcomas (BE = 60%, NL = 79%) in 2010–2015, and for neuroblastoma in both periods (2004–2009: BE = 76%, NL = 64%; 2010–2015: BE = 82%, NL = 64%). Overall cancer mortality in children decreased by approximately 3 percent-points annually in both countries, but was slightly lower in Belgium in 2004–2009 (SRR = 0.9, 95% CI 0.7–1.0). Despite differences for specific cancer types, overall cancer incidence, survival, and mortality were comparable between Dutch and Belgian children and young adolescents in 2010–2015. Variability in screening, diagnosis, and registration practices probably explains the observed differences in incidence and survival of neuroblastoma and malignant CNS tumors.     

Serum insulin and C-peptide concentration and breast cancer: a meta-analysis

Purpose

Chronic hyperinsulinemia may play a role in breast cancer etiology. We performed a meta-analysis examining whether serum concentrations of insulin and C-peptide are associated with increased breast cancer risk.

Methods

We restricted our analyses to prospective studies. After a systematic literature search, we computed summary relative risks (SRRs) and 95 % confidence intervals (95 % CIs) using random effect models applied to the relative risk associated with the highest versus lowest quantile of serum concentrations. We also graphically examined results in order to identify whether dose–response relationships were present.

Results

Six articles including 1,890 cases were retrieved for serum insulin levels and five for serum C-peptide levels including 1,759 cases. SRR and 95 % CI were 1.08 (0.66–1.78) for insulin and 1.04 (0.77–1.41) for C-peptide. Heterogeneity of results between studies was high for insulin and inexistent for C-peptide. Restricting the analysis to women diagnosed with breast cancer before or after menopause did not alter results. In insulin studies, SRR computed from relative risks not adjusted for body mass index (and other risk factors) was 1.22 (0.91–1.63). The SRR fell to 1.02 (0.53–1.97) in studies that adjusted for body mass index and other factors. Similar drops occurred in C-peptide studies, from 1.11 (0.87–1.41) to 1.06 (0.70–1.61). No consistent dose–response relationship was apparent in either pre- or post-menopausal cancers.

Conclusions

Our meta-analysis of observational studies found no evidence of an association between serum insulin or C-peptide concentrations and breast cancer risk. Increased risk found by some studies may have been due to inadequate control for adiposity.     

Epidemiology of cancer among Hispanic males. The experience in Florida

To assess cancer incidence among Hispanic males in Dade County, Florida, data were analyzed from the statewide tumor registry. For all cancer sites (combined), the age standardized rate among Hispanic males was 308.75 cases per 100,000 person-years, compared with 349.55 among non-Hispanics (standardized rate ratio [SRR] = 0.88; 95% confidence interval [CI] = 0.84-0.93). Hispanics experienced significantly greater rates of cancers of the larynx (SRR = 1.58; 1.19-2.09), thyroid (SRR = 3.12; 1.18-8.26), and gallbladder (SRR = 5.45; 1.55-19.15), compared with non-Hispanics, but significantly lower rates of testicular cancer (SRR = 0.17; 0.09-0.37), melanoma (SRR = 0.20; 0.12-0.34), esophagus (SRR = 0.52; 0.49-0.55), stomach (SRR = 0.61; 0.43-0.87), pancreas (SRR = 0.65; 0.45-0.94), kidney and renal pelvis (SRR = 0.68; 0.48-0.97), colon (SRR = 0.79; 0.67-0.94), lung (SRR = 0.82; 0.73-0.94), and Kaposi's sarcoma (SRR = 0.03; 0.00-0.25). These data suggest that Dade Hispanic males have not experienced the cancers traditionally elevated among US Latinos, or those common among non-Hispanics.     

Hysterectomy and kidney cancer risk: A meta‐analysis

Recent cohort findings suggest that women who underwent a hysterectomy have an elevated relative risk of kidney cancer, although evidence from past studies has been inconsistent. We conducted a systematic review and meta‐analysis of published cohort and case–control studies to summarize the epidemiologic evidence investigating hysterectomy and kidney cancer. Studies published from 1950 through 2012 were identified through a search of PubMed and of references from relevant publications. Meta‐analyses were conducted using random‐effects models to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs) for hysterectomy, age at hysterectomy (<45, 45+ years) and time since hysterectomy (<10, 10+ years). The SRR for hysterectomy and kidney cancer for all published studies (seven cohort, six case–control) was 1.29 (95% CI, 1.16–1.43), with no evidence of between‐study heterogeneity or publication bias. The summary effect was slightly weaker, although still significant, for cohorts (SRR, 1.26; 95% CI, 1.11–1.42) compared with case–control findings (1.37; 95% CI, 1.09–1.73) and was observed irrespective of age at hysterectomy, time since the procedure and model adjustment for body mass index, smoking status and hypertension. Women undergoing a hysterectomy have an approximate 30% increased relative risk of subsequent kidney cancer. Additional research is needed to elucidate the biological mechanisms underlying this association.     

The Incidence of Malignant Tumors in Environmentally Disadvantaged Regions of Kazakhstan

Objective: To explore the prevalence of malignant tumors in the adult population through 2003-2014 in parts of the Aral Sea region: a zone of ecological disaster, a zone of ecological crisis and a zone of precritical conditions. Methods: The long-time average annual levels of cancer morbidity stratified by zones of the Aral Sea region and trends of long-time average annual incidence indicators of malignant tumors were identified. Leading cancer localizations in the adult population was established and associations between cancer incidence and environmental pollution were analyzed. In addition, associations between individual risk factors and cancer incidence in the adult population was established. Correlations between a hazard index and the cancer incidence in the adult population were calculated. Results: In all three Aral Sea regions, as well as in Zhanaarkinskii district, leading cancer in adult population was esophageal, stomach, tracheal, lung, hepatobiliary, and breast. Long-time average annual levels of cancer morbidity in adult population living in the Aral sea region is 1.5 times higher comparing to the control region. In particular, long-time average annual levels of cancer morbidity in adult population living in the zone of ecological disaster was 57.2% higher, in the zone of ecological crisis - 61.9% higher, and in the zone of precritical condition – 16.8% higher. Long-time average annual levels in the adult population of the Aral Sea region significantly exceeded control levels for brain and central nervous system cancer, cancer of bone and articular cartilage, and thyroid cancer. Conclusion: It has was established that the total cancer morbidity depended on the total hazard index associated with the inhalation of nickel and the combined cadmium intake (r=0.8).     

Incidence of and survival from upper aerodigestive tract cancers in the U.K.: the influence of deprivation

The aim of the study was to investigate the effect of social deprivation on the incidence of and survival from upper aerodigestive tract (UAT) cancers in the U.K. Incidence was calculated on 25 903 cases of malignant upper aerodigestive tract cancers collected from four cancer registries in the U.K. for the period 1984–1993. A Cox proportional hazard model was used to determine the influence of deprivation, measured in Carstairs quintiles for crude and cause-specific survival on 17 393 of these cases. Patients with UAT cancers who were younger, males or of South Asian origin were more likely to live in a deprived area than in an affluent area. The incidence of UAT cancers in a district was correlated with deprivation score for the district for both men (r=0.78) and for women (r=0.60). People who lived in deprived areas had a relative risk of 1.25 (95% confidence interval (CI):1.15–1.35) of dying from their cancer and of 1.24 (95% CI: 1.13–1.35) of dying from all causes compared with people who lived in affluent areas. People living in deprived areas were more likely to get UAT cancer and were more likely to die from their cancer than people living in affluent areas.     

Cancer among Hispanic women in South Florida: an 18-year assessment: a report from the Florida Cancer Data System

BACKGROUND: The Hispanic population now represents the majority of residents in Miami-Dade County, Florida. The authors present cancer incidence and mortality data for South Florida's Hispanic women for the period 1990-1998 and compare these data to previously reported data from 1981-1989. Cancer incidence, risk, and mortality data should reflect current population distribution, lifestyle, and environmental risk factors so that cancer prevention and control activities are informed optimally. METHODS: The study population consisted of all women with malignant disease during 1981-1998 from Miami-Dade County found in the Florida Cancer Data System data base; patients were divided into 2 9-year periods for analysis. Age-standardized incidence and mortality rates were computed for common disease sites; rates for Hispanic women were compared with the rates for non-Hispanic white (NHW) women as standardized rate ratios (SRR) with 95% confidence intervals (95%CIs). Incidence and mortality trends were analyzed using linear regression. RESULTS: Over 70,000 cancer incidents were analyzed. The overall decreased cancer risk for Hispanic women (SRR, 0.65; 95%CI, 0.64-0.67), compared with NHW women, remained essentially constant over the two study periods. Cancer incidence increased similarly for the two racial-ethnic groups. The incidence of lung carcinoma increased in both groups, becoming the second most common disease site for NHW women and the third most common disease site for Hispanic women. CONCLUSIONS: The decreased relative cancer risk for Hispanic women in South Florida has remained stable over the past 18 years. Lung carcinoma is increasing among women in both racial-ethnic groups.     

2001-2019年深圳市南山区结直肠癌发病及趋势分析

目的:了解深圳市南山区2001-2019年结直肠癌发病的流行特征及变化趋势，为针对性开展结直肠癌防治提供参考依据。方法:根据深圳市慢性病防治管理系统登记的2001-2019年南山区常住户籍人口诊断为结直肠癌的所有病例数据，计算结直肠癌粗发病率、中标率、世标率、年龄别发病率。采用Joinpoint回归分析结直肠癌发病的时间趋势，计算年度发病变化百分比（annual percent change，APC）。结果:南山区2001-2019年共报告结直肠癌新发病例1 732例，粗发病率16.96/10万，中标率23.16/10万，世标率23.79/10万。男女发病比为1.46∶1，不同性别间的年龄别发病率均呈上升趋势。结直肠癌发病率随着年龄增长而升高，0~69岁的人群发病率上升趋势尤为显著， 85岁及以上的人群发病率则达到高峰。世标率从2001年的13.30/10万上升至2019年的35.20/10万，Joinpoint结果显示，2001-2019年结直肠癌的世标率APC为3.91%（P＜0.01）。结论:南山区结直肠癌发病形势严峻，为降低其发病率，结直肠癌筛查及早诊早治工作应要积极落实推进。