Changing cancer incidence in Kampala,Uganda, 1991–2006

Incidence rates of different cancers have been calculated for the population of Kyadondo County (Kampala, Uganda) for a 16‐year period (1991–2006). This period coincides with continuing social and lifestyle changes and the peak and subsequent wane of the epidemic of HIV‐AIDS. There has been an overall increase in the risk of cancer during the period in both sexes, with the incidence rates of cancers of the breast and prostate showing particularly marked increases (4.5% annually). Prostate cancer is now the most common cancer in men. The incidence of cancer of the esophagus, formerly the most common cancer in men and second in frequency in women, has remained relatively constant, whereas the incidence of cancer of the cervix, the most common malignancy in women, continues to increase. Since the early 1990s the incidence of Kaposi sarcoma (KS) in men has declined, and while remaining relatively constant in women, it has been diagnosed at progressively later ages. The rates of pediatric KS have declined by about 1/3rd. The incidence of squamous cell cancers of the conjunctiva has also declined since the mid 1990s. Cancer control in Uganda, as elsewhere in sub‐Saharan Africa, involves meeting the challenge of emerging cancers associated with westernization of lifestyles (large bowel, breast and prostate); although the incidence of cancers associated with poverty and infection (liver, cervix, esophagus) shows little decline, the residual burden of the AIDS‐associated cancers remains a major burden.     

Trends in the incidence of cancer in the black population of Harare,Zimbabwe 1991–2010

Incidence rates of different cancers have been calculated for the black population of Harare, Zimbabwe for a 20‐year period (1991–2010) coinciding with continuing social and lifestyle changes, and the peak, and subsequent wane, of the HIV‐AIDS epidemic. The overall risk of cancer increased during the period in both sexes, with rates of cervix and prostate cancers showing particularly dramatic increases (3.3% and 6.4% annually, respectively). By 2004, prostate cancer had become the most common cancer of men. The incidence of cancer of the esophagus, formerly the most common cancer of men, has remained relatively constant, whereas rates of breast and cervix cancers, the most common malignancies of women, have shown significant increases (4.9% and 3.3% annually, respectively). The incidence of Kaposi sarcoma increased to a maximum around 1998–2000 and then declined in all age groups, and in both sexes The incidence of squamous cell cancers of the conjunctiva is relatively high, with temporal trends similar to those of Kaposi sarcoma. Non‐Hodgkin lymphoma, the fifth most common cancer of men and fourth of women, showed a steady increase in incidence throughout the period (6.7–6.9% annually), although rates in young adults (15–39) have decreased since 2001. Cancer control in Zimbabwe, as elsewhere in sub‐Saharan Africa, involves meeting the challenge of emerging cancers associated with westernization of lifestyles (large bowel, breast and prostate), while the incidence of cancers associated with poverty and infection (liver, cervix and esophagus) shows little decline, and the residual burden of the AIDS‐associated cancers remains significant.     

Trends in cancer incidence in Kyadondo County, Uganda, 1960-1997

Incidence rates of different cancers have been calculated for the population of Kyadondo County (Kampala, Uganda) for four time periods (1960-1966; 1967-1971; 1991-1994; 1995-1997), spanning 38 years in total. The period coincides with marked social and lifestyle changes and with the emergence of the AIDS epidemic. Most cancers have increased in incidence over time, the only exceptions being cancers of the bladder and penis. Apart from these, the most common cancers in the early years were cervix, oesophagus and liver; all three have remained common, with the first two showing quite marked increases in incidence, as have cancers of the breast and prostate. These changes have been overshadowed by the dramatic effects of the AIDS epidemic, with Kaposi's sarcoma emerging as the most common cancer in both sexes in the 1990s, and a large increase in incidence of squamous cell cancers of the conjunctiva. In the most recent period, there also seems to have been an increase in the incidence of non-Hodgkin lymphomas. So far, lung cancer remains rare. Cancer control in Uganda, as elsewhere in sub-Saharan Africa, faces a threefold challenge. With little improvement in the incidence of cancers associated with infection and poverty (liver, cervix, oesophagus), it must face the burden of AIDS-associated cancers, while coping with the emergence of cancers associated with Westernization of lifestyles (large bowel, breast and prostate).     

Trends in the incidence of cancer in the Sousse region,Tunisia, 1993–2006

In this article, we analyzed trends in incidence rates of the major cancer sites for a 14‐year period, 1993–2006, in the Sousse region localized in the centre of Tunisia. Five‐year age‐specific rates, crude incidence rates (CR), world age‐standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. A total of 6,975 incident cases of cancer were registered, with a male to‐female sex ratio of 1.4:1. ASRs showed stable trends (?0.1% in males, and +1.0% in females). The leading cancer sites in rank were lung, breast, lymphoma, colon‐rectum, bladder, prostate, leukemia, stomach and cervix uteri. For males, the incidence rates of lung, bladder and prostate cancers remained stable over time. While, cancers of colon‐rectum showed a marked increase in incidence (APC: +4.8%; 95% CI: 1.2%, 8.4%) and non‐Hodgkin's lymphoma (NHL) showed a notable decline (APC: ?4.4%; 95% CI: ?8.2, ?0.6). For females, cancers of the breast (APC: +2.2%; 95% CI: 0.4%, 4.0%) and corpus uteri (APC: +7.4%; 95% CI: 2.8%, 12.0%) showed a marked increase in incidence during the study period, while the cervix uteri cancer decreased significantly (APC: ?6.1%; 95% CI: ?9.2%, ?3.0%). The results underline the increasing importance of cancer as a cause of mortality and morbidity in Tunisia. Our findings justify the need to develop effective program aiming at the control and prevention of the spread of cancer amongst Tunisian population.     

Trends in cancer incidence in rural Eastern Cape Province; South Africa, 1998–2012

There are few cancer trend data reported in sub‐Saharan Africa notably due to the scarcity of population‐based cancer registries (PBCRs). The Eastern Cape Province PBCR is amongst the few registries in sub‐Saharan Africa that reports data for a rural population. Trends in cancer incidence are reported for the period 1998–2012. Registered cases, age‐standardized rates (ASRs) and standardized rate ratios are presented for the most common cancers in both males and females in three periods (1998–2002, 2003–2007 and 2008–2012). In males, the most commonly diagnosed cancer during the 15 year period was cancer of the oesophagus; incidence rates showed a significant decline over the 15 year period, entirely due to a 30% decrease between 2003–2007 and 2008–2012, to an ASR of 23.2 per 100,000 population. This was followed by prostate cancer, the incidence of which was more than doubled to a level of 9.9/100,000. In women, cancer of the cervix uteri has become the most common malignancy, with a significant increase in incidence during the period to 29.0/100,000. Oesophageal cancer is second in frequency, with (as in males) a significant decline in the final 10 years to an incidence of 14.5/100,000 in 2008–2012. The incidence of breast cancer increased by 61%, although the absolute rate remains low (12.2/100,000). The incidence rates of colorectal cancer are low, and the increases in incidence, although relatively large (35% in men, 63% in women) were not statistically significant. Kaposi sarcoma showed a dramatic increase in incidence in both sexes (3.5‐fold in men, 11‐fold in women) although the incidence remains relatively low by southern African standards. Cancer prevention and control activities in the area need to be informed by these data and strengthened.     

Three‐year cancer incidence in Blantyre,Malawi (2008–2010)

In this paper, we present incidence rates of different cancers calculated for the population of Blantyre, Malawi for the period 2008–2010, using data from the Malawi Cancer Registry. Active methods were used for case finding, with standard checks for accuracy and validity performed in CanReg 4. During this 3‐year period, a total of 3,711 cases were registered comprising 1,643 men (an estimated age‐standardized incidence rate (ASR) of 169.8 per 100,000) and 2,068 women (ASR 238.7 per 10⁵). Kaposi sarcoma (KS) was the most common cancer in men (40.5% of all cancers in men; ASR 54.0 per 10⁵) while cervical cancer was the commonest in women (33.3%; ASR 88.6 per 10⁵). The incidence rates for esophageal cancer remain one of the highest in the world (ASR 30.9 per 100,000 in men, 22.1 per 100,000 in women). Incidence of cancer of the prostate is relatively low in Blantyre (5.1%; ASR 16.4 per 10⁵), compared with elsewhere in Africa. In childhood, the cancer spectrum is dominated by Burkitt lymphoma (32.5% ASR 90.9 per 10⁶) followed by Wilms tumor (11.3%; ASR 35.9 per 10⁶) and pediatric KS (11.0%; ASR 31.1 per 10⁶). The overall percentage of cases with histological verification was 47.5%, a slight improvement from 42.4% in late 1990s also indicating successful case finding outside laboratories.     

Black–white differences in cancer risk in Harare,Zimbabwe, during 1991–2010

Data from 20 years of cancer registration in Harare (Zimbabwe) are used to investigate the risk of cancer in the white population of the city (of European origin), relative to that in blacks (of African origin). In the absence of information on the respective populations‐at‐risk, we calculated odds of each major cancer among all cancers, and took the odds ratios of whites to blacks. Some major differences reflect obvious phenotypic differences (the very high incidence of skin cancer—melanoma and nonmelanoma—in the white population), whereas others (high rates of liver cancer, Kaposi sarcoma and conjunctival cancers in blacks) are the result of differences in exposure to infectious agents. Of particular interest are cancers related to lifestyle factors, and how the differences in risk are changing over time, as a result of evolving lifestyles. Thus, the high risk of cancers of the esophagus and cervix uteri in blacks (relative to whites) and colorectal cancers in whites show little change over time. Conversely, the odds of breast cancer, on average four times higher in whites than blacks, has shown a significant decrease in the differential over time. Cancer of the prostate, with the odds initially (1991–1997) 15% higher in whites had become 33% higher in blacks by 2004–2010.     

Trends in the incidence of ovarian cancer in sub-Saharan Africa

Ovarian cancer (OC) is one of the commonest cancers of women in sub-Saharan Africa (SSA), although to date no data have been available on time trends in incidence to better understand the disease pattern in the region. We estimate time trends by histological subtype from 12 population-based cancer registries in 11 countries: Kenya (Nairobi), Mauritius, Seychelles, Uganda (Kampala), Congo (Brazzaville), Zimbabwe (Bulawayo and Harare), Cote d'Ivoire (Abidjan), The Gambia, Mali (Bamako), Nigeria (Ibadan) and South Africa (Eastern Cape). The selected registries were those that could provide consistent estimates of the incidence of ovarian cancer and with quality assessment for periods of 10 or more years. A total of 5423 cases of OC were included. Incidence rates have been increasing in all registries except Brazzaville, Congo, where a nonsignificant decline of 1% per year was seen. Statistically significant average annual increases were seen in Mauritius (2.5%), Bamako (5.3%), Ibadan (3.9%) and Eastern Cape (8%). Epithelial ovarian cancer was responsible for the increases observed in all registries. Statistically significant average annual percentage changes (AAPC) for epithelial OC were present in Bamako (AAPC = 5.9%), Ibadan (AAPC = 4.7%) and Eastern Cape (AAPC = 11.0%). Creating awareness among professionals of the growing importance of the disease is surely an important step to improving availability of, and access to, diagnosis and treatment of OC in SSA. Support must be given to the cancer registries to improve the availability of good-quality data on this important cancer.     

Cancer incidence in a rural population of South Africa, 1998–2002

Cancer incidence rates and patterns are reported for a rural population, living in the Eastern Cape Province of South Africa for the period 1998–2002. The population‐based cancer registry has operated for 20 years, using both active and passive methods for case finding, through collaborations with 19 health facilities: 11 district hospitals, 7 referral hospitals and 1 regional laboratory. The age standardized incidence rates for all cancers were 73.1 per 100,000 in males and 64.1 per 100,000 in females. The leading top 5 cancers for males were oesophagus (32.7 per 100,000), lung (5.8 per 100,000), prostate (4.4 per 100,000), liver (4.4 per 100,000) and larynx (2.5 per 100,000) whereas for females they were cervix (21.7 per 100,000), oesophagus (20.2 per 100,000), breast (7.5 per 100,000), ovary (0.9 per 100,000) and liver (0.9 per 100,000). The incidence of Kaposi sarcoma was low, and higher for males (1.6 per 100,000) than females (0.3 per 100,000). Lung cancer in both males and females was relatively low compared to the high incidence of oesophagus cancer.     

Cancer survival in Kampala, Uganda

Epidemiological data on the occurrence of cancer in sub-Saharan Africa are sparse, and population-based cancer survival data are even more difficult to obtain due to various logistic difficulties. The population-based Cancer Registry of Kampala, Uganda, has followed up the vital status of all registered cancer patients with one of the 14 most common forms of cancer, who were diagnosed and registered between 1993 and 1997 in the study area. We report 5-year absolute and relative survival estimates of the Ugandan patients and compare them with those of black American patients diagnosed in the same years and included in the SEER Program of the United States. In general, the prognosis of cancer patients in Uganda was very poor. Differences in survival between the two patient populations were particularly dramatic for those cancer types for which early diagnosis and effective treatment is possible. For example, 5-year relative survival was as low as 8.3% for colorectal cancer and 17.7% for cervical cancer in Uganda, compared with 54.2 and 63.9%, respectively, for black American patients. The collection of good-quality follow-up data was possible in the African environment. The very poor prognosis of Ugandan patients is most likely explained by the lack of access to early diagnosis and treatment options in the country. On the policy level, the results underscore the importance of the consistent application of the national cancer control programme guidelines as outlined by the World Health Organization.     

Trends in colorectal cancer incidence in Norway 1962–2006: an interpretation of the temporal patterns by anatomic subsite

There have been rapid increases in the incidence of colorectal cancer in Norway since the 1960s, and rates rank among the highest worldwide. The primary objectives are to describe trends in left‐ and right‐sided colon cancer and rectal cancer by calendar period and birth cohort and to generate hypotheses as to the etiological factors in operation. Although the age‐adjusted incidence rates of both colon and rectal cancer increased in Norway in both sexes up to the 1980s, subsite‐ and age‐specific analyses reveal a deceleration in the rate of increase thereafter, apparent in the rates of both left‐sided colon and rectal cancer. Overall trends in incidence of right‐sided colon cancer continue to increase in both sexes. Rates in both left‐ and right‐sided colon cancers have tended to stabilize or decrease among successive generations born after 1950, however, while incidence rates of rectal cancer appear to be increasing in recent generations. The all‐ages rates are thus in keeping with the commonly reported “left to right shift” of colon cancer, although standardization masks important observations. The cohort patterns provide further evidence that factors earlier in life are important, and while the complex etiology makes interpretation difficult, modifications in diet, obesity and physical activity in Norway are likely among the drivers of the trends in one or more of the colorectal subsites examined. In summary, the recent downturn in the disease at younger ages provides some reason for optimism, although possible increases in rectal cancer among recent birth cohorts are of concern.     

Trends in survival for patients diagnosed with cancer in Vaud, Switzerland, between 1974 and 1993

Background:Analysis of trends in cancer survival in defined wellsurveilled populations can provide useful indications on advancements incancer management and treatment. Patients and methods:Survival rates from the Vaud Cancer Registrywere computed for 31,158 cases registered in 1984–1993, and comparedwith those registered in 1974–1978 and 1979–1983. Results:A systematic, albeit generally moderate, tendency towardsincreasing five-year relative survival was observed for both sexes and mostmajor cancer sites, including oral cavity and pharynx (0.38–0.43),stomach (0.21–0.26), colon (0.49–0.55), rectum (0.45–0.51),lung (0.08–0.12), skin melanoma (0.67–0.89), female breast(0.67–0.80), endometrium (0.72–0.84), ovary (0.28–0.37).prostate (0.44–0.66), testis (0.73–0.96), bladder(0.31–0.50), kidney and renal pelvis (0.41–0.59), thyroid(0.73–0.81), non-Hodgkin's lymphomas (0.37–0.63), Hodgkin'sdisease (0.61–0.81), and leukaemias (0.27–0.39). Survival for allcancers and both sexes combined, rose from 0.51–0.64 (0.57 for males,0.71 for females). No appreciable change in survival was observed for cancersof oesophagus, liver, gallbladder, pancreas, larynx, cervix uteri, brain,multiple myeloma, as well as unidentified or unknown origin neoplasms. Conclusions:Survival estimates for most cancer sites arecomparable to the US SEER dataset, and their pattern of trends are discussedin terms of improved diagnosis and treatment for various neoplasms.     

Trends in Incidence of Childhood Leukemia,Khon Kaen,Thailand, 1985-2002

Background: The Khon Kaen Cancer Registry (KKCR), providing both hospital and population-based ‍registration, was established in 1984 in the Faculty of Medicine, Khon Kaen University. Leukemia is the most ‍common cancer among Thai children in Thailand, including both curable and preventable types, but no assessment ‍of trends has hitherto been performed. Objective: To perform a statistical assessment of the incidence trend of ‍childhood leukemia in Khon Kaen, Thailand, between 1985 and 2002. Methods: Population-based cases of childhood ‍leukemia registered between 1985 and 2002 were retrieved from the KKCR and cases with an ICD-O diagnosis ‍(coding C42) in children under 15 were selected. Incidence trends were calculated using the Generalized Linear ‍Model method (GLM), which generates incidence-rate-based logarithms. Results: Of the 277 cases of leukemia, ‍boys were affected two times more frequently than girls and half of the cases were 0-4 years of age. Most diagnoses ‍were histologically- or cytologically-proven and the most common type (affecting two-thirds, 65.7%) was acute ‍lymphoblastic leukemia (ALL). The overall, age-standardized rate (ASR) for leukemia was 31.9 per million (95%CI: ‍28.1 to 35.7); 40.3 per million (95%CI: 34.2 to 46.4) in boys and 27.0 (95%CI: 21.8 to 32.2) in girls. Incidence has ‍been increasing by 2.4% per year in boys (95% CI: -0.5 to 5.3) and 4.1% per year in girls (95% CI: 1.1 to 7.2). ‍Conclusions: This incidence-rate-based logarithm indicates that childhood leukemia has been increasing, suggesting ‍further epidemiological research on causes and possible prevention is needed.     

Thyroid cancer incidence attributable to overdiagnosis in the United States 1981–2011

Papillary thyroid cancer incidence has increased in the United States from 1978 through 2011 for both men and women of all ages and races. Overdiagnosis is partially responsible for this trend, although its magnitude is uncertain. This study examines papillary thyroid cancer incidence according to stage at diagnosis and estimates the proportion of newly diagnosed tumors that are attributable to overdiagnosis. We analyzed stage specific trends in papillary thyroid cancer incidence, 1981–2011, using the Surveillance, Epidemiology and End Results national cancer registries. Yearly changes in early and late‐stage thyroid cancer incidence were calculated. We estimate that the proportion of incident papillary thyroid cancers attributable to overdiagnosis in 2011 was 5.5 and 45.5% in men ages 20–49 and 50+ and 41.1 and 60.1% in women ages 20–49 and 50+, respectively. Overdiagnosis has resulted in an additional 82,000 incident papillary thyroid cancers that likely would never have caused any clinical symptoms. The detection of early‐stage papillary thyroid cancer outpaced that of late‐stage disease from 1981 through 2011, in part due to overdiagnosis. Further studies into the prevention, risk stratification and optimal treatment of papillary thyroid cancer are warranted in response to these trends.     

Endometrial cancer incidence trends in Norway during 1953–2007 and predictions for 2008–2027

Endometrial cancer is the most common cancer of the female genital tract in Western countries. Monitoring the incidence is important for health care planning and the identification of risk factors. We present an age‐period‐cohort analysis of incidence trends of endometrial cancer in Norway from 1953 to 2007 and compare the incidence trends with those in 3 other Nordic countries. Based on the observed trends, we have predicted endometrial cancer rates in Norway in 2015 and 2025. In women at postmenopausal age (≥55 years), the annual incidence increase was 2.1% (95% CI: 0.9%, 3.4%) from 1988 to 1997 and 1.7% (95% CI: 0.6%, 2.8%) from 1998 to 2007. In younger women, there was an annual reduction of 0.6% (95% CI: ?2.3%, 2.2%) from 1988 to 1997, followed by an annual increase of 1.7% (95% CI: ?0.4%, 3.9%) from 1998 to 2007. The secular changes are likely to reflect both cohort and period effects. Our prediction estimates by 2025 suggest an incidence increase in the range of 50 to 100%, relative to the observed incidence in 2005. There has been a strong and consistent incidence increase in endometrial cancer in the Nordic countries over the last 50 years. The increase has been most pronounced in postmenopausal women, but in the last decade, rates have increased also in women younger than 55 years. The prediction for the next 20 years suggests that endometrial cancer rates will dramatically increase unless effective preventive strategies are implemented.     

International trends in liver cancer incidence,overall and by histologic subtype, 1978–2007

Primary liver cancer, the most common histologic types of which are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), is the second leading cause of cancer death worldwide. While rising incidence of liver cancer in low‐risk areas and decreasing incidence in some high‐risk areas has been reported, trends have not been thoroughly explored by country or by histologic type. We examined liver cancer incidence overall and by histology by calendar time and birth cohort for selected countries between 1978 and 2007. For each successive 5‐year period, age‐standardized incidence rates were calculated from volumes V‐IX of the Cancer Incidence in Five Continents electronic database (CI5plus) and the newly released CI5X (volume X) database. Wide global variations persist in liver cancer incidence. Rates of liver cancer remain highest in Asian countries, specifically Eastern and South‐Eastern Asian countries. While rates in most of these high‐risk countries have been decreasing in recent years, rates in India and several low‐risk countries of Africa, Europe, the Americas, and Oceania have been on the rise. Liver cancer rates by histologic type tend to convey a similar temporal profile. However, in Thailand, France, and Italy, ICC rates have increased while HCC rates have declined. We expect rates in high‐risk countries to continue to decrease, as the population seroprevalence of hepatitis B virus (HBV) continues to decline. In low‐risk countries, targeted screening and treatment of the hepatitis C virus (HCV), treatment of diabetes and primary prevention of obesity, will be key in reducing future liver cancer incidence.     

Childhood cancer incidence in Australia, 1982–1991

The data of the Australian Paediatric Cancer-Registry on childhood cancer incidence in Australia for the 10-year period 1982–1991 are presented. The crude average annual incidence of cancer in children under the age of 15 years was 13.8 per 100,000. The incidence of childhood cancer in Australia is rising. Significant increases were seen in acute non-lymphoblastic leukaemia, astrocytoma and melanoma. The age-standardised incidence of 14.4 per 100,000 is about 34% higher than in the UK. Most types of cancer had a higher incidence in Australia than in the UK, and the difference was significant for acute lymphoblastic leukaemia, astrocytoma and melanoma. Of particular interest is malignant melanoma, whose incidence in Australia is more than 5 times that in the UK, as a result of excessive UV exposure. Australia has a higher incidence of Ewing's tumour than osteosarcoma, nearly twice that of the UK. International comparative studies may help to elucidate the aetiology of these tumours. © 1996 Wiley-Liss, Inc.     

Cancer incidence and cancer control in Mongolia: Results from the National Cancer Registry 2008–12

Mongolia has a high burden from noncommunicable diseases, with cancer now the second leading cause of mortality. Given the paucity of situation analyses from the country, this study reports cancer data based on new cases 2008–12 from the National Cancer Registry of Mongolia covering the entire population (2.87 million). New cancer cases of 21,564 were diagnosed over the 5‐year period, with a slight predominance of cases (52%) in men. Liver cancer was the leading cancer site in both sexes (ASRs of 114.7 and 74.6 per 100,000 males and females), and responsible for almost two‐fifths of all cancer diagnoses, followed by cancers of stomach, lung and oesophagus in men and cervix, stomach and oesophagus in women. The cumulative risk of incidence for all cancers (27.7% and 20.8% in men and women, respectively) positions Mongolia above China (20.2% and 13.3%), below the United States (34.1% and 28.5%) and similar to Russia (26.1% and 19.1%). These figures shed light on the considerable magnitude of cancer in the country and the large fraction of cancers that can be prevented by lifestyle modifications and vaccine implementation. An expansion of activities of the cancer registry and the continued development of research are necessary steps in support of national cancer control planning in Mongolia.     

Cancer Incidence Trends in Thailand , 1989-2000

Through 2004, five cancer registries in Thailand have collected data for more than ten years. Three-year cancerincidence in Thailand covering the years 1989-1997 has been regularly reported in three volumes of ‘Cancer inThailand’. Since the data for the last decade of the 20th century have been collected, the trends in incidence of somecancer sites were analyzed. Data sources were registry data from Chiang Mai, Lampang, Khon Kaen, Bangkok, andSongkhla, which are representative of the four major geographic regions of Thailand. The data drawn in 2002covered the years 1989 to 1997 for Bangkok, the other four registries drew data from 1989 to 2000. The populationdenominators were estimated from the two censuses in 1990 and 2000. Only cancers of the liver, lung, colon-rectum,female breast, uterine cervix, and all cancer sites were analyzed since cancers of these sites may have major publichealth impacts. Age-specific incidence rates of different 5-year age groups were projected through the period 2007-2009 using a linear regression model if the rates were increasing, and a log-linear model to prevent prediction of anegative rate if the rates were decreasing. During the past decade, colorectal and breast cancers showed a statisticalsignificant increasing trend, while the trend was generally stable for cancer of other sites. The number of new cancercases of all sites is expected to be approximately 125,000 by the year 2008, compared with 81,000 in 1999. However,the accuracy of projections depends very much on the quality of the cancer registries’ data. The Bangkok registrysignificantly improved case ascertainment in recent years, while the Chiang Mai registry had a consistent drop inincidence of cancer at many sites. In-depth investigation of some cancer sites and age period cohort modeling arerequired for better understanding of cancer trends in Thailand.     

Childhood cancer survival in Switzerland (1976–2013): Time‐trends and predictors

Population‐based studies on childhood cancer survival are key to monitor progress against cancer and to detect potential differences between regions and other subgroups in the population. We investigated time trends and factors associated with childhood cancer survival on a national level in Switzerland, from 1976 to 2013. We extracted data from the population‐based Swiss Childhood Cancer Registry of 5,776 children (age 0–14 years) diagnosed with cancer from 1985 to 2014 in Switzerland. We calculated age‐adjusted 5‐year survival, defined the annual reduction in risk of death (ARR), and explored associations of survival with clinical and demographic factors. Overall, 5‐year survival improved significantly, from 64% in 1976–1983 to 88% in 2004–2013. ARR over the whole period was 4% for all diagnostic groups, greatest for Hodgkin lymphomas (8%), ependymomas (6%), Burkitt's lymphomas (6%) and germ cell tumours (6%). Children treated in hospitals without specialised paediatric cancer centre for leukaemia (HR 12.9), lymphoma (HR 5.0) and neuroblastoma (HR 3.7) were at higher risk of death. In French‐speaking Switzerland, risk of death was lower for lymphoma (HR 0.6), CNS tumours (HR 0.7) and neuroblastoma (HR 0.5). Children with migration background had a higher risk of death from all tumours except bone tumours. Childhood cancer survival significantly improved from 1976 to 2013, but there is room for further improvement. Survival rates varied by type of clinical treatment, language region and nationality. All paediatric cancer patients should be referred to a specialised paediatric cancer centre. Further research is needed to intervene and completely eliminate inequalities in survival.