Cumulative Risk and Trends in Prostate Cancer Incidence in Mumbai,India

Background: Information relating to cancer incidence trends in a community forms the scientific basis for the ‍planning and organization of prevention, diagnosis and treatment of cancer. We here estimated the cumulative risk ‍and trends in incidence of prostate cancer in Mumbai, India, using data collected by the Bombay Population-based ‍Cancer Registry from the year 1986 to 2000. ‍Methods: During the 15 year period, a total of 2864 prostate cancer cases (4.7% of all male cancers and 2.4% of ‍all cancers) were registered by the Bombay Population-based Cancer Registry. For evaluation of the trend, we ‍applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage ‍changes were also computed for the evaluation. Cumulative incidence rates percentages were calculated by adding ‍up the age specific incidence rates at single ages and then expressed as a percentage. ‍Results: Analysis of the trends in age-adjusted incidence rates of prostate cancer during the period 1986 to 2000 ‍showed no statistically significant increase or decrease and the rates proved stable across the various age groups (00- ‍49, 50-69 and 70+) also. The probability estimates indicated that one out of every 59 men will contract a prostate ‍cancer at some time in his whole life and 99% of the chance is after he reaches the age of 50. ‍Conclusion: The stability in age adjusted-incidence rates indicates that there are no changes in the etiological ‍factors for prostate cancer in Mumbai, India. These findings may be of general interest because changes in diagnostic ‍practices are confounded in the time trends of prostate cancer change in many western countries preventing inferences ‍on the changes in risk. ‍     

Level of Cancer Awareness among Women of Low Socioeconomic Status in Mumbai Slums

Background: Cancer, a major cause of morbidity and mortality in India can be prevented by early detectionthrough screening, for which, awareness is essential. Aim: Determining cancer awareness among low socioeconomicwomen in Mumbai. Settings and Design: Community based cancer screening study using a mobilevan. Materials and methods: Data of consenting participants, collected using structured questionnaire, wasdifferentiated into good and poor level of awareness using point based grading procedure. Results: Mean age of182 participants, majority (90.5%) belonging to lower socioeconomic strata, was 43.0±8.8 years. Knowledge aboutcancer (84.6%) was good compared to knowledge of cancer screening (35.1%), awareness being higher amongricher and more educated. Major sources of information were friends or relatives (46.1%) and media (35.2%).Only 6.6% had undergone prior screening. Conclusion: In spite of appreciable knowledge about cancer, creatingawareness about screening, its availability, and motivating the general population for screening is necessary.     

江苏省昆山市2006~2012年肺癌发病趋势分析

[目的]分析昆山市2006~2012年肺癌发病趋势。[方法]2006~2012年肺癌新发病例来源于昆山市肿瘤登记报告系统,计算肺癌粗发病率、中国人口年龄标化发病率（中标率）和年度变化百分比（annual change percent,APC）。[结果]昆山市2006~2012肺癌新发病例共2738例;粗发病率为56.2/10万（男性82.1/10万,女性30.5/10万）,中标率为33.1/10万（男性46.9/10万,女性18.3/10万）。男性肺癌中标率由2006年的48.1/10万变化到2012年的47.9/10万（APC=0.66%,t=0.61,P=0.5703）。女性中标率由2006年的15.3/10万上升到2012年的20.8/10万（APC=4.78%,t=2.84,P=0.0364）。[结论]昆山市肺癌男性发病率在高水平趋于稳定,而女性则持续上升,肺癌防治相关措施亟需开展。     

A Case-control Study of Risk Factors for Lung Cancer in Mumbai,India

In the year 2010, it is estimated that nearly 1.35 million new cases and 1.18 million deaths with lung canceroccurred. In India, among males, lung cancer rates vary across the country which has encouraged us to conduct acase-control study to study the risk factors. The present unmatched hospital-based case-control study conductedat Tata Memorial Hospital included subjects registered between the years 1997-99. There were 408 lung ‘cancercases’ and 1383 ‘normal controls. Data on age, tobacco habits, occupational history, dietary factors, tea, coffeewere collected by the social investigators. Univariate and regression analysis were applied for obtaining theodds ratio for risk factors. In the study, cigarette smoking (OR=5.2) and bidi smoking (OR=8.3), as well asalcohol consumption (OR=1.8), demonstrated dose-response relationships with lung cancer risk. Among thedietary items, only red-meat consumption showed 2.2-fold significant excess risk. Consumption of milk showeda 60% reduction in risk; while coffee showed a 2-fold excess risk for lung cancer. In addition, exposure to useof pesticides showed a 2.5-fold significant excess risk for lung cancer.     

新疆石河子市2010年肺癌发病和死亡特征

[目的]了解2010年石河子市肺癌发病与死亡的流行特征,为肺癌的预防控制提供科学依据。[方法]根据石河子市肿瘤登记处2010年登记的恶性肿瘤发病及死亡资料,统计和分析肺癌粗发病率、粗死亡率、年龄别发病率、年龄别死亡率、中标率及世标率。[结果]2010年石河子市肺癌新发病例176例,死亡病例68例,肺癌发病率为30.70/10万（男性39.83/10万,女性21.23/10万）,中标率为20.80/10万,世标率为15.21/10万;肺癌死亡率为11.86/10万（男性17.32/10万,女性6.33/10万）,中标率为6.92/10万,世标率为9.36/10万。肺癌发病率和死亡率均为男性高于女性,且随着年龄的增长而升高（χ2趋势发病=304.86,P〈0.001;χ2趋势死亡=69.544,P〈0.001）。[结论]石河子市肺癌发病率和死亡率均高于世界平均水平,应加强肺癌综合防控措施,提高早诊早治水平,有效降低石河子市肺癌流行水平。     

Incidence and Mortality of Female Breast Cancer in Jiangsu,China

Objectives: The aim of this study was to describe and analyze the incidence and mortality of female breastcancer in Jiangsu Province of China. Methods: Incidence and mortality data for female breast cancer andcorresponding population statistics from eligible cancer registries in Jiangsu from 2006 to 2010 were collected andanalyzed. Crude rates, age-specific rates and age-standardized rates of incidence and mortality were calculated,and annual present changes (APCs) were estimated to describe the time trends. Results: From 2006 to 2010, 11,013new cases and 3,068 deaths of female breast cancer were identified in selected cancer registry areas of Jiangsu.The annual average crude incidence and age-standardized incidence by world population (ASW) were 25.2/ and17.9/100,000 respectively. The annual average crude and ASW for mortality rates were 7.03/ and 4.81/100,000.The incidence was higher in urban areas than that in rural areas, and this was consistent in all age groups. Nosignificant difference was observed in mortality between urban and rural areas. Two peaks were observed whenlooking at age-specific rates, one at 50-59 years and another at over 85 years. During the 5 years, incidence andmortality increased with APCs of 4.47% and 6.89%, respectively. Compared to the national level, Jiangsu isan area with relatively low risk of female breast cancer. Conclusion: Breast cancer has become a main publichealth problem among Chinese females. More prevention and control activities should be conducted to reducethe burden of this disease, even in relatively low risk areas like Jiangsu.     

Incidence and Current Trends of Colorectal Malignancies in an Unscreened,Low Risk Population

Introduction: Karachi falls into a low risk region for colorectal (CRC). The incidence rate is known butdetailed epidemiology and pathology data regarding the disease are not available. The aim of this study is todescribe CRC with reference to incidence, gender; topographic sub-site, tumor morphology, grade and stage atdiagnosis and to determine the trends of incidence. Materials and Methods: Four hundred and seventy threecases of colorectal cancer submitted to the Karachi Cancer Registry for Karachi South, years 1995-2002 werereviewed. Cases were analyzed in two time periods (1995-7 and 1998-2002) to facilitate the study of time trends.Results: A total of 151 CRC cases were registered during period one [86 (57%) males; 65 (43%) females] and322 cases [210 (65%) males; 112 (35%) females] in period two. Age standardized rate (ASR) world per 100,000,crude incidence rate (CIR) and relative frequency in period one were 5.3, 3.2 and 4.1% in males and 5.5, 3.2and 3.2% in females respectively. Corresponding figures for period two were 7.1, 4.5 and 4.7% for males and5.2, 2.8 and 2.7% in females. The male, female ratio was equal for colon (1:1). Men had more rectal cancers(2:1) and overall CRC (1.7:1). The mean age of the patients varied with sub-site and gender from 43.7 years to51.2 years. Cancers of the rectum presented at a relatively earlier age. Less then 5% of the cases were diagnosedin adolescents, 50% above 50 years of age and only 30% above 60 years. The ratio under-40 to above-40 forCRC patients was 0.3, which is much higher than the international average, indicating a younger age group atrisk. The first cases were observed in adolescents (15-19 years) and a peak was observed in the seventh decade.Colon to rectum ratio was 1:1 in males and 2:1 in females. Most cases presented with advanced disease, thoughsome down staging was observed in period 2 (1998-2002). Conclusion: The current low but increasing incidence(especially in men), the younger age and advanced stage of CRC at diagnosis reflects a low risk, unscreenedpopulation. With existing prevalence of high risk factors in Pakistan, the low CRC incidence may be an artifact.There are concerns that an aging population over the next decade and changing lifestyle patterns may translateinto a higher CRC incidence. Screening must be considered as part of the health sector planning for the futureand include the high risk younger age groups.     

Lung Cancer Incidence in the Arab League Countries: Risk Factors and Control

Although lung cancer incidence rates and mortalities are still low in the Arab world as compared to Europe orUSA, they is gradually increasing in the region. Furthermore, there is great variation between different parts ofthe Arab world. For instance, the age-standardized rates (ASRs) for lung cancer incidence are about 15 fold higherin Tunisia than in Sudan for men, and about 10 fold higher in Bahrain than in Yemen for females. Percentage datafor both sexes of lung cancer in the Arab world show that 15/22 (68.1%) of the Arab countries have lung canceras one of the most frequent five types of cancer. Despite major advances in understanding and treating cancer,the 5-year relative survival rate in North Africa and the Middle East is only 8%. With the notable exception ofAlgeria, and to a lesser extent Tunisia, where squamous cell carcinomas are more common, the two main typesshow approximately the same proportions in males, while adenocarcinomas tend to predominate in females.The estimated numbers of new lung cancer cases in 2008 were 9,537 in ages below 65 for both sexes, and 7,059cases for ages above 65. In 2020 there is expected to be 14,788 new lung cancer cases in the Arab countries forages below 65, and 14,788 cases for ages above 65 in both males and females. Between 1990 and 1997, cigaretteconsumption increased 24% in the Middle East, one of only two regions of the world where cigarette salesincreased during that period, so that continued rise in cancer rates can be expected. Improvement of tobaccocontrol, registration and treatment are all necessary to decrease the burden of lung cancer in the Arab world.     

Oral Cancers in Mumbai,India: a Fifteen Years Perspective with Respect to Incidence Trend and Cumulative Risk

Objective: We estimated the time trends in the incidence and the risk of developing an oral cancer in Mumbai, ‍Indian population using the data collected by the Bombay Population Based Cancer Registry during the 15 year ‍period from 1986 to 2000. ‍Methods: A total of 9,670 oral cancers (8.2% of all neoplasms) were registered, of which 6577 were in males and ‍3093 in females (10.7% and 5.4% of the respective totals for the two genders) . For evaluation of the trend, we ‍applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage ‍changes were also computed for the incidence rates to evaluate the time trend. ‍Results: In males, a statistically significant decreasing trend in the overall age-adjusted incidence rates were ‍observed during the period 1986 to 2000, with an yearly decrease of 1.70%. This decrease was significant for men ‍above the age of 40, but for young adult men below the age of 40, there was no significant decrease, the level being ‍stable. In females, the overall decreasing trend in the age-adjusted incidence rates of oral cancers was not significant, ‍but in the age group 40-59, a significant decline was observed. The probability estimates indicated that one out of ‍every 57 men and one out of every 95 women will contract any oral cancer at some time in their whole life and 97% ‍of the chance is after he or she completes the age of 40. ‍Conclusion: The observed decreasing trend in oral cancers in Indian men may be attributed to a decrease in the ‍usage of pan and tobacco. The high prevalence of the usage of smokeless tobacco among young adult men and ‍women may explain the stable trend in oral cancer incidence in this group. These findings help to strengthen the ‍association between tobacco use and oral cancer risk. ‍     

Anti-smoking Initiative and Decline in Incidence Rates of Lung Cancer in Viet Nam

Viet Nam had the highest reported male smoking prevalence rate (72.8-74.3%) in the world in the 1990s. Productionof tobacco products was about 0.44 kg or 600 cigarettes per capita per year in 1994 for domestic use. Populationattributablerisk per cent of lung cancer due to smoking was about 69.7%. Males in the south have a lower reportedsmoking prevalence rate (OR = 0.7) and a significant lower incidence rate of lung cancer, age-standardized-incidencerateper 100,000 (ASR): 33.1 vs 24.6 when compared to males in the north. Incidence rates of lung cancer significantlydeclined in Hanoi (ASR 34.9 –33.1 and 6.3 – 5.8) and Ho Chi Minh City (ASR 24.6 – 23.7 and 6.8 – 5.6) between 1991-1997 and at the national level between 1990-2000 (ASR 30.4 – 30.1 and 6.7 – 6.6) in males and females, respectively.This decline in incidence rate of lung cancer resulted from the great achievements of the National Tobacco ControlProgram over about a 10-year period from 1989 to help people stop smoking. The present finding should stimulatefurther primary cancer prevention efforts in developing countries, including Viet Nam. It also suggests that themethod applied to translate scientific evidence of smoking harm to people and into health policy, is a useful tool todrive people’s attitude to stop smoking and remove its human carcinogens from our society.     

Future Trends in Breast, Cervical, Lung, Mouth and Pharyngeal Cancer Incidence in Slovenia

Objectives: Breast, cervical, lung, mouth and pharyngeal cancers are important public health problems in Slovenia, and in many other Central and South European countries. The aim of this study was to predict the incidence of these cancers in Slovenia up to the year 2009, based on the data of the Cancer Registry of Slovenia for the period 1965 1994 and on the official national population projections for the Republic of Slovenia. Methods: Age-period-cohort models were applied. In the case of data heterogeneity in lung as well as in mouth and oropharyngeal cancer in males, an additional parameter indicating differences in lifestyle was introduced in the model. Results: After accounting for major site-specific risk factors, we predict in females a steady increase in breast and lung cancer, but no major changes in cervical cancer case-load. In males a steady decrease in the lung cancer case-load is expected throughout the predicted period, while for mouth and pharyngeal cancer a moderate decrease is expected only after the year 2000. Conclusion: Despite some uncertainties inherent in cancer incidence predictions, the obtained results are import in setting priorities for national cancer control strategies in Slovenia, especially in further efforts towards primary prevention of lung, mouth and pharyngeal cancer, and in more efficient early detection of breast, cervical, mouth and pharyngeal cancer.     

Incidence Trends of Colorectal Cancer in the West of IranDuring 2000-2005

Background: Colorectal cancer is a main leading cause of cancer death in western countries. Although manystudies have been conducted on incidence trends all over the world in recent years, information regarding changesin incidence of colorectal cancer in Iran is insufficient. The present study of colorectal cancer in the west of Iranduring recent years was therefore performed. Materials and Methods: The registered data for colorectal cancercases in National Cancer Registry System were extracted from the Ministry of Health and Medical Education,Center for Disease Control and Management. The codes from 18-21 among cancers were selected for colon andrectum cancers. Incidence rates were standardized directly using WHO population. The significance of incidencerate trends during 2000-2005 was tested through Poisson regression. Results: 762 cases of colorectal cancer wereobserved during 6 years in this region, with a gender ratio of men to women of 1.2. It increased from 65 casesin 2000 to 213 cases in 2005 or from 1.5 per100,000 per persons per year to 4.8. Significant increasing trendswere evident in Kermanshah and Hamadan provinces; however, change did not reach significance in Ilam andKurdistan provinces. Conclusions: Colorectal cancer has an increasing trend in the west of Iran. Although itseems that the increasing rate of colorectal cancer is due to increasing of cancer risk factors, some proportionmay be related to the improvement of surveillance systems in Iran.     

Brain Metastases among Cancer Patients Diagnosed from 2010–2017 in Canada: Incidence Proportion at Diagnosis and Estimated Lifetime Incidence

The incidence of BM among Canadian cancer patients is unknown. We aimed to estimate IP of BM at the time of cancer diagnosis and during the lifetime of patients with selected primary cancers. Data on BM at diagnosis from 2010–2017 was obtained from the CCR. Site-specific IPs of BM were estimated from provincial registries containing ≥90% complete data on BM. The CCR IP estimates and the IP estimates from literature were applied to the total diagnosed primary cancers to estimate the number of concurrent BM and lifetime BM from 2010–2017 in Canada, respectively. The annual average number of patients with BM at diagnosis from all cancer sites was approximately 3227. The site-specific IPs of BM at diagnosis were: lung (9.42%; 95% CI: 9.16–9.68%), esophageal (1.58%; 95% CI: 1.15–2.02%), kidney/renal pelvis (1.33%; 95% CI: 1.12–1.54%), skin melanoma (0.73%; 95% CI: 0.61–0.84%), colorectal (0.22%; 95% CI: 0.18–0.26%), and breast (0.21%; 95% CI: 0.17–0.24%). Approximately 76,546 lifetime BM cases (or 5.70% of selected fifteen primary cancers sites) were estimated to have occurred from the 2010–2017 cancer patient cohort. These findings reflect results of population analyses in the US and Denmark. We recommend improved standardization of the collection of BM data within the CCR.     

启东市1972~2011年肺癌发病趋势分析

[目的]分析启东市1972-2011年肺癌发病趋势,为制定肺癌预防控制措施与策略提供依据。[方法]肺癌发病资料来自启东肿瘤登记处,计算粗发病率、中国人口标化率（中标率）、世界人口标化率（世标率）、35-64岁截缩率、0-74岁累积率、累积风险、变化百分比（PC）、年均变化百分比（APC）、各时期发病率及出生队列发病率等指标。[结果]启东1972-2011年肺癌发病15 340例,其中男性11 028例,女性4312例。肺癌粗发病率为34.12/10万,中标率为15.74/10万,世标率为25.41/10万。35-64岁截缩发病率为36.96/10万,0-74岁累积发病率为3.27%,肺癌发病的累积风险为3.22%。肺癌的发病率从1972年的12.09/10万上升到2011年76.09/10万,PC为626.68%,APC为4.92%。[结论]40年中,启东肺癌的发病率约上升了6倍;加强肺癌预防与控制已成为当务之急。     

Hospital-based Study of Endometrial Cancer Survival inMumbai,India

Background: Endometrial cancer is common in western women, and the rates are very high; however inIndia, the rates are as low as 4.3 per 100,000 (Delhi). Objective: To estimate the survival of endometrial cancerpatients based on age, education, family history, tobacco habit, number of pregnancies, clinical extent of diseaseand treatment received. Materials and Methods: The present retrospective study was carried out at the TataMemorial Hospital (TMH), Mumbai, India, between 1999-2002. 310 cases treated in TMH were considered aseligible entrants for the study. Five-year survival rates were estimated using actuarial and loss-adjusted (LAR)methods. Results: The proportions of patients dying above 50 years of age, non-residents and illiterates washigher than their counterparts. 54.8% of patients had some form of treatment before attending TMH. Therewere only 4.2% tobacco-chewers and only 6.1% had a family history of cancer. There were 25.8% who had3-5 pregnancies (not living children) and 38.1% did not remember the pregnancy history. The 5-year overallsurvival rate was 92%. The five-year rates indicated better prognosis for those aged less than 50 years (97%),non-tobacco-chewers (94%), with no family history of cancer (93%), with localized disease (93%) and thosetreated with surgery either alone or as a combination treatment (95%). Conclusions: The present study showedthat endometrial cancer patients with localized disease at diagnosis have a good outcome in India. A detailedstudy will help in understanding the prognostic indicators for survival especially with the newer treatmenttechnologies now available.     

An Assessment of Cancer Incidence Patterns in Parsi and Non Parsi Populations,Greater Mumbai

The Mumbai Cancer Registry has been in operation since 1964 and reliable morbidity and mortality data on cancer havebeen obtained for the first time in India, from a precisely outlined population. An attempt has been made to examine thedifferences noticed in the site-specific cancer risk, between two groups of people living in this area-the Parsi and non Parsipopulation of Mumbai.For this study, data has been utilized, collected by Mumbai Cancer Registry for the latest five years. For comparisonbetween Parsi and non Parsi populations, crude and age-adjusted rates have been used.The overall age-adjusted rates for the Parsi’s were found to be lower than those for the non Parsi populations and morenoticeably their site-specific risks seem to differ radically from the non Parsi pattern. Cancers of the buccal cavity, pharynx,larynx, oesophagus and cervix uteri which are frequently seen in the non Parsi population, are less commonly observed inthe Parsi community. On the other hand the Parsi rates are higher at site such as the female breast, endometrium, lymphomasand leukaemias.The observed site-specific contrast are believed to be due to differences present in the habits, customs and economicstatus of the two groups.     

中国部分市县1998～2002年肺癌的发病与死亡

[目的]探讨中国居民肺癌的发病、死亡流行特征。[方法]分析中国30个肿瘤登记处1998-2002年肺癌登记资料。[结果]肺癌新病例69597例，死亡病例61090例。肺癌世界人口调整发病率介于116．9／10万～9．9／10万之间。肺癌世界人口调整死亡率介于43．9／10万～8．1／10万之间。[结论]肺癌是威胁我国居民身体健康的主要恶性肿瘤，应作为当前肿瘤防治工作的重点。     

2008～2014年江苏省徐州市肺癌死亡率状况及趋势分析

[目的]分析徐州市肺癌死亡率状况及其随变化趋势.[方法]分析整理2008～2014年间徐州市死因登记报告中肺癌数据资料,计算历年肺癌死亡率、标化死亡率(中标率)及分地区、分年龄段死亡率,并利用年度变化百分比(annual percentage change,APC)计算肺癌死亡率变化趋势.[结果] 2008～2014年,肺癌死亡人数共23 878例,其中市区死亡5074例(21.25％),农村死亡18 804例(78.75％);男性死亡16 948例(70.98％),女性死亡6930例(29.02％).全市、市区及农村肺癌死亡率分别由2008年的32.08/10万(中标率22.21/10万)、38.50/10万、33.30/10万上升到2014年的40.41/10万(中标率27.27/10万)、55.81/10万、37.86/10万;男性、女性肺癌死亡率分别由2008年的44.19/10万、19.30/10万上升到2014年的54.07/10万、25.70/10万.肺癌死亡率的APC为3.34％ (95％CI:1.0％～5.7％),中标率的APC为3.07％(95％CI:0.9％～5.3％),死亡率呈上升趋势.肺癌死亡率自40～岁年龄组开始上升,到80～岁年龄组达高峰(约380/10万),男性死亡高峰也在80～岁年龄组(约600/10万),女性高峰则出现在80岁之后,80～年龄组与85岁及以上年龄组死亡率相当(平均约230/10万).[结论]徐州市肺癌死亡率整体呈增长趋势,市区高于农村,男性高于女性,死亡高峰集中于老年龄段人群.