Association between green tea/coffee consumption and biliary tract cancer: A population‐based cohort study in Japan

Green tea and coffee consumption may decrease the risk of some types of cancers. However, their effects on biliary tract cancer (BTC) have been poorly understood. In this population‐based prospective cohort study in Japan, we investigated the association of green tea (total green tea, Sencha, and Bancha/Genmaicha) and coffee consumption with the risk for BTC and its subtypes, gallbladder cancer, and extrahepatic bile duct cancer. The hazard ratios and 95% confidence intervals were calculated using the Cox proportional hazard model. A total of 89 555 people aged 45–74 years were enrolled between 1995 and 1999 and followed up for 1 138 623 person‐years until 2010, during which 284 cases of BTC were identified. Consumption of >720 mL/day green tea was significantly associated with decreased risk compared with consumption of ≤120 mL/day (hazard ratio = 0.67 [95% confidence interval, 0.46–0.97]), and a non‐significant trend of decreased risk associated with increased consumption was observed (P‐trend = 0.095). In the analysis according to the location of the primary tumor, consuming >120 mL green tea tended to be associated with decreased risk of gallbladder cancer and extrahepatic bile duct cancer. When Sencha and Bancha/Genmaicha were analyzed separately, we observed a non‐significant trend of decreased risk of BTC associated with Sencha but no association with Bancha/Genmaicha. For coffee, there was no clear association with biliary tract, gallbladder, or extrahepatic bile duct cancer. Our findings suggest that high green tea consumption may lower the risk of BTC, and the effect may be attributable to Sencha consumption.     

National cancer incidence and mortality in China, 2012

Background

Population-based cancer registration data in 2012 from all available cancer registries were collected by the National Central Cancer Registry (NCCR). NCCR estimated the numbers of new cancer cases and cancer deaths in China with compiled cancer incidence and mortality rates.

Methods

In 2015, there were 261 cancer registries submitted cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the NCCR criteria of data quality. Qualified data from 193 registries were used for cancer statistics analysis as national estimation. The pooled data were stratified by area (urban/rural), gender, age group [0, 1–4, 5–9, 10–14, …, 85+] and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding national population in 2012. The Chinese census data in 2000 and Segi’s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year.

Results

Qualified 193 cancer registries (74 urban and 119 rural registries) covered 198,060,406 populations (100,450,109 in urban and 97,610,297 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 69.13% and 2.38%, respectively, and the mortality to incidence rate ratio (M/I) was 0.62. A total of 3,586,200 new cancer cases and 2,186,600 cancer deaths were estimated in China in 2012. The incidence rate was 264.85/100,000 (289.30/100,000 in males, 239.15/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 191.89/100,000 and 187.83/100,000 with the cumulative incidence rate (0–74 age years old) of 21.82%. The cancer incidence, ASIRC and ASIRW in urban areas were 277.17/100,000, 195.56/100,000 and 190.88/100,000 compared to 251.20/100,000, 187.10/100,000 and 183.91/100,000 in rural areas, respectively. The cancer mortality was 161.49/100,000 (198.99/100,000 in males, 122.06/100,000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 112.34/100,000 and 111.25/100,000, and the cumulative mortality rate (0–74 years old) was 12.61%. The cancer mortality, ASMRC and ASMRW were 159.00/100,000, 107.231/100,000 and 106.13/100,000 in urban areas, 164.24/100,000, 118.22/100,000 and 117.06/100,000 in rural areas, respectively. Cancers of lung, stomach, liver, colorectum, esophagus, female breast, thyroid cervix, brain tumor and pancreas were the most common cancers, accounting for about 77.4% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, pancreatic cancer, female breast cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 84.5% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates.

Conclusions

Cancer surveillance information in China is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in China, so that, cancer prevention and control, including health education, health promotion, cancer screening and cancer care services in China, should be enhanced.     

The association of coffee intake with liver cancer incidence and chronic liver disease mortality in male smokers

Background:

Coffee intake is associated with reduced risk of liver cancer and chronic liver disease as reported in previous studies, including prospective ones conducted in Asian populations where hepatitis B viruses (HBVs) and hepatitis C viruses (HCVs) are the dominant risk factors. Yet, prospective studies in Western populations with lower HBV and HCV prevalence are sparse. Also, although preparation methods affect coffee constituents, it is unknown whether different methods affect disease associations.

Methods:

We evaluated the association of coffee intake with incident liver cancer and chronic liver disease mortality in 27 037 Finnish male smokers, aged 50–69, in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, who recorded their coffee consumption and were followed up to 24 years for incident liver cancer or chronic liver disease mortality. Multivariate relative risks (RRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazard models.

Results:

Coffee intake was inversely associated with incident liver cancer (RR per cup per day=0.82, 95% CI: 0.73–0.93; P-trend across categories=0.0007) and mortality from chronic liver disease (RR=0.55, 95% CI: 0.48–0.63; P-trend<0.0001). Inverse associations persisted in those without diabetes, HBV- and HCV-negative cases, and in analyses stratified by age, body mass index, alcohol and smoking dose. We observed similar associations for those drinking boiled or filtered coffee.

Conclusion:

These findings suggest that drinking coffee may have benefits for the liver, irrespective of whether coffee was boiled or filtered.     

Profiling global cancer incidence and mortality by socioeconomic development

Economic and living conditions have improved over time in most countries, although often in association with detrimental lifestyle and environmental changes that are major determinants of cancer. In this ecological study, we assess the association between national socioeconomic levels and incidence and mortality rates for all cancers combined and 27 cancer types, in 175 countries. We obtained national level cancer incidence and mortality estimates for 2018 from GLOBOCAN and computed an index of socioeconomic development based on national education and income levels extracted from the United Nations Development Programme. Cancer incidence rates are strongly positively associated with the national socioeconomic level for all cancers combined and for a large number of cancer types, in both sexes. Conversely, the association between socioeconomic development and cancer mortality rates is less clear. The most common pattern for type-specific cancers is an increasing incidence rate with a relatively stable mortality rate as socioeconomic development increases. Despite the high incidence rates for many cancer types, mortality rates are relatively low in high-income countries, partly due to the availability of early detection and effective treatments. As socioeconomic development continues to rise, countries with currently low- and medium-development levels may experience large increases in the incidence of several cancers. Given the limited resources and lack of infrastructure, increases in incidence rates in low-income countries will likely be paralleled by increases in mortality rates. Efforts to plan, implement and evaluate prevention programs must therefore be considered as greater priorities in Low- and Middle-income countries.     

Cancer incidence and mortality: A cohort study in China, 2008–2013

The National Central Cancer Registry of China (NCCR) was the only available source of cancer monitoring in China, even though only about 70% of cancer registration sites were qualified by now. In this study, based on a national large prospective cohort‐the China Kadoorie Biobank (CKB), we aimed to provide additional cancer statistics and compare the difference of cancer burden between urban and rural areas of China. A total of 497,693 cancer‐free participants aged 35–74 years were recruited and successfully followed up from 2004 to 2013 in 5 urban and 5 rural areas across China. Except for traditional registration systems, the national health insurance system and active follow‐up were used to determine new cancer incidents and related deaths. The mortality‐to‐incidence ratio (MIR) was used to compare the differences of cancer burden between urban and rural areas of China. We found that cancer mortality coincided well between our cohort and NCCR, while the incidence was much higher in our cohort. Based on CKB, we found the MIR of all cancers was 0.54 in rural areas, which was approximately one‐third higher than that in urban areas with 0.39. Cancer profiles in urban areas were transiting to Western distributions, which were characterized with high incidences of breast cancer and colorectal cancer; while cancers of the esophagus, liver and cervix uteri were still common in rural areas of China. Our results provide additional cancer statistics of China and demonstrate the differences of cancer burden between urban and rural areas of China.     

Trends in testicular cancer incidence and mortality in 22 European countries: continuing increases in incidence and declines in mortality

This study profiles testicular cancer incidence and mortality across Europe, and the effects of age, period and generational influences, using age-period-cohort modeling. Despite a 5-fold variation in incidence rates, there were consistent mean increases in incidence in each of the 12 European countries studied, ranging from around 6% per annum (Spain and Slovenia) to 1-2% (Norway). In contrast, declines in testicular cancer mortality of 3-6% per annum were observed in the 1980s and 1990s for the majority of the 22 countries studied, particularly in Northern and Western Europe. The mortality trends in several European countries were rather stable (Romania and Bulgaria) or increasing (Portugal and Croatia). Short-term attenuations in increasing cohort-specific risk of incidence were indicated among men born between 1940 and 1945 in 7 European countries. In Switzerland, successive generations born from the mid 1960s may have experienced a steadily declining risk of disease occurrence. While the underlying risk factors responsible remain elusive, the temporal and geographical variability in incidence may point to an epidemic in different phases in different countries-the result of country-specific differences in the prevalence of one or several ubiquitous and highly prevalent environmental determinants of the disease. Advances in treatment have led to major declines in mortality in many European countries from the mid 1970s, which has translated to cohorts of men at successively lower risk of death from the disease. Slower progress in the delivery of optimal care is however evident from the mortality trends in several lower-resource countries in Southern and Eastern Europe. The first beneficiaries of therapy in these populations may be those men born--rather than diagnosed--in the era of major breakthrough in testicular cancer care.     

淮安市女性乳腺癌发病和死亡分析

目的分析淮安市2009-2011年女性乳腺癌发病与死亡的流行特征,为乳腺癌的防治工作提供依据。方法利用淮安市恶性肿瘤登记报告工作收集淮安市2009-2011年女性乳腺癌的发病和死亡数据,分年龄、地区(城市和农村)分析淮安市乳腺癌流行病学特征。结果淮安地区2009-2011年乳腺癌发病共1 225例,粗发病率16.01/10万,城市20.22/10万,农村11.77/10万;标化发病率为13.19/10万,城市16.33/10万,农村10.03/10万。乳腺癌死亡共415例,粗死亡率为5.43/10万,城市6.66/10/10万,农村4.18/10万;标化死亡率为4.23/10万,城市5.15/10万,农村3.25/10万。发病死亡均为城市高于农村。2009-2011年发病(χ2=94.57,P<0.001)和死亡(χ2=8.66,P<0.001)均呈现逐年增加趋势。分年龄组分析,乳腺癌发病呈单峰分布,高峰在55~岁年龄组;死亡则呈双峰分布,高峰分别在55~岁年龄组及80~岁年龄组,最高峰在55~岁年龄组。结论淮安区城市乳腺癌发病和死亡均高于农村,并呈现逐年上升趋势,发病和死亡最高峰均在55~岁年龄组,严重威胁淮安地区中老年女性的生命健康。     

Testicular cancer: marked birth cohort effects on incidence and a decline in mortality in southern Netherlands since 1970

The aim of our study was to interpret the changing incidence, and to describe the mortality of patients with testicular cancer in the south of the Netherlands between 1970 and 2004. On the basis of data from the Eindhoven Cancer Registry and Statistics Netherlands, 5-year moving average standardised incidence and mortality rates were calculated. An age-period-cohort (APC) Poisson regression analysis was performed to disentangle time and birth cohort effects on incidence. The incidence rate remained stable for all ages at about 3 per 100,000 person-years until 1989 but increased annually thereafter by 4% to 6 in 2004. This increase can almost completely be attributed to an increase in localised tumours. The largest increase was found for seminoma testicular cancer (TC) patients aged 35-39 and non-seminoma TC patients aged 20-24 years. Relatively more localised and tumours with lymph node metastases were detected in the later periods. APC analysis showed the best fit with an age-cohort model. An increase in incidence of TC was found for birth cohorts since 1950. The mortality rate dropped from 1.0 per 100,000 person-years in 1970 to 0.3 in 2005, with a steep annual decline of 12% in the period 1979-1986. In conclusion, the increase in incidence of TC was strongly correlated with birth cohorts since 1945. The increase in incidence is possibly caused by in utero or early life exposure to a yet unknown risk factor. There was a steep decline in mortality in the period 1979-1986.     

Peak oxygen consumption and long‐term all‐cause mortality in nonsmall cell lung cancer

BACKGROUND:

Identifying strong markers of prognosis is critical to optimize treatment and survival outcomes in patients with nonsmall cell lung cancer (NSCLC). The authors investigated the prognostic significance of preoperative cardiorespiratory fitness (peak oxygen consumption [VO_2peak]) among operable candidates with NSCLC.

METHODS:

By using a prospective design, 398 patients with potentially resectable NSCLC enrolled in Cancer and Leukemia Group B 9238 were recruited between 1993 and 1998. Participants performed a cardiopulmonary exercise test to assess VO_2peak and were observed until death or June 2008. Cox proportional models were used to estimate the risk of all‐cause mortality according to cardiorespiratory fitness category defined by VO_2peak tertiles (<0.96 of 0.96‐1.29/>1.29 L/min^?1) with adjustment for age, sex, and performance status.

RESULTS:

Median follow‐up was 30.8 months; 294 deaths were reported during this period. Compared with patients achieving a VO_2peak <0.96 L/min^?1, the adjusted hazard ratio (HR) for all‐cause mortality was 0.64 (95% confidence interval [CI], 0.46‐0.88) for a VO_2peak of 0.96 to 1.29 L/min^?1, and 0.56 (95% CI, 0.39‐0.80) for a VO_2peak of >1.29 L/min^?1 (P_trend = .0037). The corresponding HRs for resected patients were 0.66 (95% CI, 0.46‐0.95) and 0.59 (95% CI, 0.40‐0.89) relative to the lowest VO_2peak category (P_trend = .0247), respectively. For nonresected patients, the HRs were 0.78 (95% CI, 0.34‐1.79) and 0.39 (95% CI, 0.16‐0.94) relative to the lowest category (P_trend = .0278).

CONCLUSIONS:

VO_2peak is a strong independent predictor of survival in NSCLC that may complement traditional markers of prognosis to improve risk stratification and prognostication. Cancer 2010. © 2010 American Cancer Society.     

Association between sleep duration and breast cancer incidence: The multiethnic cohort

Breast cancer is the most common cancer and the second-leading cause of cancer-related death among women. Inconsistent findings for the relationship between melatonin levels, sleep duration and breast cancer have been reported. We investigated the association of sleep duration at cohort entry and its interaction with body mass index (BMI) with risk of developing breast cancer in the large population-based Multiethnic Cohort study. Among the 74,481 at-risk participants, 5,790 breast cancer cases were identified during the study period. Although we detected no significant association between sleep duration and breast cancer incidence, higher risk estimates for short (HR = 1.03; 95% CI: 0.97–1.09) and long sleep (HR = 1.05; 95% CI: 0.95–1.15) compared to normal sleep (7–8 hr) were found. The patterns for models stratified by age, BMI, ethnicity and hormone receptor status were similar but did not indicate significant interaction effects. When examining the combined sleep duration and BMI interaction effect, in comparison to the normal BMI-normal sleep group, risk estimates for underweight, overweight and obesity were similar across categories of sleep duration (≤6, 7–8, and ≥9 hr). The underweight-normal sleep group had lower breast cancer incidence (HR = 0.66, 95% CI: 0.50–0.86), whereas the overweight-short sleep, overweight-normal sleep group and all obese women experienced elevated breast cancer incidence. The respective HRs for short, normal and long sleep among obese women were 1.35 (95% CI: 1.20–1.53), 1.27 (95% CI: 1.15–1.42) and 1.46 (95% CI: 1.21–1.76). Future perspectives need to examine the possibility that sleep quality, variations in circadian rhythm and melatonin are involved in breast cancer etiology.     

Ovary cancer incidence and mortality in China, 2011

Objective

To evaluate and analyze ovary cancer incidence and mortality in China in 2011 using ovary cancer data from population-based cancer registration in China, and to provide scientific information for its control and prevention.

Methods

Invasive cases of ovary cancer were extracted and analyzed from the overall Chinese cancer database in 2011, which were based on data from 177 population-based cancer registries distributing in 28 provinces. The crude, standardized, and truncated incidences and mortalities et al. were calculated and new and deaths cases from ovary cancer throughout China and in different regions in 2011 were estimated using Chinese practical population.

Results

The estimates of new ovary cancer cases and deaths were 45,223 and 18,430, respectively, in China in 2011. The crude incidence rate, age-standardized rate by Chinese standard population (ASR-C) and age-standardized rate by world standard population (ASR-W) incidence were 6.89/100,000, 5.35/100,000 and 5.08/100,000, respectively; the crude, ASR-C and ASR-W mortalities were 2.81/100,000, 2.01/100,000 and 1.99/100,000, respectively. The incidence and mortality in urban areas were higher than those in rural areas. The age-specific incidence and mortality increased rapidly from age 35-39 and peaked at age 60-64 or 75-79 years. After age 45 or 55, the age-specific incidence and death rates in urban were much higher than those in rural areas.

Conclusions

Compared with GLOBOCAN 2012 data, the ovary cancer incidence in China in 2011 was at middle level, but its mortality was at low level worldwide.     

Obstructive sleep apnoea and the incidence and mortality of cancer: a meta‐analysis

As there are conflicting reports regarding the association between obstructive sleep apnoea (OSA) and cancer incidence and mortality, a meta‐analysis was performed to evaluate whether OSA is independently associated with cancer incidence and mortality. Pubmed, EMBASE and Web of Science were searched up until November 2014. Studies that assessed OSA and the future risk of cancer incidence or mortality were included. Pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) were calculated. Subgroup analysis was conducted based on the polysomnographic variable, apnoea–hypopnoea index. Six studies, which involved 114 105 participants, were pooled in this meta‐analysis. Fixed‐effects analysis showed the pooled adjusted HR of cancer incidence as 0.91 (95% CI, 0.74–1.13; P = 0.408) for mild OSA, 1.07 (95% CI, 0.86–1.33; P = 0.552) for moderate OSA and 1.03 (95% CI, 0.85–1.26; P = 0.743) for severe OSA. Random‐effects analysis demonstrated neither mild OSA (adjusted HR, 0.79; 95% CI, 0.46–1.34; P = 0.381), moderate OSA (adjusted HR, 1.92; 95% CI, 0.63–5.88; P = 0.251) nor severe OSA (adjusted HR, 2.09; 95% CI, 0.45–9.81; P = 0.349) correlated with cancer mortality. This meta‐analysis indicates that OSA is not independently associated with cancer incidence and mortality according to currently available data. Additional experimental and human research is required to determine the exact association between OSA and cancer.     

Liver cancer incidence and mortality in China, 2009

Liver cancer is a common cancer and a leading cause of cancer deaths in China. To aid the government in establishing a control plan for this disease, we provided real-time surveillance information by analyzing liver cancer incidence and mortality in China in 2009 reported by the National Central Cancer Registry. Liver cancer incidence and cases of death were retrieved from the national database using the ICD-10 topography code "C22". Crude incidence and mortality were calculated and stratified by sex, age, and location (urban/rural). China's population in 1982 and Segi (world) population structures were used for age-standardized rates. In cancer registration areas in 2009, the crude incidence of liver cancer was 28.71/100,000, making it the fourth most common cancer in China, third most common in males, and fifth most common in females. The crude mortality of liver cancer was 26.04/100,000, making it the second leading cause of cancer death in China and urban areas and the third leading cause in rural areas. Incidence and mortality were higher in males than in females and were higher in rural areas than in urban areas. The age-specific incidence and mortality were relatively low among age groups under 30 years but dramatically increased and peaked in the 80 -84 years old group. These findings confirm that liver cancer is a common and fatal cancer in China. Primary and secondary prevention such as health education, hepatitis B virus vaccination, and early detection should be carried out both in males and females, in urban and rural areas.     

广州市城区2000～2004年儿童恶性肿瘤发病和死亡率分析

背景与目的:恶性肿瘤是儿童死亡的主要原因之一。本研究分析广州市儿童肿瘤的发病率,探讨儿童肿瘤的发病规律,为广州市儿童肿瘤的防治研究提供科学依据。方法:收集广州市肿瘤登记处2000~2004年儿童肿瘤的发病资料和死亡资料,统计和分析儿童肿瘤的发病率和死亡率。用卡方检验比较不同年份儿童肿瘤的发病率和各年龄别发病率。结果:2000~2004年,广州市儿童肿瘤的发病率为17.91/10万(其中男性18.92/10万,女性16.70/10万),死亡率为4.73/10万(其中男性4.65/10万,女性4.83/10万)。儿童肿瘤发病率最高的前3位肿瘤依次为淋巴样白血病、中枢神经系统肿瘤和非霍奇金淋巴瘤。0岁组的发病率为77.52/10万, 1~4岁组为21.49/10万, 5~9岁组为9.66/10万, 10~14岁组为17.11/10万, 4组发病率比较差异有统计学意义(χ2=307.602,P<0.001)。结论:淋巴样白血病、中枢神经系统肿瘤和非霍奇金淋巴瘤是广州市儿童最常见的恶性肿瘤。4岁以下的儿童是肿瘤的高发人群。