温州市鹿城区2004年肿瘤发病分析

[目的] 了解温州市鹿城区居民恶性肿瘤发病情况与流行特征。[方法] 对2004年恶性肿瘤新发病例报告资料进行分析，计算发病率、标化发病率、35-64岁标化截缩率等指标。[结果] 2004年鹿城区恶性肿瘤发病率344．55／10万，标化发病率240．05／10万。男性以肺癌、肝癌、胃癌多见，女性以乳腺癌、肺癌、大肠癌为主。[结论] 恶性肿瘤防治工作的重点应放在40岁以上人群。加强肺癌、乳腺癌防治研究具有重要意义。     

温州市鹿城区2003～2005年新发肿瘤发病分析

目的了解温州市鹿城区居民恶性肿瘤发病情况与流行特征。方法对2003~2005年恶性肿瘤新发病例报告资料进行分析,计算发病率、标化发病率、标化截缩率(是指35~64岁截缩人口标化率)等。结果2003~2005年鹿城区恶性肿瘤年平均发病率为368.68/10万,标化发病率为243.05/10万,≥40岁恶性肿瘤发病率为211.88/10万,以肺癌、肝癌和胃癌多见,女姓以乳腺癌、肺癌和大肠癌为主。结论恶性肿瘤防治工作的重点应放在≥40岁人群,男性肺癌发病水平高,而乳腺癌对中壮年女性的生命健康危害大。加强肺癌等主要肿瘤危险因素研究,开展女性乳腺癌筛查具有重要意义。     

绍兴市区1996年～2000年居民恶性肿瘤发病分析

[目的]了解绍兴市区1996年—2000年恶性肿瘤发病情况，为防治工作提供依据。[方法]调查人员经培训后，对市区居民展开全面调查登记，根据ICD-9进行恶性肿瘤分类统计，计算发病率、标化发病率。[结果]绍兴市区恶性肿瘤年平均发病率213．92／10万，标化发病率为153．7／10万。男性标化发病率居前5位的是：肺癌、胃癌、肝癌、大肠癌、食管癌；女性标化发病率居前5位的是：肺癌、乳腺癌、胃癌、大肠癌、肝癌，总标化发病率居前5位的是：肺癌、胃癌、大肠癌、肝癌、乳腺癌。[结论]绍兴市区恶性肿瘤以肺癌和消化系统肿瘤为主，应作为防治重点。     

兰州市2005年恶性肿瘤发病率分析

[目的]了解兰州市2005年恶性肿瘤发病状况。[方法]利用兰州市2005年恶性肿瘤登记数据库资料及人口资料．分析粗发病率、中国标化发病率（中标率）、世界标化发病率（世标率）、累积率和截缩率。[结果]2005年兰州市恶性肿瘤发病率为193．0／10万,中标率为156．9／10万．世标率为206．6／10万．35～64岁截缩率为295．8／10万,0—64岁和0～74岁累计率分别为10．6％和25．7％。兰州市五区恶性肿瘤发病率以西固区为最高,发病率为208．5／10万,中标率为167．0／10万：男性前五位癌种分别为肺癌、胃癌、肝癌、食管癌、直肠癌;女性前五位癌种分别为乳腺癌、肺癌、宫颈癌、胃癌和肝癌;男性明显高于女性,高出37．15％,男性、女性发病率均在30岁年龄组开始缓慢上升,70—75岁组达到发病高峰。[结论]恶性肿瘤已成为影响兰州市居民健康的主要疾病,肺癌、乳腺癌、胃癌、肝癌、宫颈癌应作为兰州市肿瘤防治工作的重点,男性和中老年人应为癌症预防的高危人群,尤其应该加强对肺癌、乳腺癌防治研究。     

2002～2005年上海市松江区居民恶性肿瘤发病与死亡分析

[目的]分析上海市松江区2002～2005年居民新发恶性肿瘤发病与死亡分布特征。[方法]对2002～2005年松江区肿瘤发病及死亡资料进行分析。[结果]2002～2005年发病率与死亡率男性均大于女性。年龄别发病率与死亡率均随年龄增高呈上升趋势。男性恶性肿瘤发病率位于前五位的分别为肺癌、胃癌、肝癌、大肠癌、食管癌，死亡率位于前六位的分别为肺癌、胃癌、肝癌、食管癌、大肠癌、胰腺癌：女性恶性肿瘤发病率位于前五位的为乳腺癌、大肠癌、肺癌、胃癌、肝癌，死亡率前六位的为大肠癌、肺癌、胃癌、肝癌、胰腺癌、乳腺癌。男性肺癌发病率与死亡率均是最高．而乳腺癌50～70岁年龄段妇女高发，而胰腺癌死亡率升高明显已跃居男、女性死亡前六位。[结论]松江区恶性肿瘤防治重点应该为40岁以上人群，肺癌、乳腺癌、胰腺癌等应成为肿瘤防治的重点。     

山东省临朐县2005年肿瘤发病情况分析

[目的]探讨山东省临朐县恶性肿瘤发病情况及流行特征.[方法]对2005年恶性肿瘤新发病例登记报告资料进行分析,计算发病率、标化发病率、标化截缩率、发病构成、累积率等指标.[结果]临朐县2005年恶性肿瘤发病率177.64/10万.中国标化发病率102.62/10万.世界标化率为136.37/10万,35～64岁标化截缩率为182.23/10万;0～74岁累积率为16.58%.肺癌、胃癌、肝癌三大肿瘤占全部肿瘤的67.02%;其中男性占73.45%.女性占55.73%:肺癌发病率上升到第一位.[结论]恶性肿瘤防治工作的重点应放在肺癌、胃癌、肝癌上,重点人群为25～50岁的中青年.     

大连市区1991-2005年恶性肿瘤发病趋势分析

[目的]探讨大连市区1991～2005年常见恶性肿瘤的发病趋势。[方法]对大连市肿瘤登记处收集的1991～2005年常见恶性肿瘤新发病例逊行世界标准人口标化发病率以及病例数加权基础上的年度变化百分比（APC）计算。[结果]1991～2005年间，男性所有部位恶性肿瘤世界人口标化率由208．50／10万上升至221．70／10万，女性由128．50／10万上升至159.40／10万。男女性大肠癌、直肠癌、肾癌、膀胱癌、甲状腺癌、霍奇金病与非霍奇金病等均呈显著上升趋势。男性前列腺癌和胆囊癌以及女性乳腺癌、子宫体癌、宫颈癌也呈显著上升趋势。肺癌发病率在男性中变化不大，而在女性则呈显著上升趋势。男女性脑瘤以及女性食管癌和胃癌均呈显著下降趋势。男女性肝癌与男性食管癌、胃癌以及女性胰腺癌均有所下降。[结论]上述发病率的变化提示由于人口老龄化、不良生活方式等危险因素的共同作用，恶性肿瘤已成为大连市的主要公共卫生问题。     

杭州市2004～2005年恶性肿瘤发病状况分析

[目的]了解杭州市恶性肿瘤的发病及分布情况。[方法]利用2004～2005年杭州肿瘤登记处报告资料，分析肿瘤粗发病率和中国人口标化发病率。[结果]杭州市恶性肿瘤粗发病率为244．44/10万，其中男、女性粗发病率分别为273．68／10万和208．02／10万。杭州市恶性肿瘤中国人口标化率为178．52／10万；其中男、女性中国人口标化率分别为194．96／10万和159．32／10万。前5位恶性肿瘤为肺癌、胃癌、肝癌、乳腺癌、直肠癌。市区发病率295．12／10万，郊县发病率158．28／10万。[结论]恶性肿瘤是威胁杭州市居民健康的重要因素．预防和控制恶性肿瘤的发生是当前卫生工作的重要任务。     

哈尔滨市1997～2003年居民恶性肿瘤发病分析

[目的]了解哈尔滨市1997～2003年恶性肿瘤发病规律和特点,为防治工作提供科学依据.[方法]运用描述流行病学研究,对哈尔滨市1997～2003年居民恶性肿瘤的发病特征及趋势进行分析.[结果]1997～2003年恶性肿瘤发病率为143.72/10万(男性158.77/10万、女性128.47/10万)、中国标化率为97.53/10万(男性107.14/10万、女性87.14/10万).男性标化发病率居前5位的是:肺癌、肝癌、胃癌、大肠癌和食管癌;女性标化发病率居前5位的是:乳腺癌、肺癌、大肠癌、胃癌和肝癌.7年间恶性肿瘤发病率呈逐年升高的趋势,男性标化发病率由1997年的65.31/10万上升至2003年的119.79/10万,女性则由49.49/10万上升至96.82/10万.[结论]1997～2003年哈尔滨市恶性肿瘤发病呈上升趋势,消化道肿瘤、肺癌和乳腺癌是威胁我市居民身体健康的最主要肿瘤,是当前肿瘤防治工作的重点.     

海宁市1977～2006年恶性肿瘤发病趋势分析

[目的]探讨海宁市恶性肿瘤流行特征及变化趋势,为制定肿瘤预防控制策略与措施提供依据。[方法]应用海宁市肿瘤登记系统资料,对各类恶性肿瘤发病情况进行分析。[结果]1977-2006年全市恶性肿瘤发病率133．11／10万,中国标化发病率为93．10／10万,世界标化发病率为115．80／10万：构成比前5位依次为：肺癌、肝癌、胃癌、食管癌、大肠癌,占全部恶性肿瘤的68．02％。1992～2006年与1977～1991年恶性肿瘤发病率上升了34．51％（P〈0．01）;上升幅度较大的恶性肿瘤有：胰腺癌、脑肿瘤、膀胱癌、乳腺癌、肺癌、大肠癌;与此同时,食管癌、宫颈癌则有所下降。[结论]近年来恶性肿瘤发病率呈明显上升态势,癌症发病谱发生了较大变化,提示今后肿瘤防治工作的重点应放在肺癌及消化系统恶性肿瘤方面。     

Trends in Breast Cancer Mortality, Incidence, and Survival, and Mammographic screening in Tuscany, Italy

Objective: The study describes breast cancer mortality trends in Tuscany (period 1970–97), comparing Florence with the rest of Tuscany (Florence excluded), and, for Florence, incidence (period 1985–94) and survival (1985–86 versus 1991–92) trends, taking into account the diffusion of screening. Methods: Mortality and incidence rates, age-adjusted on the European population, and 95% confidence intervals (95% CI). Five-year relative survival rates and estimates of risk of dying provided by the Cox model. Results: Mammographic screening, started at the beginning of the 1970s in some municipalities, largely involved the Florence area after 1990 (mammograms/years: from 8000–9000 to 28,000–29,000, respectively, before and after 1990). In the same period no population-based screenings were ongoing in the rest of Tuscany. A significant mortality drop was observed in Tuscany (–3.7%/year), starting at the beginning of the 1990s and observed for ages 74 (especially ages 40–49: –11.2%/year). The drop was similar in Florence and in the rest of Tuscany. In ages 50–69, incidence, increasing between 1985–87 and 1988–90 (+6.5%), rose sharply in 1991–94 (+17.0%); it was stable in other ages. Local disease increased more markedly in ages 50–69 (globally: +88.3%), but also in other ages (+20–30%). Regional and metastatic cancers decreased. A significantly better 5-year survival was observed among cases diagnosed in 1991–92, persisting after adjustment by extent of disease. Conclusion: Even if the causes of breast cancer mortality trends are not easy to clarify in an observational study, our data suggest that the drop in mortality observed in Tuscany at the beginning of the 1990s could be largely explained by both earlier detection, outside of an organized screening program, and by better treatments. The increase in incidence and the shift in stage distribution that occurred before the enlargement of the screening area and in age groups not involved in the program, supports the role of a `spontaneous' widespread earlier detection. The better survival of the period 1991–92, only partly explained by the shift in stage at diagnosis, indirectly supports the role of improvement in therapy.     

Etoposide, dexamethasone, cytarabine, and cisplatin in vincristine, doxorubicin, and dexamethasone-refractory myeloma

Based on remarkable activity in refractory lymphomas, a combination of etoposide, cisplatin (both administered by 4-day continuous infusions), cytarabine (Ara-C), and dexamethasone (EDAP) was evaluated in 20 patients with advanced myeloma refractory to standard melphalan and prednisone (MP) and/or vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and dexamethasone (VAD) and even to high doses of melphalan (HDM) (seven patients). Forty percent of patients responded regardless of previously recognized risk factors (eg, duration of drug resistance, tumor mass, and serum lactic dehydrogenase [LDH] level). While the median survival was only 4.5 months, patients with good performance (Zubrod less than 2) and low or intermediate tumor stage survived more than 14 months compared with only 2 months for the remaining group. EDAP could be readily administered in the outpatient clinic, but neutropenic fever prompted hospital admission in 80% of patients, half of whom developed penumonia and sepsis, a fatal outcome in four patients. Severe myelosuppression was of short duration, so that subsequent cycles could be administered every 3 to 4 weeks. No serious extramedullary toxicity, including renal toxicity, was encountered. Marrow toxicity and hence infectious complications may be reduced by elimination of Ara-C without compromising treatment efficacy. We conclude that the lack of cross-resistance with VAD and even HDM makes EDAP or a similar combination an attractive regiment to be formally explored in an alternating sequence with VAD in high-risk myeloma.     

Mate drinking, alcohol, tobacco, diet, and esophageal cancer in Uruguay

A case-control study was conducted in Uruguay to investigate the role of mate drinking, alcohol, tobacco, and certain dietary factors in the etiology of esophageal cancer. The study included 261 patients with squamous cell carcinoma of the esophagus and 522 hospital controls matched by sex and age. A strong association with a clear dose-response relationship was observed with the amount of mate drunk daily and duration of the habit. The relative risk for those drinking over 2.5 liters of mate per day was 12.2 (95% confidence interval, 3.8-39.6) after adjusting for the effects of age, area of residence, alcohol, and tobacco. Strong associations were also observed with tobacco smoking and alcohol drinking which appear to act in a multiplicative way. The relative risk for those who smoke and drink heavily compared to that of light smokers and drinkers was 22.6. The risk associated with black tobacco was about three times higher than that associated with blond tobacco. A clear protective effect was found for the consumption of fruits and vegetables but a dose-response relationship was present only for fruits. Finally, an increased risk was also found for those eating barbecued meat daily.     

Trends in cancer incidence in esophagus, stomach, colon, rectum and liver in males in India.

Time trends in cancers of the esophagus, stomach, colon, rectum and liver cancers among the male population in five Indian urban population based cancer registries (Mumbai, Bangalore, Chennai, Delhi, and Bhopal) were examined over the period of the last two decades. The model applied fits data to the logarithm of Y=ABx. This Linear Regression method showed decreasing trends in age-adjusted incidence rates for cancers of the stomach and esophagus, especially in Bjopal, and increasing trends for colon and rectum and liver, throughout the entire period of observation in most of the registries. The five cancers together constitute more than 80% of the total gastro intestinal cancers and are serious diseases in both sexes. To understand the etiology of these cancers in depth, analytic epidemiological studies should be planned in the near future on a priority basis.     

Socio-demographic variation in stage at diagnosis of breast,bladder, colon,endometrial, lung,melanoma, prostate,rectal, renal and ovarian cancer in England and its population impact

Background Stage at diagnosis strongly predicts cancer survival and understanding related inequalities could guide interventions.Methods We analysed incident cases diagnosed with 10 solid tumours included in the UK government target of 75% of patients diagnosed in TNM stage I/II by 2028. We examined socio-demographic differences in diagnosis at stage III/IV vs. I/II. Multiple imputation was used for missing stage at diagnosis (9% of tumours).Results Of the 202,001 cases, 57% were diagnosed in stage I/II (an absolute 18% ‘gap’ from the 75% target). The likelihood of diagnosis at stage III/IV increased in older age, though variably by cancer site, being strongest for prostate and endometrial cancer. Increasing level of deprivation was associated with advanced stage at diagnosis for all sites except lung and renal cancer. There were, inconsistent in direction, sex inequalities for four cancers. Eliminating socio-demographic inequalities would translate to 61% of patients with the 10 studied cancers being diagnosed at stage I/II, reducing the gap from target to 14%.Conclusions Potential elimination of socio-demographic inequalities in stage at diagnosis would make a substantial, though partial, contribution to achieving stage shift targets. Earlier diagnosis strategies should additionally focus on the whole population and not only the high-risk socio-demographic groups.Subject terms: Oncology, Health policy