Trends in incidence,mortality, and survival for kidney cancer in Canada, 1986–2007

Purpose

Kidney cancer is one of the fastest rising cancers worldwide. We aimed to examine the trends in incidence, mortality, and survival for this cancer in Canada.

Methods

Incidence data for kidney cancer for 1986–2010 were from the Canadian Cancer Registry and the National Cancer Incidence Reporting System. These data were only available up to 2007 for the province of Quebec and consequently for the same year nationally, for Canada. Mortality data for 1986–2009 were from the Canadian Vital Statistics Death Database. Changes in age-standardized rates were analyzed by Joinpoint regression. Incidence rates were projected to 2025 using a Nordpred age-period-cohort model. Five-year relative survival ratios (RSR) were analyzed for 2004–2008 and earlier periods.

Results

Between 1986 and 2007, the age-standardized incidence rate (ASIR) per 100,000 rose from 13.4 to 17.9 in males and 7.7 to 10.3 in females. Annual increases in ASIR were greatest for age groups <65 years (males) and ≥65 years (females). The ASIRs increased significantly over time in both sexes for renal cell carcinoma (RCC) but not for other kidney cancer types. RCC rates are projected to increase until at least 2025. Mortality rates decreased only slightly in each sex since 1986 (0.4 %/year in males; 0.8 %/year in females). The 5-year RSR for kidney cancer was 68 % but differed largely by morphology and age, and has increased slightly over time.

Conclusions

The incidence rate of kidney cancer in Canada has risen since at least 1986, led largely by RCC. Increasing detection of incidental tumors, and growing obesity and hypertension rates are possible factors associated with this increase. Greater prevention of modifiable risk factors for kidney cancer is needed.     

Prostate cancer: Trends in incidence,survival and mortality in the Netherlands, 1989–2006

BackgroundProstate cancer occurrence and stage distribution changed dramatically during the end of the 20th century. This study aimed to quantify and explain trends in incidence, stage distribution, survival and mortality in the Netherlands between 1989 and 2006.MethodsPopulation-based data from the nationwide Netherlands Cancer Registry and Causes of Death Registry were used. Annual incidence and mortality rates were calculated and age-adjusted to the European Standard Population. Trends in rates were evaluated by age, clinical stage and differentiation grade.Results120,965 men were newly diagnosed with prostate cancer between 1989 and 2006. Age-adjusted incidence rates increased from 63 to 104 per 100,000 person-years in this period. Two periods of increasing incidence rates could be distinguished with increases predominantly in cT2-tumours between 1989 and 1995 and predominantly in cT1c-tumours since 2001. cT4/N+/M+-tumour incidence rates decreased from 23 in 1993 to 18 in 2006. The trend towards earlier detection was accompanied by a lower mean age at diagnosis (from 74 in 1989 to 70 in 2006), increased frequency of treatment with curative intent and improved 5-year relative survival. Mortality rates decreased from 34 in 1996 to 26 in 2007.ConclusionsThe increase of prostate cancer incidence in the early 1990s was probably caused by increased prostate cancer awareness combined with diagnostic improvements (transrectal ultrasound, (thin) needle biopsies), but not PSA testing. The subsequent peak since 2001 is probably attributable to PSA testing. The decline in prostate cancer mortality from 1996 onwards may be the consequence of increased detection of cT2-tumours between 1989 and 1995. Unfortunately, data on the use of PSA tests and other prostate cancer diagnostics to support these conclusions are lacking.     

Trends in childhood brain tumor incidence, 1973–2009

In the mid-1980s, there was a rise in incidence rates of childhood brain tumors (CBT) in the United States that appeared to stabilize at a higher rate in the early 1990s. An updated analysis of the pattern of CBT over the past 2 decades, with commentary on whether the elevated incidence rate has continued, is past due. We used Surveillance, Epidemiology and End Results (SEER) data to examine trends in incidence of CBT from 1973 through 2009. We examined age-adjusted incidence rates (AAIRs) and secular trends for all malignant brain tumors combined (SEER classification) by histologic tumor type and anatomic site. The incidence of CBT remained stable from 1987 to 2009 [annual percent change (APC) = 0.10; 95 % confidence intervals (CI) ?0.39 to 0.61] with an AAIR for all CBT of 3.32 (95 % CI 3.22–3.42). The stability of rates in these two decades contrast the change that occurred in the mid-1980s (1983–1986), when the incidence of CBT increased by 53 % (APC = 14.06; 95 % CI 4.05–25.0). From 1983 to 1986, statistically significant rate increases were observed for pilocytic astrocytoma, PNET/medulloblastoma, and mixed glioma. Further, the rate of increase in pilocytic astrocytoma was similar to the rate of decrease for astrocytomas NOS from 1981 to 2009, suggesting a change from a more general to more specific classification. After the increase in rates in the mid-1980s, rates of CBT over the past two decades have stabilized. Changes in incidence rates of subtypes of tumors over this time period reflect changes both in classification of CBT and in diagnostic techniques.     

Trends in smoking-related cancer incidence in Tarragona, Spain, 1980–96

Objectives: To analyze recent trends (1980–96) in the incidence of smoking-related cancers among men and women in Tarragona, Spain. Methods: Data were obtained from a population-based cancer registry. Age-standardized incidence rates were computed. Secular trends, between 1980 and 1996, were estimated using a Poisson regression model. From these figures, age, period, and cohort effects were assessed using the method proposed by Holford. Results: The incidence of all smoking-related cancers combined increased significantly in both sexes. The annual increase was 3.0% in men and 4.5% in women. By sites the annual increase was 4.3% in oral cavity, 5.1% in pancreas, 2.5% in lung, 3.2% in bladder, and 7.7% in kidney cancers among men. Among women the corresponding increments were 7.0% in oral cavity, 7.3% in pancreas, 3.1% in lung, 2.1% in bladder, and 6.9% in kidney cancers. The increasing incidence of lung cancer in women was mostly due to the adenocarcinoma histological type. No increase was observed in esophagus and larynx cancer either in men or women. It was not possible to determine whether the increases are due to a period or cohort effect since the curvature analysis was found to be non-significant. Conclusions: All smoking-related cancers combined, except larynx and esophagus, are increasing in both sexes. The effect of tobacco, alcohol, and occupational exposure to carcinogens could explain the high rates of larynx, bladder, and upper digestive tract cancer in men. The rising incidence rates of lung cancer observed in younger women indicate a change in recent trends that is consistent with changes observed in smoking prevalence. Unless recent upward smoking trends in young women can be reversed, lung cancer in women will rise rapidly in the next few years. New smoking prevention strategies aimed at Spanish women, especially in the younger age groups, should be developed.     

Trends in breast cancer incidence and mortality in France 1990–2008

The objective of this work was to detail the incidence and mortality trends of invasive and in situ breast cancer (BC) in France, especially regarding the development of screening, over the 1990–2008 period. Data issued from nine population-based cancer registries were studied. The incidence of invasive BC increased annually by 0.8 % from 1990 to 1996 and more markedly by 3.2 % from 1996 to 2003, and then sharply decreased until 2006 (?2.3 % per year), especially among women aged 50–69 years (?4.9 % per year). This trend was similar whatever the introduction date of the organized screening (OS) program in the different areas. The incidence of ductal carcinoma in situ steadily increased between 1990 and 2005, particularly among women aged 50–69 years and 70 and older. At the same time, the mortality from BC decreased annually by 1.1 % over the entire study period. This decrease was more pronounced in women aged 40–49 and 50–69 and, during the 1990–1999 period, in the areas where OS began in 1989–1991. The similarity in the incidence trends for all periods of implementation of OS in the different areas was striking. This suggests that OS alone does not explain the changes observed in incidence rate. Our study highlights the importance of closely monitoring the changes in incidence and mortality indicators, and of better understanding the factors causing variation.     

Chordoma: incidence and survival patterns in the United States, 1973–1995

Background: Chordoma, a rare tumor arising from notochordal remnants, has been described to date only by single-institution case series or small population-based surveys. Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, 1973–1995, to calculate age-adjusted incidence and survival rates for 400 cases of microscopically confirmed chordoma and to derive information regarding case distribution and risk of second cancer. Results: The age-adjusted chordoma incidence rate (IR) of 0.08 per 100,000 was age-dependent, more common in males (IR 0.10) than females (IR 0.06) and rare among patients aged <40 years and blacks. Within the axial skeleton 32% of cases were cranial, 32.8% spinal and 29.2% sacral. Young age (<26 years; p = 0.0001) and female sex (p = 0.037) were associated with greater likelihood of cranial presentation. There was no overall increased risk for second primary cancers after chordoma. Median survival was 6.29 years; 5- and 10-year relative survival rates were 67.6% and 39.9%, respectively. Comparison with other bone sarcomas revealed racial disparities in incidence for the two developmental tumors, chordoma and Ewing's sarcoma. Conclusions: This study provides new data regarding incidence and survival patterns of chordoma in the US. Additional epidemiologic studies are required to elucidate the genetic and environmental determinants underlying this rare, distinctive neoplasm.     

Diverging trends in incidence and mortality,and improved survival of non-Hodgkin's lymphoma,in the Netherlands, 1989–2007

BackgroundWe studied progress in the fight against non-Hodgkin's lymphoma (NHL) in the Netherlands by describing the changes in incidence, treatment, relative survival, and mortality during 1989–2007.Patients and methodsWe included all adult patients with NHL [i.e. all mature B-, T-, and natural killer (NK) cell neoplasms, with the exception of plasma cell neoplasms], newly diagnosed in the period 1989–2007 and recorded in the Netherlands Cancer Registry (n = 55 069). Regular mortality data were derived from Statistics Netherlands. Follow-up was completed up to 1 January 2009. Annual percentages of change in incidence, mortality, and relative survival were calculated.ResultsThe incidence of indolent B-cell and T- and NK-cell neoplasms rose significantly (estimated annual percentage change = 1.2% and 1.3%, respectively); incidence of aggressive B-cell neoplasms remained stable. Mortality due to NHL remained stable between 1989 and 2003, and has decreased since 2003. Five-year relative survival rates rose from 67% to 75%, and from 43% to 52%, respectively, for indolent and aggressive mature B-cell neoplasms, but 5-year survival remained stable at 48% for T- and NK-cell neoplasms.ConclusionsIn the Netherlands, incidence of indolent mature B-cell and mature T- and NK-cell neoplasms has increased since 1989 but remained stable for aggressive neoplasms. Survival increased for all mature B-cell neoplasms, preceding a declining mortality and increased prevalence of NHL (17 597 on 1 January 2008).     

Breast cancer incidence and use of hormone therapy in Denmark 1978–2007

Objective  

Internationally, there have recently been reports of declining incidence rates for breast cancer. Decreased use of hormone therapy and decreased use of mammography has been put forward as possible reasons for this decline. The aim of this study was to analyse breast cancer incidence trends in Denmark, and to evaluate if these trends could be explained by changes in use of hormone therapy and screening with mammography.     

Female breast cancer incidence and survival in Utah according to religious preference, 1985–1999

Background  

Female breast cancer incidence rates in Utah are among the lowest in the U.S. The influence of the Church of Jesus Christ of Latter-day Saint (LDS or Mormon) religion on these rates, as well as on disease-specific survival, will be explored for individuals diagnosed with breast cancer in Utah from 1985 through 1999.     

Patterns of leukemia incidence in the United States by subtype and demographic characteristics, 1997–2002

Objective Efforts to prevent leukemia have been hampered by an inability to identify significant risk factors. Exploring incidence patterns of leukemia subtypes by sex and race/ethnic group may generate new etiologic hypotheses and identify high-risk groups for further study. Methods Data from the North American Association of Central Cancer Registries for 1997–2002 were used to assess patterns of leukemia incidence by subtype, sex, age, race and ethnicity. Results A total of 144,559 leukemia cases were identified, including 66,067 (46%) acute and 71,860 (50%) chronic leukemias. The highest rates of acute myeloid leukemia with and without maturation were observed in Asian-Pacific Islanders (API). Hispanics had a higher incidence of acute lymphocytic leukemia, particularly in childhood, and promyelocytic leukemia than did non-Hispanics. African–Americans had the highest rates of HTLV-1 positive adult T-cell leukemia/lymphoma. A sharp increase in the incidence of chronic myeloid leukemia was observed for both APIs and Hispanics, 85 years and older. Conclusion Known risk factors are unlikely to explain the observed disparities in leukemia incidence. Further studies of differences in environmental and genetic risk factors in these populations by specific leukemia subtype may provide clues to the etiologies of these malignancies.     

Who are the cancer survivors? A nationwide study in Denmark, 1943–2010

Background:

No nationwide studies on social position and prevalence of comorbidity among cancer survivors exist.

Methods:

We performed a nationwide prevalence study defining persons diagnosed with cancer 1943–2010 and alive on the census date 1 January 2011 as cancer survivors. Comorbidity was compared by social position with the non-cancer population.

Results:

Cancer survivors composed 4% of the Danish population. Somatic comorbidity was more likely among survivors (OR 1.59, 95% CI 1.57–1.60) and associated with higher age, male sex, short education, and living alone among survivors.

Conclusions:

Among cancer survivors, comorbidity is common and highly associated with social position.     

Trends in survival for teenagers and young adults with cancer in the UK 1992–2006

BackgroundAlthough relatively rare, cancer in teenagers and young adults (TYA) is the most common disease-related cause of death and makes a major contribution to years of life lost in this age group. There is a growing awareness of the distinctive needs of this age group and drive for greater understanding of how outcomes can be improved. We present here the latest TYA survival trends data for the United Kingdom (UK).MethodsUsing national cancer registry data, we calculated five-year relative survival for all 15–24 year olds diagnosed with cancer or a borderline/benign CNS tumour in the UK during the periods 1992–1996, 1997–2001 and 2002–2006. We analysed trends in survival for all cancers combined and for eighteen specified groups that together represent the majority of TYA cancers. We compared our data with published data for Europe, North America and Australia.ResultsFive-year survival for all cancers combined increased from 75.5% in 1992–1996 to 82.2% in 2002–2006 (P < 0.001). Statistically significant improvements were seen for all disease groups except osteosarcoma, rhabdomyosarcoma, non-gonadal and ovarian germ cell tumours and ovarian and thyroid carcinomas. During the earliest time period, females had significantly better survival than males for five of the twelve non-gender-specific disease groups. By the latest period, only melanomas and non-rhabdomyosarcoma soft tissue sarcomas had differential survival by gender. Survival in the UK for the most recent period was generally similar to other comparable countries.ConclusionFive-year survival has improved considerably in the UK for most cancer types. For some disease groups, there has been little progress, either because survival already approaches 100% (e.g. thyroid carcinomas) or, more worryingly for some cancers with poor outcomes, because they remain resistant to existing therapy (e.g. rhabdomyosarcoma). In addition, for a number of specific cancer types and for cancer as a whole males continue to have worse outcomes than females.     

Treatment and survival of glioblastoma patients in Denmark: The Danish Neuro-Oncology Registry 2009–2014

Journal of Neuro-Oncology - As many glioblastoma patients are in a poor condition they are unable to undergo the full treatment documented in clinical trials. We aimed to examine the survival and...     

Trends by anatomic site in the incidence of cutaneous malignant melanoma in Canada, 1969–93

Trends in melanoma incidence by anatomic site were examined in Canada where ascertainment of cancer has been of a high standard. The analysis included 41,239 malignant melanomas registered between 1969 and 1993 and used an age, period and cohort modeling approach. The estimated annual increase was 4.8% for males and 3.1% for females but slowed appreciably in the later years. The lifetime risk of melanoma appeared to have peaked with women born about 1934 and men born about 1944. The age-standardized rates have now stabilized for women and are expected to plateau for men in the near future. The largest relative increases occurred for the upper limbs followed by the trunk for both sexes. Comparable generation effects were observed for intermittently exposed sites but the patterns of trend differed between sites for men and women. This supports effects due to sex- and site-specific pattern of sun exposure. The evidence, for the first time, of more favorable trends among post-World War II generations is thought to reflect reduced exposure to UV rays. This may possibly be the earliest signs of the impact of primary prevention programs, particularly if UV radiation also acts as a tumor promoter.     

Socioeconomic status and childhood acute lymphocytic leukemia incidence in São Paulo, Brazil

To investigate the association of childhood ALL and SES, we collected data on 507 children aged 0–14 years diagnosed with ALL between 1997 and 2002 from the population‐based Cancer Registry of São Paulo, Brazil, covering 96 districts. Each child was assigned to an SES category based on the district of residence at diagnosis. Four SES categories were created from high to low, based on the Social Exclusion Index (SEI) that includes the following indicators: poverty, employment, inequality, education and violence. Using Census data, cases were also classified into quintiles according to the percentage of households with more than 7 persons. Age‐specific and age‐standardized incidence rates were calculated using the 1960 world standard population. Age‐adjusted incidence rate was 3.68/100,000 for males and 2.87/100,000 for females. Children living in areas with lowest SES presented a significant lower risk of ALL compared with those living in the wealthiest districts (Rate Ratio [RR] = 0.34; 95% Confidence Interval [CI] = 0.28–0.44). Lower incidence rates of childhood ALL were also found in areas with high percentages of households with more than 7 persons (≥5.7%) compared with areas where there were ≤2.2% (RR = 0.32, 95% CI 0.25–0.43). There was a strong correlation between SEI and crowding (rho = ?0.95, p < 0.001). Population‐based attributes for SES and household size may be useful surrogate markers of early exposure to childhood infections, which has been found to decrease the risk of ALL. © 2008 Wiley‐Liss, Inc.     

The incidence of second primary invasive melanoma in Queensland, 1982–2003

OBJECTIVE: To describe the incidence of second primary invasive melanoma. METHODS: Data describing 52,997 subjects with melanoma notified to The Queensland Cancer Registry between 1982 and 2003. We calculated incidence rates of second primary invasive melanoma (per 1,000 person-years) by sex, age, and characteristics of the first primary. RESULTS: The rate of second primary invasive melanoma was relatively constant over 20 years of follow-up at 6.01 per 1,000 person-years indicating a high, constant lifetime risk of second primary invasive melanoma. Rates were 62% higher in males than in females and increased with age at first diagnosis with the rate in older patients (80+ years) more than double the rate observed in younger patients (40-49 years). Rates in patients with melanomas thicker than 2 mm were over 50% higher than in patients with thinner melanomas. CONCLUSIONS: Melanoma patients are at high risk of a second primary invasive melanoma. This risk does not diminish with time and does not differ significantly between patients first diagnosed with lentigo maligna, in situ melanoma or invasive melanoma. These results indicate that all melanoma patients require lifetime surveillance. Current treatment guidelines should be modified to reflect this.