Oral cancer in Ireland, 1984-1988

Cancer mortality in Ireland, 1926-1995

BACKGROUND

Investigation of long time series of cancer data can still be very useful in helping to identify Cancer Control priorities and achievements. Since the partition of Ireland into the independent Republic of Ireland and Northern Ireland, which remained part of the United Kingdom, cancer mortality data have been published in an essentially similar format in both countries. The information presented here will contribute to providing a basis for the collaborative Cancer Research programme initiated recently.

PATIENTS AND METHODS

Cancer mortality data have been assembled and analysed separately for the Republic of Ireland and Northern Ireland: the data have then been combined to present mortality rates for the whole of Ireland, covering the period from 1926 to 1995. Several rubrics had to be aggregated to provide data continuously over the time span (e.g. colon and rectum and cervix and body of the uterus). When data were only available in 10-year classes of age, the EM algorithm was employed to obtain 5-year age-specific rates. All rates presented are age-standardised, employing the World Standard Population.

RESULTS

In women, the death rate from all neoplasms combined increased very slightly from 117 per 100 000 in 1946-1950 to 120 per 100 000 in 1991-1995. In men, the death rate increased from 127 per 100 000 to 172 per 100 000 over the same time period. The overall cancer death rate in Ireland is currently similar to the European average in men, although in women it is among the top fifth of national cancer mortality rates in European countries. While cancer is a major cause of death in Ireland, there is no evidence of an evolving epidemic building up: the death rates from most forms of cancer are declining towards the end of the time period considered.

CONCLUSIONS

As demonstrated by falling death rates from Hodgkin's disease and testicular cancer, major treatment advances appear to have been incorporated effectively into clinical practice in Ireland. Progress is apparent in tobacco control and further initiatives in this area must be undertaken since tobacco appears to be the only major new carcinogen introduced recently into the Irish environment during the period covered by this study. Effective population-based screening programmes for cervix and breast cancer and, more controversially, consideration of a National Prostate Cancer Screening programme, offer scope for further improvement in mortality. Examination of this long time series of mortality data from Ireland provides information about the evolving cancer pattern and provides the necessary background to evaluate the impact of the cross-border cancer research activities now being launched.

The epidemiology of lip cancer: a review of global incidence and aetiology

Lip cancer (140 ICD-9) is a form of oral cancer that has a distinctive global epidemiology. This review summarises global incidence rates for male and female lip cancer with the aid of cancer atlases. High male lip cancer rates are reported for regions of North America (12.7 per 100 000 per annum), Europe (12.0 per 100 000 per annum) and Oceania (13.5 per 100 000 per annum), while it is virtually unknown in parts of Asia. Factors commonly cited as important in the aetiology of lip cancer include solar radiation, tobacco smoking and viruses. An attempt is made to summarise the evidence for factors that may be important in lip carcinogenesis. While incidence rates are generally stable or falling among males worldwide, they are rising in many female populations. The aetiology of the disease is far from established and much information regarding its pathogenesis is based on anecdotal rather than case-controlled epidemiological evidence. The epidemiology of lip cancer supports the proposal that the lip should be considered as a distinct cancer site, rather than being included with other forms of intraoral cancer.