Perspectives in cancer chemotherapy

Sea Conch Peptides Hydrolysate Alleviates DSS-Induced Colitis in Mice through Immune Modulation and Gut Microbiota Restoration

Inflammatory bowel disease (IBD) is a persistent, lifelong inflammation of the digestive system. Dextran sulfate sodium is commonly used to induce colitis in experimental animal models, which causes epithelial damage, intestinal inflammation, mucin depletion, and dysbiosis of the gut microbiota. Various prebiotics, polysaccharides, and polypeptides are used for IBD treatment. In this study, we used a murine model utilizing BALB/c mice, with 10 mice per group, to investigate the treatment effect of sea conch peptide hydrolysate (CPH) on DSS-induced colitis mice. Colitis was induced through the administration of 2.5% DSS in drinking water over a seven-days period. Furthermore, on the eighth day of the experiment, sea conch peptide hydrolysate (CPH) at low (100 mg/kg), medium (200 mg/kg), and high (400 mg/kg) doses, which were continued for 14 days, were assessed for medicinal purposes in DSS-induced colitis mice. Our results showed that CPH treatment significantly alleviated the severity and symptoms of colitis. The epithelial integrity and histological damage were improved. Intestinal inflammation and inflammatory cell infiltration were improved. Furthermore, the expression of pro-inflammatory cytokines was reduced, and intestinal barrier integrity was restored by elevating the tight junction proteins. Moreover, 16s RNA sequencing revealed dysbiosis of the gut microbiota was observed upon DSS treatment, which was reinstated after CPH treatment. An increased level of Firmicutes and Lactobacillus was observed in the treatment groups. Finally, our results suggest that CPH would be recommended as a functional food source and also have the potential to be used as a medicinal product for different gastrointestinal disorders.

Marine Natural Products: A Source of Novel Anticancer Drugs

Cancer remains one of the most lethal diseases worldwide. There is an urgent need for new drugs with novel modes of action and thus considerable research has been conducted for new anticancer drugs from natural sources, especially plants, microbes and marine organisms. Marine populations represent reservoirs of novel bioactive metabolites with diverse groups of chemical structures. This review highlights the impact of marine organisms, with particular emphasis on marine plants, algae, bacteria, actinomycetes, fungi, sponges and soft corals. Anti-cancer effects of marine natural products in in vitro and in vivo studies were first introduced; their activity in the prevention of tumor formation and the related compound-induced apoptosis and cytotoxicities were tackled. The possible molecular mechanisms behind the biological effects are also presented. The review highlights the diversity of marine organisms, novel chemical structures, and chemical property space. Finally, therapeutic strategies and the present use of marine-derived components, its future direction and limitations are discussed.

Marine Natural Products: A Source of Novel Anticancer Drugs

Cancer remains one of the most lethal diseases worldwide. There is an urgent need for new drugs with novel modes of action and thus considerable research has been conducted for new anticancer drugs from natural sources, especially plants, microbes and marine organisms. Marine populations represent reservoirs of novel bioactive metabolites with diverse groups of chemical structures. This review highlights the impact of marine organisms, with particular emphasis on marine plants, algae, bacteria, actinomycetes, fungi, sponges and soft corals. Anti-cancer effects of marine natural products in in vitro and in vivo studies were first introduced; their activity in the prevention of tumor formation and the related compound-induced apoptosis and cytotoxicities were tackled. The possible molecular mechanisms behind the biological effects are also presented. The review highlights the diversity of marine organisms, novel chemical structures, and chemical property space. Finally, therapeutic strategies and the present use of marine-derived components, its future direction and limitations are discussed.

Cancer Mortality in Italy, 1998

This short report provides data and statistics of cancer mortality in Italy in 1998, updating previous work on the issue. The material and methods of this report are similar to those previously described1,2. Briefly, cancer death certification numbers by cause and estimates of the resident population in 1998, stratified by sex and quinquennia of age, were abstracted from data provided by the Istituto Nazionale di Statistica (ISTAT)3. All cancers or groups of cancers, classified according to the standard International Classification of Diseases (ICD), Ninth Revision4, were grouped in 31 categories, besides total cancer mortality and other and unspecified sites. We grouped together all intestinal sites, melanomas and non-melanomatous skin neoplasms, all uterine neoplasms (cervix and corpus), all neoplasms of the brain and nerves (benign and malignant), all leukemias, and all non-Hodgkin's lymphomas.

Eight tables were produced, including the following statistics: 1) number of deaths, crude and age-standardized death certification rates, and percentages of all cancer deaths for population at all ages and truncated 35-64 years (Table 1 for males and Table 2 for females). Two different standards were used: i) the 1971 Italian census population, corrected for census undercount and subdivided into 16 quinquennia of age from 0-4 to 75-79, plus 80 and over, and ii) the world standard population, for purposes of comparison with other countries; 2) age-specific death certification rates for each sex and quinquennium of age from 0-4 to 75-79, plus 80 and over (Table 3 for males and Table 4 for females); 3) total number of registered deaths for each cancer or group of cancers, sex and age group (Table 5 for males and Table 6 for females); 4) percentage of all cancer deaths for each sex and age group (Table 7 for males and Table 8 for females).

A few comments are included, mainly in order to assist reading and interpretation of data for major cancer sites, and to recall underlying long-term tendencies. Any inference should in any case be based on age-standardized rates, and, essentially, on detailed inspection of age-specific rates.

Cancer Mortality in Italy, 2003

Aims and Background

This report provides data and statistics for cancer mortality in Italy in 2003, updating previous work on the issue.

Methods

Cancer death certification numbers by cause and estimates of the resident population in 2003, stratified by sex and quinquennium of age, were obtained from the World Health Organization database. In 2003, cause of death encoding was changed from the 9th to the 10th Revision of the International Classification of Diseases (ICD). All cancers and groups of cancers, classified according to the 10th revision of the ICD, were grouped into 30 categories, besides other and unspecified sites. Mortality rates were age-standardized on the world standard population in five-year age groups up to 80-84 years and 85+.

Results

The total number of cancer deaths in Italy was 167,144 in 2003 (96,127 men and 71,017 women), with age-standardized death rates of 160.63 and 89.32 per 100,000 inhabitants, respectively. Lung cancer mortality in men confirmed the favorable trend, with rates of 43.72/100,000 and 51.68/100,000 in the all ages and truncated groups, respectively. Most other tobacco-related cancers were also declining in men but not in women. Cancers of the female breast and uterus (cervix and corpus) continue to decrease, with overall rates of 17.11/100,000 and 3.71/100,000. Declines were also observed in stomach and testis cancers. A few cancer sites such as prostate and multiple myeloma appeared to rise, but these trends were mainly due to the ICD change and the stricter age-standardization categories (80-84 and 85+ instead of 80+).

Conclusions

Trends in cancer mortality remained favorable for most major cancer sites, mainly in men for tobacco-related cancers. Due to the classification changes brought about by the change of ICD and the stricter age standardization, the present mortality rates should only be compared to previous ones with due caution.

Cancer Mortality in Italy, 1970–2002

Aims and background

To update previous work on Italian cancer mortality.

Methods

WHO data were used to calculate death rates for 30 cancer sites for 2002. Trends were analyzed with joinpoint regression over the 1970–2002 period.

Results

Total cancer deaths for 2002 in Italy were 163,070 (93,398 men, 69,672 women). Male cancer mortality rose until 1988 and since then has had a 1.4% yearly fall. The first cause of cancer death in males was lung cancer, accounting for 28% of deaths. The decrease in mortality from male lung cancer came about the end of the 1980's (estimated annual percentage change, EAPC, −1.26 from 1989 to 1993 and −2.32 thereafter) and was the main reason for the favorable trends in total male cancer mortality, reflecting the change in smoking prevalence in Italian males. Female total cancer mortality trends have also been favorable, with an overall yearly drop of 1.1% since 1992. The most frequent causes of cancer deaths in females were breast and colorectal cancers, accounting for 16% and 14% of cancer deaths, and both showed declining trends (EAPC, −1.80 since 1992 and −1.51 from 1993 for breast and colorectal cancers, respectively). Female lung cancer has been on the rise (EAPC, 0.82 since 1987) for the last decades due to the rise in cigarette smoking since the 1970's in Italian females.

Discussion

Mortality from the most common cancers in Italy showed a favorable trend over recent years, the maintenance and potential improvement of which would require a strategy focusing on the control of tobacco and alcohol consumption, nutrition and diet. Early diagnosis for selected neoplasms can also have a relevant impact, together with advancements in treatments.

Silencing Receptor EphA2 Enhanced Sensitivity to Lipoplatin™ in Lung Tumor and MPM Cells

Receptor EphA2 is overexpressed in lung cancer and malignant pleural mesothelioma (MPM) which promote tumorogenesis. Lipoplatin™, a new liposomal cisplatin formulation, is used against resistant tumors. Use of cisplatin-based drugs leads to unacceptable toxicities. To improve the effectiveness of Lipoplatin, enhancing the cellular sensitivity of lung tumor and MPM cells is critical. Therefore, we targeted receptor EphA2 by silencing interference RNA (siRNA) and treated tumor cells with Lipoplatin. The combined effects of siRNA-EphA2 and Lipoplatin were determined. We report that silencing EphA2 significantly enhanced the cellular sensitivity of lung tumor and MPM cells to Lipoplatin and maybe a potential therapy for lung cancer.

THEORETICAL STUDY ON THE BINDING OF THE ANTICANCER DRUGS Cis/Trans-[PtCl52(NH3){HN = C(CH3)2}] AND Cis/Trans-[PtCl2{HN = C(CH3)2}2] TO PURINE BASES

The monofunctional (the first substitution reactions) and bifunctional (the second substitution reactions) binding of the title antitumor drugs to purine bases were studied computationally by using density functional theory and IEF-PCM solvation models. For the first substitutions with guanine and adenine, our calculations demonstrate that the trans monoaqua and diaqua reactant complexes (RCs) can generate trans- or cis-monoadducts via identical or very similar trigonal-bipyramidal transition-state structures, predicting that the cis-monoadducts generated by trans RCs can subsequently close by coordination to the adjacent purine bases to form 1,2-intrastrand Pt –DNA adducts and eventually distort DNA in the same way as cisplatin. Thus it is likely that the transplatin analogues have the same mechanism of anticancer activity of cisplatin. In general, the monoaqua and diaqua monofunctional substitutions prefer guanine over adenine. The calculated lowest activation free energy in aqueous solution is 15.2 kcal/mol in the monoaqua substitutions (substituted by guanine from trans- [Pt{HN = C(CH3)2}2Cl(H2O)]+ to trans/cis-monoadduct), and 11.4 kcal/mol in the diaqua substitutions (substituted by guanine from cis- [Pt{HN = C(CH3)2}2(H2O)2]2+ to cis-monoadduct). For the second substitutions, all the reactants are started from the diaqua product complexes of the first substitutions substituted by guanine. The data obtained for the complexation energy difference between guanine and adenine RCs suggest that a thermodynamic favors the formation of GG over GA adducts by ∼ 5 - 12 kcal/mol in aqueous solution. Moreover, there is a kinetic preference for the formation of GG over GA adduct for the cis-monoadduct to cis-diadduct paths, while for the trans-monoadduct to trans-diadduct paths there is no certain trend biased toward GG adduct. In addition, the second substitutions of the trans-monoadduct to trans-diadduct paths have lower activation barriers than the corresponding cis-monoadduct to cis-diadduct paths. The lowest activation energy in the bifunctional substitutions from cis-monoadduct to cis-diadduct is 20.5 kcal/mol in the Pt (acetonimine)2GG2+ head-to-head (HH) path, while it is 17.7 kcal/mol from trans-monoadduct to trans-diadduct in the Pt(NH3) (acetonimine)GA2+ head-to-tail (HT) path. For the first and second substitutions, hydrogen-bonds play an important role in stabilizing these species.

Time trends of cancer mortality among elderly in Italy, 1970-2008: an observational study

Background

The aging of the Italian population will unavoidably lead to a growing number of persons diagnosed and living with cancer. A comprehensive description of the burden of cancer mortality among Italian elderly (65-84 years of age) in the last four decades has not been carried out yet. Cancer mortality rates were used to describe time trends between 1970-2008.

Methods

Mortality counts, provided by the Italian National Institute of Statistics, were grouped according to data availability: in quinquennia from 1970-74 through 1995-99, and in 2000-03 and 2006-08 groups. Age-standardized rates (world population) were computed by calendar periods while annual percent changes (APCs) were computed for elderly and middle aged (35-64 years) people for the period 1995-2008.

Results

The number of cancer deaths in elderly nearly doubled between 1970-74 (31,400 deaths/year in men, and 24,000 in women) and 2006-08 (63,000 deaths/year in men, and 42,000 in women). Overall cancer mortality rates peaked during the quinquennia 1985-89 and 1990-94 (about 1,500/100,000 in men and 680 in women) and declined thereafter. Throughout 1995-2008 cancer mortality rates decreased by -1.6%/year in men and -0.9%/year in women. These decreases were mainly driven by cancers of the stomach, bladder, prostate, and lung (APC = -3.3%, -2.7%, -2.5%, -2.2%, respectively) in men, and by cancers of the stomach, bladder, and breast (APC = -3.5%, -1.9%, -1.1%, respectively) in women. Conversely, increases in mortality rates between 1995 and 2008 were recorded for lung cancer (APC = +0.6%) in women, cutaneous melanoma (APC = +1.7%) in men, and pancreatic cancer (APC = +0.6% in men and +0.9% in women).

Conclusions

Overall favorable trends in cancer mortality were observed among Italian elderly between 1995 and 2008. Early diagnosis, improved efficacy of anti-cancer treatments and management of comorbidities are the most likely explanations of these positive observations. However, enduring preventive interventions against the most common risk factor (e.g. cigarette smoking), early diagnosis, and access to care should be reconsidered and extended to match the reductions of cancer mortality recorded in the elderly with those in the middle aged.

Cholesterol-based anionic long-circulating cisplatin liposomes with reduced renal toxicity

Cholesterol anchored derivatives of 5-Cholestene-3-beta-ol 3-hemisuccinate (CHO-HS) and 1-cholesteryl-4-ω-methoxy-polyethylene glycol succinate (CHO-PEG) have been synthesized via esterification and employed at various ratios with di-stearoylphosphatidylcholine (DSPC) in the preparation of anionic long-circulating nanoliposmes for cisplatin (CDDP) delivery. In the present study, CHO-HS and CHO-PEG were characterized by FTIR and (1)H NMR. The particle size and zeta potential of liposomes were determined by Dynamic lights scattering (DLS). The obtained liposomes have concentratedly distributed nanosizes around 100 nm and proper zeta potentials between -39.7 mV and -3.18 mV and good physical stability in test period of 28 days. Fine morphology of the liposomal vesicles can be observed via transmission electron microscopy (TEM). The CDDP encapsulating percentage of liposomes was 43-94% and loading efficiency was 7.5-29.3%, depending on the presence or absence of CHO-HS and CHO-PEG. In addition, the in vitro drug release behaviors, in vitro cytotoxicity against HeLa cells and 293T cells and in vivo CDDP distribution of CDDP loaded CHO-HS/CHO-PEG liposomes were evaluated. The results suggest that CHO-HS/CHO-PEG nanoliposomes represent a promising strategy for the CDDP delivery as an effective long-circulating drug carrier system which may reduce the acute renal toxicity.

Synthesis, experimental and theoretical characterization of palladium(II) and platinum(II) saccharinate complexes with 2-(2-pyridyl)benzimidazole

New palladium(II) and platinum(II) complexes of saccharinate (sac) with 2-(2-pyridyl)benzimidazole (pybim) have been synthesized and characterized by elemental analysis and spectroscopic techniques. From the experimental studies, these complexes were formulated as [Pd(pybim)(sac)2] (1), and [Pt(pybim)(sac)2]·4H2O (2). The ground-state geometries of both complexes were optimized using density functional theory (DFT) methods at the B3LYP level. A bidentate pybim ligand together with two N-coordinated sac ligands form the square-planar MN4 coordination geometry around the palladium(II) and platinum(II) ions. The calculated IR and UV-vis spectral data have been correlated to the experimental results. Thermal analysis data support the molecular structures of both complexes.

Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975

BACKGROUND

To update the pattern of cancer mortality in Europe.

MATERIALS AND METHODS

We analysed cancer mortality in 34 European countries during 2000-2004, with an overview of trends in 1975-2004 using data from the World Health Organization.

RESULTS

From 1990-1994 to 2000-2004, overall cancer mortality in the European Union declined from 185.2 to 168.0/100 000 (world standard, -9%) in men and from 104.8 to 96.9 (-8%) in women, with larger falls in middle age. Total cancer mortality trends were favourable, though to a variable degree, in all major European countries, including Russia, but not in Romania. The major determinants of these favourable trends were the decline of lung (-16%) and other tobacco-related cancers in men, together with the persistent falls in gastric cancer, and the recent appreciable falls in colorectal cancer. In women, relevant contributions came from the persistent decline in cervical cancer and the recent falls in breast cancer mortality, particularly in northern and western Europe. Favourable trends were also observed for testicular cancer, Hodgkin lymphomas, leukaemias, and other neoplasms amenable to treatment, though the reductions were still appreciably smaller in eastern Europe.

CONCLUSION

This updated analysis of cancer mortality in Europe showed a persistent favourable trend over the last years.

Cancer mortality in the European Union, 1970-2003, with a joinpoint analysis

BACKGROUND

Cancer mortality peaked in the European Union (EU) in the late 1980s and declined thereafter.

MATERIALS AND METHODS

We analyzed EU cancer mortality data provided by the World Health Organization in 1970-2003, using join point analysis.

RESULTS

Overall, cancer mortality levelled off in men since 1988 and declined in 1993-2003 (annual percent change, APC = -1.3%). In women, a steady decline has been observed since the early 1970s. The decline in male cancer mortality has been driven by lung cancer, which levelled off since the late 1980s and declined thereafter (APC = 2.7% in 1997-2003). Recent decreases were also observed for other tobacco-related cancers, as oral cavity/pharynx, esophagus, larynx and bladder, as well as for colorectal (APC = -0.9% in 1992-2003) and prostate cancers (APC = -1.0% in 1994-2003). In women, breast cancer mortality levelled off since the early 1990s and declined thereafter (APC = -1.0% in 1998-2003). Female mortality declined through the period 1970-2003 for colorectal and uterine cancer, while it increased over the last three decades for lung cancer (APC = 4.6% in 2001-2003). In both sexes, mortality declined in 1970-2003 for stomach cancer and for a few cancers amenable to treatment.

CONCLUSION

This update analysis of the mortality from cancer in the EU shows favorable patterns over recent years in both sexes.

Testicular cancer mortality in the Americas, 1980–2003

BACKGROUND

Testicular cancer is generally curable if appropriate treatment is given. Data and statistics on testicular cancer mortality over the last decades are available from the US and Canada, but are more difficult to find, in a standard and comparable format, for Central and South American countries. The objective of the study was to compare death rates and trends over the 1980-2003 period in all the American countries that provide data.

METHODS

Overall and 20 to 44 years age-standardized (world population) mortality rates from testicular cancer, derived from the World Health Organization (WHO) database, are presented for the most recent available calendar years in 10 American countries. Trends in mortality for selected countries of the Americas are also given over the period 1980-2003.

RESULTS

In the early 1980s the highest testicular cancer mortality rates were observed in Chile (1.7/100,000 at all ages, 3.6/100,000 at 20-44 years) and Argentina (0.9/100,000 at all ages, 1.7/100,000 at 20-44 years), as compared with 0.4/100,000 for all ages and 0.6/100,000 at 20 to 44 years in Canada, and 0.3/100,000 for all ages and 0.7/100,000 at 20 to 44 years in the US. In 2001-2003, testicular cancer mortality had fallen to 0.2/100,000 in men aged 20 to 44 years in Canada, and to 0.4/100,000 in the US. Conversely, rates were still 1.6/100,000 in Argentina, 2.2/100,000 in Chile and 1.2/100,000 in Mexico, and were around 0.5-0.6/100,000 in most other Latin American countries that provide data.

CONCLUSIONS

Mortality from testicular cancer in (young) men remains exceedingly high in most Latin American countries. Urgent intervention is required to provide treatment (essentially modern integrated platinum-based chemotherapy) for this largely curable neoplasm in young men.

Trends in cancer mortality in Switzerland, 1980-2001

Trends in cancer mortality in Switzerland were analysed over the period 1980-2001, on the basis of the World Health Organization database. Appropriately developed correction factors were utilized for the period before 1995, to allow for spurious trends introduced by the change between the 8th and the 10th revisions of the ICD. Steady declines in cancer mortality were observed, particularly from the mid-1980s onwards. Over the last decade, the fall in overall age-standardized (world standard) cancer mortality was 11.1% in men (from 158.1 in 1990-1991 to 140.6/100,000 in 2000-2001) and 7.6% in women (from 91.6 to 84.7/100,000), and the decline was larger in truncated rates from 35 to 64 years (-18.0 and -9.7%). In men, all major tobacco and alcohol neoplasms have declined until the late 1990s but have levelled off over the last few years, reflecting recent trends in alcohol and tobacco consumption. The fall in male lung cancer mortality was 20% over the last decade (from 42.9 to 34.3/100,000). In contrast, lung cancer mortality in women has steadily increased by 38% between 1981 and 1991 and by 47% between 1991 and 2001, to reach 10.7/100,000 at all ages and 18.3 at age 35 to 64, due to increased prevalence of smoking in subsequent generations of Swiss women. Other sites showing substantial declines include stomach and colorectum in both sexes, (cervix) uteri and breast in women. Likewise, prostate cancer showed modest favourable trends after 1995. Steady declines were observed for leukaemias, Hodgkin's disease and testicular cancer, namely, the neoplasms most influenced by therapeutic improvements, while trends in lymphomas and myeloma showed no clear pattern.

Monitoring the decrease in breast cancer mortality in Europe

Trends in mortality from breast cancer over the period 1970-2000 were analysed for 38 European countries and the European Union (EU). Age-standardized mortality rates were computed by the direct method, and joinpoint analysis was used to identify significant changes in rates. A favourable pattern in breast cancer mortality in the 25 countries of the EU (as defined in May 2004) was observed after 1989, leading to a fall in overall rates from 21.3/100,000 in 1990 to 18.9 in 2000. The annual percentage change in the EU was -2.1% between 1995 and 2000. Most northern European countries, including several Scandinavian countries and the UK, but also some central and southern European countries like Germany, Poland, the Czech Republic, Austria, Switzerland, Italy and Spain showed appreciable falls in rates (i.e. between 8 and 19% in the last 5 calendar years). The declines were larger below age 50, approaching 20% in several countries. The falls were smaller in France, Greece, Portugal and most eastern European countries. In the Russian Federation, all-age breast cancer mortality increased from 16.1 to 17.3/100,000 (+7.5% over the last 5 calendar years). These patterns reflect converging trends in breast cancer rates across Europe, which can be related to the more uniform reproductive and lifestyle habits. The fall in breast cancer mortality observed in most European countries over the last decade has to be attributed to earlier detection and improved treatment, although the definite reasons for the different trends in various countries remain at least in part unclear.

In vitro anti-leukemic and antiviral activities of traditionally used medicinal plants in Taiwan

Medicinal plants have been historically used as treatment for different kinds of human diseases. In this study, hot water (HW) extract of five Taiwanese traditionally used medicinal plants was evaluated for their in vitro anti-leukemic (including anti-K562, L1210, P3HR1, Raji and U937 leukemia cells) and antiviral (including HSV-1 and HSV-2) activities. Results showed that Blumea lacera exhibited broad anti-leukemic activity at magnitudes ranging from moderate to mild and Ixeris chinensis is effective at inhibiting the proliferation of K562 cells. B. lacera and Tithonia diversifolia suppressed the replication of HSV-1 and HSV-2, and had IC50 values below 100 microg/ml. The medicinal plants showed no cytotoxic effect at concentrations that inhibited HSV infection. It was, therefore, concluded that the HW extract of tested medicinal plants exhibited anti-leukemic and antiviral activities at different magnitudes of potency.

Trends in cancer mortality in the Americas, 1970-2000

BACKGROUND

Data and statistics on cancer mortality over the last decades are available for most developed countries, while they are more difficult to obtain, in a standardized and comparable format, for countries of Latin America.

PATIENTS AND METHODS

Age standardized (world population) mortality rates around the year 2000, derived from the WHO database, are presented for 14 selected cancers and total cancer in 10 countries of Latin America, plus, for comparative purposes, Canada and the USA. Trends in mortality are also given over the period 1970-2000.

RESULTS

In 2000, the highest total cancer mortality for males was observed in Argentina and Chile, with rates comparable to those of Canada and the USA, i.e. about 155/100,000. For women, Chile and Cuba had the highest rates in Latin America (114 and 103/100,000, respectively), again comparable to those of North America (around 105/100,000). These reflect the comparatively high mortality from cancer of the stomach (for Chile), lung and intestines (for Argentina) in men, and of stomach and uterus (for Chile), intestines and lung (for Cuba) in women. Colombia, Ecuador and Mexico had the lowest total cancer mortality for men, due to low mortality from stomach, colorectal and lung cancer. For women, the lowest rates were in Brazil and Puerto Rico, reflecting their low stomach and cervical cancer rates. In Argentina, Chile, Colombia, Costa Rica and Venezuela cancer mortality rates tended to decline, particularly in men. Rates were stable in Ecuador and Puerto Rico, and were increasing in Mexico and Cuba.

CONCLUSIONS

Mortality from some common cancers (including colorectal and lung) is still low in Latin America compared with Canada and the USA, and decreasing trends have been observed in the last decades for some cancer sites (including stomach, uterus, lung and other tobacco-related cancers) in several countries. However, mortality from female lung and breast cancers has been increasing in most countries of Latin America, and several countries still show an extremely elevated mortality from cancer of the cervix. Selected neoplasms amenable to treatment, including testis and leukemias, also show unsatisfactory trends in Latin America.

Cancer mortality in Europe, 1995-1999, and an overview of trends since 1960

Mortality data, abstracted from the World Health Organization database, are presented in tabular form for 26 cancer sites or groups of sites, plus total cancer mortality, in 36 European countries during the period 1995-1999. Trends in mortality are also given in graphic form for 23 major countries plus the European Union as a whole over the period 1960-1999. In the European Union, total cancer mortality declined by 7% for both sexes over the last 5 years considered. The fall since the late 1980s was 10% in both sexes, corresponding to the avoidance of over 90000 deaths per year, as compared to the rates of the late 1980s. For the first time, over the last few years, some leveling of mortality was reported also in the Russian Federation, the Czech Republic, Poland, Hungary and other Eastern European countries, although cancer rates in those areas remain exceedingly high. The overall favorable pattern of cancer mortality over recent years is largely driven by the decline of tobacco-related cancer mortality in men. However, important components of the trends are also the persistence of substantial falls in gastric cancer, mainly in Russia and Eastern Europe, the recent decline in intestinal cancer in both sexes and of breast cancer in women, together with the long-term falls in uterine (cervical) cancer, leukemias, Hodgkin's disease and other neoplasms amenable to advancements in diagnosis and treatment. Female lung cancer mortality has been declining in the Russian Federation, but is still rising in other areas of the continent. Thus, urgent intervention is needed to bring under control the tobacco-related lung cancer epidemic in European women before it reaches the high level observed in North America. Supplementary material for this article can be found on the International Journal of Cancer website at http://www.interscience.wiley.com/jpages/0020-7136/suppmat/index.html

Ovarian cancer in Europe: Cross-sectional trends in incidence and mortality in 28 countries, 1953-2000

We have considered trends in incidence and mortality in 28 European countries using incidence data from successive volumes of Cancer Incidence in Five Continents and mortality from the WHO database. Countries with the highest rates in the early 1960s included the Nordic countries, Austria, Germany and the United Kingdom, but trends in these areas have tended to decline over recent calendar periods, particularly with regard to mortality. Southern European countries showed upward trends, at least until the early 1980s for France and Italy. Likewise, in most central and eastern European countries, ovarian cancer incidence and mortality rates were originally relatively low, but tended to rise over time. Falls in mortality, but not in incidence, over recent years were observed in the Czech Republic and Hungary. In several countries, mainly in northern Europe, trends were more favorable at younger age (25-49 years) than in the subsequent age groups. Thus, recent trends in ovarian cancer have led to a leveling of rates across various areas of the continent, although a 2.5-fold variation was still observed in the late 1990s between the highest mortality rate of 9.3/100,000 in Denmark and the lowest one of 3.6 in Portugal. These patterns should be viewed in the light of an observed reduction in parity, mainly in southern and eastern Europe, and the spread of oral contraceptive use, mainly in northern Europe, since these are the best recognized protective factors with regard to ovarian carcinogenesis. The declining mortality trends can also in part be ascribed to improvements in treatment.

Gynaecologic concerns for young women exposed to gonadotoxic chemotherapy

PURPOSE OF REVIEW

Due to the improved long-term survival of adolescents and young women with systemic malignancies such as lymphomas and leukaemia undergoing gonadotoxic chemotherapy, preservation of future fertility has been the focus of recent ubiquitous interest. This review summarizes, in brief, the recent progress in the various attempts to prevent premature ovarian failure in these young women with unconsumed fertility potential.

RECENT FINDINGS

The investigational endeavours of ovarian cryopreservation await the clinical experience of auto- or xenotransplantation, or in-vitro maturation of thawed primordial follicles, and in-vitro fertilization. Although promising, this procedure is not available yet. Moreover, the risk of possible reimplantation of malignant stem cells with the thawed cryopreserved ovary has been highlighted following experimental animal observations. The gonadotropin-releasing hormone agonist has been efficient in primates in a prospective study, and in young women in several nonrandomized series. The disruption of the acid sphingomyelinase gene, or sphingosine-1-phosphate, in rodents can prevent follicle destruction by ionizing radiation, possibly indicating in-vivo protection in cancer patients at risk of iatrogenic sterilization.

SUMMARY

The recent enormous scientific advance lends hope that the future may hold answers to the questions regarding safety and efficiency of oocyte, follicle, or ovarian tissue cryopreservation, and the most efficient means of using the thawed tissue - auto-, hetero-, or xenotransplantation versus IVM on the one hand, and in-vivo pharmacological attempts to minimize follicle depletion by gonadotropin-releasing hormone agonist or other modalities on the other hand. Until then, a combination of all the clinically available modalities should be offered to these young women with unconsumed fertility potential who face gonadotoxic therapy.

Mortality from major cancer sites in the European Union, 1955-1998

After long-term rises, over the last decade age-standardised mortality from most common cancer sites has fallen in the European Union (EU). For males, the fall was 11% for lung and intestines, 12% for bladder, 6% for oral cavity and pharynx, and 5% for oesophagus. For females, the fall was 7% for breast and 21% for intestines. There were also persisting declines in stomach cancer (30% in both sexes), uterus (mainly cervix, -26%) and leukaemias (-10%). Mortality rates for other common neoplasms, including pancreas for both sexes, prostate and ovary, tended to stabilise. The only unfavourable trends were observed for female lung cancer (+15%). Lung cancer rates in women from the EU are approximately one-third of those in the USA, and 50% lower than breast cancer rates in the EU. Lung cancer rates in European women have also tended to stabilise below the age of 75 years. Thus, effective interventions on tobacco control could, in principle, avoid a major lung cancer epidemic in European women.