1
|
Morgan E, Arnold M, Rutherford MJ, Bardot A, Ferlay J, De P, Engholm G, Jackson C, Little A, Saint-Jacques N, Walsh P, Woods RR, O'Connell DL, Bray F, Parkin DM, Soerjomataram I. The impact of reclassifying cancers of unspecified histology on international differences in survival for small cell and non-small cell lung cancer (ICBP SurvMark-2 project). Int J Cancer 2021; 149:1013-1020. [PMID: 33932300 DOI: 10.1002/ijc.33620] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/07/2022]
Abstract
Survival from lung cancer remains low, yet is the most common cancer diagnosed worldwide. With survival contrasting between the main histological groupings, small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), it is important to assess the extent that geographical differences could be from varying proportions of cancers with unspecified histology across countries. Lung cancer cases diagnosed 2010-2014, followed until 31 December 2015 were provided by cancer registries from seven countries for the ICBP SURVMARK-2 project. Multiple imputation was used to reassign cases with unspecified histology into SCLC, NSCLC and other. One-year and three-year age-standardised net survival were estimated by histology, sex, age group and country. In all, 404 617 lung cancer cases were included, of which 47 533 (11.7%) and 262 040 (64.8%) were SCLC and NSCLC. The proportion of unspecified cases varied, from 11.2% (Denmark) to 29.0% (The United Kingdom). After imputation with unspecified histology, survival variations remained: 1-year SCLC survival ranged from 28.0% (New Zealand) to 35.6% (Australia) NSCLC survival from 39.4% (The United Kingdom) to 49.5% (Australia). The largest survival change after imputation was for 1-year NSCLC (4.9 percentage point decrease). Similar variations were observed for 3-year survival. The oldest age group had lowest survival and largest decline after imputation. International variations in SCLC and NSCLC survival are only partially attributable to differences in the distribution of unspecified histology. While it is important that registries and clinicians aim to improve completeness in classifying cancers, it is likely that other factors play a larger role, including underlying risk factors, stage, comorbidity and care management which warrants investigation.
Collapse
Affiliation(s)
- Eileen Morgan
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Melina Arnold
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mark J Rutherford
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Aude Bardot
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Prithwish De
- Analytics and Informatics, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | | | - Alana Little
- Cancer Institute NSW, Alexandria, New South Wales, Australia
| | - Nathalie Saint-Jacques
- Nova Scotia Health Authority Cancer Care Program, Registry & Analytics, Halifax, Nova Scotia, Canada
| | - Paul Walsh
- National Cancer Registry Ireland, Cork Airport Business Park, Cork, Ireland
| | | | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - D Max Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | |
Collapse
|
2
|
Andersson TML, Myklebust TÅ, Rutherford MJ, Møller B, Soerjomataram I, Arnold M, Bray F, Parkin DM, Sasieni P, Bucher O, De P, Engholm G, Gavin A, Little A, Porter G, Ramanakumar AV, Saint-Jacques N, Walsh PM, Woods RR, Lambert PC. The impact of excluding or including Death Certificate Initiated (DCI) cases on estimated cancer survival: A simulation study. Cancer Epidemiol 2021; 71:101881. [PMID: 33440295 DOI: 10.1016/j.canep.2020.101881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/26/2020] [Accepted: 12/24/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Population-based cancer registries strive to cover all cancer cases diagnosed within the population, but some cases will always be missed and no register is 100 % complete. Many cancer registries use death certificates to identify additional cases not captured through other routine sources, to hopefully add a large proportion of the missed cases. Cases notified through this route, who would not have been captured without death certificate information, are referred to as Death Certificate Initiated (DCI) cases. Inclusion of DCI cases in cancer registries increases completeness and is important for estimating cancer incidence. However, inclusion of DCI cases will generally lead to biased estimates of cancer survival, but the same is often also true if excluding DCI cases. Missed cases are probably not a random sample of all cancer cases, but rather cases with poor prognosis. Further, DCI cases have poorer prognosis than missed cases in general, since they have all died with cancer mentioned on the death certificates. METHODS We performed a simulation study to estimate the impact of including or excluding DCI cases on cancer survival estimates, under different scenarios. RESULTS We demonstrated that including DCI cases underestimates survival. The exclusion of DCI cases gives unbiased survival estimates if missed cases are a random sample of all cancer cases, while survival is overestimated if these have poorer prognosis. CONCLUSION In our most extreme scenarios, with 25 % of cases initially missed, the usual practice of including DCI cases underestimated 5-year survival by at most 3 percentage points.
Collapse
Affiliation(s)
- Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Mark J Rutherford
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Bjørn Møller
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Isabelle Soerjomataram
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Melina Arnold
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - D Max Parkin
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Peter Sasieni
- King's College London, Clinical Trials Unit, London, United Kingdom
| | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Prithwish De
- Analytics and Informatics, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Gerda Engholm
- Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Alana Little
- Cancer Institute NSW, Alexandria, NSW, Australia
| | - Geoff Porter
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada
| | | | - Nathalie Saint-Jacques
- Nova Scotia Health Cancer Care Program, Registry & Analytics, Halifax, Nova Scotia, Canada
| | | | - Ryan R Woods
- Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada
| | - Paul C Lambert
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| |
Collapse
|
3
|
Andersson TML, Rutherford MJ, Myklebust TÅ, Møller B, Soerjomataram I, Arnold M, Bray F, Parkin DM, Sasieni P, Bucher O, De P, Engholm G, Gavin A, Little A, Porter G, Ramanakumar AV, Saint-Jacques N, Walsh PM, Woods RR, Lambert PC. Exploring the impact of cancer registry completeness on international cancer survival differences: a simulation study. Br J Cancer 2021; 124:1026-1032. [PMID: 33293692 PMCID: PMC7921088 DOI: 10.1038/s41416-020-01196-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/13/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Data from population-based cancer registries are often used to compare cancer survival between countries or regions. The ICBP SURVMARK-2 study is an international partnership aiming to quantify and explore the reasons behind survival differences across high-income countries. However, the magnitude and relevance of differences in cancer survival between countries have been questioned, as it is argued that observed survival variations may be explained, at least in part, by differences in cancer registration practice, completeness and the availability and quality of the respective data sources. METHODS As part of the ICBP SURVMARK-2 study, we used a simulation approach to better understand how differences in completeness, the characteristics of those missed and inclusion of cases found from death certificates can impact on cancer survival estimates. RESULTS Bias in 1- and 5-year net survival estimates for 216 simulated scenarios is presented. Out of the investigated factors, the proportion of cases not registered through sources other than death certificates, had the largest impact on survival estimates. CONCLUSION Our results show that the differences in registration practice between participating countries could in our most extreme scenarios explain only a part of the largest observed differences in cancer survival.
Collapse
Affiliation(s)
- Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Mark J Rutherford
- Department of Health Sciences, University of Leicester, Leicester, UK
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Bjørn Møller
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Isabelle Soerjomataram
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Melina Arnold
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - D Max Parkin
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Peter Sasieni
- King's College London, Clinical Trials Unit, London, UK
| | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Prithwish De
- Analytics and Informatics, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Gerda Engholm
- Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Northern Ireland, UK
| | - Alana Little
- Cancer Institute NSW, Alexandria, NSW, Australia
| | - Geoff Porter
- Canadian Partnership Against Cancer, Toronto, ON, Canada
| | | | - Nathalie Saint-Jacques
- Nova Scotia Health Authority Cancer Care Program, Registry & Analytics, Halifax, NS, Canada
| | - Paul M Walsh
- National Cancer Registry, Ireland, Cork, Ireland
| | - Ryan R Woods
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Paul C Lambert
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Health Sciences, University of Leicester, Leicester, UK
| |
Collapse
|
4
|
Gupta S, Aitken J, Bartels U, Bhakta N, Bucurenci M, Brierley JD, De Camargo B, Chokunonga E, Clymer J, Coza D, Fraser C, Fuentes-Alabi S, Gatta G, Gross T, Jakab Z, Kohler B, Kutluk T, Moreno F, Nakata K, Nur S, Parkin DM, Penberthy L, Pole J, Poynter JN, Pritchard-Jones K, Ramirez O, Renner L, Steliarova-Foucher E, Sullivan M, Swaminathan R, Van Eycken L, Vora T, Frazier AL. Development of paediatric non-stage prognosticator guidelines for population-based cancer registries and updates to the 2014 Toronto Paediatric Cancer Stage Guidelines. Lancet Oncol 2020; 21:e444-e451. [PMID: 32888473 DOI: 10.1016/s1470-2045(20)30320-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 12/24/2022]
Abstract
Population-based cancer registries (PBCRs) generate measures of cancer incidence and survival that are essential for cancer surveillance, research, and cancer control strategies. In 2014, the Toronto Paediatric Cancer Stage Guidelines were developed to standardise how PBCRs collect data on the stage at diagnosis for childhood cancer cases. These guidelines have been implemented in multiple jurisdictions worldwide to facilitate international comparative studies of incidence and outcome. Robust stratification by risk also requires data on key non-stage prognosticators (NSPs). Key experts and stakeholders used a modified Delphi approach to establish principles guiding paediatric cancer NSP data collection. With the use of these principles, recommendations were made on which NSPs should be collected for the major malignancies in children. The 2014 Toronto Stage Guidelines were also reviewed and updated where necessary. Wide adoption of the resultant Paediatric NSP Guidelines and updated Toronto Stage Guidelines will enhance the harmonisation and use of childhood cancer data provided by PBCRs.
Collapse
Affiliation(s)
- Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
| | | | - Ute Bartels
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nickhill Bhakta
- Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | | | - James D Brierley
- Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON, Canada
| | - Beatriz De Camargo
- Research Centre, National Cancer Institute National Cancer Institute, Rio de Janeiro, Brazil
| | | | - Jessica Clymer
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Dana Coza
- Romanian National Child Cancer Registry, Constanta, Romania
| | - Chris Fraser
- Department of Oncology, Children's Health Queensland Hospital, South Brisbane, QLD, Australia
| | | | | | - Thomas Gross
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | - Zsuzsanna Jakab
- Hungarian Childhood Cancer Registry, Semmelweis University, Budapest, Hungary
| | - Betsy Kohler
- North American Association of Central Cancer Registries, Springfield, IL, USA
| | - Tezer Kutluk
- Department of Paediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | | | - Kayo Nakata
- Cancer Control Centre, Osaka International Cancer Institute, Osaka, Japan
| | - Sari Nur
- Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jawa Barat, Indonesia
| | - D M Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK; Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Lynne Penberthy
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | - Jason Pole
- Pediatric Group of Ontario, Toronto, ON, Canada
| | - Jenny N Poynter
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | | | - Oscar Ramirez
- Centro Médico Imbanaco, Cali, Valle del Cauca, Colombia
| | - Lorna Renner
- University of Ghana School of Medicine, Accra, Ghana
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Michael Sullivan
- Faculty of Medicine, University of Melbourne, Parkville, VIC, Australia
| | | | | | - Tushar Vora
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A L Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| |
Collapse
|
5
|
Arnold M, Rutherford MJ, Bardot A, Ferlay J, Andersson TML, Myklebust TÅ, Tervonen H, Thursfield V, Ransom D, Shack L, Woods RR, Turner D, Leonfellner S, Ryan S, Saint-Jacques N, De P, McClure C, Ramanakumar AV, Stuart-Panko H, Engholm G, Walsh PM, Jackson C, Vernon S, Morgan E, Gavin A, Morrison DS, Huws DW, Porter G, Butler J, Bryant H, Currow DC, Hiom S, Parkin DM, Sasieni P, Lambert PC, Møller B, Soerjomataram I, Bray F. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995-2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019; 20:1493-1505. [PMID: 31521509 PMCID: PMC6838671 DOI: 10.1016/s1470-2045(19)30456-5] [Citation(s) in RCA: 558] [Impact Index Per Article: 111.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/11/2019] [Accepted: 06/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Population-based cancer survival estimates provide valuable insights into the effectiveness of cancer services and can reflect the prospects of cure. As part of the second phase of the International Cancer Benchmarking Partnership (ICBP), the Cancer Survival in High-Income Countries (SURVMARK-2) project aims to provide a comprehensive overview of cancer survival across seven high-income countries and a comparative assessment of corresponding incidence and mortality trends. METHODS In this longitudinal, population-based study, we collected patient-level data on 3·9 million patients with cancer from population-based cancer registries in 21 jurisdictions in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the UK) for seven sites of cancer (oesophagus, stomach, colon, rectum, pancreas, lung, and ovary) diagnosed between 1995 and 2014, and followed up until Dec 31, 2015. We calculated age-standardised net survival at 1 year and 5 years after diagnosis by site, age group, and period of diagnosis. We mapped changes in incidence and mortality to changes in survival to assess progress in cancer control. FINDINGS In 19 eligible jurisdictions, 3 764 543 cases of cancer were eligible for inclusion in the study. In the 19 included jurisdictions, over 1995-2014, 1-year and 5-year net survival increased in each country across almost all cancer types, with, for example, 5-year rectal cancer survival increasing more than 13 percentage points in Denmark, Ireland, and the UK. For 2010-14, survival was generally higher in Australia, Canada, and Norway than in New Zealand, Denmark, Ireland, and the UK. Over the study period, larger survival improvements were observed for patients younger than 75 years at diagnosis than those aged 75 years and older, and notably for cancers with a poor prognosis (ie, oesophagus, stomach, pancreas, and lung). Progress in cancer control (ie, increased survival, decreased mortality and incidence) over the study period was evident for stomach, colon, lung (in males), and ovarian cancer. INTERPRETATION The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, international disparities persist. While truly valid comparisons require differences in registration practice, classification, and coding to be minimal, stage of disease at diagnosis, timely access to effective treatment, and the extent of comorbidity are likely the main determinants of patient outcomes. Future studies are needed to assess the impact of these factors to further our understanding of international disparities in cancer survival. FUNDING Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; National Health Service England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; and Wales Cancer Network.
Collapse
Affiliation(s)
- Melina Arnold
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
| | - Mark J Rutherford
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France; Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Aude Bardot
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Jacques Ferlay
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | | | - Vicky Thursfield
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
| | - David Ransom
- WA Cancer and Palliative Care Network Policy Unit, Health Networks Branch, Department of Health, Perth, WA, Australia
| | - Lorraine Shack
- Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada
| | | | - Donna Turner
- Population Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
| | | | - Susan Ryan
- Newfoundland Cancer Registry, Cancer Care Program - Eastern Health, Dr H Bliss Murphy Cancer Centre, St John's, Newfoundland, NL, Canada
| | - Nathalie Saint-Jacques
- Nova Scotia Health Authority Cancer Care Program, Registry & Analytics, Halifax, NS, Canada
| | - Prithwish De
- Surveillance and Cancer Registry, Cancer Care Ontario, Toronto, ON, Canada
| | - Carol McClure
- Prince Edward Island Cancer Registry, Charlottetown, PE, Canada
| | | | | | | | | | | | - Sally Vernon
- National Cancer Registration and Analysis Service, Public Health England, Cambridge, UK
| | - Eileen Morgan
- Northern Ireland Cancer Registry, Queen's University Belfast, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, UK
| | - David S Morrison
- Scottish Cancer Registry, Information Services Division, National Health Services Scotland, Edinburgh, UK
| | - Dyfed W Huws
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, UK
| | - Geoff Porter
- Canadian Partnership Against Cancer, Toronto, ON, Canada
| | | | - Heather Bryant
- Canadian Partnership Against Cancer, Toronto, ON, Canada
| | | | | | - D Max Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Peter Sasieni
- King's College London, Clinical Trials Unit, London, UK
| | - Paul C Lambert
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bjørn Møller
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Isabelle Soerjomataram
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| |
Collapse
|
6
|
Griesel M, Parkin DM, Thomssen C, Kantelhardt EJ. Cervical Cancer in Sub-Saharan Africa – a multinational population-based study on treatment guideline adherence. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1692081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- M Griesel
- Universitätsklinik und Poliklinik für Gynäkologie und Institut für Med. Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg
| | - DM Parkin
- Universitätsklinik und Poliklinik für Gynäkologie und Institut für Med. Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg
| | - C Thomssen
- Universitätsklinik und Poliklinik für Gynäkologie und Institut für Med. Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg
| | - EJ Kantelhardt
- Universitätsklinik und Poliklinik für Gynäkologie und Institut für Med. Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg
| |
Collapse
|
7
|
Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, Znaor A, Bray F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2018; 144:1941-1953. [PMID: 30350310 DOI: 10.1002/ijc.31937] [Citation(s) in RCA: 4293] [Impact Index Per Article: 715.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 12/24/2022]
Abstract
Estimates of the worldwide incidence and mortality from 36 cancers and for all cancers combined for the year 2018 are now available in the GLOBOCAN 2018 database, compiled and disseminated by the International Agency for Research on Cancer (IARC). This paper reviews the sources and methods used in compiling the cancer statistics in 185 countries. The validity of the national estimates depends upon the representativeness of the source information, and to take into account possible sources of bias, uncertainty intervals are now provided for the estimated sex- and site-specific all-ages number of new cancer cases and cancer deaths. We briefly describe the key results globally and by world region. There were an estimated 18.1 million (95% UI: 17.5-18.7 million) new cases of cancer (17 million excluding non-melanoma skin cancer) and 9.6 million (95% UI: 9.3-9.8 million) deaths from cancer (9.5 million excluding non-melanoma skin cancer) worldwide in 2018.
Collapse
Affiliation(s)
- J Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon Cedex, 08, France
| | - M Colombet
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon Cedex, 08, France
| | - I Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon Cedex, 08, France
| | - C Mathers
- Mortality and Health Analysis, World Health Organization, Geneva, Switzerland
| | - D M Parkin
- Clinical Trial Service Unit & Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom
| | - M Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon Cedex, 08, France
| | - A Znaor
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon Cedex, 08, France
| | - F Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon Cedex, 08, France
| |
Collapse
|
8
|
Griesel M, Feuchtner J, Seraphin T, Hämmerl L, Mezger N, Korir A, Wabinga H, Thomssen C, Wienke A, Parkin DM, Kantelhardt EJ. Cervical cancer in Sub-Saharan Africa: a multinational population-based study on patterns of care. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Griesel
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - J Feuchtner
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - T Seraphin
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - L Hämmerl
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - N Mezger
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - A Korir
- Kenya Medical Research Institute, Nairobi Cancer Registry, Nairobi, Kenia
| | - H Wabinga
- Department of Pathology, Makerere University, Kampala, Uganda
- Kampala Cancer Registry, Makerere University, Kampala, Uganda
| | - C Thomssen
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - A Wienke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - DM Parkin
- African Cancer Registry Network, Oxford, Vereinigtes Königreich
- Clinical Trials Service Unit & Epidemiological Studies Unit, University of Oxford, Oxford, Vereinigtes Königreich
| | - EJ Kantelhardt
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| |
Collapse
|
9
|
Abstract
The present study reports on the analysis of cancer mortality in Italian first-generation migrants resident in Canada, deceased in the period between 1964-1985 (5,801 males: 3,267 females). Mortality in migrants is compared to that of the host population as well as to that in the migrants’ country of origin. This is carried out both on a national level (Italy), and on a regional level with those regions that have made the greatest contribution to the Italian migratory flow (Southern Italy). Compared with the Canada-born population, significantly higher risks were evident for nasopharynx, stomach, liver and gallbladder tumors in migrants. Lower risks were observed for the oral cavity, esophagus, colon, rectum, pancreas (females), larynx, lung, melanoma, breast, ovary, prostate, bladder (females), and non-Hodgkin's lymphoma in migrants. This is consistent with that evidenced in the comparison between Italy and Canada. The data are discussed in relation to the results of other studies on Italian migrants and the prevalence of main risk factors.
Collapse
Affiliation(s)
- M Geddes
- National Institute for Cancer Research, Genoa, Italy
| | | | | | | | | |
Collapse
|
10
|
Whiteman DC, Webb PM, Green AC, Neale RE, Fritschi L, Bain CJ, Parkin DM, Wilson LF, Olsen CM, Nagle CM, Pandeya N, Jordan SJ, Antonsson A, Kendall BJ, Hughes MCB, Ibiebele TI, Miura K, Peters S, Carey RN. Cancers in Australia in 2010 attributable to modifiable factors: introduction and overview. Aust N Z J Public Health 2016; 39:403-7. [PMID: 26437722 PMCID: PMC4606764 DOI: 10.1111/1753-6405.12468] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/01/2015] [Accepted: 07/01/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To describe the approach underpinning a national project to estimate the numbers and proportions of cancers occurring in Australia in 2010 that are attributable to modifiable causal factors. METHODS We estimated the population attributable fraction (PAF) (or prevented fraction) of cancers associated with exposure to causal (or preventive) factors using standard formulae. Where possible, we also estimated the potential impact on cancer incidence resulting from changes in prevalence of exposure. Analyses were restricted to factors declared causal by international agencies: tobacco smoke; alcohol; solar radiation; infectious agents; obesity; insufficient physical activity; insufficient intakes of fruits, vegetables and fibre; red and processed meat; menopausal hormone therapy (MHT); oral contraceptive pill (OCP); and insufficient breast feeding. Separately, we estimated numbers of cancers prevented by: aspirin; sunscreen; MHT; and OCP use. We discuss assumptions pertaining to latent periods between exposure and cancer onset, choices of prevalence data and risk estimates, and approaches to sensitivity analyses. RESULTS Numbers and population attributable fractions of cancer are presented in accompanying papers. CONCLUSIONS This is the first systematic assessment of population attributable fractions of cancer in Australia.
Collapse
Affiliation(s)
- David C Whiteman
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland.,Cancer Research UK, Manchester Institute and Institute of Inflammation and Repair, University of Manchester, United Kingdom
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Lin Fritschi
- School of Public Health, Curtin University, Western Australia
| | - Christopher J Bain
- QIMR Berghofer Medical Research Institute, Queensland.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australian Capital Territory
| | - D Max Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom
| | | | - Catherine M Olsen
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Christina M Nagle
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Nirmala Pandeya
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Susan J Jordan
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | | | - Bradley J Kendall
- QIMR Berghofer Medical Research Institute, Queensland.,School of Medicine, The University of Queensland
| | | | | | - Kyoko Miura
- QIMR Berghofer Medical Research Institute, Queensland
| | - Susan Peters
- Occupational Respiratory Epidemiology, School of Population Health, The University of Western Australia
| | - Renee N Carey
- School of Public Health, Curtin University, Western Australia
| |
Collapse
|
11
|
Whiteman DC, Webb PM, Green AC, Neale RE, Fritschi L, Bain CJ, Parkin DM, Wilson LF, Olsen CM, Nagle CM, Pandeya N, Jordan SJ, Antonsson A, Kendall BJ, Hughes MCB, Ibiebele TI, Miura K, Peters S, Carey RN. Cancers in Australia in 2010 attributable to modifiable factors: summary and conclusions. Aust N Z J Public Health 2016; 39:477-84. [PMID: 26437735 PMCID: PMC4606779 DOI: 10.1111/1753-6405.12471] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/01/2015] [Accepted: 07/01/2015] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To estimate the numbers and proportions of cancers occurring in Australia in 2010 attributable to modifiable causal factors. METHODS We estimated the population attributable fraction (PAF) of cancers associated with exposure to 13 causal factors using standard formulae incorporating exposure prevalence and relative risk data. We also calculated the potential impact of changing exposure to some factors. RESULTS A total of 32% of all cancers diagnosed in Australia in 2010 (excluding keratinocyte cancers) were attributable to the 13 factors assessed (men 33%; women 31%). Leading factors were tobacco smoke (PAF all cancers: 13.4%), solar radiation (6.2%), inadequate diet (6.1%) and overweight/obesity (3.4%). Factors conferring highest PAFs differed by sex: highest PAFs for men were tobacco smoke (15.8%), solar radiation (7.1%) and alcohol (3.0%); while highest PAFs for women were tobacco smoke (10.1%), solar radiation (5.0%) and overweight/obesity (4.5%). Sites with the highest counts of potentially preventable cancers were lung (8,569), colorectal (7,404), melanoma of the skin (7,220) and breast (3,233). CONCLUSIONS At least one in three cancers in Australia is attributable to exposure to known modifiable factors. IMPLICATIONS Up to 37,000 cancers could be prevented in Australia each year if the population avoided exposure to 13 common factors known or strongly suspected to cause cancer.
Collapse
Affiliation(s)
- David C Whiteman
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland.,Cancer Research UK, Manchester Institute and Institute of Inflammation and Repair, University of Manchester, United Kingdom
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Lin Fritschi
- School of Public Health, Curtin University, Western Australia
| | - Christopher J Bain
- QIMR Berghofer Medical Research Institute, Queensland.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australian Capital Territory
| | - D Max Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom
| | | | - Catherine M Olsen
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Christina M Nagle
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Nirmala Pandeya
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Susan J Jordan
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | | | - Bradley J Kendall
- QIMR Berghofer Medical Research Institute, Queensland.,School of Medicine, The University of Queensland
| | | | | | - Kyoko Miura
- QIMR Berghofer Medical Research Institute, Queensland
| | - Susan Peters
- Occupational Respiratory Epidemiology, School of Population Health, The University of Western Australia
| | - Renee N Carey
- School of Public Health, Curtin University, Western Australia
| |
Collapse
|
12
|
Abstract
Objectives: To investigate the effectiveness of screening for liver cancer in reducing mortality from the disease in a high-risk population in China. Setting: A randomised controlled trial was carried out among men aged 30-69 who were chronic carriers of hepatitis-B virus (HBsAg positive) during the period 1989-1995 in Qidong county, Jiangsu Province, China. Methods: 5581 HBsAg carriers were identified by population screening and randomly assigned to a screening group (group A, 3712 men), and controls (group B, 1869 men). Screening was planned to be six monthly alpha-fetoprotein (AFP) assays, with follow-up of subjects having an abnormal (≥20 μg/l) test. All subjects were followed up for liver cancer and/or death until 31 December 1995. Results: The overall sensitivity and specificity of the programme was 55.3% and 86.5%, respectively; in subjects who complied with all scheduled screening tests, the values were 80.0% and 80.9%. Three hundred and seventy-four primary liver cancer (PLC) cases were diagnosed. The percentage of cases in stage I was significantly higher in group A (29.6%) than in group B (6.0%). The one-, three-, and five-year relative survival rates were 23.7%, 7.0%, and 4.0% in group A, and 9.7%, 4.0%, and 4.1% in group B respectively, with no difference in five-year survival between the groups. The mortality rate in the screened group (1138 per 100,000 person-years) was not significantly different from that in the controls (1114 per 100,000). A Poisson regression model showed that the probability of death (rate ratio) in the screening group was 0.83 (95% CI 0.68-1.03) relative to the control group. Conclusions: Screening with AFP resulted in earlier diagnosis of liver cancer, but the gain in lead time did not result in any overall reduction in mortality, because therapy for the patients found by screening was ineffective. Further studies using improved methods of screening, diagnosis and treatment are indicated.
Collapse
Affiliation(s)
- J-G Chen
- Qidong Liver Cancer Institute, Qidong, Jiangsu, China
| | | | | | | | | | | | | |
Collapse
|
13
|
Cheng ML, Zhang L, Borok M, Chokunonga E, Dzamamala C, Korir A, Wabinga HR, Hiatt RA, Parkin DM, Van Loon K. The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot? Cancer Epidemiol 2015; 39:143-9. [PMID: 25662402 PMCID: PMC4470609 DOI: 10.1016/j.canep.2015.01.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 01/06/2015] [Accepted: 01/08/2015] [Indexed: 12/15/2022]
Abstract
The incidence of oesophageal cancer (OC) varies geographically, with more than 80% of cases and deaths worldwide occurring in developing countries. The aim of this study is to characterize the disease burden of OC in four urban populations in Eastern Africa, which may represent a previously undescribed high-incidence area. Data on all cases of OC diagnosed between 2004 and 2008 were obtained from four population-based cancer registries in: Blantyre, Malawi; Harare, Zimbabwe; Kampala, Uganda; and Nairobi, Kenya. Age-standardized incidence rates (ASRs) were calculated for each population, and descriptive statistics for incident cases were determined. In Blantyre, 351 male (59%) and 239 (41%) female cases were reported, with ASRs of 47.2 and 30.3. In Harare, 213 male (61%) and 134 (39%) female cases were reported, with ASRs of 33.4 and 25.3, respectively. In Kampala, 196 male (59%) and 137 female (41%) cases were reported, with ASRs of 36.7 and 24.8. In Nairobi, 323 male (57%) and 239 female (43%) cases were reported, with ASRs of 22.6 and 21.6. Median age at diagnosis was significantly different among the four populations, ranging from 50 years in Blantyre to 65 years in Harare (p<0.0001). Except in Nairobi, incidence among males was significantly higher than among females (p<0.01). Squamous cell OC was the predominant histologic subtype at all sites. ASRs at all four sites were remarkably higher than the mean worldwide ASR. Investigation to evaluate potential etiologic effects of dietary, lifestyle, environmental, and other factors impacting the incidence in this region is needed.
Collapse
Affiliation(s)
- Michael L Cheng
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | - Li Zhang
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | | | | | | | - Anne Korir
- Nairobi Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya
| | - Henry R Wabinga
- Kampala Cancer Registry, Makerere University, Kampala, Uganda
| | - Robert A Hiatt
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | | | - Katherine Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States.
| |
Collapse
|
14
|
Chokunonga E, Borok MZ, Chirenje ZM, Nyakabau AM, Parkin DM. Trends in the incidence of cancer in the black population of Harare, Zimbabwe 1991-2010. Int J Cancer 2013; 133:721-9. [PMID: 23364833 DOI: 10.1002/ijc.28063] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 01/09/2013] [Indexed: 12/15/2022]
Abstract
Incidence rates of different cancers have been calculated for the black population of Harare, Zimbabwe for a 20-year period (1991-2010) coinciding with continuing social and lifestyle changes, and the peak, and subsequent wane, of the HIV-AIDS epidemic. The overall risk of cancer increased during the period in both sexes, with rates of cervix and prostate cancers showing particularly dramatic increases (3.3% and 6.4% annually, respectively). By 2004, prostate cancer had become the most common cancer of men. The incidence of cancer of the esophagus, formerly the most common cancer of men, has remained relatively constant, whereas rates of breast and cervix cancers, the most common malignancies of women, have shown significant increases (4.9% and 3.3% annually, respectively). The incidence of Kaposi sarcoma increased to a maximum around 1998-2000 and then declined in all age groups, and in both sexes The incidence of squamous cell cancers of the conjunctiva is relatively high, with temporal trends similar to those of Kaposi sarcoma. Non-Hodgkin lymphoma, the fifth most common cancer of men and fourth of women, showed a steady increase in incidence throughout the period (6.7-6.9% annually), although rates in young adults (15-39) have decreased since 2001. Cancer control in Zimbabwe, as elsewhere in sub-Saharan Africa, involves meeting the challenge of emerging cancers associated with westernization of lifestyles (large bowel, breast and prostate), while the incidence of cancers associated with poverty and infection (liver, cervix and esophagus) shows little decline, and the residual burden of the AIDS-associated cancers remains significant.
Collapse
Affiliation(s)
- E Chokunonga
- Zimbabwe National Cancer Registry, Harare, Zimbabwe
| | | | | | | | | |
Collapse
|
15
|
Abstract
The overall objective of the study is to estimate the percentage of cancers
(excluding non-melanoma skin cancer) in the UK in 2010 that were the result of
exposure to 14 major lifestyle, dietary and environmental risk factors: tobacco,
alcohol, four elements of diet (consumption of meat, fruit and vegetables, fibre
and salt), overweight, lack of physical exercise, occupation, infections,
radiation (ionising and solar), use of hormones and reproductive history (breast
feeding). The number of new cases attributable to suboptimal exposure levels in
the past, relative to a theoretical optimum exposure distribution, is evaluated.
For most of the exposures, the attributable fraction was calculated based on the
distribution of exposure prevalence (around 2000), the difference from the
theoretical optimum (by age group and sex) and the relative risk per unit
difference. For tobacco smoking, the method developed by Peto et al (1992) was used, which relies on the ratio
between observed incidence of lung cancer in smokers and that in non-smokers, to
calibrate the risk. This article outlines the structure of the supplement
– a section for each of the 14 exposures, followed by a Summary chapter,
which considers the relative contributions of each factor to the total number of
cancers diagnosed in the UK in 2010 that were, in theory, avoidable.
Collapse
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
16
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
17
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
18
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
19
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
20
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
21
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
22
|
Abstract
This chapter summarises the results of the preceding sections, which estimate the fraction of cancers occurring in the UK in 2010 that can be attributed to sub-optimal, past exposures of 14 lifestyle and environmental risk factors. For each of 18 cancer types, we present the percentage of cases attributable to one or all of the risk factors considered (tobacco, alcohol, four elements of diet (consumption of meat, fruit and vegetables, fibre, and salt), overweight, lack of physical exercise, occupation, infections, radiation (ionising and solar), use of hormones, and reproductive history (breast feeding)).Exposure to less than optimum levels of the 14 factors was responsible for 42.7% of cancers in the UK in 2010 (45.3% in men, 40.1% in women)--a total of about 134,000 cases.Tobacco smoking is by far the most important risk factor for cancer in the UK, responsible for 60, 000 cases (19.4% of all new cancer cases) in 2010. The relative importance of other exposures differs by sex. In men, deficient intake of fruits and vegetables (6.1%), occupational exposures (4.9%) and alcohol consumption (4.6%) are next in importance, while in women, it is overweight and obesity (because of the effect on breast cancer)--responsible for 6.9% of cancers, followed by infectious agents (3.7%).Population-attributable fractions provide a valuable quantitative appraisal of the impact of different factors in cancer causation, and are thus helpful in prioritising cancer control strategies. However, quantifying the likely impact of preventive interventions requires rather complex scenario modelling, including specification of realistically achievable population distributions of risk factors, and the timescale of change, as well as the latent periods between exposure and outcome, and the rate of change following modification in exposure level.
Collapse
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| | | | | |
Collapse
|
23
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| | | |
Collapse
|
24
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| |
Collapse
|
25
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London,Charterhouse Square, London, UK.
| |
Collapse
|
26
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| | | |
Collapse
|
27
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| | | |
Collapse
|
28
|
Affiliation(s)
- D M Parkin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
| | | | | |
Collapse
|
29
|
Abstract
Background: Projections of cancer incidence are important for planning health services and to provide a baseline for assessing the impact of public health interventions. Methods: Rates estimated from smooth function age–period–cohort modelling of cancer incidence data from Great Britain 1975 to 2007 are extrapolated to 2030 and applied to UK population projections. Prostate and breast cancer projections take into account the effect of screening. Results: Overall rates of cancer are projected to be stable over the next 20 years, but this masks individual changes. In both sexes, age-standardised rates of cancers of the stomach, larynx, bladder and leukaemia are projected to fall by ⩾1% per year, whereas cancers of the lip, mouth and pharynx (ICD-10 C00-C14) and melanoma are projected to increase by ⩾1% per year. The growing and aging populations will have a substantial impact: numbers of cancers in men and women are projected to increase by 55% (from 149 169 to 231 026) and 35% (from 148 716 to 200 929), respectively, between 2007 and 2030. The model used yields similar results to those of Nordpred, but is more flexible. Conclusion: Without new initiatives for smoking and obesity reduction, the number of cancers in the United Kingdom will increase substantially reflecting the growing and aging populations.
Collapse
Affiliation(s)
- M Mistry
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | | | | | | |
Collapse
|
30
|
Wabinga H, Parkin DM, Nambooze S, Amero J. Cancer survival in Kampala, Uganda, 1993-1997. IARC Sci Publ 2011:243-247. [PMID: 21675429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The Kampala cancer registry was established in 1954 as a population-based cancer registry, and registration of cases is done by active methods. The registry contributed data on survival for 15 cancer sites or types registered in 1993-1997. For Kaposi sarcoma, only a random sample of the total incident cases was provided for survival study. Follow-up has been carried out predominantly by active methods, with median follow-up ranging from 4-26 months. The proportion with histologically verified diagnosis for various cancers ranged between 36-83%; death certificate only (DCO) cases were negligible; 58-92% of total registered cases were included for survival analysis. Complete follow-up at five years ranged between 47-87% for different cancers. Five-year age-standardized relative survival rates for selected cancers were Kaposi sarcoma (22%), cervix (19%), oesophagus (5%), non-Hodgkin lymphoma (26%), breast (36%) and prostate (46%). None survived beyond 5 years for cancers of the stomach and lung. Five-year relative survival by age group was fluctuating with no definite pattern or trend emerging and no survivors in many age intervals.
Collapse
Affiliation(s)
- H Wabinga
- Kampala Cancer Registry, Department of Pathology, Makerere University Faculty of Medicine, Kampala, Uganda.
| | | | | | | |
Collapse
|
31
|
Chokunonga E, Borok MZ, Chirenje ZM, Nyabakau AM, Parkin DM. Cancer survival in Harare, Zimbabwe, 1993-1997. IARC Sci Publ 2011:249-255. [PMID: 21675430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The Zimbabwe national cancer registry was established in 1985 as a population-based cancer registry covering Harare city. Cancer is not a notifiable disease, and registration of cases is done by active methods. The registry contributed data on randomly drawn sub-samples of Harare resident cases among 17 common cancer sites or types registered during 1993-1997 from black and white populations. Follow-up was carried out predominantly by active methods with median follow-up ranging from 1-54 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged from 20-100%; death certificate only (DCO) cases comprised 0-34%; 58-97% of total registered cases were included for survival analysis. Complete follow-up at five years ranged from 94-100%. Five-year age-standardized relative survival rates of selected cancers among both races combined were cervix (42%), breast (68%), Kaposi sarcoma (4%), liver (3%), oesophagus (12%), stomach (20%) and lung (14%). Survival was markedly higher among white than black populations for most cancers with adequate cases. Five-year relative survival by age group was fluctuating, with no definite pattern or trend.
Collapse
Affiliation(s)
- E Chokunonga
- Zimbabwe National Cancer Registry, Parirenyatwa Hospital, Avondale, Harare, Zimbabwe.
| | | | | | | | | |
Collapse
|
32
|
Affiliation(s)
- D Max Parkin
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom.
| | | | | | | | | | | | | |
Collapse
|
33
|
Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JMA, Parkin DM, Wardle J, Duffy SW, Cuzick J. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 2010; 375:1624-33. [PMID: 20430429 DOI: 10.1016/s0140-6736(10)60551-x] [Citation(s) in RCA: 1083] [Impact Index Per Article: 77.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Colorectal cancer is the third most common cancer worldwide and has a high mortality rate. We tested the hypothesis that only one flexible sigmoidoscopy screening between 55 and 64 years of age can substantially reduce colorectal cancer incidence and mortality. METHODS This randomised controlled trial was undertaken in 14 UK centres. 170 432 eligible men and women, who had indicated on a previous questionnaire that they would accept an invitation for screening, were randomly allocated to the intervention group (offered flexible sigmoidoscopy screening) or the control group (not contacted). Randomisation by sequential number generation was done centrally in blocks of 12, with stratification by trial centre, general practice, and household type. The primary outcomes were the incidence of colorectal cancer, including prevalent cases detected at screening, and mortality from colorectal cancer. Analyses were intention to treat and per protocol. The trial is registered, number ISRCTN28352761. FINDINGS 113 195 people were assigned to the control group and 57 237 to the intervention group, of whom 112 939 and 57 099, respectively, were included in the final analyses. 40 674 (71%) people underwent flexible sigmoidoscopy. During screening and median follow-up of 11.2 years (IQR 10.7-11.9), 2524 participants were diagnosed with colorectal cancer (1818 in control group vs 706 in intervention group) and 20 543 died (13 768 vs 6775; 727 certified from colorectal cancer [538 vs 189]). In intention-to-treat analyses, colorectal cancer incidence in the intervention group was reduced by 23% (hazard ratio 0.77, 95% CI 0.70-0.84) and mortality by 31% (0.69, 0.59-0.82). In per-protocol analyses, adjusting for self-selection bias in the intervention group, incidence of colorectal cancer in people attending screening was reduced by 33% (0.67, 0.60-0.76) and mortality by 43% (0.57, 0.45-0.72). Incidence of distal colorectal cancer (rectum and sigmoid colon) was reduced by 50% (0.50, 0.42-0.59; secondary outcome). The numbers needed to be screened to prevent one colorectal cancer diagnosis or death, by the end of the study period, were 191 (95% CI 145-277) and 489 (343-852), respectively. INTERPRETATION Flexible sigmoidoscopy is a safe and practical test and, when offered only once between ages 55 and 64 years, confers a substantial and longlasting benefit. FUNDING Medical Research Council, National Health Service R&D, Cancer Research UK, KeyMed.
Collapse
Affiliation(s)
- Wendy S Atkin
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Ferlay J, Parkin DM, Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer 2010; 46:765-81. [PMID: 20116997 DOI: 10.1016/j.ejca.2009.12.014] [Citation(s) in RCA: 1596] [Impact Index Per Article: 114.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 12/02/2009] [Accepted: 12/04/2009] [Indexed: 11/25/2022]
Abstract
Up-to-date statistics on cancer occurrence and outcome are essential for the planning and evaluation of programmes for cancer control. Since the relevant information for 2008 is not generally available as yet, we used statistical models to estimate incidence and mortality data for 25 cancers in 40 European countries (grouped and individually) in 2008. The calculations are based on published data. If not collected, national rates were estimated from national mortality data and incidence and mortality data provided by local cancer registries of the same or neighbouring country. The estimated 2008 rates were applied to the corresponding country population estimates for 2008 to obtain an estimate of the numbers of cancer cases and deaths in Europe in 2008. There were an estimated 3.2 million new cases of cancer and 1.7 million deaths from cancer in 2008. The most common cancers were colorectal cancers (436,000 cases, 13.6% of the total), breast cancer (421,000, 13.1%), lung cancer (391,000, 12.2%) and prostate cancer (382,000, 11.9%). The most common causes of death from cancer were lung cancer (342,000 deaths, 19.9% of the total), colorectal cancer (212,000 deaths, 12.3%), breast cancer (129,000, 7.5%) and stomach cancer (117,000, 6.8%).
Collapse
Affiliation(s)
- J Ferlay
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
| | | | | |
Collapse
|
35
|
Bray F, Parkin DM. Evaluation of data quality in the cancer registry: Principles and methods. Part I: Comparability, validity and timeliness. Eur J Cancer 2009; 45:747-55. [DOI: 10.1016/j.ejca.2008.11.032] [Citation(s) in RCA: 270] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 11/05/2008] [Accepted: 11/10/2008] [Indexed: 10/21/2022]
|
36
|
Abstract
Others have argued that as many as a third of women treated for high-grade cervical intraepithelial neoplasia (CIN) would have developed cervical cancer in the absence of screening and treatment. Under various assumptions and using past data on CIN grade 3 (CIN3) registrations in England and Scotland, we estimate what cervical cancer rates would have been in the absence of screening. Data on registrations of cervical carcinoma in situ for England and Scotland were used to project the additional numbers of invasive cervical cancers that would have resulted had the carcinoma in situ not been treated. We compare the resulting cervical cancer rates (under different models) with rates recorded in Cancer Incidence in 5 Continents. In order for the projected rates in England and Scotland at ages 20-24 not to be exceptionally high compared to maximum recorded rates for each registry in Cancer Incidence in 5 Continents, the progression rate from CIN3 to invasive cancer in women aged 20-24 should not exceed 1% per year. Similar progression rates were reasonable for women aged 25-29. Under the previously accepted assumption of 4.33% progression per year, cervical cancer rates in women aged 20-29 in both England and Scotland would have been 2-5 times greater than any observed rate (other than one registry, based on just 4 cases). From this analysis, at most 1.5% of women treated (equivalent to 3% of CIN3 registrations) would have had cancer by age 25, whereas it is reasonable to assume that over half of them would have regressed by age 25.
Collapse
Affiliation(s)
- Peter Sasieni
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Bart's & The London School of Medicine, Queen Mary University of London, London, United Kingdom.
| | | | | |
Collapse
|
37
|
Parkin DM, Bray F. Evaluation of data quality in the cancer registry: principles and methods Part II. Completeness. Eur J Cancer 2009; 45:756-64. [PMID: 19128954 DOI: 10.1016/j.ejca.2008.11.033] [Citation(s) in RCA: 287] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 11/05/2008] [Accepted: 11/10/2008] [Indexed: 02/06/2023]
Abstract
The completeness of cancer registry data -- the extent to which all of the incident cancers occurring in the population are included in the registry database -- is an extremely important attribute of a cancer registry. Only a high degree of completeness in case-finding procedures will ensure cancer incidence rates and survival proportions are close to their true value. This second instalment of a two-part review of data quality methods at the cancer registry, focuses on the principles and techniques available for estimating completeness, separating methods into those that are semi-quantitative -- in that they give an indication of the degree of completeness relative to other registries or over time, and more quantitative techniques -- those that provide a numerical evaluation of the extent to which all eligible cases have been registered.
Collapse
Affiliation(s)
- D Max Parkin
- Clinical Trials Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK.
| | | |
Collapse
|
38
|
Parkin DM, Tappenden P, Olsen AH, Patnick J, Sasieni P. Predicting the impact of the screening programme for colorectal cancer in the UK. J Med Screen 2008; 15:163-74. [DOI: 10.1258/jms.2008.008024] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objectives Screening for colorectal cancer by biennial testing for faecal occult blood is being introduced in the UK from 2007. We examine the likely impact of the programme, in terms of reduced mortality, lives saved and changes in incidence, over the next 20 years. Setting Projections of incidence and mortality of colorectal cancer in England, and the policy that has been adopted for screening in England (biennial at ages 60–69 from 2007, then 60–74 in 2010). Methods The results are based on the output of a simulation model that has been used to examine cost-effectiveness of screening policy options, with two scenarios regarding compliance with screening; both assume that 20% of the population will never attend for screening, but attendance of those who do is modelled either as a random 60% or 80%, at each screening round. Results The decrease in mortality rates expected 20 years after introducing screening is 13–17% in men and 12–15% in women (depending on the attendance levels). The model predicts an initial rise in incidence, followed (after six to seven years) by a fall, so that there is little net change in the number of cases detected over a 20-year period. Conclusion Percentage changes in mortality seem modest, but the projected saving in terms of numbers of lives is not negligible – 1800–2400 per year by 2025 in England (equivalent numbers are 2200–2700 in all over the UK). Newer screening modalities may improve on these projected results.
Collapse
Affiliation(s)
- D M Parkin
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - P Tappenden
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - A H Olsen
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - J Patnick
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - P Sasieni
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
- Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| |
Collapse
|
39
|
Olsen AH, Parkin DM, Sasieni P. Cancer mortality in the United Kingdom: projections to the year 2025. Br J Cancer 2008; 99:1549-54. [PMID: 18854832 PMCID: PMC2579704 DOI: 10.1038/sj.bjc.6604710] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 09/12/2008] [Accepted: 09/15/2008] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to project mortality rates in the United Kingdom for the period 2006-2025 for 21 major cancers on the basis of the observed trends in mortality rates during 1971-2005, and to estimate the implication in terms of expected deaths. Age-period-cohort models were applied to official statistics. The projected decrease in age-standardised mortality rates for all cancers from 2003 to 2023 was 17% in men and 16% in women. Future mortality rates were projected to decline for most cancer sites. In men, there were small projected increases in mortality rates from cancers of the oral cavity, oesophagus and melanoma, with a larger projected increase (14% over 20 years) in mortality of liver cancer. In women, the only projected increase (18%) was for corpus uteri. The numbers of deaths will increase for most cancers, with a 30% increase in all cancers projected for men and a 12% increase projected for women. Mortality rates from cancer as a whole have been falling in the United Kingdom since 1990, and this decline was projected to continue into the future as well as the declining rates in both sexes for most cancers. Actual numbers of deaths will increase for most cancers.
Collapse
Affiliation(s)
- A H Olsen
- Department of Mathematics and Statistics, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - D M Parkin
- Department of Mathematics and Statistics, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - P Sasieni
- Department of Mathematics and Statistics, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| |
Collapse
|
40
|
|
41
|
Brenner H, Coebergh JW, Parkin DM, Izarzugaza I, Clavel J, Arndt V, Steliarova-Foucher E. Up-to-date monitoring of childhood cancer long-term survival in Europe: leukaemias and lymphomas. Ann Oncol 2007; 18:1569-77. [PMID: 17660497 DOI: 10.1093/annonc/mdm187] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In recent decades, following the introduction of effective chemotherapy, the prognosis of children with leukaemia and lymphoma has dramatically improved, but data reflecting further possible improvement achieved in the 1990s are scarce. METHODS Using the Automated Childhood Cancer Information (ACCIS) database, we carried out a period analysis of 10-year survival for the 1995-99 period. Analyses were carried out by diagnostic groups, age-group at diagnosis, sex and four European regions. RESULTS Ten-year survival estimates for the 1995-99 period were 73% for any type of leukaemia, 78% for acute lymphoid leukaemia and 52% for acute non-lymphocytic leukaemia. The corresponding 10-year survival rates for all types of lymphomas, Hodgkin lymphoma, and non-Hodgkin lymphoma were 84, 91 and 79%, respectively. These figures are much higher than those obtained by traditional (cohort-based) methods of survival analysis. A large difference in prognosis is still observed between the East and other parts of Europe. CONCLUSION Major improvement in prognosis for children with leukaemia or lymphoma has been ongoing in Europe during the 1990s, but further monitoring and investments are required to remove the large regional differences between European regions.
Collapse
Affiliation(s)
- H Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
| | | | | | | | | | | | | |
Collapse
|
42
|
Steliarova-Foucher E, Arndt V, Parkin DM, Berrino F, Brenner H. Timely disclosure of progress in childhood cancer survival by 'period' analysis in the Automated Childhood Cancer Information System. Ann Oncol 2007; 18:1554-60. [PMID: 17698836 DOI: 10.1093/annonc/mdm194] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A few years ago, a new method of survival analysis, denoted 'period' analysis, was introduced to provide more up-to-date survival estimates of cancer patients. PATIENTS AND METHODS We evaluated the period survival method using the large database of the Automated Childhood Cancer Information System (ACCIS). Our evaluation is based on data from 35 191 children diagnosed with cancer in 13 European countries between 1975 and 1989 and followed for vital status until around 1999. RESULTS Using the follow-up data available in 1989, 10-year survival for all children with cancer calculated by the period method for the 1985-89 period was 58%, while it was 43% when calculated by traditional 'cohort' life-table analysis (based on children diagnosed in 1975-79). The period method provided a better estimate of the true 10-year survival of 62%, observed 10 years later in the cohort of patients diagnosed in 1985-89. Similar results were observed for each of the common groups of childhood cancer. CONCLUSION Period analysis is especially useful for monitoring childhood cancer survival, because at a given point in time it provides more timely estimates of long-term survival expectations than the cohort life-table method. Using the ACCIS database, up-to-date estimates of period survival for childhood cancer are derived in subsequent papers in this journal.
Collapse
Affiliation(s)
- E Steliarova-Foucher
- Data Analysis and Interpretation Group, International Agency for Research on Cancer, Lyon, France.
| | | | | | | | | |
Collapse
|
43
|
Steliarova-Foucher E, Stiller CA, Pukkala E, Lacour B, Plesko I, Parkin DM. Thyroid cancer incidence and survival among European children and adolescents (1978-1997): report from the Automated Childhood Cancer Information System project. Eur J Cancer 2006; 42:2150-69. [PMID: 16919778 DOI: 10.1016/j.ejca.2006.06.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 06/08/2006] [Indexed: 11/26/2022]
Abstract
Data on 1690 childhood and adolescent cases of thyroid cancer registered in 61 European cancer registries were extracted from the database of the Automated Childhood Cancer Information System (ACCIS) and included in analyses of incidence and survival. In 1988-1997, the age-standardised incidence rates (ASR) for children aged 0-14 years varied in European regions from 0.5 to 1.2 per million and the age-specific incidence in adolescents aged 15-19 years ranged from 4.4 to 11.0 per million. Over the age-span 0-19 years, the female to male ratio increased from 1 to around 3. Papillary thyroid cancer accounted for almost 65% of cases in children and 77% in adolescents. In the childhood population of Belarus, the ASR for 1989-1997 was 23.6 per million and the proportion of papillary tumours was 87%. No association was found between thyroid cancer risk and national dietary iodine status across 16 countries. Incidence of thyroid carcinoma among children and adolescents in Europe (excluding Belarus) increased during 1978-1997 by 3% per year, largely due to papillary carcinoma. Survival of children and adolescents was high over the entire study period and in all regions of Europe. Children with medullary carcinoma had slightly lower 5-year survival (95%, 95% CI 81-99), than those with papillary carcinoma (99%, 95% CI 95-100). More than 90% of patients survived 20 years after diagnosis. Further standardisation of diagnostic, classification and registration criteria will be fundamental for future studies of thyroid carcinomas in young people.
Collapse
Affiliation(s)
- E Steliarova-Foucher
- Descriptive Epidemiology Group, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France.
| | | | | | | | | | | |
Collapse
|
44
|
Ekalaksananan T, Pientong C, Sriamporn S, Kongyingyoes B, Pengsa P, Kleebkaow P, Kritpetcharat O, Parkin DM. Usefulness of combining testing for p16 protein and human papillomavirus (HPV) in cervical carcinoma screening. Gynecol Oncol 2006; 103:62-6. [PMID: 16494930 DOI: 10.1016/j.ygyno.2006.01.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2005] [Revised: 01/04/2006] [Accepted: 01/16/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the value of the combination of p16 and HPV detection in the screening for cervical cancer. METHODS 186 patients with previous abnormal cervical lesion were studied. After colposcopic examination, two conventional Pap slides were prepared: the first was Papanicolaou-stained and examined by cytologist; the second was immunocytochemically stained for p16. Cervical cells were collected by brush using for HPV detection by Hybrid Capture II. Biopsy of any colposcopically abnormal lesions was performed. RESULTS The 186 cervical samples were classified cytologically as normal (148), ASCUS (13), low-grade (11), high-grade (12) dysplasia and squamous cell carcinoma (2). P16 and HPV were found in all high-grade dysplasia and SCC, and in 64% and 27% of low-grade dysplasia, 62% and 0% of ASCUS and 7.4% and 3.4% of normal, respectively. 18 of p16-positive cases (11%) were HPV-negative, 14 of them in the ASCUS and normal group. Compared to histological results, all of the p16-positive cases of squamous metaplasia, CIN II/III and SCC were HR-HPV-positive. Therefore, the cases that were positive for both with normal cytology (5 cases) or low-grade dysplasia (3 cases) may comprise a high-risk group for neoplastic change. CONCLUSION The combination of p16 and HPV detection may be useful in cervical cancer screening to identify high-risk patients requiring early and proper management.
Collapse
|
45
|
Steliarova-Foucher E, Kaatsch P, Lacour B, Pompe-Kirn V, Eser S, Miranda A, Danzon A, Ratiu A, Parkin DM. Quality, comparability and methods of analysis of data on childhood cancer in Europe (1978–1997): Report from the Automated Childhood Cancer Information System project. Eur J Cancer 2006; 42:1915-51. [PMID: 16919762 DOI: 10.1016/j.ejca.2006.05.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 05/22/2006] [Indexed: 10/24/2022]
Abstract
In collaboration with 62 population-based cancer registries contributing to the Automated Childhood Cancer Information System (ACCIS), we built a database to study incidence and survival of children and adolescents with cancer in Europe. We describe the methods and evaluate the quality and internal comparability of the database, by geographical region, period of registration, type of registry and other characteristics. Data on 88,465 childhood and 15,369 adolescent tumours registered during 1978-1997 were available. Geographical differences in incidence are caused partly by differences in definition of eligible cases. The observed increase in incidence rates cannot be explained by biases due to the selection of datasets for analyses, and only partially by the registration of non-malignant or multiple primary tumours. Part of the observed differences in survival between the regions may be due to variable completeness of follow-up, but most is probably explained by resource availability and organisation of care. Further standardisation of data and collection of additional variables are required so that this study may continue to yield valuable results with reliable interpretation.
Collapse
Affiliation(s)
- E Steliarova-Foucher
- Descriptive Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Yang L, Li LD, Chen YD, Parkin DM. [Time trends, estimates and projects for breast cancer incidence and mortality in China]. Zhonghua Zhong Liu Za Zhi 2006; 28:438-40. [PMID: 17152490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Using comprehensive available data on women breast cancer in China, to describe the mortality trends from late 1970s, estimate and project the profile in 2000 and 2005, and to aim to provide a reference for clinic, basic research and prevention and control strategy making for breast cancer in China. METHODS Using Joinpoint model, the mortality trends were analyzed on the basis of routine surveillance data. Combining with the data from the second national mortality survey and several cancer registries, using the log-linear model (based on Poisson distribution), the breast cancer profile in 2000 and 2005 were estimated and projected. RESULTS Although there was a slight decline in mortality between early 1970s and 1990s, the age-specific mortality rates among young and middle age women increased dramatically which followed a continuing increase trend on both rates and absolute numbers, in both urban and rural areas in recent 15 years. Compared with 2000, there are 470 thousands more new breast cancer cases and 130 thousands more deaths from breast cancer in 2005. CONCLUSION Due to the double effects of both increasing risk factors and population growth and ageing, breast cancer will be one of the most extensively increasing cancers in Chinese women. The prevention and control of breast cancer will be of great emphasis for future cancer control strategy in China.
Collapse
Affiliation(s)
- Ling Yang
- National Office for Cancer Prevention and Control, Beijing 100021, China.
| | | | | | | |
Collapse
|
47
|
Gondos A, Parkin DM, Chokunonga E, Brenner H. Calculating age-adjusted cancer survival estimates when age-specific data are sparse: an empirical evaluation of various methods. Br J Cancer 2006; 94:450-4. [PMID: 16434986 PMCID: PMC2361143 DOI: 10.1038/sj.bjc.6602976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We evaluated empirically the performance of various methods of calculating age-adjusted survival estimates when age-specific data are sparse. We have illustrated that a recently proposed alternative method of age adjustment involving the use of balanced age groups or age truncation may be useful for enhancing calculability and reliability of adjusted survival estimates.
Collapse
Affiliation(s)
- A Gondos
- Department of Epidemiology, German Centre for Research on Ageing, Bergheimer Str. 20, Heidelberg 69115, Germany
| | - D M Parkin
- Unit of Descriptive Epidemiology, International Agency for Research on Cancer, Lyon, France
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - E Chokunonga
- Zimbabwe National Cancer Registry, Harare, Zimbabwe
| | - H Brenner
- Department of Epidemiology, German Centre for Research on Ageing, Bergheimer Str. 20, Heidelberg 69115, Germany
- Department of Epidemiology, German Centre for Research on Ageing, Bergheimer Str. 20, Heidelberg 69115, Germany. E-mail:
| |
Collapse
|
48
|
Sriamporn S, Snijders PJF, Pientong C, Pisani P, Ekalaksananan T, Meijer CJLM, Parkin DM. Human papillomavirus and cervical cancer from a prospective study in Khon Kaen, Northeast Thailand. Int J Gynecol Cancer 2006; 16:266-9. [PMID: 16445643 DOI: 10.1111/j.1525-1438.2006.00356.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The risk of developing carcinoma of the cervix in women infected with human papillomavirus (HPV) was estimated in a nested case-control analysis of 33 cancers (invasive and in situ) and 113 controls, matched by age and sex, from an ongoing cohort study of lifestyle and cancer in a rural population of Northeast Thailand. Oncogenic HPV types were present in 10.8% of control women and in 31/33 of the carcinoma cases, corresponding to an odds ratio of 130.6 (95% CI 11.7-1457.0). There was no significant difference in risk between prevalent cancer cases (diagnosed less than 3 months after HPV testing) and incident cases (diagnosed an average of 2.1 years later). HPV 16 and 18 were the most prevalent oncogenic HPV types present. The results confirm that some two of three of cervical cancer cases in this population of Northeast Thailand are caused by HPV 16 and 18.
Collapse
Affiliation(s)
- S Sriamporn
- Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand.
| | | | | | | | | | | | | |
Collapse
|
49
|
Pisani P, Parkin DM, Ngelangel C, Esteban D, Gibson L, Munson M, Reyes MG, Laudico A. Outcome of screening by clinical examination of the breast in a trial in the Philippines. Int J Cancer 2005; 118:149-54. [PMID: 16049976 DOI: 10.1002/ijc.21343] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The value of screening by Clinical Examination of the Breast (CBE) as a means of reducing mortality from breast cancer (BC) is not established. The issue is relevant, as CBE may be a suitable option for countries in economic transition, where incidence rates are on the increase but limited resources do not permit screening by mammography. Our aims were to assess whether mass screening by CBE carried out by trained para-medical personnel is feasible in an urban population of a low-income country, and its efficacy in reducing BC mortality. Our study was designed as a randomised controlled trial of the effect on BC mortality of 5 annual CBE carried out by trained nurses. The target population was women aged 35-64 years, resident in 12 municipalities of the National Capital Region of Manila, Philippines. The units of randomization were the 202 health centres (HC) within the selected municipalities. During 1995 nurses and midwives were recruited and trained in performing CBE. The first round of screening took place in 1996-1997. The intervention however showed a refractory attitude of the population with respect to clinical follow-up and was discontinued after the completion of the first screening round. Cases of breast cancer occurring in the study population during 1996-1999 were identified by the 2 local population-based registries. In the single screening round 151,168 women were interviewed and offered CBE, 92% accepted (138,392), 3,479 were detected positive for a lump and referred for diagnosis. Of these only 1220 women (35%) completed diagnostic follow-up, whereas 42.4% actively refused further investigation even with home visits, and 22.5% were not traced. Of 53 cases that occurred among screen-positive women in the 2 years after CBE only 34 were diagnosed through the intervention. Eighty cases occurred among screen-negative women. The test sensitivity for CBE repeated annually was 53.2%. The actual sensitivity of the programme was 25.6% and positive predictive value 1%. Screen-detected cases were non-significantly less advanced than the others. Previous studies have shown that most breast cancer cases in the Philippines present at advanced stages and have an unfavourable outcome. Although CBE undertaken by health workers seems to offer a cost-effective approach to reducing mortality, the sensitivity of the screening programme in the real context was low. Moreover, in this relatively well-educated population, cultural and logistic barriers to seeking diagnosis and treatment persist and need to be addressed before any screening programme is introduced.
Collapse
Affiliation(s)
- Paola Pisani
- Unit of Descriptive Epidemiology, International Agency for Research on Cancer, Lyon, France.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
The objective of this study was to determine how many population-based cancer registries exist in China, what methods are being used, and the statistical data that are available from them, and to identify future needs with respect to technical support. A two-stage survey was conducted in 2002 at provincial and cancer registry level. Based on the questionnaire used in these two stages, the basic distribution and descriptive information on population-based cancer registry practices in China are addressed. There are 48 cancer registries in China, covering 73 million people (5.7% of the total population of China in 2000). The oldest three registries are LinZhou, ShangHai and QiDong. There are marked variations in practice between registries, with respect to data collection, data management and coding. Differences are also found in administrative aspects and sources of financial support. In conclusion, this first national survey of Chinese cancer registry practice provides a benchmark against which development and standardization can be evaluated in the future. The survey suggests that lack of qualified personnel, insufficient funding support and lack of stability of the population are major problems in carrying out registration work in China. It also indicates several ways in which registry practice, and hence availability and quality of incidence and survival data can be improved.
Collapse
Affiliation(s)
- L Yang
- Descriptive Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas 69372 Lyon Cedex 08, France.
| | | | | | | | | | | | | |
Collapse
|