The paper presents epidemiologic data of malignant oral tumors in Sweden 1958-77 including the total number of cases, the number and relative frequency of cases in different sublocations of the oral region and the mean annual age standardized incidence rate, all ages, per one million population, by site and sex. An analysis of different histopathologic types of oral tumors is also presented. A comparison is made between the two 10-yr periods 1958-67 and 1968-77. Errors involved in epidemiologic studies are discussed.
A review was conducted of 660 cases of cancer of the bladder diagnosed in two periods, 1960--62 and 1968--70. A significant increase in the incidence of bladder cancer in both sexes, paralleling the trends in other parts of North America, was found. During the second period the disease was diagnosed earlier and, once diagnosed, was apparently treated more successfully. Overall 5-year survival rates increased from 57% to 70% for patients with stage O or A disease, but were relatively constant, at about 36%, for patients with stage B1 or B2 disease. The survival rate for patients with stage O or A disease appeared to improve without clearly defined changes in treatment. Prospective randomized treatment trials are needed to properly assess the value of definitive and adjunctive methods of treatment.
Three hundred and seventy-nine cases of laryngeal cancer diagnosed between the years 1970 to 1984 were compiled and analyzed with respect to pathology, staging, treatment and outcome. The most common cancer reported was squamous cell carcinoma. Also reported were verrucous carcinoma, spindle cell carcinoma and one case of chondrosarcoma. Males comprised 88% of the patients, females 12%. The average age of the patients was 59 years. The most common lesion reported was stage I squamous carcinoma of the laryngeal glottis. The study will present data on the treatment and outcome of these cases of laryngeal cancer.
A population-based survey was conducted in the two northernmost provinces of Finland to describe the incidence of tongue cancer as well as patient and tumour characteristics in cases diagnosed between 1974 and 1994. A total of 105 new patients with cancer of the oral tongue were included in the 21-year study period. The age-standardised incidence (per 100,000 years) of the carcinoma in men increased from 0.6 in the first 7-year period (1974-1980) to 1.0 in the last period (1988-1994). The incidences in women were 0.7 to 1.4, respectively. The average patient profile remained much the same through the years. The median duration of symptoms also remained the same over the 2 decades, as did the median size and location of the tumour at diagnosis. In conclusion, the incidence of carcinoma of the tongue about doubled in both the male and the female population from 1974 to 1994. However, the patient and tumour characteristics remained about the same, the tumours being relatively large at the time of diagnosis in spite of well-developed community health and dental care.
OBJECTIVE: To review the incidence, treatment and outcome of cervical cancer during pregnancy in the Western region of Sweden. METHODS: Population based data on cervical cancer during pregnancy were collected from 1973 to 1992. RESULTS: Cervical carcinoma was diagnosed in 33 women in association with pregnancy, giving an incidence of 11.1 cases per 100,000 deliveries and 7.5 cases per 100,000 pregnancies. Pregnancy complicated one of every 55 cases of invasive carcinoma. Twelve women were in the 3rd trimester and nine women were post partum. Abnormal bleeding was the symptom that led to examination and diagnosis in 54.5% of the women and 45.5% of the women were asymptomatic but had an abnormal cervico-vaginal cytological test (39.4%) or abnormal finding at vaginal examination (6.1%) in association with pregnancy. In the 1st-2nd trimester all but one woman and in the 3rd trimester all but two women, had a stage I carcinoma. Post partum five women were in stage I, three women were in stage II and one woman had a stage III carcinoma. Histology revealed squamous cell carcinoma in 29 women, adenocarcinoma in three women and adenosquamous carcinoma in one woman. During the follow up period 1/12 women in the 1st trimester, 4/12 in the 3rd trimester and 2/9 women post partum have died of disease. CONCLUSION: During the years of this study different modalities of treatment were used, with a change from primary radiation to primary surgery.
INTRODUCTION: The purpose of the study was to describe developments in the incidence of invasive cervical cancer in Denmark, focusing on histological types, over a period of 60 years. We also describe developments in the incidence of carcinoma in situ and mortality. MATERIAL AND METHODS: The study is based on the Danish Cancer Registry database of 39,623 reported cases of invasive cervical cancer diagnosed among Danish women in the period 1943-2002. The most important variables and measures are age-specific and age-standardized incidence and estimated annual percent changes in incidence. RESULTS: A significant reduction in incidence of invasive squamous cell carcinoma among women over 30 during the last 35 years and in incidence of invasive adenocarcinoma among women over 40 during the last 15 years has been seen. In both histological subgroups the relative estimated annual percent change in incidence was largest in the period 1988-2002 as compared to 1968-1987, coinciding with an increase in the number of Danish women covered by the organized screening program. Women 20-29 years old showed a relatively stable squamous cell carcinoma incidence but an increasing adenocarcinoma incidence throughout the study period. CONCLUSIONS: These results suggest that the increasing coverage of the Danish organized screening program is associated with a significant reduction in incidence of invasive squamous cell carcinoma among women over 30, and of invasive adenocarcinoma among women over 40. So far, squamous cell carcinoma incidence and adenocarcinoma incidence among women 20-29 years old seem quite unaffected by the organized screening program.
One hundred and eight patients from Frederiksborg County, Denmark with cervical cancer diagnosed from 1990 to 1993 were analysed concerning type of carcinoma, tumour stage and screening history. The following types of carcinoma were found: 87 (81%) squamous, 5 (5%) adenosquamous, 15 (14%) adenocarcinoma and one (1%) small cell carcinoma. All women aged 23-60 receive a written invitation to participate in the screening programme. Of the 57 patients who had never or only sporadically been screened 23 were outside the target population. Tumour stage was generally higher for the non-screened, i.e. only 57.9% stage I compared to 82.4% for the screened population. In 51 cases the following errors had occurred: seven sampling errors, 21 screening errors, 15 lack of follow-up of abnormal or inadequate smears, six inadequate cryotherapy and two interval cancers.
Both major morphologic types of cervical cancer, squamous cell carcinoma (SCC) and adenocarcinoma (AC), are causally related to persistent infection with high-risk human papillomavirus (hrHPV), but screening has primarily been effective at preventing SCC. We analysed incidence trends of cervical cancer in Norway stratified by morphologies over 55 years, and projected SCC incidence in the absence of screening by assessing the changes in the incidence rate of AC. The Cancer Registry of Norway was used to identify all 19,530 malignancies in the cervix diagnosed in the period 1956-2010. The majority of these (82.9%) were classified as SCCs, 10.5% as ACs and the remaining 6.6% were of other or undefined morphology. By joint-point analyses of a period of more than five decades, the average annual percentage change in the age-standardised incidence was -1.0 (95%CI: -2.1-0.1) for cervical SCC, 1.5 (95%CI:1.1-1.9) for cervical AC and -0.9 (95%CI: -1.4 to -0.3) for cervical cancers of other or undefined morphology. The projected age-standardised incidence rate of cervical SCC in Norway, assuming no screening, was 28.6 per 100,000 woman-years in 2010, which compared with the observed SCC rate of 7.3 corresponds to an estimated 74% reduction in SCC or a 68% reduction due to screening in the total cervical cancer burden. Cytology screening has impacted cervical cancer burden more than suggested by the overall observed cervical cancer incidence reduction since its peak in the mid-1970s. The simultaneous substantial increase in cervical adenocarcinoma in Norway is presumably indicative of an increase in exposure to HPV over time.
The incidence of cutaneous squamous cell carcinoma is increasing worldwide. In most epidemiological studies, only the first case of cutaneous squamous cell carcinoma is registered, underestimating the burden of the disease. To determine the frequency and detailed characteristics of cutaneous squamous cell carcinoma in a Finnish patient cohort, we performed a retrospective 10-year study taking into account multiple tumours in one patient. On the pathology database search and medical record review we identified 774 patients with a total of 1,131 cutaneous squamous cell carcinomas. The crude incidence increased from 18.6/100,000 persons in 2006 to 28.1 in 2015. The location of tumours differed between men and women: the greatest difference concerned cutaneous squamous cell carcinoma of the ear, with 93% of cases occurring in men. One fourth (24%) of patients had more than one tumour. A small shift from poorly to well-differentiated tumours was seen. In conclusion, the incidence of cutaneous squamous cell carcinoma increased, with many patients presenting with multiple tumours.