Residents of geothermal areas have higher incidence of non-Hodgkin's lymphoma, breast cancer, prostate cancer, and kidney cancers than others. These populations are exposed to chronic low-level ground gas emissions and various pollutants from geothermal water. The aim was to assess whether habitation in geothermal areas and utilisation of geothermal water is associated with risk of cancer according to duration of residence.
The cohort obtained from the census 1981 was followed to the end of 2013. Personal identifier was used in record linkage with nation-wide emigration, death, and cancer registries. The exposed population, defined by community codes, was located on young bedrock and had utilised geothermal water supply systems since 1972. Two reference populations were located by community codes on older bedrock or had not utilised geothermal water supply systems for as long a period as had the exposed population. Adjusted hazard ratio (HR), 95% confidence intervals (CI) non-stratified and stratified on cumulative years of residence were estimated in Cox-model.
The HR for all cancer was 1.21 (95% CI 1.12-1.30) as compared with the first reference area. The HR for pancreatic cancer was 1.93 (1.22-3.06), breast cancer, 1.48 (1.23-1.80), prostate cancer 1.47 (1.22-1.77), kidney cancer 1.46 (1.03-2.05), lymphoid and haematopoietic tissue 1.54 (1.21-1.97), non-Hodgkin´s lymphoma 2.08 (1.38-3.15) and basal cell carcinoma of the skin 1.62 (1.35-1.94). Positive dose-response relationship was observed between incidence of cancers and duration of residence, and between incidence of cancer and degree of geothermal/volcanic activity in the comparison areas.
The higher cancer incidence in geothermal areas than in reference areas is consistent with previous findings. As the dose-response relationships were positive between incidence of cancers and duration of residence, it is now more urgent than before to investigate the chemical and physical content of the geothermal water and of the ambient air of the areas to detect recognized or new carcinogens.
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Mortality rates from kidney cancer increased throughout Europe up until the late 1980s or early 1990s. Trends in western European countries, the European Union (EU) and selected central and eastern European countries have been updated using official death certification data for kidney cancer abstracted from the World Health Organisation (WHO) database over the period 1980-1999. In EU men, death rates increased from 3.92 per 100,000 (age standardised, world standard) in 1980-81 to 4.63 in 1994-95, and levelled off at 4.15 thereafter. In women, corresponding values were 1.86 in 1980-81, 2.04 in 1994-95 and 1.80 in 1998-99. Thus, the fall in kidney cancer mortality over the last 5 years was over 10% for both sexes in the EU. The largest falls were in countries with highest mortality in the early 1990s, such as Germany, Denmark and the Netherlands. Kidney cancer rates levelled off, but remained very high, in the Czech Republic, Baltic countries, Hungary, Poland and other central European countries. Thus, in the late 1990s, a greater than three-fold difference in kidney cancer mortality was observed between the highest rates in the Czech Republic, the Baltic Republics and Hungary, and the lowest ones in Romania, Portugal and Greece. Tobacco smoking is the best recognised risk factor for kidney cancer, and the recent trends in men, mainly in western Europe, can be related to a reduced prevalence of smoking among men. Tobacco, however, cannot account for the recent trends registered in women.
In the Western world the incidence of renal cell carcinoma (RCC) has been increasing for several decades. In Sweden the incidence has decreased since 1980. This may reflect better health of the population. Another possible explanation could be a decrease in incidentally diagnosed RCC. Since these tumours are smaller, relatively more advanced tumours would then enter the cancer registry. The aim of this study was to compare methods of detection of RCC, tumour characteristics and survival from three periods over a timespan of more than 20 years.
Adult patients (n = 515) with RCC were identified in a well-defined population-based area with the same incidence of RCC as the rest of Sweden. Patient data from three periods, 1979 - 1981 (A), 1989 - 1991 (B) and 1999 - 2001 (C), were collected for gender, age, tumour side, method of detection, tumour size, tumour type, metastasis, T stage and Fuhrman grade at the time of diagnosis. Using the Swedish Cause-of-Death Register, cause-specific survival was calculated. When available, tissue was reanalysed according to modern standards by an experienced pathologist.
The frequency of ultrasound and computed tomography increased and autopsy and intravenous pyelography decreased with time as the first detection method. There was a significant change towards smaller tumours and less severe stages and grades in more recent periods. Metastatic disease was most common in the first period. The distribution between the different histological tumour types did not change over time. Five-year cause-specific survival increased significantly from 41% to 63%. Subgroup analysis found significantly increased survival for patients with no metastases or with low-grade tumours.
The data support a true decrease in the incidence of RCC over time in Sweden with a migration towards lower tumour stages but no change in distribution between the different histological subtypes over time.
The epidemiological data based on the exposure of pentachlorophenol (PCP) and cancer incidence and mortality were analyzed to study the relationship between PCP exposure and cancer risk.
According to the online search of relevant literatures, Poisson regression was used to analyze mortality rates for major cancer sites and fixed-effect model was employed to assess cancer SMR. The dose-response relationship between PCP exposure and cancer risk was also analyzed.
Major cancer mortality rates of exposure populations researched in American and Canadian studies were approximate to or lower than national male cancer mortality rates respectively. The incidence rate of colorectal cancer in occupational exposure population was over 16.4 times in comparison with the population exposed from to drinking water and food. The pooled SMR value of kidney cancer was 1.34 (95% CI 1.02-1.77). The pooled RR for major cancer mortality increased with the rise of PCP exposure level.
A potential dose-response relationship between PCP exposure and cancer risk could exist. In comparison with to the population to exposed from the drinking water and food, the risk of colorectal cancer in occupational exposure population was higher. PCP may be one of the risk factors of the kidney cancer in occupational exposure population.
The 15,160 males and females diagnosed with kidney cancer in Denmark in the period 1943-87, and eligible for inclusion were covered in the analysis. Crude and relative five-year survival from this cancer has improved with calendar time, especially for men. For patients diagnosed in 1943-47, the relative five-year survival was 18% for men and 29% for women; for those diagnosed in 1983-87, it had improved to 35 and 36%, respectively. Patients with localized tumours at the time of diagnosis had a more favourable prognosis than those with disseminated disease, with a five-year survival of 51% for men and 53% for women; people of each sex with metastatic disease had a five-year survival of only 3%. Treatment of kidney cancer throughout the period was surgical removal of the kidney and lymph nodes. The moderate improvement in survival seen with calendar time may be due to better, more efficient surgical techniques. The 32,701 patients diagnosed with cancer of the urinary bladder in 1943-87 and included in the study experienced a marked improvement in crude five-year survival: for both men and women, from 24% for patients diagnosed in 1943-47 to 47% for those diagnosed in 1983-87. Patients whose tumours were localized at the time of diagnosis in 1978-87 had a more favourable prognosis, with survival after 10 years of 36% (men) and 43% (women), than patients with metastatic disease with 10-year survival of less than 1% (men and women). The treatment of bladder tumours underwent a number of changes during the study period. The improvement in survival with calendar time may be due to more efficient treatment, although registration artefacts cannot be excluded.
The temporal changes in childhood and adolescent cancer survival in Sweden 1960-1984 were analyzed. Complete follow-up through 1986 of 6,262 patients younger than 20 years at diagnosis revealed that the overall 5-year survival rates increased from 36.1 to 65.7% in males and from 43.6 to 73.6% in females. The temporal trends differed markedly between age groups and tumour sites and types. Over the study period, 5-years, survival for testicular cancer increased from 46.9 to 87.2%, kidney cancer, predominantly Wilms' tumour from 35.5 to 77.1% (with a higher rate of 89.1% in 1975-1979), Hodgkin's disease from 61.2 to 91.9%, non-Hodgkin's lymphoma from 32.5 to 76.6%, and all leukemias from 8.9 to 58.7%. Only a moderate improvement was noted for tumours of the bone, muscle and connective tissue, and survival rates for tumours of the nervous system remained largely unchanged. Our data reflect the remarkable therapeutic improvements that have occurred for cancer in the young and indicate that these improvements have rapidly become available in Sweden.
The purpose of this study is to elucidate incidence, mortality, survival, and prevalence of kidney cancer in elderly persons compared with younger persons in Denmark.
Cancer of the kidney was defined as ICD-10 code DC 64. Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence and relative survival in the Nordic countries, where the Danish data were delivered from the Danish Cancer Registry and the Danish Cause of Death Registry with follow-up for death or emigration until the end of 2013.
The proportion of patients diagnosed with kidney cancer over the age of 70 years has decreased from 43% in 1980 to 32% in 2012 in men and remained almost constant in women, around 50%. Incidence rates were at least five times higher in men aged 70 years more but there was no particular trend with time. In men aged less than 70 years, the incidence rates started increasing around 2000. The incidence rates were lower in women but with a similar pattern as in men. Mortality rates remained stable over time in persons aged 70 years or more while they decreased with time in younger women. Both the one- and the five-year relative survival increased steadily over time for all age groups but the survival was lower for patients aged 70 years or more than for younger patients. The prevalence increased three times from 1559 patients being alive after kidney cancer in 1980 to 4713 in 2012.
A challenge in managing kidney cancer in the elderly is to establish interdisciplinary collaborations between different specialties, such as surgeons, clinical oncologists, and geriatricians to be able to deliver the best possible care in the future.