In Canada, it is estimated that in 1992 115,000 new cases of cancer will be diagnosed. This total excludes 47,200 estimated new cases of non-melanoma skin cancer. The number of new cases is increasing by about 3,000 per year due partly to the aging population, improved registration, earlier detection of cancer and real increases in the incidence of some types of cancer. It is estimated that there will be 58,300 cancer deaths in 1992. By 1992, prostate cancer will have overtaken lung cancer as the leading cancer among men in the four western provinces while lung cancer is expected to exceed breast cancer as the leading cause of cancer deaths among women in some provinces, notably British Columbia. In British Columbia, the relative survival rates for most cancers improved between the periods 1970 to 1974 and 1980 to 1984. However, stomach, lung and pancreatic cancers, which have low survival rates, showed little improvement. This article is based on 1992 estimates of cancer incidence and mortality, cancer trends in Canada and relative cancer survival rates in British Columbia, found in Canadian Cancer Statistics 1992. This publication was prepared at Statistics Canada through a collaborative effort involving the Canadian Cancer Society, Health and Welfare Canada and the provincial/territorial cancer registries.
Adenocarcinoma of the appendix is less than 0.5% of all gastrointestinal cancers. The aim of this study was to analyse the incidence, symptoms, pathology and treatment of appendiceal adenocarcinoma in a well defined cohort as well as the prognosis of the patients.
This is a retrospective study on all patients diagnosed with adenocarcinoma of the appendix in Iceland from 1990-2009. Information on epidemiological factors, survival and treatment was collected. All histological material was reviewed. Overall survival was estimated with median follow up of 15 months (range, 0-158).
A total of 22 patients were diagnosed with appendiceal adenocarinoma in the study period (median age 63 yrs, range: 30-88, 50% males). Age-standardized incidence was 0.4/100,000/year. The most common symptom was abdominal pain (n=10). Eight patients had clinical signs of appendicitis. Most patients were diagnosed at operation or at pathological examination but one patient was diagnosed at autopsy. Five patients had an appendectomy and 11 a right hemicolectomy. One patient was not operated on and in three patients only a biopsy was taken. Twelve patients had chemotherapy and seven of them for metastatic disease. Eight patients had adenocarcinoma, seven mucinous adenocarcinoma, three signet ring adenocarcinoma, one mixed goblet cell carcinoid and mucinous adenocarcinoma,one mixed adenocarcinoma and signet ring adenocarcinoma and two a mucinous tumour of unknown malignant potential. In eight cases the tumor originated in adenoma. Most of the patients had a stage IV disease (n=13), three stage III, three stage II and three stage I. Operative mortality was 4.8% (n=1). Disease specific five year survival was 54% but overall five year survival was 44% respectively.
Adenocarcinoma of the appendix is a rare disease. No patients were diagnosed pre-operatively. Over half of the patients presented with stage IV disease.
Survival curves may be adjusted for covariates using Aalen's additive risk model. Survival curves may be compared by taking the ratio of two adjusted survival curves; the ratio is denoted the generalized relative survival rate. Adjusting both survival curves for all but one of a common set of covariates gives the partial relative survival rate, which measures the covariate-specific contribution to the generalized relative survival rate. The generalized and partial relative survival rates have interpretations similar to the traditional relative survival rates frequently used in cancer epidemiology. In fact, the traditional relative survival rate can be generalized to a regression context using the additive risk model. This population-adjusted relative survival rate is an alternative and useful method for removing confounding effects of age, cohorts, and sex. The authors use a data set of malignant melanoma patients diagnosed from 1965 to 1974 in Norway. The 25-year survival of 1967 individuals is studied.
The impact of overweight duration and intensity during adulthood on the prognosis after a cancer diagnosis remains largely unknown. We investigated this association in Swedish women with breast and colorectal cancer.
A cohort of 47,051 women from the Swedish Lifestyle and Health Study was included, of whom 1,241 developed postmenopausal breast (mean age at diagnosis, 57.5 years) and 259 colorectal (mean age at diagnosis, 59.1 years) cancer. Trajectories of body mass index (BMI) between ages 20 and 50 years were estimated for the full cohort using a quadratic growth model and studied in relation to risk of death from any cause using multivariate Cox regression models among cancer survivors.
Compared with patients with cancer who were never overweight (BMI
Late age at first childbirth is a well-established risk factor for breast cancer. Previous studies have, however, shown conflicting results to whether late age at first childbirth also influences the prognosis of breast cancer survival. The aim of this study was to examine age at first birth in relation to survival after breast cancer diagnosis.
We used information from the Malmö Diet and Cancer study. At baseline 17,035 women were included. All women were followed from the year they developed breast cancer until they either died or until the end of follow-up. All women were asked how many children they had given birth to and were then divided into different groups, =?20, >?20 to ?=?25, >?25 to ?=?30 and >?30. Nulliparous women form a separate group. Survival analyses were then performed using Cox proportional hazard survival analysis. Women in all age groups had a lower risk of breast cancer specific death as compared to the reference group?=?20, however non-significantly. Nulliparous women had a higher risk of breast cancer specific death as compared to the same reference group, however these results were not statistically significant. We could not see any negative effect of late first childbirth on breast cancer specific survival.
Groups with assumed health-protective life-styles have been studied for several decades, in search of causes for cancer. We have analyzed cancer incidence, total mortality, and cause-specific mortality in Norwegian teetotalers to assess the possible health gains from an alcohol-abstaining life-style. A cohort of 5332 members of the International Organization of Good Templars was followed for 10 years from 1980. The cancer incidence and the cause-specific mortality of the cohort has been compared to that of the total Norwegian population. The standardized incidence ratio (SIR) for all cancer sites was 74 [95% confidence interval (CI), 64-80] for men and 72 (95% CI, 61-84) for women. For possible alcohol-associated cancers, such as cancer of the oral cavity, pharynx, esophagus, liver, and larynx, the SIR was 43 (95% CI, 17-88) for both sexes combined. For lung cancer the SIR was 57 (95% CI, 37-90) for men and 10 (95% CI, 0-57) for women. When all alcohol- and tobacco-associated cancers were excluded, the SIR for both sexes combined was 79 (95% CI, 69-87). The standardized mortality ratio for total mortality was 81 (95% CI, 65-74). This significant decrease in total mortality was caused by reduced risks for all major causes of death. The study indicates that members of the Norwegian chapter of the International Organization of Good Templars are a low-risk group not only regarding alcohol- and tobacco-associated cancers, but also regarding all other cancers.
Trends observed in Belarus during 1970-1999 and related with mortality of different-type cancer, e.g. breast cancer in women, cancer of the mouth, pharynx, esophagus and stomach, were analyzed versus trends related with the per-capita consumption of various beverages by using the time-series analysis. The results reveal a positive and statistically significant effect of the per-capita vodka consumption on the cancer mortality rate. According to the analysis, a 1% increase in the per-capita vodka consumption entails a 0.58% growth in the breast cancer mortality rate and a 0.66% growth in the esophagus cancer mortality rate. The case study is another solid proof to the fact that a substantial share of breast cancers and of esophageal cancers are brought about by strong beverages.
Alcohol intake may be associated with cancer risk, but epidemiologic evidence for prostate cancer is inconsistent. We aimed to prospectively investigate the association between midlife alcohol intake and drinking patterns with future prostate cancer risk and mortality in a population-based cohort of Finnish twins.
Data were drawn from the Older Finnish Twin Cohort and included 11,372 twins followed from 1981 to 2012. Alcohol consumption was assessed by questionnaires administered at two time points over follow-up. Over the study period, 601 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between weekly alcohol intake and binge drinking patterns with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were performed to control for potential confounding by shared genetic and early environmental factors.
Compared to light drinkers (=3 drinks/week; non-abstainers), heavy drinkers (>14 drinks/week) were at a 1.46-fold higher risk (HR 1.46; 95 % CI 1.12, 1.91) of prostate cancer, adjusting for important confounders. Among current drinkers, binge drinkers were at a significantly increased risk of prostate cancer (HR 1.28; 95 % CI 1.06, 1.55) compared to non-binge drinkers. Abstainers were at a 1.90-fold higher risk (HR 1.90; 95 % CI 1.04, 3.47) of prostate cancer-specific mortality compared to light drinkers, but no other significant associations for mortality were found. Co-twin analyses suggested that alcohol consumption may be associated with prostate cancer risk independent of early environmental and genetic factors.
Heavy regular alcohol consumption and binge drinking patterns may be associated with increased prostate cancer risk, while abstinence may be associated with increased risk of prostate cancer-specific mortality compared to light alcohol consumption.
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