Annual Age-adjusted Incidence Rates Research Articles

Secular Trends in the Incidence of Cholangiocarcinoma in the USA and the Impact of Misclassification

It has been reported that the incidence of intrahepatic cholangiocarcinoma (ICC) has increased in the USA, while extrahepatic cholangiocarcinoma (ECC) has decreased or remained stable. However, neither the recent trends nor the effects of the misclassification of Klatskin tumors are known. Using the Surveillance, Epidemiology, and End Results program databases, we calculated the average annual age-adjusted incidence rates (AA-IRs) of ICC and ECC in 4-year time periods (1992-1995, 1996-1999, 2000-2003, 2004-2007). These AA-IRs were calculated with misclassified as well as correctly classified Klatskin tumors. AA-IRs were also calculated based on age, sex, and race. Multivariable Poisson regression models were used to evaluate the secular trends of ICC and ECC. The AA-IR of ICC was 0.92 in 1992-1995 and 0.93 in 2004-2007, while the AA-IR of ECC increased from 0.70 in 1992-1995 to 0.95 in 2004-2007. There was no significant trend in AA-IR of ICC (p = 0.07), while there was a significant increase in ECC across the 4-year time periods (p < 0.001). Klatskin tumors comprised 6.7% of CCs with approximately 90 and 45% misclassified as ICC during 1992-2000 and 2001-2007, respectively. Adjusted Poisson models showed no significant differences in the temporal trend of ICC or ECC due to misclassification of Klatskin tumors. The incidence of ICC has remained stable between 1992 and 2007 with only slight fluctuations, while the incidence of ECC has been increasing. Misclassification of Klatskin tumors does not appear to play a significant role in the trends of CCs.

Rate of Disorders of Consciousness in a Prospective Population-Based Study of Adults With Traumatic Brain Injury

Establish rate of disorders of consciousness (DOC) and course of recovery in adults who have sustained severe traumatic brain injury (sTBI). Four Norwegian neurosurgical departments. Vegetative or minimally conscious patients. Prospective, longitudinal population-based study of adults with sTBI with follow-ups at 3, 12, and 24-36 months postinjury. Coma Recovery Scale-Revised, Glasgow Coma Scale, Extended Glasgow Outcome Scale, and Disability Rating Scale. Three months postinjury, 2% of the sTBI population remained in a vegetative or minimally conscious state, reduced by the half after 1 year, corresponding to average annual age-adjusted incidence rates of DOC of 0.09 per 100 000 3 months post-sTBI. At 3 and 12 months, the incidence was 0.06 and 0.01 per 100 000 for the vegetative state and 0.03 and 0.04 per 100 000 for the minimally conscious state. Diagnostic categorization was stable between 12 and 24-36 months, although clinically relevant improvements were observed in minimally conscious patients. The data suggest that prolonged DOC is rare following sTBI in Norway, contrary to the commonly held belief that improvements in intensive care treatment have resulted in an increased incidence of DOC. Prolonged DOC was associated with severity of injury, subcortical lesions, and diffuse axonal injury.

Clinical features of leiomyosarcoma of the urinary bladder: Analysis of 183 cases

IntroductionExperience with management of urinary bladder leiomyosarcoma (LMS) is rare. Therefore, to better elucidate the disease characteristics of urinary bladder LMS, we utilized a large population-based cancer registry to examine the epidemiology, natural history, pathological characteristics, prognostic factors, and treatment outcomes. Material and methodsThe Surveillance, Epidemiology, and End Results database (1973–2010) was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined. ResultsA total of 183 histologically confirmed cases were identified between 1973 and 2010. The annual age-adjusted incidence rate was 0.23 cases per 1,000,000 and did not significantly change over time. Median age of the patients was 65 years (interquartile range: 47–78y). Of the patients with a known pathologic tumor stage (n = 164), 50% had a regional or distant disease. Overall, 63.2% of patients with known histologic grade (n = 106), had poorly differentiated or undifferentiated histology. Most patients (92.9%) received cancer-directed surgery (CDS), with 34.4% having radical or partial cystectomy. Only 7.7% of patients received radiation therapy in combination with surgery. The median disease-specific survival was 46 months. Five- and 10-year cancer-specific survival rates were 47%, and 35%, respectively. On multivariate analysis, a worse outcome was associated with an undifferentiated tumor grade, distant disease, and failure to undergo CDS. ConclusionThis series represents the largest cohort of LMS of the urinary bladder studied to date. LMS commonly presented as high grade and advanced stage with a poor prognosis. Reduced disease-specific survival was associated with increasing age, undifferentiated tumor grade, distant disease, and failure to undergo CDS.

The descriptive epidemiology of atypical teratoid/rhabdoid tumors in the United States, 2001-2010.

Atypical teratoid/rhabdoid tumor is a rare malignant CNS tumor that most often affects children ≤ 3 years old. The Central Brain Tumor Registry of the United States contains the largest aggregation of population-based incidence data for primary CNS tumors in the US. Its data were used to describe the incidence, associated trends, and relative survival after diagnosis of atypical teratoid/rhabdoid tumor. Using data from 50 cancer registries between 2001 and 2010, age-adjusted incidence rates per 100 000 and 95% CIs were calculated by sex, race, Hispanic ethnicity, age at diagnosis, and location of tumor in the CNS for children aged 0 to 19 years. Relative survival rates and 95% CIs were also calculated. The average annual age-adjusted incidence rate was 0.07 (95% CI: 0.07, 0.08). Incidence rates did not significantly vary by sex, race, or ethnicity. Age had a strong effect on incidence rate, with highest incidence among children <1 year, and decreasing incidence with increasing age. The 6-month, 1-year, and 5-year relative survival rates for all ages were 65.0%, 46.8%, and 28.3%, respectively. Atypical teratoid/rhabdoid tumor can occur anywhere in the CNS, but supratentorial tumors were more common with increasing age. We confirm differences in survival by age at diagnosis, treatment pattern, and location of tumor in the brain. This contributes to our understanding of these tumors and may stimulate research leading to improved treatment of this devastating childhood disease.

Incidence of Primary Central Nervous System Germ Cell Tumors in Childhood: A Regional Survey in Kumamoto Prefecture in Southern Japan

Background/Aims: Central nervous system germ cell tumors (CNS-GCTs) are relatively rare. While their incidence was thought to be higher in East Asia than the USA, recent evidence suggests the difference between Japan and the USA is not statistically significant. The aim of this study was to determine the rate of pediatric primary CNS-GCTs in Kumamoto prefecture, Japan. Methods: We surveyed 6,615 new cases of primary intracranial tumors diagnosed in Kumamoto prefecture between 1989 and 2011. Among these, 251 (3.8%) occurred in patients younger than 15 years. The age-adjusted incidence rates were calculated by the direct method using 5-year age groupings; the incidence in the total Japanese population in the year 2000 was the standard. Results: During the 23-year period, 70 cases of primary GCT were diagnosed. Of these tumors, 31 (44.3%) arose in patients aged between 0 and 14 years (22 boys, 9 girls). Their tumor location was pineal in 45.2%; the other sites were nonpineal. There were more germinomas (64.5%) than nongerminomas (35.5%) in this group. The age-adjusted annual incidence rate was 0.45 cases (boys: 0.64, girls: 0.28) per 10⁵ children. At 2.29, the ratio of CNS-GCTs was higher in these boys than girls. Our data showed higher rates than data from CBTRUS 2012 (0.18/10⁵), SEER 2008 (0.15/10⁵) and Germany (0.10/10⁵). Conclusions: Our survey showed that the incidence of primary CNS-GCTs in children was higher in Kumamoto prefecture than in the USA and other Western countries, suggesting that racial backgrounds play a role.

MP50-07 CLINICAL FEATURES OF LEIOMYOSARCOMA OF THE URINARY BLADDER: ANALYSIS OF 183 CASES.

You have accessJournal of UrologyBladder Cancer: Natural History & Pathophysiology1 Apr 2014MP50-07 CLINICAL FEATURES OF LEIOMYOSARCOMA OF THE URINARY BLADDER: ANALYSIS OF 183 CASES. Dayron Rodríguez, Mark A. Preston, Glen W. Barrisford, and Adam S. Feldman Dayron RodríguezDayron Rodríguez More articles by this author , Mark A. PrestonMark A. Preston More articles by this author , Glen W. BarrisfordGlen W. Barrisford More articles by this author , and Adam S. FeldmanAdam S. Feldman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1128AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Experience with management of urinary bladder leiomyosarcomas is rare. Therefore, in order to better elucidate the disease characteristics of urinary bladder leiomyosarcomas we utilized a large population-based cancer registry to examine the epidemiology, natural history, pathological characteristics, prognostic factors and treatment outcomes. Methods The Surveillance, Epidemiology, and End Results (SEER) database (1973-2010) was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined. Results A total of 183 histology confirmed cases were identified between 1973 and 2010. The annual age-adjusted incidence rate was 0.23 cases per 1,000,000, and did not significantly change over time. Median age of the patients was 65 years (range 7–94). Of the patients with a known tumor stage (N = 164), 50% had a regional or distant stage; 63.2% of patients with known histology grade (N = 106), had poorly or undifferentiated histology. The majority of patients (92.9%) received cancer directed surgery, with 34.4% having radical or partial cystectomy. Only 7.7% of patients received radiation therapy in combination with surgery. The median disease specific survival was 46 months. Five and ten-year cancer specific survival rates were 47%, and 35%. On multivariate analysis, a worst outcome was associated with increasing age, an undifferentiated tumor grade, distant stage, and failure to undergo cancer directed surgery. Conclusions This series represents the largest cohort of leiomyosarcoma of the urinary bladder studied to date. Leiomyosarcoma commonly presented as high grade and advanced stage with a poor prognosis. A worst outcome was associated with increasing age, an undifferentiated tumor grade, distant stage, and failure to undergo cancer directed surgery. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e496 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Dayron Rodríguez More articles by this author Mark A. Preston More articles by this author Glen W. Barrisford More articles by this author Adam S. Feldman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Ependymoma in children under the age of 3 years: a report from the Canadian Pediatric Brain Tumour Consortium

The determination of optimal therapy for ependymoma (EP) in infants is ongoing. We describe the incidence, management and outcomes of Canadian infants with EP to discern potential future research questions. Of 579 cases registered in a national database of children <36months of age diagnosed with a brain tumor from 1990 to 2005, inclusive, 75 (13%) were EP. These cases were analyzed. A mean annual age-adjusted incidence rate of 4.6 per 100,000 children years was calculated. The male:female ratio was 1.77. Of the tumors, 80% were infratentorial in location, 67% were WHO grade II histology, and 29% were metastatic at diagnosis. All patients underwent a surgical procedure. A complete resection of the tumor was achieved in 56% of the cases; 43% of these patients survive while 36% of the patients with tumors less than completely resected survive. Initial therapy consisted of surgery alone in 23% of patients, or surgery plus chemotherapy (37%), radiation therapy (RT; 19%), or both (21%). Any use of RT increased with patient age. The 5-year EFS rates for patients in each of the four treatment groups was 22, 11.5, 46.2 and 64.8%, respectively. For all patients the median survival was 63±6 months and 5-year overall survival was 55±6%. Patients treated with surgery and chemotherapy alone were younger and had a lower rate of survival than older patients who were more often treated with radiation therapy containing regimens. Further study is needed to determine which patients are optimally served with these treatment modalities.

Pediatric melanoma in New Mexico American Indians, Hispanics, and non-Hispanic whites, 1981–2009

BackgroundPediatric melanoma rates are increasing nationally. Our purpose was to determine the incidence of melanoma in New Mexico's (NM's) American Indian, Hispanic, and non-Hispanic white children. MethodsA retrospective review (1981 to 2009) of the NM Tumor Registry was conducted. Melanomas diagnosed in children <19 years of age were identified. Average annual age-adjusted incidence rates per million were calculated. ResultsSixty-four cases were identified. Rates per million were 7.4 for non-Hispanic whites, 2.1 for Hispanics, and 3.3 for American Indians. Fifty-nine percent were women. Fifty-five (86%) cases were localized, 6 (9%) were regional, and 1 (3%) case was metastatic. Majority of cases (49/64; 77%) occurred in children >14 years of age. American Indians presented with thicker melanomas as compared to whites and Hispanics. ConclusionsIncidence rates for pediatric melanoma in NM are highest for non-Hispanic whites. Distant metastasis is uncommon. Melanoma in children is rare, but practitioners must be aware of its occurrence for prompt diagnosis and treatment.

Temporal trends in incidence rates of herpes zoster among patients treated in primary care centers in Madrid (Spain), 2005–2012

This study aimed to estimate total and age-specific incidence rates of HZ with data from electronic clinical records in primary care (ECRPC) and to analyze trends by sex and age. Descriptive cross-sectional study covering the incident HZ episodes registered in the ECRPC of the Madrid Regional Public Health System in 2005-2012. Annual crude and age-adjusted incidence rates were calculated. Differences by sex and age were assessed by poisson regression. The annual percentage of change (APC) of incidence rates and 'breakthrough points' of the time trends were determined with the Joinpoint Regression Program. 211,650 episodes of HZ were identified (60.6% women, 52.2% > 55 years). The incidence rate increased from 363.21 to 481.92 per 100,000 person-year in 2005-2012. Rates were higher among women and increased with age. The APC for the period was 3.59% in men and 3.67% in women (p < 0.05). Age-specific rates increased in patients over 14 years. The APC in the 25-44 age group was 7.4% since 2007. The incidence rate ratio (women/men) was highest in this group. The incidence of HZ presents an upward trend in 2005-2012 in adults and the elderly. Monitoring the incidence and age-specific rates, will help to detect changes in trends.

CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2006-2010

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control (CDC) and National Cancer Institute (NCI), is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors (malignant and non-malignant) and supersedes all previous CBTRUS reports in terms of completeness and accuracy. All rates (incidence and mortality) are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 23.79 (Malignant AAAIR=7.08, non-Malignant AAAIR=16.71). This rate was higher in females compared to males (26.31 versus 21.09), Blacks compared to Whites (23.88 versus 23.83), and non-Hispanics compared to Hispanics (24.23 versus 21.48). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.5% of all tumors), and the most common non-malignant tumor was meningioma (38.3% of all tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.14. An estimated 83,830 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2020 (24,970 malignant and 58,860 non-malignant). There were 81,246 deaths attributed to malignant brain and other CNS tumors between 2013 and 2017. This represents an average annual mortality rate of 4.42. The 5-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 23.5% and for a non-malignant brain and other CNS tumor was 82.4%.

Chemical Characterisation of Organic Functional Group Compositions in PM2.5Collected at Nine Administrative Provinces in Northern Thailand during the Haze Episode in 2013

Along with rapid economic growth and enhanced agricultural productivity, particulate matter emissions in the northern cities of Thailand have been increasing for the past two decades. This trend is expected to continue in the coming decade. Emissions of particulate matter have brought about a series of public health concerns, particularly chronic respiratory diseases. It is well known that lung cancer incidence among northern Thai women is one of the highest in Asia (an annual age-adjusted incidence rate of 37.4 per 100,000). This fact has aroused serious concern among the public and the government and has drawn much attention and interest from the scientific community. To investigate the potential causes of this relatively high lung cancer incidence, this study employed Fourier transform infrared spectroscopy (FTIR) transmission spectroscopy to identify the chemical composition of the PM2.5 collected using Quartz Fibre Filters (QFFs) coupled with MiniVolTM portable air samplers (Airmetrics). PM2.5 samples collected in nine administrative provinces in northern Thailand before and after the "Haze Episode" in 2013 were categorised based on three-dimensional plots of a principal component analysis (PCA) with Varimax rotation. In addition, the incremental lifetime exposure to PM2.5 of both genders was calculated, and the first derivative of the FTIR spectrum of individual samples is here discussed.

Higher incidence and mortality rates of cervical cancer in African-American women in Louisiana.

e17522 Background: Cervical cancer [CC] incidence in the United States has decreased over the last thirty years in black and white Americans, however it is recognized that black women [BW] have higher incidence and mortality rates than white women [WW]. We evaluated race-specific incidence of CC, mortality rates of CC, and HPV vaccine usage rates in Louisiana [LA] during the last decade, the state with the second highest proportion of black Americans in the United States [US]. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) registries were analyzed for trends in incidence and mortality rate [MR] in BW and WW in LA and the US. SEER 13 and SEER 18 data were used and standardized to the 2000 US population to estimate annual age-adjusted incidence and mortality rates. Results: The incidence of CC in WW in LA was 8.2 per 100,000 from 2006 to 2009, and 7.9 per 100,000 in WW in US. The incidence in BW in LA was 13.3 per 100,000, as compared to the US at 9.7 per 100,000, a 36% higher incidence in BW. The MR in WW in LA and the US was 2.4 and 2.2 per 100,000. The MR for BW in LA was 5.8 per 100,000 and the US was 4.3 per 100,000, a 37% higher incidence in BW. WW in LA and the US showed a peak in incidence between the ages of 35 and 45 from 2006 to 2009. The incidence in BW in LA peaked at 37.1 per 100,000 at age 85 and the incidence in BW in the US peaked at 25.6 per 100,000 at age 85. HPV vaccination rates for LA females ages 13-15 in 2008 and 2009 were 16.1% and 35.4%. Conclusions: BW in LA were twice as likely to be diagnosed with CC than WW with a higher MR. Though the incidence rate of CC is decreasing in WW and BW in the US and in WW in LA, it is increasing in BW in LA and continues to trend up throughout life in BW compared to WW. The high incidence of CC in BW in LA highlights the need to improve utilization of the HPV vaccine. A screening and treatment program targeting CC was implemented within the last decade in the LA public hospital system with the goal of reducing CC incidence and mortality.

Descriptive epidemiology of ependymal tumours in the United States

Background:Ependymomas are rare primary gliomas that commonly affect both children and adults, but unique as survival is worse in children.Methods:Data on brain and central nervous system primary malignant and non-malignant ependymal tumours from the Central Brain Tumor Registry of the United States analytic data set and primary malignant ependymal tumours from the SEER 13 registries research data file were used to evaluate incidence and survival, respectively.Results:The 2004–2009 average annual age-adjusted incidence rate of ependymal tumours was 0.41/100 000. Spinal cord/cauda equina was the primary site at diagnosis for 50–60% of ependymal tumours in adult age groups in contrast to about 20% in children and adolescents. Ependymoma was the most frequent histology in all age groups; however, anaplastic ependymoma comprised about 30% in cases 0–19 years of age compared with about 3–5% in adult age groups. Overall, relative survival was favourable with rates at ∼85% and 75% at 3 and 10 years post diagnosis, respectively. However, children and adolescents, the oldest adult age group, cases diagnosed with anaplastic ependymoma and/or tumour location in a brain site had lowest survival rates.Conclusion:Paediatric cases had worse outcomes compared with adults for numerous reasons including having a higher percentage of anaplastic ependymomas and greater percentage of cases of intracranial disease.

Abstract WP201: Racial Disparities among Incident Ischemic Stroke Cases in the District of Columbia: the ASPIRE Study

Background: Racial disparities in ischemic stroke incidence have been found in previous studies with blacks having higher rates compared to whites. Recent data has suggested a decrease in stroke incidence but not necessarily a decrease in race differentials. We sought to document incidence of ischemic stroke and explore race-ethnic differentials in the urban, Washington, DC metro area. METHODS: ASPIRE is a multi-dimensional intervention with a three-pronged approach (community, hospital, EMS) to acute stroke preparedness targeted to increase IV tPA utilization in underserved black communities in DC. Using a comprehensive active and passive surveillance strategy including stroke admission alerts, stroke champions, admission/discharge data and chart review, the ASPIRE research team prospectively identified all hospitalized incident ischemic strokes between January 2008 and July 2012. Direct age-adjusted rates were estimated using age specific proportions from the 2010 census of the DC population for each sex, gender and race subgroup. RESULTS: Over 4.5 years, we captured 691 incident ischemic strokes: mean age 67 yrs +/- 15 yrs; 79% were blacks; and 55% females. Over 45% of the incident ischemic strokes occurred in black-females. Risk factors including hypertension (79%), diabetes (39%), and current smoking (28%) were significantly greater for blacks than whites. The age-adjusted average annual incidence rate per 100,000 was 226 overall: 171 for blacks, 45 for whites; 65 for black-males; 19 for white-males; 106 for black-females; and 26 for white-females CONCLUSION: We report significant racial disparities in the incidence of hospitalized ischemic in the DC metro area despite potential undercounting of non-hospitalized stroke cases, and potential competing mortalities in black men (ie. ICH, homicide, AIDS). This continued excess burden of ischemic stroke, particularly in black females, highlights the ongoing importance of projects such as ASPIRE to continue education and preparedness among those with increased risk.

Incidence rates for anal cancer in the United States: 1980-2009.

357 Background: Anal squamous cell carcinoma (SCC) is rare, but results in significant morbidity and mortality. The aim of this study was to characterize the trends of anal SCC in the U.S. between 1980-2009. Methods: Subjects were identified from records in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. The study included incident malignant squamous cell cancer of the anus, anal canal, and anorectum diagnosed among nine core areas of the SEER program from 1980-2009. Average annual age-adjusted incidence rates were calculated by the direct method with the U.S. 2000 standard population. 95% confidence intervals were calculated using the Tiwari adjustment. Temporal trends were assessed by joinpoint regression. Results: Incidence rates of anal cancer in the U.S. more than doubled during this period. A linear increase in anal cancer incidence rates was observed with an Annual Percent Change (APC) of 4.6 (p&lt;0.01) for all races and both sexes-combined. Incidence rates were consistently greater for women than men, however, the increase in incidence rates was greater for men (APC=5.4, p&lt;0.01) than for women (APC=4.3, p&lt;0.01). Similar trends were seen for whites and blacks. Conclusions: Anal cancer is a relatively rare disease, yet incidence rates increased dramatically in the U.S. over the last three decades. Correlation of this increased incidence with HPV infection remains to be determined. [Table: see text]

Incidence Rate of Cerebrovascular Diseases in Northern Japan Determined from the Iwate Stroke Registry with an Inventory Survey System

Long-term stroke registries in large populations often fail to maintain accuracy. This study presents an inventory survey system for stroke registries and the incidence rate of cerebrovascular diseases in a region with the highest stroke mortality rate in Japan. Using the data of the stroke registry determined with the inventory survey from 2004 to 2008 in northern Iwate Prefecture, with a population of 235,280 (111,584 men and 123,696 women), the age-specific annual incidence rates, the age-adjusted annual incidence rates, and the ratio of incidence rate relative to mortality rate of the cerebrovascular diseases were investigated. A total of 3415 cases (1714 men and 1701 women) were registered and analyzed in this study. The age-adjusted incidence rates by the 1985 model population of Japan and by the world standard population (range 35-64 years) were 100.4 and 89.4per 100,000 population in men and 49.8 and 29.7 in women for cerebral infarction; 53.6 and 77.2 in men and 34.2 and 39.5 in women for intracerebral hemorrhage; 12.9 and 23.3 in men and 21.1 and 34.6 in women for subarachnoid hemorrhage; and 166.9 and 189.8 in men and 105.0 and 103.7 in women for all subtypes. The ratios of incidence rate relative to mortality rate were 1.66 for all stroke subtypes, 1.69 for cerebral infarction, 1.76 for intracerebral hemorrhage, and 1.31 for subarachnoid hemorrhage. High incidence rates of cerebrovascular diseases were revealed in the stroke registry with a good inventory survey in northern Iwate Prefecture, Japan.

Enucleation in Iceland 1992–2004: study in a defined population

To determine the incidence rate as well as causative diagnoses and surgical indications of enucleation in Iceland during the years 1992-2004. A retrospective population-based incidence study involving the entire population of Iceland. Medical records of all patients who underwent enucleation in Iceland from January 1992 through December 2004 were reviewed. The annually updated Icelandic census was used as a denominator data. Fifty-six eyes were enucleated during 1992-2004. No eviscerations were done, and the three exenterations performed were not included in the study. The mean annual age-adjusted incidence rate of enucleation in Iceland was 1.48 enucleations per 100 000 population in comparison with 2.66 enucleations per 100 000 for the time period 1964-1991. With advancing age, a significant increasing linear trend existed (p < 0.001). The median age at enucleation was 51 years (SD 22; mean 55 years; 16-91 years). The three most common surgical indications for enucleation were blind painful eye, suspected ocular malignancy and acute trauma. The most common causative diagnosis for enucleation was traumatic lesion (39%). The annual incidence was 2.00 enucleations per 100 000 for men and 0.95 for women. There were significantly more men in the traumatic lesion group (p < 0.001), but no gender predominance was found in the other groups of causative diagnoses (p = 0.8). The overall mean annual incidence of enucleation in Iceland is continually decreasing, although the incidence of severe ocular trauma and ocular malignancy is fairly stable.

Trends in the Incidence of Stroke and Cardiovascular Risk Factors on the Isolated Island of Okinawa: The Miyakojima Study

Rapid deterioration of cardiovascular risk control, especially obesity, has occurred in Okinawa; this may affect cardiovascular disease incidence, including stroke. Cross-sectional field studies were conducted in 2 periods, 1988-1991 as the first period, and 2002-2005 as the second period, in the isolated island of Okinawa, Miyakojima. To evaluate population backgrounds related to cardiovascular risk factors, data from the health checkup programs conducted in 1987 and 2001 were surveyed. Total of 257 patients in the first period and 370 in the second were diagnosed with first-time stroke. The age-adjusted annual incidence rate of first-time stroke of the first and second periods was 124 and 144 per 100,000 standard population of Japan. The age-adjusted annual incidence rate showed an upward trend for brain infarction (50 to 73) and downward trend for brain hemorrhage (61 to 54); however, those trends were not significant. The health checkup surveys illustrated that blood pressure decreased in all age groups during the second survey period. However, the body mass index increased in patients aged 50 years or more. Fasting blood glucose levels of patients aged 30-79 years and non-HDL cholesterol levels of patients aged 50-79 years significantly increased. In Miyakojima, the incidence of first-time stroke and all of its subtypes did not change significantly between two periods, even though blood pressure decreased significantly in the second period. Metabolic deterioration may be associated with the upward trend in incidence of brain infarction.

Incidence and Survival of Colorectal Cancer Among Hispanics in the United States: A Population-Based Study

Hispanics are the largest and fastest growing ethnic group in the United States (US). We evaluated the incidence and survival of colorectal cancer (CRC) among this population. Data from the surveillance, epidemiology, and end results program were used to calculate CRC age-adjusted and age-specific incidence rates in Hispanics during 1993-2007. Temporal trends in CRC incidence were examined using annual percent change (APC) and Poisson regression. The 1- and 5-year survival rates were calculated. The annual age-adjusted incidence rates for CRC in Hispanics of all ages declined from 47.4 per 100,000 in 1993-1997 to 43.8 per 100,000 in 2003-2007, with an APC during 1993-2007 equal to -0.8/year. However, there was a 45 % increase in CRC incidence among Hispanic men and women aged 20-49 years that affected both the right and left colon. The proportions of CRC cases with regional (+37 %) and distant (+18 %) spread increased, now constituting 72 % of cases diagnosed at that age. The Poisson model confirmed the increasing CRC incidence in Hispanics aged 20-49 years during 1993-2007 while adjusting for sex and geographic region. The 1-year survival improved in younger Hispanics from approximately 86 % in 1993-1997 to 91 % in 2003-2007 with no significant improvement in 5-year survival. In Hispanics aged >50 years, no significant improvements in survival were observed. The incidence of CRC in young Hispanic men and women has increased in the US. Most are diagnosed with regional or distant disease. No significant improvement in long-term survival was observed in young Hispanics with CRC.

Abstract A54: The association of county level characteristics with the incidence of squamous cell carcinoma of the cervix in Hispanic women.

Abstract Purpose: To evaluate the association of county level characteristics with the incidence of invasive squamous cell carcinoma of the cervix among Hispanic women. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program's 18 registries from 2000-2009 were queried and average annual age-adjusted incidence rates per 100,000 Hispanic women for invasive squamous cell carcinoma of the cervix (SCC) were calculated. Patients were stratified by residence in a county with high versus low percent language isolation, percent of Hispanics with less than a high school education and percent of Hispanic families below the poverty level. Results: Between 2000-2009, 5,534 Hispanic women were diagnosed with SCC in SEER. Incidence rates were highest among those living in counties with high levels of LI (8.9 v 10.7), or low levels of education (8.9 v 10.8) or income (8.7 v 11.0). The incidence of SCC was significantly less in women living in counties with higher levels of education and income and lower levels of LI than among those living in counties with lower levels of education and income and higher levels of LI (8.6 v. 11.3). Counties that have higher levels of income and education are less likely to be LI whereas counties with lower levels of income and education are more likely to be LI. Conclusions: Among Hispanic women, county level characteristics such as LI, education, and income have a complex interaction that appears to be associated with the incidence of SCC. Community level interventions need to be evaluated to decrease the high incidence of SCC in this population. Citation Format: Kristy K. Ward, Angelica M. Roncancio, Steven C. Plaxe. The association of county level characteristics with the incidence of squamous cell carcinoma of the cervix in Hispanic women. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A54.