Austrian National Cancer Registry Research Articles

Time Trends in Male Breast Cancer Incidence, Mortality, and Survival in Austria (1983-2017).

Male breast cancer (MBC) comprises less than 1% of all breast cancer cases globally and remains understudied with persisting sex-specific survival disadvantages. We aim to contribute to better understanding of MBC with a comprehensive analysis of time-trends over several decades in Austria. We used Austrian National Cancer Registry data on 1648 cases of MBC cases diagnosed between 1983 and 2017 in Austria. Overall incidence, mortality, and survival rates, as well as age-, stage-, and period-specific incidence and survival rates were calculated. Joinpoint regression was performed to assess trends. MBC incidence rates increased throughout the whole observation period (1983-2017) with an annual percent change (APC) of 1.44% (95% confidence interval, CI: 0.77 to 2.11). During the same period, morality rates were stable (APC: -0.25, 95% CI: -0.53 to 0.60). Ten-year survival rates showed three phases of decreasing increases with an average APC of 2.45%, 1983-2009 (95% CI: 2.1 to 2.74). Five-year survival rates improved until 2000 (APC: 2.31, 95% CI: 1.34 to 3.30) and remained stable thereafter (APC: 0.10, 95% CI: -0.61 to 0.80). Stage-specific analyses showed a single trend of stable incidence rates of distant disease MBC (APC: -0.03, 95% CI: -1.67 to 1.65). Further, we observed increases in localised, regional, and unknown stage cancer incidence and increases in incidence rates across all age groups over the whole observation period. However, the estimates on these subgroup-specific trends (according to age- and stage) show wider 95% CIs and lower bounds closer to zero or negative in comparison to our findings on overall incidence, mortality, and survival. Despite improvements in survival rates, MBC mortality rates remained largely stable between 1983 and 2017 in Austria, possibly resulting from a balance between increasing overall incidence and stable incidence rates of distant disease MBC.

Increase and Plateauing of Testicular Cancer Incidence in Austria—A Time Trend Analysis of the Past Four Decades

BackgroundTesticular germ cell tumors (TGCTs) are the most common malignant tumors in young men. Despite considerable geographic, ethnic, and temporal variations in the incidence of TGCTs, without convincing explanation, incidence rates of TGCTs have been increasing in many countries since, at least, the mid-20th century. ObjectiveTo investigate the incidence rates of TGCTs in Austria by analyzing data from the Austrian Cancer Registry. Design, setting, and participantsAvailable data between 1983 and 2018 were provided by the Austrian National Cancer Registry and analyzed retrospectively. Outcome measurements and statistical analysisGerm cell tumors derived from germ cell neoplasia in situ were classified into seminomas and nonseminomas. Age-specific incidence rates and age-standardized rates were calculated. Annual percent changes (APCs) and average annual percent changes in incidence rates were determined to describe trends from 1983 to 2018. All statistical analyses were performed using SAS version 9.4 and joinpoint. Results and limitationsThe study population consists of 11 705 patients diagnosed with TGCTs. The median age at diagnosis was 37.7 yr. The standardized incidence rate of TGCTs increased significantly (p < 0.0001) from 4.1 (3.4, 4.8) per 100 000 in 1983 to 8.7 (7.9, 9.6) per 100 000 in 2018 by an average APC of 1.74 (1.20, 2.29). The joinpoint regression revealed a change point in time trend in 1995 with an APC of 4.24 (2.77, 5.72) before 1995 and an APC of 0.47 (0.06, 0.89) thereafter. Incidence rates were about twice as high for seminomas as for nonseminomas. A trend analysis by age group showed that the highest TGCT incidence rate was observed among men aged 30–40 yr, with a steep increase before 1995. ConclusionsThe incidence rate of TGCTs increased in Austria over the past decades and appears to have reached a plateau at a high level. A time trend analysis by age group for the overall incidence was highest in men aged 30–40 yr, with a steep increase before 1995. These data should lead to awareness campaigns and research to further investigate the causes of this development. Patient summaryWe reviewed the data between 1983 and 2018 provided by the Austrian National Cancer Registry to analyze the incidence and incidence trend in testicular cancer. Testicular cancer shows an increasing incidence in Austria. The overall incidence was highest in men aged 30–40 yr, with a steep increase before 1995. The incidence appears to have reached a plateau at a high level in recent years.

Improvement in colorectal cancer outcomes over time is limited to patients with left-sided disease.

Incidence and mortality of colorectal cancer (CRC) declined over the last decades. However, survival depends on the primary tumor location. It is unknown if all progress in outcomes vary depending on left-sided (LCRC) versus right-sided (RCC) colorectal cancer. We compare incidence and mortality rates over time according to the primary tumor location. Data from the Austrian National Cancer Registry spanning from 1983 to 2018 were used to calculate annual incidence and mortality rates and survival stratified by primary tumor localization and stage. Joinpoint regression with linear regression models were used on different subgroups to identify significant changes of incidence- and mortality slopes. A total of 168,260 (incidence dataset) and 87,355 cases (mortality dataset) were identified. Survival of disseminated RCC was worse compared to LCRC (HR 1.14; CI 1.106-1.169). Total and LCRC incidence and mortality rates declined steadily over time, whereas the rates of RCC did not. Incidence of disseminated RCC declined significantly less (slope - 0.07; CI - 0.086; - 0.055) than in LCRC (slope - 0.159; CI - 0.183; - 0.136); mortality rate of RCC was unchanged over time. Incidence and mortality of localized RCC remained unchanged over time, whereas both rates declined independently of stage in LCRC. Colorectal cancer outcomes during the last 35years have preferentially improved in LCRC but not in RCC, indicating that the progress made is limited to LCRC. It is necessary to define RCC as a distinct form of CRC and to focus on specific strategies for its early detection and treatment.

968P - Long term relative survival (RS) in patients with primary metastatic kidney cancer (primary mRCC): An analysis of 2,167 patients from the Austrian National Cancer Registry (ANCR)

BackgroundThe introduction of thyrosinkinase inhibitors (TKI) changed the treatment of mRCC. To elaborate the potential impact of TKI therapies, we studied trends in OS for patients diagnosed with primary mRCC between 1998 - 2015 in Austria. MethodsAll patients with primary mRCC (≥18 years), diagnosed from 1998 - 2015 were derived from the ANCR (n=2,490). Patients diagnosed from 2004-2005 (n=323) were excluded (transition period of systemic therapies). To evaluate survival differences between patients treated before and after the introduction of Sunitinib (preTKI-era and TKI-era), 3 periods were defined: 1998 - 2003 (preTKI-era; N=937), 2006 - 2010 (TKI-era P1; N=687) and 2011 - 2015 (TKI-era P2; N=543). Follow-up was complete until Dec. 31st, 2016. The Cox proportional hazard model was used to calculate hazard ratios (HR). ResultsA total of 2,167 patients were included, median age was 70 yrs in the 3 eras. The incidence of T1 tumors increased from 6.9% in the preTKI-era to 10% in the TKI-era while T4 tumors decreased from 15% to 8% (p <.001). Surgery rate declined from 50% in the preTKI-era to 43% in 2011-2015 (p =.02). 5-year RS for patients undergoing surgery slightly increased from 18% in the preTKI-era to 23% in TKI-era P1 (p =.04). For patients without surgery 5-year OS improved from 5.2% in the preTKI-era to 9.1% in TKI-era P1 (p <.001). Further survival gain was observed in patients < 75 yrs of+6% (p =.01), patients>= 75 years of+0.2% (p =.03) and for T3/T4 tumors of+6% (p =.002). The Relative Excess Risk of dying (RER) for patients treated in the TKI-eras was reduced compared to the preTKI-era (HR 0.78, 95% CI 0.76-0.95) adjusted for sex, age, T-stage and surgery. Survival advantage for patients undergoing surgery remained significant (HR: 0.46, 95% CI 0.41-0.52) after adjustment for TKI-era, sex, age, T-stage. ConclusionsPatients treated in the TKI era show improved RS compared to the cytokine era. Most benefit was observed in non-surgical patients, younger patients and for T3/T4 disease. Surgery contributed to an additional survival benefit. Legal entity responsible for the studyPriv. Doz. Dr. Martin Marszalek. FundingPfizer Austria. DisclosureAll authors have declared no conflicts of interest.

Long term relative survival (RS) in patients with primary metastatic kidney cancer: An analysis of 2,167 patients from the Austrian National Cancer Registry (ANCR).

e16069 Background: The introduction of thyrosinkinase inhibitors (TKI) changed the treatment of metastatic kidney cancer fundamentally. In Austria, TKI was in troduced in 2006. To elaborate the potential impact of TKI therapies, we studied trends in OS for patients diagnosed with primary metastatic kidney cancer between1998 and 2015 in Austria. Methods: All patients with primary metastatic kidney cancer aged ≥18 years, diagnosed from 1998-2015 were derived from the ANCR (n = 2,490). Patients diagnosed from 2004-2005 (n = 323) were excluded (transition period of systemic therapies). To evaluate survival differences between patients treated before and after the introduction of Sunitinib (preTKI-era and TKI-era), three periods were defined: 1998-2003 (preTKI-era; N = 937), 2006-2010 (TKI-era P1; N = 687) and 2011-2015 (TKI-era P2; N = 543). Follow-up was complete until December 31st, 2016. RS rates were estimated by using method. The Cox proportional hazard model was used to calculate hazard ratios (HR). Results: A total of 2,167 patients was included in the analysis. The median age of the study population was 70 yrs and did not differ between the three eras. The incidence of T1 tumors increased from 6.9% in the preTKI-era to 10% in the TKI-era while T4 tumors decreased from 15% to 8% (p &lt; .001). Surgery rate declined from 50% in the preTKI-era to 43% in 2011-2015 (p = .02). Five-year RS for patients undergoing surgery slightly increased from 18% in the preTKI-era to 23% in TKI-era P1 (p = .04). For patients without (p = .04). For patients without surgery 5-year OS improved from 5.2% in the preTKI-era to 9.1% in TKI-era P1 (p &lt; .001). Apart from surgery, survival gain was observed for younger patients ( &lt; 75 yrs) of +6% (p = .01), older patients ( &gt; = 75 years) of +0.2% (p = .03) and for T3/T4 tumors of +6% (p = .002). The Relative Excess Risk of dying (RER) for patients treated in the TKI-eras was reduced compared to the preTKI-era (HR 0.78, 95% CI 0.76-0.95) adjusted for sex, age, T-stage and surgery. Survival advantage for patients undergoing surgery remained significant (HR: 0.46, 95% CI 0.41-0.52) after adjustment for TKI-era, sex, age, T-stage. Conclusions: Patients with primary metastatic kidney cancer treated in the TKI era show improved RS compared to the cytokine era. Most benefit was observed in non-surgical patients, younger patients and for T3/T4 disease. Surgery remains as an important therapy for additional survival benefit.

Impact of rural/urban residence on relative survival (RS) in patients with kidney cancer: An analysis of 14576 patients from the Austrian National Cancer Registry (ANCR).

e16072 Background: Access to medical diagnostics and treatment might be limited for patients living in rural areas compared to urban residents. To evaluate the potential impact of urban/rural residence, we analyzed trends in RS for patients diagnosed with kidney cancer between 1998 and 2015 in Austria. Methods: All patients with kidney cancer aged ≥18 years, diagnosed between 1998 and 2015 were derived from the ANCR (N = 22,041). Patients were categorized into two groups: rural (N = 7,53) and urban (N = 10,552) based on a complex algorithm considering infrastructure, commuter interrelations, accessibility of centers and tourism at the time of diagnosis. Relative survival was calculated based on complete follow-up until December 31st, 2016. Poisson regression modeling was used to evaluate survival differences between the two groups and to calculate the relative excess risk of dying (RER). Analyses were performed for the total patient population and primary metastatic patients (M+, N = 2,490). Results: Distribution of age and surgical treatment did not differ between rural and urban patients. Five-year RS was 75% for rural patients compared to 73% for urban patients (RER for rural: 0.85, 95%CI 0.80-0.91). In M+ patients, 5-year RS was 14% for urban patients and 15% for rural patients (p = .02) Multivariate analysis showed that residence remained as an independent predictor for survival in the overall kidney cancer population (RER of rural patients 0.84, 95%CI 0.78-0.89). For M+ patients the RER of rural patients was 0.86 ( 95%CI 0.79-0.94) compared to urban M+ patients. For patients without surgery, rural patients were even stronger benefited in their survival than urban patients (overall population: RER 0.77, 95% CI 0.71-0.83; M+ patients: RER 0.81, 95%CI 0.72-0.91) wherereas in surgical patients RS did not differ between rural and urban patients. Conclusions: An advantage in RS was observed for kidney cancer patients living in rural areas. This advantage was evident in metastatic and non-metastatic patients, especially in patients who did not undergo surgery for (metastatic) kidney cancer. These results suggest that access to medical health care for kidney cancer patients in Austria is not limited by rural residence.

P113 - Long term overall survival (OS) in patients with primary metastatic kidney cancer: an analysis of 1468 patients from the Austrian National Cancer Registry (ANCR)

489Background: The introduction of thyrosinkinase inhibitors (TKI) changed the treatment of metastatic kidney cancer fundamentally. To elaborate the potential impact of TKI therapies, we studied tr...

Long term overall survival (OS) in patients with primary metastatic kidney cancer: An analysis of 1468 patients from the Austrian National Cancer Registry (ANCR).

489 Background: The introduction of thyrosinkinase inhibitors (TKI) changed the treatment of metastatic kidney cancer fundamentally. To elaborate the potential impact of TKI therapies, we studied trends in OS for patients with primary metastatic kidney cancer between 1998 and 2014 in Austria. Methods: All patients with primary metastatic kidney cancer aged ≥18 years, diagnosed from 1998-2009 were derived from the ANCR (n=2134). Patients diagnosed from 2004-2006 (n=316) were excluded (transition period of systemic therapies). To evaluate differences in OS between patients treated in preTKI-era and TKI-era, two periods were defined: 1998-2003 (before the introduction of Sunitinib in Austria, P1; n=926) and 2006-2009 (P2; n=542). Follow-up was complete until December 31st, 2014. OS rates were estimated by using the Kaplan-Meier method. The Cox proportional hazard model was used to calculate hazard ratios (HR). Results: A total 1468 patients was included in the analysis. The median age of the study population was 70 yrs (sd ±12) and did not differ between the two eras. The incidence of T1 tumors increased from 6.6% in P1 to 10% in P2 while T4 tumors decreased from 15% to 6.5% (p&lt;0.001). Surgery rate remained stable at 48% (p=0.14). Five-year OS for patients undergoing surgery slightly increased from 16% in P1 to 20% in P2, although not significant (p=0.11). For patients without surgery 5-year OS improved from 4.3% in P1 to 7.9% in P2 (p=0.02). Apart from surgery, survival gain was observed for younger patients (&lt;75 yrs) of 4% (p=0.04) and for T3/T4 tumors of 7% (p=0.008). The risk of death (HR) for patients treated in the TKI-era was reduced compared to the preTKI-era (HR 0.83, 95% CI 0.74-0.93) adjusted for sex, age, T-stage, and surgery. Survival advantage for patients undergoing surgery remained significant (HR: 0.50, 95% CI 0.45-0.57) after adjustment for TKI-era, sex, age, and T-stage. Conclusions: Patients with primary metastatic kidney cancer treated in the TKI era show improved OS compared to the cytokine era. Most benefit was observed in non-surgical patients, younger patients, and for T3/T4 disease. Surgery remains as an important therapy for additional survival benefit.

Impact of rural/urban residence on relative survival (RS) in patients with kidney cancer: An analysis of 14576 patients from the Austrian National Cancer Registry (ANCR).

491 Background: Access to medical diagnostics and treatment might be limited for patients living in rural areas compared to urban residents. To evaluate the potential impact of urban/rural residence, we analyzed trends in RS for patients diagnosed with kidney cancer between 1998 and 2009 in Austria. Methods: All patients with kidney cancer aged ≥18 years, diagnosed from 1998-2009 were derived from the ANCR (n=14,576). Patients were categorized into two groups: rural (n=7,537) and urban (n=7,039) based on a complex algorithm considering infrastructure, commuter interrelations, accessibility of centers, and tourism at the time of diagnosis. Relative survival was calculated based on complete follow-up until December 31st, 2014. Poisson regression modeling was used to evaluate survival differences between the two groups and to calculate the relative excess risk of dying (RER). Analyses were performed for the total patient population and primary metastatic patients (M+). Results: Distribution of sex, age, stage of disease, year of diagnosis, and surgical treatment did not differ between rural and urban patients. Five-year RS was 74% for rural compared to 73% for urban patients (RER for rural: 0.88, 95% CI 0.81-0.95). In M+ patients, 5-year RS was 14% for both residence groups. On multivariate analysis, residence remained as an independent predictor for survival in the overall kidney cancer population (RER of rural patients 0.87, 95% CI 0.81-0.94). For M+ patients the RER was 0.90 ( 95% CI 0.81-1.00). For patients without surgery, rural patients were even stronger benefited in their survival than urban patients (overall population: RER 0.81, 95% CI 0.74-0.89; M+ patients: RER 0.84, 95% CI 0.73-0.97) wherereas in surgical patients RS did not differ between rural and urban patients. Conclusions: An advantage in RS was observed for kidney cancer patients living in rural areas. This advantage was evident in metastatic and non-metastatic patients, especially in patients who did not undergo surgery for (metastatic) kidney cancer. These results suggest that access to medical health care for kidney cancer patients in Austria is not limited by rural residence.

Trends in incidence, survival and mortality of childhood and adolescent cancer in Austria, 1994⿿2011

BackgroundThis is the first study on trends in cancer incidence, survival and mortality for children and adolescents in Austria. The aim was to assess to what extent progress against childhood and adolescent cancer has been made in Austria since the 1990s and to complement the childhood and adolescent cancer trends for Central Europe. MethodsAll malignant neoplasms and non-malignant tumours of the Central Nervous System (CNS) in patients aged less than 20 years and diagnosed between 1994 and 2011 (N=5425) were derived from the Austrian National Cancer Registry (ANCR). Incidence and mortality trends were evaluated by the average annual percentage change (AAPC). Observed survival rates were calculated based on follow-up until December 31st 2013. ResultsChildhood cancer remained stable with 182 cases per million in 2011, but rose among girls by 1.4% (95% CI: .1, 3.6) annually due to an increase of non-malignant CNS tumours and Non-Hodgkin lymphoma. Adolescent cancer rose by 1.5% (95% CI: .4, 2.6) annually, from 182 cases per million in 1994⿿269 in 2011, especially leukaemia, CNS tumours (including non-malignant types) and epithelial tumours. Five-year survival improved by 5⿿7% reaching 86% for both groups (p<.05). Mortality declined by ⿿2.4% (95% CI: ⿿3.7, ⿿1.2) and ⿿2.0% (95% CI: ⿿4.6, .5), respectively, especially for childhood leukaemia. ConclusionProgress is demonstrated by improved survival and declined mortality most likely related to improved diagnostic techniques, more effective therapeutic regimes, supportive care and a central advisory function of experts in the Austrian paediatric oncology.

Suicide among 915,303 Austrian cancer patients: Who is at risk?

ObjectivesThe aim of this study was to determine whether time since first diagnosis, site, and stage of cancer impacted suicide risk within a nationwide cohort of Austrian cancer patients. MethodsData for this population-based study were derived from the Austrian National Cancer Registry and Austrian Statistics on Causes of Death. The study of population comprised 915,303 patients diagnosed with cancer between 1983 and 2000 and 14,532,682 person-years of follow-up. Standardized suicide mortality ratios (SMRs) were calculated by sex, time since first diagnosis, site, and stage of cancer. ResultsA total of 2877 suicides were registered among all cancer patients over the observation period. Indicating excess suicide risk relative to the general Austrian population, the SMR for the patient cohort was 1.23 (95% CI: 1.19–1.28), and was higher for men (1.41; 95% CI: 1.35–1.47) than women (1.24; 95% CI: 1.15–1.34). This excess risk varied with time since first cancer diagnosis. SMRs peaked in year one after diagnosis (3.17; 95% CI: 2.96–3.40). An excess suicide risk was observed for patients with late locally advanced (SMR=1.59; 95% CI: 1.47–1.71) or metastasized cancer (SMR=4.07; 95% CI: 3.58–4.61), and cancers of the lung (SMR 3.86; 95% CI: 3.36–4.42) and central nervous system (SMR 2.81; 95% CI: 1.92–3.97). LimitationsNo data were available on psychiatric comorbidities, genetic variables, family characteristics, social factors, and community characteristics. ConclusionsOur study shows that cancer patients have an excess risk for suicide, relative to the general population, which varies with time since first diagnosis, disease severity, and anatomical site. The diagnostic process needs to be sensitive and responsive to their mental health needs. Psychological care should be an integral component of cancer treatment programs.

Epidemiological Trends of Hepatocellular Carcinoma in Austria

Background/Aims: The heterogeneous epidemiology of hepatocellular carcinoma (HCC) with the highest incidence rates in East Asia, sub-Saharan Africa and Melanesia results from variations in the main risk factors. We investigated epidemiological trends, including incidence and mortality, of patients diagnosed with HCC over a 20-year period in Austria. Methods: Data on age-adjusted incidence rates of HCC were obtained from the Austrian National Cancer Registry, which compiles nationwide data on all newly diagnosed cancers. Data on age-adjusted mortality were obtained from the national death registry (Statistics Austria). Results: Of 24,939 patients diagnosed with hepatobiliary tumors between 1990 and 2009, 8,561 subjects had HCC (m/f ratio 75/25%; mean age 69 years). Lymph node and distant metastases were present in 7.5 and 12.2%, respectively. The age-adjusted incidence rate was significantly higher in men than women (m/f ratio 4.5/1) and markedly increased in men (4.68/5.10) but remained stable in women (1.18/1.11). Similarly, the age-adjusted mortality rate was significantly higher in men than women (m/f ratio 4.5/1), increased in men (4.02/4.98) and remained stable in women (0.92/1.0). The median overall survival was 4.5 months for men and 3.2 months for women with 1-/5-year survival rates of 33/11% and 28/10%, respectively. Conclusion: HCC is the most common hepatobiliary neoplasia in Austria and has a very poor prognosis. The age-adjusted incidence and mortality rates were higher in males, increased over time in men and remained stable in women. Extrahepatic metastases were rarely diagnosed and associated with dismal survival.

Incidence and mortality trends for biliary tract cancers in Austria

The epidemiology of biliary tract cancers (BTC) varies between geographical regions and has changed over time globally. We investigated the incidence and mortality trends of patients diagnosed with BTC over a 20-year period in Austria. Patients diagnosed with intrahepatic (iCCC)/extrahepatic cholangiocarcinoma (eCCC), ampullary carcinoma, gall bladder carcinoma (GBC), overlapping lesions or unspecified carcinomas of the biliary tract and liver were included. Data on age-adjusted incidence were obtained from the Austrian National Cancer Registry which compiles data on all newly diagnosed cancers. Data on age-adjusted mortality were obtained from the national death registry (Statistics Austria). Between 1990 and 2009, 15201 patients were diagnosed with BTC (m/f=42/58%; mean age, 73years). The median survival of all patients with BTC was 4.8 months with a 1-/5-year survival rate of 31%/10%. In iCCC, the incidence and mortality rates increased from 1990 to 2009 in both men and women while in eCCC, the incidence and mortality rates decreased over time in both sexes. In ampullary carcinoma, the incidence slightly decreased in men and remained stable in women. The mortality rate remained stable in both sexes. In GBC, the age-adjusted incidence and mortality rates dramatically decreased in both sexes. GBC and iCCC were the most common entities amongst BTC. While incidence and mortality rates of iCCC increased in men and women over time, incidence and mortality rates of eCCC and GBC decreased in both sexes. Other carcinomas of the biliary tract i.e. ampullary carcinoma were rarely diagnosed.

Brain tumor epidemiology in Austria and the Austrian Brain Tumor Registry

Cancer registries provide incidence and mortality data on patients with cancer at the population level. Cancer registration is most often restricted to the group of malignant neoplasms, whereas information on benign and intermediate tumors is generally not available. Brain tumors however differ from other sites by 1) the large spectrum of different tumor types, and 2) the exclusive localization in proximity to eloquent areas with considerable neurological comorbidity and mortality irrespective of their biological behavior. In order to obtain a comprehensive overview of the brain tumor burden, specialized brain tumor registries, which provide information on all brain tumor types, have emerged in several countries. This thesis synopsis summarizes the Austrian experience on the establishment of such a specialized brain tumor registry: the Austrian Brain Tumor Registry (ABTR). The initial steps are reported - from consensus and commitment of the Austrian Society of Neuropathology, formation of an interdisciplinary team of experts, setup of the infrastructure including data confidentiality issues, to the sustained support of the Austrian neurooncology community and major cooperation with the Austrian National Cancer Registry. ABTR differs from other registries by its scientific setting and neuropathological background warranting strong expertise in brain tumor typing and tissue-based research. Thereby, ABTR constitutes also a virtual brain tumor biobank. By having achieved these steps, first investigational results demonstrate that ABTR provides valid and accurate population-based incidence and survival data for individual brain tumor types. The exact incidence of rare tumor entities is estimated, key diagnostic criteria of newly proposed tumor entities are refined, common standards for testing of molecular markers are advocated, and medical progress via real-life outcome analyses is assessed. The diverse scientific contributions highlight the enormous scientific potential of ABTR for continued work.

Incidence and mortality trends for biliary tract cancers in Austria

Background & Aims The epidemiology of biliary tract cancers (BTC) varies between geographical regions and has changed over time globally. We investigated the incidence and mortality trends of patients diagnosed with BTC over a 20-year period in Austria. Methods Patients diagnosed with intrahepatic (iCCC)/extrahepatic cholangiocarcinoma (eCCC), ampullary carcinoma, gall bladder carcinoma (GBC), overlapping lesions or unspecified carcinomas of the biliary tract and liver were included. Data on age-adjusted incidence were obtained from the Austrian National Cancer Registry which compiles data on all newly diagnosed cancers. Data on age-adjusted mortality were obtained from the national death registry (Statistics Austria). Results Between 1990 and 2009, 15201 patients were diagnosed with BTC (m/f=42/58%; mean age, 73 years). The median survival of all patients with BTC was 4.8 months with a 1-/5-year survival rate of 31%/10%. In iCCC, the incidence and mortality rates increased from 1990 to 2009 in both men and women while in eCCC, the incidence and mortality rates decreased over time in both sexes. In ampullary carcinoma, the incidence slightly decreased in men and remained stable in women. The mortality rate remained stable in both sexes. In GBC, the age-adjusted incidence and mortality rates dramatically decreased in both sexes. Conclusions GBC and iCCC were the most common entities amongst BTC. While incidence and mortality rates of iCCC increased in men and women over time, incidence and mortality rates of eCCC and GBC decreased in both sexes. Other carcinomas of the biliary tract i.e. ampullary carcinoma were rarely diagnosed.

Estimation of completeness of case ascertainment of Austrian cancer incidence data using the flow method

The international comparability of data from population-based cancer registries depends strongly on the completeness of case ascertainment. Furthermore, Austrian observed incidence rates suggest that the completeness of case ascertainment differs between Austrian federal states. Completeness of case ascertainment is to be investigated on national and regional level. We used the flow method to evaluate the completeness of the Austrian National Cancer Registry. This method is based on the logical flow of data in the registration system, and on the time distribution of various probabilities inherent in this flow. Overall completeness of the Austrian cancer incidence data 2005 was 94.2% after a registration period of 5 years. The flow method found striking differences in completeness between the federal states, which are contrary to the time series analyses. Overall completeness of the Austrian National Cancer Registry is in concordance with estimates from international registries. The biggest part of the decrease of incidence rates in the past 2 published years seems to be a result of incompleteness. The importance of the registration date of a cancer case and the survival time on completeness estimation using the flow method has become apparent. Further investigation into the comparability of registration date between the federal states and into the quality of survival time estimates is recommended.

The Austrian Brain Tumour Registry: a cooperative way to establish a population-based brain tumour registry

In Austria, registration of malignant brain tumours is legally mandatory, whereas benign and borderline tumours are not reported. The Austrian Brain Tumour Registry (ABTR) was initiated under the auspices of the Austrian Society of Neuropathology for the registration of malignant and non-malignant brain tumours. All Austrian neuropathology units involved in brain tumour diagnostics contribute data on primary brain tumours. Non-microscopically verified cases are added by the Austrian National Cancer Registry to ensure a population-based dataset. In 2005, we registered a total of 1,688 newly diagnosed primary brain tumours in a population of 8.2 million inhabitants with an overall age-adjusted incidence rate of 18.1/100,000 person-years. Non-malignant cases constituted 866 cases (51.3%). The incidence rate was higher in females (18.6/100,000) as compared to males (17.8/100,000), while 95/1,688 (5.6%) cases were diagnosed in children (<18 years). The most common histology was meningioma (n = 504, 29.9%) followed by glioblastoma (n = 340, 20.1%) and pituitary adenoma (n = 151, 8.9%). Comparison with the Central Brain Tumor Registry of the United States (CBTRUS) database showed high congruency of findings. The ABTR model led by neuropathologists in collaboration with epidemiologists and the Austrian National Cancer Registry presents a cooperative way to establish a population-based brain tumour registry with high quality data. This setting links cancer registration to the mission of medical practice and research as defined by the World Medical Association in the Declaration of Helsinki. The continued operation of ABTR will aid in monitoring changes in incidence and in identifying regional disease clusters or geographic variations in brain tumour morbidity/mortality.