Cancer Age-standardized Rates Research Articles

Analyzing Cancer Incidence Trends in Oman From 1996 to 2019: A Comprehensive Study of the National Cancer Annual Reports.

Previous studies have reported that cancer incidence trends in Oman varied by tumor site and sex. No comprehensive analysis of all cancer sites had been reported. The objective of this study is to analyze cancer incidence trends in Oman and calculate the annual percent change (APC) in age-standardized rates (ASRs) for all-cancer and 61 individual cancer sites in Omani men and women from 1996 to 2019. We gathered incidence data from The Omani National Cancer Registry for all cancers combined and individual tumor sites. We estimated the APC using Poisson regression. The cancer ASR in the Omani population increased by 23% (from 95/100,000 in 1996 to 117.2/100,000 in 2019), with the increase being more pronounced in females (48% v 7% in males). Among the male population, there was significant increase in the ASRs of colon, rectum, thyroid, and prostate cancers, with APCs of 6.92%, 4.24%, 4.19%, and 2.03%, respectively. Among females, all-cancer incidence showed significant increase (APC = 1.39%), and increasing trends were observed in uterine, colon, rectum, thyroid, and breast cancers (APCs = 7.57%, 7.08%, 5.19%, 5.16%, and 4.19%, respectively). The ASR of all-cancer increased significantly in Omani women but not in men. Uterine cancer had the highest APC. Colorectal cancer and thyroid ASR increased in both males and females. Breast and prostate cancers showed increasing trends. Further research is needed to explore factors contributing to increasing cancer incidences.

Cancer Burden Variations and Convergences in Globalization: A Comparative Study on the Tracheal, Bronchus, and Lung (TBL) and Liver Cancer Burdens Among WHO Regions from 1990 to 2019

Lung cancer and liver cancer are the leading and third causes of cancer death, respectively. Both lung and liver cancer are with clear major risk factors. A thorough understanding of their burdens in the context of globalization, especially the convergences and variations among WHO regions, is useful in precision cancer prevention worldwide and understanding the changing epidemiological trends with the expanding globalization. The Global Burden of Disease (GBD) and WHO Global Health Observatory (GHO) database were analyzed to evaluate the burden metrics and risk factors of trachea, bronchus, and lung (TBL) cancer and liver cancer. Western Pacific Region (WPR) had the highest age-standardized incidence rate (ASIR) for both liver cancer (11.02 [9.62–12.61] per 100,000 population) and TBL cancer (38.82 [33.63–44.04] per 100,000 population) in 2019. Disability-adjusted life years (DALYs) for liver and TBL cancer elevated with the increasing sociodemographic index (SDI) level, except for liver cancer in WPR and TBL cancer in European Region (EUR). Region of the Americas (AMR) showed the biggest upward trends of liver cancer age-standardized rates (ASRs), as well as the biggest downward trends of TBL cancer ASRs, followed by Eastern Mediterranean Region (EMR). Alcohol use and smoking were the leading cause of liver and TBL cancer death in most WHO regions. Variances of ASRs for liver and TBL cancer among WHO memberships have been decreasing during the past decade. The homogenization and convergence of cancer burdens were also demonstrated in different agegroups and sexes and in the evolution of associated risk factors and etiology. In conclusion, our study reflects the variations and convergences in the liver and lung cancer burdens among the WHO regions with the developing globalization, which suggests that we need to be acutely aware of the global homogeneity of the disease burden that accompanies increasing globalization, including the global convergences in various populations, risk factors, and burden metrics.Graphical

The Incidence of Lung Cancer and Smoking in Iran, Turkey, England, and the USA: A Comparative Study

Objectives: Lung cancer is the deadliest and the costliest cancer in the world. In this study, we compared the situation of this disease in several countries by considering the most important risk factor of lung cancer (smoking). Methods: This is a comparative study, a comprehensive one which was done on lung cancer rates in four countries: Iran, Turkey, England, and the USA, during the past twenty years (2002-2021). Age-standardized rate (ASR) index and the percentage of smokers were extracted from available information in the World Health Organization (WHO) databases, The Organization for Economic Co-operation and Development (OECD) Health Statistics 2021, and other valid related articles. After comparison, control procedures were examined. Results: England, with an ASR of 46, has the highest rate of lung cancer, and Iran, with an ASR of 21, has the lowest rate. Turkey has the highest percentage of smokers (29.3%), and the lowest percentage belongs to Iran (20%). Regarding the increasing trend of the ASR index, lung cancer in Iran and Turkey has had an upward trend, and England and the United States have a downward trend. Taxes on cigarettes are a significant factor in smoking reduction. Among these 4 countries, the lowest cigarette tax belongs to Iran (4.83%). Discussion: The result of this study shows that the incidence of lung cancer in Iran is rising, so following successful countries in imposing cigarette taxes can be an effective step to reduce smoking. Training programs, cultural improvement, and new diagnostic methods can also be useful in reducing lung cancer ASR.

Trends and predictions of lung cancer incidence in Jiangsu Province, China, 2009–2030: a bayesian age-period-cohort modelling study

BackgroundLung cancer is currently the most frequent cancer in Jiangsu Province, China, and the features of cancer distribution have changed continuously in the last decade. The aim of this study was to analyse the trend of the incidence of lung cancer in Jiangsu from 2009 to 2018 and predict the incidence from 2019 to 2030.MethodsData on lung cancer incidence in Jiangsu from 2009 to 2018 were retrieved from the Jiangsu Cancer Registry. The average annual percentage change (AAPC) was used to quantify the trend of the lung cancer age-standardized rate (ASR) using Joinpoint software. Bayesian age-period-cohort models were used to predict lung cancer incidence up to 2030.ResultsIn Jiangsu, the lung cancer crude rate increased from 45.73 per 100,000 in 2009 to 69.93 per 100,000 in 2018. The lung cancer ASR increased from 29.03 per 100,000 to 34.22 per 100,000 during the same period (AAPC = 2.17%, 95% confidence interval [CI], 1.54%, 2.80%). Between 2019 and 2030, the lung cancer ASR is predicted to decrease slightly to 32.14 per 100,000 (95% highest density interval [HDI], 24.99, 40.22). Meanwhile, the ASR showed a downward trend in males and rural regions while remaining stable in females and urban regions.ConclusionWe predict that the incidence of lung cancer in Jiangsu will decrease in the next 12 years, mainly due to the decrease in males and rural areas. Therefore, future lung cancer prevention and control efforts should be focused on females and urban regions.

Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003\u20132017: part 3 \u2013 spatiotemporal, multivariable and causal inferential pathfinding and exploratory analyses of prostate and ovarian cancers

BackgroundThe epidemiology of cannabinoid-related cancerogenesis has not been studied with cutting edge epidemiological techniques. Building on earlier bivariate papers in this series we aimed to conduct pathfinding studies to address this gap in two tumours of the reproductive tract, prostate and ovarian cancer.MethodsAge-standardized cancer incidence data for 28 tumour types (including “All (non-skin) Cancer”) was sourced from Centres for Disease Control and National Cancer Institute using SEER*Stat software across US states 2001–2017. Drug exposure was sourced from the nationally representative household survey National Survey of Drug Use and Health conducted annually by the Substance Abuse and Mental Health Services Administration 2003–2017 with response rate 74.1%. Federal seizure data provided cannabinoid concentration data. US Census Bureau provided income and ethnicity data. Inverse probability weighted mixed effects, robust and panel regression together with geospatiotemporal regression analyses were conducted in R. E-Values were also calculated.Results19,877 age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003–2017 of 124,896,418,350. Inverse probability weighted regressions for prostate and ovarian cancers confirmed causal associations robust to adjustment. Cannabidiol alone was significantly associated with prostate cancer (β-estimate = 1.61, (95%C.I. 0.99, 2.23), P = 3.75 × 10− 7). In a fully adjusted geospatiotemporal model at one spatial and two temporal years lags cannabidiol was significantly independently associated with prostate cancer (β-estimate = 2.08, (1.19, 2.98), P = 5.20 × 10− 6). Cannabidiol alone was positively associated with ovarian cancer incidence in a geospatiotemporal model (β-estimate = 0.36, (0.30, 0.42), P < 2.20 × 10− 16). The cigarette: THC: cannabidiol interaction was significant in a fully adjusted geospatiotemporal model at six years of temporal lag (β-estimate = 1.93, (1.07, 2.78), P = 9.96 × 10− 6). Minimal modelled polynomial E-Values for prostate and ovarian cancer ranged up to 5.59 × 1059 and 1.92 × 10125. Geotemporospatial modelling of these tumours showed that the cannabidiol-carcinogenesis relationship was supra-linear and highly sigmoidal (P = 1.25 × 10− 45 and 12.82 × 10− 52 for linear v. polynomial models).ConclusionCannabinoids including THC and cannabidiol are therefore important community carcinogens additive to the effects of tobacco and greatly exceeding those of alcohol. Reproductive tract carcinogenesis necessarily implies genotoxicity and epigenotoxicity of the germ line with transgenerational potential. Pseudoexponential and causal dose-response power functions are demonstrated.

Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003\u20132017: part 2 \u2013 categorical bivariate analysis and attributable fractions

BackgroundAs the cannabis-cancer relationship remains an important open question epidemiological investigation is warranted to calculate key metrics including Rate Ratios (RR), Attributable Fractions in the Exposed (AFE) and Population Attributable Risks (PAR) to directly compare the implicated case burden between emerging cannabinoids and the established carcinogen tobacco.MethodsSEER*Stat software from Centres for Disease Control was used to access age-standardized state census incidence of 28 cancer types (including “All (non-skin) Cancer”) from National Cancer Institute in US states 2001–2017. Drug exposures taken from the National Survey of Drug Use and Health 2003–2017, response rate 74.1%. Federal seizure data provided cannabinoid exposure. US Census Bureau furnished income and ethnicity. Exposure dichotomized as highest v. lowest exposure quintiles. Data processed in R.ResultsNineteen thousand eight hundred seventy-seven age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003–2017 of 124,896,418,350. Fifteen cancers displayed elevated E-Values in the highest compared to the lowest quintiles of cannabidiol exposure, namely (in order): prostate, melanoma, Kaposi sarcoma, ovarian, bladder, colorectal, stomach, Hodgkins, esophagus, Non-Hodgkins lymphoma, All cancer, brain, lung, CLL and breast. Eleven cancers were elevated in the highest THC exposure quintile: melanoma, thyroid, liver, AML, ALL, pancreas, myeloma, CML, breast, oropharynx and stomach. Twelve cancers were elevated in the highest tobacco quintile confirming extant knowledge and study methodology. For cannabidiol RR declined from 1.397 (95%C.I. 1.392, 1.402), AFE declined from 28.40% (28.14, 28.66%), PAR declined from 15.3% (15.1, 15.5%) and minimum E-Values declined from 2.13. For THC RR declined from 2.166 (95%C.I. 2.153, 2.180), AFE declined from 53.8% (53.5, 54.1%); PAR declined from 36.1% (35.9, 36.4%) and minimum E-Values declined from 3.72. For tobacco, THC and cannabidiol based on AFE this implies an excess of 93,860, 91,677 and 48,510 cases; based on PAR data imply an excess of 36,450, 55,780 and 14,819 cases.ConclusionData implicate 23/28 cancers as being linked with THC or cannabidiol exposure with epidemiologically-causal relationships comparable to those for tobacco. AFE-attributable cases for cannabinoids (91,677 and 48,510) compare with PAR-attributable cases for tobacco (36,450). Cannabinoids constitute an important multivalent community carcinogen.

Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003\u20132017: part 1 \u2013 continuous bivariate analysis

BackgroundThe genotoxic and cancerogenic impacts of population-wide cannabinoid exposure remains an open but highly salient question. The present report examines these issues from a continuous bivariate perspective with subsequent reports continuing categorical and detailed analyses.MethodsAge-standardized state census incidence of 28 cancer types (including “All (non-skin) Cancer”) was sourced using SEER*Stat software from Centres for Disease Control and National Cancer Institute across US states 2001–2017. It was joined with drug exposure data from the nationally representative National Survey of Drug Use and Health conducted annually by the Substance Abuse and Mental Health Services Administration 2003–2017, response rate 74.1%. Cannabinoid data was from Federal seizure data. Income and ethnicity data sourced from the US Census Bureau. Data was processed in R.ResultsNineteen thousand eight hundred seventy-seven age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003–2017 of 124,896,418,350. Regression lines were charted for cancer-substance exposures for cigarettes, alcohol use disorder (AUD), cannabis, THC, cannabidiol, cannabichromene, cannabinol and cannabigerol. In this substance series positive trends were found for 14, 9, 6, 9, 12, 6, 9 and 7 cancers; with largest minimum E-Values (mEV) of 1.76 × 109, 4.67 × 108, 2.74 × 104, 4.72, 2.34 × 1018, 2.74 × 1017, 1.90 × 107, 5.05 × 109; and total sum of exponents of mEV of 34, 32, 13, 0, 103, 58, 25, 31 indicating that cannabidiol followed by cannabichromene are the most strongly implicated in environmental carcinogenesis. Breast cancer was associated with tobacco and all cannabinoids (from mEV = 3.53 × 109); “All Cancer” (non-skin) linked with cannabidiol (mEV = 1.43 × 1011); pediatric AML linked with cannabis (mEV = 19.61); testicular cancer linked with THC (mEV = 1.33). Cancers demonstrating elevated mEV in association with THC were: thyroid, liver, pancreas, AML, breast, oropharynx, CML, testis and kidney. Cancers demonstrating elevated mEV in relation to cannabidiol: prostate, bladder, ovary, all cancers, colorectum, Hodgkins, brain, Non-Hodgkins lymphoma, esophagus, breast and stomach.ConclusionData suggest that cannabinoids including THC and cannabidiol are important community carcinogens exceeding the effects of tobacco or alcohol. Testicular, (prostatic) and ovarian tumours indicate mutagenic corruption of the germline in both sexes; pediatric tumourigenesis confirms transgenerational oncogenesis; quantitative criteria implying causality are fulfilled.

Inference about ratios of age-standardized rates with sampling errors in the population denominators for estimating both rates.

A rate ratio (RR) is an important metric for comparing cancer risks among different subpopulations. Inference for RR becomes complicated when populations used for calculating age-standardized cancer rates involve sampling errors, a situation that arises increasingly often when sample surveys must be used to obtain the population data. We compare a few strategies of estimating the standardized RR and propose bias-corrected ratio estimators as well as the corresponding variance estimators and confidence intervals that simultaneously consider the sampling error in estimating populations and the traditional Poisson error in the occurrence of cancer case or death. Performance of the proposed methods is evaluated empirically based on simulation studies. An application to immigration disparities in cancer mortality among Hispanic Americans is discussed. Our simulation studies show that a bias-corrected RR estimator performs the best in reducing the bias without increasing the coefficient of variation; the proposed variance estimators for the RR estimators and associated confidence intervals are fairly accurate. Finding of our application study are both interesting and consistent with the common sense as well as the results of our simulation studies.

Epidemiology of Ocular Malignancies Among the Lebanese Population: A 12-Year Review

PurposeOur article aims to assess the epidemiology of eye cancer in Lebanon and compare it with other regions worldwide and to study its future trends among Lebanese males and females.MethodsData on eye cancer cases from 2005 to 2016 were obtained from the Lebanese National Cancer Registry (NCR). Age-specific rates, crude rates, and age-standardized rates (ASRs) were subsequently calculated. Joinpoint was used to determine the changes in the slope of trends. A projection for the next 14 years was predicted using linear and logarithmic regression models.ResultsAmong all tumors, eye cancer ranked 40 in females and 41 in males. The eye cancer ASR was 0.24 and 0.22 per 100,000 in males and females, respectively. However, the mean age of eye cancer was 31.94 years in males and 22.04 years in females. The cumulative risk between 0 and 74 years was 0.02%. From 2004 till 2016, a negative trend of eye cancer was observed, with a parallelism of trends between males and females. Age-specific rates showed a bimodal distribution in males. The first cluster was witnessed in the age group of 0-4 years and the second one in those above 50. An additional cluster of distribution was observed in females between 35 and 44 years of age. Forecasts for the next 14 years revealed a steady rate of eye cancer incidence of about 0.2 per 100,000. Moreover, Lebanon showed a relatively low eye cancer ASR compared to other regions worldwide, especially Zimbabwe with 5.8 and 4.8 per 100,000 in females and males, respectively.ConclusionOcular malignancies showed a negative trend of incidence. A 14-year projection predicts a steady incidence rate in Lebanon and worldwide. Eye cancer seems to be affected by many risk factors. Future efforts are needed for a better understanding of the disease and a better outcome.

The epidemiology of cancer in the United Arab Emirates: A systematic review.

We conducted a systematic review to explore the United Arab Emirates (UAE)'s cancer-specific epidemiological profiles. We followed the standardized methods for conducting and reporting systematic reviews. We employed a highly sensitive and extensive strategy to identify all studies on the prevalence and incidence of cancer in the UAE, searching electronic databases and the grey literature. We assessed the methodological quality of the studies, summarized them, and qualitatively analyzed their results. We included 4 retrospective studies published between 2003 and 2011, reporting data gathered between 1982 and 2004. The majority of the data were collected from national cancer registries and addressed adult Emiratis and certain cancer types. All included studies employed validated procedures for diagnostic confirmation. The overall age-standardized cancer rates were 70.1 and 74.2 per 100,000 in males and females, respectively. Lung, gastric, and prostate cancer ranked as the top 3 types in Emirati males; while breast, cervical, and thyroid cancer were the top 3 types in Emirati females. Men exhibited higher rates of lung and stomach cancers compared with women. The majority of the studies were of acceptable methodological quality. Our findings highlight the need for high-quality future research and systematic cancer data collection and registration to provide reliable data on the current incidence of cancer. We hope that our findings guide the tailoring of interventions aimed at curbing cancer rates in the UAE.

Quantifying temporal trends of age-standardized rates with odds

BackgroundTo quantify temporal trends in age-standardized rates of disease, the convention is to fit a linear regression model to log-transformed rates because the slope term provides the estimated annual percentage change. However, such log-transformation is not always appropriate.MethodsWe propose an alternative method using the rank-ordered logit (ROL) model that is indifferent to log-transformation. This method quantifies the temporal trend using odds, a quantity commonly used in epidemiology, and the log-odds corresponds to the scaled slope parameter estimate from linear regression. The ROL method can be implemented by using the commands for proportional hazards regression in any standard statistical package. We apply the ROL method to estimate temporal trends in age-standardized cancer rates worldwide using the cancer incidence data from the Cancer Incidence in Five Continents plus (CI5plus) database for the period 1953 to 2007 and compare the estimates to their scaled counterparts obtained from linear regression with and without log-transformation.ResultsWe found a strong concordance in the direction and significance of the temporal trends in cancer incidence estimated by all three approaches, and illustrated how the estimate from the ROL model provides a measure that is comparable to a scaled slope parameter estimated from linear regression.ConclusionsOur method offers an alternative approach for quantifying temporal trends in incidence or mortality rates in a population that is invariant to transformation, and whose estimate of trend agrees with the scaled slope from a linear regression model.

A Review on Dietary and Non-Dietary Risk Factors Associated with Gastrointestinal Cancer.

Cancer is a complex disease involving neoplasm of abnormal cells leading to development of tumor cells. Gene mutations result in aberrant gene expression, which is the major cause observed in all the cancers. The GLOBOCAN 2012 reported the highest age-standardized rates for cancer of the colorectum followed by stomach, liver, and esophagus, which are gastrointestinal cancers, and the new cases also followed the same order across the globe. Various risk factors are associated with different types of cancer which can be classified as dietary and non-dietary risk factors. The dietary risk factors include diet, alcohol, and nutrient deficiencies, whereas the non-dietary risk factors of cancers are tobacco, lifestyle choices, certain infections, occupational exposures, and environmental factors. The aim of this review is to focus on the dietary and non-dietary risk factors linked to gastrointestinal cancers, which could be beneficial in clinical decision-making.

Increasing late stage colorectal cancer and rectal cancer mortality demonstrates the need for screening: a population based study in Ireland, 1994-2010.

BackgroundThis paper describes trends in colorectal cancer incidence, survival and mortality from 1994 to 2010 in Ireland prior to the introduction of population-based screening.MethodsWe examined incidence (National Cancer Registry Ireland (NCRI) and mortality (Central Statistics Office) from 1994 to 2010. Age standardised rates (ASR) for incidence and mortality have been calculated, weighted by the European standard population. Annual percentage change was calculated in addition to testing for linear trends in treatment and case fraction of early and late stage disease. Relative survival was calculated considering deaths from all causes.ResultsThe colorectal cancer ASR was 63.7 per 100,000 in males and 38.7 per 100,000 in females in 2010. There was little change in the ASR over time in either sex, or when colon and rectal cancers were considered separately; however the number of incident cancers increased significantly during 1994-2010 (1752 to 2298). The case fractions of late stage (III/IV) colon and rectal cancers rose significantly over time. One and 5 year relative survival improved for both sexes between the periods 1994-2008. Colorectal cancer mortality ASRs decreased annually from 1994-2009 by 1.8% (95% CI -2.2, -1.4). Rectal cancer mortality ASRs rose annually by 2.4% (95% CI 1.1, 3.6) and 2.8% (95% CI 1.2, 4.4) in males and females respectively.ConclusionsIncreases in late-stage disease and rectal cancer mortality demonstrate an urgent need for colorectal cancer screening. However, the narrow age range at which screening is initially being rolled-out in Ireland means that the full potential for reductions in late-stage cancers and incidence and mortality are unlikely to be achieved. While it is possible that the observed increase in rectal cancer mortality may be partly an artefact of cause of death misclassification, it could also be explained by variations in treatment and adherence to best practice guidelines; further investigation is warranted.

Trends and social indicators of both mortality breast cancer and cervical cancer in Antioquia, Colombia, 2000-2007

To estimate the mortality age-standardized rates (ASR) for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03) but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003). Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty.

Trends of genitourinary cancer among Saudis

IntroductionSaudi Arabia has a low incidence of cancer; the age-standardized rate of cancer is only 83/100,000, compared to the world rate of 181/100,000. Recent reports confirm a yearly increase in cancer in general, and of genitourinary cancer (GUC) in particular. The aim of the study was to assess the trends of GUC among Saudi nationals. MethodsAll available annual reports of the Saudi Cancer Registry (SCR) from 1994 to 2006 were analysed and compared with worldwide data. ResultsOver a period of 13years, 7132 GUCs were identified among Saudis, comprising 8.9% of all cancers reported, compared to 12.7% worldwide. The incidence rate of GUC increased over the study period, with the greatest increase in prostate and kidney cancer, at 48% and 33%, respectively. Summary stage data (Surveillance, Epidemiology and End Results programme) showed late presentation of GUC at the time of diagnosis. An improvement in stage was only found in testicular and prostate cancer, at 79% and 50%, respectively. While prostate and bladder cancer ranked sixth and ninth in the male population, penile cancer continued to be a rare disease. ConclusionsThe incidence of GUC in Saudi Arabia is still low, but there was a significant increase in prostate and kidney cancer. More effort is needed to detect GUC at an earlier stage. A national cancer control programme is suggested.

Comparison of cancer incidence between production and office workers at a shipyard in Korea: A retrospective cohort study from 1992 to 2005

Cancer is a major concern in shipbuilding. Since 1970s, shipbuilding and repair has been a strategic industry in Korea, which has become currently the world's largest shipbuilding country. The aim of this study is to investigate the cancer incidence in shipyard workers in Korea. The cohort comprised 30,288 male employees (20,647 production workers and 9,641 office workers) ever employed between 1992 and 2005 in a shipyard in Korea. The authors compared the cancer incidence between the groups using the participants' hospital medical records and data received from Korea National Cancer Incidence Database and Korean National Statistical Office. The total number of cancers was 135 among office workers and 519 among production workers in the shipyard. The age-standardized cancer rates among office and production workers were 136.2 and 179.7 per 100,000 person-years, respectively. The standardized rate ratios for stomach cancer, liver cancer, and lung cancer in production workers compared with office workers were 1.67 (95% CI: 1.12-2.49), 2.13 (95% CI: 1.37-3.36), and 3.71 (95% CI: 1.68-8.19), respectively. The observed increase in stomach, liver, and lung cancers among production workers suggests that some occupational factors in the shipyard might have contributed to the increased cancer risk. Further study is needed to clarify the risk of those cancers and to identify the specific factors involved.

A cancer incidence survey in Tianjin: the third largest city in China—between 1981 and 2000

During the past three decades, the social/natural environment and lifestyle of people in China have undergone a marked transformation to westernization. However, age-standardized cancer rates have not been determined to any great extent in China. In this study, we tracked the cancer incidence between 1981 and 2000 in Tianjin, to identify the changes in incidence associated with social and economic changes. Cancer incidence data were collected by the Tianjin Cancer Registry. Sex, age, and organ site-specific incidence trends were analyzed by the "join-point regression" method. Overall crude cancer incidence increased, but the age-standardized incidence slightly decreased during the study period. The incidence of lung cancer increased between 1981 and 1996 but decreased between 1996 and 2000. The incidences of uterine, esophageal, stomach, and liver cancers decreased. However, the incidences of colorectal, pancreatic, breast, ovarian, and prostate cancers all increased during the study period. There was an aging-related increase in the overall crude cancer incidence and an alteration in the distribution of cancer types in Tianjin. The incidences of cancer types that are more prevalent in developed countries appeared to increase in China, whereas the incidences of cancer types that are more prevalent in developing countries appeared to decline.

Cancer incidence and trends in Bombay, India

DISCUSSION During 1977 to 1990,340OO new male cancer cases and 29 300 female cases were reported to the Registry and during the same period there were 18 269 male cancer deaths and 13 900 female cancer deaths notified. Table 1 and Fig. 1 shows the numbers of new cases, the percentage distribution, the crude incidence rates and the world age-standardised incidence rates per 100 000 males and females for 1990. Table 2 shows the corresponding mortality data and Fig. 2 shows South Australian 5-year survival rates as compared with rates for the United States. While the cancer burden in South Australia will increase with further ageing of the population, there is evidence that age-standardised cancer rates are stable for most sites, and in some instances they

Mortality from cancer of the digestive system in Italy: 1950-1975 cross-sectional rates and cohort analysis.

In this study of mortality from cancer of the digestive system in Italy, 1950-1975, both cross-sectional rates and cohort analysis were used. The study found that in both sexes age-standardized rates for cancer of the colon, rectum, liver and biliary tract, and pancreas are increasing whereas the rates for cancer of the stomach are decreasing. Rates for esophagus cancer have remained fairly constant. Cohort analysis showed different trends for selected sites. As to cancer of the stomach, for both sexes, cohorts born up until about 1881 have constant or increasing rates; cohorts born after 1881 have declining rates. For cancer of the esophagus in males the rates reach a peak in the 1896 birth-cohort; cohorts born prior to 1896 show an increase in rates and cohorts born later show a decline. For cancer of the colon, liver and biliary tract, and pancreas, the rates rise constantly for all ages and all cohorts in both sexes. The rates for cancer of the rectum rise after age 75 whereas below that age the rates tend to level off and decline.