Carcinoma In Men Research Articles

Lung cancer in african americans

Excluding squamous and basal cell carcinomas of the skin, lung cancer is the most frequently diagnosed cancer and remains the leading cause of death from cancer in the United States. It has been estimated that in 2001, 1.2 million new cases of cancer were diagnosed in the United States [1]. Data reported by the U.S. Bureau of Census, and the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program has been used to report important trends in diagnosis and treatment of cancer in the general population [2]. While the incidence of bronchopulmonary carcinoma in men has leveled off over the last decade, the overall incidence in women continues to rise. Moreover, since the mid 1980s, primary lung cancer has surpassed breast cancer as the leading cause of cancer death in women and now accounts for an estimated 25% of death from cancer in women [3] (Fig 1). An in-depth evaluation of these statistics reveal disturbing variances in cancer incidence, stage at presentation, and mortality in certain subpopulations of our society. African-American patients have the highest overall incidence of cancer and are 33% more likely to die of cancer than Caucasians, and more than twice as likely to die from cancer as are Asian Pacific Islanders, American Indians, and Hispanics [1]. In 1999, cancer was the second leading cause of death among all racial and ethnic groups. The average annual age-adjusted incidence of lung cancer is 73.39 per 100,000 for African Americans and 54.31 per 100,000 for Caucasians [4, 5]. These statistics underscore the importance of smoking cessation programs, early diagnosis and treatment, and vigilant surveillance in all populations and especially in the AfricanAmerican community.

Physical activity and the risk of lung cancer in Canada.

A population-based case-control study of 2,128 cases with histologically confirmed incident lung cancer and 3,106 population controls aged 20-76 years was conducted to assess the impact of recreational physical activity on lung cancer risk in Canada in 1994-1997. The multivariable-adjusted odds ratios and 95% confidence intervals for the second, third, and fourth quartiles versus the lowest quartile of total recreational physical activity were, respectively, 0.82 (95% confidence interval: 0.68, 0.98), 0.76 (95% confidence interval: 0.63, 0.92), and 0.73 (95% confidence interval: 0.60, 0.89) (p for trend=0.0008). The risk reduction was observed for both men and women and was attributed to both moderate and vigorous activities. A greater risk reduction was found for squamous cell carcinoma in women, small cell carcinoma in men, and other types/unspecified histologic subtypes in both genders. The physical-activity-associated risk reduction was more profound among smokers and those with low and medium body mass indexes. This study provides additional evidence that recreational physical activity reduces lung cancer risk. More studies are needed to confirm the differences between histologic subtypes and between genders and to address the underlying biologic mechanisms.

Gonadotropin-releasing hormone antagonists: impact of IVF practice and potential non-assisted reproductive technology applications.

To provide the clinician with updated knowledge of the most recent findings on the clinical use of gonadotropin-releasing hormone antagonists. Gonadotropin-releasing hormone antagonists, which have recently been introduced in clinical practice, cause an immediate suppression of gonadotropin secretion by competitive blocking of pituitary gonadotropin-releasing hormone receptors. Thus, they are effective in preventing the premature luteinizing hormone surges during ovarian stimulation for in-vitro fertilization and may improve the patient's response to lower doses of gonadotropins. Better patient acceptance, shorter treatment cycles and fewer follicles and oocytes are also reported. Data existing so far concerning the necessity of luteal phase support after the use of gonadotropin-releasing hormone antagonists show that it might not be mandatory when used in clomiphene citrate costimulated cycles or in intrauterine insemination cycles. The use of gonadotropin-releasing hormone antagonists seems to be safe for pregnant women and their offspring. All sex-hormone-dependent disorders, currently treated with gonadotropin-releasing hormone agonists, may in future be indications for a gonadotropin-releasing hormone antagonist, including endometriosis, leiomyoma, and breast cancer in women, benign prostatic hypertrophy and prostatic carcinoma in men, and central precocious puberty in children. The vast majority of the available clinical data up till now, however, are in assisted reproduction and prostate cancer. It is expected that the availability of gonadotropin-releasing hormone antagonist will lead to the use of 'softer' ovarian stimulation protocols, which will be shorter, cheaper and safer compared with the conventional protocols.

Environmental factors affect colon carcinoma and rectal carcinoma in men and women differently.

Colon cancer is thought to be more closely associated with environmental factors than rectal cancer, but evidence is currently insufficient. We examined whether there are differences in the degree of environmental effect on colon cancer and rectal cancer in Japan. We performed a birth cohort analysis for colon and rectal cancers using Japanese vital statistics from 1950 to 1998 and analyzed time trends by cancer site and gender. The mean annual increase in age-adjusted mortality rate from colon cancer was greater than that from rectal cancer and was greater in men than in women. In men left colon cancer showed the greatest rate of increase whereas cancer of the right colon showed only a slight change. Although left colon cancer rapidly increased until the middle 1980s and thereafter showed no change, right colon cancer showed no change until the middle 1980s and thereafter rapidly increased in men. However, the rates of increase in left colon cancer were greater than those in right colon cancer until the middle 1980s, after which a reversal in trend was seen in women. Birth cohort analysis indicates that for all cohorts the mortality rates at the same age were higher in the recent cohorts than in the previous ones. This trend was more marked for colon cancer than for rectal cancer and was stronger among men than among women. Colon cancer is more closely associated than rectal cancer with environmental factors, and this association is more pronounced in men than in women. Consequently cancers at these two sites should not be combined in studies of the role of lifestyle factors in causing these neoplasms. Furthermore, the causes of these diseases may differ in men and women.

Current opinion on the etiology of differentiated thyroid carcinoma

It is apparent that in the last decade carcinoma of the thyroid is becoming increasingly prevalent. The multistage complex theory of thyroid carcinogenesis is based on observations made on cohort patients studies and during animal experiments over a period of last fifty years. The process of thyroid oncogenesis is conceived to be a series of events induced by genetic and environmental factors which alter follicular cells division and growth control. These factors can be considered as initiators (chemical agents and ionising radiation) and promoters (some goitrogenes and drugs). The first class of factors induce incipient tumorigenesis while the second augments TSH secretion and radically increases tumour growth. Normally silent, intracellular proto-oncogenes (of which Ret/PTC series are the most conceived ones) can become activated by chromosomal translocations, deletions or mutations and can transform normal follicular cell into a condition of uncontrolled division and growth. The most significant known cause of thyroid carcinomas in men is exposure to external or internal ionising radiation. Beside that, long-term iodine deficiency, effects of certain chemical carcinogens, drugs and goitrogenes must be considered as significant risk factors. Possible role of sodium/iodide symporter is becoming an objective of the most recent investigations.

Ratio Of Prostate Specific Antigen Minor Molecular Forms-To-Total Prostate Specific Antigen Is Constant Regardless Of The Pathological Condition Of The Prostate

We assessed 3 molecular forms of prostate specific antigen (PSA) prospectively to determine the real proportion of the nonfree, nonalpha1-antichymotrypsin complex form of PSA-to-total PSA and evaluated the clinical significance of its various forms. We prospectively assessed 1,878 serum samples from 994 subjects for total PSA, free PSA and PSA-alpha1-antichymotrypsin complex (ACT). Nonfree, nonPSA-ACT PSA (minor form PSA) was calculated as the difference between total PSA and the sum of free PSA plus PSA-ACT complex. The proportion of the minor form PSA was approximately 20% to 25% of total PSA at any range of total PSA, whereas that of free PSA and PSA-ACT decreased and increased, respectively, in correlation with the increment of total PSA. There was no significant difference in the percent of minor form PSA in patients with prostatic carcinoma and those with benign prostatic status. The proportion of minor form PSA was constant, while the percent of free PSA and PSA-ACT increased and decreased, respectively, in accordance with total PSA regression after hormonal therapy for prostatic carcinoma. PSA-ACT was judged to be superior to total PSA for distinguishing prostatic carcinoma in men with PSA 2 to 10 ng./ml. by ROC analysis. Approximately a fourth of total PSA consists of minor forms of complexed PSA. The average proportion of minor form-to-total PSA was constant at various levels of total PSA and at any prostatic status of patients. PSA-ACT was superior to total PSA for the early detection of prostatic carcinoma.

Genital squamous cell carcinoma in men treated by photochemotherapy. A cancer registry-based study from 1978 to 1998: reply from author

Genital squamous cell carcinoma in men treated by photochemotherapy. A cancer registry-based study from 1978 to 1998: reply from author

Cytopathologie des tumeurs malignes épithéliales

Epithelial tumours account for 98 % of all malignant breast tumours. The most frequent are common ductal types, lobular and particular types which often have very characteristic cytological aspects. The importance of treatment diagnosis for these particular types can be justified by an often better prognosis. Diagnosing malignancy can be confirmed by a cytological examination. Difficulties occur on the one hand when the atypias are discrete, and on the other hand in confirming the lobular variety of the proliferation. The in situ types can be suggered but it is always impossible to be precise about the cytological in situ or infiltrating character the proliferation. Carcinoma diagnosis in the pre- and post-partum period is often unambiguous ; the difficulty is to know well the physiological changes in the breast during this period so as not to wrongly diagnose malignancy. Carcinomas in man, essentially of the ductal type, can show all the cytological aspects of this tumor. The clinical presentation, in general, suggests malignancy with or without inflammatory cutaneous features, very different from the simple aspect of a gynaecomastia.

Physical variables in experimental photocarcinogenesis and quantitative relationships between stages of tumor development

Solar ultraviolet (UV) radiation is a prominent environmental carcinogen, but it does not penetrate any deeper than the skin. The UV-related skin cancers are by far the most common form of cancer among white Caucasians in the USA and Australia, and this poses a serious public health problem. Chronic UV exposure of hairless mice is a well established model for squamous cell carcinomas in man. It is important to identify the essential physical variables, and explore fully how photocarcinogenesis evolves in dependence of these variables. The 3 main physical variables in photocarcinogenesis are (i) the wavelength of the radiation, (ii) the exposure and (iii) time. A good quantitative description of tumor induction and precursing stages can be given in terms of these variables. An analysis of this description shows us that the early induction of clusters of epidermal cells that over-express mutant p53 ('p53 patches') are closely and, most likely, causally linked to the eventual tumors. These p53 patches may thus serve as early indicators of tumor risk. The induction of an immune-tolerance toward the UV-induced tumors precedes the actual occurrence of the tumors at high daily doses, but extrapolation indicates that this order of events may be reversed at low daily doses. This disparity between the dose-time relationships for the tumor tolerance and the tumors needs to be investigated further. It could imply a shift to non-immunogenic tumors at low daily doses.

Physical variables in experimental photocarcinogenesis and quantitative relationships between stages of tumor development.

Solar ultraviolet (UV) radiation is a prominent environmental carcinogen, but it does not penetrate any deeper than the skin. The UV-related skin cancers are by far the most common form of cancer among white Caucasians in the USA and Australia, and this poses a serious public health problem. Chronic UV exposure of hairless mice is a well established model for squamous cell carcinomas in man. It is important to identify the essential physical variables, and explore fully how photocarcinogenesis evolves in dependence of these variables. The 3 main physical variables in photocarcinogenesis are (i) the wavelength of the radiation, (ii) the exposure and (iii) time. A good quantitative description of tumor induction and precursing stages can be given in terms of these variables. An analysis of this description shows us that the early induction of clusters of epidermal cells that over-express mutant p53 ('p53 patches') are closely and, most likely, causally linked to the eventual tumors. These p53 patches may thus serve as early indicators of tumor risk. The induction of an immune-tolerance toward the UV-induced tumors precedes the actual occurrence of the tumors at high daily doses, but extrapolation indicates that this order of events may be reversed at low daily doses. This disparity between the dose-time relationships for the tumor tolerance and the tumors needs to be investigated further. It could imply a shift to non-immunogenic tumors at low daily doses.

A prospective study of a total material of lung cancer from a county in Sweden 1997–1999: gender, symptoms, type, stage, and smoking habits

The epidemiology of lung cancer is changing in many parts of the world. In the industrialized countries, there is a trend that the incidence in men is declining, while it is increasing for women. Also, adenocarcinomas are becoming relatively more common, especially among men. The purpose of this study was to investigate whether such trends also occur in Sweden and also to describe other aspects of an unselected lung cancer material today, such as symptoms, stage and smoking habits. In the county of Gaevleborg, Sweden, practically all patients with lung cancer are referred to the lung department, and thus a total material of lung cancer patients with only a minimal selection bias can be studied. All patients with lung cancer in the county from January 1, 1997 to December 31, 1999, were investigated prospectively regarding stage, type of cancer, and symptoms. In all, there were 364 patients, 237 (65.1%) men and 127 (34.9%) women. The mean age for men was 69.8 and for women, 68.1 years. 91.9% of the men and 78.6% of the women were smokers or ex-smokers. In general the men were heavier smokers than were the women ( P<0.0001). Adenocarcinoma was the most common subtype found in women and squamous cell carcinoma in men. The excess of adenocarcinoma in women was due to never-smoking women; for smoking and ex-smoking men and women, the proportion of adenocarcinomas was the same. In all, 240 patients (68.0%) were diagnosed at Stage IIIb (27.2%) or IV (40.8%), with no significant differences between the sexes. The most common first symptom was cough. Only 7.0% of patients were asymptomatic. In conclusion, the trend of an increasing proportion of adenocarcinoma in lung cancer is seen also in Sweden. A depressingly high percentage of patients present in late stages and are thus inoperable.

Risk of second primary malignancies in patients with cutaneous melanoma

In several studies an increased risk for development of breast cancer, malignant lymphoma and neoplasms of the kidney as second primary cancers in patients with cutaneous melanomas was discussed. To determine the risk for development of second primary neoplasms in patients with cutaneous melanomas. A prospective study was performed between 1977 and 1992 to evaluate the occurrence of second primary malignancies in 4597 patients (2083 men, 2514 women) with invasive cutaneous melanomas, diagnosed and treated at the Department of Dermatology and Allergology, Ludwig-Maximilians-University, Munich, Germany. During a median follow-up of 7.2 years, 296 of 4597 patients (6.4%) developed one or more neoplasms at the time of or subsequent to the diagnosis of the first cutaneous melanoma. More than half of these patients developed one or more further melanomas (152, 3.3%). Cancers of the breast, prostate, colon, rectum and kidney occurred less frequently. Statistical calculations revealed a 33.8-fold increased risk for the development of a second melanoma in the entire group [relative risk 38.5 for men (95% CI, 30.4-48.1), 29.0 for women (95% CI, 22.0-37.5)]. Moreover, a significantly increased risk for the development of kidney carcinoma in men was found [relative risk 3.5 (95%, CI, 1.4-7.2)]. Thorough follow-up and skin examination in patients with cutaneous melanomas is recommended for early detection of other primary melanomas. Furthermore, ultrasound examinations routinely performed in melanoma patients for the detection of melanoma metastases may also be of value for early detection of kidney carcinomas in male patients.

Osteoprotegerin in Serum as a Novel Marker of Bone Metastatic Spread in Prostate Cancer

Prostate cancer (PCa) is the most frequent carcinoma in men and is often complicated by skeletal metastasis (1). Because bone scintigraphy, the standard method of monitoring metastatic bone involvement, is expensive, lacks specificity, and is not particularly suitable for the follow-up of patients, various metabolic bone markers have been studied as indicators for bone metastasis in PCa patients (2)(3). Markers that reflect osteoblast proliferation, e.g., skeletal alkaline phosphatase (sALP), are reportedly useful, which is consistent with the osteoblastic reactions seen in the skeletal metastases (4). The balance between osteoblastic and osteoclastic activity in bone is essentially influenced by osteoclastogenesis. The latter is regulated by three proteins: receptor activator of nuclear factor-κB (RANK), which is expressed on osteoclast precursor cells; its ligand (RANKL), which is expressed on the surface of preosteoblastic and stromal cells; and osteoprotegerin (5)(6). The interaction of RANKL with RANK stimulates the differentiation of osteoclasts, whereas osteoprotegerin blocks this process by functioning as a decoy receptor for RANKL. This novel cytokine system appears to play an important role in the establishment of bone metastases in PCa patients (7). Osteoprotegerin has recently been found to be overexpressed in bone metastases of these patients (8). This overexpression could indirectly favor osteoblastic reactions by inhibiting osteoclastogenesis and might explain the bone lesions typically seen PCa patients. Because tissue overexpression of proteins often is reflected in blood, osteoprotegerin could be a potential serum marker for diagnosis of bone metastasis. Using a recently introduced novel osteoprotegerin assay, we performed the present study to evaluate the diagnostic validity of osteoprotegerin as a potential bone metastasis marker in PCa in comparison with sALP and cross-linked N-telopeptides of type I collagen (NTx), which represent osteoblastic and osteoclastic markers, respectively. The study included 36 male controls (mean age, 51.4 years) with no …

Genital squamous cell carcinoma in men treated by photochemotherapy. A cancer registry-based study from 1978 to 1998.

One single report from the U.S. 16-centre-trial indicated that psoralen and ultraviolet A radiation (PUVA) therapy may induce an increased risk of genital tumours in men, and protection of the genital area is, therefore, recommended. To evaluate the relevance of this risk in routine clinical practice. Two groups of patients were included in a 1978-98 retrospective study. Case records of men with genital squamous cell carcinoma (SCC) identified from the Cancer Registry of the Doubs area of France were examined for a history of PUVA therapy, topical tar treatment, psoriasis, human papillomavirus infection or genital dermatitis. In addition, all the dermatologists of the Doubs area (in public and private practice) using PUVA therapy were asked to provide information on the number of patients having received PUVA therapy and whether the genital area was exposed during treatment. Between 1978 and 1998, among the 48 men who had developed a genital SCC in the Doubs area, only one had a history of intensive PUVA therapy. About 150,000 treatments with PUVA therapy had been performed by 15 dermatologists in the Doubs area for 5400 patients since 1978. No case of genital SCC had been reported, despite the fact that the genital area had not been protected during UVA exposure. Although retrospective, our study demonstrates that the occurrence of genital SCC in men treated with PUVA therapy is a very rare event in common dermatological practice.

High prevalence of anal squamous intraepithelial lesions and squamous-cell carcinoma in men who have sex with men as seen in a surgical practice

Anal high-grade squamous intraepithelial lesions are probable invasive anal squamous-cell cancer precursors, and although unproved, treatment of high-grade squamous intraepithelial lesions may prevent progression to anal squamous-cell cancer. Men who have sex with men are often treated for benign anorectal disorders without consideration given to the possibility of concurrent high-grade squamous intraepithelial lesions or anal squamous-cell cancer. We determined the prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer in an urban surgical practice of men who have sex with men referred for treatment of anal condyloma and other benign noncondylomatous anal disorders. One hundred thirty-one HIV-positive and 69 HIV-negative men who have sex with men referred for surgical treatment of presumed benign anorectal disease were evaluated by anal cytology, high-resolution anoscopy, and biopsy. Anal cytology and histology were reported with a modified Bethesda classification. One hundred fifty-seven patients (79 percent) were referred for condyloma, 4 (2 percent) for anal squamous intraepithelial lesions (anal high-grade squamous intraepithelial lesions) diagnosed by primary care providers, and 39 (19 percent) for other benign anorectal disorders. One hundred forty-three patients (93 percent) had abnormal anal cytology, with 107 (54 percent) having high-grade squamous intraepithelial lesions on cytology. Biopsy results revealed 120 patients (60.0 percent) with high-grade squamous intraepithelial lesions and 5 patients (3 percent) with invasive squamous-cell carcinoma. Four of five men with anal squamous-cell cancer were HIV positive. Fourteen men (36 percent) who have sex with men referred for noncondylomatous benign anal disorders had high-grade squamous intraepithelial lesions, and three (8 percent) had anal squamous-cell cancer. High-grade squamous intraepithelial lesions and anal squamous-cell cancer were seen most often at the squamocolumnar junction. Men who have sex with men referred for treatment of either condyloma or noncondylomatous benign anorectal disease had a high prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer. All men who have sex with men referred for treatment of benign anorectal disease should have high-resolution anoscopy and aggressive biopsy of all abnormal areas. Treatment of external lesions alone could miss high-grade squamous intraepithelial lesions or anal squamous-cell cancer.

Long term follow‐up of mass screening for prostate carcinoma in men with initial prostate specific antigen levels of 4.0 ng/ml or less

BACKGROUND Long term follow-up for subjects whose initial prostate specific antigen (PSA) levels were 4.0 ng/mL or lower was conducted to investigate the proper interval for PSA screening. METHODS Eight thousand five hundred ninety-five men aged 50 years or older with an initial PSA level of 4.0 ng/mL or lower were screened with tumor marker measurement and/or digital rectal examination (DRE) and/or transrectal ultrasonography as a first step in the mass screening, and a prostate biopsy was performed for individuals with abnormal findings. RESULTS Cancer was detected in 0.18% (8 of 4526), 1.0% (27 of 2724), and 3.6% (49 of 1345) of men whose initial PSA levels were lower than 1.0, 1.0–1.9, and 2.0–4.0 ng/mL, respectively. Among these prostate carcinoma cases, 25% (6 of 8), 56% (15 of 27), and 63% (31 of 49) were detected by abnormal PSA in patients with initial PSA levels lower than 1.0, 1.0–1.9, and 2.0–4.0 ng/mL, respectively. The detection rates of prostate carcinoma within 3 years after the initial visit were 0.07%, 0.24%, and 1.2% in cases with initial PSA levels lower than 1.0, 1.0–1.9, and 2.0–4.0 ng/mL, respectively. CONCLUSIONS It is recommended that DRE and PSA measurements should be performed once every 3 years in individuals with initial PSA levels of less than 1.0 ng/mL. The prostate carcinoma detection rate increased over time in individuals with initial PSA levels of 1.0 to 4.0 ng/mL, especially in cases with 2.0–4.0 ng/mL, and annual measurement of PSA was more useful than DRE. Therefore, it is recommended that PSA screening should be performed once every year for individuals with initial PSA levels of 1.0 to 4.0 ng/mL. Cancer 2001;91:744–51. © 2001 American Cancer Society.

Long term follow-up of mass screening for prostate carcinoma in men with initial prostate specific antigen levels of 4.0 ng/ml or less

Long term follow-up for subjects whose initial prostate specific antigen (PSA) levels were 4.0 ng/mL or lower was conducted to investigate the proper interval for PSA screening. Eight thousand five hundred ninety-five men aged 50 years or older with an initial PSA level of 4.0 ng/mL or lower were screened with tumor marker measurement and/or digital rectal examination (DRE) and/or transrectal ultrasonography as a first step in the mass screening, and a prostate biopsy was performed for individuals with abnormal findings. Cancer was detected in 0.18% (8 of 4526), 1.0% (27 of 2724), and 3.6% (49 of 1345) of men whose initial PSA levels were lower than 1.0, 1.0-1.9, and 2.0-4.0 ng/mL, respectively. Among these prostate carcinoma cases, 25% (6 of 8), 56% (15 of 27), and 63% (31 of 49) were detected by abnormal PSA in patients with initial PSA levels lower than 1.0, 1.0-1.9, and 2.0-4.0 ng/mL, respectively. The detection rates of prostate carcinoma within 3 years after the initial visit were 0.07%, 0.24%, and 1.2% in cases with initial PSA levels lower than 1.0, 1.0-1.9, and 2.0-4.0 ng/mL, respectively. It is recommended that DRE and PSA measurements should be performed once every 3 years in individuals with initial PSA levels of less than 1.0 ng/mL. The prostate carcinoma detection rate increased over time in individuals with initial PSA levels of 1.0 to 4.0 ng/mL, especially in cases with 2.0-4.0 ng/mL, and annual measurement of PSA was more useful than DRE. Therefore, it is recommended that PSA screening should be performed once every year for individuals with initial PSA levels of 1.0 to 4.0 ng/mL.

Thirty-year experience of surgery for breast carcinoma in men.

To present the long-term outcome after surgery for breast carcinoma in men. Retrospective study. University Hospital, Switzerland. 37 consecutive men who were operated on for breast carcinoma between 1968 and 1998. The mean age was 67 years (range 41-89). The delay between the first clinical presentation and operation ranged from 1 month to 3 years (median 3.5 months). Operations included modified radical mastectomy (n = 19), radical mastectomy (n = 12), simple mastectomy (n = 3), Halsted procedure (n = 1), and conservative resection (n = 1). One patient had only a biopsy and was excluded from survival analysis. There were 30 infiltrating ductal carcinomas, 4 in situ ductal carcinomas, 2 papillary carcinomas, and 1 adenoid cystic carcinoma. Most tumors (n = 25, 68%) were in the subareolar region. The overall survival at 10 years was 44%, but it was significantly influenced by the stage of disease, ranging from 57% in stage I (n = 12), to 26% in stage II (n = 15), and 0 in stage III (n = 8). Although the long term survival in stage I and II is similar in men and women, the rarity of breast carcinoma in men and its location in the subareolar region may delay diagnosis and treatment.

Cancer in the very elderly Dutch population

BACKGROUND Cancer incidence and mortality rates rarely are studied in people age > 85 years. Usually, patients ages 65 years, 75 years, and 85 years of age are combined into 1 group because of small numbers. The number of people age ≥ 85 years in the Netherlands increased from 99,000 in 1976 to 203,000 in 1995 (an increase of 105%). The growth of the total population in this period was only 13%. This study addressed cancer incidence and mortality rates among the very elderly in the Netherlands. METHODS Cancer mortality data (1976–1995) and population data were obtained from Statistics Netherlands, whereas cancer incidence data (1989–1995) were provided by the Netherlands Cancer Registry. Cancer incidence and mortality rates were calculated and trends in cancer mortality were studied. RESULTS Total cancer incidence rates were highest in the age group 85–94 years, in men and women (3466/100,000 person-years and 1604/100,000 person-years, respectively). Prostate carcinoma was the most frequent cancer in men ages 85–94 years, followed by colorectal carcinoma. In women ages 85–94 years, colorectal carcinoma was most frequent, closely followed by breast carcinoma. In the 95+ years age group squamous cell skin carcinoma was the most frequent cancer in both men and women, followed by prostate carcinoma in men and breast carcinoma in women. Cancer mortality rates increased with increasing age to nearly 3700/100,000 person-years in men age 95+ years and 2500/100,000 person-years in women age 95+ years. In men, lung carcinoma was the most frequent cancer-related cause of death in patients age ≤ 85 years, whereas in older men this applied to prostate carcinoma. In women, breast carcinoma was the most frequent cancer-related cause of death in all age groups > 55 years. Cancer as a cause of death became less prominent with increasing age. Over the period 1991–1995, 42% of deaths in men ages 55–64 years were attributed to cancer versus 52% of deaths in women (total population); these proportions in the 95+ years age group were 11% and 7%, respectively. CONCLUSIONS Peak incidence rates of major cancers were found in the very elderly population in the Netherlands. Different trends in age specific mortality rates of individual cancer sites were found, with stable rates in the middle age groups and increasing rates in the oldest age groups. This may reflect a real increase caused for instance by changes in mortality from other diseases and/or an artifactual increase caused by increased cancer detection rates in the (very) elderly. Cancer 2000;89:1121–33. © 2000 American Cancer Society.

Cancer in the very elderly Dutch population.

Cancer incidence and mortality rates rarely are studied in people age > 85 years. Usually, patients ages 65 years, 75 years, and 85 years of age are combined into 1 group because of small numbers. The number of people age > or = 85 years in the Netherlands increased from 99,000 in 1976 to 203,000 in 1995 (an increase of 105%). The growth of the total population in this period was only 13%. This study addressed cancer incidence and mortality rates among the very elderly in the Netherlands. Cancer mortality data (1976-1995) and population data were obtained from Statistics Netherlands, whereas cancer incidence data (1989-1995) were provided by the Netherlands Cancer Registry. Cancer incidence and mortality rates were calculated and trends in cancer mortality were studied. Total cancer incidence rates were highest in the age group 85-94 years, in men and women (3466/100,000 person-years and 1604/100,000 person-years, respectively). Prostate carcinoma was the most frequent cancer in men ages 85-94 years, followed by colorectal carcinoma. In women ages 85-94 years, colorectal carcinoma was most frequent, closely followed by breast carcinoma. In the 95+ years age group squamous cell skin carcinoma was the most frequent cancer in both men and women, followed by prostate carcinoma in men and breast carcinoma in women. Cancer mortality rates increased with increasing age to nearly 3700/100,000 person-years in men age 95+ years and 2500/100,000 person-years in women age 95+ years. In men, lung carcinoma was the most frequent cancer-related cause of death in patients age < or = 85 years, whereas in older men this applied to prostate carcinoma. In women, breast carcinoma was the most frequent cancer-related cause of death in all age groups > 55 years. Cancer as a cause of death became less prominent with increasing age. Over the period 1991-1995, 42% of deaths in men ages 55-64 years were attributed to cancer versus 52% of deaths in women (total population); these proportions in the 95+ years age group were 11% and 7%, respectively. Peak incidence rates of major cancers were found in the very elderly population in the Netherlands. Different trends in age specific mortality rates of individual cancer sites were found, with stable rates in the middle age groups and increasing rates in the oldest age groups. This may reflect a real increase caused for instance by changes in mortality from other diseases and/or an artifactual increase caused by increased cancer detection rates in the (very) elderly.