Annual Number Of New Cases Research Articles

Estimation of Annual Incidence of Lung Cancer Associated with Work Place Exposure to Passive Smoking in France

This study attempted to estimate the number of annual new cases of lung cancer from workplace exposure to Environmental Tobacco Smoke (ETS) in France. The number of new lung cancer cases attributable to workplace ETS exposure in France was estimated with regard to the following factors: excess risk of lung cancer from workplace ETS exposure, incidence of lung cancer in non-exposed non-smokers, and number of French workers exposed to passive smoking. The excess risk of lung cancer from workplace ETS exposure was estimated as from 0.12 to 0.39 by different references. The French workforce, regularly exposed to ETS in their workplace is about 3.2 millions. The incidence of lung cancer of non-smokers without exposure to ETS is between 3.7 to 10 per hundred thousand. If these three factors are combined, it is estimated that exposure to workplace passive smoking causes around 14 to 125 new cases of lung cancer each year in France. New lung cancer cases from workplace exposure to ETS represent a few percent of all occupational lung cancers, and a minuscule number in regards to the whole lung cancer annual incidence (14 to 125 for 23,000 lung cancers in France=0.06% to 0.54%).

Sleep in Persons with Dementia: Increasing Quality of Life By Managing Sleep Disorders

In individuals with dementia, sleep disruptions (e.g., increased number of nighttime awakenings after falling asleep, lower sleep efficiency, increased daytime napping, changes in the amount of rapid eye movement (REM) and non-rapid eye movement (NREM) sleep increase as the dementia increases in severity. Sleep can also be disrupted in individuals with dementia because of primary sleep disorders, such as obstructive sleep apnea, advanced sleep phase syndrome, and restless legs. Other factors that contribute to disrupted sleep in individuals with dementia include age, acute and chronic illness, mood disorders, and medication use.

An innovative rapid response radiotherapy program to reduce waiting time for palliative radiotherapy

Waiting for radiation therapy (RT) in Ontario has been a major problem for the past decade. In 1996, the Toronto-Sunnybrook Regional Cancer Centre (TSRCC) initiated a Rapid Response Radiotherapy Program (RRRP) to provide timely palliative RT for symptom relief of patients with terminal cancer. This study reviews the clinical activity of the RRRP over the past 8 years to evaluate if we are meeting the objectives of the program. From the TSRCC oncology patient information system (OPIS) database, we retrieved the number of patients referred to the RRRP, their demographics, diagnosis and treatment for the calendar years 1996 to 2003 inclusive. We calculated the time interval between referral to consultation, consultation to simulation and the percentage of cases who started RT on their initial consultation for all new cases referred to the RRRP. From 1996 to 2003, the number of cases seen in consultation increased from just over 200 cases annually in the first 2 years to about 500 cases per year in the last 4 years, for a total of 3,290. There were 1,792 (54%) men and 1,498 (46%) women; median age was 69 years (range, 21-95 years). Breast, lung, genitourinary and gastrointestinal primaries accounted for over 80% of all referrals. The majority was referred for palliative treatment of symptomatic bone (70%) or brain (14%) metastases. The dose fractionation for bone metastases was a single 8-Gy fraction in 45%, 20 Gy in five fractions in 42%, 30 Gy in ten fractions in 4% and other dose fractionations in 9%. Nearly 90% were seen within 2 weeks of referral (38% within 1 week). Eighty-five percent were simulated on the day of their initial consultation. Sixty percent started their RT treatment on the day of their consultation visit. The overall median interval from referral to treatment was 8 days. Over the past 8 years, the annual number of new cases referred to the RRRP has doubled. The overall median interval from referral to consultation was 8 days. Sixty percent were simulated, planned and started treatment on the day of their initial consultation. We therefore are meeting our goal of providing rapid access to palliative RT for symptomatic cancer patients.

Nasal carriage of Mycobacterium leprae DNA in healthy individuals in Lega Robi village, Ethiopia.

The number of registered leprosy patients world-wide has decreased dramatically after extensive application of WHO recommended Multiple Drug Therapy (MDT). The annual number of new cases has, however, been almost unchanged in several populations, indicating that the infection is still present at community level. Nasal carriage of Mycobacterium leprae DNA was studied in Lega Robi village in Ethiopia. MDT had been applied for more than ten years, and 718 residents over 5 years old were eligible for the study. During the first survey nasal swab samples were collected from 664 (92.5%) individuals. The results of a Peptide Nucleic Acid-ELISA test for M. leprae DNA interpreted by stringent statistical criteria were available for 589 (88.7%) subjects. Thirty-five (5.9%) individuals without clinical signs of leprosy were positive for M. leprae DNA. Seven PCR positive individuals lived in a household where one or two other members were also positive for M. leprae DNA. During a second survey 8 (46%) of 175 interpretable PNA-ELISA tests were positive. Of 137 individuals tested twice, only two were positive on both occasions whereas 10 were PCR positive only once. The study confirms the widespread distribution of M. leprae DNA in healthy individuals. The feasibility of curbing possible transmission of subclinical infection needs further consideration.

Diffuse toxic goiter in children: incidence at iodine deficient territories of the Russian Federation

Time course of changes in the incidence of diffuse toxic goiter (DTG) in children aged 0-14years was studied in 1986-1999 at territories with slight iodine deficiency and normal radiation levels in the Central Federal Region of Russia (Belgorod, Voronezh, and Orel regions, a total of 45 territories, n = 665,987). The mean incidence of DTG over 14years in this cohort was 0.59per 100,000 children annually, which corresponds to the prevalence of this condition at a territory with slight and moderate iodine deficit. A notable increase in the incidence of DTG was observed during recent 5 years (1995-1999) in comparison with the beginning of observation (1986-1990): annual number of new cases and the morbidity level doubled (from 2.6+ 0.7 to 5.6+0.5, p - 0.01, and from 0.39 to 0.84, p < 0.03, respectively). The relative risk, of DTG in childhood increased to 2.15 (1.13-4.15, p < 0.029) in recent years; this is true mainly for pubertal girls. These negative shifts in DTG epidemiology among children in Central Russia were not caused by principal changes in the level of iodine consumption and were observed in the presence of persisting slight iodine deficiency under conditions of neglected overall iodine prevention.

Cancer: A reality in the emerging world

World societies have changed significantly in the last decades. The main characteristics of these changes are reciprocal connections and interdependencies. It has been thus realized that a major part of the world population still lives in poverty. Due to specific health care interventions and consequent demographic changes, it is expected that the population in general, and of the older people in particular, will increase significantly in the future. The annual number of new cases of cancer is expected to double from 10 million at present to 20 million in the next 20 years. Considering the increases in life expectancy and in tobacco abuse worldwide, and the existence of viral diseases leading to cancer in less developed countries besides other factors, the majority of new cases will probably occur in the emerging world. The number of new cases of cancer could in the future be reduced with the enhancement of education on vertical and horizontal levels in less developed countries. On the vertical arm, the education would concentrate on physicians, nurses, and other health care workers, while on the horizontal arm, it would be provided to government officials, politicians, and other decision-makers. It should be accepted that the world is one and that the problems associated with cancer in less developed countries are global problems.

Trends in prostate cancer incidence, mortality and survival in England and Wales 1971-1998.

To examine trends in prostate cancer incidence and mortality in England and Wales between 1971 and 1998, using a newly developed and validated national cancer database and the national mortality database. Age-standardized incidence and death rates were calculated directly and trends in relative survival rates among men with prostate cancer registered during 1971-1990 were examined. The annual number of new cases of prostate cancer registered in England and Wales increased by 179% between 1971 and 1993, from 6174 to 17 210. Directly age-standardized incidence rates increased by 104% between 1971 and 1993, from 29 to 59 per 100 000. The number of deaths from prostate cancer increased by 113% between 1971 and 1998, from 4027 to 8570. Directly age-standardized death rates increased by 49% between 1971 and 1995 and then decreased by 8% between 1995 and 1998, an overall increase of 38% (20 to 27 per 100 000) between 1971 and 1998. The relative survival rate for prostate cancer among men diagnosed during 1986-1990 was 77% at 1 year and 42% at 5 years, compared with 67% and 33%, respectively, for cases diagnosed during 1971-1975. The increase in survival rates was confined to men diagnosed with prostate cancer up to 1985 and no increase was seen for cases diagnosed after 1985. Prostate cancer is becoming a growing burden on the health service. The explanation for the large increase in prostate cancer incidence and mortality is unclear and needs further investigation. The lack of any improvement in survival rates in cases diagnosed after 1985 is of concern, and suggests that the current management of prostate cancer in both primary and secondary care may need to be reviewed.

Switzerland: the status of silicosis from the past to the end of the 20th century. Control and prevention.

The silicosis issue in Switzerland is reviewed on the basis of data provided by Suva, the Swiss National Insurance Fund, in charge of law enforcement and of prevention. Pictures of the past period and nowadays consecutively to the occupational medicine surveillance and industrial hygiene practice showed that major improvements have been realized. In the 30's, a constant rise of new cases of silicosis has been observed every year. From 1940 to end of the 60's, a plateau was reached with about 200 to 300 cases per year. Since 1974, a significant decrease is observed, the annual number of new cases being about 100. Since 1989, the new cases level off at 30-50 per year due to drastic control measures and present announced cases are residuals of previous exposures. The number of annual deaths ranges at the unit level with a patient's life expectancy nearly equal to that of the general population. Prevention efforts however should be continued since the activities of concern have changed. Small enterprises with a limited number of personnel dispersed throughout the country, working in the sectors of stone cutting and grinding, civil engineering and cleaning of building surfaces make prevention difficult and may lower its efficiency. In addition, information should also reach categories of individual workers like professional pottery crafstmen or leisure-exposed persons.

Hepatocellular carcinoma in western Sydney

To examine the incidence of hepatocellular carcinoma (HCC) in western Sydney over the last 14 years, to assess risk factors for the disease among ethnic groups of Australian residents, and to consider the opportunities for improving its usually poor outcome. Retrospective case-record review of clinical features in all (122) patients discharged from a 900-bed tertiary-referral teaching hospital with a diagnosis of HCC from January 1979 to March 1993. Annual number of new cases; risk factors according to birthplace; surgical resectability of tumours. New cases admitted each year at least doubled between 1979-1985 and 1986-1992. This apparent increase involved individuals born in Australia (50% of all patients) as well as immigrants. Cirrhosis was found in 93% at liver biopsy or autopsy. Excessive alcohol intake was an associated risk factor for 46% of Australian-born patients and for 13% of those born overseas. Among the latter, HCC was associated with markers of hepatitis B virus infection in 64%. Since hepatitis C virus (HCV) tests became available in 1990, five of nine patients tested were anti-HCV positive. Surveillance screening of patients known to have cirrhosis detected eight cases of early HCC. Seven of these had surgical resection and all are alive. New diagnoses of HCC have increased recently, irrespective of country of birth. In Australian-born patients alcoholic liver disease remains a major aetiological factor but the role of HCV requires further evaluation. Among immigrants, cirrhosis from chronic viral hepatitis accounts for most cases. We propose that prevention of cirrhosis caused by chronic viral hepatitis should have the greatest long-term impact on prevention of HCC in Australia. The role of surveillance of people with cirrhosis to detect small and potentially resectable tumours should be explored.

Tuberculosis: Distribution, Risk Factors, Mortality

About a century after KOCH'S discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic and increasing drug resistance. The impact of the HIV epidemic is already felt in many sub-Saharan African countries and now threatens Asia where almost two-thirds of the world's TB infected population live and where HIV is spreading. Tuberculosis has also reemerged as a major public health problem in industrialized countries due to international migration, the breakdown of health services, including TB services etc. The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort.

Nine Years of the Freebase Cocaine Epidemic in the Bahamas

Nine years after the beginning of the epidemic of freebase (crack) cocaine abuse in the Bahamas, this historical study was done to characterize the natural course of the epidemic and to estimate the effectiveness of control measures. The authors' data include the incidence of new cases at the only psychiatric hospital in the Bahamas and at the primary community psychiatric clinic in the nation. The Bahamian response included 1) demand reduction, 2) supply reduction, and 3) reduction of money laundering. The annual number of new cases of crack abuse presenting for treatment declined from 1987 to mid‐1991 in both facilities, but in 1992 it began rising again in the inpatient setting only. The changes in recent years have been accompanied by an increase in violent crimes against persons, especially robberies. (American Journal on Addictions 1994; 3:14–24)

Hepatitis B virus infection and health care workers

Hepatitis B virus (HBV) infection is the major occupational risk of health care workers, among whom HBV infection risk is 2 to 10-fold elevated above that of the general population. Risk is most clearly related to the degree of direct contact with human blood and body fluids, and to frequency of traumatic exposures in the workplace. Most exposures result from unsuspected asymptomatic HBV carriers, who represent 1 to 2% of hospitalized patients. Risk of HBV infection also varies with the frequency of HBV carriers in the patient population. In the USA, the annual number of new cases has been constant over the last decade, despite a 50% overall increase in acute HBV disease. Control of HBV in the work setting is based on universal precautions for exposure to human blood or body fluids, and hepatitis B vaccination. Increased attention to these recommendations appears to be reducing this problem in the USA.

職場の精神障害者に対する精神保健活動 第１部 精神障害者の発見

A mental health program was commenced in 1957 in an electric power company which has about 360 offices and 17,000 employees scattered throughout Kyushu (excluding Okinawa). During a period of 30 yr from 1957 to 1986, a total of 949 mentally ill employees sought consultation regarding various mental health problems. The mean annual number of new cases that sought consultation was 32, giving a rate of 0.19% of the number of employees as of the end of year. The rate increased with length of service and reached 4.4% of the initially employed number after 25-29 yr of service. In addition to cases of direct interview, indirect consultation was sought from family members and/or superiors of the employees. About one-half of this number later sought direct interview, but the remaining cases remained as latent cases in places of work. Psychiatric diagnoses of the subjects by interview included neurotic disorders, alcoholic mental disorders (alcoholic psychoses and dependence), schizophrenic psychoses, affective psychoses, personality disorders, epilepsy and other non-organic psychoses (reactive psychoses).

DNA flow cytometric analysis indicates that many breast cancers detected in the first round of mammographic screening have a low malignant potential.

An organized mammographic screening program covered 8,690 women from selected birth cohorts (aged 50-59) in the Tampere University Central Hospital district. Forty-four breast cancer cases were detected in the first round of mammographic screening, which is 3.7 times the expected annual number of new cases in this population. To evaluate the proliferative kinetics and biological properties of these cancers, DNA flow cytometric analysis was carried out in 37 of the screen detected cancers (SDCs) using 60 clinically detected stage I-II cancers and 30 screen-detected benign lesions as reference. DNA aneuploidy was observed in 17/37 (46%) of the SDCs as compared to 41/60 (68%) in the clinical controls (p less than 0.05), while all the benign lesions were DNA-diploid. The median S-phase fraction (SPF) in the SDCs was significantly (p less than 0.001) lower (3.5%) than in the clinical controls (9.6%). Differences in SPF persisted in subgroups defined by DNA ploidy and histological type. In stage-I SDCs the median SPF value (2.5%) approached that of benign tumors (1.9%). Our epidemiological and biological data indicate that the first round of mammography predominantly detects prevalent preclinical lesions, some of which are of very low malignant potential. At present such patients may often receive too extensive treatment. DNA flow cytometry could help in the identification of cases which could be treated, for example, by breast-conserving methods.

Descriptive epidemiology of Creutzfeldt-Jakob disease in Finland.

In 1974-84 30 patients died with a diagnosis of Creutzfeldt-Jakob disease (CJD) in Finland. Sixteen of the patients were pathologically confirmed and 14 were probable cases; 6 were familial (20%). One further familial patient was alive at the end of 1984. The median age of the 30 patients at death was 59.5 years (range 46-73 years). The familial patients were significantly younger than sporadic cases (median and range 49.5 and 46-57 versus 61.5 and 51-73; P less than 0.01). Only 5 of the 24 sporadic patients were men (male to female ratio 1:3.8). The annual number of new cases as well as the death rate increased in the late 1970's (annual death rate 0.57 per million in 1974-84 and 0.91 in 1979-84). This probably reflects the growing awareness of CJD among neurologists, rather than a real increase of the incidence and death rate. Annual age-specific death rate per 1 million population in 1974-84 reached a peak value of 2.57 in the age group of 60-64 years. In sporadic CJD the age-specific death rate of women was higher than that of men in all age groups. A chronic medical condition, precedent or concomitant with CJD, was seen in 15 patients.