Incidence Of Stomach Cancer Research Articles

The role of vitamin E in the prevention of cancer: Meta-analysis of randomized controlled trials

1017 Background: Several in vitro studies showed antioxidant vitamins to have a significant protective effect against cancer. We did a meta-analysis of Randomized Controlled Trials (RCTs) to evaluate the role of vitamin E supplements in the prevention of Cancer in adults Methods: We included RCTs, in which outcomes of the intake of vitamin E supplement alone or with other supplements, were compared to a control group.The primary outcomes were total mortality, cancer mortality, total incidence of Cancer, incidence of Lung, stomach, esophageal, pancreatic, prostate, breast and thyroid cancers. All identified trials were reviewed independently by the two reviewers to determine whether trials should be included or excluded. The quality of all included studies was scored independently by the two reviewers. RevMan, version 4.2 was used for the data analysis. Results: Twelve studies met inclusion criteria, including 167025 participants. There were no statistically significant differences in total mortality (RR 0.99; 95%CI 0.96–1.03), cancer incidence (OR 0.96; 95%CI 0.92, 1.01), and cancer mortality (OR 1.00; 95%CI 0.96–1.03) among the different groups of patients included in this meta-analysis. Vitamin E did not reduce the incidence of any type of cancer that was available for analysis; However there was a statistically significant reduction in the incidence of prostate cancer in patients receiving vitamin E, RR 0.85 [0.73–0.96, NNT=500]. Conclusions: Vitamin E supplementation was not associated with a reduction in total mortality or cancer incidence, and cancer mortality, but it was associated with a statistically significant reduction in the incidence of prostate cancer. Vitamin E can be used in the prevention of Prostate cancer in men who are at high risk of prostate cancer. No significant financial relationships to disclose.

Endoscopic Screening for Gastric Cancer

Population endoscopic screening for gastric cancer is generally deemed not to be cost-effective except in Japan, where its prevalence is very high. However, in the absence of screening, patients present with advanced disease, and prognosis is poor. We conducted a cost utility analysis to determine whether endoscopic screening for stomach cancer in intermediate-risk population would be cost-effective and to better define the high-risk groups in the population who would benefit from such strategy. Cost-effectiveness analysis was performed by using a Markov Model. Simulation was performed on Singapore (intermediate-risk) population and various high-risk subgroups. Comparison was made between 2-yearly endoscopic mass screening program versus no screening. Data sources were extracted from relevant studies published from 1980-2004 identified via systematic PUBMED search. Main outcome measures were deaths caused by stomach cancer averted, cost per life saved, and incremental cost-effectiveness ratio expressed as cost per quality-adjusted life year (QALY) saved. Screening of high-risk group of Chinese men (age-standardized rate, 25.9/100,000) from 50-70 years old is highly cost-effective, with cost benefit of United States $26,836 per QALY. Screening this cohort of 199,000 subjects prevents 743 stomach cancer deaths and saves 8234 absolute life years. Cost of averting 1 cancer death is United States $247,600. Cost-effectiveness was most sensitive to incidence of stomach cancer and cost of screening endoscopy. Screening of stomach cancer in moderate to high-risk population subgroups is cost-effective. Targeted screening strategies for stomach cancer should be explored.

Different regression equations relate age to the incidence of Lauren types 1 and 2 stomach cancer in the SEER database: these equations are unaffected by sex or race

BackgroundAlthough impacts upon gastric cancer incidence of race, age, sex, and Lauren type have been individually explored, neither their importance when evaluated together nor the presence or absence of interactions among them have not been fully described.MethodsThis study, derived from SEER (Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute) data, analyzed the incidences of gastric cancer between the years 1992–2001. There were 7882 patients who had developed gastric cancer. The total denominator population was 145,155, 669 persons (68,395,787 for 1992–1996, 78,759,882 for 1997–2001). Patients with multiple tumors were evaluated as per the default of the SEER*Stat program. 160 age-, five year period (1992–1996 vs 1997–2001)-, sex-, race (Asian vs non-Asian)-, Lauren type- specific incidences were derived to form the stratified sample evaluated by linear regression. (160 groups = 2 five year periods × 2 race groups × 2 sexes × 2 Lauren types × 10 age groups.) Linear regression was used to analyze the importance of each of these explanatory variables and to see if there were interactions among the explanatory variables.ResultsRace, sex, age group, and Lauren type were found to be important explanatory variables, as were interactions between Lauren type and each of the other important explanatory variables. In the final model, the contribution of each explanatory variable was highly statistically significant (t > 5, d.f. 151, P < 0.00001). The regression equation for Lauren type 1 had different coefficients for the explanatory variables Race, Sex, and Age, than did the regression equation for Lauren type 2.ConclusionThe change of the incidence of stomach cancer with respect to age for Lauren type 1 stomach cancer differs from that for Lauren type 2 stomach cancers. The relationships between age and Lauren type do not differ across gender or race. The results support the notion that Lauren type 1 and Lauren type 2 gastric cancers have different etiologies and different patterns of progression from pre-cancer to cancer. The results should be validated by evaluation of other databases.

Occupational Risk Factors for Esophageal and Stomach Cancers among Female Textile Workers in Shanghai, China

The authors evaluated associations between occupational exposures in the textile industry and the risks of esophageal cancer and stomach cancer. The authors conducted a case-cohort study nested in a cohort of female textile workers in Shanghai, China. One hundred and two workers with incident esophageal cancer and 646 workers with incident stomach cancer diagnosed between 1989 and 1998 were compared with an age-stratified reference subcohort (n = 3,188). Work histories were ascertained for all study subjects from factory personnel records or interviews. Exposures were reconstructed for chemicals and dusts by linking work history data with a job-exposure matrix developed for the Shanghai textile industry. Hazard ratios and 95 percent confidence intervals were calculated with Cox proportional hazards modeling adapted for the case-cohort design. Risk of esophageal cancer was associated with long-term (> or = 10 years) exposure to silica dust (hazard ratio = 15.8, 95% confidence interval: 3.5, 70.6) and metals (hazard ratio = 3.7, 95% confidence interval: 1.9, 7.1). Cumulative exposure to endotoxin, a contaminant of cotton dust, was inversely related to risks of both esophageal cancer (p-trend = 0.01) and stomach cancer (p-trend < 0.001) when exposures were lagged 20 years. Endotoxin has not been previously reported to be a protective factor for either stomach cancer or esophageal cancer and therefore warrants further study.

Reflections on the new classification of tumors by the WHO and changes in esophageal cancer in a high-risk area

In year 2000, a book entiled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epidemiologic change of tumors in over 30 years in the high-risk area with esophageal cancer. The following phenomenon was found: accompanied by the sharp decrease in the incidence and mortality of esophageal cancer, there was an increase in the incidence and death rate of stomach cancer involving cardiac cancer. This fact should be considered when analyzing the sharp decrease in esophageal cancer incidence and mortality rate. More attention was given to diagnosis of cardiac cancer; at the same time it is more practical to improve the early screening of cancers. To observe the development of high and low-grade intraepithelial neoplasms will be an urgent task for esophageal cancer research in the high risk area, according to WHO’s new classification.

Glycemic load, glycemic index and carbohydrate intake in relation to risk of stomach cancer: A prospective study

The glycemic effects of diets high in refined grains and starchy foods might increase stomach cancer risk by affecting circulating glucose, insulin and insulin-like growth factor-I levels. No prospective data on the role of high glycemic load and glycemic index diets on stomach cancer risk have been reported. We therefore prospectively investigated dietary glycemic load, overall glycemic index and carbohydrate intake in relation to the incidence of stomach cancer among 61,433 women in the population-based Swedish Mammography Cohort. Diet was assessed at baseline (1987-1990) and again in 1997. During 903,586 person-years of follow-up, a total of 156 incident cases of stomach cancer were ascertained. We observed no material associations of dietary glycemic load, overall glycemic index and total carbohydrate intake with the risk of stomach cancer. The multivariate hazard ratios for the highest versus the lowest quintile were 0.76 (95% CI = 0.46-1.25) for glycemic load, 0.77 (95% CI = 0.46-1.30) for overall glycemic index and 0.85 (95% CI = 0.50-1.43) for carbohydrate intake. The associations did not vary according to body mass index. Lack of information on Helicobacter pylori infection status did not allow stratification by this potential effect modifier. Findings from this population-based prospective cohort of middle-aged and elderly women did not provide evidence of a positive association between glycemic load, glycemic index and carbohydrate intake with risk of stomach cancer.

Longitudinal trends of stomach cancer and esophageal cancer in Yangzhong County: a high-incidence rural area of China

This study aims to investigate the recent trends in incidence rates of stomach cancer and esophageal cancer in a high-incidence rural area of China. All new cancer occurrences registered between 1991 and 2003 in the Yangzhong Cancer Registry were reviewed. Yearly age-specific and age-adjusted incidence rates were calculated for males and for females. Longitudinal trends of cancer incidence were estimated by the estimated annual percentage change method. In total 12 691 incident cancer cases were registered, with 7159 males (56.41%) and 5532 females (43.59%). Adjusting to the world standard population, the incidence rate of all cancers decreased significantly across the period 1991-2003 from 357.02 to 283.21 per 10 person-years. For males this rate decreased from 447.22 to 346.72 per 10 person-years, and for females the incidence rate decreased from 284.36 to 225.73 per 10 person-years. The major cancers in Yangzhong County were stomach cancer and esophageal cancer, accounting for more than 70% of all cancer occurrences. During the past 13 years, the incidence rates of stomach cancer decreased greatly from 231.92 to 145.26 per 10 person-years in males and from 114.16 to 74.59 per 10 person-years in females. The estimated annual percentage changes of stomach cancer incidence were -2.96% [95% confidence interval (CI), -2.99% to -2.92%] in males and -2.86% (95% CI, -2.89% to -2.82%) in females. Incidence rates for esophageal cancer decreased slightly from 121.48 to 93.84 per 10 person-years in males with an estimated annual percentage change of -1.39% (95% CI, -1.42% to -1.36%), and from 99.74 to 73.73 per 10 person-years in females at an annual change of -2.18% (95% CI, -2.22% to -2.14%). Findings from this study showed that, although there is a decreasing trend of stomach cancer and esophageal cancer in this high-incidence area, the rates remain high. Future effort should be directed toward identifying factors behind the high rates and those contributing to the decreasing trend.

Induction of Detoxication Enzymes in Mice by Naturally Occurring Allyl Nitrile

Little is known about whether glucosinolate-derived nitriles have the ability to increase phase 2 detoxication enzymes and glutathione (GSH) in vivo. In this study, the ability of allyl nitrile, a hydrolysis product of the glucosinolate sinigrin, to increase tissue levels of the phase 2 detoxication enzymes glutathione S-transferase and quinone reductase and GSH in a variety of mouse tissues was examined. At the lowest dose level (11.8 mg/kg/day), allyl nitrile showed inductive ability in the stomach and lungs. At 23.6 mg/kg/day, the inductive effect was observed in the stomach, rectum, urinary bladder, and lungs, whereas at 47.2 mg/kg/day, it was recorded in the stomach, rectum, urinary bladder, kidneys, and lungs. These results show that allyl nitrile displays its maximum potency in the stomach and lungs, which is of interest in light of epidemiological studies demonstrating an inverse association between crucifer intake and the incidence of stomach and lung cancers.

Incidence of Small Bowel Cancer in the United States and Worldwide: Geographic, Temporal, and Racial Differences

To examine the demographic and geographic patterns of small bowel cancer incidence in the United States and worldwide. Incidence data from the Surveillance, Epidemiology, and End Results (SEER) program between 1973 to 2000 were used to analyze the four histologic types of small bowel cancer, adenocarcinomas, carcinoid tumors, lymphomas, and sarcomas. International comparisons were made using data from Cancer Incidence in Five Continents (CIVIII). Geographic correlations between small bowel and both large bowel and stomach cancer incidence, were performed. Men had higher rates than women for all types of small bowel cancer. Blacks had almost double the incidence of carcinomas and carcinoid tumors compared to whites (10.6 vs. 5.6 per million people; 9.2 vs. 5.4 per million people, respectively). Small bowel cancer incidence has risen, with the greatest increase for carcinoid tumors (21%) and black men (120%). A geographic correlation between small and large bowel cancer incidence, but not small bowel and stomach cancer, were observed. Small bowel cancer incidence in the U.S. is higher in blacks compared to whites, particularly for carcinomas and carcinoid tumors. Small bowel cancer incidence is rising, particularly in black men. The geographic correlation between large and small bowel cancer suggests shared etiologies.

Tobacco Use and Stomach Cancer in Mizoram, India

The incidence of stomach cancer in India is lower than that of any other country around the world. However, in Mizoram, one of the north-eastern state of India, a very high age-adjusted incidence of stomach cancer is recorded. A hospital-based case-control study was carried out to identify the influence of tobacco use on the risk of developing stomach cancer in Mizoram. Among the cases, the risk of stomach cancer was significantly elevated among current smokers [odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.4-8.4] but not among ex-smokers. Higher risks were seen for meiziol (a local cigarette) smokers (OR, 2.2; 95% CI, 1.3-9.3). The increased risk was apparent among subjects who had smoked for >or=30 years. The increased risk was significant with 2-fold increase in risk among the subjects who smoked for >or=11 pack-years. The risk increased with increasing cumulative dose of tobacco smoked (mg). Tuibur (tobacco smoke-infused water), used mainly in Mizoram, was seemed to increased the risk of stomach cancer among current users in both univariate and multivariate models (OR, 2.1; 95% CI, 1.3-3.1). Tobacco chewer alone (OR, 2.6; 95% CI, 1.1-4.2) showed significant risk. Tobacco use in any form [smoking and smokeless (tuibur and chewing)] increased the risk of stomach cancer in Mizoram independently after adjusting for confounding variables.

Cancer incidence in Arkhangelskaja Oblast in northwestern Russia. The Arkhangelsk Cancer Registry

BackgroundData concerning incidence and prevalence of cancer in the different regions of Russia have traditionally not been provided on a basis that facilitated comparison with data from countries in western parts of Europe. The oncological hospital in Arkhangelsk, in co-operation with Universitetet i Tromsø (Norway), has established a population based cancer registry for Arkhangelskaja Oblast (AO). AO is an administrative unit with 1.3 million inhabitants in northwestern Russia. The aim of this investigation was to assess the content and quality of the AO cancer registry (AKR), and to present the site-specific cancer-incidence rates in AO in the period 1993–2001.MethodsThe population in this study consisted of all individuals registered as residents of AO. All new cancer cases in the period 1993 – 2001, registered the AKR, were included in the study (ICD-10: C00-C95, except for C77-78). The annual gender and age-group-specific population figures were obtained from the AO statistics office.ResultsA total of 34 697 cases of primary cancers were included. The age-adjusted (world standard) incidence rate for all sites combined was 164/100 000 for women and 281/100 000 for men. The highest incidence was for cancer of the trachea, bronchus and lung (16.3% of all cases), whereof 88.6 % of the cases were among men. Among women, cancer of the breast constituted 15.9 percent of all cases. The age-adjusted incidences of the most frequent cancer sites among men were: lung (77.4/100 000); stomach (45.9); rectum (13.4); oesophagus (13.0); colon (12.2); bladder (11.6); and prostate cancer (11.1). Among women they were: breast (28.5); stomach (19.7); colon (12.2); and ovary cancer (9.0).ConclusionOur findings confirm and strengthen the indication that the incidences of stomach, larynx, liver, pancreas, prostate, colon, bladder and melanoma cancer are quite different in male populations in Russia compared to many other European countries. Among women, most major cancer types, except stomach, appear to be relatively low in Russian populations. The AKR provides quality data for estimations and insight to the cancer incidence in a northern Russian population, and we consider the reported incidence rates to reflect the cancer situation in AO well.

Cancer incidence in Kyrgyzstan

9699 Background: To study age, sex, geographic, site specific and ethnic cancer incidence in Kyrgyzstan. Methods: Calculated the incidence of cancer between 1997 and 1999 in all population. Estimated population relative risk for main tumours in urban and rural areas. Detailed population figures from census are available from National Center of Statistics. The population figures and cancer incidence rates were provided in for each age, ethnic and sex groups. Counted crude, age-standardised rates (ASR) per 100 000. Results: There were 4896 males and 5034 females registered with new diagnoses of cancer. Male-female proportion - 1,03. Histologically verified cases 80,5%. ASR annual incidence was in males 201.2 and females 137.9 (total 169.55)The most frequent diagnostic groups in males were tumours of the stomach (44.65), lung (41.0), skin (27.8), oesophagus (11.65), haemoblastoses (8.6), bladder (6.6) colon (5.9), and prostate (5.9); in females - skin (23.5), breast (19.1), stomach (16.2), cervical cancer (15.5), ovary (6.7), lung (5.9), corpus uteri (5.5), oesophagus (5.4), blood and lymph (5.2). Cancer incidence was significantly higher in urban (255.5-male, 161.9-female) than rural (161.8-male, 118.5-female) regions. However, in some tumours (oesophagus, stomach in males and cervical cancer in females) incidence rate was slightly higher in rural areas. Incidence was significantly higher in the Slavic ethnic groups (Russians, with an ASR of 263.8 cases per 100 000, Ukrainians 239.8, Byelorussians 185.0) compared with 65.7 for Kyrgyzs, 52.5 for Uzbeks and 61.5 for Kazakhs people. Excess relative risk (RR) was higher among Russians in tumours of skin (6,6), endometrial cancer (2,5), breast cancer (2,2), and lung cancer (1,7). However, oesophagus, cervix of uteri, stomach cancer incidence in native ethnic people was significantly higher than Russians and other Slavic groups. Cancer incidence in the mountain areas was differing. High incidence registered in low altitude (650 - 1500 m. above level sea), with ASR 205.9, middle altitude (1500 - 2500 m.), with ASR 118.7, than high altitude (2500 - 3500 m.) regions, with ASR 60.8. Conclusions: Cancer incidence in Kyrgyzstan is low and similar to those reported from some Asian developing countries. No significant financial relationships to disclose.

Occupation and risk of stomach cancer in Poland

Background: In spite of the dramatic decline in the incidence of stomach cancer in the twentieth century, Poland has one of the highest rates in the world. Aims: To evaluate...

Mortality and Incidence Rates of Stomach Cancer in the JACC Study

BACKGROUND: The objective of this study was to examine the mortality and incidence of stomach cancer in the Japan Collaborative Cohort Study (JACC Study), and compare them with those of the general population of Japan.METHODS: The cohort study involved 127,477 people living in 45 municipalities in Japan. The deaths due to stomach cancer were ascertained by death certificates. The age-adjusted mortality rate per 100,000 was calculated based on 110,792 subjects aged between 40 and 79 years at the baseline in all study areas. The incident cases were defined as the subjects in whom stomach cancer had developed, or subjects who died of stomach cancer during the observed period of survey for cancer incidence. The age-adjusted incidence rate per 100,000 was ascertained and calculated in 64,820 people aged 40-79 years at the baseline living in 24 study municipalities with cancer registries. Then, the mortality rate was compared with the mortality data published in vital statistics of Japan of 1995, and the incidence rate compared with the incidence data published in The Research Group for Population-based Cancer Registration in Japan of 1992.RESULTS: During more than 10 years of follow-up, there were 582 male deaths and 287 female deaths due to stomach cancer. The age-adjusted mortality rate was 93.4/100,000 person-year (95% confidence interval [CI]: 84.6-102.2) in males and 31.1 (95% CI: 27.0-35.3) in females. There were 646 incident cases in males and 370 in females. The age-adjusted incidence rate was 245.3 / 100,000 person-year (95% CI: 221.6-268.9) and 94.8 (95% CI: 83.0-106.6) in males and females, respectively.CONCLUSION: The mortality rate of stomach cancer in the JACC Study was lower than that in the vital statistics in Japan. Similar incidence rate of stomach cancer seems to be found between data of the JACC Study and that of the Research Group for Population-based Cancer Registration, but care is needed to interpret this similarity, because it might be due to different degree of completeness of incidence survey between the 2 studies

Estimated effects of solvents and mineral oils on cancer incidence and mortality in a cohort of aerospace workers

A retrospective cohort study of workers employed at a California aerospace company between 1950 and 1993 was conducted; it examined cancer mortality from exposures to the rocket fuel hydrazine. In this study, we employed a job exposure matrix (JEM) to assess exposures to other known or suspected carcinogens-including trichloroethylene (TCE), polycyclic aromatic hydrocarbons (PAHs), mineral oils, and benzene-on cancer mortality (1960-2001) and incidence (1988-2000) in 6,107 male workers. We derived rate- (hazard-) ratios estimates from Cox proportional hazard models with time-dependent exposures. High levels of TCE exposure were positively associated with cancer incidence of the bladder (rate ratio (RR): 1.98, 95% confidence interval (CI) 0.93-4.22) and kidney (4.90; 1.23-19.6). High levels of exposure to mineral oils increased mortality and incidence of lung cancer (1.56; 1.02-2.39 and 1.99; 1.03-3.85), and incidence of melanoma (3.32; 1.20-9.24). Mineral oil exposures also contributed to incidence and mortality of esophageal and stomach cancers and of non-Hodgkin's lymphoma and leukemia when adjusting for other chemical exposures. Lagging exposure measures by 20 years changed effect estimates only minimally. No associations were observed for benzene or PAH exposures in this cohort. Our findings suggest that these aerospace workers who were highly exposed to mineral oils experienced an increased risk of developing and/or dying from cancers of the lung, melanoma, and possibly from cancers of the esophagus and stomach and non-Hodgkin's lymphoma and leukemia. These results and the increases we observed for TCE and kidney cancers are consistent with findings of previous studies.

Rare Helicobacter pylori infection as a factor for the very low stomach cancer incidence in Yogyakarta, Indonesia

To elucidate factors associated with the very low risk of gastric neoplasia in Yogyakarta, Indonesia, approximately 1/50 of the level in Japan, we recruited 52 male and 39 female participants from the general populace in the city of Yogyakarta in October 2003. Helicobacter pylori IgG antibodies were found in only 5% (0–13) (95% confidence interval) and 4% (0–9) for Javanese males and females, respectively, and were statistically lower than the 62% (58–65) and 57% (53–60), respectively, in Japanese. Furthermore, positive findings of pepsinogen test were only 0 and 2% (0–6) for males and females, in Yogyakarta, and were again significantly lower than the 23% (22–25) and 22% (20–23), in Japan. The very low incidence of stomach cancer in Yogyakarta may be due to a low prevalence of H. pylori infection and chronic atrophic gastritis.

Cancer incidence of Nordic asphalt workers

The aim of the study was to investigate cancer risk following employment in the asphalt industry. Cancer incidence was studied among 22 362 male asphalt workers employed for more than one season in jobs entailing exposure to bitumen (mainly road pavers) in Denmark, Finland, Norway, and Sweden. These workers are part of a European cohort of asphalt workers, for which results on mortality have been reported. The follow-up was almost complete, and reference rates were obtained from national cancer registries. The incidence of cancer was reduced in all four countries [overall standardized incidence ratio (SIR) 0.89, 95% confidence interval (95% CI) 0.86-0.94]. Lung cancer incidence was increased in all four countries, yielding an overall SIR of 1.21 (95% CI 1.07-1.36), but no trend was detected according to time since first employment. No overall increased incidence of bladder cancer was observed, but there was a suggestion of a tendency towards higher risk with longer time since first employment, with a relative risk of 1.85 (95% CI 0.90-3.78) for more than 30 years versus 1-14 years (P-value for trend 0.1). The incidence of lip and stomach cancer was nonsignificantly increased, and the excess was present mainly in Denmark. No increased incidence was detected for other neoplasms, notably malignant melanoma, nonmelanoma skin cancer, and kidney cancer. The results of this study confirm the pattern of cancer risk detected in the mortality analysis of the European cohort; in addition, they provide suggestive evidence of an excess risk of bladder cancer among asphalt workers.

Cancer in Greenlandic Inuit 1973–1997

Objectives. During the second half of the 20th century living conditions of the Inuit populations in the Arctic have undergone major transitions. The objective was to investigate how the cancer pattern was affected by these changes, using data from the Danish Cancer Registry and the Civil Registration System. Results. In the period 1973–1997 total cancer incidence increased by 4% per 5 years for men and 6% per 5 years for women. The incidence of lung, stomach, breast and colon cancer increased in both sexes, whereas the incidence of cervical cancer decreased. Conclusions. Thus, the overall cancer incidence among Greenlandic Inuit is increasing as a result of increases in several cancers that are common in Western populations. In contrast to global trends, a significant increase in the incidence of stomach cancer in both sexes was observed.

Population-based incidence and mortality cancer trends (1986–1997) from the network of Italian cancer registries

The objective of this study was to analyse incidence and mortality cancer trends in the Italian Network of Cancer Registries (about 8,000,000 inhabitants) during the period 1986-1997. Included were 525,645 newly diagnosed cancers and 269,902 cancer deaths (subjects > 14 years). Joinpoints (points in time where trend significantly changes from linearity) were found and estimated annual percentage changes (EAPC) used to summarize tendencies. Overall cancer incidence increased in both sexes and cancer mortality significantly decreased (since 1991 among men). Lung cancer showed significantly decreasing incidence (EAPC = -1.4%) and mortality (EAPC = -1.6%) among men and increasing trends among women. In women, breast cancer incidence significantly increased (EAPC= +1.7%) and mortality decreased since 1989 (EAPC= -2.0%). Stomach cancer incidence and mortality decreased in both sexes. Prostate incidence sharply increased since 1991 and mortality decreased. Colon cancer incidence increased and rectum mortality decreased significantly in both sexes. Significant increases in incidence were also found for kidney (up to 1991 among men), urinary bladder, skin epithelioma, melanoma, liver (up to 1993 among men), pancreas, mesothelioma, Kaposi's sarcoma (up to 1995 among men), testis, thyroid, non-Hodgkin's lymphomas and multiple myeloma. Mortality significantly decreased for cancers of the oral cavity and pharynx, oesophagus, liver (women), larynx (men), bone, cervix (since 1990), central nervous system, urinary bladder, thyroid, Hodgkin's lymphomas and leukaemias (men). Non-Hodgkin's lymphoma mortality increased in both sexes. In conclusion, most of the changes seen can be explained as the effect of changes in smoking habits and of the extension of secondary prevention activities. The Italian health care system will also have to cope with growing cancer diagnostic and therapeutic needs due to population ageing.

Aerodigestive and gastrointestinal tract cancers and exposure to crocidolite (blue asbestos): incidence and mortality among former crocidolite workers.

The objective of this article was to assess the association between the incidence and mortality from aerodigestive cancers and exposure to crocidolite (blue asbestos). Our study is a cohort study of former workers of the now-defunct crocidolite mining and milling operation at Wittenoom, Western Australia, who have been followed up since 1979 and on whom asbestos exposure and smoking information was known. Standardised mortality and incidence rates were used to compare former workers with the Western Australian male population. Cases were matched with up to 10 randomly assigned controls, and conditional logistic regression was used to examine the relationship between asbestos exposure, smoking status and cancer incidence. There were 129 incident cases from all cancers of interest and 57 deaths. Former workers had a significantly higher risk of mortality from upper aerodigestive cancers than the Western Australian male population. The incidence of upper and lower aerodigestive cancers was higher in the Wittenoom cohort but not significantly so. Cumulative exposure to asbestos did not appear to be associated with the incidence of stomach cancer, colorectal cancer or upper aerodigestive cancers. Smoking status was strongly associated with the incidence of upper aerodigestive cancers, with current smokers experiencing the greatest risk. Our study with longer and more complete follow-up, smoking information and a stronger study design does not show an association between cumulative asbestos exposure and stomach cancer or other gastrointestinal cancers. The excess mortality from upper aerodigestive cancers seen in this cohort of former asbestos workers compared to the Western Australian male population does not appear to be associated with exposure to crocidolite.