Updated Incidence Research Articles

Incidence of Herpes Zoster in a Large Cohort of Persons Living with HIV

Herpes Zoster (HZ) incidence has decreased over 40% in the United States but remains elevated in persons living with HIV (PLWH). HZ vaccine is not routinely recommended for PLWH and provider-prescribing patterns vary greatly. Updated incidence information in this population is needed to guide vaccine strategies. Using data from the US military HIV Natural History Study (NHS), we evaluated the incidence and risk factors for HZ in the modern ART era. NHS subjects undergo bi-annual visits with laboratory testing, examinations, and records reviewed for clinical diagnosis, including HZ. Analysis was restricted to subjects contributing to follow-up after 2001. Risk factors for HZ (demographic and HIV-specific) were assessed with a multivariate Cox proportional hazards model. Of the 2954 subjects meeting inclusion criteria, 237 (8%) were diagnosed with HZ. At HZ diagnosis, the median age, CD4 count, and viral load were 38.6 years [IQR-30.8, 45.8], 461 cells/uL [IQR-333, 638] and 1900 copies/mL [IQR-50, 19580] respectively. The incidence of HZ was highest prior to 1996 at 3.24 cases/100 person-years (PY) of follow-up (2.96–3.54) and declined significantly over time with 1.9 (1.6–2.3), 1.4 (1.2–1.8), 1.4 (1.1–1.7), and 0.9 (0.7–1.2) cases/100 PY recorded in 1996–2000, 2001–2005, 2006–2010, and 2011–2016, respectively. In the multivariate model, longer time from HIV diagnosis to ART initiation was associated with HZ. ART use, higher CD4 count, recent year of HIV diagnosis, and older age were protective (Table 1). HZ remains a common diagnosis in the ART era. NHS subjects with HZ were in the fourth and fifth decades of their life and had preserved CD4 counts highlighting the need for HZ vaccine safety and efficacy studies to help guide provider practice. Delays in ART initiation were associated with HZ emphasizing the need for compliance with current ART guidelines. Table 1. Table 1. All authors: No reported disclosures.

Incidence and mortality of cervical cancer in China, 2013.

Estimating the incidence and mortality rate of cervical cancer became necessary to establish prevention measures and healthy policies. The aim of this study was to estimate the updated incidence and mortality rate of cervical cancer in 2013 in China. According to the evaluation criteria developed by the National Central Cancer Registry of China, the data submitted from 255 cancer registries met the required standards in 2013. Cervical cancer cases were retrieved from the national database and combined with the 2013 national population data. The age-standardized incidence and mortality rates were based on the demographic structure of the national census 2000 and Segi's world population. In 2013, the estimated number of new cases and deaths from cervical cancer were 100,700 and 26,400, respectively. The crude incidence of cervical cancer was 15.17/100,000. The age-standardized incidence rates based on the Chinese standard population (ASIRC) and the world standard population (ASIRW) were 11.30/100,000 and 10.30/100,000, respectively. The incidence of cervical cancer in urban areas was 15.62/100,000 and the ASIRC was 11.12/100,000. The incidence of cervical cancer in rural areas was 14.65/100,000 and the ASIRC was 11.47/100,000. The mortality rate of cervical cancer was 3.98/100,000. The age-standardized mortality rates based on the Chinese (ASMRC) and world standard populations (ASMRW) were 2.76/100,000 and 2.62/100,000, respectively. The mortality rate of cervical cancer in urban areas was 3.85/100,000 and in rural areas was 4.14/100,000. Cervical cancer incidence and mortality increased with age. Urban areas had a higher incidence of cervical cancer and lower mortality rates when compared with rural areas. Dynamic monitoring of cervical cancer incidence and mortality is the fundamental work of cervical cancer prevention and control. Cervical cancer is a serious issue in women's health, and prevention strategies need to be enhanced, such as human papilloma virus (HPV) vaccination and screening programs.

P2.04-006 Updated Incidence of Thymic Epithelial Tumors (TET) in France and Clinical Presentation at Diagnosis: Topic: Thymic Malignancies Clinical and Translational

P2.04-006 Updated Incidence of Thymic Epithelial Tumors (TET) in France and Clinical Presentation at Diagnosis: Topic: Thymic Malignancies Clinical and Translational

Laparoscopic hysterectomy with morcellation vs abdominal hysterectomy for presumed fibroids: an updated decision analysis following the 2014 Food and Drug Administration safety communications

Previous decision analyses demonstrate the safety of minimally invasive hysterectomy for presumed benign fibroids, accounting for the risk of occult leiomyosarcoma and the differential mortality risk associated with laparotomy. Studies published since the 2014 Food and Drug Administration safety communications offer updated leiomyosarcoma incidence estimates. Incorporating these studies suggests that mortality rates are low following hysterectomy for presumed benign fibroids overall, and a minimally invasive approach remains a safe option. Risk associated with morcellation, however, increases in women age >50 years due toincreased leiomyosarcoma rates, an important finding for patient-centered discussions of treatment options for fibroids.

Incidence and Prevalence of Crohn's Disease and Ulcerative Colitis in Olmsted County, Minnesota From 1970 Through 2010.

The incidence and prevalence of inflammatory bowel diseases (IBD) continue to increase worldwide. We sought to update incidence rates of Crohn's disease (CD) and ulcerative colitis (UC) in a well-defined United States population, calculating values for Olmsted County, Minnesota through 2010. We also calculated prevalence values. The resources of the Rochester Epidemiology Project were used to identify county residents who were diagnosed with IBD (CD or UC), based on previously set criteria. Those with new diagnoses of CD or UC between 1970 and 2010 were identified as incidence cases, and those meeting diagnostic criteria on January 1, 2011, were identified as prevalence cases. Incidence rates were estimated (adjusted for age and sex to the US white population in 2010). Trends in incidence based on age at diagnosis, sex, and year of diagnosis were evaluated by Poisson regression. The incidence cohort included 410 patients with CD (51% female) and 483 individuals with UC (56% male). Median age of diagnosis was 29.5 years for persons with CD (range, 4-93 years) and 34.9 years for UC (range, 1-91 years). From 2000 through 2010, the adjusted annual incidence rate for CD was 10.7 cases per 100,000 person-years (95% confidence interval [CI], 9.1-12.3 person-years) and for UC was 12.2 per 100,000 (95% CI, 10.5-14.0 person-years). On January 1, 2011, there were 380 residents with CD, with an adjusted prevalence of 246.7 cases per 100,000 persons (95% CI, 221.7-271.8 cases per 100,000 persons), and 435 residents with UC, with an adjusted prevalence of 286.3 (95% CI, 259.1-313.5 cases per 100,000 persons). Male sex was significantly associated with a higher incidence rate of UC, and younger age was significantly associated with a higher incidence rate of CD. Estimated incidence rates for UC and CD in Olmsted County are among the highest in the United States. Extrapolating the adjusted prevalence to the most recent US Census, there could be approximately 1.6 million persons in the United States with IBD.

Occupation and mesothelioma in Sweden: updated incidence in men and women in the 27 years after the asbestos ban.

OBJECTIVESWe updated the Swedish component of the Nordic Occupational Cancer (NOCCA) Study through 2009 in order to investigate the incidence of mesothelioma of the peritoneum and pleura in both genders, and explored occupational exposures that may be associated with mesothelioma.METHODSThe Swedish component of the NOCCA Study includes 6.78 million individuals. Data from this cohort were linked to the population-based Swedish Cancer Registry and Swedish Total Population Registry for three periods between 1961 and 2009, and then further linked to the Swedish NOCCA job-exposure matrix, which includes 25 carcinogenic substances and the corresponding exposure levels for 280 occupations. Multivariate analysis was used to calculate standardized incidence ratios (SIRs) for mesothelioma of the peritoneum and pleura by gender, occupational category, carcinogenic substance, and for multiple occupational exposures simultaneously.RESULTSA total of 3,716 incident mesotheliomas were recorded (21.1% in women). We found a significantly increased risk of mesothelioma in 24 occupations, as well as clear differences between the genders. Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest elevation of risk among plumbers (SIR, 4.99; 95% confidence interval, 4.20 to 5.90). Among women, increased risks were observed in sewing workers, canning workers, packers, cleaners, and postal workers. In multivariate analysis controlling for multiple occupational exposures, significant associations were only observed between asbestos exposure and mesothelioma.CONCLUSIONSAsbestos exposure was associated with mesothelioma incidence in our study. The asbestos ban of 1982 has yet to show any clear effect on the occurrence of mesothelioma in this cohort. Among women, the occupations of canning workers and cleaners showed increased risks of mesothelioma of the pleura without evidence of asbestos exposure.

Predictive Model for Estimating the Cost of Incident Diabetes Complications.

The cost of diabetes care accounts for a significant proportion of healthcare expenditures. Cost models based on updated incident complication rates and associated costs are needed to improve financial planning and quality assessment across the U.S. healthcare system. We developed a cost model using published data to estimate the direct medical costs of incident diabetes-related complications in a U.S. population of adults. A systematic literature review of MEDLINE, EMBASE, and TRIP databases was conducted on studies reporting the incidence and/or cost of diabetes-related complications (cardiovascular disease, neuropathy, nephropathy, ophthalmological disease, and acute metabolic events). A total of 54 studies met eligibility criteria. A baseline model was constructed for a U.S. population with type 1 and 2 diabetes mellitus and used to determine the expected costs of managing such a population over 1-, 3-, and 5-year time horizons. The most costly incident complications in a population of 10,000 adults with diabetes were (1) congestive heart failure (CHF): annual expected cost of $7,320,287, 5-year expected cost of $50,697,865; (2) end-stage renal disease (ESRD): annual expected cost of $4,225,384, 5-year expected cost of $13,211,204; and (3) gangrene: annual expected cost of $2,844,381, 5-year expected cost of $17,200,417. This cost model estimates the direct healthcare costs of incident diabetes-related complications in a U.S. adult population with diabetes and provides a benchmark for evaluating the cost-effectiveness and potential leakage within a care delivery network.

Updated incidence rates and risk factors of esophageal cancer in Nan'ao Island, a coastal high-risk area in southern China.

Esophageal cancer (EC) is one of the most common cancers in China. The purpose of this study was to investigate the updated incidence rates and risk factors of EC in Nan'ao Island, where the EC incidence rate was chronically the highest in southern China. To calculate the annual incidence rate, data on 338 EC cases from Nan'ao Cancer Registry system diagnosed during 2005-2011 were collected. A case-control study was conducted to explore the EC risk factors. One hundred twenty-five alive EC patients diagnosed during 2005-2011 and 250 controls were enrolled into the case-control study. A pre-test questionnaire on demography, dietary factors, drinking water treatment, and behavioral factors was applied to collect information of all participants. The average EC incidence rates during 2005-2011 were 66.09/105, 94.62/105, 36.83/105 for both genders, males and females, respectively, in Nan'ao Island. The EC incidence rate in males was 2.40- to 4.55-fold higher than that in females in the period from 2006 to 2011 (P < 0.05). Considering the onset age, males tend to be much younger than females and reached peak incidence rate at a younger age (P < 0.05). Drinking water treatment by filter (odds ratio [OR] = 0.28, 95% confidence interval [95% CI] = 0.13-0.58) and fruit consumption (OR = 0.55, 95% CI = 0.32-0.94) reduced the risk for EC. On the contrary, the pickled vegetables consumption (OR = 2.64, 95% CI = 1.46-4.76) and liquor drinking (OR = 2.32, 95% CI = 1.21-4.44) increased the risk for EC. These results may be of importance for future research on EC etiology and prevention strategies.

Incidence and survival of adult cancer patients in Taiwan, 2002-2012.

Little is known about the annual changes in cancer incidence and survival that occurred after the establishment of the long-form cancer registry database in Taiwan. Therefore, this study aimed to investigate the updated incidence and stage-specific relative survival rates (RSRs) among adult cancer patients in Taiwan. Cancer incidence data from 2002 to 2012 were collected using the Taiwan Cancer Registry Database. Age-standardized incidence rates, average annual percent changes (AAPCs), and sex ratios were calculated for adults. Five-year stage-specific RSRs were estimated for cases diagnosed between 2004 and 2008 and were followed up to 2013 for major cancers. The overall age-standardized incidence rates per 100,000 populations increased from 348.39 in 2002 to 401.18 in 2012, and the AAPC was 1.7% (p<0.05), whereas the male:female ratio was approximately 1:3 during the entire period. Most cancer sites showed a trend of increasing incidence, with the exception of common cancers such as cervix uteri (AAPC=-6.2%, p<0.05), bladder (AAPC=-2.5%, p<0.05), stomach (AAPC=-2.4%, p<0.05), nasopharynx (AAPC=-1.2%, p<0.05), and liver (AAPC=-1.1%, p<0.05). The 5-year RSRs for Stage I cancers were greater than 93% for the colon and rectum, female breast, and cervix uteri, whereas RSRs for patients with Stage IV cancers ranged from 2.9% to 38.9%, with patients with liver cancer and those with oral cancer showing the lowest and highest RSRs, respectively. Our study showed increased incidence in most cancers and provided baseline estimates of stage-specific RSRs among the Taiwanese adult population. Continuous surveillance may help politicians to improve health policies and cancer care in Taiwan.

Database for accidents and incidents in the fuel ethanol industry

The purpose of the present research is to collect information about accidents and incidents that have occurred at fuel ethanol facilities from 1998 to October 2014, and to keep complete unified records of them in a database. The developed database contains general information about the accident or incident, its sequence, mitigation measures, its causes and consequences for humans, environment and for the plant. Until now, this information is not available. The work consisted in gathering information from different documental sources and subsequent organization in a database. It complements the previous work made for biodiesel industry and fills the existing gap in the field of ethanol. Knowledge about this information enables us to manage plant risks, since the accidents that are more likely to occur and the main sources of risk can be easily identified. Also, it makes it possible to exchange information with interested third parties. Statistical analysis shows that accident frequency has an oscillatory behavior, rising in the last year. Fire is the most common type of accident, while equipment mechanical failure is the main cause of accident. Partial material loss has been identified as the most common consequence. Finally, some conclusions are obtained concerning to the importance of having an updated and complete accident and incident database.

Facebook advertising’s influence on intention-to-purchase and purchase amongst Millennials

Purpose – The purpose of this paper is to investigate the influence of behavioural attitudes towards the most popular social medium in the world, Facebook, amongst Millennials in South Africa (SA), and to determine whether various usage and demographic variables have an impact on intention-to-purchase and purchase perceptions. Design/methodology/approach – Quantitative research was conducted by means of a survey among a sample of over 3,500 respondents via self-administered structured questionnaires in SA. A generalised linear model was used to analyse the data. Findings – The results confirm that advertising on Facebook has a positive influence on the behavioural attitudes (intention-to-purchase and purchase) of Millennials who reside in SA. The usage characteristics, log on duration and profile update incidence, as well as the demographic influence of ethnic orientation also resulted in more favourable perceptions of Facebook advertising. Research limitations/implications – Research on Facebook advertising was only conducted in SA, whereas other emerging countries warrant further investigation to establish if they share the slight positive sentiment towards intention-to-purchase and purchase. This inquiry only provides a “snap shot” of behavioural attitudes, usage and demographic factors towards social media advertising, whereas future research could consider the development of cognitive, affective and behavioural attitudes towards Facebook advertising by employing longitudinal and qualitative research designs. Practical implications – Organisations and managers should consider that their existing Facebook advertising strategies may only have a limited effect on intention-to-purchase and purchase in SA. However, certain usage characteristics, namely the more time spent logged on to Facebook and the greater frequency of profile update incidence, as well as the demographic variable, namely black and coloured Millennials, resulted in more favourable behavioural attitudes towards Facebook advertising. Hence, organisations and managers should be prepared to alter or adapt their Facebook advertising tactics accordingly when targeting the notoriously fickle Millennials. Originality/value – This investigation found that Facebook advertising has a nominal positive influence on behavioural attitudes among Millennials, which is in congruence with the communications of the effect pyramid model that was established through traditional advertising research. This paper also makes a noteworthy contribution to attitudinal research in emerging countries where there is a dearth of research in social media advertising.

Incidence of solid tumours among pesticide applicators exposed to the organophosphate insecticide diazinon in the Agricultural Health Study: an updated analysis

ObjectiveDiazinon, a common organophosphate insecticide with genotoxic properties, was previously associated with lung cancer in the Agricultural Health Study (AHS) cohort, but few other epidemiological studies have examined diazinon-associated cancer...

Su1313 Epidemiology and Characteristics of Inflammatory Bowel Disease in a Large Population-Based Cohort in the Netherlands

Background and aims: The epidemiology of inflammatory bowel disease (IBD) is changing. In Europe, recent incidence and prevalence rates are lacking. The primary objective of this study is to update incidence and prevalence figures in a large well-phenotyped populationbased IBD cohort.Methods: All IBD patients living in the adherence area of 2 non-academic hospitals between 20042010 were identified. Patients were searched in 3 independent hospital databases case finding sources. 1378 Possible IBD cases were scrutinized, IBD diagnosis was based on established clinical, endoscopic and pathologic criteria. Location and behaviour of IBD was reported according to the Montreal classification. Results: 768 IBD patients were included. 255 (33.2%) patients were diagnosed with Crohn's disease (CD), 432 (56.3%) with ulcerative colitis (UC) and 81 (10.5%) with IBD-Unspecified (IBDU). The male-female ratio of IBD was 1:1.3 (P<0.001). The mean incidence for IBD was 28.0 per 100,000 inhabitants per year; 7.4 for CD, 17.4 for UC and 3.3 for IBD-U. The point prevalence on 01-01-2009 was 345.7 per 100,000 inhabitants; 113.3 for CD, 194.8 for UC and 37.6 for IBD-U. A peak in the mean age-specific incidence for CD was found at the age of 2125 years. For UC 3 peaks were found at the age of 2125, 5155, and 6165 years. In CD, 64 patients (25%) had ileitis without colitis, 91 patients (35.7%) had a colitis, 86 patients (33.7%) had an ileocolitis. 14 Patients (5.5%) had upper GI involvement. Nonstricturing, nonpenetrating behaviour of CD was found in 139 patients (54.5%), stricturing, nonpenetrating was found in 59 (23.1%) patients, penetrating was found in 53 (20.8%) patients. 118 UC patients (27.3%) had a proctitis, 189 patients (43.8%) a left-sided colitis and 124 patients (28.7%) a pancolitis. Male patients had a more extensive UC than female patients (P= 0.003). Conclusion: The population based incidence for IBD was: 28.0 per 100,000 inhabitants per year, with a point prevalence of 345.7 per 100,000 inhabitants. In UC, male patients have a more extensive colitis than female patients.

Characterization of dementia and Alzheimer's disease in an older population: updated incidence and life expectancy with and without dementia.

We estimated dementia incidence rates, life expectancies with and without dementia, and percentage of total life expectancy without dementia. We studied 3605 members of Group Health (Seattle, WA) aged 65 years or older who did not have dementia at enrollment to the Adult Changes in Thought study between 1994 and 2008. We estimated incidence rates of Alzheimer's disease and dementia, as well as life expectancies with and without dementia, defined as the average number of years one is expected to live with and without dementia, and percentage of total life expectancy without dementia. Dementia incidence increased through ages 85 to 89 years (74.2 cases per 1000 person-years) and 90 years or older (105 cases per 1000 person-years). Life expectancy without dementia and percentage of total life expectancy without dementia decreased with age. Life expectancy with dementia was longer in women and people with at least a college degree. Percentage of total life expectancy without dementia was greater in younger age groups, men, and those with more education. Efforts to delay onset of dementia, if successful, would likely benefit older adults of all ages.

Updated Incidence and Prevalence of Crohn’s Disease and Ulcerative Colitis in Olmsted County, Minnesota (1970-2010): ACG IBD Research Award

Introduction: The incidence and prevalence of Crohn’s disease (CD) and ulcerative colitis (UC) in a population-based cohort of Olmsted County, Minnesota residents was last updated through the year 2000. We sought to update these rates through 2010. Methods: The resources of the Rochester epidemiology project, a linked diagnostic index, were used to identify potential cases of Olmsted County residents who were diagnosed with CD or UC. Diagnosis was based on previously set criteria. Residents of Olmsted County with new diagnoses of CD or UC between 1970 and 2010 were identified as incidence cases, and residents who met diagnostic criteria on the preset date of January 1, 2011 were identified as prevalence cases. Rates were age- and sex-adjusted to the 2010 U.S. Census for whites. Poisson regression was used to examine whether incidence rates were associated with age, gender, or year of diagnosis. Results: The incidence cohort included 410 patients with CD and 483 patients with UC. The median age of diagnosis was 29.5 years (range, 4-93) for CD and 34.9 (1-91) for UC. In 2000-2010, the adjusted annual incidence rates for CD and UC were 10.7 cases per 100,000 person-years (95% confidence interval [CI], 9.1-12.3) and 12.2 (95% CI, 10.5-14.0), respectively. On January 1, 2011, there were 380 residents with CD, with an adjusted prevalence of 246.7 cases per 100,000 persons (95% CI, 221.7-271.8), and 435 residents with UC, with an adjusted prevalence of 286.3 (95% CI, 259.1-313.5). In the Poisson regression analysis, male gender was significantly associated with a higher incidence rate of UC (p<0.001); the association between year of diagnosis and UC incidence rate was of borderline significance (p=0.06). Younger age at diagnosis (p<0.001) and year of diagnosis (p=0.003) were significantly associated with higher incidence rates of CD. Conclusion: The estimated UC and CD incidence rates we estimated in Olmsted County are amongst the highest in the U.S. Extrapolating the adjusted prevalence rates to the current U.S. Census, there are approximately 785,000 Americans with CD and 910,000 with UC, for a total of approximately 1.6 million Americans with IBD.Figure 1: Age- and sex-adjusted incidence rate of Crohn’s disease (CD) and ulcerative colitis (UC) in a population-based cohort of Olmsted County patients between 1970 and 2010.

Osteoarthritis incidence and trends in administrative health records from British Columbia, Canada.

To calculate the incidence rates of osteoarthritis (OA) and to describe the changes in incidence using 18 years of administrative health records. We analyzed visits to health professionals and hospital admission records in a random sample (n = 640,000) from British Columbia, Canada, from 1991/1992 through 2008/2009. OA was defined in 2 ways: (1) at least 1 physician diagnosis or 1 hospital admission; and (2) at least 2 physician diagnoses in 2 years or 1 hospital admission. Crude and age-standardized rates were calculated, and the annual relative changes were estimated from the Poisson regression models. In 2008/2009, the overall crude incidence rate (95% CI) of OA using definition 1 was 14.6 (14.0-14.8); [12.5 (12.0-13.0) among men and 16.3 (15.8-16.8) among women] per 1000 person-years. The rates were lower by about 44% under definition 2. For the period 2000/2001-2008/2009, crude incidence rates based on definition 1 varied from 11.8 to 14.2 per 1000 person-years for men, and from 15.7 to 18.5 for women. Annually, on average, crude rates rose by about 2.5-3.3% for both men and women. The age-adjusted rates increased by 0.6-0.8% among men and showed no trend among women. Our study generated updated incidence rates of administrative OA for the Province of British Columbia. Physician-diagnosed overall incidence rates of OA varied with the case definitions used; however, trends were similar in both case definitions. Age-adjusted rates among men increased slightly during the period 2000/2001-2008/2009. These findings have implications for projecting future prevalence and costs of OA.

Retinoblastoma Incidence Patterns in the US Surveillance, Epidemiology, and End Results Program

IMPORTANCE Several studies have found no temporal or demographic differences in the incidence of retinoblastoma except for age at diagnosis, whereas other studies have reported variations in incidence by sex and race/ethnicity. OBJECTIVE To examine updated US retinoblastoma incidence patterns by sex, age at diagnosis, laterality, race/ethnicity, and year of diagnosis. DESIGN, SETTING, AND PARTICIPANTS The Surveillance, Epidemiology, and End Results (SEER) databases were examined for retinoblastoma incidence patterns by demographic and tumor characteristics. We studied 721 children in SEER 18 registries, 659 in SEER 13 registries, and 675 in SEER 9 registries. MAIN OUTCOMES AND MEASURES Incidence rates, incidence rate ratios (IRRs), and annual percent changes in rates. RESULTS During 2000-2009 in SEER 18, there was a significant excess of total retinoblastoma among boys compared with girls (IRR, 1.18; 95% CI, 1.02 to 1.36), in contrast to earlier reports of a female predominance. Bilateral retinoblastoma among white Hispanic boys was significantly elevated relative to white non-Hispanic boys (IRR, 1.81; 95% CI, 1.22 to 2.79) and white Hispanic girls (IRR, 1.75; 95% CI, 1.11 to 2.91) because of less rapid decreases in bilateral rates since the 1990s among white Hispanic boys than among the other groups. Retinoblastoma rates among white non-Hispanics decreased significantly since 1992 among those younger than 1 year and since 1998 among those with bilateral disease. CONCLUSIONS AND RELEVANCE Although changes in the availability of prenatal screening practices for retinoblastoma may have contributed to these incidence patterns, further research is necessary to determine their actual effect on the changing incidence of retinoblastoma in the US population. In addition, consistent with other cancers, an excess of retinoblastoma diagnosed in boys suggests a potential effect of sex on cancer origin.

Continued Increase in Incidence of Renal Cell Carcinoma, Especially in Young Patients and High Grade Disease: United States 2001 to 2010

More than 50,000 Americans were diagnosed with kidney and renal pelvis cancer in 2010. The National Program of Cancer Registries and SEER (Surveillance, Epidemiology and End Results) combined data include cancer incidences from the entire United States. Our study presents updated incidence data, evaluates trends and adds geographic distribution to the literature. We examined invasive, microscopically confirmed kidney and renal pelvis cancers diagnosed from 2001 to 2010 that met United States Cancer Statistics reporting criteria for each year, excluding cases diagnosed by autopsy or death certificate. Histology codes classified cases as renal cell carcinoma. Rates and trends were estimated using SEER∗Stat. A total of 342,501 renal cell carcinoma cases were diagnosed. The renal cell carcinoma incidence rate increased from 10.6/100,000 individuals in 2001 to 12.4/100,000 in 2010 and increased with age until ages 70 to 74 years. The incidence rate in men was almost double that in women. The annual percent change was higher in women than in men, in those 20 to 24 years old and in grade III tumors. The annual percent change incidence increased from 2001 to 2010. Asian/Pacific Islanders and 20 to 24-year-old individuals had the highest annual percent change. While some increase resulted from localized disease, the highest annual percent change was in grade III tumors, indicating more aggressive disease. Continued monitoring of trends and epidemiological study are warranted to determine risk factors.

Tumours of the lacrimal gland. Epidemiological, clinical and genetic characteristics.

Tumours of the lacrimal gland are rare, but the prognosis may be grave. To date, no population-based incidence and distribution data on lacrimal gland tumours exist. In addition, almost nothing is known about the genetic profile of epithelial tumours of the lacrimal gland. We collected specimens and clinical files on all biopsied lacrimal gland lesions in Denmark over a 34-year period and re-evaluated the diagnosis to provide updated population-based incidence rates and epidemiological characteristics. Clinical data regarding symptoms, clinical examinations, treatment and follow-up were collected for patients with adenoid cystic carcinoma (ACC), pleomorphic adenoma (PA), carcinoma ex pleomorphic adenoma (Ca-ex-PA) and mucoepidermoid carcinoma (MEC). Using RT-PCR, FISH, immunohistochemistry, Q-PCR and high-resolution array-based comparative genomic hybridization (arrayCGH) we explored the genetic characteristics including copy number alterations (CNA) in ACC, PA, Ca-ex-PA and MEC. The incidence of biopsied lacrimal gland lesions was 1.3/1,000,000/year, and ~50% were neoplastic lesions. Of these, 55% were malignant tumours with epithelial tumours as the most frequent. The overall incidence was increasing, and this was caused by an increase in biopsied non-neoplastic lesions. We found that 10/14 ACCs either expressed the MYB-NFIB fusion gene and/or had rearrangements of MYB. All ACCs expressed the MYB protein. ACC was characterized by recurrent copy number losses involving 6q, 12q and 17q and gains involving 19q, 8q and 11q. ArrayCGH revealed an apparently normal genomic profile in 11/19 PAs. The remaining 8 PAs had recurrent copy number losses involving 1p, 6q, 8q and 13q and gain involving 9p. PA expressed PLAG1 in all tumours whereas only 2/29 tumours expressed HMGA2. Ca-ex-PA was characterized by recurrent copy number gain involving 22q. PLAG1 was expressed in 3/5 Ca-ex-PA whereas none of these tumours expressed HMGA2. MEC expressed the CRTC1-MAML2, and this fusion was found to be tumour-specific for lacrimal gland MEC. In conclusion, lacrimal gland lesions that require pathological evaluation are rare in the Danish population, and the incidence rate of biopsied benign lesions is increasing. Epithelial tumours of the lacrimal gland are molecularly very similar to their salivary gland counterparts in the expression of the tumour-specific fusion genes and in their genomic imbalances as demonstrated by arrayCGH. MYB-NFIB is a useful biomarker for ACC and MYB, and its downstream target genes may be potential therapeutic targets for these tumours.

275 Occupation and mesothelioma in pleura and peritoneum in Sweden - Updated incidence for males and females 1961–2009

ObjectivesMesothelioma incidence increased in Sweden between years 1970 and 2000, and seems to have reached a plateau in the last decade. We used data from the Swedish component of the...