Sriwattanapongse, Wattanavadee; Prasitwattanaseree, Sukon
Liver Cancer has been a leading cause of death in Thailand. The purpose of this study was to model and forecast liver cancer mortality rate in Thailand using death certificate reports. A retrospective analysis of the liver cancer mortality rate was conducted. Numbering of 123,280 liver cancer causes of death cases were obtained from the national vital registration database for the 10-year period from 2000 to 2009, provided by the Ministry of Interior and coded as cause-of-death using ICD-10 by the Ministry of Public Health. Multivariate regression model was used for modeling and forecasting age-specific liver cancer mortality rates in Thailand. Liver cancer mortality increased with increasing age for each sex and was also higher in the North East provinces. The trends of liver cancer mortality remained stable in most age groups with increases during ten-year period (2000 to 2009) in the Northern and Southern. Liver cancer mortality was higher in males and increase with increasing age. There is need of liver cancer control measures to remain on a sustained and long-term basis for the high liver cancer burden rate of Thailand.
"A graphical method developed by Gabriel to display the rows and columns of a matrix is applied to tables of age- and period-specific cancer mortality rates. It is particularly useful when the pattern of age-specific rates changes with time. Trends in age-specific rates and changes in the age distribution are identified as projections. Three examples [from England and Wales] are given."
Simkin, Jonathan; Woods, Ryan; Elliott, Catherine
ABSTRACT Background: Although cancer is the leading cause of death in Canada, cancer in the North has been incompletely described. Objective: To determine cancer mortality rates in the Yukon Territory, compare them with Canadian rates, and identify major causes of cancer mortality. Design: The Yukon Vital Statistics Registry provided all cancer deaths for Yukon residents between 1999-2013. Age-standardised mortality rates (ASMRs) were calculated using direct standardisation and compared with Canadian rates. Standardised mortality ratios (SMRs) were calculated using indirect standardisation relative to age-specific rates from Canada, British Columbia (BC), and three sub-provincial BC administrative health regions : Interior Health (IH), Northern Health (NH) and Vancouver Coastal Health (VCH). Trends in smoothed ASMRs were examined with graphical methods. Results: Yukon’s all-cancer ASMRs were elevated compared with national and provincial rates for the entire period. Disparities were greatest compared with the urban VCH: prostate (SMRVCH=246.3, 95% CI 140.9–351.6), female lung (SMRVCH=221.2, 95% CI 154.3–288.1), female breast (SMRVCH=169.0 95% CI, 101.4–236.7), and total colorectal (SMRVCH=149.3, 95% CI 101.8–196.8) cancers were significantly elevated. Total stomach cancer mortality was significantly elevated compared with all comparators. Conclusions: Yukon cancer mortality rates were elevated compared with national, provincial, urban, and southern-rural jurisdictions. More research is required to elucidate these differences. PMID:28598269
Farkas, Klaudia; Szűcs, Mónika; Nyári, Tibor András
The aim of this study was to investigate the annual death trends for gastrointestinal cancer in Hungary between 1963 and 2012. Data on the numbers of cancer deaths were obtained from the published nationwide population register. Numbers of deaths from esophageal, gastric and colorectal cancer were available during the study period. However, the mortality data for hepatic, pancreatic and gallbladder cancer have been published only since 1979. Joinpoint regression was applied to investigate the annual trends in the rates of cancer mortality. The annual mortality rates of gastric and gallbladder cancer decreased throughout the study period. Furthermore, declines in mortality from esophageal and hepatic cancers have been observed since 1998 and 1995, respectively. However, the rates of colorectal and pancreatic cancer mortality have been increasing in the past few years. Nevertheless, the mortality rates of colorectal and pancreatic cancers have increased in males aged 40-59 years during the study period. Moreover, significantly higher risks of gastrointestinal cancer-related deaths have been observed in males as compared with females except for death related to cancer of the gallbladder. The presented data suggest that the Hungarian mortality rates are particularly high. The detection of gastrointestinal cancers at an early stage would significantly improves the outcome of these malignancies.
Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thomaz, Erika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; de Souza, Marta Rovery; Lein, Adriana; Alvares, Viviane; de Almeida, Dante Grapiuna; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Staton, Catherine; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto
Cervical cancer is a common neoplasm that is responsible for nearly 230 000 deaths annually in Brazil. Despite this burden, cervical cancer is considered preventable with appropriate care. We conducted a longitudinal ecological study from 2002 to 2012 to examine the relationship between the delivery of preventive primary care and cervical cancer mortality rates in Brazil. Brazilian states and the federal district were the unit of analysis (N = 27). Results suggest that primary health care has contributed to reducing cervical cancer mortality rates in Brazil; however, the full potential of preventive care has yet to be realized. PMID:28252500
Abu Hassan, Muhammad Radzi; Ismail, Ibtisam; Mohd Suan, Mohd Azri; Ahmad, Faizah; Wan Khazim, Wan Khamizar; Othman, Zabedah; Mat Said, Rosaida; Tan, Wei Leong; Mohammed, Siti Rahmah Noor Syahireen; Soelar, Shahrul Aiman; Nik Mustapha, Nik Raihan
This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.
OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate. PMID:26971697
Wyatt, Stephen W; Maynard, William Ryan; Risser, David R; Hakenewerth, Anne M; Williams, Melanie A; Garcia, Rebecca
Diseases of the heart and malignant neoplasms (all-cancers) are the leading causes of death in the United States. The gap between the two has been closing in recent years. To assess the gap status in Texas and to establish a baseline to support evaluation efforts for the Cancer Prevention Research Institute of Texas, mortality data from 2006 to 2009 were analyzed. Immediate cause of death data in Texas for the years 2006-2009 were analyzed and rates developed by sex, race/ethnicity, and four metropolitan counties. Overall, for the years 2006-2009, the age-adjusted mortality rates (AARs) among Texas residents for both diseases of the heart and all-cancers decreased; however, during this time frame, there was greater improvement in diseases of the heart AARs as compared with all-cancers AARs. For the four large metropolitan counties of Bexar, Dallas, Harris, and Travis, data were analyzed by sex and race/ethnicity, and 11 of the 12 largest percent mortality rate decreases were for diseases of the heart. Age-adjusted mortality rates among Texas residents from diseases of the heart are showing improvement as compared with the rates for all-cancers.
Freedman, D M
For many years, Maryland has ranked among the top states in cancer mortality. This study analyzed mortality data from the National Center for Health Statistics (CDC-Wonder) to help explain Maryland's cancer rate and rank. Age-adjusted rates are based on deaths per 100,000 population from 1991 through 1995. Rates and ranks overall, and stratified by age, are calculated for total cancer mortality, as well as for four major sites: lung, breast, prostate, and colorectal. Because states differ in their racial/gender mix, race/gender rates among states are also compared. Although Maryland ranks seventh in overall cancer mortality, its rates and rank by race and gender subpopulation are less high. For those under 75, white men ranked 26th, black men ranked 20th, and black and white women ranked 12th and 10th, respectively. Maryland's overall rank, as with any state, is a function of the rates of its racial and gender subpopulations and the relative size of these groups in the state. Many of the disparities between Maryland's overall high cancer rank and its lower rank by subpopulation also characterize the major cancer sites. Although a stratified presentation of cancer rates and ranks may be more favorable to Maryland, it should not be used to downplay the attention cancer mortality in Maryland deserves.
Llanos, Adana A M; Warner, Wayne A; Luciani, Silvana; Lee, Tammy Y; Bajracharya, Smriti; Slovacek, Simeon; Roach, Veronica; Lamont-Greene, Marjorie
To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries. Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries). Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region. Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation.
Hu, Shang-ying; Zheng, Rong-shou; Zhao, Fang-hui; Zhang, Si-wei; Chen, Wan-qing; Qiao, You-lin
To evaluate the trend of cervical cancer incidence and mortality rates during 1989-2008 in Chinese women, so as to inform the development of relevant policies and strategies in China. The incidence and mortality rates of cervical cancer during 1989-2008 in urban and rural areas were calculated based on the data from the National Cancer Registry Database. Age-standardized rates were calculated using the Chinese population of 1982 and World Segi's population of 1985. Joinpoint regression analysis was performed to obtain annual percentage changes (APC) so as to assess the trend of incidence and mortality rates over the period from 1989 to 2008. The crude incidence rate of cervical cancer in Chinese women increased from 3.06/10(5) in 1989-1990 to 11.87/10(5) in 2007-2008 (from 4.96/10(5) to 11.98/10(5) in urban registration areas and from 2.39/10(5) to 11.77/10(5) in rural registration areas).The crude mortality rate slightly increased from 2.19/10(5) in 1989-1990 to 3.20/10(5) in 2007-2008 (from 3.21/10(5) to 2.56/10(5) in urban registration areas and from 1.82/10(5) to 3.75/10(5) in rural registration areas). Generally, the upward trends of crude incidence rates were shown over the year 1989-2008, with an APC of 14.4% after 1997 in urban areas and 22.5% after 1999 in rural areas.After age standardization of world population, the APC of incidence rates in recent decade in urban areas remained stable, and the one in rural areas slightly decreased.Although the overall crude and world age-standardized mortality rates had no significant changes during 1989-2008, the crude mortality rates increased by 8.1% annually after 1999.The upward trends were also shown for crude and world age-standardized mortality rates in urban areas after 2001 with an APC of 7.3%.The crude mortality rates in rural areas increased by 3.9% annually during 1989-2008, but no significant change was found after age standardization. Over the last decade, the cervical cancer incidence and mortality rates
Sopik, Victoria; Rosen, Barry; Giannakeas, Vasily; Narod, Steven A
Over the last 40 years, the age-adjusted ovarian cancer mortality rate in the USA declined by 23%. The decline in mortality paralleled a decline in incidence, which was largely due to changes in reproductive risk factors. There was no reduction in ovarian cancer case-fatality at 12 years, indicating that improvements in early detection or in treatment did not contribute to the decline in mortality. Here, we discuss potential strategies to further reduce ovarian cancer mortality through prevention, early detection and treatment. The first approach is to increase genetic testing, in order to identify women who are at a high risk of developing ovarian cancer and offer them preventive bilateral salpingo-oophorectomy. At present, up to 17% of ovarian cancers are potentially preventable through population-based genetic testing of known ovarian cancer susceptibility genes. The second approach is to increase the proportion of ovarian cancer patients who achieve a status of no residual disease through primary debulking surgery and subsequently receive adjuvant intraperitoneal chemotherapy. We believe that through a combination of screening to better identify low-volume advanced stage ovarian cancer, aggressive surgery to leave no residual disease and adjuvant intraperitoneal chemotherapy, the cure rate of ovarian cancer might be improved significantly. Copyright © 2015 Elsevier Inc. All rights reserved.
Wehner, Mackenzie R; Nead, Kevin T; Linos, Eleni
Population-level disease metrics are critical to guide the distribution of resources and implementation of public health initiatives. Internet search data reflect population interest in health topics and may be an alternative metric of disease characteristics when traditional sources are lacking, such as in basal and squamous cell carcinomas, which are not included in national cancer registries. However, these data are not yet well validated or understood. To evaluate whether state-specific normalized internet search volume correlates with incidence and mortality rates of common cancers in the United States, including melanoma. This was a cross-sectional analysis of Google search volume index data and US cancer incidences and mortalities of 8 of the most incident cancers in the United States in 2009 to 2013, at the state level, per the National Program of Cancer Registries. Participants were people performing Google searches and patients diagnosed as having cancers reported to cancer registries. Correlation between Google search volumes, normalized to total Google search volume, and National Program of Cancer Registries recorded cancer incidence and mortality rates. By state, relative Google search volume statistically significantly correlated with cancer incidence rates in 5 of 8 commonly diagnosed cancers in the United States (colon cancer: R = 0.61; P < .001; lung cancer: R = 0.73; P < .001; lymphoma: R = 0.51; P < .001; melanoma: R = 0.36; P = .01; and thyroid cancer: R = 0.30; P = .03). For 4 of those 5 cancers (colon cancer: R = 0.61; P < .001; lung cancer: R = 0.62; P < .001; lymphoma: R = 0.38; P = .006; and melanoma: R = 0.31; P = .03), relative Google search volume also correlated with mortality rates. Population-level internet search behavior may be a valuable real-time tool to estimate cancer incidence and mortality rates, especially for cancers not included in national
Tang, Siau-Wei; Liu, Jenny; Juay, Lester; Czene, Kamila; Miao, Hui; Salim, Agus; Verkooijen, Helena M; Hartman, Mikael
With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring. From the Swedish Multi-generation Register and Cancer Register, we identified 84,752 men ≤70 years with a history of cancer, for which we calculated relative birth rates as compared to the background population(Standardized Birth Ratios, SBRs). We also identified 126,696 offspring of men who had cancer, and compared their risks of death to the background population(Standardized Mortality Ratio, SMRs). Independent factors associated with reduced birth rates and mortality rates were estimated with Poisson modelling. Men with a history of cancer were 23 % less likely to father a child compared to the background population(SBR 0.77, 95 % Confidence Interval[CI] 0.75-0.79). Nulliparous men were significantly more likely to father a child after diagnosis (SBR 0.81, 95 % CI 0.79-0.83) compared to parous men (SBR 0.68, 95 % CI 0.66-0.74). Cancer site(prostate), onset of cancer during childhood or adolescence, parity status at diagnosis(parous), current age(>40 years) and a recent diagnosis were significant and independent predictors of a reduced probability of fathering a child after diagnosis. Of the 126,696 children born to men who have had a diagnosis of cancer, 2604(2.06 %) died during follow up. The overall mortality rate was similar to the background population(SMR of 1.00, 95 %CI 0.96-1.04) and was not affected by the timing of their birth in relation to father's cancer diagnosis. Male cancer survivors are less likely to father a child compared to the background population. This is influenced by cancer site, age of onset and parity status at diagnosis. However, their offspring are not at an increased risk of death.
Malta, Deborah Carvalho; de Abreu, Daisy Maria Xavier; de Moura, Lenildo; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth
ABSTRACT OBJECTIVE To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. METHODS The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. RESULTS Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. CONCLUSIONS Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. PMID:27355467
Walker, R.D.; Connor, T.H.; MacDonald, E.J.; Trieff, N.M.; Legator, M.S.; MacKenzie, K.W. Jr.; Dobbins, J.G.
Air particulate extracts from a series of solvents were tested in the Ames mutagen detection system and were found to be mutagenic in varying degrees as a function of the particulate collection site in Houston, Texas. The mutagenicity level at seven sites was compared with age-adjusted mortality rates in the same areas. Significant correlation was found with the lung cancer mortality rates but not with mortality rates for other causes. These findings support the hypothesis of a contribution of urban air particulate to the lung cancer rates. Furthermore, these findings suggest that an index of the mutagenicity of air particulate is a more powerful measure of the human health hazard of air pollution than the traditional indices of particulate concentration.
Robertson, C; Boyle, P
The interpretation of time trends in disease rates can be facilitated using estimable contrasts from age-period-cohort models. Cohort and period trends in breast cancer incidence and mortality rates in Scotland were investigated using contrasts that measure the changes in the linear trends. These contrasts were compared with estimates obtained from mortality rates in the USA and Japan. A significant moderation of both breast cancer incidence and mortality rates was observed in Scotland, associated with cohorts of women born after the Second World War compared with women born between the two world wars. The moderation of breast cancer mortality among cohorts born after 1925 compared with cohorts born before 1925 that was observed in the USA and Japan was also observed in this study. This moderation is not present in the incidence rates. The relative decline in the risk of breast cancer seen in younger cohorts seems to be contradictory to the temporal pattern present among breast cancer risk factors. It may well be that the alteration of eating patterns as a result of rationing in the wartime and immediate post-war period, and the subsequent influence on certain breast cancer risk factors probably produced by such changes, may have had some influence on the development of healthier girls and women. Such speculation could be addressed in a well-designed epidemiological study. There have been no changes in the mortality rate trends with period in Scotland, although the changes in the incidence rate trends with period are consistent with an increase in registration coverage.
Beavis, Anna L; Gravitt, Patti E; Rositch, Anne F
The objectives of this study were to determine the age-standardized and age-specific annual US cervical cancer mortality rates after correction for the prevalence of hysterectomy and to evaluate disparities by age and race. Estimates for deaths due to cervical cancer stratified by age, state, year, and race were derived from the National Center for Health Statistics county mortality data (2000-2012). Equivalently stratified data on the prevalence of hysterectomy for women 20 years old or older from the Behavioral Risk Factor Surveillance System survey were used to remove women who were not at risk from the denominator. Age-specific and age-standardized mortality rates were computed, and trends in mortality rates were analyzed with Joinpoint regression. Age-standardized rates were higher for both races after correction. For black women, the corrected mortality rate was 10.1 per 100,000 (95% confidence interval [CI], 9.6-10.6), whereas the uncorrected rate was 5.7 per 100,000 (95% CI, 5.5-6.0). The corrected rate for white women was 4.7 per 100,000 (95% CI, 4.6-4.8), whereas the uncorrected rate was 3.2 per 100,000 (95% CI, 3.1-3.2). Without the correction, the disparity in mortality between races was underestimated by 44%. Black women who were 85 years old or older had the highest corrected rate: 37.2 deaths per 100,000. A trend analysis of corrected rates demonstrated that white women's rates decreased at 0.8% per year, whereas the annual decrease for black women was 3.6% (P < .05). A correction for hysterectomy has revealed that cervical cancer mortality rates are underestimated, particularly in black women. The highest rates are seen in the oldest black women, and public health efforts should focus on appropriate screening and adequate treatment in this population. Cancer 2017;123:1044-50. © 2016 American Cancer Society. © 2017 American Cancer Society.
Cheng, Iona; Witte, John S; McClure, Laura A; Shema, Sarah J; Cockburn, Myles G; John, Esther M; Clarke, Christina A
The racial/ethnic disparities in prostate cancer rates are well documented, with the highest incidence and mortality rates observed among African-Americans followed by non-Hispanic Whites, Hispanics, and Asian/Pacific Islanders. Whether socioeconomic status (SES) can account for these differences in risk has been investigated in previous studies, but with conflicting results. Furthermore, previous studies have focused primarily on the differences between African-Americans and non-Hispanic Whites, and little is known for Hispanics and Asian/Pacific Islanders. To further investigate the relationship between SES and prostate cancer among African-Americans, non-Hispanic Whites, Hispanics, and Asian/Pacific Islanders, we conducted a large population-based cross-sectional study of 98,484 incident prostate cancer cases and 8,997 prostate cancer deaths from California. Data were abstracted from the California Cancer Registry, a population-based surveillance, epidemiology, and end results (SEER) registry. Each prostate cancer case and death was assigned a multidimensional neighborhood-SES index using the 2000 US Census data. SES quintile-specific prostate cancer incidence and mortality rates and rate ratios were estimated using SEER*Stat for each race/ethnicity categorized into 10-year age groups. For prostate cancer incidence, we observed higher levels of SES to be significantly associated with increased risk of disease [SES Q1 vs. Q5: relative risk (RR) = 1.28; 95% confidence interval (CI): 1.25-1.30]. Among younger men (45-64 years), African-Americans had the highest incidence rates followed by non-Hispanic Whites, Hispanics, and Asian/Pacific Islanders for all SES levels. Yet, among older men (75-84 years) Hispanics, following African-Americans, displayed the second highest incidence rates of prostate cancer. For prostate cancer deaths, higher levels of SES were associated with lower mortality rates of prostate cancer deaths (SES Q1 vs. Q5: RR = 0.88; 95% CI: 0
Spangler, John G; Reid, Jeffrey C
Manganese is an element essential for health in trace amounts, but toxic at higher exposures. Since manganese is replacing lead in gasoline globally, evaluation of potential cancer effects is essential. To determine whether environmental manganese is related to cancer at the county level in North Carolina (n = 100 counties; North Carolina 2000 population = 8,049,313), we carried out an ecological study using data from the North Carolina State Center for Health Statistics, North Carolina Geological Survey, US Geological Survey, and US Census. County-level all-cause and cancer mortality rates between 1997 and 2001 reported in deaths per 100,000 population associated by multivariable regression with logarithmically transformed groundwater (microgram per liter) and airborne (microgram per cubic meter) manganese concentrations by county measured between 1973 and 1979 (water) and in 1996 (air). Models controlled for county characteristics. Median all-cause and cancer mortality rates by county in North Carolina (1997-2001) exceeded those of the USA (2000). For each log increase in groundwater manganese concentration, there was a corresponding county-level increase of 12.10 deaths/100,000 population in all-site cancer rates, 2.84 deaths/100,000 in colon cancer rates, and 7.73 deaths/100,000 in lung cancer rates. For each log increase in airborne manganese concentration, there was a corresponding county-level decrease of 8.10 deaths/100,000 population in all-site cancer rates, 3.28 deaths/100,000 in breast cancer rates, and 3.97 deaths/100,000 in lung cancer rates. Neither groundwater nor air concentrations of manganese correlated with county-level all-cause or prostate cancer death rates. These are the first data we know of to document a potential relationship between environmental manganese and population-level cancer death rates. The positive association between groundwater manganese and specific cancer mortality rates might be a function of the high concentrations
Tabatabai, Mohammad A.; Kengwoung-Keumo, Jean-Jacques; Eby, Wayne M.; Bae, Sejong; Guemmegne, Juliette T.; Manne, Upender; Fouad, Mona; Partridge, Edward E.; Singh, Karan P.
Background The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010. Methods The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations. Results Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland. Conclusions In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing. PMID:25226583
Tabatabai, Mohammad A; Kengwoung-Keumo, Jean-Jacques; Eby, Wayne M; Bae, Sejong; Guemmegne, Juliette T; Manne, Upender; Fouad, Mona; Partridge, Edward E; Singh, Karan P
The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010. The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations. Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland. In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing.
The analysis of health data and putative covariates, such as environmental, socioeconomic, demographic, behavioral, or occupational factors, is a promising application for geostatistics. Transferring methods originally developed for the analysis of earth properties to health science, however, presents several methodological and technical challenges. These arise because health data are typically aggregated over irregular spatial supports (e.g., counties) and consist of a numerator and a denominator (i.e., rates). This article provides an overview of geostatistical methods tailored specifically to the characteristics of areal health data, with an application to lung cancer mortality rates in 688 U.S. counties of the southeast (1970–1994). Factorial Poisson kriging can filter short-scale variation and noise, which can be large in sparsely populated counties, to reveal similar regional patterns for male and female cancer mortality that correlate well with proximity to shipyards. Rate uncertainty was transferred through local cluster analysis using stochastic simulation, allowing the computation of the likelihood of clusters of low or high cancer mortality. Accounting for population size and rate uncertainty led to the detection of new clusters of high mortality around Oak Ridge National Laboratory for both sexes, in counties with high concentrations of pig farms and paper mill industries for males (occupational exposure) and in the vicinity of Atlanta for females. PMID:20445829
Barbosa, Isabelle R.; de Souza, Dyego L.B.; Bernal, María M.; Costa, Íris do C.C.
Abstract Cancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030. This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions. Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030. There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil. PMID:25906105
Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo
Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984-2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): -3.1 (95% CI, -4.6 to -1.6)) and lung cancers decreased from 2002 to 2013 (APC -2.4 (95% CI -2.7 to -2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC -2.5 (95% CI -4.1 to -0.8)) and from 2002 to 2013 (APC -5.2 (95% CI -5.7 to -4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): -3.3 (95% CI -4.7 to -1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.
Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo
Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates. PMID:27929405
De Petris, Luigi; Bergfeldt, Kjell; Hising, Christina; Lundqvist, Andreas; Tholander, Bengt; Pisa, Pavel; van der Zanden, Henk G M; Masucci, Giuseppe
Molecular-target therapies are novel approaches to the treatment of prostate and ovarian cancer, but to ensure the best response, a very careful selection of patients, based on immunological characteristics, must be performed. We screened for HLA type, 24 patients with advanced ovarian cancer and 26 patients with hormone-refractory prostate cancer, in order to be recruited to vaccine protocols. HLA typing was performed with PCR in ovarian cancer patients and with serological assay in prostate cancer patients. The results were then extended to a population level, comparing the HLA genotype frequencies in Europe with ovarian and prostate cancer mortality rates. An overrepresentation of HLA-A2 phenotype was observed in both patient groups compared to the normal Swedish population (p = 0.01). As it is already known, the higher phenotype frequency of this allele found in Scandinavian countries decreases significantly as one moves further south in Europe. Ovarian and prostate cancer mortality rates decrease as well as the demographic changes in HLA-A2. These observations have to be confirmed by more extended investigations in order to elucidate if HLA-A2 higher frequency is already present at the diagnosis (risk factor) or is selected during the course of the disease (prognostic factor). Moreover, this fact would suggest different strategies for specific immunotherapy in addition to first line conventional treatments.
Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia
Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986–2006) and data on mortality (1997–2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252
Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia
Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.
Vittecoq, Marion; Elguero, Eric; Lafferty, Kevin D.; Roche, Benjamin; Brodeur, Jacques; Gauthier-Clerc, Michel; Missé, Dorothée; Thomas, Frédéric
The incidence of adult brain cancer was previously shown to be higher in countries where the parasite Toxoplasma gondii is common, suggesting that this brain protozoan could potentially increase the risk of tumor formation. Using countries as replicates has, however, several potential confounding factors, particularly because detection rates vary with country wealth. Using an independent dataset entirely within France, we further establish the significance of the association between T. gondii and brain cancer and find additional demographic resolution. In adult age classes 55 years and older, regional mortality rates due to brain cancer correlated positively with the local seroprevalence of T. gondii. This effect was particularly strong for men. While this novel evidence of a significant statistical association between T. gondii infection and brain cancer does not demonstrate causation, these results suggest that investigations at the scale of the individual are merited.
Robbins, Anthony S; Siegel, Rebecca L; Jemal, Ahmedin
Since the early 1980s, colorectal cancer (CRC) mortality rates for whites and blacks in the United States have been diverging as a result of earlier and larger reductions in death rates for whites. We examined whether this mortality pattern varies by stage at diagnosis. The Incidence-Based Mortality database of the Surveillance, Epidemiology, and End Results (SEER) Program was used to examine data from the nine original SEER regions. Our main outcome measures were changes in stage-specific mortality rates by race. From 1985 to 1987 to 2006 to 2008, CRC mortality rates decreased for each stage in both blacks and whites, but for every stage, the decreases were smaller for blacks, particularly for distant-stage disease. For localized stage, mortality rates decreased 30.3% in whites compared with 13.2% in blacks; for regional stage, declines were 48.5% in whites compared with 34.0% in blacks; and for distant stage, declines were 32.6% in whites compared with 4.6% in blacks. As a result, the black-white rate ratios increased from 1.17 (95% CI, 0.98 to 1.39) to 1.41 (95% CI, 1.21 to 1.63) for localized disease, from 1.03 (95% CI, 0.93 to 1.14) to 1.30 (95% CI, 1.17 to 1.44) for regional disease, and from 1.21 (95% CI, 1.10 to 1.34) to 1.72 (95% CI, 1.58 to 1.86) for distant-stage disease. In absolute terms, the disparity in distant-stage mortality rates accounted for approximately 60% of the overall black-white mortality disparity. The black-white disparities in CRC mortality increased for each stage of the disease, but the overall disparity in overall mortality was largely driven by trends for late-stage disease. Concerted efforts to prevent or detect CRC at earlier stages in blacks could improve the worsening black- white disparities.
Wiggs, L.D.; Wilkinson, G.S.; Tietjen, G.L.; Acquavella, J.F.
This report documents work performed in support of preparation of an Environmental Impact Statement (EIS) regarding the Department of Energy's Pantex Plant near Amarillo, Texas. This report considers cancer mortality rates in the region surrounding the Pantex nuclear weapons facility. The working hypothesis was that increased cancer mortality rates would exist in counties proximal to the Pantex Plant. To evaluate this hypothesis, we compared age-adjusted cancer mortality rates for the six surrounding counties with Texas state rates for three time periods: 150 to 1959, 1960 to 1969, and 1970 to 1978. These comparisons showed that cancer mortality rates for Carson County (where the plant is located) and the five adjacent and downwind counties were not significantly different from rates for the State of Texas.
Dehghani, Mansooreh; Keshtgar, Laila; Javaheri, Mohammad Reza; Derakhshan, Zahra; Oliveri Conti, Gea; Zuccarello, Pietro; Ferrante, Margherita
World Health Organization classifies air pollution as the first cause of human cancer. The present study investigated impact of air pollutants on the mortality rates of lung cancer and leukemia in Shiraz, one of the largests cities of Iran. This cross‑sectional (longitudinal) study was carried out in Shiraz. Data on six main pollutants, CO, SO2, O3, NO2, PM10 and PM2.5, were collected from Fars Environmental Protection Agency for 3,001 days starting from 1 January, 2005. Also, measures of climatic factors (temperature, humidity, and air pressure) were obtained from Shiraz Meteorological Organization. Finally, data related to number of deaths due to lung and blood cancers (leukemia) were gathered from Shiraz University Hospital. Relationship between variations of pollutant concentrations and cancers in lung and blood was investigated using statistical software R and MiniTab to perform time series analysis. Results of the present study revealed that the mortality rate of leukemia had a direct significant correlation with concentrations of nitrogen dioxide and carbon monoxide in the air (P<0.05). Therefore, special attention should be paid to sources of these pollutants and we need better management to decrease air pollutant concentrations through, e.g., using clean energy respect to fossil fuels, better management of urban traffic planning, and the improvement of public transport service and car sharing.
In a rural county, Xuan Wei, China, the lung cancer mortality rate is among China's highest, especially in women. This mortality rate is more associated with indoor air burning of smoky coal, as opposed to smokeless coal or wood, for cooking and heating under unvented conditions....
In a rural county, Xuan Wei, China, the lung cancer mortality rate is among China's highest, especially in women. This mortality rate is more associated with indoor air burning of smoky coal, as opposed to smokeless coal or wood, for cooking and heating under unvented conditions....
Ryu, So Yeon; Crespi, Catherine M; Maxwell, Annette E
This study compared trends in colorectal cancer (CRC) incidence and mortality rates among Koreans in South Korea and Korean Americans and non-Hispanic whites in California between 1999 and 2009, and examined CRC screening rates and socio-demographic correlates of CRC screening in the two Korean populations. Age-standardized CRC incidence and mortality rates of Koreans in South Korea and Korean Americans and non-Hispanic whites in California for the years 1999-2009 were obtained from annual reports of cancer statistics and modeled using joinpoint regression. Using 2009 data from the Korean National Health and Nutrition Examination Survey and the California Health Interview Survey, we estimated and compared CRC screening rates and test modalities. We used multiple logistic regression to examine socio-demographic correlates of completion of CRC screening according to the guidelines among the two Korean populations. CRC incidence and mortality rates among South Koreans increased during 1999-2009 but more slowly during the late 2000s. In California, CRC incidence increased among Korean American females but decreased among non-Hispanic whites. About 37% of South Koreans and 60% of Korean Americans reported completion of CRC screening according to guidelines in 2009. Among South Koreans, married status, higher income, and private health insurance were associated with CRC screening, adjusting for other factors. Among Korean Americans, having health insurance was associated with CRC screening. Despite almost identical CRC screening guidelines in South Korea and the USA and substantially higher screening rates among Korean Americans as compared to South Koreans, disparities remain in both populations with respect to CRC statistics. Thus, efforts to promote primary and secondary prevention of CRC in both Korean populations are critically important in both countries.
Rosenberg, Philip S; Check, David P; Anderson, William F
Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly Web tool. Input data for the Web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates, period and cohort rate ratios that incorporate the overall annual percentage change (net drift), and estimators of the age-specific annual percentage change (local drifts). The Web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value file. Model outputs can be saved in a variety of formats, including R and Excel. APC methodology can now be carried out through a freely available user-friendly Web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. The Web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns. ©2014 American Association for Cancer Research.
Rosenberg, Philip S.; Check, David P.; Anderson, William F.
BACKGROUND Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. METHODS We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly web tool. RESULTS Input data for the web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates; period and cohort rate ratios that incorporate the overall annual percentage change (net drift); and estimators of the age-specific annual percentage change (local drifts). The web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value (csv) file. Model outputs can be saved in a variety of formats including R and Excel. CONCLUSIONS APC methodology can now be carried out through a freely-available user-friendly web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. IMPACT The web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns. PMID:25146089
Malta, Deborah Carvalho; Abreu, Daisy Maria Xavier de; Moura, Lenildo de; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth
To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. Descrever a tendência da mortalidade por câncer de pulmão no Brasil e regiões, antes e após as correções por sub-registro de óbitos, redistribuição de causas mal definidas e causas inespecíficas. Foram utilizados dados de óbitos por câncer de pulmão da população de 30 a 69 anos, notificados ao Sistema de Informação sobre Mortalidade, entre 1996 e 2011, corrigidos para sub-registro de óbitos, declaração de sexo e idade ignorados e causas com códigos mal definidos e inespecíficos segundo sexo, idade e região. Foram calculadas taxas padronizadas por idade para dados brutos e corrigidos. Realizou-se análise da tendência temporal da mortalidade por câncer de pulmão por meio do modelo de regressão com erros autorregressivos. O câncer de pulmão no Brasil apresentou taxas mais elevadas em homens que em mulheres e a região Sul foi a que apresentou maior risco de morte em 1996 e
López-Campos, Jose Luis; Ruiz-Ramos, Miguel; Calero, Carmen
Lung cancer continues to be the leading cause of cancer-related mortality in the European Union (EU) and deaths from lung cancer have been projected to escalate to epidemic proportions amongst females over the next years. We examined lung cancer mortality rates in men and women from Andalusia (Spain) over a 37-year period [1975-2012]. Longitudinal epidemiological study analyzing lung cancer mortality trends in males and females. Data on lung cancer mortality in Andalusia for the period 1975-2012 were obtained from the official cause-of-death publications of the Institute of Statistics of Andalusia. For each sex, age-standardized (European standard population) mortality rates (ASR) from lung cancer were calculated for all ages and truncated at 30-64, 65-74, and >75 years using the direct method. Standardized rate trends by age and sex were estimated by joinpoint regression analysis. In men, the ASR steadily increased through the period 1993-1995, reaching a peak of 145.72 deaths/100,000 people. Subsequently, lung cancer deaths decreased to a rate of 125.47 in the 2011-2012 period. A moderate increase was seen in women until the late 1990s and early 2000s. Thereafter, a very notable rise was observed in females for all age groups, the only exception being older subjects. The sex differences decreased from 8.6:1 in the 1975-1977 period to 6.8:1 in the 2011-2012 period. Lung cancer mortality rates decreased significantly in Andalusian men from 1975 to 2012. More importantly, we demonstrate for the first time the beginning of the lung cancer epidemics in Andalusian women as previously predicted for this area.
Chen, Kai; Liao, Qi Lin; Ma, Zong Wei; Jin, Yang; Hua, Ming; Bi, Jun; Huang, Lei
Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population.
Carroll, Douglas; Drayson, Mark T.
Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95%CI = 0.73–0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality. PMID:26699127
Jemal, Ahmedin; Simard, Edgar P; Xu, Jiaquan; Ma, Jiemin; Anderson, Robert N
Mortality rates continue to increase for liver, esophagus, and pancreatic cancers in non-Hispanic whites and for liver cancer in non-Hispanic blacks. However, the extent to which trends vary by socioeconomic status (SES) is unknown. We calculated age-standardized death rates for liver, esophagus, and pancreas cancers for non-Hispanic whites and non-Hispanic blacks aged 25-64 years by sex and level of education (≤12, 13-15, and ≥16 years, as a SES proxy) during 1993-2007 using mortality data from 26 states with consistent education information on death certificates. Temporal trends were evaluated using log-linear regression, and rate ratios (RRs) with 95 % confidence intervals (CIs) compared death rates in persons with ≤12 versus ≥16 years of education. Generally, death rates increased for cancers of the liver, esophagus, and pancreas in non-Hispanic whites and non-Hispanic blacks (liver cancer only) with ≤12 and 13-15 years of education, with steeper increases in the least educated group. In contrast, rates remained stable in persons with ≥16 years of education. During 1993-2007, the RR (rates in ≤12 versus ≥16 years of education) increased for all three cancers, particularly for liver cancer among men which increased from 1.76 (95 % CI, 1.38-2.25) to 3.23 (95 % CI, 2.78-3.75) in non-Hispanic whites and from 1.28 (95 % CI, 0.71-2.30) to 3.64 (95 % CI, 2.44-5.44) in non-Hispanic blacks. The recent increase in mortality rates for liver, esophagus, and pancreatic cancers in non-Hispanic whites and for liver cancer in non-Hispanic blacks reflects increases among those with lower education levels.
Chu, Kenneth C.; Miller, Barry A.; Springfield, Sanya A.
OBJECTIVES: In the 1990s, U.S. cancer mortality rates declined due to reductions in tobacco use among men and beneficial cancer interventions, such as mammography and Pap smears. We examined the cancer rates by racial/ethnic group, socioeconomic status and time period to identify disparities underlying the overall mortality trend. METHODS: We examined racial/ethnic disparities by measuring excess cancer burden [rate ratio (RR) and ratio differences (RD)] and trends in their cancer rates for nine cancer sites. The trend (T) is calculated as a ratio of the average annual cancer mortality rate for 1995-2000 relative to the rate for 1990-1994 for three levels of poverty (counties with <10% living below the poverty level, 10% - <20% and > or =20%) for the major racial/ethnic populations. We also compared the trend for each racial/ethnic SES group to the trend for lowest SES white group (TD). RESULTS: Blacks have RR disparities relative to whites for each cancer site examined, except for female lung cancer, while the other minorities had RR disparities for cervical cancer (RR>1). There are increases in RR disparities from 1990-1994 to 1995-2000 (RD>0) for colorectal cancer, prostate cancer and breast cancer for each racial/ethnic minority. Whites and blacks had declining trends for every SES group (T<1) and positive high SES gradients (the highest SES group had the best trend and the lowest SES group had the worst trend) at each cancer site, except female lung cancer (T>1). In contrast, American Indians/Alaska natives, Hispanics and Asians/ Pacific Islanders had increasing trends for some of their cancer sites, and their trends did not have the SES gradients. CONCLUSIONS: Increases in racial/ethnic disparities (RD>0) for colorectal, breast and prostate cancer were largest in the lowest SES groups. At some cancer sites, the highest SES group for minorities had worse trend results than the trends for the lowest SES white group (TD>0). PMID:17987912
Baquet, Claudia R.; Commiskey, Patricia; Mack, Kelly; Meltzer, Stephen; Mishra, Shiraz I.
BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease. Images Figure 1 PMID:16334494
Populations in areas of uraniferous geology may be at risk from radon emissions. Twenty-eight municipalities were examined as to their location with respect to uraniferous geology. Communities with possible radon risk had higher rates for all cancers and cancer of the respiratory system, but differences were not statistically significant. Some possible reasons for the results are discussed.
Howard, David H; Ekwueme, Donatus U; Gardner, James G; Tangka, Florence K; Li, Chunyu; Miller, Jacqueline W
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free or low-cost breast and cervical cancer screening to low-income, uninsured or underinsured women. The authors analyzed the impact of the NBCCEDP on breast cancer mortality rates. The data consisted of observations for each state and year for the period from 1990 through 2004. The outcome variable was the breast cancer mortality rate for women ages 40 to 64 years. Independent variables included the proportion of women ages 40 to 64 years screened under NBCCEDP. The impact of screening intensity was estimated using least-squares regression with state and year fixed effects. In 2004, 1.2% of women ages 40 to 64 years were screened under NBCCEDP. The NBCCEDP screening rate was related significantly and negatively to breast cancer mortality in the same year. Results indicate that, for every 1000 women screened, there were 0.6 fewer deaths because of breast cancer among women ages 40 to 64 years. Changes in screening rates were unrelated to breast cancer mortality≥2 years in the future. In the current study, there was some evidence suggesting that the NBCCEDP led to a reduction in breast cancer mortality rates. However, the failure to detect an impact of screening on mortality rates in subsequent years suggests that caution is needed in interpreting these results as strong evidence in favor of the effectiveness of the NBCCEDP in reducing breast cancer mortality. Copyright © 2010 American Cancer Society.
Chu, Kenneth C.; Chu, Kristine T.
We report upper and lower boundary estimates of the 1999–2001 site-specific cancer mortality rates for Asian Indians, Chinese, Filipinos, Koreans, Vietnamese, Native Hawaiians, and Samoans. These rates are for the seven states (California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington) that officially record mortality data for these ethnicities. The rates are based on the 2000 Census, which reports two population counts as follows: persons who identify themselves as belonging to a single ethnic group (which forms the basis for an upper boundary estimate of the rates) and persons who identify themselves as belonging to a single ethnic group or to multiple groups that include the single ethnic group (which forms the basis for a lower boundary estimate for the rates). The top five cancers for each Asian and Pacific Islander ethnic group by gender are reported. In addition, the 1988–1992 cancer mortality rates based on the 1990 Census for Chinese, Filipino, Japanese, and Native Hawaiians are determined. Their 1999–2001 and 1988–1992 rates are compared. PMID:16270326
Chuang, J. C.; Cao, S. R.; Xian, Y. L.; Harris, D. B.; Mumford, J. L.
In a rural county, Xuan Wei, China, the lung cancer mortality rate is among China's highest, especially in women. This mortality rate is more associated with indoor air burning of smoky coal, as opposed to smokeless coal or wood, for cooking and heating under unvented conditions. Homes using different fuels from communes with high and low lung cancer mortality rates were sampled for particulate matter (< 10 μm) and semivolatile organics. The fine particles obtained from homes using smoky coal contained highest concentrations of organic matter (> 70%), including PAH, followed by homes using wood and smokeless coal. The major components present in the smoky coal filter samples were PAH and alkylated PAH. The smokeless coal filter samples exhibited profiles which were similar to the smoky coal samples except that some sulfur compounds were found. The estimated concentration levels of PAH in the smokeless coal samples were about one to two orders of magnitude lower than those of the smoky coal samples. In addition to PAH, aliphatic compounds and fatty acids were the major components found in the wood samples. Selected sample extracts from homes using smoky coal were fractionated into four fractions, and the results showed that the PAH and polar fractions have high mutagenic activity. Chemical characterization of the PAH fraction indicated that concentrations of some alkylated PAH were higher than those of their parent compounds. Chemical characterization of the polar fractions showed that nitrogen heterocyclic compounds are present.
Goovaerts, Pierre; Jacquez, Geoffrey M.; Greiling, Dunrie
This paper presents a geostatistical methodology which accounts for spatially varying population size in the processing of cancer mortality data. The approach proceeds in two steps: (1) spatial patterns are first described and modeled using population-weighted semivariogram estimators, (2) spatial components corresponding to nested structures identified on semivariograms are then estimated and mapped using a variant of factorial kriging. The main benefit over traditional spatial smoothers is that the pattern of spatial variability (i.e. direction-dependent variability, range of correlation, presence of nested scales of variability) is directly incorporated into the computation of weights assigned to surrounding observations. Moreover, besides filtering the noise in the data the procedure allows the decomposition of the structured component into several spatial components (i.e. local versus regional variability) on the basis of semivariogram models. A simulation study demonstrates that maps of spatial components are closer to the underlying risk maps in terms of prediction errors and provide a better visualization of regional patterns than the original maps of mortality rates or the maps smoothed using weighted linear averages. The proposed approach also attenuates the underestimation of the magnitude of the correlation between various cancer rates resulting from noise attached to the data. This methodology has great potential to explore scale-dependent correlation between risks of developing cancers and to detect clusters at various spatial scales, which should lead to a more accurate representation of geographic variation in cancer risk, and ultimately to a better understanding of causative relationships. PMID:16915345
Zayeri, Farid; Sheidaei, Ali; Mansouri, Anita
Colorectal cancer is the second most common cause of cancer death with half a million deaths per year. Incidence and mortality rates have demonstrated notable changes in Asian and African countries during the last few decades. In this study, we first aimed to determine the trend of colorectal cancer mortality rate in each Institute for Health Metrics and Evaluation (IHME) region, and then re-classify them to find more homogenous classes. Our study population consisted of 52 countries of Asia and North Africa in six IHME pre-defined regions for both genders and age-standardized groups from 1990 to 2010.We first applied simple growth models for pre-defined IHME regions to estimate the intercepts and slopes of mortality rate trends. Then, we clustered the 52 described countries using the latent growth mixture modeling approach for classifying them based on their colorectal mortality rates over time. Statistical analysis revealed that males and people in high income Asia pacific and East Asia countries were at greater risk of death from colon and rectum cancer. In addition, South Asia region had the lowest rates of mortality due to this cancer. Simple growth modeling showed that majority of IHME regions had decreasing trend in mortality rate of colorectal cancer. However, re-classification these countries based on their mortality trend using the latent growth mixture model resulted in more homogeneous classes according to colorectal mortality trend. In general, our statistical analyses showed that most Asian and North African countries had upward trend in their colorectal cancer mortality. We therefore urge the health policy makers in these countries to evaluate the causes of growing mortality and study the interventional programs of successful countries in managing the consequences of this cancer.
Rosenberg, Marjorie A
Simulation models analyzing the impact of treatment interventions and screening on the level of breast cancer mortality require an input of mortality from causes other than breast cancer, or competing risks. This chapter presents an actuarial method of creating cohort life tables using published data that removes breast cancer as a cause of death. Mortality from causes other than breast cancer as a percentage of all-cause mortality is smallest for women in their forties and fifties, as small as 85% of the all-cause rate, although the level and percentage of the impact varies by birth cohort. This method produces life tables by birth cohort and by age that are easily included as a common input by the various CISNET modeling groups to predict mortality from other causes. Attention to removing breast cancer mortality from all-cause mortality is worthwhile, because breast cancer mortality can be as high as 15% at some ages.
This study examines the variation of radon risks with changing mortality rates. The Canadian age-specific mortality rates averaged over five year periods from 1986 to 1990 and from 1996 to 2000 were used in the risk calculations. Because of the synergistic interaction between smoking and radon, the risk of radon induced lung cancer for Canadian men decreased with the declining lung cancer mortality rates while for Canadian women the radon risks increased with the rising lung cancer mortality rates.
This study examines the variation of radon risks with changing mortality rates. The Canadian age-specific mortality rates averaged over five year periods from 1986 to 1990 and from 1996 to 2000 were used in the risk calculations. Because of the synergistic interaction between smoking and radon, the risk of radon induced lung cancer for Canadian men decreased with the declining lung cancer mortality rates while for Canadian women the radon risks increased with the rising lung cancer mortality rates
Odintsova, I N; Pisareva, L F; Khryapenkov, A V; Choinzonov, E L
Cancer mortality rate in the Altai Republic is the lowest among the territories of the Siberian Federal District. Cancer mortality rate in females is 1.9 times lower than that in males. From 2003 to 2012 cancer mortality rate ranged within the confidence interval. Men most often die from tumors localized in the respiratory and digestive systems and women--from tumors of the reproductive and digestive systems. Age-standardized incidence rates are significantly higher in urban males and females than in rural population (p < 0.05). Mortality from lung, liver and kidney cancers is higher for urban than for rural males. For urban females, mortality from breast, stomach and rectum cancers is higher than for rural females. Rural women die of esophageal cancer more often than urban women. Risk to die of cancer in 2012 was 23.6% (33.9% for males and 18.9% for females) being higher in urban than in rural population.
Seoane-Mato, Daniel; Aragonés, Nuria; Ferreras, Eva; García-Pérez, Javier; Cervantes-Amat, Marta; Fernández-Navarro, Pablo; Pastor-Barriuso, Roberto; López-Abente, Gonzalo
Although oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours. Specific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. Among men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950-1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer. While the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.
Experiencing remarkable decreases in mortality rates over the past 3 decades, Malaysia currently has one of the lowest mortality rates among developing countries, a rate that compares favorably with those of developed countries. Between 1957 and 1989, the crude death rate dropped from 12.4/1000 population to 4.6. Over the same period, Malaysia recorded even greater decreases in the infant mortality rate, from 75.5/1000 births to 15.2. The Maternal mortality rate also declined from 1.48 in 1970 to 0.24 in 1988. The data indicates that mortality rates vary from state to state, and that rural areas have a higher mortality than urban areas. According to a study by the National Population and Family Development Board, the use of maternal and child health services has played an important role in reducing neonatal, perinatal, infant, child, and maternal mortality rates. Nearly all women in Malaysia receive antenatal services. While the country has achieved great gains on mortality rates, programs focusing on specific age and socioeconomic groups could lead to even greater reductions. The Minister for National Unity and Social Development, Dato Napsiah Omar, has called for the development of programs designed to improve the population's quality of life.
Dallo, Florence J; Schwartz, Kendra; Ruterbusch, Julie J; Booza, Jason; Williams, David R
The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, all-cause and cause-specific mortality rates for Arab Americans were in the range of whites and blacks. However, Arab American men had lower mortality rates from cancer and chronic lower respiratory disease compared to both whites and blacks. Among women, Arab Americans had lower mortality rates from heart disease, cancer, stroke, and diabetes than whites and blacks. Arab Americans are growing in number. Future study should focus on designing rigorous separate analyses for this population.
Benson, Michael D
The objective of this study was to determine the mortality rate of amniotic fluid embolism (AFE) using population-based studies and case series. A literature search was conducted using the two key words: 'amniotic fluid embolism (AFE)' AND 'mortality rate'. Thirteen population-based studies were evaluated, as well as 36 case series including at least two patients. The mortality rate from population-based studies varied from 11% to 44%. When nine population-based studies with over 17 000 000 live births were aggregated, the maternal mortality rate was 20.4%. In contrast, the mortality rate of AFE in case series varies from 0% to 100% with numerous rates in between. The AFE mortality rate in population-based studies varied from 11% to 44% with the best available evidence supporting an overall mortality rate of 20.4%. Data from case series should no longer be used as a basis for describing the lethality of AFE. © 2017 Japan Society of Obstetrics and Gynecology.
The Cohort Consortium Vitamin D Polling Project of Rarer Cancers (VDPP ) study failed to find a beneficial role of prediagnostic serum 25-hydroxyvitamin D [25(OH)D] levels on risk of seven types of rarer cancer: endometrial, esophageal, gastric, kidney, ovarian and pancreatic cancer and non-Hodgkin's lymphoma (NHL). However, ecological studies and studies of oral vitamin D intake have generally found solar ultraviolet B (UVB) and oral vitamin D inversely correlated with incidence and/or mortality rates of these cancers. To explore the discrepancy, I conducted an ecological study of cancer mortality rates for white Americans in the United States for 1950–1994 with data for 503 state economic areas in multiple linear regression analyses with respect to UVB for July, lung cancer, alcohol consumption and urban/rural residence. UVB was significantly inversely correlated with six types of cancer (not pancreatic cancer) in both periods. However, the adjusted R2 values were much lower for cancers with lower mortality rates than those in an earlier ecological study that used state-averaged data. This finding suggests that the VDPP study may have had too few cases. Thus, the VDPP study should not be considered as providing strong evidence against the solar UVB-vitamin D-cancer hypothesis. PMID:21547102
Fernández, Mario I; López, J Francisco; Vivaldi, Bruno; Coz, Fernando
In this study we assessed bladder cancer health care and mortality trends in recent decades in a well studied arsenic exposed area in Northern Chile. Arsenic levels in the affected region were obtained for the last 60 years, and correlated with bladder cancer hospital discharge and mortality rates in recent decades. Bladder cancer hospital discharge rates were significantly higher in the affected region (peak RR 3.6, 95% CI 3.0-4.7). Mortality rates for bladder cancer showed a trend of increase during the period analyzed, reaching peak mortality rates of 28.4 per 100,000 for men and 18.7 per 100,000 for women in the last 10 years. Poisson regression models showed an increased mortality risk in the studied region compared to the rest of the country until the present for men (IRR 5.3, 95% CI 4.8-5.8) and women (IRR 7.8, 95% CI 7.0-8.7). Mean age at cancer specific death was significantly lower in the exposed region (69.6 years, 95% CI 68.4-70.7 vs 73.7 years, 95% CI 73.3-74.2, p <0.01). Exposure to arsenic is related to a significant need for bladder cancer health care and to high mortality rates even 20 years after having controlled arsenic levels in drinking water. Affected individuals should be aware of the significant impact of this ecological factor. Further research is required to identify strategies for the management of bladder cancer in arsenic exposed populations. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Motorykin, Oleksii; Matzke, Melissa M; Waters, Katrina M; Massey Simonich, Staci L
The objective of this research was to investigate the relationship between lung cancer mortality rates, carcinogenic polycyclic aromatic hydrocarbon (PAH) emissions, and smoking on a global scale, as well as for different socioeconomic country groups. The estimated lung cancer deaths per 100,000 people (ED100000) and age standardized lung cancer death rate per 100,000 people (ASDR100000) in 2004 were regressed on PAH emissions in benzo[a]pyrene equivalence (BaPeq), smoking prevalence, cigarette price, gross domestic product per capita, percentage of people with diabetes, and average body mass index using simple and multiple linear regression for 136 countries. Using stepwise multiple linear regression, a statistically significant positive linear relationship was found between loge(ED100000) and loge(BaPeq) emissions for high (p-value <0.01) and for the combination of upper-middle and high (p-value <0.05) socioeconomic country groups. A similar relationship was found between loge(ASDR100000) and loge(BaPeq) emissions for the combination of upper-middle and high (p-value <0.01) socioeconomic country groups. Conversely, for loge(ED100000) and loge(ASDR100000), smoking prevalence was the only significant independent variable in the low socioeconomic country group (p-value <0.001). These results suggest that reducing BaPeq emissions in the U.S., Canada, Australia, France, Germany, Brazil, South Africa, Poland, Mexico, and Malaysia could reduce ED100000, while reducing smoking prevalence in Democratic People's Republic of Korea, Nepal, Mongolia, Cambodia, and Bangladesh could significantly reduce the ED100000 and ASDR100000.
Grant, William B
There are large geographical variations of cancer mortality rates in the United States. In a series of ecological studies in the U.S., a number of risk-modifying factors including alcohol, diet, ethnic background, poverty, smoking, solar ultraviolet-B (UVB), and urban/rural residence have been linked to many types of cancer. Air pollution also plays a role in cancer risk. Cancer mortality rates averaged by state for two periods, 1950-1969 and 1970-1994, were used in multiple-linear regression analyses with respect to many of the risk-modifying factors mentioned with the addition of an air pollution index in the form of a map of acid deposition in 1985. This index is correlated with emissions from coal-fired power plants. In addition, lung cancer mortality rates for five-year periods from 1970-74 to 1990-94 were used in multiple linear regression analyses including air pollution and cigarette smoking. The air pollution index correlated with respiratory, digestive tract, urogenital, female, blood and skin cancer. Air pollution was estimated to account for 5% of male cancer deaths and 3% of female cancer deaths between 1970-1994. Solar UVB was inversely correlated with all these types of cancer except the respiratory, skin and cervical cancer. Cigarette smoking was directly linked to lung cancer but not to other types of cancer in this study. Combustion of coal, diesel fuel and wood is the likely source of air pollution that affects cancer risk on a large scale, through production of black carbon aerosols with adsorbed polycyclic aromatic hydrocarbons.
Kiberd, B A; Rose, C; Gill, J S
Immunosuppression is associated with an increased risk of cancer in kidney transplant recipients compared to the general population. It is less clear whether standardized cancer mortality ratios (SMRs) are also increased. This study's hypothesis is that SMRs are not increased because of competing risks of death. During the median follow-up of 5.05 years (Q1-Q3: 2.36-8.62), there were 1937 cancer deaths and 36 619 noncancer deaths among 164 078 first kidney-only transplant recipients captured in the United States Renal Data System between January 1990 and December 2004. The observed cancer death rate was 206 per 100 000 patient-years compared to an expected rate of 215 per 100,000 patient-years in the general population. The overall age- and sex-adjusted SMR was only 0.96 (95% CI 0.92-1.00). However, patients <50 years had SMRs significantly greater than unity while patients >60 had SMRs lower than unity. Up to 25% of cancer-related deaths occurred after allograft failure. These findings challenge the notion that cancer is a major cause of premature death in all kidney transplant recipients and has implications for design of cancer prevention strategies in kidney transplant recipients.
Lin, Wei-Chih; Lin, Yu-Pin; Wang, Yung-Chieh; Chang, Tsun-Kuo; Chiang, Li-Chi
In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman’s rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk. PMID:24566045
Lin, Wei-Chih; Lin, Yu-Pin; Wang, Yung-Chieh; Chang, Tsun-Kuo; Chiang, Li-Chi
In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman's rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk.
Morgan, Robert David; Webster, Premila; Rayner, Mike
Introduction It is unclear how much of the geographical variation in coronary heart disease (CHD), stroke and cancer mortality rates within the UK is associated with diet. The aim of this study is to estimate how many deaths from CHD, stroke and cancer would be delayed or averted if Wales, Scotland and Northern Ireland adopted a diet equivalent in nutritional quality to the English diet. Methods Mortality data for CHD, stroke and 10 diet-related cancers for 2007–2009 were used to calculate the mortality gap (the difference between actual mortality and English mortality rates) for Wales, Scotland and Northern Ireland. Estimates of mean national consumption of 10 dietary factors were used as baseline and counterfactual inputs in a macrosimulation model (DIETRON). An uncertainty analysis was conducted using a Monte Carlo simulation with 5000 iterations. Results The mortality gap in the modelled scenario (achieving the English diet) was reduced by 81% (95% credible intervals: 62% to 108%) for Wales, 40% (33% to 51%) for Scotland and 81% (67% to 99%) for Northern Ireland, equating to approximately 3700 deaths delayed or averted annually. For CHD only, the mortality gap was reduced by 88% (69% to 118%) for Wales, 58% (47% to 72%) for Scotland, and 88% (70% to 111%) for Northern Ireland. Conclusion Improving the average diet in Wales, Scotland and Northern Ireland to a level already achieved in England could have a substantial impact on reducing geographical variations in chronic disease mortality rates in the UK. Much of the mortality gap between Scotland and England is explained by non-dietary risk factors. PMID:22080528
Santos Arrontes, D; Fernández Arjona, M; Valer López-Fando, M P; Cortés Aránguez, I
To evaluate if the climatic factors of temperature and rainfall influence mortality associated with prostate cancer for a period of five years. The mortality trends associated with prostate cancer will be evaluated in the period ranging from 1st january 1998 to 31st december 2002, in the geographical area of Spain. The demographic and mortality data were obtained from the National Institute of Statistics and the climatologically data on temperature and rainfall were obtained from the National Meteorology Institute applying the values registered in 2002. Based on the meteorological data, the different provinces are classified in accordance with Koppën climate classification and climatic index of Lang that defines them from the mean annual and monthly temperature and rainfall data. Mortality rates will be expressed by 100.000 men year, applying for their study the Kruskall-Wallis test for "n" independent samples through the SPSS v12.0 Windows software. Three main climatic areas are obtained, one area with type B climate, which accounts for 13% of the total population, a Csa climate, and a Csb, accounting for 67 and 20% respectively. The mortality found is higher in the Csb type for prostate cancer (p= 0.007), as compared to the other two climatic areas. Mortality associated with prostate cancer is significantly higher in the regions with a lower sun exposure. However, randomized prospective studies confirming these findings are warranted.
Banas, Tomasz; Juszczyk, Grzegorz; Pitynski, Kazimierz; Nieweglowska, Dorota; Ludwin, Artur; Czerw, Aleksandra
Objectives This study aimed to analyze incidence and mortality trends in breast cancer (BC), corpus uteri cancer (CUC), and ovarian cancer (OC) in Poland in the context of sociodemographic changes. Materials and methods Incidence and mortality data (1980–2013) were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960–2013) were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC). Results A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980–1990 2.14, AAPC1990–1996 4.71, AAPC1996–2013 2.21), with a small but significant decrease in mortality after a slight increase (AAPC1980–1994 0.52, AAPC1994–2013 −0.66). During the period 1980–2013, a significant increase in CUC incidence (AAPC1980–1994 3.7, AAPC1994–2013 1.93) was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980–2006 −1.12, AAPC2006–2013 3.74). After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980–1994 2.98, AAPC1994–2013 −0.49), as did the mortality rate (AAPC1980–1994 0.52, AAPC1994–2013 −0.66). Conclusion After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in mortality rate was observed for BC and OC predominantly at the end of the study period, while for CUC, after a long decreasing mortality trend, a significant increase was observed. PMID:27660470
Bosetti, Cristina; Garavello, Werner; Levi, Fabio; Lucchini, Franca; Negri, Eva; La Vecchia, Carlo
After a steady increase since the 1950s, laryngeal cancer mortality had tended to level off since the early 1980s in men from most European countries. To update trends in laryngeal cancer mortality in Europe, age-standardized (world standard) mortality rates per 100,000 were derived from the WHO mortality database for 33 European countries over the period 1980-2001. Jointpoint analysis was used to identify significant changes in mortality rates. In the European Union (EU) as a whole, male mortality declined by 0.8% per year between 1980 and 1989, by 2.8% between 1989 and 1995, by 5.3% between 1995 and 1998, and by 1.5% thereafter (rates were 5.1/100,000 in 1980-1981 and 3.3/100,000 in 2000-2001). This mainly reflects a decrease in rates in men from western and southern European countries, which had exceedingly high rates in the past. Male laryngeal mortality rose up to the early 1990s, and leveled off thereafter in several countries from central and eastern Europe. In 2000-2001 there was still a 10-15-fold variation in male laryngeal mortality between the highest rates in Croatia (7.9/100,000) and Hungary (7.7/100,000) and the lowest ones in Sweden (0.5/100,000) and Finland (0.8/100,000). Laryngeal cancer mortality was comparatively low in women from most European countries, with stable rates around 0.3/100,000 in the EU as a whole over the last 2 decades. Laryngeal cancer trends should be interpreted in terms of patterns and changes in exposure to alcohol and tobacco. Despite recent declines, the persistence of a wide variability in male laryngeal cancer mortality indicates that there is still ample scope for prevention of laryngeal cancer in Europe.
Sturgeon, Susan R; Graubard, Barry I; Schairer, Catherine; McAdams, Mary; Hoover, Robert N; Gail, Mitchell H
We assessed the contribution of variation in risk factor prevalence to population-density and county-level variation in breast cancer mortality rates. In 1995 we collected risk factor information in a telephone interview of a random digit dialed sample of: (1) 1241 women from counties in the upper and lower tertiles of population density as of 1970 in the Northeast and South of the United States (Design A); (2) 2492 women from counties in the upper and lower tertiles of 1970-1979 breast cancer mortality rates in the four populations from Design A, and; (3) 276 women in Nassau County in New York State. We calculated 1990-94 mortality ratios (MRs) adjusted for breast cancer risk factors. The high/low population-density fully-adjusted MRs in women > or = 55 years were 1.01 (95% CI 0.9-1.2) and 1.00 (95% CI 0.8-1.2). The fully-adjusted MRs for high versus low mortality counties ranged from 0.95 (95% CI 0.8-1.2) to 1.29 (95% CI 1.0-1.6) in women > or = 55 years. Differences in risk factor prevalence explained higher rates in high-density versus low-density areas in older women. Modest elevations in the adjusted high/low breast cancer MRs among older women in certain groups of counties may reflect unidentified risk factors but more likely are due to chance.
Hill, K; Boesch, C; Goodall, J; Pusey, A; Williams, J; Wrangham, R
In order to compare evolved human and chimpanzees' life histories we present a synthetic life table for free-living chimpanzees, derived from data collected in five study populations (Gombe, Taï, Kibale, Mahale, Bossou). The combined data from all populations represent 3711 chimpanzee years at risk and 278 deaths. Males show higher mortality than females and data suggest some inter-site variation in mortality. Despite this variation, however, wild chimpanzees generally have a life expectancy at birth of less than 15 years and mean adult lifespan (after sexual maturity) is only about 15 years. This is considerably lower survival than that reported for chimpanzees in zoos or captive breeding colonies, or that measured among modern human hunter-gatherers. The low mortality rate of human foragers relative to chimpanzees in the early adult years may partially explain why humans have evolved to senesce later than chimpanzees, and have a longer juvenile period.
Smith, Malcolm A; Altekruse, Sean F; Adamson, Peter C; Reaman, Gregory H; Seibel, Nita L
To evaluate whether progress continues in identifying more effective treatments for children and adolescents with cancer, the authors examined both overall and disease-specific childhood cancer mortality rates for the United States, focusing on data from 2000 to 2010. Age-adjusted US mortality trends from 1975 to 2010 were estimated using joinpoint regression analysis. Analyses of annual percentage change (APC) were performed on the same diagnostic groupings for the period restricted to 2000 through 2010 for groupings ages <20 years, <15 years, and 15 to 19 years. After a plateau in mortality rates during 1998 to 2002 (APC, 0.3%), the annual decline in childhood cancer mortality from 2002 to 2010 (APC, -2.4%) was similar to that observed from 1975 to 1998 (APC, -2.7%). Statistically significant declines in mortality rates from 2000 to 2010 were noted for acute lymphoblastic leukemia, acute myeloid leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma, neuroblastoma, central nervous system cancers, and gonadal cancers. From 2000 to 2010, the rates of decline in mortality for the group ages 15 to 19 years generally were equal to or greater than the rates of decline for the group ages birth to 14 years. Improvements in treatment since 1975 resulted >45,000 cancer deaths averted through 2010. Cancer mortality for both children and adolescents declined from 2000 to 2010, with significant declines observed for multiple cancer types. However, greater than 1900 cancer deaths still occur each year among children and adolescents in the United States, and many survivors experience long-term effects that limit their quality of life. Continued research directed toward identifying more effective treatments that produce fewer long-term sequelae is critical to address these remaining challenges. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
Hansen, Jens; Gandaglia, Giorgio; Bianchi, Marco; Sun, Maxine; Rink, Michael; Tian, Zhe; Meskawi, Malek; Trinh, Quoc-Dien; Shariat, Shahrokh F.; Perrotte, Paul; Chun, Felix K.-H.; Graefen, Markus; Karakiewicz, Pierre I.
Introduction: It is customary to consider deaths that occur within 90 days of surgery as caused by that surgery. However, such practice may overestimate the true short-term mortality rates after radical prostatectomy (RP). Indeed, treatment-unrelated events might affect short-term mortality rates. We assess RP-specific excess short-term mortality. Methods: We performed a retrospective analysis of a population-based cohort of 59 010 patients (RP = 28 281 and external beam radiation therapy [EBRT] as reference group, n = 30 729) who were treated between 1998 and 2005 for non-metastatic prostate cancer. Using univariate and multivariate logistic regression analyses, we assessed the rates of 30-, 60- and 90-day mortality after either RP or EBRT. Results: Within the cohort, 30-, 60- and 90-day mortality rates were 0.2, 0.5 and 0.6%, and 0.1, 0.4 and 0.6% for RP and EBRT patients, respectively. This resulted in overall 30-, 60, and 90- day mortality differences of 0.1, 0.1 and 0%, respectively. After stratification according to age and Charlson comorbidity index (CCI), the magnitude of these differences increased up to 3.2% in favour of EBRT in patients aged >75 years with CCI ≥2. In multivariable analysis, rates of 30-, 60- and 90- day mortality were 5.2-, 1.8- and 1.3-fold higher after RP than EBRT, respectively. Our study is limited by its non-randomized design. Conclusion: Overall, absolute short-term mortality rates after RP are comparable to those of EBRT. The difference decreases over time: 90 days <60 days <30 days. Nonetheless, their magnitude is far from trivial in the elderly and sickest patients. PMID:24554978
Gorham, Edward D.; Garland, Frank C.; Mohr, Sharif B.; Grant, William B.; Garland, Cedric F.
Although most ultraviolet B (UVB) radiation is absorbed by stratospheric ozone, dense anthropogenic sulfate aerosols in the troposphere may further attenuate UVB in some regions. Mortality rates from colon and breast cancer tend to be much higher in areas with low levels of UVB radiation. These high rates may be due in part to inadequate cutaneous photosynthesis of vitamin D. Satellite data on atmospheric aerosols, stratospheric ozone, and cloud cover were obtained from the National Aeronautics and Space Administration (NASA) and the National Oceanic and Atmospheric Administration (NOAA). These data were combined with age-adjusted mortality rates from 175 countries reporting to the World Health Organization. Regression was used to assess the relationship of stratospheric ozone thickness, aerosol optical depth, cloud cover, solar UVB irradiance at the top of the atmosphere, average skin exposure, and a dietary factor with colon and breast cancer mortality rates. Solar UVB irradiance at the top of the atmosphere, total cloud cover, and atmospheric aerosols had the strongest associations with mortality rates, apart from a strong influence of diet. Since 95% of circulating vitamin D is derived from current or stored products of photosynthesis, which may be nonexistent or minimal much of the year above 37°N or below 37°S, attenuation of UVB by atmospheric aerosols and clouds may have a greater than expected adverse effect on human health.
Abdullaev, F I; Rivera-Luna, R; Roitenburd-Belacortu, V; Espinosa-Aguirre, J
Public and governmental concern regarding increasing cancer mortality trends in children in Mexico led us to investigate the current situation of childhood cancer in this country, as well as to discuss the reasons for which no decline in total and childhood cancer mortality has been documented during the past decades. The data used for analysis of total cancer mortality and study of the trends in mortality of specific childhood cancer in Mexico were retrieved from official Mexican Cancer Mortality Statistics for the period of 1955-1995, as well as from the latest official death records of the Mexican National Institute of Statistics, Geography and Informatics. Actual mortality rates from all sites of cancer in Mexico show a tendency to increase in adults and in children over the last decades. The mortality rate due to all malignant neoplasms in the Mexican population increased significantly, from 28.1 per 100,000 inhabitants in 1955 to 52.6 per 100,000 inhabitants in 1995, whereas the rate of total mortality tended to decrease. The death rate among Mexican children under 15 years of age from all malignant neoplasms increased from 1980-1995 by 20.3%. Although these findings offer some support for the suggestion that socioeconomic factors and delayed diagnosis and treatment may be the major contributors to childhood cancer death rates in Mexico, other explanations cannot be excluded. Further and more detailed research into the nature of the influence of environmental exposures, geographical distribution-including rural vs. city life-and purely biological factors concerned with the cancer situation is warranted. Predictions indicate that the increase of both total and childhood cancer mortality will continue. The pattern in the epidemiology of childhood diseases is changing in view of better national health measures to control infectious diseases, diarrheas, and neonatal problems. All these measures would lead to an increase in the incidence of childhood cancer in
Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Xia, Changfa; Zuo, Tingting; Yang, Zhixun; Zou, Xiaonong; He, Jie
National Central Cancer Registry of China (NCCRC) updated nationwide statistics of cancer incidence and mortality in China using population-based cancer registration data in 2013 from all available cancer registries. In 2016, 255 registries' data were qualified and included in this analysis. We estimated numbers of new cancer cases and deaths in China in 2013 using age-specific rates and corresponding national population stratified by area, sex, age group (0, 1-4, 5-9, 10-14…85+) and cancer type. The world Segi's population was applied for age-standardized rates. All rates were expressed per 100,000 person-year. A total of 3,682,000 new cancer cases and 2,229,300 cancer deaths were estimated in China in 2013. Cancers of lung, female breast, stomach, liver, colon-rectum and esophagus were the most common cancers, accounting for about half of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer were the five leading causes of cancer death, accounting for about 60% of all cancer deaths. The cancer patterns showed differences not only between male and female, but also among different geographic regions in China. For overall cancers, the age-standardized incidence rates were stable during the past decades in male, but significantly increased by 2.2% per year in female. Cancer poses a major threat to public health and the cancer burden keep raising in China. The annual updated cancer statistics can provide scientific basis for cancer prevention and control. Copyright © 2017. Published by Elsevier B.V.
Trujillo-Santos, Javier; Monreal, Manuel
Cancer patients with venous thromboembolism (VTE) are at increased risk of mortality. Estimating the risks for specific causes of death may help to weigh the risks and benefits of different therapeutic strategies in an individual patient. In the Registro Informatizado de la Enfermedad Trombo Embólica Registry of 15 520 consecutive patients with VTE, cancer was present in 20% and was associated with a two-fold increase in the risk of fatal pulmonary embolism. In a subsequent study including 2474 women with cancer, 329 (13%) died during the first month. The incidence of fatal pulmonary embolism (n = 71) exceeded that of fatal bleeding (n = 22), except in women with cancer of the bladder or vulva. Then, we compared the mortality rate according to initial presentation in 3978 women with cancer and VTE, of whom 438 (11%) died during the first month. The risk of fatal bleeding was twice as high as the risk of fatal pulmonary embolism (12 vs. 5 deaths) in those with deep-vein thrombosis alone. The higher risk of dying from bleeding than from pulmonary embolism in some women with cancer and VTE suggests that a less aggressive anticoagulant strategy might reduce fatal bleeding more than it would increase fatal pulmonary embolism during this period.
Ruíz-Godoy, L; Rizo Rios, P; Sánchez Cervantes, F; Osornio-Vargas, A; García-Cuellar, C; Meneses García, A
The highest mortality due to cancer worldwide for both genders corresponds to lung cancer (1,179,000 deaths). In Mexico, the crude mortality rate due to lung cancer was of 5.01 per 10(5) inhabitants in 1979. The most important risk factor is smoking. The present study was aimed at analyzing the mortality due to lung cancer in Mexico, assessing data from each of the states constituting the Mexican Republic during the 1998-2004 period. Data were obtained from the National Institute of Statistics, Geography and Informatics (INEGI, for its initials in Spanish) corresponding to deaths due to lung cancer (1998-2004). We estimated the mean annual mortality rate (MAMR) for each of the 32 states of Mexico. We used the "World Population Standard". The MAMR was standardized according to age (ARS) direct method, and the standard error was determined by Poisson's approximation at a 95% confidence interval. To know the excess risk due to mortality, we calculated the standardized mortality ratios (SMRs) of ARS for each federal state, using the national rate as reference. In this period, 397,400 deaths due to malignant neoplasms were recorded, corresponding 45,578 (11.5%) to lung cancer; for men, 31,025 (68.1%) with MAMR of 8.9 and the respective ARS of 13.2 both x10(5) inhabitants. For women, results were 4553 (31.9%) deaths with MAMR of 4.1 and ARS of 5.4 both x10(5) inhabitants. The highest mortality rates due to lung cancer in both genders were observed in the north of Mexico, whereas for women this was observed in the central states. Although smoking is the main risk for lung cancer, there are other factors such as environmental pollution or exposure to toxicants that could be associated to this cancer. The years potentially lost due to lung cancer were 258,550 for men and 133,315 for women, with a total of 391,865 according to histopathology registry neoplasm malignant RHNM (1985-1995). Studies focused on the characterization and measurement of polluting agents would be a
Jakobsson, K; Horstmann, V; Welinder, H
OBJECTIVE--To explore associations between exposure to cement dust and cause specific mortality and tumour morbidity, especially gastrointestinal tumours. DESIGN--A retrospective cohort study. SUBJECTS AND SETTING--2400 men, employed for at least 12 months in two Swedish cement factories. MAIN OUTCOME MEASURES--Cause specific morality from death certificates (1952-86). Cancer morbidity from tumour registry information (1958-86). Standardised mortality rates (SMRs; national reference rates) and standardised morbidity incidence rates (SIRs; regional reference rates) were calculated. RESULTS--An increased risk of colorectal cancer was found > or = 15 years since the start of employment (SIR 1.6, 95% confidence interval (95% CI) 1.1-2.3), mainly due to an increased risk for tumours in the right part of the colon (SIR 2.7, 95% CI 1.4-4.8), but not in the left part (SIR 1.0, 95% CI 0.3-2.5). There was a numerical increase of rectal cancer (SIR 1.5, 95% CI 0.8-2.5). Exposure (duration of blue collar employment)-response relations were found for right sided colon cancer. After > or = 25 years of cement work, the risk was fourfold (SIR 4.3, 95% CI 1.7-8.9). There was no excess of stomach cancer or respiratory cancer. Neither total mortality nor cause specific mortality were significantly increased. CONCLUSIONS--Diverging risk patterns for tumours with different localisations within the large bowel were found in the morbidity study. Long term exposure to cement dust was a risk factor for right sided colon cancer. The mortality study did not show this risk. PMID:8457494
Marshall, Dominic C; Webb, Thomas E; Hall, Richard A; Salciccioli, Justin D; Ali, Raghib; Maruthappu, Mahiben
Background: Until 1990, there was an upward trend in mortality from breast, lung, prostate, and colon cancers in the United Kingdom. With improvements in cancer treatment there has, in general, been a fall in mortality over the last 20 years. We evaluate regional cancer mortality trends in the United Kingdom between 1991 and 2007. Methods: We analysed mortality trends for breast, lung, prostate, and colon cancers using data obtained from the EUREG cancer database. We have described changes in age-standardised rates (using European standard population) per 100 000 for cancer mortality and generated trends in mortality for the 11 regions using Joinpoint regression. Results: Across all regions in the United Kingdom there was a downward trend in mortality for the four most common cancers in males and females. Overall, deaths from colon cancer decreased most rapidly and deaths from prostate cancer decreased at the slowest rate. Similar downward trends in mortality were observed across all regions of the United Kingdom with the data for lung cancer exhibiting the greatest variation. Conclusions: Mortality from the four most common cancers decreased across all regions of the United Kingdom; however, the rate of decline varied between cancer type and in some instances by region. PMID:26766741
Pritchard, Colin; Hickish, Tamas; Rosenorn-Lanng, Emily; Wallace, Mark
Every Western nation expends vast sums on health, especially for cancer; thus, the question is how efficient is the UK in reducing adult (55-74) cancer mortality rates and total mortality rates (TMR) compared to the other Western nations in the context of economic-input to health, the percentage of Gross-Domestic-Product-expenditure-on-Health. WHO mortality rates for baseline 3 years 1989-1991 and 2008-2010 were analysed, and confidence intervals determine any significant differences between the UK and other countries in reducing the mortalities. Efficiency ratios are calculated by dividing reduced mortality over the period by the average % of national income. Twenty-one similar socio-economic Western countries. The 21 countries' general population. Cancer mortality rates, total mortality rates Gross Domestic Product and Efficiency Ratios. Economic Input: In 1980, UK national income was 5.6% and the European average was 7.1%. By 2010, UK national income was 9.4% being equal 17th of 21 averaging 7.1% over the period. Europe's 1980-2010 average of 8.4% yields a UK to Europe ratio of 1:1.18. Clinical output 1989-2010: UK Cancer Mortality Rates was the sixth highest, but equal sixth biggest fall, significantly greater than 14 other countries. UK Total Mortality Rates was the fifth highest but third biggest decline, significantly greater than 17 countries. UK's cancer Efficiency Ratios is largest at 1:301 and second biggest for Total Mortality Rates at 1.1341; the USA ratios were 1:152 and 1:525, respectively. UK reduced mortalities indicate that the NHS achieves proportionally more with relatively less, but UK needs to match European average Gross-Domestic-Product-expenditure-on-Health to meet future challenges.
Schreinemachers, D M; Creason, J P; Garry, V F
Because of its unique geology, Minnesota can be divided into four agricultural regions: south-central region one (corn, soybeans); west-central region two (wheat, corn, soybeans); northwest region three (wheat, sugar beets, potatoes); and northeast region four (forested and urban in character). Cancer mortality (1980-1989) in agricultural regions one, two, and three was compared to region four. Using data compiled by the National Center for Health Statistics, cancer mortality was summarized by 5-year age groups, sex, race, and county. Age-standardized mortality rate ratios were calculated for white males and females for all ages combined, and for children aged 0-14. Increased mortality rate ratios and 95% confidence intervals (CIs) were observed for the following cancer sites: region one--lip (men), standardized rate ratio (SRR) = 2.70 (CI, 1.08-6.71); nasopharynx (women), SRR = 3.35 (CI, 1.20-9.31); region two--non-Hodgkin's lymphoma (women), SRR = 1.35 (CI, 1.09-1.66); and region three--prostate (men), SRR = 1.12 (CI, 1.00-1.26); thyroid (men), SRR = 2.95 (CI, 1.35-6.44); bone (men), SRR = 2.09 (CI, 1. 00-4.34); eye (women), SRR = 5.77 (CI, 1.90-17.50). Deficits of smoking-related cancers were noted. Excess cancers reported are consistent with earlier reports of agriculturally related cancers in the midwestern United States. However, reports on thyroid and bone cancer in association with agricultural pesticides are few in number. The highest use of fungicides occurs in region three. Ethylenebisdithiocarbamates, whose metabolite is a known cause of thyroid cancer in rats, are frequently applied. This report provides a rationale for evaluation of the carcinogenic potential of this suspect agent in humans. Images Figure 1 PMID:10064550
Cabanes, A; Vidal, E; Aragonés, N; Pérez-Gómez, B; Pollán, M; Lope, V; López-Abente, G
Since the 1990s, there has been a downturn in mortality for specific types of tumour in Spain and other European countries. This article reports on the current situation of cancer mortality in Spain, as well as mortality trends over the period 1980-2007, and provides an overview of cancer mortality trends in Europe in recent years. Data were sourced from the National Statistics Institute (Instituto Nacional de Estadística - INE) and the World Health Organization mortality database. Mortality trends were studied using change-point Poisson regression models. All-cancer mortality decreased in both sexes from 1980 to 2007, owing to the fact that the tumours responsible for the highest number of deaths registered declining trends from the mid-1990s onwards. In men, mortality due to stomach and prostate cancer fell by >3% per annum in the last 10 years of the study period. In women, the largest contributions to the fall in cancer mortality were due to breast and colorectal cancers. In contrast, female mortality due to smoking-related cancers rose significantly. Within the European context, Spain's estimated 2005 mortality rates were intermediate for men and low for women. Cancer control is progressing in the right direction in Spain. Further interventions directed to reduce tobacco-related cancer mortality remain a priority, particularly for women.
Hamashima, Chisato; Ogoshi, Kazuei; Narisawa, Rintarou; Kishi, Tomoki; Kato, Toshiyuki; Fujita, Kazutaka; Sano, Masatoshi; Tsukioka, Satoshi
AIM: To investigate mortality reduction from gastric cancer based on the results of endoscopic screening. METHODS: The study population consisted of participants of gastric cancer screening by endoscopy, regular radiography, and photofluorography at Niigata city in 2005. The observed numbers of cumulative deaths from gastric cancers and other cancers were accumulated by linkage with the Niigata Prefectural Cancer Registry. The standardized mortality ratio (SMR) of gastric cancer and other cancer deaths in each screening group was calculated by applying the mortality rate of the reference population. RESULTS: Based on the results calculated from the mortality rate of the population of Niigata city, the SMRs of gastric cancer death were 0.43 (95%CI: 0.30-0.57) for the endoscopic screening group, 0.68 (95%CI: 0.55-0.79) for the regular radiographic screening group, and 0.85 (95%CI: 0.71-0.94) for the photofluorography screening group. The mortality reduction from gastric cancer was higher in the endoscopic screening group than in the regular radiographic screening group despite the nearly equal mortality rates of all cancers except gastric cancer. CONCLUSION: The 57% mortality reduction from gastric cancer might indicate the effectiveness of endoscopic screening for gastric cancer. Further studies and prudent interpretation of results are needed. PMID:25741155
Abu-Rmeileh, Niveen M E; Gianicolo, Emilio Antonio Luca; Bruni, Antonella; Mitwali, Suzan; Portaluri, Maurizio; Bitar, Jawad; Hamad, Mutaem; Giacaman, Rita; Vigotti, Maria Angela
The burden of cancer is difficult to study in the context of the occupied Palestinian territory because of the limited data available. This study aims to evaluate the quality of mortality data and to investigate cancer mortality patterns in the occupied Palestinian territory's West Bank governorates from 1999 to 2009. Death certificates collected by the Palestinian Ministry of Health for Palestinians living in the West Bank were used. Direct and indirect age-standardised mortality rates were computed and used to compare different governorates according to total and specific cancer mortality. Furthermore, standardised proportional mortality ratios were calculated to compare mortality by urban, rural and camp locales. The most common cause of death out of all cancer types was lung cancer among males (22.8 %) and breast cancer among females (21.5 %) followed by prostate cancer for males (9.5 %) and by colon cancer for females (11.4 %). Regional variations in cancer-specific causes of death were observed. The central- West Bank governorates had the lowest mortality for most cancer types among men and women. Mortality for lung cancer was highest in the north among men (SMR 109.6; 95%CI 99.5-120.4). For prostate cancer, mortality was highest in the north (SMR 103.6; 95%CI 88.5-120.5) and in the south (SMR 118.6; 95%CI 98.9-141.0). Breast cancer mortality was highest in the south (SMR 119.3; 95%CI 103.9-136.2). Similar mortality rate patterns were found in urban, rural and camp locales. The quality of the Palestinian mortality registry has improved over time. Results in the West Bank governorates present different mortality patterns. The differences might be explained by personal, contextual and environmental factors that need future in-depth investigations.
Oriel, K A; Hartenbach, E M; Remington, P L
To describe the epidemiology of ovarian cancer mortality in the United States from 1979 to 1995. The mortality data of the Centers for Disease Control and Prevention were accessed using the Wide-ranging Online Data for Epidemiologic Research (WONDER). We selected all deaths among women with International Classification of Diseases, Ninth Revision (ICD-9) code 183.0 (ovarian malignant neoplasm). Mortality data for the years 1979-1995 were age-adjusted to the United States 1990 female population, and mortality rates for each year were calculated for females of all ages by age category, by race, and by geographic location. Trends were obtained for the periods 1979-1983 to 1991-1995, and the impact on the number of ovarian cancer deaths was calculated. Age-adjusted ovarian cancer mortality rates have changed little in the United States from 1979 to 1995, but rates are increasing in older women (65 years and older) and decreasing in younger women. Age-adjusted mortality rates are higher among whites than in blacks. Ovarian cancer mortality rates are higher in northern compared with southern states. The trends in ovarian cancer mortality among younger and older women parallel published changes in incidence and may be due to changes in risk factors, such as the use of oral contraceptives. The reasons for the higher ovarian cancer death rates in northern states are unknown. Better understanding of how modifiable risk factors and treatment methods affect ovarian cancer mortality trends is needed.
Girianelli, Vania Reis; Gamarra, Carmen Justina; Azevedo e Silva, Gulnar
OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson’s correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment. PMID:25119941
Llorca, J.; Prieto, M. D.; Delgado-Rodriguez, M.
BACKGROUND: The trend in cervical cancer mortality in Spain from 1951 to 1991 is examined. METHODS: Analysis of national mortality statistics calculating age standardised mortality rates and an age-period cohort analysis. A fit to the Gompertz function was made to estimate the influence of the environmental factors on the mortality rates evolution. MAIN RESULTS: The age standardised mortality rate in Spain is lower than in other developed countries (USA or Estonia) and equal to Norwegian and Finland rates; but whereas in these countries the trend is to decrease, the Spanish rate has increased during this period, because of a cohort effect. A misclassification bias could be responsible for the trend in women aged 40 and older but the increasing trend in younger women could not be interpreted as espurious. The Gompertzian analysis suggests an increase in environmental factors causing cervical cancer. CONCLUSIONS: Cervical cancer mortality rates are increasing in Spain because of environmental factors. PMID:10492733
Parkes, H G; Veys, C A; Waterhouse, J A; Peters, A
Although it is over 30 years since an excess of bladder cancer was first identified in British rubber workers, the fear has persisted that this hazard could still be affecting men working in the industry today. Furthermore, suspicions have also arisen that other and hitherto unsuspected excesses of cancer might be occurring. For these reasons 33 815 men, who first started work in the industry between 1 January 1946 and 31 December 1960, have been followed up to 31 December 1975 to ascertain the number of deaths attributable to malignant disease and to compare these with the expected number calculated from the published mortality rates applicable to the male population of England and Wales and Scotland. The findings confirm the absence of any excess mortality from bladder cancer among men entering the industry after 1 January 1951 (the presumed bladder carcinogens were withdrawn from production processes in July 1949), but they confirm also a statistically significant excess of both lung and stomach cancer mortality. A small excess of oesophageal cancer was also observed in both the tyre and general rubber goods manufacturing sectors. American reports of an excess of leukaemia among rubber workers receive only limited support from the present study, where a small numerical excess of deaths from leukaemia is not statistically significant. A special feature of the study is the adoption of an analytical method that permits taking into account the long latent period of induction of occupational cancer. PMID:7093147
Ait Ouakrim, Driss; Pizot, Cécile; Boniol, Magali; Malvezzi, Matteo; Boniol, Mathieu; Negri, Eva; Bota, Maria; Jenkins, Mark A; Bleiberg, Harry
Objective To examine changes in colorectal cancer mortality in 34 European countries between 1970 and 2011. Design Retrospective trend analysis. Data source World Health Organization mortality database. Population Deaths from colorectal cancer between 1970 and 2011. Profound changes in screening and treatment efficiency took place after 1988; therefore, particular attention was paid to the evolution of colorectal cancer mortality in the subsequent period. Main outcomes measures Time trends in rates of colorectal cancer mortality, using joinpoint regression analysis. Rates were age adjusted using the standard European population. Results From 1989 to 2011, colorectal cancer mortality increased by a median of 6.0% for men and decreased by a median of 14.7% for women in the 34 European countries. Reductions in colorectal cancer mortality of more than 25% in men and 30% in women occurred in Austria, Switzerland, Germany, the United Kingdom, Belgium, the Czech Republic, Luxembourg, and Ireland. By contrast, mortality rates fell by less than 17% in the Netherlands and Sweden for both sexes. Over the same period, smaller or no declines occurred in most central European countries. Substantial mortality increases occurred in Croatia, the former Yugoslav republic of Macedonia, and Romania for both sexes and in most eastern European countries for men. In countries with decreasing mortality, reductions were more important for women of all ages and men younger than 65 years. In the 27 European Union member states, colorectal cancer mortality fell by 13.0% in men and 27.0% in women, compared with corresponding reductions of 39.8% and 38.8% in the United States. Conclusion Over the past 40 years, there has been considerable disparity in the level of colorectal cancer mortality between European countries, as well as between men and women and age categories. Countries with the largest reductions in colorectal cancer mortality are characterised by better accessibility to screening
Degomme, Olivier; Guha-Sapir, Debarati
Several mortality estimates for the Darfur conflict have been reported since 2004, but few accounted for conflict dynamics such as changing displacement and causes of deaths. We analyse changes over time for crude and cause-specific mortality rates, and assess the effect of displacement on mortality rates. Retrospective mortality surveys were gathered from an online database. Quasi-Poisson models were used to assess mortality rates with place and period in which the survey was done, and the proportions of displaced people in the samples were the explanatory variables. Predicted mortality rates for five periods were computed and applied to population data taken from the UN's series about Darfur to obtain the number of deaths. 63 of 107 mortality surveys met all criteria for analysis. Our results show significant reductions in mortality rates from early 2004 to the end of 2008, although rates were higher during deployment of fewer humanitarian aid workers. In general, the reduction in rate was more important for violence-related than for diarrhoea-related mortality. Displacement correlated with increased rates of deaths associated with diarrhoea, but also with reduction in violent deaths. We estimated the excess number of deaths to be 298 271 (95% CI 178 258-461 520). Although violence was the main cause of death during 2004, diseases have been the cause of most deaths since 2005, with displaced populations being the most susceptible. Any reduction in humanitarian assistance could lead to worsening mortality rates, as was the case between mid 2006 and mid 2007. Copyright 2010 Elsevier Ltd. All rights reserved.
Jung, Kyu-Won; Won, Young-Joo; Oh, Chang-Mo; Kong, Hyun-Joo; Lee, Duk Hyoung; Lee, Kang Hyun
This study aimed to report on cancer incidence and mortality for the year 2017 in Korea in order to estimate the nation's current cancer burden. Cancer incidence data from 1999 to 2014 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2015 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observe age-specific cancer rates against observed years, and then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly; we only used data of the latest trend. A total of 221,143 new cancer cases and 80,268 cancer deaths are expected to occur in Korea in 2017. The most common cancer sites are the colorectum, stomach, lung, thyroid, and breast. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites are the lung, liver, colorectal, stomach, and pancreas. The incidence rate of all cancers in Korea appears to have decreased mainly because of a decrease in thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs.
Jung, Kyu-Won; Won, Young-Joo; Oh, Chang-Mo; Kong, Hyun-Joo; Lee, Duk Hyoung; Lee, Kang Hyun
Purpose This study aimed to report on cancer incidence and mortality for the year 2017 in Korea in order to estimate the nation’s current cancer burden. Materials and Methods Cancer incidence data from 1999 to 2014 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2015 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observe age-specific cancer rates against observed years, and then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly; we only used data of the latest trend. Results A total of 221,143 new cancer cases and 80,268 cancer deaths are expected to occur in Korea in 2017. The most common cancer sites are the colorectum, stomach, lung, thyroid, and breast. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites are the lung, liver, colorectal, stomach, and pancreas. Conclusion The incidence rate of all cancers in Korea appears to have decreased mainly because of a decrease in thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs. PMID:28301926
Bleyer, Archie; Baines, Cornelia; Miller, Anthony B
The degree to which observed reductions in breast cancer mortality is attributable to screening mammography has become increasingly controversial. We examined this issue with three fundamentally different approaches: (i) Chronology--the temporal relationship of the onset of breast cancer mortality decline and the national implementation of screening mammography; (ii) Magnitude--the degree to which breast cancer mortality declined relative to the amount (penetration) of screening mammography; (iii) Analogy--the pattern of mortality rate reductions of other cancers for which population screening is not conducted. Chronology and magnitude were assessed with data from Europe and North America, with three methods applied to magnitude. A comparison of eight countries in Europe and North America does not demonstrate a correlation between the penetration of national screening and either the chronology or magnitude of national breast cancer mortality reduction. In the United States, the magnitude of the mortality decline is greater in the unscreened, younger women than in the screened population and regional variation in the rate of breast cancer mortality reduction is not correlated with screening penetrance, either as self-reported or by the magnitude of screening-induced increase in early-stage disease. Analogy analysis of United States data identifies 14 other cancers with a similar distinct onset of mortality reduction for which screening is not performed. These five lines of evidence from three different approaches and additional observations discussed do not support the hypothesis that mammography screening is a primary reason for the breast cancer mortality reduction in Europe and North America.
Breast cancer mortality between 1950 and 1987 after exposure to fractionated moderate-dose-rate ionizing radiation in the Canadian fluoroscopy cohort study and a comparison with breast cancer mortality in the atomic bomb survivors study.
Howe, G R; McLaughlin, J
The relationship between exposure to low-linear energy transfer ionizing radiation and subsequent breast cancer mortality risk is reported based on a further 7 years of follow-up in the Canadian fluoroscopy study. Amongst 31,917 women first treated for tuberculosis in a Canadian institution between 1930 and 1952, a total of 688 breast cancer deaths were observed between 1950 and 1987. There is a strong linear trend of increasing risk with increasing dose (P < 0.0001), with the excess relative risk per sievert decreasing with age at exposure (P = 0.0003). The excess relative risk is approximately constant between 5 and 39 years after exposure, with a suggestion of a decrease between 40 and 57 years after exposure, though this could be a chance effect (P = 0.22). Combined analyses of the Canadian fluoroscopy data and the data for the atomic bomb survivors with respect to breast cancer mortality are also reported. In general the two studies are reasonably consistent, the only distinct difference being the much greater excess relative risk per sievert amongst women exposed to very high doses in the province of Nova Scotia (P, heterogeneity <0.0001). Based on the combined data sets a simple relative risk (RR) model for the effect of a dose of D sieverts at age A years is developed: RR(D) = 1.0 + 0.52D exp[-0.10(A-15)]. This model fits the combined data well, and is used to predict excess lifetime risks of breast cancer mortality after radiation exposure from routine annual mammography.
Son, Mia; Yun, Jae-Won
Predicting cancer mortality is important to estimate the needs of cancer-related services and to prevent cancer. Despite its significance, a long-term future projection of cancer mortality has not been conducted; therefore, our objective was to estimate future cancer mortality in Korea by cancer site through 2032. The specially designed Nordpred software was used to estimate cancer mortality. The cancer death data from 1983 to 2012 and the population projection data from 1983 to 2032 were obtained from the Korean National Statistics Office. Based on our analysis, age-standardized rates with the world standard population of all cancer deaths were estimated to decline from 2008-2012 to 2028-2032 (men: -39.8%, women: -33.1%). However, the crude rates are predicted to rise (men: 29.8%, women: 24.4%), and the overall number of the cancer deaths is also estimated to increase (men: 35.5%, women: 32.3%). Several cancer deaths are projected to increase (lung, liver and gallbladder, colon and rectum, pancreas and leukemia in both sexes; prostate cancer in men; and breast and ovarian cancer in women), whereas other cancer deaths are expected to decrease (stomach, esophagus and larynx in both sexes and cervical cancer in women). The largest contribution to increasing cancer deaths is due to the aging of the Korean population. In conclusion, a strategy for primary prevention, early detection, and early treatment to cope with the rapidly increasing death of cancer due to population aging is urgently required.
Choi, Yun Mi; Jang, Eun Kyung; Kwon, Hyemi; Jeon, Min Ji; Kim, Won Gu; Shong, Young Kee; Kim, Won Bae
Background The prevalence of thyroid cancer has increased very rapidly in Korea. However, there is no published report focusing on thyroid cancer mortality in Korea. In this study, we aimed to evaluate standardized thyroid cancer mortality using data from Statistics Korea (the Statistical Office of Korea). Methods Population and mortality data from 1985 to 2010 were obtained from Statistics Korea. Age-standardized rates of thyroid cancer mortality were calculated according to the standard population of Korea, as well as World Health Organization (WHO) standard population and International Cancer Survival Standard (ICSS) population weights. Results The crude thyroid cancer mortality rate increased from 0.1 to 0.7 per 100,000 between 1985 and 2010. The pattern was the same for both sexes. The age-standardized mortality rate (ASMR) for thyroid cancer for Korean resident registration population increased from 0.19 to 0.67 between 1985 and 2000. However, it decreased slightly, from 0.67 to 0.55, between 2000 and 2010. When mortality was adjusted using the WHO standard population and ICSS population weights, the ASMR similarly increased until 2000, and then decreased between 2000 and 2010. Conclusion Thyroid cancer mortality increased until 2000 in Korea. It started to decrease from 2000. PMID:25559576
Trujillo-Santos, Javier; Casas, José Manuel; Casa, José Manuel; Casado, Ignacio; Samperiz, Angel Luis; Quintavalla, Roberto; Sahuquillo, Joan Carles; Monreal, Manuel
The influence of the site of cancer on outcome in cancer women with venous thromboembolism (VTE) is poorly understood. Reliable information on its influence might facilitate better use of prevention strategies. We assessed the 30-day outcome in all women with active cancer in the RIETE Registry, trying to identify if differences exist according to the tumor site. Up to May 2010, 2474 women with cancer and acute VTE had been enrolled. The most common sites were the breast (26%), colon (13%), uterus (9.3%), and haematologic (8.6%) cancers. During the 30-day study period, 329 (13%) patients died. Of them, 71 (2.9%) died of pulmonary embolism (PE), 22 (0.9%) died of bleeding. Fatal PE was more common in women with breast, colorectal, lung or pancreatic cancer (59% of the fatal PEs). Fatal bleeding was more frequent in women with colorectal, haematologic, ovarian cancer or carcinoma of unknown origin (55% of fatal bleedings). © 2011 Elsevier Ltd. All rights reserved.
Although hair dyes have been shown to be highly mutagenic the literature on possible human cancer risk is confused. A variety of studies using different methods in different countries have provided a range of positive and negative findings. In the present study the observed and expected mortality among a sample of hairdressers identified in the 1961 census was examined and followed until 1978; attention was focused on five malignancies reported to have increased in male hairdressers in the other studies. The overall mortality and number of deaths from all neoplasms were lower than the 'expected' figures. No appreciable or significant excess was found for cancer of the oesophagus, larynx, lung, and bladder, or for leukaemia. The present report, based on the follow-up of nearly 2000 hairdressers for more than 15 years, provides no support for other work which has suggested that male hairdressers or barbers are at risk of certain cancers. These results provide only a limited probe into the influence of hair dyes; another part of the study involves follow-up of women hairdressers from the 1971 census, though it will be a number of years before enough deaths have accumulated to warrant analysis. PMID:7441138
According to the 2006 Census, almost the Canadian population were foreign-born, a percentage that is projected to reach at least 25% by 2031. Studies based on age-standardized mortality rates (ASMR) have found a healthy immigrant effect, with lower overall rates among immigrants. A duration effect has also been observed-immigrants' mortality advantage lessened as their time in Canada increased. ASMRs based on the 1991 to 2001 census mortality follow-up study indicate a healthy immigrant effect and a duration effect at the national level for all-cause mortality for both sexes. However, at the national level, the mortality rate among women from the United States and from Sub-Saharan Africa was similar to that of Canadian-born women. For the three largest Census Metropolitan Areas (Toronto, Montreal and Vancouver), a healthy immigrant effect was not observed among women or among most men from the United States or Sub-Saharan Africa.
Peng, Wen-Jia; Mi, Jing; Jiang, Yu-Hong
Occupational exposure to asbestos occurs in many workplaces and is well known to cause asbestosis, lung cancer, and mesothelioma. However, the link between asbestos exposure and other malignancies was not confirmed. The aim of the current meta-analysis was to provide a summary measure of risk for laryngeal cancer associated with occupational asbestos exposure. Systematic review and meta-analysis. Electronic databases were searched for studies characterizing the association between asbestos and laryngeal cancer. Standardized mortality rate (SMR) with its 95% confidence interval (CI) of each study was combined using a fixed or random effect model. Significantly increased SMR for laryngeal cancer was observed when subjects were exposed to asbestos (SMR = 1.69, 95% CI = 1.45-1.97, P < .001), with little evidence of heterogeneity among studies (Q = 15.39, P = .803, I(2) = 0.0%). Effect estimates were larger for cohorts controlling for male subjects, Europe and Oceania, mining and textile industries, exposure to crocidolite, long study follow-up (>25 years), and SMR for lung cancer > 2.0. Publication bias was not detect by Begg test (P = .910) and Egger test (P = .340). Our study supports the association of exposure to asbestos with an increased risk of laryngeal cancer mortality among male workers. NA Laryngoscope, 126:1169-1174, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
Carioli, G; La Vecchia, C; Bertuccio, P; Rodriguez, T; Levi, F; Boffetta, P; Negri, E; Malvezzi, M
From most recent available data, we predicted cancer mortality statistics in selected Latin American countries for the year 2017, with focus on lung cancer. We obtained death certification data from the World Health Organization and population data from the Pan American Health Organization database for all neoplasms and selected cancer sites. We derived figures for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela. Using a logarithmic Poisson count data joinpoint model, we estimated number of deaths and age-standardized (world population) mortality rates in 2017. Total cancer mortality rates are predicted to decline in all countries. The highest mortality rates for 2017 are in Cuba, i.e. 132.3/100 000 men and 93.3/100 000 women. Mexico had the lowest predicted rates, 64.7/100 000 men and 60.6/100 000 women. In contrast, the total number of cancer deaths is expected to rise due to population ageing and growth. Men showed declines in lung cancer trends in all countries and age groups considered, while only Colombian and Mexican women had downward trends. Stomach and (cervix) uteri rates are predicted to continue their declines, though mortality from these neoplasms remains comparatively high. Colorectal, breast and prostate cancer rates were predicted to decline moderately, as well as leukaemias. There was no clear pattern for pancreatic cancer. Between 1990 and 2017 about 420 000 cancer deaths were avoided in 5 of the 7 countries, no progress was observed in Brazil and Cuba. Cancer mortality rates for 2017 in seven selected Latin American countries are predicted to decline, though there was appreciable variability across countries. Mortality from major cancers-including lung and prostate-and all cancers remains comparatively high in Cuba, indicating the need for improved prevention and management.
Pickle, L W; Gottlieb, M S
As a preliminary step in the investigation of high pancreas-cancer mortality among White males in a cluster of Louisiana parishes, we examined 876 pairs of certificates of death which occurred in this area during 1960--75. The pancreas-cancer death records were matched to controls by age, race, sex, year of death, and parish of residence. The odds ratios were increased about two-fold for workers in the oil refining and paper manufacturing industries, and slight elevations were seen among residents near refineries and food processing plants. Despite the limited residential and occupational information available on death certificates, this study suggests leads to environmental factors that can be further investigated by a case-control interview study in Louisiana. PMID:7356088
Monson, R R; Fine, L J
Mortality and morbidity from cancer among a cohort of 13,570 white male rubber workers were examined. Each man worked for at least 5 years at the Akron, Ohio, plant of the B. F. Goodrich Company. The potential period of follow-up was from January 1, 1940 to June 30, 1976. Departmental work histories were based primarily on records maintained by Local no. 5, United Rubber Workers. The occurrence of cancer was measured by death certificates and by a survey of Akron-area hospital tumor registries from 1964 to 1974. Two types of analyses were made: 1) an external comparison of mortality rates of rubber workers versus rates of U.S. white males, and 2) an internal comparison of cancer morbidity rates among persons who were employed in various work areas of the plant. Excess cases of specific cancers (observed/expected numbers) among workers in specific work areas included: stomach and intestine: rubber making (30/14.4); lung: tire curing (31/14.1), fuel cells and/or deicers (46/29.1); bladder: chemical plant (6/2.4), and tire building (16/10.7); skin cancer: tire assembly (12/1.9); brain cancer: tire assembly (8/2.0); lymphatic cancer: tire building (8/3.2); and leukemia: calendering (8/2.2), tire curing (8/2.6), tire building (12/7.5), elevators (4/1.4), tubes (4/1.6), and rubber fabrics (4/1.1). Agents that may be responsible for these excesses were considered.
Chatenoud, Liliane; Bertuccio, Paola; Bosetti, Cristina; Levi, Fabio; Curado, Maria Paula; Malvezzi, Matteo; Negri, Eva; La Vecchia, Carlo
Scanty information, limited to selected areas of the country, is available on cancer mortality in Brazil. Age-standardized (world population) mortality rates between 1980 and 2004, derived from the WHO database, were computed for all cancers and 24 major cancer sites in Brazil. Joinpoint regression analyses were used to identify the significant changes in trends and estimate annual percent change (APC) in rates. Total cancer mortality rates increased over the last decade in men (APC = 0.5) to reach 101.2/100 000, and in women (APC = 0.3) to reach 71.3/100 000. In men, upward trends were observed for cancers of the oral cavity and pharynx with a rate of 5.9/100 000 in 2000-2004, intestines (whose rate, however was low, i.e. 7.6), prostate (12.2), and leukemias (3.4). Male lung cancer increased until 1993 (APC = 1.39) and decreased thereafter (APC = -0.29), with a relatively low rate of 16.2/100 000 in 2000-2004. In women, there were steady upward trends for cancers of the lung (APC = 2.3), reaching 6.2/100 000 in 2000-2004, and leukemias (2.5). Breast cancer mortality leveled off at around 10/100 000 in the last decade, whereas declines were observed for cancers of the uterus, whose rate (8.3) however, remained comparatively high. Declines were observed for stomach cancer in both sexes, with rates of 11.1 in men and 4.6 in women. In conclusion, the key issues of cancer mortality in Brazil are the high rates of head and neck cancers in men and (cervix) uterine cancer in women, that is, in principle cancers that are largely avoidable through prevention, screening, and early diagnosis.
Ording, Anne Gulbech; Boffetta, Paolo; Garne, Jens Peter; Nyström, Petra Mariann Witt; Cronin-Fenton, Deirdre; Frøslev, Trine; Silliman, Rebecca; Sørensen, Henrik Toft; Lash, Timothy L
It remains unknown whether incident chronic diseases are more often fatal among breast cancer survivors than among women free of breast cancer. We conducted a nationwide matched cohort study of all Danish breast cancer patients diagnosed between 1994 and 2007, who survived for five years. We compared their long-term mortality with five times as many women from the general population without breast cancer, matched on age. We used time-varying methods to compute mortality rate ratios (MRRs) for incident diseases included in the Charlson Comorbidity Index (CCI). One third of five-year breast cancer survivors developed incident diseases during 14 years of follow-up, with about the same incidence as women without breast cancer. Mortality associated with any incident disease was similar among breast cancer survivors (MRR = 7.1, 95% confidence interval (CI): 6.7, 7.4) and comparison women (MRR = 7.5, 95% CI: 7.3, 7.7). Among breast cancer patients, relative mortality associated with incident diseases was higher among patients treated with chemotherapy (MRR = 10, 95% CI: 8.7, 12) and radiotherapy (MRR = 9.8, 95% CI: 8.8, 11) than among patients who received surgery (MRR = 7.0, 95% CI: 6.7, 7.4) or hormonal therapy (MRR = 6.3, 95% CI: 5.8, 6.9). There were no marked differences in mortality of diseases among breast cancer survivors and women from the general population. Among breast cancer patients, new diseases were more often fatal in patients treated with chemotherapy and radiotherapy. Five-year breast cancer survivors have similar risk of dying from new chronic medical conditions as women from the general population without breast cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.
Mojarro, O; Hernandez, D
Data are presented on maternal mortality in the Mexican Institute of Social Security (IMSS) system. World Health Organization recommendations for the definition and measurement of maternal mortality were followed. Death certificates were used to estimate mortality levels, data on the number of live births were used to calculate death rates, and reports of the Study Committees on Maternal Mortality were used to analyze causes of death. Maternal mortality rates declined during the 1980s from 59.9/100,000 live births in 1982-84 to 42.4 in 1987-89, a reduction of 29%. The overall maternal mortality rate in Mexico was estimated at 65/100,000 in 1986. The declining maternal mortality rate, in the context of deteriorating living conditions of the population, appears to be due primarily to the effect of greater coverage of prenatal care, prevention of pregnancies, and a greater relative number of pregnancies at younger ages. Maternal mortality in 1982-84 formed a J-shaped curve in which mortality of younger mothers was higher than that of mothers in intermediate age groups but not as high as that of mothers in the oldest groups. The J-shaped curve was no longer observed in 1987-89, probably because of application of the risk focus in obstetric services and the reproductive risk focus in family planning services. The 5 principal causes of maternal deaths, according to the Study Committees on Maternal Mortality, were toxemia, hemorrhages of pregnancy or delivery, puerperal sepsis, abortion complications, and other complications in the puerperium. These causes accounted for almost 80% of maternal deaths in 1984-86. The decline in the maternal mortality rate does not appear to be associated with reduction in any of the 5 main causes of death except abortion. Greater availability of family planning services contributed to a reduction in the rate of complications of abortion attended by IMSS facilities from 13.7 to 8.0 per 1000 fertile-aged women during the 1980's. Improved
Icaza, Gloria; Núñez, Loreto; Bugueño, Herna
Among women, breast cancer is the leading cause of death due to cancer worldwide. To describe the epidemiology of breast cancer mortality in Chilean women by age, time trend and explore its ecological association with socio-demographic variables. Descriptive study of age specific death rates (2009-2013), and time trend analysis of crude mortality rates (1995-2013) using RiskDiff analysis. Additionally, time trend analysis of age specific death rates was done using Jointpoint regression. The relationship between county mortality risk and socio-demographic variables in the period 2001-2008 was done through an ecological analysis. Socio-demographic variables were: education, income, occupation, housing and living in rural areas. Breast cancer mortality in Chilean women increases with age, with a sharp increase from 80 years old on. In the 1995-2013 period the increase in the crude death rate was 21.8%, this increment was due to changes in demographic structure (43.4%) and decrease in risk (21.7%). The county relative risk of breast cancer mortality is positively associated with education level and negatively associated with living in rural areas. The risk of dying from breast cancer in women has decreased in the period 1995-2013. Nonetheless, the crude death rate has increased in the same period. At an ecological level (counties), breast cancer mortality in Chile is associated with a higher socioeconomic status, measured by educational level and living in rural areas.
Zeng, Hong-mei; Zheng, Rong-shou; Zhang, Si-wei; Zhao, Ping; He, Jie; Chen, Wan-qing
Cancer is one of the leading causes of death in China. The study aimed to examine the temporal trend of cancer mortality rate during 1989-2008 in urban and rural areas of China. The mortality data of all cancers from 1989 to 2008 from National Cancer Registry database were sorted and checked. Age standardized mortality rates were calculated by the direct methods using the China population of 1982 and World Segi's population. Joinpoint regression was performed to obtain the annual percentage changes (APC) in mortality rates. The top ten cancer sites were calculated and analyzed. The mortality rates were compared with statistics of the United States. From 1989 to 2008, the trend of crude cancer mortality increased with an annual percentage change (APC) of 1.0%. After age standardization, the mortality rate was significantly decreased, with an APC of -1.2%. In urban areas, lung cancer was the most common cancer of death, whereas in rural areas, stomach cancer and esophageal cancer remained top cancers of death. Especially, in both urban and rural areas, the mortality of lung cancer was on increase. The mortality rates of stomach and esophageal cancers showed a decrease in urban areas. Compared with the cancer mortality rates of the United States, the Chinese cancer mortality rate in males remained highest. The decreasing trend of cancer mortality in females of China was less obvious than that of the United States. The crude mortality rates of cancer in China show an increase whereas the age standardized mortality raters has declined between 1989 and 2008. Cancer is still a major public health issue threatening people's life in China. Effective intervention for cancer control and prevention is needed in the future.
Selvin, S.; Sacks, S.T.; Merrill, D.W.
Because age is a significant variable in the occurrence and frequency of human disease, any comparison of disease or mortality rates, to be useful, must be age-specific or age-adjusted. Age-specific comparisons are not always appropriate or possible, however. A common method of eliminating the influence of age in comparing mortality rates from one community to another is to employ statistical methods of age-adjustment. While a variety of methods will accomplish this task, most are weighted averages of the age-specific rates. Two widely used adjustment procedures are direct and indirect age-adjustment.
Selvin, S; Sacks, S T; Merrill, D W
Because age is a significant variable in the occurrence and frequency of human disease, any comparison of disease or mortality rates, to be useful, must be age-specific or age-adjusted. Age-specific comparisons are not always appropriate or possible, however. A common method of eliminating the influence of age in comparing mortality rates from one community to another is to employ statistical methods of age-adjustment. While a variety of methods will accomplish this task, most are weighted averages of the age-specific rates. Two widely used adjustment procedures are direct and indirect age-adjustment.
Zheng, Rongshou; Zhang, Siwei; Zhao, Ping; Zeng, Hongmei; Zou, Xiaonong
Purpose To estimate the cancer incidences and mortalities in China in 2010. Methods On basis of the evaluation procedures and data quality criteria described in the National Central Cancer Registry (NCCR), data from 219 cancer registries were evaluated. Data from 145 registries were identified as qualified and then accepted for the 2010 cancer registry report. The incidences and mortalities of major cancers and the overall incidence and mortality were stratified by residency (urban or rural), areas (eastern, middle, and western), gender, and age. The cancer cases and deaths were estimated based on age-specific rate and national population in 2010. The China 2010 Population Census data and Segi’s world population data were used for calculating the age-standardized cancer incidence/mortality rates. Results Data were obtained from a total of 145 cancer registries (63 in urban areas and 82 in rural areas) covering 158,403,248 people (92,433,739 in urban areas and 65,969,509 in rural areas). The percentage of morphologically verified cases (MV%) were 67.11%; 2.99% of incident cases were identified through proportion of death certification only (DCO%), with the mortality to incidence ratio of (M/I) 0.61. The estimates of new cancer cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The crude incidence was 235.23/105 (268.65/105 in males and 200.21/105 in females), the age-standardized rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 184.58/105 and 181.49/105, and the cumulative incidence rate (0-74 age years old) was 21.11%. The cancer incidence and ASR China were 256.41/105 and 187.53/105 in urban areas and 213.71/105 and 181.10/105 in rural areas. The crude cancer mortality in China was 148.81/105 (186.37/105 in males and 109.42/105 in females), the age-standardized mortalities by Chinese standard population and by world standard population were 113.92/105 and 112.86/105, and the cumulative
Berrospi, F; Ruiz, E; Morante, C; Celis, J; Montalbelti, J A
Determination of the postoperative morbidity and mortality after gastroenterostomy in patients with unresectable gastric cancer. Retrospective review of clinical records of all patients with obstructive distal gastric cancer who underwent gastroenterostomy at the Instituto de Enfermedades Neoplásicas between 1980 and 1993. The following factors were analyzed: age, sex, hemoglobin, albumin, preoperative risk, ascites, extent of disease, operative time, hospital stay, morbidity and mortality. 198 gastroenterostomy were done with a morbidity and mortality rates of 20% and 10%, respectively. Pneumonia was the principal cause of postoperative morbidity and mortality. High operative risk, adjacent organ invasion by the tumor and peritoneal metastasis were factors associated with increased postoperative morbidity (p > 0.05). High operative risk was the only prognostic factor for postoperative mortality (p < 0.01). Because of high postoperative morbidity and mortality, gastroenterostomy should not be done in patients with unresectable gastric cancer and high preoperative risk.
Lin, Hualiang; Ning, Bofu; Li, Jihua; Zhao, Guangqiang; Huang, Yunchao; Tian, Linwei
Although a number of studies have examined the etiology of lung cancer in Xuanwei County, China, other types of cancer in this county have not been reported systematically. This study aimed to investigate the temporal trend of eight major cancers in Xuanwei County using data from three mortality surveys (1973-1975, 1990-1992, and 2004-2005). The Chinese population in 1990 was used as a standard population to calculate agestandardized mortality rates. Cancers of lung, liver, breast, brain, esophagus, leukemia, rectum, and stomach were identified as the leading cancers in this county in terms of mortality rate. During the three time periods, lung cancer remained as the most common type of cancer. The mortality rates for all other types of cancer were lower than those of the national average, but an increasing trend was observed for all the cancers, particularly from 1990-1992 to 2004-2005. The temporal trend could be partly explained by changes in risk factors, but it also may be due to the improvement in cancer diagnosis and screening. Further epidemiological studies are warranted to systematically examine the underlying reasons for the temporal trend of the major cancers in Xuanwei County.
... Rates by U.S. State Cancer Rates by Race/Ethnicity and Sex Cancer Trends by Race/Ethnicity and Sex Incidence Trends Among Men Mortality Trends ... cases) and death rates by sex, racial and ethnic group, age group, U.S. Census region, state, county-level ...
Landman, Gijs W.D.; Kleefstra, Nanne; van Hateren, Kornelis J.J.; Groenier, Klaas H.; Gans, Rijk O.B.; Bilo, Henk J.G.
OBJECTIVE Several studies have suggested an association between specific diabetes treatment and cancer mortality. We studied the association between metformin use and cancer mortality in a prospectively followed cohort. RESEARCH DESIGN AND METHODS In 1998 and 1999, 1,353 patients with type 2 diabetes were enrolled in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study in the Netherlands. Vital status was assessed in January 2009. Cancer mortality rate was evaluated using standardized mortality ratios (SMRs), and the association between metformin use and cancer mortality was evaluated with a Cox proportional hazards model, taking possible confounders into account. RESULTS Median follow-up time was 9.6 years, average age at baseline was 68 years, and average A1C was 7.5%. Of the patients, 570 died, of which 122 died of malignancies. The SMR for cancer mortality was 1.47 (95% CI 1.22–1.76). In patients taking metformin compared with patients not taking metformin at baseline, the adjusted hazard ratio (HR) for cancer mortality was 0.43 (95% CI 0.23–0.80), and the HR with every increase of 1 g of metformin was 0.58 (95% CI 0.36–0.93). CONCLUSIONS In general, patients with type 2 diabetes are at increased risk for cancer mortality. In our group, metformin use was associated with lower cancer mortality compared with nonuse of metformin. Although the design cannot provide a conclusion about causality, our results suggest a protective effect of metformin on cancer mortality. PMID:19918015
Zhang, Shao-Kai; Zheng, Rongshou; Chen, Qiong; Zhang, Siwei
Objective To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods Data from 177 population-based cancer registries distributed in 28 provinces were accepted for this study after evaluation based on quality control criteria, covering a total of 175,310,169 populations and accounting for 13.01% of the overall national population in 2011. Incidence and mortality rates were calculated by area, gender and age groups. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. The Chinese population in 2000 and World Segi’s population were used for age-standardized rates. Results The estimate of new cases diagnosed with oral cancer was 39,450 including 26,160 males and 13,290 females. The overall crude incidence rate for oral cancer was 2.93/100,000. The age-standardized rates by China (ASRCN) population and by World population (ASRwld) were 2.22/100,000 and 2.17/100,000, respectively. Among subjects aged 0-74 years, the cumulative incidence rate was 0.25%. The estimated number of oral cancer deaths of China in 2011 was 16,933, including 11,794 males and 5,139 females. The overall crude mortality rate was 1.26/100,000, accounting for 0.80% of all cancer deaths. The ASRCN and ASRwld for mortality were 0.90/100,000 and 0.89/100,000, respectively. Among subjects aged 0-74 years, the cumulative mortality rate was 0.10%. The incidence and mortality rates of oral cancer were much higher in males and urban areas than in females and rural areas. In addition, the incidence and mortality rates were increased by the raising of ages. Conclusions Results in the study may have important roles for oral cancer prevention and research. Although oral cancer burden of China is not high, we must pay attention to this malignancy as well. In addition, further researches need to be done for
Chrisman, Juliana de Rezende; Koifman, Sérgio; de Novaes Sarcinelli, Paula; Moreira, Josino Costa; Koifman, Rosalina Jorge; Meyer, Armando
In Brazil, where the use of pesticide grows rapidly, studies that evaluate the impact of pesticide exposure on cancer incidence and mortality are very scarce. In this study, we evaluated the degree of correlation between pesticide sales in 1985 in eleven Brazilian states and cancer mortality rates during 1996-1998. Information of all cancer deaths occurred in men 30-69 years old from 1996 to 1998 were collected from National Mortality System. Single and multiple linear regression coefficients were obtained to assess the relationship between per capita sales of pesticides in 1985, specific-site cancer mortality rates (prostate, soft tissue, larynx, leukemia, lip, esophagus, lung, pancreas, bladder, liver, testis, stomach, brain, non-Hodgkin's lymphoma, and multiple myeloma) during 1996-1998, and several covariates. In addition, states were stratified into three groups according to tertiles of pesticides sales and cancer mortality rate ratios (MRR) were then calculated using first tertile as reference. Finally, a factor analysis was performed to reveal unapparent relationships between pesticide use and cancer mortality. Pesticide sales showed statistically significant correlation with the mortality rates for the cancers of prostate (r=0.69; p=0.019), soft tissue (r=0.71; p=0.015), leukemia (r=0.68; p=0.021), lip (r=0.73; p=0.010), esophagus (r=0.61; p=0.046), and pancreas (r=0.63; p=0.040). Moderate to weak correlations were observed for the cancers of larynx, lung, testis, bladder, liver, stomach, brain, and NHL and multiple myeloma. In addition, correlation between pesticide sales and specific-site cancer mortality rates was reinforced by multiple regression analysis. For all specific-sites, cancer mortality rates were significantly higher in the states of moderate (2nd tertile) and high (3rd tertile) pesticide sales, with MRR ranging from 1.11 to 5.61. Exploring hidden relationships between pesticide sales and cancer mortality in Brazil, through a factor analysis
Zhang, S W; Zheng, R S; Zuo, T T; Zeng, H M; Chen, W Q; He, J
To estimate the nationwide mortality of esophageal cancer in China in 2012, to investigate the trends of the disease, and to provide support data for esophageal cancer prevention and control in China. Data of population-based cancer registry of China were extracted by sex and geographical area. Joinpoint software was used to analyze the trends of esophageal cancer from 2000 to 2011 using the continuous data of 22 cancer registries. Average annual percentage change rates (AAPC) were calculated, and 17 cancer registries data during 2003-2005 were analyzed. In 2012, there were estimated 210.9 thousand new cases of esophageal cancer death in China, with 149 thousand in males and 61.9 thousand in females, accounting for 9.65% of overall cancer death. The crude mortality rate of esophageal cancer in 2012 was 15.58 per 100 000, accounting for the fourth-leading cause of overall cancer deaths. The age-standardized mortality rates by world population and China population were 10.67 per 100 000 and 10.62 per 100 000, respectively. The cumulative mortality rate for age 0-74 was 1.28%. The age-specific mortality rates were increasing with age, and there was a sharp increase after 50 years of age. From 2000 to 2011, there was a slight decreasing trend for crude mortality rate, with the AAPC of -1.1% (95% CI: -1.8% to -0.5%). However, the age standardized mortality rates were decreasing significantly with the AAPC of -4.6% (95% CI: -5.7% to -3.6%). The AAPCs for age-standardized esophageal cancer mortality were -3.8% in urban areas and -2.4% in rural areas. For combined 5-year age standardized relative survival was 20.9% (95%CI: 20.2% to 21.7%) and the 1-, 3- and 5-year observed survival rates were 54.0%, 25.5%, 18.4%, respectively. There is still a heavy burden of esophageal cancer in China. Prevention and early diagnosis of the disease in esophageal cancer high-risk areas is very essential.
Landman, G W D; Ubink-Veltmaat, L J; Kleefstra, N; Kollen, B J; Bilo, H J G
It is unclear whether there is a relationship between type two diabetes and cancer mortality. It also is unclear whether obesity and body mass index (BMI) are associated with cancer in type 2 diabetes patients. In 1998, 1,145 patients with type two diabetes mellitus were enrolled in the Zwolle Outpatient Diabetes project Intergrating Available Care (ZODIAC) study. In this project, general practitioners (GPs) were assisted by hospital-based diabetes specialist nurses. Vital status was assessed in September 2004. The cancer mortality rate was evaluated using standardized mortality ratio (SMR) and its association with BMI (kg/m2) and obesity (>30 kg/m2) with the Cox proportional hazard ratio. The median follow-up time was 5.8 years. A total of 335 patients had died, of whom 70 died from malignancy. The SMR for cancer mortality was 1.38 (95% CI 1.07-1.75). BMI and obesity were not associated with cancer death. An increased cancer mortality rate was found in type two diabetes mellitus patients but there was no significant association between BMI or obesity and cancer mortality.
Hashim, Dana; Manczuk, Marta; Holcombe, Randall; Lucchini, Roberto; Boffetta, Paolo
The East Harlem (EH), Central Harlem (CH), and Upper East Side (UES) neighborhoods of New York City are geographically contiguous to tertiary medical care, but are characterized by cancer mortality rate disparities. This ecological study aims to disentangle the effects of race and neighborhood on cancer deaths. Mortality-to-incidence ratios were determined using neighborhood-specific data from the New York State Cancer Registry and Vital Records Office (2007-2011). Ecological data on modifiable cancer risk factors from the New York City Community Health Survey (2002-2006) were stratified by sex, age group, race/ethnicity, and neighborhood and modeled against stratified mortality rates to disentangle race/ethnicity and neighborhood using logistic regression. Significant gaps in mortality rates were observed between the UES and both CH and EH across all cancers, favoring UES. Mortality-to-incidence ratios of both CH and EH were similarly elevated in the range of 0.41-0.44 compared with UES (0.26-0.30). After covariate and multivariable adjustment, black race (odds ratio=1.68; 95% confidence interval: 1.46-1.93) and EH residence (odds ratio=1.20; 95% confidence interval: 1.07-1.35) remained significant risk factors in all cancers' combined mortality. Mortality disparities remain among EH, CH, and UES neighborhoods. Both neighborhood and race are significantly associated with cancer mortality, independent of each other. Multivariable adjusted models that include Community Health Survey risk factors show that this mortality gap may be avoidable through community-based public health interventions.
Phillips, A. J.; Owchar, Margaret
A statistical analysis by sexes was made of the deaths in 1950 and 1951 in eight countries (Australia, Canada, England and Wales, France, Israel, Japan, the Netherlands and the USA) from cancer in the following sites: buccal cavity and pharynx, digestive organs and peritoneum, respiratory system, breast (female), uterus, genital organs (male) and urinary organs. Comparisons between countries were made on the basis of age-adjusted and age-specific death rates. Substantial variations were found for the specific sites of the disease: they are presented in detail in the tables and graphs. PMID:13426758
García-Pérez, Javier; Lope, Virginia; López-Abente, Gonzalo; González-Sánchez, Mario; Fernández-Navarro, Pablo
We investigated whether there might be excess ovarian cancer mortality among women residing near Spanish industries, according to different categories of industrial groups and toxic substances. An ecologic study was designed to examine ovarian cancer mortality at a municipal level (period 1997-2006). Population exposure to pollution was estimated by means of distance from town to facility. Using Poisson regression models, we assessed the relative risk of dying from ovarian cancer in zones around installations, and analyzed the effect of industrial groups and pollutant substances. Excess ovarian cancer mortality was detected in the vicinity of all sectors combined, and, principally, near refineries, fertilizers plants, glass production, paper production, food/beverage sector, waste treatment plants, pharmaceutical industry and ceramic. Insofar as substances were concerned, statistically significant associations were observed for installations releasing metals and polycyclic aromatic chemicals. These results support that residing near industries could be a risk factor for ovarian cancer mortality. Copyright © 2015 Elsevier Ltd. All rights reserved.
O’Keefe, Eileen B.; Meltzer, Jeremy P.; Bethea, Traci N.
Declining cancer incidence and mortality rates in the United States (U.S.) have continued through the first decade of the twenty-first century. Reductions in tobacco use, greater uptake of prevention measures, adoption of early detection methods, and improved treatments have resulted in improved outcomes for both men and women. However, Black Americans continue to have the higher cancer mortality rates and shorter survival times. This review discusses and compares the cancer mortality rates and mortality trends for Blacks and Whites. The complex relationship between socioeconomic status and race and its contribution to racial cancer disparities is discussed. Based on current trends and the potential and limitations of the patient protection and affordable care act with its mandate to reduce health care inequities, future trends, and challenges in cancer mortality disparities in the U.S. are explored. PMID:25932459
Predicting cancer mortality is important to estimate the needs of cancer-related services and to prevent cancer. Despite its significance, a long-term future projection of cancer mortality has not been conducted; therefore, our objective was to estimate future cancer mortality in Korea by cancer site through 2032. The specially designed Nordpred software was used to estimate cancer mortality. The cancer death data from 1983 to 2012 and the population projection data from 1983 to 2032 were obtained from the Korean National Statistics Office. Based on our analysis, age-standardized rates with the world standard population of all cancer deaths were estimated to decline from 2008-2012 to 2028-2032 (men: -39.8%, women: -33.1%). However, the crude rates are predicted to rise (men: 29.8%, women: 24.4%), and the overall number of the cancer deaths is also estimated to increase (men: 35.5%, women: 32.3%). Several cancer deaths are projected to increase (lung, liver and gallbladder, colon and rectum, pancreas and leukemia in both sexes; prostate cancer in men; and breast and ovarian cancer in women), whereas other cancer deaths are expected to decrease (stomach, esophagus and larynx in both sexes and cervical cancer in women). The largest contribution to increasing cancer deaths is due to the aging of the Korean population. In conclusion, a strategy for primary prevention, early detection, and early treatment to cope with the rapidly increasing death of cancer due to population aging is urgently required. PMID:27247498
Antunes, J L F; Toporcov, T N; de Andrade, F P
This study aims at documenting differentials in the cancer mortality profile of European countries during the recent process of intense geo-political transformations. The World Health Organization Regional Office for Europe provided information on cancer mortality and several covariates for each country. In contrast with the European Union and Nordic countries, Central and Eastern Europe presented higher current levels and increasing trend of cancer mortality. Age-standardized rates for overall cancer mortality increased at an annual average of 2.43% in Central and Eastern European countries during the period from 1980 to 2001, while the European Union, Nordic countries and Switzerland underwent an average decrease of 7.27% per year. Trends in cancer death rates were associated with indices of welfare and socio-economic status at the country level: gross national product, health expenditure, unemployment, food intake, smoking habits and air pollution. Concurrent with this observation, we registered an extended gap in standings for these figures between richer and poorer European countries. These observations suggest that part of cancer mortality in Central and Eastern Europe could be prevented with current technology and health promotion. The drop of rates in Nordic and Western European countries indicates a progress in cancer control that, regrettably, does not hold for the whole Continent.
Smittenaar, C R; Petersen, K A; Stewart, K; Moitt, N
Background: Cancer incidence and mortality projections are important for understanding the evolving landscape for cancer risk factors as well as anticipating future burden on the health service. Methods: We used an age–period–cohort model with natural cubic splines to estimate cancer cases and deaths from 2015 to 2035 based on 1979–2014 UK data. This was converted to rates using ONS population projections. Modified data sets were generated for breast and prostate cancers. Results: Cancer incidence rates are projected to decrease by 0.03% in males and increase by 0.11% in females yearly between 2015 and 2035; thyroid, liver, oral and kidney cancer are among the fastest accelerating cancers. 243 690 female and 270 261 male cancer cases are projected for 2035. Breast and prostate cancers are projected to be the most common cancers among females and males, respectively in 2035. Most cancers' mortality rate is decreasing; there are notable increases for liver, oral and anal cancer. For 2035, there are 95 961 female deaths projected and 116 585 male deaths projected. Conclusions: These findings stress the need to continue efforts to address cancer risk factors. Furthermore, the increased burden of the number of cancer cases and deaths as a result of the growing and ageing population should be taken into consideration by healthcare planners. PMID:27727232
Sorahan, T; Waterhouse, J A; McKiernan, M J; Aston, R H
The cancer mortality experienced by a cohort of 1807 workers from a semiconductor factory during the period 1970-82 has been investigated (as has cancer morbidity for 1970-81). Expectations for mortality were calculated on the basis of rates of mortality for the general population of England and Wales. Expectations for cancer incidence were calculated on the basis of incidence rates for the West Midland Region. For the total study cohort, observed numbers of deaths and incident cases for all cancers were close to expectation. For melanoma incidence, an observed of 3 cases was compared with an expectation of 0.68. PMID:4016006
Zheng, Yinan; Joyce, Brian T; Colicino, Elena; Liu, Lei; Zhang, Wei; Dai, Qi; Shrubsole, Martha J; Kibbe, Warren A; Gao, Tao; Zhang, Zhou; Jafari, Nadereh; Vokonas, Pantel; Schwartz, Joel; Baccarelli, Andrea A; Hou, Lifang
Biological measures of aging are important for understanding the health of an aging population, with epigenetics particularly promising. Previous studies found that tumor tissue is epigenetically older than its donors are chronologically. We examined whether blood Δage (the discrepancy between epigenetic and chronological ages) can predict cancer incidence or mortality, thus assessing its potential as a cancer biomarker. In a prospective cohort, Δage and its rate of change over time were calculated in 834 blood leukocyte samples collected from 442 participants free of cancer at blood draw. About 3-5 years before cancer onset or death, Δage was associated with cancer risks in a dose-responsive manner (P = 0.02) and a one-year increase in Δage was associated with cancer incidence (HR: 1.06, 95% CI: 1.02-1.10) and mortality (HR: 1.17, 95% CI: 1.07-1.28). Participants with smaller Δage and decelerated epigenetic aging over time had the lowest risks of cancer incidence (P = 0.003) and mortality (P = 0.02). Δage was associated with cancer incidence in a 'J-shaped' manner for subjects examined pre-2003, and with cancer mortality in a time-varying manner. We conclude that blood epigenetic age may mirror epigenetic abnormalities related to cancer development, potentially serving as a minimally invasive biomarker for cancer early detection.
Sun, Yuelian; Vedsted, Peter; Fenger-Grøn, Morten; Wu, Chun Sen; Bech, Bodil Hammer; Olsen, Jørn; Benros, Michael Eriksen; Vestergaard, Mogens
Depression is common after a cancer diagnosis and is associated with an increased mortality, but it is unclear whether depression occurring before the cancer diagnosis affects cancer mortality. We aimed to study cancer mortality of people treated with antidepressants before cancer diagnosis. We conducted a population based cohort study of all adults diagnosed with cancer between January 2003 and December 2010 in Denmark (N = 201,662). We obtained information on cancer from the Danish Cancer Registry, on the day of death from the Danish Civil Registry, and on redeemed antidepressants from the Danish National Prescription Registry. Current users of antidepressants were defined as those who redeemed the latest prescription of antidepressant 0-4 months before cancer diagnosis (irrespective of earlier prescriptions), and former users as those who redeemed the latest prescription five or more months before cancer diagnosis. We estimated an all-cause one-year mortality rate ratio (MRR) and a conditional five-year MRR for patients who survived the first year after cancer diagnosis and confidence interval (CI) using a Cox proportional hazards regression model. Overall, 33,111 (16.4%) patients redeemed at least one antidepressant prescription in the three years before cancer diagnosis of whom 21,851 (10.8%) were current users at the time of cancer diagnosis. Current antidepressant users had a 32% higher one-year mortality (MRR = 1.32, 95% CI: 1.29-1.35) and a 22% higher conditional five-year mortality (MRR = 1.22, 95% CI: 1.17-1.26) if patients survived the first year after the cancer diagnosis than patients not redeeming antidepressants. The one-year mortality was particularly high for patients who initiated antidepressant treatment within four months before cancer diagnosis (MRR = 1.54, 95% CI: 1.47-1.61). Former users had no increased cancer mortality. Initiation of antidepressive treatment prior to cancer diagnosis is common and is associated with an increased mortality.
Pearce, Alison; Bradley, Cathy; Hanly, Paul; O'Neill, Ciaran; Thomas, Audrey Alforque; Molcho, Michal; Sharp, Linda
When individuals stop working due to cancer this represents a loss to society - the loss of productivity. The aim of this analysis was to estimate productivity losses associated with premature mortality from all adult cancers and from the 20 highest mortality adult cancers in Ireland in 2011, and project these losses until 2030. An incidence-based method was used to estimate the cost of cancer deaths between 2011 and 2030 using the Human Capital Approach. National data were used for cancer, population and economic inputs. Both paid work and unpaid household activities were included. Sensitivity analyses estimated the impact of assumptions around future cancer mortality rates, retirement ages, value of unpaid work, wage growth and discounting. The 233,000 projected deaths from all invasive cancers in Ireland between 2011 and 2030 will result in lost productivity valued at €73 billion; €13 billion in paid work and €60 billion in household activities. These losses represent approximately 1.4 % of Ireland's GDP annually. The most costly cancers are lung (€14.4 billion), colorectal and breast cancer (€8.3 billion each). However, when viewed as productivity losses per cancer death, testis (€364,000 per death), cervix (€155,000 per death) and brain cancer (€136,000 per death) are most costly because they affect working age individuals. An annual 1 % reduction in mortality reduces productivity losses due to all invasive cancers by €8.5 billion over 20 years. Society incurs substantial losses in productivity as a result of cancer-related mortality, particularly when household production is included. These estimates provide valuable evidence to inform resource allocation decisions in cancer prevention and control.
de Souza Giusti, Angela Carolina Brandão; de Oliveira Salvador, Pétala Tuani Candido; dos Santos, Juliano; Meira, Karina Cardoso; Camacho, Amanda Rodrigues; Guimarães, Raphael Mendonça; Souza, Dyego L B
AIM: To analyze the effect of age-period and birth cohort on gastric cancer mortality, in Brazil and across its five geographic regions, by sex, in the population over 20 years of age, as well as make projections for the period 2010-2029. METHODS: An ecological study is presented herein, which distributed gastric cancer-related deaths in Brazil and its geographic regions. The effects of age-period and birth cohort were calculated by the Poisson regression model and projections were made with the age-period-cohort model in the statistical program R. RESULTS: Progressive reduction of mortality rates was observed in the 1980’s, and then higher and lower mortality rates were verified in the 2000’s, for both sexes, in Brazil and for the South, Southeast and Midwest regions. A progressive decrease in mortality rates was observed for the Northeast (both sexes) and North (men only) regions within the period 1995-1999, followed by rising rates. CONCLUSION: Regional differences were demonstrated in the mortality rates for gastric cancer in Brazil, and the least developed regions of the country will present increases in projected mortality rates. PMID:27605887
de Souza Giusti, Angela Carolina Brandão; de Oliveira Salvador, Pétala Tuani Candido; Dos Santos, Juliano; Meira, Karina Cardoso; Camacho, Amanda Rodrigues; Guimarães, Raphael Mendonça; Souza, Dyego L B
To analyze the effect of age-period and birth cohort on gastric cancer mortality, in Brazil and across its five geographic regions, by sex, in the population over 20 years of age, as well as make projections for the period 2010-2029. An ecological study is presented herein, which distributed gastric cancer-related deaths in Brazil and its geographic regions. The effects of age-period and birth cohort were calculated by the Poisson regression model and projections were made with the age-period-cohort model in the statistical program R. Progressive reduction of mortality rates was observed in the 1980's, and then higher and lower mortality rates were verified in the 2000's, for both sexes, in Brazil and for the South, Southeast and Midwest regions. A progressive decrease in mortality rates was observed for the Northeast (both sexes) and North (men only) regions within the period 1995-1999, followed by rising rates. Regional differences were demonstrated in the mortality rates for gastric cancer in Brazil, and the least developed regions of the country will present increases in projected mortality rates.
Wellmann, J; Weiland, S K; Neiteler, G; Klein, G; Straif, K
Background Few studies have investigated cancer risks in carbon black workers and the findings were inconclusive. Methods The current study explores the mortality of a cohort of 1535 male German blue‐collar workers employed at a carbon black manufacturing plant for at least one year between 1960 and 1998. Vital status and causes of death were assessed for the period 1976–98. Occupational histories and information on smoking were abstracted from company records. Standardised mortality ratios (SMR) and Poisson regression models were calculated. Results The SMRs for all cause mortality (observed deaths (obs) 332, SMR 120, 95% CI 108 to 134), and mortality from lung cancer (obs 50, SMR 218, 95% CI 161 to 287) were increased using national rates as reference. Comparisons to regional rates from the federal state gave SMRs of 120 (95% CI 107 to 133) and 183 (95% CI 136 to 241), respectively. However, there was no apparent dose response relationship between lung cancer mortality and several indicators of occupational exposure, including years of employment and carbon black exposure. Conclusions The mortality from lung cancer among German carbon black workers was increased. The high lung cancer SMR can not fully be explained by selection, smoking, or other occupational risk factors, but the results also provide little evidence for an effect of carbon black exposure. PMID:16497850
D'Este, Catherine; Attia, John R; Brown, Anthony M; Gibson, Richard; Gibberd, Robert; Tavener, Meredith; Guest, Maya; Horsley, Keith; Harrex, Warren; Ross, James
A cancer incidence and mortality study was conducted in response to health concerns raised by workers from F-111 aircraft deseal/reseal fuel tank maintenance programs, to determine whether personnel exposed to deseal/reseal had an excess of cancers and mortality. Number of deaths and cancers for individuals involved in F-111 DSRS activities were matched against two Air Force comparison groups. Analyses were weighted to adjust for differences in age, exposure period and rank. Eight hundred seventy-three exposed, 7,577 comparison group one, and 9,408 comparison group two individuals were matched against death and cancer data, with 431 cancers and 431 deaths. Cancer incidence was higher in the exposed group, with marginally significant increases of 40-50% (cancer incidence rate ratio range 1.45-1.62). Exposed group mortality was significantly lower than both comparison groups, likely due to survivor bias in the exposed group (mortality rate ratio range 0.33-0.44). On the balance of probabilities, there is an increased risk of cancer associated with participation in F-111 deseal/reseal activities. 2007 Wiley-Liss, Inc
Spinelli, J.J.; Band, P.R.; Svirchev, L.M.; Gallagher, R.P. )
An historical cohort study was conducted among 4,213 men who worked for 5 or more years at a Soderberg aluminum reduction plant in British Columbia (BC), Canada. Standardized mortality and incidence ratios were used to compare the mortality and cancer incidence of the cohort with that of the BC population and to examine risk by cumulative exposure to coal-tar pitch volatiles (CTPV) and electromagnetic fields. Significantly elevated rates were observed for bladder cancer incidence (standardized incidence ratio (SIR) = 1.69) and brain cancer mortality (standardized mortality ratio = 2.17). The risk of bladder cancer was strongly related to cumulative exposure to CTPV (P less than .01). The risk for non-Hodgkin's lymphoma also increased with increasing exposure (P less than .05), although the overall rate was similar to that of the general population (SIR = 1.06). The lung cancer rate was as expected (SIR = 0.97), but showed a weak association with CTPV exposure that was not statistically significant. No individual cause of death or incident cancer site was related to exposure to electromagnetic fields. Analysis of the joint effect of smoking and CTPV exposure on lung and bladder cancer showed the exposure response relationships to be independent of smoking.
Spallek, Jacob; Arnold, Melina; Razum, Oliver; Juel, Knud; Rey, Grégoire; Deboosere, Patrick; Mackenbach, Johan Pieter; Kunst, Anton Eduard
The aim of this study on cancer mortality among Turkish immigrants, for the first time, traditional comparisons in migrant health research have been extended simultaneously in two ways. First, comparisons were made to cancer mortality from the immigrants' country of origin and second, cancer mortality among Turkish immigrants across four host countries (Belgium, Denmark, France and the Netherlands) was compared. Population-based cancer mortality data from these countries were included. Age-standardized mortality rates were computed for the local-born and Turkish population of each country. Relative differences in cancer mortality were examined by fitting country-specific Poisson regression models. Globocan data on cancer mortality in Turkey from 2008 were used in order to compare mortality rates of Turkish immigrants with those from their country of origin. Turkish immigrants had lower all-cancer mortality than the local-born populations of their host countries, and mortality levels comparable to all-cancer mortality rates in Turkey. In the Netherlands and France breast cancer mortality was consistently lower in Turkish immigrants women than among local-born women. Lung cancer mortality was slightly lower in Turkish immigrants in the Netherlands and France but varied considerably between migrants in these two host countries. Stomach cancer mortality was significantly higher in Turkish immigrants when compared to local-born French and Dutch. Our findings indicate that exposures both in the country of origin and in the host country can have an effect on the cancer mortality of immigrants. Despite limitations affecting any cross-country comparison of mortality, the innovative multi-comparison approach is a promising way to gain further insights into determinants of trends in cancer mortality of immigrants.
The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.
The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.
Perez-Lopez, Faustino R; Pasupuleti, Vinay; Gianuzzi, Ximena; Palma-Ardiles, Gabriela; Hernandez-Fernandez, Wendy; Hernandez, Adrian V
Obesity, insulin resistance and type 2 diabetes mellitus (T2DM) have been associated with endometrial cancer (EC). In this systematic review and meta-analysis we evaluated the effect of metformin on clinical outcomes in patients with EC and insulin resistance or T2DM. Four research databases were searched for original articles published in all languages up to 30 October 2016. Outcomes of interest were overall mortality (OM), cancer-specific mortality, disease progression, and metastases. We performed a random effect meta-analysis of adjusted effects expressed as hazard ratios (HR); heterogeneity among studies was described with the I(2) statistic. Of the 290 retrieved citations, 6 retrospective cohort studies in women with EC (n=4723) met the inclusion criteria, and 8.9% to 23.8% were treated with metformin; OM data was available from 5 studies. In 4 studies of EC patients (n=4132), metformin use was associated with a significant reduction in OM in comparison with not using metformin (adjusted HR [aHR] 0.64, 95% CI 0.45-0.89, p=0.009). In three studies evaluating patients with EC and T2DM (n=2637), metformin use was associated with a significant reduction in OM (aHR 0.50, 95%CI 0.34-0.74, p=0.0006). There was low to moderate heterogeneity of adjusted effects across studies. There was no information about the effect of metformin on cancer-specific mortality, disease progression, or metastases. Metformin treatment is associated with a significant reduction in OM irrespective of diabetes status in patients with EC. The survival benefit suggests that diabetes screening and maintenance of good glycemic control may improve outcomes in EC. Copyright © 2017 Elsevier B.V. All rights reserved.
Yang, C Y; Hsieh, Y L
Many investigators have examined urbanization gradients in cancer rates. The purpose of this report was to identify urban-rural trends in cancer mortality rates (1982-1991) for municipalities in Taiwan. For this purpose, Taiwan's municipalities were classified as rural, suburban, urban, or metropolitan, using population density as an ordinal indicator of the degree of urbanization. Average annual age-adjusted, site-specific cancer mortality rates were calculated for both sexes within each population density group. Significant increasing trends with more urbanization were observed in mortality rates for cancers of the lung, pancreas, and kidney among both males and females, as well as male prostate cancer, and female breast and ovary cancer. In addition, this study revealed a significant rural excess for nonmelanoma skin cancer among both males and females, as well as male non-Hodgkin's lymphoma, and cancers of the female bone, and female connective tissue. Analytic studies for sites with consistent urban-rural trends may be fruitful in identifying the aspect of population density, or other unmeasured factors, that contribute to these trends.
Razzaghi, Hilda; Quesnel-Crooks, Sarah; Sherman, Recinda; Joseph, Rachael; Kohler, Betsy; Andall-Brereton, Glennis; Ivey, Marsha A; Edwards, Brenda K; Mery, Les; Gawryszewski, Vilma; Saraiya, Mona
Cancer is one of the leading causes of deaths worldwide (1); in 2012, an estimated 65% of all cancer deaths occurred in the less developed regions of the world (2). In the Caribbean region, cancer is the second leading cause of mortality, with an estimated 87,430 cancer-related deaths reported in 2012 (3). The Pan American Health Organization defines the Caribbean region as a group of 27 countries that vary in size, geography, resources, and surveillance systems.* CDC calculated site- and sex-specific proportions of cancer deaths and age-standardized mortality rates (ASMR) for 21 English- and Dutch-speaking Caribbean countries, the United States, and two U.S. territories (Puerto Rico and the U.S. Virgin Islands [USVI]), using the most recent 5 years of mortality data available from each jurisdiction during 2003-2013. The selection of years varied by availability of the data from the countries and territories in 2015. ASMR for all cancers combined ranged from 46.1 to 139.3 per 100,000. Among males, prostate cancers were the leading cause of cancer deaths, followed by lung cancers; the percentage of cancer deaths attributable to prostate cancer ranged from 18.4% in Suriname to 47.4% in Dominica, and the percentage of cancer deaths attributable to lung cancer ranged from 5.6% in Barbados to 24.4% in Bermuda. Among females, breast cancer was the most common cause of cancer deaths, ranging from 14.0% of cancer deaths in Belize to 29.7% in the Cayman Islands, followed by cervical cancer. Several of the leading causes of cancer deaths in the Caribbean can be reduced through primary and secondary preventions, including prevention of exposure to risk factors, screening, early detection, and timely and effective treatment.
Asulin, Y; McCann, T J; McCarty, C W; Hage, R W; Rooney, P J; Macpherson, C N L
This paper summarizes and discusses the available cancer incidence (1996-2000) and mortality data (1990-2000) for the tri-island Caribbean nation of Grenada, Carriacou and Petit Martinique. Data for the analysis came from three sources: the Grenada Department of Statistics, the histopathology specimen books from St George's General Hospital and the Death Registry of the Ministry of Health, Grenada. The age-standardized rates (ASR) per 100 000 for all cancer sites combined were 170.2 in females and 158.2 in males. The four most frequent diagnoses (ASR) by cancer site in females were cervix (60.7), breast (49.1), uterus (28.4) and skin (13.3); and among males, prostate (61.4), bladder (16.3), skin (19.3) and stomach (10). Age-standardized mortality rates per 100 000 for all cancer sites combined were 105.4 in females and 165 in males. The four most frequent cancer associated mortalities (ASR) in females were breast (17.9), uterus (11.2), colon (10.3) and cervix (9.7); and among males, prostate (53.6), lung (18.7), stomach (14.5) and colon (10.9). This study found statistically significant spatial trends for overall cancer mortality and temporal trends in incidence and mortality rates for prostate and for incidence rates of stomach cancer. These rates are compared with those from other areas in the Caribbean and the United States of America and encourage efforts to establish a cancer registry in Grenada.
Guérin, Sylvie; Richard, Gaël; Biau, Alain; Lebre, Sophie; Crescini, Danièle; Haddy, Nadia; Guldner, Laurence; Paoletti, Catherine; Hill, Catherine; de Vathaire, Florent
Nuclear workers from French contracting companies have received higher doses than workers from Electricité de France (EDF) or Commissariat à l'Energie Atomique (CEA). A cohort study of 9,815 workers in 11 contracting companies, monitored for exposure to ionizing radiation between 1967 and 2000 were followed up for a median duration of 12.5 years. Standardized mortality ratios (SMRs) were computed. Between 1968 and 2002, 250 deaths occurred. Our study demonstrated a clear healthy worker effect (HWE) with mortality attaining half that expected from national mortality statistics (SMR = 0.54, 95% CI = [0.47-0.61]). The HWE was lower for all cancers (SMR = 0.65) than for non-cancer deaths (SMR = 0.46). The analysis by cancer site showed no excess compared with the general population. Significant trends were observed according to the level of exposure to ionizing radiation for deaths from cancer, deaths from digestive cancer and deaths from respiratory cancer. The mortality of nuclear workers from contracting companies is very low compared to French national mortality. Copyright 2009 Wiley-Liss, Inc.
Bouchardy, Christine; Fioretta, Gerald; Rapiti, Elisabetta; Verkooijen, Helena Maria; Rapin, Charles Henry; Schmidlin, France; Miralbell, Raymond; Zanetti, Roberto
Prostate specific antigen (PSA) screening was introduced to detect prostate cancer at an early stage and to reduce prostate cancer-specific mortality. Until results from clinical trials are available, the efficacy of PSA screening in reducing prostate cancer mortality can be estimated by surveillance of prostate cancer mortality trends. Our study analyzes recent trends in prostate cancer mortality in 38 countries. We used the IARC-WHO cancer mortality database and performed joinpoint analysis to examine prostate cancer mortality trends and identified 3 patterns. In USA, and to a lesser extent in Germany, Switzerland, Canada, France, Italy and Spain, prostate cancer-specific mortality decreased to a level lower than before the introduction of PSA screening. In Australia, New Zealand, Austria, Finland, The Netherlands, Norway, United Kingdom, Hungary, Slovakia, Israel, Singapore, Sweden and Portugal, mortality from prostate cancer decreased but rates remain higher than before the introduction of PSA screening. Prostate cancer mortality continued to increase in Belgium, Denmark, Greece, Ireland, Bulgaria, Czech Republic, Belarus, Ukraine, Russian Federation, Romania, Poland, Argentina, Chile, Cuba, Mexico, Japan, China Hong Kong and the Republic of Korea. The trends in prostate cancer mortality rates in examined countries suggest that PSA screening may be effective in reducing mortality from prostate cancer. (c) 2008 Wiley-Liss, Inc.
Schreinemachers, D M
Chlorophenoxy herbicides are used both in cereal grain agriculture and in nonagricultural settings such as right-of-ways, lawns, and parks. Minnesota, North Dakota, South Dakota, and Montana grow most of the spring and durum wheat produced in the United States. More than 90% of spring and durum wheat is treated with chlorophenoxy herbicides, in contrast to treatment of approximately 30% of winter wheat. In this ecologic study I used wheat acreage as a surrogate for exposure to chlorophenoxy herbicides. I investigated the association of chlorophenoxy herbicides with cancer mortality during 1980-1989 for selected counties based on level of agriculture ([greater and equal to] 20%) and rural population ([greater and equal to] 50%). Age-standardized cancer mortality rates were determined for grouped counties based on tertiles of wheat acreage per county or for individual counties for frequently occurring cancers. The cancer sites that showed positive trends of increasing cancer mortality with increasing wheat acreage were esophagus, stomach, rectum, pancreas, larynx, prostate, kidney and ureter, brain, thyroid, bone, and all cancers (men) and oral cavity and tongue, esophagus, stomach, liver and gall bladder and bile ducts, pancreas, cervix, ovary, bladder, and other urinary organs, and all cancers (women). Rare cancers in men and women and cancers in boys and girls were studied by comparing counties above and below the median of wheat acreage per county. There was increased mortality for cancer of the nose and eye in both men and women, brain and leukemia in both boys and girls, and all cancers in boys. These results suggest an association between cancer mortality and wheat acreage in counties of these four states. PMID:11017893
Sims, Mario; Sims, Tammy L; Bruce, Marino A
This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.
Sims, Mario; Sims, Tammy L.; Bruce, Marino A.
This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity. PMID:17444423
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Mangano, J J
Oak Ridge, Tennessee, is the site of one of the two oldest nuclear facilities in the United States. Although precise records have not been maintained, low levels of radioactive products have been released into the environment since the facility began operation in World War II. Changes in age-adjusted cancer mortality rates for whites between the periods 1950-1952 and 1987-1989 were analyzed to assess whether these radioactive releases have had any adverse effects on the population living near Oak Ridge. Results indicate that the increases in the local area (under 100 miles from Oak Ridge) exceeded regional increases and far exceeded national increases. Within the region, increases were greatest in rural areas, in Anderson County (where Oak Ridge is located), in mountainous counties, and in the region downwind of Oak Ridge. Each of these findings suggest that low levels of radiation, ingested gradually by local residents, were a factor in the increases in local cancer death rates. Results indicate that more studies of this type are called for and that cessation of all future radioactive emissions from nuclear facilities should be considered.
Riera, Paula; Martínez, Benjamín
Most oral cancers are squamous cell carcinomas (90%) which are two to four times more common in men than in women. The reasons for these differences are associated with exposure to factors such as tobacco and alcohol. Age is also considered as a risk factor (about 90% of the cases are diagnosed after 45 years of age). To analyze the frequency of oral cavity cancer during the last years in Chile. Mortality rates were obtained from death records of the "Instituto Nacional de Estadísticas" and publications of the World Health Organization, from 1955 to 2002. Morbidity from 1969 to 2002 was obtained from hospital discharge records of the Chilean Ministry of Health. Oral cancer corresponded to 1.6% of total cancer cases in Chile, with a male:female ratio of 2.3 to 1. Deaths due to oral cancer was 1% of all cancer deaths, with a male:female ratio of 2.8 to 1. The morbidity rate for both genders increased while the mortality rate was relatively constant. However, we observed an increase in the mortality rate among women from 1980 to 2002, associated with more than 100% increase in the frequency of smoking, between 1970 and 1998. The most common anatomical location was the tongue. The incidences of oral cancer is increasing in Chilean women, but men are more commonly affected.
The purpose of this study was to investigate the possible relationships between aqueous metals and cancer mortality in the upper Colorado River Basin in the State of Colorado for the period 1970-1980. All death certificates for the State of Colorado for the study period were examined for cause of death, and a magnetic tape containing abstracts of certificates for all cancer mortality was produced by the Vital Statistics Division of the Colorado Department of Health. Decedents were grouped by county, sex, and type of cancer and all records for cancers of the digestive organs, genital organs, and urinary organs were categorized by county and sex. Standardized cause- and sex-specific mortality ratios were calculated for each year for each of the fourteen counties in the Colorado Basin and were used as the dependent variables in subsequent analyses. Aqueous metals data were obtained from the Environmental Protection Agency master data base for the area and period and were factor analyzed to establish objective groups of metals which were present in the waters of the Basin. Metals included in the study were As, Be, Cd, Cu, Cr, Fe, Pb, Mn, Hg, Ni, Se, and Zn. The correlation matrix was factor analyzed and five common factors were extracted by promax rotation. The set of Mn, Zn, Cu, Fe, and Pb was found to relate to cancer mortality in each sex. Further independent analyses for each sex. Further independent analyses for each sex indicated that Mn was most directly related to cancer mortality for both sexes, and that Zn was most inversely related to cancer mortality for both sexes.
Whittemore, A.S.; McMillan, A.
This report examines lung cancer mortality among a cohort of white underground uranium miners in the Colorado plateau and is based on mortality follow-up through December 31, 1977. The analytic methods represent a miner's annual age-specific lung cancer mortality rate as the (unspecified) rate among nonsmoking men born at the same time and with no mining history, multiplied by the relative risk factor R. This factor depends on the miner's total exposures to radon daughters (in working level months (WLM) and to cigarettes (in packs), accumulated from start of exposure until 10 years before his current age. Among those examined, the relative risk function giving the highest likelihood of the data was R . (1 + 0.31 X 10(-/sup 2/) WLM)(1 + 0.51 X 10(-/sup 3/) packs). This multiplicative function specifies that ratios of mortality rates for miners versus nonminers with similar age and smoking characteristics do not depend on smoking status. By contrast, differences between miners' and nonminers' mortality rates are substantially higher for smokers than for nonsmokers. The data rejected (P . .01) several additive functions for R that specify relative risk as a sum of components due to radiation and to cigarette smoking. Cumulative exposures to both radiation and cigarettes gave better fits to the data than did average annual exposure rates. Age at start of underground mining had no effect on risk, after controlling for age at lung cancer death, year of birth, and cumulative radiation and smoking exposures.
Lopez-Abente, G; Hernandez-Barrera, V; Pollan, M; Aragones, N; Perez-Gomez, B
Background: Pleural cancer is a recognised indicator of exposure to asbestos and mesothelioma mortality. Aims: To investigate the distribution of municipal mortality due to this tumour, using the autoregressive spatial model proposed by Besag, York, and Molliè. Methods: It was possible to compile and ascertain the posterior distribution of relative risk on the basis of a single Bayesian spatial model covering all of Spain's 8077 municipal areas. Maps were plotted depicting standardised mortality ratios, smoothed relative risk (RR) estimates, and the distribution of the posterior probability that RR >1. Results: There was a higher risk of death due to pleural cancer in well defined towns and areas, many of which correspond to municipalities where asbestos using industries once existed for many years, the prime example being the municipal pattern registered for Barcelona Province. The quality of mortality data, the suitability of the model used, and the usefulness of municipal atlases for environmental surveillance are discussed. PMID:15723885
Park, Robert M; Stayner, Leslie T; Petersen, Martin R; Finley-Couch, Melissa; Hornung, Richard; Rice, Carol
Objectives Prior investigations identified an association between airborne cadmium and lung cancer but questions remain regarding confounding by arsenic, a well-established lung carcinogen. Methods A cadmium smelter population exhibiting excess lung cancer was re-analysed using a retrospective exposure assessment for arsenic (As), updated mortality (1940–2002), a revised cadmium (Cd) exposure matrix and improved work history information. Results Cumulative exposure metrics for both cadmium and arsenic were strongly associated making estimation of their independent effects difficult. Standardised mortality ratios (SMRs) were modelled with Poisson regression with the contribution of arsenic to lung cancer risk constrained by exposure–response estimates previously reported. The results demonstrate (1) a statistically significant effect of Cd independent of As (SMR=3.2 for 10 mg-year/m3 Cd, p=0.012), (2) a substantial healthy worker effect for lung cancer (for unexposed workers, SMR=0.69) and (3) a large deficit in lung cancer mortality among Hispanic workers (SMR=0.27, p=0.009), known to have low lung cancer rates. A supralinear dose-rate effect was observed (contribution to risk with increasing exposure intensity has declining positive slope). Lung cancer mortality was somewhat better predicted using a cadmium burden metric with a half-life of about 20–25 years. Conclusions These findings support an independent effect for cadmium in risk of lung cancer mortality. 1/1000 excess lifetime risk of lung cancer death is predicted from an airborne exposure of about 2.4 μg/m3 Cd. PMID:22271639
Acquavella, J F; Riordan, S G; Anne, M; Lynch, C F; Collins, J J; Ireland, B K; Heydens, W F
Alachlor is the active ingredient in a family of preemergence herbicides. We assessed mortality rates from 1968 to 1993 and cancer incidence rates from 1969 to 1993 for manufacturing workers with potential alachlor exposure. For workers judged to have high alachlor exposure, mortality from all causes combined was lower than expected [23 observed, standardized mortality ratio (SMR) = 0.7, 95% CI, 0.4-1.0], cancer mortality was similar to expected (6 observed, SMR = 0.7, 95% CI, 0.3-1.6), and there were no cancer deaths among workers with 5 or more years high exposure and 15 or more years since first exposure (2.3 expected, SMR = 0, 95% CI, 0-1.6). Cancer incidence for workers with high exposure potential was similar to the state rate [18 observed, standardized incidence ratio (SIR) = 1.2, 95% CI, 0.7-2.0], especially for workers exposed for 5 or more years and with at least 15 years since first exposure (4 observed, SIR = 1.0, 95% CI, 0.3-2.7). The most common cancer for these latter workers was colorectal cancer (2 observed, SIR 3.9, 95% CI, 0.5-14.2 among workers). Despite the limitations of this study with respect to small size and exposure estimating, the findings are useful for evaluating potential alachlor-related health risks because past manufacturing exposures greatly exceeded those characteristic of agricultural operations. These findings suggest no appreciable effect of alachlor exposure on worker mortality or cancer incidence rates during the study period. PMID:8841758
Sharpe, C M
A recent article by Joseph Mangano concluded that changes in cancer mortality near Oak Ridge (Anderson County) in Tennessee over a 40-year period (1950-1989) suggest an increase in cancer deaths linked to radiation contamination. These conclusions are not supported by available, representative data. In his analysis, Mangano selected for comparison two three-year periods (1950-1952 and 1987-1989) that are not representative of the entire 40 years. An analysis by decade of the 42-year period from 1950 to 1991, using U.S. mortality rates from the National Center for Health Statistics and Tennessee mortality rates from the NCHS and the Tennessee Health Department, shows that the relation between expected and actual cancer deaths for the white population of Anderson County does not differ from that for the State of Tennessee. In addition, changes in methods of reporting death statistics during the 40-year period invalidate any attempt to compare current cause-specific mortality data (such as cancer deaths) with data from the 1950s. Relevant comparisons that can be made for the period 1970-1991 again show that cancer deaths for whites in Anderson County have been statistically equivalent to the expected rates.
Tovar-Guzmán, V; Hernández-Girón, C; Barquera, S; Rodríguez-Salgado, N; López-Carrillo, L
Annually, there are more than 6 million deaths from a type of malignant neoplasia worldwide. In developing countries, the highest rates of incidence of malignant neoplasias are uterine cervical cancer, stomach, lung, esophagus, pharynx, and liver cancers. Recent estimates on the incidence of cancer worldwide show that, in 1990, stomach cancer (SC) was the second most frequent type of cancer (900,000 new cases annually). Rates of incidence have decreased consistently in nearly all areas of the world. In Mexico, however, rates of incidence and mortality have increased gradually between 1980 and 1997; in 1995, 4,685 people died of SC in Mexico. This report presents a descriptive analysis of SC mortality in Mexico. A mortality database edited from the electronic files of the National Institute of Informatics, Statistics and Geography (INEGI) in Mexico was used; population denominators were edited by the Mexican National Population Council (Conapo). Adjusted mortality rates, taking as standard of reference the population of Mexico City by sex, year, and 10-year age groups were calculated as well as the sex ratio for the 1980-1997 period. To evaluate the magnitude of risks by state, the standardized mortality ratio (SMR) was calculated; prematurity was evaluated through the potential lost-life years index (PLLYI). The analysis was carried out using the Excel and Stata 5.0 software programs. During the years from 1980 to 1997, in Mexico the total number of deaths from SC was 76,315. The male:female ratio was 1.2:1.0. SMR by state showed that the states of Yucatán, Sonora, Zacatecas, Michoacán, and Chiapas had higher mortality rates. The PLLYI was higher for males in the states of Chiapas, Sonora, Chihuahua, Zacatecas, and Southern Baja California, and higher for females in Chiapas, Oaxaca, Yucatán, Puebla, and Campeche. World statistics on mortality caused by SC suggest a decreasing trend. Findings for this study show an increase in the adjusted mortality rates by SC
Thompson, Trevor D.; Soman, Ashwini; Møller, Bjorn; Leadbetter, Steven; White, Mary C.
Introduction Healthy People 2020 (HP2020) calls for a 10% to 15% reduction in death rates from 2007 to 2020 for selected cancers. Trends in death rates can be used to predict progress toward meeting HP2020 targets. Methods We used mortality data from 1975 through 2009 and population estimates and projections to predict deaths for all cancers and the top 23 cancers among men and women by race. We apportioned changes in deaths from population risk and population growth and aging. Results From 1975 to 2009, the number of cancer deaths increased among white and black Americans primarily because of an aging white population and a growing black population. Overall, age-standardized cancer death rates (risk) declined in all groups. From 2007 to 2020, rates are predicted to continue to decrease while counts of deaths are predicted to increase among men (15%) and stabilize among women (increase <10%). Declining death rates are predicted to meet HP2020 targets for cancers of the female breast, lung and bronchus, cervix and uterus, colon and rectum, oral cavity and pharynx, and prostate, but not for melanoma. Conclusion Cancer deaths among women overall are predicted to increase by less than 10%, because of, in part, declines in breast, cervical, and colorectal cancer deaths among white women. Increased efforts to promote cancer prevention and improve survival are needed to counter the impact of a growing and aging population on the cancer burden and to meet melanoma target death rates. PMID:26133647
Ñamendys-Silva, Silvio A; González-Herrera, María O; Herrera-Gómez, Angel
Outcomes of critically ill cancer patients admitted to the intensive care unit (ICU) had improved; it could be associated with medical advances in critical care, introduction of new anticancer treatments, and better supportive care. Recent reports have described ICU mortality for critically ill cancer patients ranged from 15.9% to 32%. During the period 2007 to 2011, a total of 1418 critically ill cancer patients were admitted to our ICU with a mortality rate lower (17.5%) than that reported by other centers. The ICUs around the world should consider the improvement in the prognosis of critically ill cancer patients who require critical care and they should not be denied ICU admission only on the basis of a patient having cancer.
Hendryx, Michael; Fedorko, Evan; Halverson, Joel
To conduct an assessment of rural environmental pollution sources and associated population mortality rates. The design is a secondary analysis of county-level data from the Environmental Protection Agency (EPA), Department of Agriculture, National Land Cover Dataset, Energy Information Administration, Centers for Disease Control and Prevention, the US Census, and others. We described the types of pollution sources present in metropolitan and nonmetropolitan counties and examined the associations between these sources and rates of all-cause, cardiovascular, respiratory, and cancer mortality while controlling for age, race, and other covariates. Rural counties had 65,055 EPA-monitored pollution discharge sites. As expected, rural counties had significantly greater exposure to potential agriculture-related pollution. Regression models specific to rural counties indicated that greater density of water pollution sources was significantly associated with greater total and cancer mortality. Rural air pollution sources were associated with greater cancer mortality rates. Rural coal mining areas had higher total, cancer, and respiratory disease mortality rates. Agricultural production was generally associated with lower mortality rates. Greater levels of human development were significantly related to higher adjusted total and cancer mortality. The association between pollution sources and mortality risk is not a phenomenon limited to metropolitan areas. Results carry policy implications regarding the need for effective environmental standards and monitoring. Further research is needed to better understand the types and distributions of pollution in rural areas, and the health consequences that result. © 2010 National Rural Health Association.
Fu, Zhentao; Lu, Zilong; Li, Yingmei; Zhang, Jiyu; Zhang, Gaohui; Chen, Xianxian; Chu, Jie; Ren, Jie; Liu, Haiyan
Objective Population-based cancer registration data in 2012 from all available cancer registries in Shandong province were collected by Shandong Center for Disease Control and Prevention (SDCDC). SDCDC estimated the numbers of new cancer cases and cancer deaths in Shandong province with compiled cancer incidence and mortality rates. Methods In 2015, there were 21 cancer registries submitted data of cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the National Central Cancer Registry (NCCR) criteria of data quality. Qualified data from 15 registries were used for cancer statistics analysis as provincial estimation. The pooled data were stratified by area (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+ years) and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding provincial population in 2012. The Chinese census data in 2000 and Segi’s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year. Results Qualified 15 cancer registries (4 urban and 11 rural registries) covered 17,189,988 populations (7,486,039 in urban and 9,703,949 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 66.12% and 2.93%, respectively, and the mortality to incidence rate ratio (M/I) was 0.60. A total of 253,060 new cancer cases and 157,750 cancer deaths were estimated in Shandong province in 2012. The incidence rate was 263.86/100,000 (303.29/100,000 in males, 223.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 192.42/100,000 and 189.50/100,000 with the cumulative incidence rate (0.74 years old) of 22.07%. The cancer incidence, ASIRC and ASIRW in urban areas were 267.64/100,000, 195.27/100,000 and 192.02/100,000 compared to 262.32/100,000, 191.26/100,000 and 188.48/100,000 in
Burns, Carol; Harrison, Ken; Jammer, Brenda; Zuccarini, Dores; Lafrance, Bryan
Previously, the mortality was reported in a cohort of male workers at an Ontario chemical plant. To expand the cohort and to investigate the mortality and cancer incidence risk among chemical manufacturing sites. We followed 5277 men and 1301 women from 1950 to 1999. Employees experienced lower mortality and cancer incidence rates than the general population for several major causes of death, including heart disease, respiratory cancer and many other cancers. There were no cases of angiosarcoma of the liver. We observed a lower mortality rate of prostate cancer [standardized mortality ratio = 0.79, 95% confidence interval (CI) 0.43-1.32], but a higher incidence rate of prostate cancer [standardized incidence ratio (SIR) = 1.22, 95% CI 1.00-1.48]. Among the Sarnia employees, the incidence of pleural neoplasms was increased (5 observed versus 1.48 expected, SIR = 3.37, 95% CI 1.09-7.86). These cancers were included in the 12 deaths with malignant mesothelioma at Sarnia. Consistent with the earlier report, lower mortality rates were observed for the major classifications of disease and malignant neoplasms. The higher incidence rates of prostate cancer are not readily explainable but may reflect increased screening among current employees and recent retirees. Past asbestos exposure prior to 1980 is probably a contributor to the deaths due to malignant mesothelioma but is not reflected in lung cancer mortality. We find little indication of any other increased rates of mortality or cancer within the overall workforce of these chemical plants.
Negri, E; Piolatto, G; Pira, E; Decarli, A; Kaldor, J; La Vecchia, C
An analysis of the mortality of a cohort of 6629 workers employed from 1906 to 1981 in a rubber tyre factory in northern Italy (978 deaths and over 133,000 man-years at risk) showed that the all cause mortality ratio was slightly lower than expected (0.91). Overall cancer mortality was close to expected (275 v 259.4) but there were significant excess rates for two cancer sites: pleura (9 observed v 0.8 expected, which may be due to the use of fibre containing talc) and bladder (16 observed v 8.8 expected). Death rates were not raised for other sites previously associated with employment in the rubber industry, such as cancers of the lung and brain, leukaemias, or lymphomas. The substantially reduced relative risk of pleural cancer among workers first employed after 1940 (RR = 0.05 compared with before 1940) probably reflected improvements in working conditions over more recent periods. For cancer of the bladder, the relative risk was also lower for workers first engaged after 1940. Thus no appreciable risk for any disease was apparent for workers employed over the past four decades. Analysis for each of the 27 job categories showed a substantial excess for cancer of the pleura in the mechanical maintenance workers (4 observed v 0.17 expected); an excess of cancer of the lung (21 v 13.48) was also present in this job category. PMID:2789965
Fernández-Navarro, Pablo; García-Pérez, Javier; Ramis, Rebeca; Boldo, Elena; López-Abente, Gonzalo
Mining installations are releasing toxic substances into the environment which could pose a health problem to populations in their vicinity. We sought to investigate whether there might be excess cancer-related mortality in populations residing in towns lying in the vicinity of Spanish mining industries governed by the Integrated Pollution Prevention and Control Directive, and the European Pollutant Release and Transfer Register Regulation, according to the type of extraction method used. An ecologic study was designed to examine municipal mortality due to 32 types of cancer, across the period 1997 through 2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Poisson regression models, using the Bayesian conditional autoregressive model proposed by Besag, York and Molliè and Integrated Nested Laplace Approximations for Bayesian inference, were used: to analyze risk of dying from cancer in a 5-kilometer zone around mining installations; effect of type of industrial activity; and to conduct individual analyses within a 50-kilometer radius of each installation. Excess mortality (relative risk, 95% credible interval) of colorectal cancer (1.097, 1.041-1.157), lung cancer (1.066, 1.009-1.126) specifically related with proximity to opencast coal mining, bladder cancer (1.106, 1.016-1.203) and leukemia (1.093, 1.003-1.191) related with other opencast mining installations, was detected among the overall population in the vicinity of mining installations. Other tumors also associated in the stratified analysis by type of mine, were: thyroid, gallbladder and liver cancers (underground coal installations); brain cancer (opencast coal mining); stomach cancer (coal and other opencast mining installations); and myeloma (underground mining installations). The results suggested an association between risk of dying due to digestive, respiratory, hematologic and thyroid cancers and proximity to Spanish mining
Politis, Michael; Higuera, Gladys; Chang, Lissette Raquel; Gomez, Beatriz; Bares, Juan; Motta, Jorge
Cancer is one of the leading causes of death worldwide and its incidence is expected to increase in the future. In Panama, cancer is also one of the leading causes of death. In 1964, a nationwide cancer registry was started and it was restructured and improved in 2012. The aim of this study is to utilize Joinpoint regression analysis to study the trends of the incidence and mortality of cancer in Panama in the last decade. Cancer mortality was estimated from the Panamanian National Institute of Census and Statistics Registry for the period 2001 to 2011. Cancer incidence was estimated from the Panamanian National Cancer Registry for the period 2000 to 2009. The Joinpoint Regression Analysis program, version 4.0.4, was used to calculate trends by age-adjusted incidence and mortality rates for selected cancers. Overall, the trend of age-adjusted cancer mortality in Panama has declined over the last 10 years (-1.12% per year). The cancers for which there was a significant increase in the trend of mortality were female breast cancer and ovarian cancer; while the highest increases in incidence were shown for breast cancer, liver cancer, and prostate cancer. Significant decrease in the trend of mortality was evidenced for the following: prostate cancer, lung and bronchus cancer, and cervical cancer; with respect to incidence, only oral and pharynx cancer in both sexes had a significant decrease. Some cancers showed no significant trends in incidence or mortality. This study reveals contrasting trends in cancer incidence and mortality in Panama in the last decade. Although Panama is considered an upper middle income nation, this study demonstrates that some cancer mortality trends, like the ones seen in cervical and lung cancer, behave similarly to the ones seen in high income countries. In contrast, other types, like breast cancer, follow a pattern seen in countries undergoing a transition to a developed economy with its associated lifestyle, nutrition, and body weight
Politis, Michael; Higuera, Gladys; Chang, Lissette Raquel; Gomez, Beatriz; Bares, Juan; Motta, Jorge
Abstract Cancer is one of the leading causes of death worldwide and its incidence is expected to increase in the future. In Panama, cancer is also one of the leading causes of death. In 1964, a nationwide cancer registry was started and it was restructured and improved in 2012. The aim of this study is to utilize Joinpoint regression analysis to study the trends of the incidence and mortality of cancer in Panama in the last decade. Cancer mortality was estimated from the Panamanian National Institute of Census and Statistics Registry for the period 2001 to 2011. Cancer incidence was estimated from the Panamanian National Cancer Registry for the period 2000 to 2009. The Joinpoint Regression Analysis program, version 4.0.4, was used to calculate trends by age-adjusted incidence and mortality rates for selected cancers. Overall, the trend of age-adjusted cancer mortality in Panama has declined over the last 10 years (−1.12% per year). The cancers for which there was a significant increase in the trend of mortality were female breast cancer and ovarian cancer; while the highest increases in incidence were shown for breast cancer, liver cancer, and prostate cancer. Significant decrease in the trend of mortality was evidenced for the following: prostate cancer, lung and bronchus cancer, and cervical cancer; with respect to incidence, only oral and pharynx cancer in both sexes had a significant decrease. Some cancers showed no significant trends in incidence or mortality. This study reveals contrasting trends in cancer incidence and mortality in Panama in the last decade. Although Panama is considered an upper middle income nation, this study demonstrates that some cancer mortality trends, like the ones seen in cervical and lung cancer, behave similarly to the ones seen in high income countries. In contrast, other types, like breast cancer, follow a pattern seen in countries undergoing a transition to a developed economy with its associated lifestyle, nutrition, and
de Vries, Esther; Arroyave, Ivan; Pardo, Constanza; Wiesner, Carolina; Murillo, Raul; Forman, David; Burdorf, Alex; Avendaño, Mauricio
Background There is paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and a rapid expansion of health insurance coverage. Methods Population mortality data (1998–2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25–64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the Slope Index of Inequality in cancer mortality. Results We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (RR primary versus tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities, and RR=1.98 for females, contributing 14% to total cancer inequalities), and lung (RR=1.64 for males contributing 17% of total cancer inequalities, and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. Conclusion There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reducing cervical cancer through reducing HPV infection, early detection and improved access to treatment of preneoplasic lesions. Reinforcing anti-tobacco measures may be particularly important to curb inequalities in cancer mortality. PMID:25492898
Körblein, Alfred; Hoffmann, Wolfgang
The authors investigated a possible association between background gamma radiation (BGR) and cancer and infant mortality rates. In an in-country ecological study, they performed a population-weighted linear regression of cancer (infant) mortality rates on BGR, adjusted for unemployment rate and population density. Crude cancer rates showed a highly significant increase with BGR: 38 excess cases per 100,000 person-years per millisievert/year (p < .0001). After adjusting for unemployment rate and population density, the authors found that the excess absolute risk reduced to 23.6 cases per 100,000 person-years per mSv/year (p = .0014). The corresponding excess relative risk was 10.2% (95% confidence interval = 3.9-16.7) per mSv/year. The excess relative risk for infant mortality rates was 24% (95% confidence interval = 9-42) per mSv/year. The cancer risk derived from this ecological study is 0.24/Sv, which compares with an International Commission on Radiological Protection value of 0.05/Sv. However, because they are based on highly aggregated data, the results should be interpreted with caution.
Fryzek, J P; Mumma, M T; McLaughlin, J K; Henderson, B E; Blot, W J
From the 1950s to the 1980s, hexavalent chromium compounds were used as additives at certain water-cooling towers at three southern California gas compressor facilities. Claims of potential residential chromium exposure prompted the examination of age-adjusted mortality rates during 1989 to 1998 for lung cancer, all cancer, and all deaths for neighborhoods near versus distant from the plants. Differences in the rates between areas tended to be small and not statistically significant. The only significant difference was a lower, rather than higher, rate of total cancer among women in the potentially exposed areas. Study limitations preclude a definitive assessment of risk, but similar to previous investigations of cancer in relation to environmental chromium exposure in other locations, this study found no evidence of a cancer hazard among residents living near these California gas compressor facilities.
Hennis, Anselm J. M.; Hambleton, Ian R.; Wu, Suh-Yuh; Skeete, Desiree H.-A.; Nemesure, Barbara; Leske, M. Cristina
We describe prostate cancer incidence and mortality in Barbados, West Indies. We ascertained all histologically confirmed cases of prostate cancer during the period July 2002 to December 2008 and reviewed each death registration citing prostate cancer over a 14-year period commencing January 1995. There were 1101 new cases for an incidence rate of 160.4 (95% Confidence Interval: 151.0–170.2) per 100,000 standardized to the US population. Comparable rates in African-American and White American men were 248.2 (95% CI: 246.0–250.5) and 158.0 (95% CI: 157.5–158.6) per 100,000, respectively. Prostate cancer mortality rates in Barbados ranged from 63.2 to 101.6 per 100,000, compared to 51.1 to 78.8 per 100,000 among African Americans. Prostate cancer risks are lower in Caribbean-origin populations than previously believed, while mortality rates appeared to be higher than reported in African-American men. Studies in Caribbean populations may assist understanding of disparities among African-origin populations with shared heredity. PMID:22110989
Peel, J. Brent; Sui, Xuemei; Adams, Swann A.; Hébert, James R.; Hardin, James W.; Blair, Steven N.
Purpose Physical activity may protect against breast cancer. Few prospective studies have evaluated breast cancer mortality in relation to cardiorespiratory fitness, an objective marker of physiologic response to physical activity habits. Methods We examined the association between cardiorespiratory fitness and risk of death from breast cancer in the Aerobics Center Longitudinal Study. Women (N=14,811), aged 20 to 83 years with no prior breast cancer history, received a preventive medical examination at the Cooper Clinic in Dallas, TX, between 1970 and 2001. Mortality surveillance was completed through December 31, 2003. Cardiorespiratory fitness was quantified as maximal treadmill exercise test duration and was categorized for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). At baseline, all participants were able to complete the exercise test to at least 85% of their age-predicted maximal heart rate. Results A total of 68 breast cancer deaths occurred during follow-up (mean=16 years). Age-adjusted breast cancer mortality rates per 10,000 woman-years were 4.4, 3.2, and 1.8 for low, moderate, and high cardiorespiratory fitness groups, respectively (trend P = 0.008). After further controlling for body mass index, smoking, drinking, chronic conditions, abnormal exercise electrocardiogram responses, family history of breast cancer, oral contraceptive use, and estrogen use, hazard ratios (95% CI) for breast cancer mortality across incremental cardiorespiratory fitness categories were 1.00 (referent), 0.67 (0.35–1.26), 0.45 (0.22–0.95); trend P = 0.04. Conclusions These results indicate that cardiorespiratory fitness is associated with a reduced risk of dying from breast cancer in women. PMID:19276861
Bradshaw, Patrick T.; Stevens, June; Khankari, Nikhil; Teitelbaum, Susan L.; Neugut, Alfred I.; Gammon, Marilie D.
Background Cardiovascular disease (CVD) is of increasing concern among breast cancer survivors. However the burden of this comorbidity in this group relative to the general population, and its temporal pattern, remains unknown. Methods We compared deaths due to CVD in a population-based sample of 1,413 women with incident breast cancer diagnosed in 1996-1997, and 1,411 age-matched women without breast cancer. Date and cause of death through December 31, 2009 were assessed through the National Death Index and covariate data was gathered through structured interviews and medical record abstraction. Hazard ratios and 95% confidence intervals (CI) were calculated using Cox regression for overall mortality (HR) and CVD-specific death (cause-specific HR). Subdistribution hazard ratios (sHR) for CVD death were estimated from the Fine-Gray model. Results Risk of death was greater among breast cancer survivors compared to women without breast cancer [HR: 1.8 (1.5, 2.1)]. An increase in CVD-related death among breast cancer survivors was evident only 7 years after diagnosis [years 0-7, cause-specific HR: 0.80 (0.53, 1.2), subdistribution HR: 0.59 (0.40, 0.87)]; years 7+, cause-specific HR: 1.8 (1.3, 2.5), subdistribution HR: 1.9 (1.4, 2.7); p-interaction: 0.001]. An increase in CVD-related mortality was observed among breast cancer survivors receiving chemotherapy. Conclusions Breast cancer survivors are at greater risk for CVD-related mortality compared to women without breast cancer and this increase in risk is manifest approximately 7 years after diagnosis. Efforts should be made to identify risk factors and interventions that can be employed during this brief window to reduce the excess burden of CVD in this vulnerable population. PMID:26414938
... HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by State Language: English Español (Spanish) ... incidence data are currently available. Rates of Getting Lung Cancer by State The number of people who ...
Stokes, C. Shannon; Brace, Kathy D.
A study of 1,497 nonmetropolitan counties was conducted to test the possible contribution of agricultural chemical use to cancer mortality rates in rural counties. The dependent variables were 20-year age-adjusted mortality rates for 1950 to 1969 for five categories of cancer: genital, urinary, lymphatic, respiratory, and digestive. Because sex…
Brantley-Sieders, Dana M.; Fan, Kang-Hsien; Deming-Halverson, Sandra L.; Shyr, Yu; Cook, Rebecca S.
Despite available demographic data on the factors that contribute to breast cancer mortality in large population datasets, local patterns are often overlooked. Such local information could provide a valuable metric by which regional community health resources can be allocated to reduce breast cancer mortality. We used national and statewide datasets to assess geographical distribution of breast cancer mortality rates and known risk factors influencing breast cancer mortality in middle Tennessee. Each county in middle Tennessee, and each ZIP code within metropolitan Davidson County, was scored for risk factor prevalence and assigned quartile scores that were used as a metric to identify geographic areas of need. While breast cancer mortality often correlated with age and incidence, geographic areas were identified in which breast cancer mortality rates did not correlate with age and incidence, but correlated with additional risk factors, such as mammography screening and socioeconomic status. Geographical variability in specific risk factors was evident, demonstrating the utility of this approach to identify local areas of risk. This method revealed local patterns in breast cancer mortality that might otherwise be overlooked in a more broadly based analysis. Our data suggest that understanding the geographic distribution of breast cancer mortality, and the distribution of risk factors that contribute to breast cancer mortality, will not only identify communities with the greatest need of support, but will identify the types of resources that would provide the most benefit to reduce breast cancer mortality in the community. PMID:23028869
Zhang, S W; Yang, Z X; Zheng, R S; Zeng, H M; Chen, W Q; He, J
Objective: To estimate the incidence and mortality of stomach cancer in China based on the cancer registration data in 2013, collected by the National Central Cancer Registry (NCCR). Methods: There were 347 cancer registries that submitted stomach cancer incidence and deaths occurred in 2013 to NCCR. After evaluating the data quality, 255 registries' data were accepted for analysis and stratified by areas (urban/rural), sex, and age group. Combined with data on national population in 2013, the nationwide incidence and mortality of stomach cancer were estimated. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Results: Qualified 255 cancer registries covered a total of 226 494 490 populations (111 595 772 in urban and 114 898 718 in rural areas). The percentage of cases morphologically verified and death certificate-only cases were 76.27% and 1.98%, respectively, and the mortality to incidence rate ratio was 0.72. It is estimated that there were 427 000 new cases for stomach cancer nationwide, with a crude incidence rate of 31.38 per 100 000 (42.85 per 100 000 in males, 19.33 per 100 000 in females). The age-standardized incidence rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 21.40 per 100 000 and 21.32 per 100 000, respectively, with a cumulative incidence rate (0-74 age years old) of 2.66%. The crude and ASR China incidence rates of stomach cancer in urban areas were 27.80 per 100 000 and 18.48 per 100 000, respectively, whereas those were 35.54 per 100 000 and 24.93 per 100 000 in rural areas. It is estimated that there were 301 000 deaths for stomach cancer nationwide, with a crude mortality rate of 22.13 per 100 000 (29.85 per 100 000 in males, 14.03 per 100 000 in females). The ASR China and ASR world mortality rates were 14.68 per 100 000 and 14.54 per 100 000, respectively, with a cumulative mortality rate (0-74 years old) of 1.70%. The crude
Cayuela, A; Cayuela, L; Ruiz-Romero, M V; Rodríguez-Domínguez, S; Lendínez-Cano, G; Bachiller-Burgos, J
To describe the evolution of prostate cancer mortality in Spain during the period 1980-2013. The prostate cancer mortality data and population data needed to calculate the indicators were provided by the National Institute of Statistics. We calculated the specific rates by age group, raw and standardised globally using the direct method (European standard population). The rates are expressed for 100,000 person-years. For the analysis of trends in the rates, we used joinpoint regression models. The overall rates adjusted for age in Spain decreased from 21.7 to 15.4 deaths per 100,000 men-years between the starting and ending date of the study period (annual percentage change: -.9%; P<.05). The joinpoint analysis reflects 2 periods: 1980-1998 (.7% annual increase; P<.05) and 1998-2013, during which the rates decreased significantly (-3%; P<.05). Except for the autonomous cities of Ceuta and Melilla where the rates remained stable over the course of the study period, the communities showed 1 or 2 points of inflection in the trends, and all had a final period with a reduction in the rates (except for Galicia and Catalonia, where the rates stabilised in 2008-2013). The decline in prostate cancer mortality in Spain appears to have stopped in Galicia and Catalonia. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Byers, Tim; Wender, Richard C; Jemal, Ahmedin; Baskies, Arnold M; Ward, Elizabeth E; Brawley, Otis W
In 1996, the Board of Directors of the American Cancer Society (ACS) challenged the United States to reduce what looked to be possible peak cancer mortality in 1990 by 50% by the year 2015. This analysis examines the trends in cancer mortality across this 25-year challenge period from 1990 to 2015. In 2015, cancer death rates were 26% lower than in 1990 (32% lower among men and 22% lower among women). The 50% reduction goal was more fully met for the cancer sites for which there was enactment of effective approaches for prevention, early detection, and/or treatment. Among men, mortality rates dropped for lung cancer by 45%, for colorectal cancer by 47%, and for prostate cancer by 53%. Among women, mortality rates dropped for lung cancer by 8%, for colorectal cancer by 44%, and for breast cancer by 39%. Declines in the death rates of all other cancer sites were substantially smaller (13% among men and 17% among women). The major factors that accounted for these favorable trends were progress in tobacco control and improvements in early detection and treatment. As we embark on new national cancer goals, this recent past experience should teach us that curing the cancer problem will require 2 sets of actions: making new discoveries in cancer therapeutics and more completely applying those discoveries in cancer prevention we have already made. CA Cancer J Clin 2016;66:359-369. © 2016 American Cancer Society. © 2016 American Cancer Society.
Preston, D.L.; Kato, H.; Kopecky, K.; Fujita, S.
This study extends an earlier one by 4 years (1979-1982) and includes mortality data on 11,393 additional Nagasaki survivors. Significant dose responses are observed for leukemia, multiple myeloma, and cancers of the lung, female breast, stomach, colon, esophagus, and urinary tract. Due to diagnostic difficulties, results for liver and ovarian cancers, while suggestive of significant dose responses, do not provide convincing evidence for radiogenic effects. No significant dose responses are seen for cancers of the gallbladder, prostate, rectum, pancreas, or uterus, or for lymphoma. For solid tumors, largely due to sex-specific differences in the background rates, the relative risk of radiation-induced mortality is greater for women than for men. For nonleukemic cancers the relative risk seen in those who were young when exposed has decreased with time, while the smaller risks for those who were older at exposure have tended to increase. While the absolute excess risks of radiation-induced mortality due to nonleukemic cancer have increased with time for all age-at-exposure groups, both excess and relative risks of leukemia have generally decreased with time. For leukemia, the rate of decrease in risk and the initial level of risk are inversely related to age at exposure.
This paper analyzes the data on leukemia and solid cancers of all types among 28,000 people exposed due to discharges of radioactive waste into the Techa River in the South Urals. Cancer mortality rates for the 33-y period since the beginning of the exposure have been estimated. In addition, the paper discusses malignancy cases among the first generation offspring of the exposed people. In comparison with matched control groups, an increased incidence of malignant neoplasms was observed among the exposed population. The leukemia risk, estimated on the basis of the linear model of absolute risk, was 0.85 per 10,000 person-y Gy of the dose accumulated in red bone marrow. Solid cancer risk (except osteosarcoma), estimated using linear model of relative risk, was 0.65 per Gy of dose accumulated in soft tissues. No increase in cancer mortality has been documented for the offspring of the exposed individuals. 10 refs., 4 figs., 4 tabs.
Jung, Kyu-Won; Won, Young-Joo; Oh, Chang-Mo; Kong, Hyun-Joo; Lee, Duk Hyoung; Lee, Kang Hyun
Purpose This study presents the 2014 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality. Materials and Methods Cancer incidence data from 1999 to 2014 was obtained from the Korea National Cancer Incidence Database and followed until December 31, 2015. Mortality data from 1983 to 2014 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2015, among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, prevalence, and 5-year relative survivals were also calculated. Results In 2014, 217,057 and 76,611 Koreans were newly diagnosed and died from cancer respectively. The ASRs for cancer incidence and mortality in 2014 were 270.7 and 85.1 per 100,000, respectively. The all-cancer incidence rate has increased significantly by 3.4% annually from 1999 to 2012, and started to decrease after 2012 (2012-2014; annual percent change, –6.6%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2010 and 2014 was 70.3%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995. Conclusion Age-standardized cancer incidence rates have decreased since 2012 and mortality rates have also declined since 2002, while 5-year survival rates have improved remarkably from 1993-1995 to 2010-2014 in Korea. PMID:28279062
Herrera Riquelme, Cristian A; Kuhn-Barrientos, Lucy; Rosso Astorga, Roberto; Jiménez de la Jara, Jorge
Characterize the trends in mortality from cancer in Chile according to differences in educational level in the period 2000-2010 in the population over 20 years of age. Calculation of specific mortality from cancer, age-adjusted for different educational levels, for the period 2000-2010. The obtained rates were analyzed using a Poisson regression model, calculating the relative inequality index and the slope index of inequality for each year. 232 541 deaths from cancer were reported in the period 2000-2010. The most frequent types were breast, stomach, and gallbladder cancer in women; and stomach, prostate, and lung cancer in men. Age-standardized mortality from cancer was greater in the lower educational levels, except for breast cancer in woman and lung cancer in men. The greatest differences were found in gallbladder cancer in women and stomach cancer in men, with specific mortality rates up to 49 and 63 times higher, respectively, for low educational levels compared to higher ones. Between 2000 and 2010, the differences in mortality by educational level were smaller for all cancers combined in both genders, for breast cancer in women, and for lung and stomach in men. During the period studied, mortality from cancer in Chile was strongly associated with the educational level of the population. This information should be considered when designing national strategies to reduce specific mortality from cancer in the most vulnerable groups.
Máca, Jan; Jor, Ondřej; Holub, Michal; Sklienka, Peter; Burša, Filip; Burda, Michal; Janout, Vladimír; Ševčík, Pavel
ARDS is severe form of respiratory failure with significant impact on the morbidity and mortality of critical care patients. Epidemiological data are crucial for evaluating the efficacy of therapeutic interventions, designing studies, and optimizing resource distribution. The goal of this review is to present general aspects of mortality data published over the past decades. A systematic search of the MEDLINE/PubMed was performed. The articles were divided according to their methodology, type of reported mortality, and time. The main outcome was mortality. Extracted data included study duration, number of patients, and number of centers. The mortality trends and current mortality were calculated for subgroups consisting of in-hospital, ICU, 28/30-d, and 60-d mortality over 3 time periods (A, before 1995; B, 1995-2000; C, after 2000). The retrospectivity and prospectivity were also taken into account. Moreover, we present the most recent mortality rates since 2010. One hundred seventy-seven articles were included in the final analysis. General mortality rates ranged from 11 to 87% in studies including subjects with ARDS of all etiologies (mixed group). Linear regression revealed that the study design (28/30-d or 60-d) significantly influenced the mortality rate. Reported mortality rates were higher in prospective studies, such as randomized controlled trials and prospective observational studies compared with retrospective observational studies. Mortality rates exhibited a linear decrease in relation to time period (P < .001). The number of centers showed a significant negative correlation with mortality rates. The prospective observational studies did not have consistently higher mortality rates compared with randomized controlled trials. The mortality trends over 3 time periods (before 1995, 1995-2000, and after 2000) yielded variable results in general ARDS populations. However, a mortality decrease was present mostly in prospective studies. Since 2010, the
Inskip, P.D.; Monson, R.R.; Wagoner, J.K.; Stovall, M.; Davis, F.G.; Kleinerman, R.A.; Boice, J.D. Jr. )
Cancer mortality in relation to radiation dose was evaluated among 4153 women treated with intrauterine radium (226Ra) capsules for benign gynecologic bleeding disorders between 1925 and 1965. Average follow up was 26.5 years (maximum = 59.9 years). Overall, 2763 deaths were observed versus 2687 expected based on U.S. mortality rates (standardized mortality ratio (SMR) = 1.03). Deaths due to cancer, however, were increased (SMR = 1.30), especially cancers of organs close to the radiation source. For organs receiving greater than 5 Gy, excess mortality of 100 to 110% was noted for cancers of the uterus and bladder 10 or more years following irradiation, while a deficit was seen for cancer of the cervix, one of the few malignancies not previously shown to be caused by ionizing radiation. Part of the excess of uterine cancer, however, may have been due to the underlying gynecologic disorders being treated. Among cancers of organs receiving average or local doses of 1 to 4 Gy, excesses of 30 to 100% were found for leukemia and cancers of the colon and genital organs other than uterus; no excess was seen for rectal or bone cancer. Among organs typically receiving 0.1 to 0.3 Gy, a deficit was recorded for cancers of the liver, gall bladder, and bile ducts combined, death due to stomach cancer occurred at close to the expected rate, a 30% excess was noted for kidney cancer (based on eight deaths), and there was a 60% excess of pancreatic cancer among 10-year survivors, but little evidence of dose-response. Estimates of the excess relative risk per Gray were 0.006 for uterus, 0.4 for other genital organs, 0.5 for colon, 0.2 for bladder, and 1.9 for leukemia. Contrary to findings for other populations treated by pelvic irradiation, a deficit of breast cancer was not observed (SMR = 1.0). Dose to the ovaries may have been insufficient to protect against breast cancer.
Elstad, Jon Ivar; Torstensrud, Rita; Lyngstad, Torkild Hovde; Kravdal, Oystein
Knowledge about educational disparities in deaths from specific cancer sites is incomplete. Even more scant is information about time trends in educational patterns in specific cancer mortality. This study examines educational inequalities in Norway 1971-2002 for mortality in lung and larynx, colorectal, stomach, melanoma, prostate, breast and cervix uteri cancer. A data file encompassing all Norwegian inhabitants registered some time during 1971-2002 while aged 45-74 was constructed with linked information from administrative registers. During an exposure of more than 40 millions person-years, about 87,000 deaths in the analysed cancer types were registered. Absolute and relative inequalities during three periods were analysed by age-standardized deaths rates, hazard regression odds ratios and Relative Index of Inequality. Educational inequalities in lung and related cancer mortality widened considerably from the 1970s to the 1990s for both sexes. The moderate educational gradient for stomach and cervix uteri cancer persisted, as did the weak gradient for colorectal cancer. No educational differences in prostate cancer were observed in any of the time periods. The modest inverse educational gradients in deaths from breast cancer and melanoma remained at the same level. Among the seven cancer types examined in this study, only lung cancer mortality showed a clear widening in educational disparities. As lung cancer mortality constitutes a large proportion of all cancer deaths, this increase may result in larger disparities for overall cancer mortality. Some explanations for the observed patterns in cancer mortality are suggested.
Sun, Yuelian; Vedsted, Peter; Fenger-Grøn, Morten; Wu, Chun Sen; Bech, Bodil Hammer; Olsen, Jørn; Benros, Michael Eriksen; Vestergaard, Mogens
Background Depression is common after a cancer diagnosis and is associated with an increased mortality, but it is unclear whether depression occurring before the cancer diagnosis affects cancer mortality. We aimed to study cancer mortality of people treated with antidepressants before cancer diagnosis. Methods and Findings We conducted a population based cohort study of all adults diagnosed with cancer between January 2003 and December 2010 in Denmark (N = 201,662). We obtained information on cancer from the Danish Cancer Registry, on the day of death from the Danish Civil Registry, and on redeemed antidepressants from the Danish National Prescription Registry. Current users of antidepressants were defined as those who redeemed the latest prescription of antidepressant 0–4 months before cancer diagnosis (irrespective of earlier prescriptions), and former users as those who redeemed the latest prescription five or more months before cancer diagnosis. We estimated an all-cause one-year mortality rate ratio (MRR) and a conditional five-year MRR for patients who survived the first year after cancer diagnosis and confidence interval (CI) using a Cox proportional hazards regression model. Overall, 33,111 (16.4%) patients redeemed at least one antidepressant prescription in the three years before cancer diagnosis of whom 21,851 (10.8%) were current users at the time of cancer diagnosis. Current antidepressant users had a 32% higher one-year mortality (MRR = 1.32, 95% CI: 1.29–1.35) and a 22% higher conditional five-year mortality (MRR = 1.22, 95% CI: 1.17–1.26) if patients survived the first year after the cancer diagnosis than patients not redeeming antidepressants. The one-year mortality was particularly high for patients who initiated antidepressant treatment within four months before cancer diagnosis (MRR = 1.54, 95% CI: 1.47–1.61). Former users had no increased cancer mortality. Conclusions Initiation of antidepressive treatment prior to cancer diagnosis is
Smailyte, G; Kurtinaitis, J; Andersen, A
Aims: To investigate mortality and cancer incidence of cement producing workers. Methods: A total of 2498 cement workers who have been employed at Portland cement producing departments for at least one year from 1956 to 2000 were followed up from 1 January 1978 to 31 December 2000. The cohort contributed 43 490 person-years to the study. Standardised incidence ratios (SIR) and standardised mortality ratios (SMR) were calculated as ratios between observed and expected numbers of cancers and deaths. The expected numbers were based on sex specific incidence and mortality rates for the total Lithuanian population. Results: Significantly increased SMRs were found for all malignant neoplasms (SMR 1.3, 95% CI 1.0 to 1.5) and for lung cancer (SMR 1.4, 95% CI 1.0 to 1.9) among male cement workers. SIR for all cancer sites was 1.2 (95% CI 1.0 to 1.4). Excess risk was found for cancer of the lung (SIR 1.5, 95% CI 1.1 to 2.1). The SIR for urinary bladder cancer was also increased (SIR 1.8, 95% CI 0.9 to 3.5). The overall cancer incidence was not increased among females (SIR 0.8, 95% CI 0.6 to 1.1). With increasing cumulated exposure to cement dust, there were indications of an increasing risk of lung and stomach cancers among males. Conclusions: This study supported the hypothesis that exposure to cement dust may increase the lung and bladder cancer risk. A dose related risk was found for stomach cancer, but no support was found for an increased risk of colorectal cancer. PMID:15150393
Kusiak, R A; Ritchie, A C; Springer, J; Muller, J
An excess of mortality from stomach cancer has been found in Ontario gold miners (observed (obs) 104, standardised mortality ratio (SMR) 152, 95% confidence interval (95% CI) 125-185) and no excess of stomach cancer could be detected in other miners in Ontario (obs 74, SMR 102, 95% CI 80-128). The excess of stomach cancer appeared five to 19 years after the miners began gold mining in Ontario. In that interval, similar patterns of excess mortality from stomach cancer were found in miners born in north America (obs 14, SMR 268, CI 147-450) and in miners born outside north America (obs 12, SMR 280, 95% CI 145-489). Twenty or more years after the miners began mining gold, an excess of mortality from stomach cancer was found in gold miners born outside of north American (obs 41, SMR 160, 95% CI 115-218) but not in gold miners born in north America (obs 37, SMR 113, 95% CI 80-156). The excess of stomach cancer in gold miners under the age of 60 (obs 45, SMR 167, 95% CI 122-223) seems larger than the excess in gold miners between the ages of 60 and 74 (obs 59, SMR 143, 95% CI 109-184). Exposures to arsenic, chromium, mineral fibre, diesel emissions, and aluminium powder were considered as possible explanations of the excess of stomach cancer in Ontario gold miners. Exposure to diesel emissions and aluminium powder was rejected as gold miners and uranium miners were exposed to both agents but an excess of stomach cancer was noted only in gold miners. The association between the excess of stomach cancer and the time since the miner began mining gold suggested that duration of exposure to dust in gold mines ought to be weighted according to the time since the exposure to dust occurred and that an appropriate time weighting function would be one in the interval five to 19 years after each year of exposure to dust and zero otherwise. A statistically significant association between the relative risk of mortality from stomach cancer and the time weighted duration of exposure to
Malvezzi, M; Carioli, G; Bertuccio, P; Boffetta, P; Levi, F; La Vecchia, C; Negri, E
We predicted cancer mortality figures in the European Union (EU) for the year 2017 using most recent available data, with a focus on lung cancer. We retrieved cancer death certification data and population figures from the World Health Organisation and Eurostat databases. Age-standardized (world standard population) rates were computed for France, Germany, Italy, Poland, Spain, the UK and the EU overall in 1970-2012. We obtained estimates for 2017 by implementing a joinpoint regression model. The predicted number of cancer deaths for 2017 in the EU is 1 373 500, compared with 1 333 400 in 2012 (+3%). Cancer mortality rates are predicted to decline in both sexes, reaching 131.8/100 000 men (-8.2% when compared with 2012) and 84.5/100 000 women (-3.6%). Mortality rates for all selected cancer sites are predicted to decline, except pancreatic cancer in both sexes and lung cancer in women. In men, pancreatic cancer rate is stable, in women it increases by 3.5%. Lung cancer mortality rate in women is predicted to rise to 14.6/100 000 in 2017 (+5.1% since 2012, corresponding to 92 300 predicted deaths), compared with 14.0/100 000 for breast cancer, corresponding to 92 600 predicted deaths. Only younger (25-44) women have favourable lung cancer trends, and rates at this age group are predicted to be similar in women (1.4/100 000) and men (1.2/100 000). In men lung cancer rates are predicted to decline by 10.7% since 2012, and falls are observed in all age groups. European cancer mortality projections for 2017 confirm the overall downward trend in rates, with a stronger pattern in men. This is mainly due to different smoking prevalence trends in different generations of men and women. Lung cancer rates in young European women are comparable to those in men, confirming that smoking has the same impact on lung cancer in the two sexes.
Dusek, L; Muzik, J; Maluskova, D; Májek, O; Pavlík, T; Koptíková, J; Melichar, B; Büchler, T; Fínek, J; Cibula, D; Babjuk, M; Svoboda, M; Vyzula, R; Ryska, A; Ryska, M; Petera, J; Abrahámová, J
The Czech Republic ranks among the countries with the highest cancer burden in Europe as well as worldwide. The purpose of this study is to summarize longterm trends in the cancer burden and to provide up-to-date estimates of incidence and mortality rates after 2011. The Czech National Cancer Registry (CNCR) was instituted in 1977 and contains information collected over a 34-year period of standardized registration covering 100% of cancer diagnoses within the entire Czech population. The CNCR analysis is supported by demographic data and by the Death Records Database. An overview of the epidemiology of malignant tumors in the Czech population is available online at www.svod.cz. All neoplasms, including nonmelanoma skin cancer, reached a crude incidence rate of almost 802 cases per 100,000 men and 681 cases per 100,000 women in 2011. The annual mortality rate exceeded 258 deaths per 100,000 individuals; in other words, more than 27,000 individuals die of cancer each year. The overall incidence of malignancies has increased with a growth index of +27.6% during the last decade (2001- 2011), while the mortality rate has been stabilized over the time span (growth index in 2001- 2011: - 5.0%). Consequently, the prevalence has significantly increased in the observed period and exceeded 475,000 cases in 2011. In addition to demographic aging of the Czech population, the cancer burden has also increased due to the growing incidence of multiple primary tumors (recently more than 15% of the total incidence). The most frequent diagnoses include colorectal cancer, lung cancer, breast cancer, and prostate cancer. Although some neoplasms are increasingly diagnosed at an early stage (e. g. the proportion of stage I or II was 75.3% for female breast cancer and 84.2% for skin melanoma), the numbers of early diagnosed cases are generally insufficient, even in the case of highly prevalent cancers such as colorectal carcinoma (only 46.1% of incident cases are diagnosed at stage I or II
Yang, Chun-Yuh; Chiu, Hui-Fen; Chiu, Jeng-Fen
An ecologic study design was used to investigate the relationship between cancer risks and residence in communities adjacent to petrochemical industrial counties (PICs). Directly age-adjusted mortality rates for cancer during 1982-1991 among 16 counties characterized by a heavy concentration of petrochemical industries were compared to rates among 16 matched counties with similar concentration of nonpetrochemical manufacturing industries, urbanization level, and demographic characteristics. An excess rate for liver cancer among males was found in the so-called PICs. The correlation could not be explained by confounding variables such as urbanization, socioeconomic class, or employment in nonpetrochemical industries. No other increased cancer risks were found to be associated with residence near petrochemical industries. 30 refs., 3 tabs.
Arnold, Melina; Sierra, Mónica S; Laversanne, Mathieu; Soerjomataram, Isabelle; Jemal, Ahmedin; Bray, Freddie
The global burden of colorectal cancer (CRC) is expected to increase by 60% to more than 2.2 million new cases and 1.1 million deaths by 2030. In this study, we aim to describe the recent CRC incidence and mortality patterns and trends linking the findings to the prospects of reducing the burden through cancer prevention and care. Estimates of sex-specific CRC incidence and mortality rates in 2012 were extracted from the GLOBOCAN database. Temporal patterns were assessed for 37 countries using data from Cancer Incidence in Five Continents (CI5) volumes I-X and the WHO mortality database. Trends were assessed via the annual percentage change using joinpoint regression and discussed in relation to human development levels. CRC incidence and mortality rates vary up to 10-fold worldwide, with distinct gradients across human development levels, pointing towards widening disparities and an increasing burden in countries in transition. Generally, CRC incidence and mortality rates are still rising rapidly in many low-income and middle-income countries; stabilising or decreasing trends tend to be seen in highly developed countries where rates remain among the highest in the world. Patterns and trends in CRC incidence and mortality correlate with present human development levels and their incremental changes might reflect the adoption of more western lifestyles. Targeted resource-dependent interventions, including primary prevention in low-income, supplemented with early detection in high-income settings, are needed to reduce the number of patients with CRC in future decades. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Siegel, Rebecca L; Sahar, Liora; Portier, Kenneth M; Ward, Elizabeth M; Jemal, Ahmedin
Knowledge of the cancer burden is important for informing and advocating cancer prevention and control. Mortality data are readily available for states and counties, but not for congressional districts, from which representatives are elected and which may be more influential in compelling legislation and policy. The authors calculated average annual cancer death rates during 2002 to 2011 for each of the 435 congressional districts using mortality data from the National Center for Health Statistics and population estimates from the US Census Bureau. Age-standardized death rates were mapped for all sites combined and separately for cancers of the lung and bronchus, colorectum, breast, and prostate by race/ethnicity and sex. Overall cancer death rates vary by almost 2-fold and are generally lowest in Mountain states and highest in Appalachia and areas of the South. The distribution is similar for lung and colorectal cancers, with the lowest rates consistently noted in districts in Utah. However, for breast and prostate cancers, while the highest rates are again scattered throughout the South, the geographic pattern is less clear and the lowest rates are in Hawaii and southern Texas and Florida. Within-state heterogeneity is limited, particularly for men, with the exceptions of Texas, Georgia, and Florida. Patterns also vary by race/ethnicity. For example, the highest prostate cancer death rates are in the West and north central United States among non-Hispanic whites, but in the deep South among African Americans. Hispanics have the lowest rates except for colorectal cancer in Wyoming, eastern Colorado, and northern New Mexico. These data can facilitate cancer control and stimulate conversation about the relationship between cancer and policies that influence access to health care and the prevalence of behavioral and environmental risk factors.
Hara, Toshiyuki; Takahashi, Ken
The elevated risk of lung cancer among chromate-producing workers has been confirmed by many epidemiological studies. Although chromium has been most used in the chromium plating industry and many platers are employed in small-scale factories, cancer studies have been documented in only a few investigations. We have conducted several prospective cohort studies in Japanese chromium platers and recently extended them through 2003. We additionally surveyed epidemiological studies among chromium platers carried out in other parts of the world. Occupational chromium exposure through chromium plating work may be a risk factor for mortality not only from lung cancer but also malignant lymphoma and brain tumor. The age at first exposure to chromium may be a more important factor than the duration of exposure for an increased risk of lung cancer and malignant lymphoma.
Liu, Yunning; Astell-Burt, Thomas; Liu, Jiangmei; Yin, Peng; Feng, Xiaoqi; You, Jinling; Page, Andrew; Zhou, Maigeng; Wang, Lijun
We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000), with higher mortality rates evident in men compared to women. Median rate ratios (MRRs) indicated important geographical variation in lung cancer mortality between provinces (MRR = 1.622) and counties/districts (MRR = 1.447). On average, lung cancer mortality increased over time and was positively associated with county-level urbanization (relative risk (RR) = 1.15). Lung cancer mortality seemed to decrease in urban and increase in rural areas. Compared to the northwest, mortality was higher in the north (RR = 1.98), east (RR = 1.87), central (RR = 1.87), and northeast (RR = 2.44). Regional differences and county-level urbanization accounted for 49.4% and 8.7% of provincial and county variation, respectively. Reductions in lung cancer mortality in urban areas may reflect improvements in access to preventive healthcare and treatment services. Rising mortality in rural areas may reflect a clustering of risk factors associated with rapid urbanization. PMID:27999279
Rossetto, Marisa; De Leo, Giulio A; Bevacqua, Daniele; Micheli, Fiorenza
The existence of an allometric relationship between mortality rates and body mass has been theorized and extensively documented across taxa. Within species, however, the allometry between mortality rates and body mass has received substantially less attention and the consistency of such scaling patterns at the intra-specific level is controversial. We reviewed 73 experimental studies to examine the relationship between mortality rates and body size among seven species of abalone (Haliotis spp.), a marine herbivorous mollusk. Both in the field and in the laboratory, log-transformed mortality rates were negatively correlated with log-transformed individual body mass for all species considered, with allometric exponents remarkably similar among species. This regular pattern confirms previous findings that juvenile abalones suffer higher mortality rates than adult individuals. Field mortality rates were higher overall than those measured in the laboratory, and the relationship between mortality and body mass tended to be steeper in field than in laboratory conditions for all species considered. These results suggest that in the natural environment, additional mortality factors, especially linked to predation, could significantly contribute to mortality, particularly at small body sizes. On the other hand, the consistent allometry of mortality rates versus body mass in laboratory conditions suggests that other sources of mortality, beside predation, are size-dependent in abalone.
Leung, Chi C; Lam, Tai H; Yew, Wing W; Chan, Wai M; Law, Wing S; Tam, Cheuk M
Malignancy is the leading cause of death in Hong Kong, and lung cancer tops the list of all cancer deaths. A cohort of clients aged ≥65 years, enrolled at 18 elderly health centres in Hong Kong from 2000 to 2003, was followed up prospectively through linkage with the territory-wide death registry for causes of death until 31 December 2008, using the identity card number as unique identifier. All subjects with suspected cancer, significant weight loss of >5% within past 6 months or obstructive lung disease at the baseline were excluded. After a total of 423 061 person-years of follow-up, 932, 690 and 1433 deaths were caused by lung cancer, other tobacco-related malignancies and non-tobacco-related malignancies, respectively. Body mass index (BMI) was independently (and negatively) associated with death from lung cancer after adjustment for other baseline variables, whereas there was only a minor or no effect for other smoking-related malignancies and non-tobacco-related malignancies. Obesity with BMI ≥30 [adjusted hazard ratio (HR), 0.55, 95% confidence interval (CI) 0.38-0.80] was associated with reduced lung cancer mortality, which was more prominent than the opposing effect of underweight (adjusted HR, 1.38, 95% CI 1.05-1.79). Consistent effects of BMI were observed after stratification into never-smokers and ever-smokers and in sensitivity analysis after excluding deaths within the first 3 years. Obesity was associated with lower lung cancer mortality in this prospective cohort analysis. As the effect was rather specific for lung cancer, further studies are indicated to explore the underlying mechanism.
Torre, Lindsey A.; Jemal, Ahmedin
Lung cancer killed approximately 1,590,000 persons in 2012 and currently is the leading cause of cancer death worldwide. There is large variation in mortality rates across the world in both males and females. This variation follows trend of smoking, as tobacco smoking is responsible for the majority of lung cancer cases. In this article, we present estimated worldwide lung cancer mortality rates in 2012 using the World Health Organization (WHO) GLOBOCAN 2012 and changes in the rates during recent decades in select countries using WHO Mortality Database. We also show smoking prevalence and trends globally and at the regional level. By region, the highest lung cancer mortality rates (per 100,000) in 2012 were in Central and Eastern Europe (47.6) and Eastern Asia (44.8) among males and in Northern America (23.5) and Northern Europe (19.1) among females; the lowest rates were in sub-Saharan Africa in both males (4.4) and females (2.2). The highest smoking prevalence among males is generally in Eastern and South-Eastern Asia and Eastern Europe, and among females is in European countries, followed by Oceania and Northern and Southern America. Many countries, notably high-income countries, have seen a considerable decrease in smoking prevalence in both males and females, but in many other countries there has been little decrease or even an increase in smoking prevalence. Consequently, depending on whether or when smoking prevalence has started to decline, the lung cancer mortality trend is a mixture of decreasing, stable, or increasing. Despite major achievements in tobacco control, with current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. The main priority to reduce the burden of lung cancer is to implement or enforce effective tobacco control policies in order to reduce smoking prevalence in all countries and prevent an increase in smoking in sub-Saharan Africa and women in low- and middle-income countries (LMICs). PMID
Landman, Gijs W D; Kleefstra, Nanne; van Hateren, Kornelis J J; Groenier, Klaas H; Gans, Rijk O B; Bilo, Henk J G
Several studies have suggested an association between specific diabetes treatment and cancer mortality. We studied the association between metformin use and cancer mortality in a prospectively followed cohort. In 1998 and 1999, 1,353 patients with type 2 diabetes were enrolled in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study in the Netherlands. Vital status was assessed in January 2009. Cancer mortality rate was evaluated using standardized mortality ratios (SMRs), and the association between metformin use and cancer mortality was evaluated with a Cox proportional hazards model, taking possible confounders into account. Median follow-up time was 9.6 years, average age at baseline was 68 years, and average A1C was 7.5%. Of the patients, 570 died, of which 122 died of malignancies. The SMR for cancer mortality was 1.47 (95% CI 1.22-1.76). In patients taking metformin compared with patients not taking metformin at baseline, the adjusted hazard ratio (HR) for cancer mortality was 0.43 (95% CI 0.23-0.80), and the HR with every increase of 1 g of metformin was 0.58 (95% CI 0.36-0.93). In general, patients with type 2 diabetes are at increased risk for cancer mortality. In our group, metformin use was associated with lower cancer mortality compared with nonuse of metformin. Although the design cannot provide a conclusion about causality, our results suggest a protective effect of metformin on cancer mortality.
Zahnd, Whitney E; Jenkins, Wiley D; Mueller-Luckey, Georgia S
The Delta Region is a federally designated, socioeconomically disadvantaged region of the United States covering 252 counties in eight states along the Mississippi River. The objective of this study is to describe the Region's cancer mortality burden. National Center for Health Statistics data were used to calculate age-adjusted mortality rates and rate ratios for the Delta Region for all cancers, lung, colorectal, breast (female), cervical, and prostate cancers. Rates were also calculated for comparison groups, and were stratified by gender, race, rurality, and socioeconomic status. The all-cancer mortality rate in the Delta Region was higher than all comparison groups across all stratifications. Higher rates were seen for cervical and colorectal cancer across comparison groups and stratifications. Delta Blacks had higher rates than Whites, and rural Delta residents had higher rates than their urban peers for most cancers. Further research and interventions should be conducted to elucidate and reduce these disparities.
For a sample of individuals from an animal or human population under observation in a clinical trial or life test, mortality rates are defined for...model, these mortality rates are shown to have an asymptotic normal distribution. An expression for the asymptotic correlation between a pair of... mortality rates is thus obtained and a necessary and sufficient condition for their asymptotic independence is investigated in some general situations with
Wilson, Lauren; Bhatnagar, Prachi; Townsend, Nick
We aimed to study the time trends underlying a change from cardiovascular disease (CVD) to cancer as the most common cause of age-standardized mortality in the UK between 1983 and 2013. A retrospective trend analysis of the World Health Organization mortality database for mortality from all cancers, all CVDs, and their three most common types, by sex and age. Age-standardized mortality rates were adjusted to the 2013 European Standard Population and analyzed using joinpoint regression analysis for annual percent changes. The difference in mortality rate between total CVD and cancer narrowed over the study period as age-standardized mortality from CVD decreased more steeply than cancer in both sexes. We observed higher overall rates for both diseases in men compared to women, with high mortality rates from ischemic heart disease and lung cancer in men. Joinpoint regression analysis indicated that trends of decreasing rates of CVD have increased over time while decreasing trends in cancer mortality rates have slowed down since the 1990s. The lowest improvements in mortality rates were for cancer in those over 75 years of age and lung cancer in women. In 2011, the age-standardized mortality rate for cancer exceeded that of CVD in both sexes in the UK. These changing trends in mortality may support evidence for changes in policy and resource allocation in the UK.
D.K. Rosenberg; R.G. Anthony
We described trapping mortality rates of northern flying squirrel (Glaucomys sabrinus) populations in western Oregon, U.S.A., and evaluated the effects of sex, age, body mass, and number of times an individual was recaptured on these rates. Although the overall trapping mortality rates were relatively low (7%) during 16-21 day trapping sessions, we...
Chen, Sung-Lang; Wang, Shao-Chuan; Ho, Cheng-Ju; Kao, Yu-Lin; Hsieh, Tzuo-Yi; Chen, Wen-Jung; Chen, Chih-Jung; Wu, Pei-Ru; Ko, Jiunn-Liang; Lee, Huei; Sung, Wen-Wei
The variation in mortality-to-incidence ratios (MIRs) among countries reflects the clinical outcomes and the available interventions for colorectal cancer treatments. The association between MIR of prostate cancer and cancer care disparities among countries is an interesting issue that is rarely investigated. For the present study, cancer incidence and mortality rates were obtained from the GLOBOCAN 2012 database. The rankings and total expenditures on health of various countries were obtained from the World Health Organization (WHO). The association between variables was analyzed by linear regression analyses. In this study, we estimated the role of MIRs from 35 countries that had a prostate cancer incidence greater than 5,000 cases per year. As expected, high prostate cancer incidence and mortality rates were observed in more developed regions, such as Europe and the Americas. However, the MIRs were 2.5 times higher in the less developed regions. Regarding the association between MIR and cancer care disparities, countries with good WHO ranking and high total expenditures on health/gross domestic product (GDP) were significant correlated with low MIR. The MIR variation for prostate cancer correlates with cancer care disparities among countries further support the role of cancer care disparities in clinical outcome. PMID:28051150
Little is known about rural-urban cancer disparities, particularly in South Korea, and this study is to identify cancer-specific mortality inequalities between the rural and urban areas of the country. For 11 specific cancer sites, age-standardised mortality rates were analysed for the rural and urban administrative districts of South Korea during 2006-2011. The Poisson log linear regression models were employed to estimate cancer-specific mortality rates, and Bonferroni comparison method was used to identify rural-urban disparities. There were significant rural-urban disparities observed for all cancer sites except prostate, pancreas and leukaemia. The mortality rates of lung, liver and stomach cancers, the three most common cancers in the country, were observed to be significantly higher in rural areas than in metropolitan areas. In contrast, the reverse relationship was observed for the reproductive system (breast and uterus) and colon cancers. Central nervous system cancer mortality was observed to be significantly higher in rural areas than in non-metro urban areas. For the first time ever, significant rural-urban disparity patterns in cancer mortality rates in South Korea have been identified in this paper. Future investigations on cancer risk factors for the country should address these disparity patterns. © 2015 National Rural Health Alliance Inc.
Krahwinkel, W; Schuler, E; Liebetrau, M; Meier-Hellmann, A; Zacher, J; Kuhlen, R
Lowering of mortality rates in hospitals with mortality rates higher than accepted reference values for acute myocardial infarction (AMI), congestive heart failure (CHF), pneumonia, stroke, mechanical ventilation (MV) and colorectal surgery by using an external peer review process that identifies areas requiring rectification and implements protocols directed at improving these areas. Retrospective, observational, quality management study using administrative data to compare in-hospital mortality rates (pre and post an external peer review process that included adoption of improvement protocols) with reference values. German general hospitals of a large, private group. Hospitals with mortality rates higher than reference values. Peer review of medical records by experienced, outside physicians triggered by in-hospital mortality rates higher than expected. Inadequacies were identified, improvement protocols enforced and mortality rates subsequently re-examined. Mortality rates 1 year before and 1 year after peer review and protocol use. For AMI, CHF, pneumonia, stroke, MV and colorectal surgery, the mortality rates 1 year post-peer review were significantly decreased as compared to pre-peer review mortality rates. The standardized mortality ratio for all of the above diagnoses was 1.45, 1 year before peer review, and 0.97, 1 year after peer review. The absolute risk reduction of 7.3% translates into 710 deaths in this population which could have been prevented. Peer review triggered and conducted in the manner described here is associated with a significant lowering of in-hospital mortality rates in hospitals that previously had higher than expected mortality rates. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.
Braga, Patrícia Emília; Latorre Md, Maria do Rosário Dias de Oliveira; Curado, Maria Paula
Analysis of cancer incidence, mortality, and survival rates can yield geographic and temporal trends that are useful for planning and evaluating health interventions. This article reviews cancer incidence and mortality rates and respective trends around the world in children under 15 years old, as well as their 5-year survival rates in developed and developing countries. We conclude that even though increasing or stable childhood cancer incidence rates and decreasing mortality rates have been observed in developed countries, the trends remain unknown in developing countries. Data from the city of Goiania, Brazil, show stable childhood cancer incidence and mortality rates. Five-year survival rates (48%) in Goiania are similar to those seen in underdeveloped regions and lower than those reported in developed countries (64-70%).
Simon, Michael S.; Chlebowski, Rowan T.; Wactawski-Wende, Jean; Johnson, Karen C.; Muskovitz, Andrew; Kato, Ikuko; Young, Alicia; Hubbell, F. Allan; Prentice, Ross L.
Purpose During the intervention phase in the Women's Health Initiative (WHI) clinical trial, use of estrogen plus progestin reduced the colorectal cancer diagnosis rate, but the cancers were found at a substantially higher stage. To assess the clinical relevance of the findings, analyses of the influence of combined hormone therapy on colorectal cancer incidence and colorectal cancer mortality were conducted after extended follow-up. Patients and Methods The WHI study was a randomized, double-blind, placebo-controlled clinical trial involving 16,608 postmenopausal women with an intact uterus who were randomly assigned to daily 0.625 mg conjugated equine estrogen plus 2.5 mg medroxyprogesterone acetate (n = 8,506) or matching placebo (n = 8,102). Colorectal cancer diagnosis rates and colorectal cancer mortality were assessed. Results After a mean of 5.6 years (standard deviation [SD], 1.03 years) of intervention and 11.6 years (SD, 3.1 years) of total follow-up, fewer colorectal cancers were diagnosed in the combined hormone therapy group compared with the placebo group (diagnoses/year, 0.12% v 0.16%; hazard ratio [HR], 0.72; 95% CI, 0.56 to 0.94; P = .014). Bowel screening examinations were comparable between groups throughout. Cancers in the combined hormone therapy group more commonly had positive lymph nodes (50.5% v 28.6%; P < .001) and were at higher stage (regional or distant, 68.8% v 51.4%; P = .003). Although not statistically significant, there was a higher number of colorectal cancer deaths in the combined hormone therapy group (37 v 27 deaths; 0.04% v 0.03%; HR, 1.29; 95% CI, 0.78 to 2.11; P = .320). Conclusion The findings, suggestive of diagnostic delay, do not support a clinically meaningful benefit for combined hormone therapy on colorectal cancer. PMID:23008295
Bulbulyan, M; Zahm, S H; Zaridze, D G
Occupational cancer mortality was evaluated among approximately three million female pensioners from urban areas of the former USSR. In 1970, these women experienced 14,918 cancer deaths. Occupational data were obtained from death certificates and the 1970 USSR National Population Census. Thirty-five occupational groups, including nine predominantly professional or office-work groups and 26 groups involving physical labor, were evaluated. The expected mortality rates were based on the urban female population of the USSR in 1970. Data for all cancer sites combined, and cancers of the esophagus, stomach, colon, rectum, lung, breast, cervix, and hematopoietic system are presented. Among all female pensioners, there were significant increases of all cancers combined (rate ratio [RR] = 1.05), and cancers of the breast (RR = 1.3), cervix (RR = 1.3), and the hematopoietic system (RR = 1.2), and a significant deficit of cancer of the esophagus (RR = 0.8). Many well-established associations between cancer and occupation among men were observed among the study group of female pensioners, such as stomach and lung cancer among miners, and hematopoietic malignancies among scientists and physicians. Other associations, to be investigated further, also were observed, such as excess lung cancer among waitresses. The peak employment period for this cohort of women was during World War II and the postwar period, when Soviet women outnumbered men almost two-to-one. Consequently, many of the women held jobs that are typically held by men. Thus, this study provides valuable information on occupational risks to women that may be relevant in other countries where women increasingly are being employed in jobs traditionally held by men.
Drake, Thomas M; Shaw, Catherine A; Garden, O James; Wigmore, Stephen J
Objectives There is controversy on the proposed benefits of publishing mortality rates for individual surgeons. In some procedures, analysis at the level of an individual surgeon may lack statistical power. The aim was to determine the likelihood that variation in surgeon performance will be detected using published outcome data. Design A national analysis surgeon-level mortality rates to calculate the level of power for the reported mortality rate across multiple surgical procedures. Setting The UK from 2010 to 2014. Participants Surgeons who performed colon cancer resection, oesophagectomy or gastrectomy, elective aortic aneurysm repair, hip replacement, bariatric surgery or thyroidectomy. Outcomes The likelihood of detecting an individual with a 30-day, 90-day or in-patient mortality rate of up to 5 times the national mean or median (as available). This was represented using a novel heat-map approach. Results Overall mortality rates for the procedures ranged from 0.07% to 4.5% and mean/median surgeon volume was between 23 and 75 cases. The national median case volume for colorectal (n=55) and upper gastrointestinal (n=23) cancer resections provides around 20% power to detect a mortality rate of 3 times the national median, while, for hip replacement, this is a rate 5 times the national average. At the mortality rates reported for thyroid (0.08%) and bariatric (0.07%) procedures, it is unlikely a surgeon would perform a sufficient number of procedures in his/her entire career to stand a good chance of detecting a mortality rate 5 times the national average. Conclusions At present, surgeons with increased mortality rates are unlikely to be detected. Performance within an expected mortality rate range cannot be considered reliable evidence of acceptable performance. Alternative approaches should focus on commonly occurring meaningful outcome measures, with infrequent events analysed predominately at the hospital level. PMID:27799243
McPhail, S; Elliss-Brookes, L; Shelton, J; Ives, A; Greenslade, M; Vernon, S; Morris, E J A; Richards, M
Background: The short-term survival following a cancer diagnosis in England is lower than that in comparable countries, with the difference in excess mortality primarily occurring in the months immediately after diagnosis. We assess the impact of emergency presentation (EP) on the excess mortality in England over the course of the year following diagnosis. Methods: All colorectal and cervical cancers presenting in England and all breast, lung, and prostate cancers in the East of England in 2006–2008 are included. The variation in the likelihood of EP with age, stage, sex, co-morbidity, and income deprivation is modelled. The excess mortality over 0–1, 1–3, 3–6, and 6–12 months after diagnosis and its dependence on these case-mix factors and presentation route is then examined. Results: More advanced stage and older age are predictive of EP, as to a lesser extent are co-morbidity, higher income deprivation, and female sex. In the first month after diagnosis, we observe case-mix-adjusted excess mortality rate ratios of 7.5 (cervical), 5.9 (colorectal), 11.7 (breast ), 4.0 (lung), and 20.8 (prostate) for EP compared with non-EP. Conclusion: Individuals who present as an emergency experience high short-term mortality in all cancer types examined compared with non-EPs. This is partly a case-mix effect but EP remains predictive of short-term mortality even when age, stage, and co-morbidity are accounted for. PMID:24045658
Kabat, Geoffrey C; Matthews, Charles E; Kamensky, Victor; Hollenbeck, Albert R; Rohan, Thomas E
Background: Several health agencies have issued guidelines promoting behaviors to reduce chronic disease risk; however, little is known about the impact of such guidelines, particularly on cancer incidence. Objective: The objective was to determine whether greater adherence to the American Cancer Society (ACS) cancer prevention guidelines is associated with a reduction in cancer incidence, cancer mortality, and total mortality. Design: The NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults aged 50–71 y at recruitment in 1995–1996, was followed for a median of 10.5 y for cancer incidence, 12.6 y for cancer mortality, and 13.6 y for total mortality. Participants who reported a history of cancer or who had missing data were excluded, yielding 476,396 subjects for analysis. We constructed a 5-level score measuring adherence to ACS guidelines, which included baseline body mass index, physical activity, alcohol intake, and several aspects of diet. Cox proportional hazards models were used to compute HRs and 95% CIs for the association of the adherence score with cancer incidence, cancer mortality, and total mortality. All analyses included fine adjustment for cigarette smoking. Results: Among 476,396 participants, 73,784 incident first cancers, 16,193 cancer deaths, and 81,433 deaths from all causes were identified in the cohort. Adherence to ACS guidelines was associated with reduced risk of all cancers combined: HRs (95% CIs) for the highest compared with the lowest level of adherence were 0.90 (0.87, 0.93) in men and 0.81 (0.77, 0.84) in women. Fourteen of 25 specific cancer sites showed a reduction in risk associated with increased adherence. Adherence was also associated with reduced cancer mortality [HRs (95% CIs) were 0.75 (0.70, 0.80) in men and 0.76 (0.70, 0.83) in women] and reduced all-cause mortality [HRs (95% CIs) were 0.74 (0.72, 0.76) in men and 0.67 (0.65, 0.70) in women]. Conclusions: In both men and women, adherence to the
Kabat, Geoffrey C; Matthews, Charles E; Kamensky, Victor; Hollenbeck, Albert R; Rohan, Thomas E
Several health agencies have issued guidelines promoting behaviors to reduce chronic disease risk; however, little is known about the impact of such guidelines, particularly on cancer incidence. The objective was to determine whether greater adherence to the American Cancer Society (ACS) cancer prevention guidelines is associated with a reduction in cancer incidence, cancer mortality, and total mortality. The NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults aged 50-71 y at recruitment in 1995-1996, was followed for a median of 10.5 y for cancer incidence, 12.6 y for cancer mortality, and 13.6 y for total mortality. Participants who reported a history of cancer or who had missing data were excluded, yielding 476,396 subjects for analysis. We constructed a 5-level score measuring adherence to ACS guidelines, which included baseline body mass index, physical activity, alcohol intake, and several aspects of diet. Cox proportional hazards models were used to compute HRs and 95% CIs for the association of the adherence score with cancer incidence, cancer mortality, and total mortality. All analyses included fine adjustment for cigarette smoking. Among 476,396 participants, 73,784 incident first cancers, 16,193 cancer deaths, and 81,433 deaths from all causes were identified in the cohort. Adherence to ACS guidelines was associated with reduced risk of all cancers combined: HRs (95% CIs) for the highest compared with the lowest level of adherence were 0.90 (0.87, 0.93) in men and 0.81 (0.77, 0.84) in women. Fourteen of 25 specific cancer sites showed a reduction in risk associated with increased adherence. Adherence was also associated with reduced cancer mortality [HRs (95% CIs) were 0.75 (0.70, 0.80) in men and 0.76 (0.70, 0.83) in women] and reduced all-cause mortality [HRs (95% CIs) were 0.74 (0.72, 0.76) in men and 0.67 (0.65, 0.70) in women]. In both men and women, adherence to the ACS guidelines was associated with reductions in all-cancer
Abdoli, Gholamreza; Bottai, Matteo; Moradi, Tahereh
In 2010, cancer deaths accounted for more than 15% of all deaths worldwide, and this fraction is estimated to rise in the coming years. Increased cancer mortality has been observed in immigrant populations, but a comprehensive analysis by country of birth has not been conducted. We followed all individuals living in Sweden between 1961 and 2009 (7,109,327 men and 6,958,714 women), and calculated crude cancer mortality rates and age-standardized rates (ASRs) using the world population for standardization. We observed a downward trend in all-site ASRs over the past two decades in men regardless of country of birth but no such trend was found in women. All-site cancer mortality increased with decreasing levels of education regardless of sex and country of birth (p for trend <0.001). We also compared cancer mortality rates among foreign-born (13.9%) and Sweden-born (86.1%) individuals and determined the effect of education level and sex estimated by mortality rate ratios (MRRs) using multivariable Poisson regression. All-site cancer mortality was slightly higher among foreign-born than Sweden-born men (MRR = 1.05, 95% confidence interval 1.04-1.07), but similar mortality risks was found among foreign-born and Sweden-born women. Men born in Angola, Laos, and Cambodia had the highest cancer mortality risk. Women born in all countries except Iceland, Denmark, and Mexico had a similar or smaller risk than women born in Sweden. Cancer-specific mortality analysis showed an increased risk for cervical and lung cancer in both sexes but a decreased risk for colon, breast, and prostate cancer mortality among foreign-born compared with Sweden-born individuals. Further studies are required to fully understand the causes of the observed inequalities in mortality across levels of education and countries of birth.
Abdoli, Gholamreza; Bottai, Matteo; Moradi, Tahereh
In 2010, cancer deaths accounted for more than 15% of all deaths worldwide, and this fraction is estimated to rise in the coming years. Increased cancer mortality has been observed in immigrant populations, but a comprehensive analysis by country of birth has not been conducted. We followed all individuals living in Sweden between 1961 and 2009 (7,109,327 men and 6,958,714 women), and calculated crude cancer mortality rates and age-standardized rates (ASRs) using the world population for standardization. We observed a downward trend in all-site ASRs over the past two decades in men regardless of country of birth but no such trend was found in women. All-site cancer mortality increased with decreasing levels of education regardless of sex and country of birth (p for trend <0.001). We also compared cancer mortality rates among foreign-born (13.9%) and Sweden-born (86.1%) individuals and determined the effect of education level and sex estimated by mortality rate ratios (MRRs) using multivariable Poisson regression. All-site cancer mortality was slightly higher among foreign-born than Sweden-born men (MRR = 1.05, 95% confidence interval 1.04–1.07), but similar mortality risks was found among foreign-born and Sweden-born women. Men born in Angola, Laos, and Cambodia had the highest cancer mortality risk. Women born in all countries except Iceland, Denmark, and Mexico had a similar or smaller risk than women born in Sweden. Cancer-specific mortality analysis showed an increased risk for cervical and lung cancer in both sexes but a decreased risk for colon, breast, and prostate cancer mortality among foreign-born compared with Sweden-born individuals. Further studies are required to fully understand the causes of the observed inequalities in mortality across levels of education and countries of birth. PMID:24682217
Baylis, M; Touti, J; Bouayoune, H; Moudni, L; Taoufiq, B; el Hasnaoui, H
Daily mortality rates of female Culicoides imicola were found for eight sites in Morocco in 1994 and for six sites in 1995. The mortality rates were found by operating Pirbright-type light traps for a number of consecutive nights in late summer or autumn and finding the parous rate assuming a feeding interval of 3 to 5 days. The mortality rates were calculated according to established methods. In Morocco the daily mortality rates were found to vary from about 5% per day (Arbaoua, 1994, 1995 and Sidi Moussa 1995) up to 20-25% per day (Berkane, Marrakech, Tangier). In general, estimates of daily mortality rate were consistent between the two years of study. Among sites, daily mortality rate was significantly correlated with the average night-time minimum wind speed but not mean or maximum night-time wind speeds, or with temperature, humidity or saturation deficit. The observed mortality rates suggest that at Arbaoua, were 1,000 flies to become infected with African horse sickness virus, at least 330 would live long enough to take 3 or more infective blood meals on hosts. At Berkane, the survival rate per 1,000 is less than 10. In general, the pattern observed for daily mortality rate, combined with the relative population sizes of C. imicola in Morocco, agree well with the observed distribution of African horse sickness in the country during the 1989-1991 epizootic.
Katanoda, Kota; Hori, Megumi; Matsuda, Tomohiro; Shibata, Akiko; Nishino, Yoshikazu; Hattori, Masakazu; Soda, Midori; Ioka, Akiko; Sobue, Tomotaka; Nishimoto, Hiroshi
The analysis of cancer trends in Japan requires periodic updating. Herein, we present a comprehensive report on the trends in cancer incidence and mortality in Japan using recent population-based data. National cancer mortality data between 1958 and 2013 were obtained from published vital statistics. Cancer incidence data between 1985 and 2010 were obtained from high-quality population-based cancer registries of three prefectures (Yamagata, Fukui and Nagasaki). Joinpoint regression analysis was performed to examine the trends in age-standardized rates of cancer incidence and mortality. All-cancer mortality decreased from the mid-1990s, with an annual percent change of -1.3% (95% confidence interval [CI]: -1.4, -1.3). During the most recent 10 years, over 60% of the decrease in cancer mortality was accounted for by a decrease in stomach and liver cancers (63% for males and 66% for females). The long-term increase in female breast cancer mortality, beginning in the 1960s, plateaued in 2008. All-cancer incidence continuously increased, with annual percent changes of 0.6% (95% CI: 0.5, 0.8) between 1985 and 2005, and 1.8% (95% CI: 0.6, 2.9) between 2005 and 2010. During the most recent 10 years, almost half of the increase in cancer incidence was accounted for by an increase in prostate cancer (60%) in males and breast cancer (46%) in females. The cancer registry quality indices also began to increase from ∼2005. Decreases in stomach and liver cancers observed for incidence and mortality reflect the reduced attribution of infection-related factors (i.e. Helicobacter pylori and hepatitis virus). However, it should be noted that cervical cancer incidence and mortality rates began to increase from ∼1990. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Malvezzi, M; Carioli, G; Rodriguez, T; Negri, E; La Vecchia, C
Over the last two decades, ovarian cancer mortality rates have levelled or declined. There are, however, persisting and substantial differences in ovarian cancer patterns and trends. We updated global trends in ovarian cancer mortality to 2012, and predicted trends in rates to 2020 using data from the World Health Organization database. In the EU, age-adjusted ovarian cancer mortality rates decreased 10% between 2002 and 2012, to 5.2/100 000. The decline was ∼16% in the USA, to 4.9/100 000 in 2012. Latin American countries had lower rates, and declines were observed in Argentina and Chile. Likewise, modest declines (-2.1%) were observed in Japan, whose rate remained low (3.2/100 000 in 2012). Australia had a rate of 4.3/100 000 in 2012, and a 12% decline. The falls were larger in young women, than in middle or old age. Recent rates at age 20-49 were higher in Japan than in the EU and the USA. Predictions to 2020 indicate a further 15% decline in the USA and 10% in the EU and Japan. The main reason for the favourable trends is the use of oral contraceptives (OCs), particularly, in the USA and countries of the EU where OCs were introduced earlier. Declines in menopausal hormone use may also have played a favourable role in elderly women, as well as improved diagnosis, management and treatment. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Loomis, D; Browning, S R; Schenck, A P; Gregory, E; Savitz, D A
OBJECTIVES: To assess whether excess mortality from cancer, malignant melanoma of the skin, and cancers of the brain and liver in particular, is associated with long term occupational exposure to polychlorinated biphenyls (PCBs). METHODS: An epidemiological study of mortality was conducted among 138,905 men employed for at least six months between 1950 and 1986 at five electrical power companies in the United States. Exposures were assessed by panels composed of workers, hygienists, and managers at each company, who considered tasks performed by workers in 28 job categories and estimated weekly exposures in hours for each job. Poisson regression was used to examine mortality in relation to exposure to electrical insulating fluids containing PCBs, controlling for demographic and occupational factors. RESULTS: Neither all cause nor total cancer mortality was related to cumulative exposure to PCB insulating fluids. Mortality from malignant melanoma increased with exposure; rate ratios (RRs) relative to unexposed men for melanoma were 1.23 (95% confidence interval (95% CI) 0.56 to 2.52), 1.71 (0.68 to 4.28) and 1.93 (0.52 to 7.14) for men with < 2000, > 2000-10,000, and > 10,000 hours of cumulative exposure to PCB insulating fluids, respectively, without consideration of latency. Lagging exposure by 20 years yielded RRs of 1.29 (0.76 to 2.18), 2.56 (1.09 to 5.97), and 4.81 (1.49 to 15.50) for the same exposure levels. Mortality from brain cancer was modestly increased among men with < 2000 hours (RR 1.61, 95% CI 0.86 to 3.01) and > 2000-10,000 hours exposure (RR 1.79, 95% CI 0.81 to 3.95), but there were no deaths from brain cancer among the most highly exposed men. A lag of five years yielded slightly increased RRs. Mortality from liver cancer was not associated with exposure to PCB insulating fluids. CONCLUSIONS: This study was larger and provided more detailed information on exposure than past investigations of workers exposed to PCBs. The results suggest that PCBs
Greenblatt, David Yu; Weber, Sharon M.; O’Connor, Erin S.; LoConte, Noelle K.; Liou, Jinn-Ing; Smith, Maureen A.
Objectives Early hospital readmission is a common and costly problem in the Medicare population. In 2009, the Centers for Medicaid and Medicare Services began mandating hospital reporting of disease-specific readmission rates. We sought to determine the rate and predictors of readmission after colectomy for cancer, as well as the association between readmission and mortality. Methods Medicare beneficiaries who underwent colectomy for stage I-III colon adenocarcinoma from 1992–2002 were identified from the SEER-Medicare database. Multivariate logistic regression identified predictors of early readmission and one-year mortality. Odds ratios were adjusted for multiple factors, including measures of comorbidity, socioeconomic status, and disease severity. Results Of 42,348 patients who were discharged, 4,662 (11.0%) were readmitted within 30 days. The most common causes of rehospitalization were ileus/obstruction and infection. Significant predictors of readmission included male gender, comorbidity, emergent admission, prolonged hospital stay, blood transfusion, ostomy, and discharge to nursing home. Readmission was inversely associated with hospital procedure volume, but not surgeon volume. After adjusting for potential confounding variables, the predicted probability of one-year mortality was 16% for readmitted patients, compared to 7% for those not readmitted. This difference in mortality was significant for all stages of cancer. Conclusions Early readmission after colectomy for cancer is common and due in part to modifiable factors. There is a remarkable association between readmission and one-year mortality. Early readmission is therefore an important quality-of-care indicator for colon cancer surgery. These findings may facilitate the development of targeted interventions that will decrease readmissions and improve patient outcomes. PMID:20224370
Katanoda, Kota; Matsuda, Tomohiro; Matsuda, Ayako; Shibata, Akiko; Nishino, Yoshikazu; Fujita, Manabu; Soda, Midori; Ioka, Akiko; Sobue, Tomotaka; Nishimoto, Hiroshi
The analysis of cancer trends in Japan has only been sporadically reported. We present a comprehensive report on the trends in cancer incidence and mortality in Japan using the most recent population-based data. National cancer mortality data between 1958 and 2011 were obtained from published vital statistics. Cancer incidence data between 1985 and 2007 were obtained from high-quality population-based cancer registries of four prefectures (Miyagi, Yamagata, Fukui and Nagasaki). Joinpoint regression analysis was performed to examine the trends in age-standardized rates of cancer incidence and mortality. All-cancer mortality decreased from the mid-1990s, with an annual percent change of -1.3% (95% confidence interval: -1.4, -1.3), while all-cancer incidence continually increased from 1985, with an annual percent change of 0.7% (95% confidence interval: 0.6, 0.8). Major cancer sites, particularly the liver, colorectum and lung (males), showed a pattern of increasing incidence and mortality rates until the mid-1990s, stabilizing or decreasing thereafter. Stomach cancer showed a long-term decreasing trend for both incidence and mortality, while female breast cancer showed a continuously increasing trend. The incidence of prostate cancer, particularly at the localized stage, increased rapidly between 2000 and 2003, while that of mortality decreased from 2004. No changes were detected in the incidence or mortality for colorectal, female breast or cervical cancers after the establishment of national screening programs for these cancers. The analysis of cancer trends in Japan revealed a recent decrease in mortality and a continuous increase in incidence, which are considered to reflect changes in the underlying risk factors such as tobacco smoking and infection, and are partially explained by early detection and improved treatment.
Abreu, Maria R; Vilar, Eduardo; Arús, Enrique R; Mejia, Jose M; Martínez, Yadina; Yasells, Ali A
Gastrointestinal malignancies are among the most common cancers suffered by Cubans. The purpose of our study is to analyse the evolution of digestive cancer mortality in Cuba. Mortality data for this study were obtained from the National Medical Records and Health Statistic Bureau. Trends (1987-2008) in age-standardized cancer mortality were described using joinpoint regression. In the data set of digestive cancer mortality, in the period 1987-2008, colorectal/anal cancer was the most frequent cause of cancer mortality in males and females. In men, a rise in mortality was observed for cancer of the oesophagus between 2001 and 2008, and pancreatic cancer showed a slight mortality rise for the period 1987-2008. In women, colorectal/anal cancer increased from 1989 to 2001. A mortality increase was observed for oesophageal cancer in the period 2005-08. The result of the joinpoint analysis for the age group of 35-64 years was consistent with those for overall mortality. The trend in mortality from digestive cancer in Cuba shows differences depending on sex, age and type of tumour. The Cuban health system has seen improvements in diagnostic systems, which has contributed even better diagnoses of digestive diseases.
Bahk, Jinwook; Jang, Sung-Mi; Jung-Choi, Kyunghee
A steadily increasing pattern of breast cancer mortality has been reported in South Korea since the late 1980s. This paper explored the trends of educational inequalities of female breast cancer mortality between 1983 and 2012 in Korea, and conducted age-period-cohort (APC) analysis by educational level. Age-standardized mortality rates of breast cancer per 100,000 person-years were calculated. Relative index of inequality (RII) for breast cancer mortality was used as an inequality measure. APC analyses were conducted using the Web tool for APC analysis provided by the Division of Cancer Epidemiology and Genetics at the U.S. National Cancer Institute. An increasing trend in breast cancer mortality among Korean women between 1983 and 2012 was due to the increased mortality of the lower education groups (i.e., no formal education or primary education and secondary education groups), not the highest education group. The breast cancer mortality was higher in women with a tertiary education than in women with no education or a primary education during 1983-1992, and the reverse was true in 1993-2012. Consequently, RII was changed from positive to negative associations in the early 2000s. The lower education groups had the increased breast cancer mortality and significant cohort and period effects between 1983 and 2012, whereas the highest group did not. APC analysis by socioeconomic position used in this study could provide an important clue for the causes on breast cancer mortality. The long-term monitoring of socioeconomic patterning in breast cancer risk factors is urgently needed.
Goldberg, Sara W; Mulshine, James L; Hagstrom, Dale; Pyenson, Bruce S
Comparing the mortality characteristics of different cohorts is an essential process in the life insurance industry. Pseudodisease, lead-time bias, and length bias, which are critical to determining the value of cancer screening, have close analogues in life insurance company management, including the temporal impact of underwriting. Ratios of all-cause mortality rates for cancer cohorts relative to standard population mortality rates can provide insights into early stage and late stage mortality differences, differences by age, sex, race, and histology, and allow modeling of biases associated with early stage detection or screening protocols. The Surveillance, Epidemiology and End Results (SEER) data set has characteristics that allow efficient application of actuarial techniques. We show the mortality burden associated with treated early stage lung cancer and that identifying all lung cancers at early stage could reduce US lung cancer deaths by over 70,000 per year.
Redmond, C K
The OSHA standard for coke oven emissions, which went into effect in January 1977, sets a permissible exposure limit to coke oven emissions of 150 micrograms/m3 benzene-soluble fraction of total particulate matter (BSFTPM). Review of the epidemiologic evidence for the standard indicates an excess relative risk for lung cancer as high as 16-fold in topside coke oven workers with 15 years of exposure or more. There is also evidence for a consistent dose-response relationship in lung cancer mortality when duration and location of employment at the coke ovens are considered. Dose-response models fitted to these same data indicate that, while excess risks may still occur under the OSHA standard, the predicted levels of increased relative risk would be about 30-50% if a linear dose-response model is assumed and 3-7% if a quadratic model is assumed. Lung cancer mortality data for other steelworkers suggest the predicted excess risk has probably been somewhat overestimated, but lack of information on important confounding factors limits further dose-response analysis. PMID:6653539
Ostenso, A; Remington, P; Ahrens, D
To compare and contrast trends in lung cancer mortality in Wisconsin's 72 counties, as a measure of long-term progress in tobacco control. Lung cancer mortality data were abstracted from the Centers for Disease Control and Prevention's WONDER database from 1979 to 1998. Percent change in lung cancer mortality rates were analyzed at the county and national levels from 1979-1983 to 1994-1998. In Wisconsin, lung cancer mortality rates increased 23%, compared to a 19% increase in the United States. There was more variation in lung cancer mortality trends between Wisconsin counties than between states, with increases in 67 of Wisconsin's 72 counties. Lung cancer mortality rates increased for men in 44 counties and for women in 68 counties. Only 4 counties in Wisconsin had fewer lung cancer deaths in 1994-1998 compared with 1979-1983. Progress in reducing lung cancer mortality in Wisconsin--a long-term measure of progress in tobacco control--has lagged behind the rest of the United States. Nevertheless, some Wisconsin counties have experienced more progress in reducing the health burden from lung cancer, suggesting that differences exist between communities in the effectiveness of their tobacco control efforts.
Du, Ling-bin; Mao, Wei-min; Chen, Wan-qing; Zhang, Si-wei; Yu, Chuan-ding; Zheng, Rong-shou; Xia, Qing-min; Wang, Xiang-hui
To analyze the patterns of incidence and mortality on larynx cancer in China. Data from 32 Cancer Registries in China were examined, sorted, and analyzed by the National Cancer Registry, to obtain the crude, Chinese national and world age-standardized rates (ASR) of incidence and mortality and their trends. The crude incidence and mortality rates of larynx cancer were 2.04/10(5) and 1.06/10(5) in China during 2003-2007. The rates were higher in males than those in females, and also higher in urban areas than those in rural areas. The highest Chinese ASRs of incidence and mortality of larynx cancer in 32 cancer registries in China were 2.08/10(5) in Zhongshan city, Guangdong province, and 1.58/10(5) in She county, Hebei province respectively. The trend of incidence and mortality of larynx cancer was stable from 2003 to 2007. Although both the incidence and mortality of larynx cancer in China were still in low level, comprehensive measures should be carried out to prevent the increase on both the incidence and mortality of larynx cancer.
Rébillard, X; Grosclaude, P; Leone, N; Velten, M; Coureau, G; Villers, A; Irani, J; Lebret, T; Rigaud, J; Pfister, C; Patard, J-J; Richaud, P; Salomon, L; Coloby, P; Soulié, M
Present national estimations of the incidence and mortality trends in urological cancers in France between 1980 and 2012. Francim database and French Register of Cancers. Analysis of the current data shows a regular increase of the incidence of renal cancer in men and women (7,781 cases in men and 3,792 in women in 2012). For bladder cancer, trends are divergent. There is a small reduction in incidence for men and an increase for women (9,549 cases in men and 2,416 in women in 2012). Testicular cancer is still increasing slightly (2,317 incidental cases in 2012). The incidence of prostate cancer experienced a huge increase up until 2005, and thereafter it decreased sharply, though it is difficult to discern whether this drop (which was observed up until 2008) continued at the same rate after that point (56,841 incidences in 2012 based on the rates calculated for 2009). The analyses by organ database show that there are significant variations in the incidence of urological cancers, particularly for prostate cancer, which shows that both the natural history of urological tumours and the methods of detection have an impact on incidence. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Torres, David; Pericchi, Luis R; Mattei, Hernando; Zevallos, Juan C
Although contemporary mortality data are important for health assessment and planning purposes, their availability lag several years. Statistical projection techniques can be employed to obtain current estimates. This study aimed to assess annual trends of mortality in Puerto Rico due to cancer and Ischemic Heart Disease (IHD), and to predict shorterm and longterm cancer and IHD mortality figures. Age-adjusted mortality per 100,000 population projections with a 50% interval probability were calculated utilizing a Bayesian statistical approach of Age-Period-Cohort dynamic model. Multiple cause-of-death annual files for years 1994-2010 for Puerto Rico were used to calculate shortterm (2011-2012) predictions. Longterm (2013-2022) predictions were based on quinquennial data. We also calculated gender differences in rates (men-women) for each study period. Mortality rates for women were similar for cancer and IHD in the 1994-1998 period, but changed substantially in the projected 2018-2022 period. Cancer mortality rates declined gradually overtime, and the gender difference remained constant throughout the historical and projected trends. A consistent declining trend for IHD historical annual mortality rate was observed for both genders, with a substantial changepoint around 2004-2005 for men. The initial gender difference of 33% (80/100,00 vs. 60/100,000) in mortality rates observed between cancer and IHD in the 1994-1998 period increased to 300% (60/100,000 vs. 20/100,000) for the 2018-2022 period. The APC projection model accurately projects shortterm and longterm mortality trends for cancer and IHD in this population: The steady historical and projected cancer mortality rates contrasts with the substantial decline in IHD mortality rates, especially in men.
Boffetta, P; Saracci, R; Andersen, A; Bertazzi, P A; Chang-Claude, J; Cherrie, J; Ferro, G; Frentzel-Beyme, R; Hansen, J; Olsen, J; Plato, N; Teppo, L; Westerholm, P; Winter, P D; Zocchetti, C
We have updated the follow-up of cancer mortality for a cohort study of man-made vitreous fiber production workers from Denmark, Finland, Norway, Sweden, United Kingdom, Germany, and Italy, from 1982 to 1990. In the mortality analysis, 22,002 production workers contributed 489,551 person-years, during which there were 4,521 deaths. Workers with less than 1 year of employment had an increased mortality [standardized mortality ratio (SMR) = 1.45; 95% confidence interval (CI) = 1.37-1.53]. Workers with 1 year or more of employment, contributing 65% of person-years, had an SMR of 1.05 (95% CI = 1.02-1.09). The SMR for lung cancer was 1.34 (95% CI = 1.08-1.63, 97 deaths) among rock/slag wool workers and 1.27 (95% CI = 1.07-1.50, 140 deaths) among glass wool workers. In the latter group, no increase was present when local mortality rates were used. Among rock/slag wool workers, the risk of lung cancer increased with time-since-first-employment and duration of employment. The trend in lung cancer mortality according to technologic phase at first employment was less marked than in the previous follow-up. We obtained similar results from a Poisson regression analysis limited to rock/slag wool workers. Five deaths from pleural mesothelioma were reported, which may not represent an excess. There was no apparent excess for other categories of neoplasm. Tobacco smoking and other factors linked to social class, as well as exposures in other industries, appear unlikely to explain the whole increase in lung cancer mortality among rock/slag wool workers. Limited data on other agents do not indicate an important role of asbestos, slag, or bitumen. These results are not sufficient to conclude that the increased lung cancer risk is the result of exposure to rock/slag wool; however, insofar as respirable fibers were an important component of the ambient pollution of the working environment, they may have contributed to the increased risk.
Samet, J M; Wiggins, C L; Key, C R; Becker, T M
We examined mortality from lung cancer and from chronic obstructive pulmonary disease in Hispanic White, Other White, and Native American residents of New Mexico during the period 1958-82. Age-specific mortality was calculated by combining death certificate data with population estimates based on the 1960, 1970, and 1980 censuses that were adjusted for inconsistencies in the designation of race and ethnicity. In Other Whites, age-adjusted mortality rates from lung cancer and from chronic obstructive pulmonary disease increased progressively in males and females. Mortality rates for both diseases also increased in Hispanics during the study period, but the most recent rates for Hispanics were well below those for Other Whites. Age-specific mortality rates for lung cancer declined for more recently born Hispanic women at older ages. In Native Americans, rates for both diseases were low throughout the study period and did not show consistent temporal trends.
Pinheiro, Paulo S; Callahan, Karen E; Ragin, Camille; Hage, Robert W; Hylton, Tara; Kobetz, Erin N
The quantitative intraracial burden of cancer incidence, survival and mortality within black populations in the United States is virtually unknown. We computed cancer mortality rates of US- and Caribbean-born residents of Florida, specifically focusing on black populations (United States, Haiti, Jamaica) and compared them using age-adjusted mortality ratios obtained from Poisson regression models. We compared the mortality of Haitians and Jamaicans residing in Florida to populations in their countries of origin using Globocan. We analyzed 185,113 cancer deaths from 2008 to 2012, of which 20,312 occurred in black populations. The overall risk of death from cancer was 2.1 (95% CI: 1.97-2.17) and 1.6 (95% CI: 1.55-1.71) times higher for US-born blacks than black Caribbean men and women, respectively (P < .001). Race alone is not a determinant of cancer mortality. Among all analyzed races and ethnicities, including Whites and Hispanics, US-born blacks had the highest mortality rates while black Caribbeans had the lowest. The biggest intraracial difference was observed for lung cancer, for which US-blacks had nearly 4 times greater mortality risk than black Caribbeans. Migration from the islands of Haiti and Jamaica to Florida resulted in lower cancer mortality for most cancers including cervical, stomach, and prostate, but increased or stable mortality for 2 obesity-related cancers, colorectal and endometrial cancers. Mortality results in Florida suggest that US-born blacks have the highest incidence rate of "aggressive" prostate cancer in the world, rather than Caribbean men.
de la Vara-Salazar, Elvia; Suárez-López, Leticia; Angeles-Llerenas, Angélica; Torres-Mejía, Gabriela; Lazcano-Ponce, Eduardo
Breast cancer has become an important health risk for women worldwide.The important growth of breast cancer-related deaths within those caused by malign tumors throughout the globe went past the 460 000 in 2008,becoming the deadliest disease worldwide. Demographic changes and lifestyles have modified the population exposure to risk factors of maladies such as cancer, and since 1980 breast cancer mortality has remained on an upward tendency, surpassing cervical cancer in 2006. After analyzing mortality rates along 30 years in Mexican women 25 or more years old, differences by state and age-groups are apparent. Although this cause of death has been associated with a highest regional development, some changes are taking place,since the number of deaths is also growing among women of less-developed regions in the country,as showed in this work. Mexico faces an evident challenge regarding breast cancer. Our country requires to join efforts and implement programs aimed at teaching self-care of health among the population,promoting healthier lifestyles, and reshaping our diagnostic infrastructure to achieve earlier detection and provide proper treatment.
Aune, D; Sen, A; ó'Hartaigh, B; Janszky, I; Romundstad, P R; Tonstad, S; Vatten, L J
Epidemiological studies have reported increased risk of cardiovascular disease, cancer and all-cause mortality with greater resting heart rate, however, the evidence is not consistent. Differences by gender, adjustment for confounding factors, as well as the potential impact of subclinical disease are not clear. A previous meta-analysis missed a large number of studies, and data for atrial fibrillation have not been summarized before. We therefore aimed to clarify these associations in a systematic review and meta-analysis of prospective studies. PubMed and Embase were searched up to 29 March 2017. Summary RRs and 95% confidence intervals (CIs) were calculated using random effects models. Eighty seven studies were included. The summary RR per 10 beats per minute increase in resting heart rate was 1.07 (95% CI: 1.05-1.10, I(2) = 61.9%, n = 31) for coronary heart disease, 1.09 (95% CI: 1.00-1.18, I(2) = 62.3%, n = 5) for sudden cardiac death, 1.18 (95% CI: 1.10-1.27, I(2) = 74.5%, n = 8) for heart failure, 0.97 (95% CI: 0.92-1.02, I(2) = 91.4%, n = 9) for atrial fibrillation, 1.06 (95% CI: 1.02-1.10, I(2) = 59.5%, n = 16) for total stroke, 1.15 (95% CI: 1.11-1.18, I(2) = 84.3%, n = 35) for cardiovascular disease, 1.14 (95% CI: 1.06-1.23, I(2) = 90.2%, n = 12) for total cancer, and 1.17 (95% CI: 1.14-1.19, I(2) = 94.0%, n = 48) for all-cause mortality. There was a positive dose-response relationship for all outcomes except for atrial fibrillation for which there was a J-shaped association. This meta-analysis found an increased risk of coronary heart disease, sudden cardiac death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer and all-cause mortality with greater resting heart rate. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
Horm, John W.; Burhansstipanov, Linda
Overall cancer incidence among southwestern American Indians is less than half that of U.S. whites; Alaska Native and white rates are similar. However, both native groups have elevated rates for specific cancers (stomach, liver, and gallbladder), and Indians have low five-year survival rates. Data tables outline incidence, mortality, and survival…
Horm, John W.; Burhansstipanov, Linda
Overall cancer incidence among southwestern American Indians is less than half that of U.S. whites; Alaska Native and white rates are similar. However, both native groups have elevated rates for specific cancers (stomach, liver, and gallbladder), and Indians have low five-year survival rates. Data tables outline incidence, mortality, and survival…
Clauer, U; Schäfer, J; Roder, J
This study analyzed morbidity, mortality and prognostic factors for patient survival in a single center collective of patients with colorectal cancer and a high follow-up rate. A total of 698 consecutive patients were included in this study. Data were collected prospectively. Descriptive and survival analyses as well as Cox regression analyses were performed to identify factors for morbidity, mortality and prognostic factors for survival. At presentation 78.8 % of the colon cancer patients and 83.5 % of rectal cancer patients showed symptomatic disease and 6.5 % of patients underwent an emergency procedure. Mortality was 3.6 %, morbidity was 42.7 % and 4.3 % of patients developed an anastomotic leakage with the need of reoperation. In spite of the regular application of a fast-track program, 10 % of patients had a prolonged duration of bowel paralysis. In patients with colon cancer there were no differences between overall survival (OAS) and disease-free survival, whereas there was a significant difference in patients with rectal cancer. The mean survival of all patients was 65.39 ± 1.722 months. The ASA score, cardiovascular disease, number of metastatic lymph nodes, lymph node ratio, residual tumor and general or surgery-associated complications were strongly independent influencing factors on OAS. A Cox analysis revealed age at diagnosis and microscopic residual tumor (TNM R1) as highly significant influencing factors on OAS. Other significant factors of influence on OAS were development of general or surgery-associated complications and the presence of cardiovascular diseases. Cardiovascular disease leads to a higher morbidity rate whereas age, International Union Against Cancer (UICC) stage, R-status, lymphatic spread and occurrence of complications are important prognostic factors for survival.
Abu Zeinah, G F; Al-Kindi, S G; Hassan, A A; Allam, A
Hyponatraemia is common in patients with cancer. The objectives of this study are to investigate the severity distribution of hyponatraemia and its association with mortality. We retrospectively reviewed medical records for patients admitted to a national centre for cancer care and research in Qatar between 2008 and 2012. A model was built through multivariate analyses to investigate the role of hyponatraemia in mortality. Patients were grouped into those who had moderate-severe hyponatraemia (Na < 130) and those who only had normal-mild hyponatraemia (Na ≥ 130). A total of 2048 patients were included in this study. Prostate (57.1%), pancreatic (50%), liver (49%) and lung (40.2%) cancers showed the highest frequency of moderate-severe hyponatraemia, while breast cancer showed the lowest frequency at 23.5%. In the multivariate analyses, patients with moderate-severe hyponatraemia (Na < 130 mmol/L) were 4.28 times more likely to die than those with normal-mild hyponatraemia (Na ≥ 130) (P < 0.05). The present study shows that hyponatraemia is a common electrolyte disturbance among hospitalised patients with cancer diagnoses. The severity of hyponatraemia was a statistically significant independent factor associated with higher in-hospital mortality. This is in accordance with the reported literature and emphasises the importance of early diagnosis and correction of hyponatraemia.
Tan, Chon Sern; Pooi, Ah Hin
A time series model based on multivariate power-normal distribution has been applied in the past literature on the United States (US) mortality data from the years 1933 to 2000 to forecast the future age-specific mortality rates of the years 2001 to 2010. In this paper, we show that the method based on multivariate power-normal distribution can still be used for an incomplete US mortality dataset that contains some missing values. The prediction intervals based on this incomplete training data are found to still have good ability of covering the observed future mortality rates although the interval lengths may become wider for long-range prediction.
Sipetic-Grujicic, Sandra; Murtezani, Zafir; Ratkov, Isidora; Grgurevic, Anita; Marinkovic, Jelena; Bjekic, Milan; Miljus, Dragan
To compare breast cancer incidence and mortality trends in Central Serbia between males and females in the period 1999-2009. In this descriptive study, mortality data were obtained from the National Statistics Institute and morbidity data were derived from Institute of Public Health of Serbia for the period of interest. Breast cancer is a leading cancer in the female population of Central Serbia, whereas in male population it is not on the list of 10 leading localizations, concerning both incidence as well as mortality. In the period 1999-2009 the average standardized incidence rates of breast cancer were 60.5/100,000 in women and 1.4/100,000 in men, while average standardized mortality rates were 20.4/100,000 and 0.4/100,000. The average standardized incidence and mortality rates were about 45 times higher in females than males. Male breast cancer comprises approximately 2.1% of all breast cancer cases. The average age-specific mortality and incidence rates increased with age in both sexes. In the observed period standardized mortality rates of breast cancer increased significantly only in men (y=0.320+0.021?, p=0.044). The increase of breast cancer incidence in both sexes and mortality in men, indicate an urgent need for Serbian health professionals to apply existing cancer control and preventive measures. Male breast cancer is more present than in other world regions, with an outstanding increase of mortality, which demands a timely identification (screening) and adequate treatment. A national policy including mammography should be considered in the light of the newest findings.
Lavasani, Sayeh; Chlebowski, Rowan T; Prentice, Ross L; Kato, Ikuko; Wactawski-Wende, Jean; Johnson, Karen C; Young, Alicia; Rodabough, Rebecca; Hubbell, F Allan; Mahinbakht, Ali; Simon, Michael S
The preponderance of observational studies describe an association between the use of estrogen alone and a lower incidence of colorectal cancer. In contrast, no difference in the incidence of colorectal cancer was seen in the Women's Health Initiative (WHI) randomized, placebo-controlled trial with estrogen alone after a mean intervention of 7.1 years and cumulative follow-up of 13.2 years. This study extends these findings by providing detailed analyses of the effects of estrogen alone on the histology, grade, and stage of colorectal cancer, relevant subgroups, and deaths from and after colorectal cancer. The WHI study was a randomized, double-blind, placebo-controlled trial involving 10,739 postmenopausal women with prior hysterectomy. Participants were assigned to conjugated equine estrogen at 0.625 mg/d (n = 5279) or a matching placebo (n = 5409). Rates of colorectal cancer diagnoses and deaths from and after colorectal cancer were assessed throughout the study. Colorectal cancer rates in the estrogen-alone and placebo groups were comparable: 0.14% and 0.12% per year, respectively (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.83-1.58; P = .43). Bowel screening examinations were comparable between the 2 groups throughout the study. The grade, stage, and location of colorectal cancer did not differ between the randomization groups. There were more colorectal cancer deaths in the estrogen-alone group (34 [0.05%] vs 24 [0.03%]; HR, 1.46, 95% CI, 0.86-2.46; P = .16), but the difference was not statistically significant. The colorectal cancer incidence was higher for participants with a history of colon polyp removal in the estrogen-alone group (0.23% vs 0.02%; HR, 13.47; nominal 95% CI, 1.76-103.0; P < .001). The use of estrogen alone in postmenopausal women with prior hysterectomy does not influence the incidence of colorectal cancer or deaths from or after colorectal cancer. A possibly higher risk of colorectal cancer in women with
Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Zuo, Tingting; Xia, Changfa; Yang, Zhixun; He, Jie
Objective To explore the cancer patterns in areas with different urbanization rates (URR) in China with data from 255 population-based cancer registries in 2013, collected by the National Central Cancer Registry (NCCR). Methods There were 347 cancer registries submitted cancer incidence and deaths occurred in 2013 to NCCR. All those data were checked and evaluated based on the NCCR criteria of data quality, and qualified data from 255 registries were used for this analysis. According to the proportion of non-agricultural population, we divided cities/counties into 3 levels: high level, with URR equal to 70% and higher; median level, with URR between 30% and 70%; and low level, with URR equal to 30% and less. Cancer incidences and mortalities were calculated, stratified by gender and age groups in different areas. The national population of Fifth Census in 2000 and Segi’s population were applied for age-standardized rates. Results Qualified 255 cancer registries covered 226,494,490 populations. The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 68.04% and 1.74%, respectively, and the mortality to incidence rate ratio (M/I) was 0.62. A total of 644,487 new cancer cases and 399,275 cancer deaths from the 255 cancer registries were submitted to NCCR in 2013. The incidence rate was 284.55/100,000 (314.06/100,000 in males, 254.19/100,000 in females), and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.10/100,000 and 186.24/100,000 with the cumulative incidence rate (0–74 age years old) of 21.60%. The cancer mortality was 176.28/100,000 (219.03/100,000 in males, 132.30/100,000 in females), and the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 110.91/100,000 and 109.92/100,000, and the cumulative mortality rate (0–74 age years old) was 12.43%. Low urbanization areas were
Coghill, Anna E; Pfeiffer, Ruth M; Shiels, Meredith S; Engels, Eric A
Background: Human immunodefieciency virus (HIV)-infected persons are living longer in the era of effective HIV treatment, resulting in an increasing cancer burden in this population. The combined effects of HIV and cancer on mortality are incompletely understood.Methods: We examined whether individuals with both HIV and cancer have excess mortality using data from the HIV/AIDS Cancer Match Study and the National Center for Health Statistics (1996-2010). We compared age, sex, and race-stratified mortality between people with and without HIV or one of the following cancers: lung, breast, prostate, colorectum, anus, Hodgkin lymphoma, or non-Hodgkin lymphoma. We utilized additive Poisson regression models that included terms for HIV, cancer, and an interaction for their combined effect on mortality. We report the number of excess deaths per 1,000 person-years for models with a significant interaction (P < 0.05).Results: For all cancers examined except prostate cancer, at least one demographic subgroup of HIV-infected cancer patients experienced significant excess mortality. Excess mortality was most pronounced at younger ages (30-49 years), with large excesses for males with lung cancer (white race: 573 per 1,000 person-years; non-white: 503) and non-Hodgkin lymphoma (white: 236; non-white: 261), and for females with Hodgkin lymphoma (white: 216; non-white: 136) and breast cancer (non-white: 107).Conclusions: In the era of effective HIV treatment, overall mortality in patients with both HIV and cancer was significantly higher than expected on the basis of mortality rates for each disease separately.Impact: These results suggest that HIV may contribute to cancer progression and highlight the importance of improved cancer prevention and care for the U.S. HIV population. Cancer Epidemiol Biomarkers Prev; 26(7); 1027-33. ©2017 AACR. ©2017 American Association for Cancer Research.
Pearce, N; Bethwaite, P
Social class differences in cancer mortality among New Zealand men aged 15-64 years are examined for the period 1984-7. Age-standardised rates are presented for all cancer deaths, and for 23 specific cancer sites. The strongest social class mortality gradients were found for cancers of the larynx, liver, buccal cavity/pharynx, oesophagus, lung and for soft tissue sarcoma. On the other hand, rectal cancer, malignant melanoma, colon cancer, brain/nervous system cancers, and multiple myeloma showed higher death rates for the more advantaged socioeconomic groups. Lung cancer accounted for 54.1% of the overall social class gradient, and the major smoking related cancers (these include buccal/pharynx, oesophagus, larynx, lung and bladder, although it should be stressed that not all cases of these cancers are caused by smoking) accounted for 77.6% of the overall gradient.
Ayotte, Joseph D; Baris, Dalsu; Cantor, Kenneth P; Colt, Joanne; Robinson, Gilpin R; Lubin, Jay H; Karagas, Margaret; Hoover, Robert N; Fraumeni, Joseph F; Silverman, Debra T
Study objective To investigate the possible relation between bladder cancer mortality among white men and women and private water use in New England, USA, where rates have been persistently raised and use of private water supplies (wells) common. Design Ecological study relating age adjusted cancer mortality rates for white men and women during 1985–1999 and proportion of persons using private water supplies in 1970. After regressing mortality rates on population density, Pearson correlation coefficients were computed between residual rates and the proportion of the population using private water supplies, using the state economic area as the unit of calculation. Calculations were conducted within each of 10 US regions. Setting The 504 state economic areas of the contiguous United States. Participants Mortality analysis of 11 cancer sites, with the focus on bladder cancer. Main results After adjusting for the effect of population density, there was a statistically significant positive correlation between residual bladder cancer mortality rates and private water supply use among both men and women in New England (men, r = 0.42; women, r = 0.48) and New York/New Jersey (men, r = 0.49; women, r = 0.62). Conclusions Use of well water from private sources, or a close correlate, may be an explanatory variable for the excess bladder cancer mortality in New England. Analytical studies are underway to clarify the relation between suspected water contaminants, particularly arsenic, and raised bladder cancer rates in northern New England. PMID:16415269
Ayotte, J.D.; Baris, D.; Cantor, K.P.; Colt, J.; Robinson, G.R.; Lubin, J.H.; Karagas, M.; Hoover, R.N.; Fraumeni, J.F.; Silverman, D.T.
Study objective: To investigate the possible relation between bladder cancer mortality among white men and women and private water use in New England, USA, where rates have been persistently raised and use of private water supplies (wells) common. Design: Ecological study relating age adjusted cancer mortality rates for white men and women during 1985-1999 and proportion of persons using private water supplies in 1970. After regressing mortality rates on population density, Pearson correlation coefficients were computed between residual rates and the proportion of the population using private water supplies, using the state economic area as the unit of calculation. Calculations were conducted within each of 10 US regions. Setting: The 504 state economic areas of the contiguous United States. Participants: Mortality analysis of 11 cancer sites, with the focus on bladder cancer. Main results: After adjusting for the effect of population density, there was a statistically significant positive correlation between residual bladder cancer mortality rates and private water supply use among both men and women in New England (men, r=0.42; women, r=0.48) and New York/New Jersey (men, r=0.49; women, r=0.62). Conclusions: Use of well water from private sources, or a close correlate, may be an explanatory variable for the excess bladder cancer mortality in New England. Analytical studies are underway to clarify the relation between suspected water contaminants, particularly arsenic, and raised bladder cancer rates in northern New England.
Silva, Gulnar Azevedo e; Gamarra, Carmen Justina; Girianelli, Vania Reis; Valente, Joaquim Gonçalves
To analyze the corrected trend of overall cancer mortality and leading sites in the state capitals and other municipalities of Brazil between 1980 and 2006. Data on deaths (n = 2,585,012) caused by cancer between 1980 and 2006 were obtained from Sistema de Informações sobre Mortalidade (Mortality Information System), and demographic data were provided by Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). The rates of overall cancer mortality and major types were corrected by proportionally redistributing 50% of ill-defined causes of death and standardizing them by age according to the standard world population. Trend curves for Brazil and its major regions were calculated for state capitals and other municipalities according to sex, and were evaluated by means of simple linear regression. Among men, ascending mortality rates were observed for lung, prostate and colorectal cancer; declining rates for stomach cancer; and stable rates for esophagus cancer. Among women, mortality from breast, lung and colorectal cancer increased, and the rates for cervical and stomach cancer declined. Mortality evolution varied across the regions of Brazil, with distinct patterns between state capitals and other municipalities. The correction of mortality rates based on redistribution of ill-defined causes of death increased the magnitude of the overall cancer mortality in Brazil by approximately 10% in 1980 and 5% in 2006. In the inland municipalities no decrease or stability was identified, differently from what was observed in the state capitals. Limited scope of prevention actions and lower access to services of cancer diagnosis and treatment for the population living away from large urban centers may partly explain these differences.
Background. This paper presents data on breast cancer prevalence and mortality among US Hispanics and Hispanic subgroups, including Cuban, Mexican, Puerto Rican, Central American, and South American. Methods. Five-year average annual female breast cancer prevalence and mortality rates for 2009–2013 were examined using data from the National Health Interview Survey (prevalence) and the National Center for Health Statistics and the American Community Survey (mortality rates). Results. Overall breast cancer prevalence among US Hispanic women was 1.03%. Although the estimates varied slightly by Hispanic subgroup, these differences were not statistically significant. The breast cancer mortality rate for Hispanics overall was 17.71 per 100,000 women. Higher rates were observed among Cubans (17.89), Mexicans (18.78), and Puerto Ricans (19.04), and a lower rate was observed among Central and South Americans (10.15). With the exception of the rate for Cubans, all Hispanic subgroup rates were statistically significantly different from the overall Hispanic rate. Additionally, all Hispanic subgroups rates were statistically significantly higher than the Central and South American rate. Conclusion. The data reveal significant differences in mortality across Hispanic subgroups. These data enable public health officials to develop targeted interventions to help lower breast cancer mortality among the highest risk populations. PMID:27672394
Pou, Sonia Alejandra; Tumas, Natalia; Coquet, Julia Becaria; Niclis, Camila; Román, María Dolores; Díaz, María Del Pilar
The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.
Valean, Simona; Acalovschi, Monica; Diculescu, Mircea; Manuc, Mircea; Goldis, Adrian; Sfarti, Catalin; Trifan, Anca
We aimed to compare the difference in case fatality rate between more developed and very high Human Development Index (HDI) regions, less developed and low HDI regions, and Romania. The incidence and mortality rates for digestive cancers were obtained from the IARC/WHO 2012 database. World mean mortality-to-incidence ratios registered the highest values in pancreatic cancer (0.97/0.94), and liver cancer (0.93/0.96) in males/females, respectively. The lowest values were recorded in colorectal cancer (0.48 in both sexes). Mortality-to-incidence ratios were generally higher in less developed areas, low HDI populations, and in Romania. The difference in case fatality rate between different areas showed higher variations for colorectal, gastric and gallbladder cancers, and smaller variations for esophageal, liver, and pancreatic cancers. In summary, mortality-to-incidence ratios of digestive cancers were high in 2012; higher values were registered in less developed and low HDI regions, and in Romania. Mortality-to-incidence ratios were similar in both sexes, even though the incidence was generally higher in men. Digestive cancer mortality variation suggests the necessity of finding better strategies for prevention, early diagnosis and treatment of digestive cancers.
El Mistiri, Mufid; Salati, Massimiliano; Marcheselli, Luigi; Attia, Adel; Habil, Salah; Alhomri, Faraj; Spika, Devon; Allemani, Claudia; Federico, Massimo
Despite the increasing burden of cancer occurred over recent years in the African continent, epidemiologic data from Northern Africa area have been so far sparse or absent. We present most recently available data from the Benghazi Cancer Registry concerning cancer incidence and mortality as well as the most comprehensive survival data set so far generated for cases diagnosed during 2003 to 2005 in Eastern Libya. We collected and analyzed data on cancer incidence, mortality and survival that were obtained over a 3-year study period from January 1st 2003 to December 31st 2005 from the Benghazi Cancer Registry. A total of 3307 cancer patients were registered among residents during the study period. The world age-standardized incidence rate for all sites was 135.4 and 107.1 per 100,000 for males and females, respectively. The most common malignancies in men were cancers of lung (18.9%), colorectum (10.4%), bladder (10.1%), and prostate (9.4%); among women, they were breast (23.2%), colorectum (11.2%), corpus uteri (6.7%), and leukemia (5.1%). A total of 1367 deaths for cancer were recorded from 2003 to 2005; the leading causes of cancer death were cancers of the lung (29.3%), colorectum (8.2%), and brain (7.3%) in males and cancers of breast (14.8%), colorectum (10.6%), and liver (7%) in females. The 5-year relative survival for all cancer combined was 22.3%; survival was lower in men (19.8%) than in women (28.2%). This study provides an updated report on cancer incidence, mortality, and survival, in Eastern Libya which may represent a useful tool for planning future interventions toward a better cancer control. Copyright © 2015 Elsevier Inc. All rights reserved.
Pira, Enrico; Manzari, Marco; Gallus, Silvano; Negri, Eva; Bosetti, Cristina; Romano, Canzio; McLaughlin, Joseph K; Boffetta, Paolo; La Vecchia, Carlo
To examine cancer mortality in continuous glass filament workers. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first employment, time since first or last employment, or duration of employment for any of the causes considered. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.
Sarma, Aruna V; Schottenfeld, David
The increased use of prostate-specific antigen (PSA) in screening for preclinical disease after 1985 is thought to be a major determinant of the changing patterns in prostate cancer incidence; however, the long-term effect of screening on future trends in mortality and survival is uncertain. This article reviews the temporal trends (1981-1998) for prostate cancer incidence, mortality, and survival, and projects prostate cancer incidence and mortality rates for 1999 to 2001. Autoregressive, quadratic, time-series models were used to describe prostate cancer mortality rates in the US population and prostate cancer incidence rates derived from the National Cancer Institute's (NCI) Surveillance, Epidemiology and End Results (SEER) program. These models were based on data collected from 1979 through 1998, with forecasts produced for 1999 to 2001. Prostate cancer incidence increased steadily from 1981 to 1989, with a steep increase in the early 1990s, followed by a decline. Incidence rates were forecasted to remain stable through the year 2001. Mortality rates decreased steadily and were forecasted to continue to decrease concurrently with increasing 5- and 10-year relative survival rates. The incidence, mortality, and survival trends were comparable in US blacks, who exhibited on average 2-fold higher mortality and 50% higher incidence than whites. Decreasing prostate cancer mortality and increasing relative survival trends in the United States were described after the introduction of PSA screening. However, the exaggerated rate of increase in the early 1990s in prostate cancer incidence was transient and likely a result of increased detection of preclinical disease that was prevalent in the general population. Copyright 2002 by W.B. Saunders Company
Espey, David K.; Swan, Judith; Wiggins, Charles L.; Eheman, Christie; Kaur, Judith S.
Objectives. We used improved data on American Indian and Alaska Native (AI/AN) ancestry to provide an updated and comprehensive description of cancer mortality and incidence among AI/AN populations from 1990 to 2009. Methods. We linked the National Death Index and central cancer registry records independently to the Indian Health Service (IHS) patient registration database to improve identification of AI/AN persons in cancer mortality and incidence data, respectively. Analyses were restricted to non-Hispanic persons residing in Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted mortality and incidence rates for AI/AN populations with White populations using rate ratios and mortality-to-incidence ratios. Trends were described using joinpoint analysis. Results. Cancer mortality and incidence rates for AI/AN persons compared with Whites varied by region and type of cancer. Trends in death rates showed that greater progress in cancer control was achieved for White populations compared with AI/AN populations over the last 2 decades. Conclusions. Spatial variations in mortality and incidence by type of cancer demonstrated both persistent and emerging challenges for cancer control in AI/AN populations. PMID:24754660
Bisanti, L; Maggini, M; Raschetti, R; Alegiani, S S; Ippolito, F M; Caffari, B; Segnan, N; Ponti, A
A cohort of 1971 chemical workers licensed to handle ethylene oxide was followed up retrospectively from 1940 to 1984 and the vital status of each subject was ascertained. No quantitative information on exposure was available and therefore cohort members were considered as presumably exposed to ethylene oxide. The cohort comprised 637 subjects allowed to handle only ethylene oxide and 1334 subjects who obtained a licence valid for ethylene oxide as well as other toxic gases. Potential confounding arising from the exposure to these other chemical agents was taken into consideration. Causes of death were found from death certificates and comparisons of mortality were made with the general population of the region where cohort members were resident. Seventy six deaths were reported whereas 98.8 were expected; the difference was statistically significant. The number of malignancies for any site exceeded the expected number (standardised mortality ratio (SMR) = 130; 43 observed deaths; 95% confidence interval (95% CI) 94-175) and approached statistical significance. For all considered cancer sites the SMRs were higher than 100 but the excess was only significant (p < 0.05, two sided test) for lymphosarcoma and reticulosarcoma (International Classification of Diseases--9th revision (ICD-9) = 200; SMR = 682; four observed deaths; 95% CI 186-1745). The excess of cases for all cancers of haematopoietic tissue (ICD-9 = 200-208) also approached statistical significance (SMR = 250; six observed deaths; 95% CI 91-544). Focusing the analysis on the subcohort of the ethylene oxide only licensed workers, who are likely to have experienced a more severe exposure to this gas, it became evident that all but one of the observed cases of haematopoietic tissue cancers in the cohort were confined to this subgroup, enhancing the relevant SMR to 700 (95% CI 237-1637) and the SMR of lymphosarcoma and reticulosarcoma to 1693 (95% CI 349-4953). PMID:8494771
Erin Noonan-Wright; Sharon M. Hood; Danny R. Cluck
Mortality and reduced growth rates due to raking accumulated basal duff were evaluated for old, large-diameter ponderosa and Jeffrey pine trees on the Lassen National Forest, California. No fire treatments were included to isolate the effect of raking from fire. Trees were monitored annually for 5 years after the raking treatment for mortality and then cored to measure...
An examination of death rates among the elderly and trends over the period 1950-1975 and 1970-1975 for selected developed nations provides evidence of continued strong mortality declines for females and somewhat mixed results for males. Implications of these trends for forecasting the mortality component of U.S. population projections are…
Zakeri, Kaveh; MacEwan, Iain; Vazirnia, Aria; Cohen, Ezra E W; Spiotto, Michael T; Haraf, Daniel J; Vokes, Everett E; Weichselbaum, Ralph R; Mell, Loren K
Black patients with head and neck cancer (HNC) have poorer survival and disease control compared to non-black patients, but disparities in death from non-cancer causes (i.e., competing mortality) are less well-studied. We conducted an analysis of 538 patients (169 black, 369 non-black) with stage III-IV HNC treated on one of six multi-institutional protocols between 1993 and 2004 involving multi-agent chemoradiotherapy with or without surgery. Competing mortality was defined as death due to intercurrent comorbid disease, treatment-related morbidity, or unknown cause in the absence of disease recurrence, progression, or second malignancy. Cox proportional hazards and competing risks regression were used to estimate the effect of black race on competing mortality. Black race was associated with increased rates of comorbidity, smoking, heavy alcohol use, advanced tumor stage, and poorer performance status (p<.001 for all). Compared to non-black patients, black HNC patients had a higher 5 year cumulative incidence of disease progression (31.4%; 95% CI, 24.4-38.5% vs 23.4%; 95% CI, 19.1-28.1%) and competing mortality (28.1%; 95% CI, 21.2-35.3% vs 14.5%; 95% CI, 11.0-18.5%). When adjusting for age, male sex, body mass index, distance traveled, smoking and alcohol use, performance status, comorbidity, and tumor stage, the black race was associated with death from comorbid disease (Cox hazard ratio 2.13; 95% CI, 1.06-4.28, p=0.033). Black patients with advanced HNC are at increased risk of both disease progression and death from competing non-cancer mortality, particularly death from comorbid disease. Improved strategies to manage comorbid disease may increase the benefit of treatment intensification in black patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
Leggett, R.W.; Crawford, D.J.
A method is presented for projecting mortality rates for certain causes on the basis of observed rates during past years. This method arose from a study of trends in age-specific mortality rates for respiratory cancers, and for heuristic purposes it is shown how the method can be developed from certain theories of cancer induction. However, the method is applicable in the more common situation in which the underlying physical processes cannot be modeled with any confidence but the mortality rates are approximable over short time intervals by functions of the form a exp(bt), where b may vary in a continuous, predictable fashion as the time interval is varied. It appears from applications to historical data that this projection method is in some cases a substantial improvement over conventional curve-fitting methods and often uncovers trends which are not apparent from observed data.
Leggett, R.W.; Crawford, D.J.
A method is presented for projecting mortality rates for certain causes on the basis of observed rates during past years. This method arose from a study of trends in age-specific mortality rates for respiratory cancers, and for heuristic purposes it is shown how the method can be developed from certain theories of cancer induction. However, the method is applicable in the more common situation in which the underlying physical processes cannot be modeled with any confidence but the mortality rates are approximable over short time intervals by functions of the form a exp(bt), where b may vary in a continuous, predictable fashion as the time interval is varied. It appears from applications to historical data that this projection method is in some cases a substantial improvement over conventional curve-fitting methods and often uncovers trends which are not from observed data.
Weinberg, C.R.; Brown, K.G.; Hoel, D.G.
The variation in background radiation levels is an important source of information for estimating human risks associated with low-level exposure to ionizing radiation. Several studies conducted in the United States, correlating mortality rates for cancer with estimated background radiation levels, found an unexpected inverse relationship. Such results have been interpreted as suggesting that low levels of ionizing radiation may actually confer some benefit. An environmental factor strongly correlated with background radiation is altitude. Since there are important physiological adaptations associated with breathing thinner air, such changes may themselves influence risk. We therefore fit models that simultaneously incorporated altitude and background radiation as predictors of mortality. The negative correlations with background radiation seen for mortality from arteriosclerotic heart disease and cancers of the lung, the intestine, and the breast disappeared or became positive once altitude was included in the models. By contrast, the significant negative correlations with altitude persisted with adjustment for radiation. Interpretation of these results is problematic, but recent evidence implicating reactive forms of oxygen in carcinogenesis and atherosclerosis may be relevant. We conclude that the cancer correlational studies carried out in the United States using vital statistics data do not in themselves demonstrate a lack of carcinogenic effect of low radiation levels, and that reduced oxygen pressure of inspired air may be protective against certain causes of death.
Ekwueme, Donatus U; Guy, Gery P; Rim, Sun Hee; White, Arica; Hall, Ingrid J; Fairley, Temeika L; Dean, Hazel D
Breast cancer is the second-leading cause of cancer-related deaths among women aged <50 years. Studies on the effects of breast cancer mortality among young women are limited. To assess trends in breast cancer mortality rates among women aged 20-49 years, estimate years of potential life lost (YPLL), and the value of productivity losses due to premature mortality. Age-adjusted rates and rate ratios (RRs) were calculated using 1970-2008 U.S. mortality data. Breast cancer mortality rates over time were assessed using Joinpoint regression modeling. YPLL was calculated using number of cancer deaths and the remaining life expectancy at the age of death. Value of productivity losses was estimated using the number of deaths and the present value of future lifetime earnings. From 1970 to 2008, the age-adjusted breast cancer mortality rate among young women was 12.02/100,000. Rates were higher in the Northeast (RR=1.03, 95% CI, 1.02-1.04). The annual decline in breast cancer mortality rates among blacks was smaller (-0.68%) compared with whites (-2.02%). The total number of deaths associated with breast cancer was 225,866, which accounted for an estimated 7.98 million YPLL. The estimated total productivity loss in 2008 was $5.49 billion and individual lifetime lost earnings were $1.10 million. Considering the effect of breast cancer on women of working age and the disproportionate impact on black women, more age-appropriate interventions with multiple strategies are needed to help reduce these substantial health and economic burdens, improve survival, and in turn reduce productivity costs associated with premature death. Published by American Journal of Preventive Medicine on behalf of American Journal of Preventive Medicine.
Borja-Aburto, Víctor Hugo; Dávila-Torres, Javier; Rascón-Pacheco, Ramón Alberto; González-León, Margot; Fernández-Gárate, José Esteban; Mejía-Rodríguez, Ivonne; González-Izquierdo, José de Jesús; Escudero-de Los Ríos, Pedro Mario
Objetive: To analyze cancer mortality in affiliates of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social - IMSS) and time trends in the risk of death due to cancer from 1989 to 2013. A descriptive analysis of cancer mortality trends in beneficiaries of the IMSS was performed. Age- and sex-adjusted mortality rates were obtained using direct standardization with the WHO population. Changes in the risk of death due to cancer over time were evaluated using Poisson regression. The absolute number of deaths due to cancer doubled from 1989 to 2013 due to increasing age of the affiliate population. The risk of death among affiliates decreased for the majority of cancers except for colon and rectal cancer. The risk of dying from cancer among IMSS affiliates showed a marked decrease, which may be due to an increase in detection and opportune treatment.
Björ, Ove; Jonsson, Håkan; Damber, Lena; Wahlström, Jens; Nilsson, Tohr
Historically, working in iron-ore mines has been associated with an increased risk of lung cancer and silicosis. However, studies on other causes of mortality are inconsistent and in the case of cancer incidence, sparse. The aim of this study was to examine the association between iron-ore mining, mortality and cancer incidence. A 54-year cohort study on iron-ore miners from mines in northern Sweden was carried out comprising 13,000 workers. Standardized rate ratios were calculated comparing the disease frequency, mortality, and cancer incidence with that of the general population of northern Sweden. Poisson regression was used to evaluate the association between the durations of employment and underground work, and outcome. Underground mining was associated with a significant decrease in adjusted mortality rate ratios for cerebrovascular and digestive system diseases, and stroke. For several outcomes, elevated standardized rate ratios were observed among blue-collar workers relative to the reference population. However, only the incidence of lung cancer increased with employment time underground (P < 0.001). Long-term iron-ore mining underground was associated with lower rates regarding several health outcomes. This is possibly explained by factors related to actual job activities, environmental exposure, or the selection of healthier workers for long-term underground employment. Copyright © 2013 Wiley Periodicals, Inc.
Moulin, J J; Lafontaine, M; Mantout, B; Belanger, A; Michel, M; Wild, P; Clavel, T; Fournier, M; Fontana, J M
A mortality study was carried out in two factories producing stainless steel in order to assess lung cancer risk among workers employed in coke oven, blast and open hearth furnaces, foundry, electric furnace, hot and cold rolling mills and pickling areas. Occupational exposures of interest were chromium compounds, nickel compounds, polycyclic aromatic hydrocarbons (PAH), silica and asbestos. All male workers having at least one year of employment between 01.01.1960 and 31.12.1990 were followed up for mortality. The vital status was assessed from birth place registries. Complete job histories since date of first employment were abstracted from the company files. The smoking habits of 50% of the cohort members were known from medical records. The observed number of deaths (obs) were compared with the expected ones based on regional rates with adjustment for age, sex and calendar time (Standardized Mortality Ratio, SMR). The cohorts included 6324 (factory 1) and 5270 (factory 2) workers. The overall mortality did not differ markedly from that expected in both factories: SMR = 0.95 (obs = 1540, p = 0.05) in factory 1 and SMR = 1.06 (obs = 916, non-significant) in factory 2. SMRs for lung cancer did not differ from unity, respectively 0.99 (obs = 105) and 1.00 (obs = 54), in whole cohorts. Non-significant lung cancer excesses were observed among workers of some workshops where exposures of interest might have occurred: coke oven (SMR = 2.04), blast furnace (SMR = 1.36), open hearth furnace (SMR = 1.75), hot rolling mills (SMR = 1.29). These processes, however, are no longer involved in the study factories. Furthermore, no lung cancer excess was observed among workers employed in current workshops: electric furnaces and cold rolling mills.
Wilson, Dulaney A; Mohr, Lawrence C; Frey, G Donald; Lackland, Daniel; Hoel, David G
The Mayak Production Association (MPA) worker registry has shown evidence of plutonium-induced health effects. Workers were potentially exposed to plutonium nitrate [(239)Pu(NO(3))(4)] and plutonium dioxide ((239)PuO(2)). Studies of plutonium-induced health effects in animal models can complement human studies by providing more specific data than is possible in human observational studies. Lung, liver, and bone cancer mortality rate ratios in the MPA worker cohort were compared to those seen in beagle dogs, and models of the excess relative risk of lung, liver, and bone cancer mortality from the MPA worker cohort were applied to data from life-span studies of beagle dogs. The lung cancer mortality rate ratios in beagle dogs are similar to those seen in the MPA worker cohort. At cumulative doses less than 3 Gy, the liver cancer mortality rate ratios in the MPA worker cohort are statistically similar to those in beagle dogs. Bone cancer mortality only occurred in MPA workers with doses over 10 Gy. In dogs given (239)Pu, the adjusted excess relative risk of lung cancer mortality per Gy was 1.32 (95% CI 0.56-3.22). The liver cancer mortality adjusted excess relative risk per Gy was 55.3 (95% CI 23.0-133.1). The adjusted excess relative risk of bone cancer mortality per Gy(2) was 1,482 (95% CI 566.0-5686). Models of lung cancer mortality based on MPA worker data with additional covariates adequately described the beagle dog data, while the liver and bone cancer models were less successful.
Day, Thomas G; Scott, Martin; Perring, Roslyn; Doyle, Pat
Motor neuron disease (MND) mortality rates are rising in Europe and the USA. The most comprehensive UK study was conducted more than 15 years ago. This study examines trends in mortality from MND in England & Wales, and Scotland, between 1975 and 2004. Age, gender, and cause-specific mortality rates were calculated for the period 1975-2004 using national data from England & Wales, and Scotland. Rates were directly age-standardized to the European standard population. Trends in mortality rates over time were examined for men and women separately, as well as by the age groups 0-59 years, and 60 or more years. MND mortality rates rose steadily over the 30-year period 1975-2004 in both sexes in England & Wales, and Scotland. There is a clear upward trend in all four groups (p for trend <0.001). All increases were largely restricted to the age group 60 years and above, with rates showing increases of 70-80%, and no evidence of a flattening of this trajectory. Rates for the 0-59 years age group remained stable over the period. There is evidence of a narrowing of the male-female gap in mortality rates for the age group over 60 years in England and Wales.
Pakzad, Reza; Mohammadian-Hafshejani, Abdollah; Ghoncheh, Mahshid; Pakzad, Iraj
Background Lung cancer is the deadliest cancer worldwide and the most common cancer in Asia. It is necessary to get information on epidemiology and inequalities related to incidence and mortality of the cancer to use for planning and further research. This study aimed to investigate epidemiology and inequality of incidence and mortality from lung cancer in Asia. Methods The study was conducted based on data from the world data of cancer and the World Bank [including the Human Development Index (HDI) and its components]. The incidence and mortality rates, and cancer distribution maps were drawn for Asian countries. To analyze data, correlation test between incidence and death rates, and HDI and its components at significant was used in the significant level of 0.05 using SPSS software. Results A total of 1,033,881 incidence (71.13% were males and 28.87% were females. Sex ratio was 2.46) and 936,051 death (71.45% in men and 28.55% in women. The sex ratio was 2.50) recorded in Asian countries in 2012. Five countries with the highest standardized incidence and mortality rates of lung cancer were Democratic Republic of Korea, China, Armenia, Turkey, and Timor-Leste, respectively. Correlation between HDI and standardized incidence rate was 0.345 (P=0.019), in men 0.301 (P=0.042) and in women 0.3 (P=0.043); also between HDI and standardized mortality rate 0.289 (P=0.052), in men 0.265 (P=0.075) and in women 0.200 (P=0.182). Conclusions The incidence of lung cancer has been increasing in Asia. It is high in men. Along with development, the incidence and mortality from lung cancer increases. It seems necessary to study reasons and factors of increasing the incidence and mortality of lung cancer in Asian countries. PMID:26798586
Ott, J J; Ullrich, A; Mascarenhas, M; Stevens, G A
The objective is to systematically estimate the current cancer incidence and mortality from the six leading cancer types globally and by sub-regions resulting from exposure to known risk factors such as tobacco use, elevated body weight, alcohol consumption, inadequate physical activity, unhealthy diet and infections. Cancer incidence, mortality and burden of disease caused by the main cancer risk factors were calculated using comparative risk assessment methods and updated data on mortality and risks. Lung cancer was the most common cancer in men and breast cancer the most common cancer in women, both in terms of incidence and mortality. The five leading behavioral and dietary risks--high body mass index, low fruit and vegetable intake, physical inactivity, tobacco use and alcohol use--were responsible for 24% of new cancer cases and 30% of cancer deaths. Cancers with the largest proportions attributable to preventable risk factors were cervical cancer (100%) and lung cancer (71%). Seventy percent of liver cancers and 60% of stomach cancers were due to infectious agents. A higher proportion of cancer deaths was attributed to infections in low- and middle-income than in high-income countries. The cancer burden is driven by changes in exposure to influential risk factors and can be influenced by preventive interventions aimed at reducing these exposures.
Sullivan, Kevin; Hossain, S M Moazzem; Woodruff, Bradley A
Surveys are conducted frequently in humanitarian emergencies to assess the health status of the population. Most often, they employ complex sample designs, such as cluster sampling. Mortality is an indicator commonly estimated in such surveys. Confidence limits provide information on the precision of the estimate and it is important to ensure that confidence limits for a mortality rate account for the survey design and utilise an acceptable methodology. This paper describes the calculation of confidence limits for mortality rates from surveys using complex sampling designs and a variety of software programmes and methods. It contains an example that makes use of the SAS, SPSS, and Epi Info software programmes. Of the three confidence interval methods examined--the ratio command approach, the modified rate approach, and the modified proportion approach--the paper recommends the ratio command approach to estimate mortality rates with confidence limits.
Hernández-Vásquez, Akram; Bendezú-Quispe, Guido; Azañedo, Diego; Huarez, Bertha; Rodríguez-Lema, Belén
To estimate and analyze the evolution of mortality rates of gastrointestinal (GI) cancer in Peru and its regions between 2005-2014. We performed a nationwide secondary analysis of Peru's Health Ministry registry of deaths during the period 2005-2014, with a focus on regional differences. Deaths registered with codes C15 to C25 (malignant neoplasms of digestive organs) from the ICD-10 were included. Calculation of age-standarized mortality rates and years of life lost (YLL) due to GI cancer per 100,000 habitants were also performed. Data of 67,527 deaths from GI cancers was analyzed, 35,055 (51.91%) were women. In 2005, the number of GI cancer deaths was 6,484, for 2014, 7,532 cases were recorded. The GI cancer age-standarized mortality rates at the country level showed a decrease of 12.70% between 2005-2014. Stomach cancer presented the highest age-standarized mortality rate despite showing a downward trend in the last years, equal for gallbladder, liver and biliary tract, and esophagus cancer. Colorectal, small intestine and anus cancer show a progressive increase. In 2014, Callao (48.8), Huancavelica (48.5), La Libertad (39.6), Lambayeque (40.5) and Huanuco (38.9) had the highest rates. The three types of GI cancers with the highest rates of YLL in 2014 were stomach cancer (118.51), followed by liver and biliary tract cancer (58.68) and colorectal (44.86). GI cancer mortality in Peru is high and a priority issue in regions like Huancavelica, Huanuco, Callao, La Libertad and Lambayeque. Stomach cancer remains the most frequent GI cancer, but with a downward trend in the study period.
Baena, Armando; Almonte, Maribel; Valencia, Marta Lía; Martínez, Santiago; Quintero, Katherine; Sánchez, Gloria I
To estimate the mortality age-standardized rates (ASR) for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03) but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003). Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty.
Sarfati, Diana; Blakely, Tony; Shaw, Caroline; Cormack, Donna; Atkinson, June
To test whether trends in breast cancer mortality varied by ethnicity and socio-economic position during the 1980s and '90s in New Zealand. Four cohorts of the entire New Zealand population for 1981-84; 86-89; 91-94 and 96-99 allowed direct determination of socio-economic trends in breast cancer mortality. For ethnicity, unlinked routine census and mortality data were used with adjustment factors for undercounting of Māori and Pacific deaths. Māori and non-Māori non-Pacific mortality rates changed little until mid-1990s with Māori experiencing 25% higher mortality. In 1996-99, Māori rates increased notably to become 68% higher than non-Māori non-Pacific (SRR 1.68; 95% CI: 1.49-1.90). Pacific women experienced an approximate three-fold increase in breast cancer mortality over time. There appeared to be reducing mortality among higher income and education groups but trends within socio-economic groups were not statistically significant. Nevertheless, by 1996-99, there was a significant 22% excess mortality (SRR 1.22; 95% CI: 1.01-1.49) for low compared with high-income groups. Widening ethnic, and probably, socio-economic disparities in breast cancer mortality are likely due to both underlying incidence and differential survival trends. Disparities are likely to increase once the full differential mortality benefits of screening impact on the population.
Bravo, Luis Eduardo; HidalgoTroya, Arsenio; Jurado, Daniel Marcelo; Bravo, Luisa Mercedes
Introduction: In Colombia, information on cancer morbidity at the population level is limited. Incidence estimates for most regions are based on mortality data. To improve the validity of these estimates, it is necessary that other population-based cancer registries, as well as Cali, provide cancer risk information. Objective: To describe the incidence and cancer mortality in the municipality of Pasto within the 1998-2007 period. Methods: The study population belongs to rural and urban areas of the municipality of Pasto. Collection, processing, and systematization of the data were performed according to internationally standardized parameters for population-based cancer registries. The cancer incidence and mortality rates were calculated by gender, age, and tumor Results: During the 1998-2007 period 4,986 new cases of cancer were recorded of which 57.7% were in female. 2,503 deaths were presented, 52% in female. Neoplasm-associated infections are the leading cause of cancer morbidity in Pasto: stomach cancer in males and cervical cancer in females. Discussion: Cancer in general is a major health problem for the population of the municipality of Pasto. The overall behavior of the increasing incidence and cancer mortality in relation to other causes of death show the need to implement and strengthen prevention and promotion programs, focusing especially on tumors that produce greater morbidity and mortality in the population. PMID:24893298
Wagner, Sara E.; Hurley, Deborah M.; Hébert, James R.; McNamara, Chrissy; Bayakly, A. Rana; Vena, John E.
Background To evaluate racial cancer disparities in Georgia (GA) by calculating and comparing mortality-to-incidence ratios (MIR) by health district and in relation to geographical factors. Methods Data sources included: cancer incidence (GA Comprehensive Cancer Registry), cancer mortality (GA Vital Records), and health factor (County Health Rankings) data. Age-adjusted incidence and mortality rates were calculated by cancer site (all sites combined, lung, colorectal, prostate, breast, oral, and cervical) for 2003–2007. MIRs and 95% confidence intervals were calculated overall and by district for each cancer site, race, and gender. MIRs were mapped by district and compared to geographic health factors. Results 186,419 incident cases and 71,533 deaths were identified. Blacks had higher MIRs than Whites for every cancer site evaluated, with especially large differentials observed for prostate, cervical, and oral cancer in men. Large geographic disparities were detected, with larger MIRs, chiefly among Blacks, in GA as compared to national data. The highest MIRs were detected in west and east central GA; the lowest MIRs were detected in and around Atlanta. Districts with better health behavior, clinical care, and social/economic factors had lower MIRs, especially among Whites. Conclusion More fatal cancers, particularly prostate, cervical, and oral cancer in men were detected among Blacks, especially in central GA, where health behavior and social/economic factors were worse. MIRs are an efficient indicator of survival and provide insight into racial cancer disparities. Additional examination of geographical determinants of cancer fatality in GA as indicated by MIRs is warranted. PMID:22294294
Divan, Hozefa A
The purpose of this paper is to provide a framework for future research and awareness activities in the United States. The current literature in the English language on cancer incidence and mortality among Asian Indians was reviewed. Asian Indians comprise 89% of the U.S. South Asian population. There are few studies in the United States or Canada on cancer incidence or mortality. In India, oral and cervical cancers have high incidence and mortality rates, but the rates of cancers common in the West are rising. In Great Britain, cancer rates in the South Asian community are similar to those of their non-Asian counterparts. Cancer incidence and mortality rates in India and Great Britain provide a foundation for scientific inquiry among this population in the United States, but more data is needed to assess the cancer burden and implement cancer prevention activities in this country.
Vilaprinyo, Ester; Gispert, Rosa; Martínez-Alonso, Montserrat; Carles, Misericòrdia; Pla, Roger; Espinàs, Josep-Alfons; Rué, Montserrat
Background Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions. Methods The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death. Results There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945–54 in the 40–49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts. Conclusion We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia
Chatenoud, L; Bertuccio, P; Bosetti, C; Malvezzi, M; Levi, F; Negri, E; La Vecchia, C
Between the 1970s and 2000 mortality in most of Latin America showed favorable trends for some common cancer sites, including stomach and male lung cancer. However, major concerns were related to mortality patterns from other cancers, particularly in women. We provide an up-to-date picture of patterns and trends in cancer mortality in Latin America. We analyzed data from the World Health Organization mortality database in 2005-2009 for 20 cancer sites in 11 Latin American countries and, for comparative purposes, in the USA and Canada. We computed age-standardized (world population) rates (per 100 000 person-year) and provided an overview of trends since 1980 using joinpoint regression models. Cancer mortality from some common cancers (including colorectum and lung) is still comparatively low in Latin America, and decreasing trends continue for other cancer sites (including stomach, uterus, male lung cancers) in several countries. However, there were upward trends for colorectal cancer mortality for both sexes, and for lung and breast cancer mortality in women from most countries. During the last decade, lung cancer mortality in women rose by 1%-3% per year in all Latin American countries except Mexico and Costa Rica, whereas rises of about 1% were registered for breast cancer in Brazil, Colombia and Venezuela. Moreover, high mortality from cancer of the cervix uteri was recorded in most countries, with rates over 13/100 000 women in Cuba and Venezuela. In men, upward trends were registered for prostate cancer mortality in Brazil and Colombia, but also in Cuba, where the rate in 2005-2009 was more than twice that of the USA (23.6 versus 10/100 000). Tobacco control, efficient screening programs, early cancer detection and widespread access to treatments continue to be a major priority for cancer prevention in most Latin American countries. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights
Cayuela, A; Vioque, J; Bolumar, F
STUDY OBJECTIVE--The aim of the study was to explore temporal changes in mortality from oesophageal cancer that could be related to tobacco and alcohol consumption. DESIGN--The study used mortality trends from oesophageal cancer over the period 1951-1985. In addition, available trends on per capita consumption of alcohol and cigarettes are also presented. SETTING--Data for this study were derived from Spain's National Institute for Statistics. MAIN RESULTS--Age standardised mortality rates from oesophageal cancer have increased significantly among men in Spain from 1951 to 1985 (p less than 0.01). Mortality rates in women have not changed significantly during the same period, although there is evidence of a certain decrease in recent years. Trends of per capita cigarette consumption from 1957 to 1982 related positively with oesophageal cancer mortality among men, whereas no significant relationship was observed in women. Trends of beer, spirits, and total alcohol consumption were also positively correlated with oesophageal cancer mortality in men. Among women, a weaker relationship was found. Wine consumption showed no relationship with oesophageal cancer mortality either in men or women. CONCLUSIONS--These results are similar to those found in other studies, supporting a role of alcohol (spirits and beer) and cigarette consumption in causation of oesophageal cancer. No relationship was observed with wine consumption. PMID:1795145
Tan, Chon Sern; Pooi, Ah Hin
Prediction of future mortality rates is crucial to insurance companies because they face longevity risks while providing retirement benefits to a population whose life expectancy is increasing. In the past literature, a time series model based on multivariate power-normal distribution has been applied on mortality data from the United States for the years 1933 till 2000 to forecast the future mortality rates for the years 2001 till 2010. In this paper, a more dynamic approach based on the multivariate time series will be proposed where the model uses stochastic parameters that vary with time. The resulting prediction intervals obtained using the model with stochastic parameters perform better because apart from having good ability in covering the observed future mortality rates, they also tend to have distinctly shorter interval lengths.
Wentzien, Derald E.; Bautista, Riza C.; Gross, Catherine C.
As Delaware’s adult obesity crisis continues to be a leading public health concern, we evaluated Delaware’s 1999–2014 vital records to examine the association between obesity and mortality. We used the Delaware population death records from the Centers for Disease Control and Prevention (CDC) WONDER database and the Delaware Health Statistics Center (DHSC). Together with the vital records, we incorporated Microsoft Excel, SAS (Statistical Analysis System) and GIS (geographic information system) tools to analyze obesity influences from county residence, economic status, education, gender, and race. Using the 15-year (1999–2014) time span with the CDC WONDER database, we observed a statistically significant 28.7% increase in the age-adjusted Delaware obesity-related mortality rates (where obesity was a contributory factor). Furthermore, obesity influenced death counts in all three Delaware counties (New Castle, Kent, and Sussex). Kent County experienced the largest increase (66.0%), followed by New Castle County (47.4%), and Sussex County (25.2%). The DHSC mortality rates for all leading causes of death from 2000 to 2011 indicated relatively stable mortality rates for Delaware. However, using CDC WONDER data, the Delaware mortality rate for obesity as a single underlying cause in 2011 was 56.9% higher than mortality rate in 2000. PMID:28690914
Nelson, A S; Ashton, L J; Vajdic, C M; Le Marsney, R E; Daniels, B; Nivison-Smith, I; Wilcox, L; Dodds, A J; O'Brien, T A
We examined risk of second cancer and late mortality in a population-based Australian cohort of 717 pediatric allogeneic stem cell transplant (HSCT) recipients treated for a malignant disease during 1982-2007. Record linkage with population-based death and cancer registries identified 17 second cancers at a median of 7.9 years post HSCT; thyroid cancer being the most common malignancy (n=8). The cumulative incidence of second cancer was 8.7% at follow-up, and second cancers occurred 20 times more often than in the general population (standardised incidence ratio 20.3, 95% confidence interval (CI)=12.6-32.7). Transplantation using radiation-based conditioning regimens was associated with increased second cancer risk. A total of 367 patients survived for at least 2 years post HSCT and of these 44 (12%) died at a median of 3.1 years after HSCT. Relapse was the most common cause of late mortality (n=32). The cumulative incidence of late mortality was 14.7%. The observed rate of late mortality was 36 times greater than in the matched general population (standardised mortality ratio 35.9, 95% CI=26.7-48.3). Recipients who relapsed or who had radiation-based conditioning regimens were at higher risk of late mortality. Second cancers and late mortality continue to be a risk for pediatric patients undergoing HSCT, and these results highlight the need for effective screening and survivorship programs.
Gibson, Todd M.; Robison, Leslie L.
Survival of children and adolescents diagnosed with cancer has improved dramatically in recent decades, but the substantial burden of late morbidity and mortality (i.e. more than five years after cancer diagnosis) associated with pediatric cancer treatments is increasingly being recognized. Progression or recurrence of the initial cancer is a primary cause of death in the initial post-diagnosis period, but as survivors age there is a dramatic shift in the cause-specific mortality profile. By 15 years post-diagnosis, the death rate attributable to health-related causes other than recurrence or external causes (e.g. accidents, suicide, assault) exceeds that due to primary disease, and by 30 years these causes account for the largest proportion of cumulative mortality. The two most prominent causes of treatment-related mortality in childhood cancer survivors are subsequent malignant neoplasms and cardiovascular problems, incidence of which can be largely attributed to the long-term toxicities of radiation and chemotherapy exposures. These late effects of treatment are likely to increase in importance as survivors continue to age, inspiring continued research to better understand their etiology and to inform early detection or prevention efforts. PMID:25474125
Gibson, Todd M; Robison, Leslie L
Survival of children and adolescents diagnosed with cancer has improved dramatically in recent decades, but the substantial burden of late morbidity and mortality (i.e., more than 5 years after cancer diagnosis) associated with pediatric cancer treatments is increasingly being recognized. Progression or recurrence of the initial cancer is a primary cause of death in the initial postdiagnosis period, but as survivors age, there is a dramatic shift in the cause-specific mortality profile. By 15 years postdiagnosis, the death rate attributable to health-related causes other than recurrence or external causes (e.g., accidents, suicide, assault) exceeds that due to primary disease, and by 30 years, these causes account for the largest proportion of cumulative mortality. The two most prominent causes of treatment-related mortality in childhood cancer survivors are subsequent malignant neoplasms and cardiovascular problems, the incidence of which can be largely attributed to the long-term toxicities of radiation and chemotherapy exposures. These late effects of treatment are likely to increase in importance as survivors continue to age, inspiring continued research to better understand their etiology and to inform early detection or prevention efforts.
Singh, Gopal K.; Azuine, Romuladus E.; Siahpush, Mohammad
Objectives This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI), socioeconomic factors, Gender Inequality Index (GII), and healthcare expenditure. Methods Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates. Results Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks. Conclusions and Public Health Implications Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by reducing
Alshayeb, Hala M; Showkat, Arif; Babar, Fatima; Mangold, Therese; Wall, Barry M
Hypernatremia is a common problem in hospitalized patients and is associated with high morbidity and mortality. This study was designed to evaluate whether physicians follow the recommended guidelines for the rate of correction of hypernatremia of ≤0.5 mEq/L/hr and to evaluate the effect of the rate of correction of severe hypernatremia on the mortality of hospitalized patients. A retrospective chart review of 131 consecutively hospitalized patients with severe hypernatremia (serum sodium ≥155 mEq/L) was performed. Primary outcomes were 30-day patient mortality and 72-hour hypernatremia correction. The first 24-hour serum sodium (Na(+)) correction rate was tested as a categorical variable; slow rate (<0.25 mEq/L/hr) and fast rate (≥0.25 mEq/L/hr). The mean admission serum Na level was 159 ± 3 mEq/L. Ninety percent of patients received the recommended <0.5 mEq/L/hr serum Na(+) correction rate; however, hypernatremia was corrected only in 27% of patients after 72 hours of treatment. Thirty-day patient mortality rate was 37%. In multivariable analysis, do not resuscitate status [hazards ratio (HR), 3.85; P < 0.0001], slower correction rate of hypernatremia (HR, 2.63; P = 0.02) and high heart rate (>100 beats/min; HR, 1.99; P = 0.03) were the independent predictors of 30-day mortality. In patients with severe hypernatremia, the rate of correction of hypernatremia was slow and resulted in inadequate correction in majority of the patients. Both slow rate of hypernatremia correction during the first 24 hours and do not resuscitate status were found to be significant predictors of 30-day patient mortality.
Joshu, Corinne E.; Kanarek, Norma; Navas-Acien, Ana; Richardson, Kelly A.; Platz, Elizabeth A.
Introduction In the United States, prostate cancer mortality rates have declined in recent decades. Cigarette smoking, a risk factor for prostate cancer death, has also declined. It is unknown whether declines in smoking prevalence produced detectable declines in prostate cancer mortality. We examined state prostate cancer mortality rates in relation to changes in cigarette smoking. Methods We studied men aged 35 years or older from California, Kentucky, Maryland, and Utah. Data on state smoking prevalence were obtained from the Behavioral Risk Factor Surveillance System. Mortality rates for prostate cancer and external causes (control condition) were obtained from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research. The average annual percentage change from 1999 through 2010 was estimated using joinpoint analysis. Results From 1999 through 2010, smoking in California declined by 3.5% per year (−4.4% to −2.5%), and prostate cancer mortality rates declined by 2.5% per year (−2.9% to −2.2%). In Kentucky, smoking declined by 3.0% per year (−4.0% to −1.9%) and prostate cancer mortality rates declined by 3.5% per year (−4.3% to −2.7%). In Maryland, smoking declined by 3.0% per year (−7.0% to 1.2%), and prostate cancer mortality rates declined by 3.5% per year (−4.1% to −3.0%).In Utah, smoking declined by 3.5% per year (−5.6% to −1.3%) and prostate cancer mortality rates declined by 2.1% per year (−3.8% to −0.4%). No corresponding patterns were observed for external causes of death. Conclusion Declines in prostate cancer mortality rates appear to parallel declines in smoking prevalence at the population level. This study suggests that declines in prostate cancer mortality rates may be a beneficial effect of reduced smoking in the population. PMID:27079649
A cohort of 3685 white males employed during 1937 to 1948 in two major industries manufacturing beryllium was followed to the end of 1976 to evaluate lung cancer mortality experience. Lung cancer mortality among beryllium-exposed workers was contrasted with that of workers employed in the viscose rayon industry. Study results demonstrated that lung cancer mortality among berylliumm-exposed workers was significantly greater than that expected on the basis of lung cancer mortality experience of workers in the viscose rayon industry having similar employment patterns. The results of the present study are consistent with earlier animal bioassay studies and recent epidemiologic studies indicating that beryllium is carcinogenic. The results of the present study are not consistent with speculation attributing the excessive lung cancer mortality among beryllium-exposed workers to personal characteristics of individuals having unstable employment patterns.
Gottlieb, M S; Carr, J K; Clarkson, J R
Thirteen Louisiana parishes (counties) using the Mississippi river as a source of potable water have the highest mortality rates (1950-1969) in the drinking water source, a comparison of cancer deaths and noncancer deaths from 1960-1975 in selected southern Louisiana parishes was conducted. Parishes were grouped for similarities in industrialization and approximately equal exposure of the population to surface water and ground water. Cancers were studied in groups by hypothesized risk: high for bladder, colon, kidney, liver, lymphoma, rectum, and stomach; low for Hodgkin's lymphoma, leukemia, lung, malignant melanoma, multiple myeloma, and prostate; and questionable for breast, brain, esophagus, and pancreas. Noncancer deaths were randomly selected and matched 1:1 to cancer deaths on age, race, sex, and year and parish group of death. Water source at death was based on residence at death, surface or ground water, and chlorinated or nonchlorinated water. The risk associated with using surface water least likely due solely to change occurred for cancer of the rectum. Other risks which were lower but still greater than 1.0 occurred for cancer of the kidney and breast. No risk was observed for other cancers of the gastrointestinal or urinary tract. Risk for multiple myeloma was associated with use of ground water.
van Wijngaarden, Edwin; Dosemeci, Mustafa
We evaluated the association between potential occupational lead exposure and the risk of brain cancer mortality in the National Longitudinal Mortality Study (NLMS), which is a prospective census-based cohort study of mortality among the noninstitutionalized United States population (1979-1989). The present study was limited to individuals for whom occupation and industry were available (n = 317,968). Estimates of probability and intensity of lead exposure were assigned using a job-exposure matrix (JEM). Risk estimates for the impact of lead on brain cancer mortality were computed using standardized mortality ratio (SMR) and proportional hazards and Poisson regression techniques, adjusting for the effects of age, gender and several other covariates. Brain cancer mortality rates were greater among individuals in jobs potentially involving lead exposure as compared to those unexposed (age- and gender-adjusted hazard ratio (HR) = 1.5; 95% confidence interval (CI) = 0.9-2.3) with indications of an exposure-response trend (probability: low HR = 0.7 (95% CI = 0.2-2.2), medium HR = 1.4 (95% CI = 0.8-2.5), high HR = 2.2 (95% CI = 1.2-4.0); intensity: low HR = 1.2 (95% CI = 0.7-2.1), medium/high HR = 1.9 (95% CI = 1.0-3.4)). Brain cancer risk was greatest among individuals with the highest levels of probability and intensity (HR = 2.3; 95% CI = 1.3-4.2). These findings provide further support for an association between occupational lead exposure and brain cancer mortality, but need to be interpreted cautiously due to the consideration of brain cancer as one disease entity and the absence of biological measures of lead exposure.
Franco-Marina, Francisco; Lazcano-Ponce, Eduardo; López-Carrillo, Lizbeth
To assess the age, period and cohort effects on breast cancer (BC) mortality in Mexico. Age, period and cohort curvature trends for BC mortality were estimated through the Poisson Regression model proposed by Holford. Nationally, BC death rates have leveled off since 1995 in most age groups. BC mortality trends are mainly determined by birth cohort and age effects in Mexico. Women born between 1940 and 1955 show the highest rate of increase in BC mortality. Women born afterwards still show an increasing trend but at a much lower rate. Mammography and adjuvant therapy have had a limited impact on mortality. Potential reasons for observed patterns are discussed. An increase in BC mortality in Mexico is expected in the following decades. Mammography screening programs and timely access to effective treatment should be a national priority to reverse the expected increasing BC mortality trend.
Frye, Thomas P; Sadowski, Daniel J; Zahnd, Whitney E; Jenkins, Wiley D; Dynda, Danuta I; Mueller, Georgia S; Alanee, Shaheen R; McVary, Kevin T
The urology work force is contracting at a time when service demand is increasing due to demographic changes, especially in rural areas. We investigated the impact of rural status and urologist density on kidney and renal pelvis, bladder and prostate cancer mortality at the county level in Illinois. We stratified the 102 Illinois counties by 2003 RUCCs as urban (36, RUCCs 1 to 3) and rural (66, RUCCs 4 to 9). Area Health Resource Files were used for county demographic data and urologist density. County level age adjusted mortality rates from 1990 to 2010 were derived from National Center for Health Statistics data using SEER*Stat. We examined the associations of urological cancer mortality rates with rural status and urologist density. Average urologist density significantly differed between rural and urban counties (1.9 vs 3.4/100,000 population, p < 0.01). The kidney and renal pelvis cancer mortality rate in rural counties was higher than in urban counties while that of prostate cancer was lower (4.9 vs 4.3 and 28.7 vs 32.2/100,000 population, respectively, each p < 0.01). Urologist density correlated with the mortality rate of kidney and renal pelvis cancer (Pearson coefficient -0.33, p < 0.01) but not with the bladder or prostate cancer mortality rate. Multiple regression analysis revealed that rurality and lower urologist density (p = 0.01 and < 0.05) were significantly associated with higher kidney and renal pelvis cancer mortality. Rural residence and low urologist density were associated with increased kidney and renal pelvis cancer mortality on the county level in Illinois. Further expansion and testing of evidence-based telemedicine is warranted because remote technical consultation is now technologically feasible, effective, inexpensive and satisfactory to patients. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Zhou, Yunhai; Zhang, Xiang; Gu, Chen; Xia, Jiazeng
Breast cancer is one of the most common malignant tumours among women worldwide. Besides, diabetes mellitus is also a major health problem in developed countries. This study explores the association between diabetes mellitus and breast cancer patients' survival outcomes. A systematic literature search in Embase (http://www.embase.com) and MEDLINE (http://www.ncbi.nlm.nih.gov/pubmed) was conducted from January 1960 to April 2014 and systematically identified clinical studies that evaluated the association between breast cancer mortality and diabetes mellitus. Clinical studies investigating the association between diabetes mellitus and breast cancer patients' survival outcomes were included. Twenty publications were chosen for the meta-analysis, of which 16 studies had all-cause mortality data and 12 studies had breast cancer mortality data. Published from 2001 to 2013, all 20 studies followed a total of 2,645,249 patients including more than 207,832 diabetic patients. Pre-existing diabetes mellitus was associated with a 37% increased risk for all-cause mortality in women with breast cancer (hazard ratio (HR) = 1.37; 95% confidence interval (CI): 1.34-1.41; P = 0.02). Diabetes mellitus was associated with a 17% increased risk for breast cancer mortality in women with breast cancer (HR = 1.17; 95% CI: 1.11-1.22; P < 0.01). Women with diabetes mellitus are at higher risk of breast cancer-specific and all-cause mortality after initial breast cancer diagnosis. © 2014 Royal Australasian College of Surgeons.
Swanson, Richard S; Pezzi, Christopher M; Mallin, Katherine; Loomis, Ashley M; Winchester, David P
Operative mortality traditionally has been defined as the rate within 30 days or during the initial hospitalization, and studies that established the volume-outcome relationship for pancreatectomy used similar definitions. Pancreatectomies reported to the National Cancer Data Base (NCDB) during 2007-2010 were examined for 30- and 90-day mortality. Unadjusted mortality rates were compared by type of resection, stage, comorbidities, and average annual hospital volume. Hierarchical logistic regression models generated risk-adjusted odds ratios for 30- and 90-day mortality. After 21,482 pancreatectomies, the unadjusted 30-day mortality rate was 3.7 % (95 % confidence interval [CI] 3.4-3.9 %), which doubled at 90 days to 7.4 % (95 % CI 7.0-7.8). The unadjusted and risk-adjusted mortality rates were higher at 30 days with increasing age, increasing stage, male gender, lower income, low hospital volume, resections other than distal pancreatectomy, Medicare or Medicaid insurance coverage, residence in a Southern census division, history of prior cancer, and multiple comorbidities. The lowest-volume hospitals (<5 per year) performed 19 % of the pancreatectomies, with a risk-adjusted odds ratios for mortality that were 4.2 times higher (95 % CI 3.1-5.8) at 30 days and remained 1.9 times higher (95 % CI 1.5-2.3) at 30-90 days compared with hospitals that had high volumes (≥40 per year). Mortality rates within 90 days after pancreatic resection are double those at 30 days. The volume-outcome relationship persists in the NCDB. Reporting mortality rates 90 days after pancreatectomy is important. Hospitals should be aware of their annual volume and mortality rates 30 and 90 days after pancreatectomy and should benchmark the use of high-volume hospitals.
Yao, Nengliang; Lengerich, Eugene J.; Hillemeier, Marianne M.
Breast cancer death rates in the U.S. have decreased in recent decades, however areas such as Appalachia with fewer cancer care resources may not have experienced comparable mortality declines. This study examines trends in breast cancer mortality rate disparities in Appalachian states and the continental U.S. using data from SEER mortality files 1969–2007 and the Area Resource File. Overall breast cancer mortality rates decreased significantly, with a smaller decline in Appalachian counties (17.5%) compared with non-Appalachian counties in Appalachian states (30.5%), and compared with non-Appalachia U.S. counties (28.3%). After accounting for poverty, rural/urban status, education, health care resources, and proportion White in the population, residence in Appalachian counties except for those in the Northern subregion was significantly associated with smaller reduction in breast cancer mortality rates. Lower levels of education, physician density, and percent White in the population were also associated with smaller reductions in breast cancer mortality. PMID:22643619
Chen, W Q; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; He, J
Objective: To estimate the cancer incidence and mortality in elderly Chinese population in 2013 based on the data from local cancer registries submitted to National Central Cancer Registry (NCCR). Methods: Data from 255 cancer registries submitted to NCCR with qualified data after checked and evaluated, were selected for this estimation. Cancer incidence and mortality were stratified by areas, sex, age groups and cancer site, combined with population data of the year 2013 to estimate cancer epidemiology in older people in China. Chinese population census in 2000 and Segi's population were used for the estimation of age-standardized incidence/mortality rates. Results: All the 255 cancer registries (88 in urban and 167 in rural areas) were selected for this estimation, covered 37 407 728 elderly subjects, accounting for 17.73% of the entire national elderly population. It was estimated about 2 171.0 thousand new cancer cases in older people in China, accounting for 58.96% of all cancer incidence, with the crude incidence rate of 1 029.16/100 000 (1 297.96 per 100 000 in male, 777.18 per 100 000 in female), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 1 019.25 per 100 000. It was estimated about 1 600.5 thousand deaths in older people in China, accounting for 67.70% of all cancer deaths, with the crude mortality of 758.72/100 000 (988.37 per 100 000 in males, 543.44 per 100 000 in females), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 730.78 per 100 000. Lung cancer, stomach cancer, colorectal cancer, liver cancer and esophageal cancer were the most common cancers, accounting for about 67.70% of all cancer cases in China. Those cancers are also the most common cancers in China, accounting for about 73.45% of all cancer deaths. Conclusions: The cancer burden of elderly population in China is very serious. The major cancer incidence and mortality in urban and rural areas are similar
Carta, P; Cocco, P L; Casula, D
The mortality of 724 subjects with silicosis, first diagnosed in 1964-70 in the Sardinia region of Italy, was followed up through to 31 December 1987. Smoking, occupational history, chest x ray films, and data on lung function were available from clinical records for each member of the cohort. The overall cohort accounted for 10,956.5 person-years. The standardised mortality ratios (SMRs) for selected causes of death (International Classification of Diseases (ICD) eighth revision) were based on the age specific regional death rates for each calendar year. An excess of deaths for all causes (SMR = 1.40) was found, mainly due to chronic obstructive lung disease, silicosis, and tuberculosis with an upward trend of the SMR with increasing severity of the International Labour Office (ILO) radiological categories. Twenty two subjects died from lung cancer (SMR = 1.29, 95% confidence interval (95% CI) = 0.8-2.0). The risk increased after a 10 and 15 year latency but the SMR never reached statistical significance. No correlation was found between lung cancer and severity of the radiological category, the type of silica (coal or metalliferous mines, quarries etc), or the degree of exposure to silica dust. A significant excess of deaths from lung cancer was found among heavy smokers (SMR = 4.11) and subjects with airflow obstruction (SMR = 2.83). A nested case-control study was planned to investigate whether the association between lung cancer and airway obstruction was due to confounding by smoking. No association was found with the ILO categories of silicosis or the estimated cumulative exposure to silica. The risk estimate for lung cancer by airflow obstruction after adjusting by cigarette consumption was 2.86 for a mild impairment and 7.23 for a severe obstruction. The results do not show any clear association between exposure to silica, severity of silicosis, and mortality from lung cancer. Other environmental or individual factors may act as confounders in the
Introduction We have recently reported that delayed cancer detection is associated with the Wellbeing Index (WI) for socioeconomic deprivation, lack of health insurance, physician shortage, and Hispanic ethnicity. The current study investigates whether these factors are determinants of cancer mortality in Texas, the United States of America (USA). Methods Data for breast, colorectal, female genital system, lung, prostate, and all-type cancers are obtained from the Texas Cancer Registry. A weighted regression model for non-Hispanic whites, Hispanics, and African Americans is used with age-adjusted mortality (2004–2008 data combined) for each county as the dependent variable while independent variables include WI, percentage of the uninsured, and physician supply. Results Higher mortality for breast, female genital system, lung, and all-type cancers is associated with higher WI among non-Hispanic whites and/or African Americans but with lower WI in Hispanics after adjusting for physician supply and percentage of the uninsured. Mortality for all the cancers studied is in the following order from high to low: African Americans, non-Hispanic whites, and Hispanics. Lung cancer mortality is particularly low in Hispanics, which is only 35% of African Americans’ mortality and 40% of non-Hispanic whites’ mortality. Conclusions Higher degree of socioeconomic deprivation is associated with higher mortality of several cancers among non-Hispanic whites and African Americans, but with lower mortality among Hispanics in Texas. Also, mortality rates of all these cancers studied are the lowest in Hispanics. Further investigations are needed to better understand the mechanisms of the Hispanic Paradox. PMID:23587269
Tarone, R E; Chu, K C; Gaudette, L A
Previous studies of regional and temporal variation in U.S. breast cancer mortality rates have been confined largely to analyses of rates for white women. Breast cancer mortality rates from 1969 through 1992 for white women and black women in four regions of the United States and for all women throughout Canada were compared to identify racial, regional, and temporal differences. Differences and trends in the rates were evaluated in view of breast cancer risk factors and relevant medical interventions. Age-period-cohort models were fit to the data, and changes in birth cohort trends (suggesting a change in a breast cancer risk factor or protective factor) and calendar period trends (suggesting, in part, the impact of new or improved medical interventions) were examined. Breast cancer mortality rates for white women were significantly higher in the Northeast than in any other region of the United States (two-sided t tests; P<.005); the rates for black women were not. Birth cohort trends for all women were similar until about 1940, with a moderation of mortality risk beginning around 1924. A marked moderation of risk by 4-year birth cohorts was observed for U.S. white women born after 1950, whereas stable or slightly decreasing trends were observed for U.S. black women and Canadian women. For women born from 1924 to around 1938, fertility rates increased for all three groups; after 1950, they declined uniformly. Looking at temporal effects, we found that the slope of the mortality calendar period trend increased in the 1980s compared with the 1970s for all women. In the last calendar period, 1991-1992, a trend of decreasing mortality rates was found for white women in the United States and for Canadian women. Widespread environmental exposures are unlikely to explain the higher relative breast cancer mortality rates observed for U.S. white women in the Northeast, since the rates for black women in this region were not higher than in other regions. The moderation of
Enstrom, J E
On the basis of Church records, detailed cancer and total death rates were determined for an average of 360,000 California Mormons during 1968--75, for an average of 700,000 Utah Mormons during 1970 and 1975, and for a subgroup of active Mormon males known as High Priests and Seventies. For cancer as a whole, the standardized mortality ratio was 68% for all California Mormon males, 83% for all California females, and 50% for active Mormon males in California and Utah compared with 1970 U.S. whites. Age-specific and age-adjusted total mortality rates were substantially lower in Mormons than in 1970 U.S. whites, with the greatest differences occurring between 35 and 65 years of age, where the rates for active Mormon males were reduced by more than 60%. Methodologic issues and sources of error were discussed, and the overall quality of the data was good. Some health-related characteristics of Mormons are also summarized.
Tereanu, Carmen; Baili, Paolo; Berrino, Franco; Micheli, Andrea; Furtunescu, Florentina L; Minca, Dana G; Sant, Milena
We analysed the mortality trends (1986-2009) for all cancers combined and selected cancers in adult Romanians by three age groups (15-49, 50-69 and older than 70 years of age) in comparison with 11 other European countries. We extracted mortality data from the WHO database and grouped the countries into four regions: central and eastern Europe (Romania, Bulgaria, the Czech Republic, Hungary), Baltic countries (Estonia, Latvia and Lithuania), western and northern Europe (Austria, the Netherlands and Finland), and southern Europe (Croatia and Slovenia). Mortality rates were age-standardized against the standard European population. Significant changes in mortality trends were identified by Joinpoint regression and annual percentage changes (APCs) were calculated for periods with uniform trends. Cancer mortality in Romania was among the lowest in Europe in 1986, but was higher than most countries by 2009. Despite the declining mortality (APC) in younger Romanians for all cancers combined (men-1.5% from 1997, women-1.2% 1997-2004 and -3.8% 2004-2009), male lung cancer (-2.8% from 1997), female breast (-3.5% from 1999) and cervical (-5.4% from 2004) cancers, mortality has increased in middle-aged and elderly patients for most cancers analysed. The exception was declining stomach cancer mortality in most Romanians, except elderly men. For most cancers analysed, mortality declined in the Baltic countries in young and middle-aged patients, and in western and northern countries for all ages. Lung cancer mortality in women increased in all countries except Latvia. We urge immediate steps to reverse the alarming increase in cancer mortality among middle-aged and elderly Romanians.
Cha, Eun Shil; Kong, Kyoung Ae; Moon, Eun Kyeong; Khang, Young-Ho; Lee, Won Jin
To examine the relationship between birth characteristics and childhood cancer mortality, a retrospective cohort study of Korean children was conducted using data collected by the national birth register between 1995 and 2006, which were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until their death or until December 31, 2006. Poisson regression analyses were used to calculate rate ratios of childhood cancer deaths according to birth characteristics. A total of 1,469 cancer deaths were noted and the childhood cancer mortality rate was found to be 3.43 per 100,000 person-years in Korea during the period of 1995-2006. The birth characteristics examined in this study (i.e. , birth weight, gestational age, multiple births, parental ages, and number of siblings) were generally found to be not significantly associated with childhood cancer mortality, and the associations did not vary meaningfully with gender nor with cancer sites. However, among children aged 5-11 yr, higher birth weight was associated with elevated childhood cancer mortality (rate ratio = 1.28, 95% confidence interval 1.04-1.58). Our results offer no overall associations between childhood cancer mortality and birth characteristics, but suggest that the association may be specific to age group.
Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan
Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.
Richardson, David B; Wing, Steve
The Oak Ridge, Tennessee Y-12 plant has operated as a nuclear materials fabrication plant since the 1940s. Given the work environment, and prior findings that lung cancer mortality was elevated among white male Y-12 workers relative to US white males, we investigated whether lung cancer mortality was associated with occupational radiation exposures. A cohort of 3,864 workers hired between 1947 and 1974 who had been monitored for internal radiation exposure was identified. Vital status was ascertained through 1990. Over the study period 111 lung cancer deaths were observed. Cumulative external radiation dose under a 5-year lag assumption was positively associated with lung cancer mortality (0.54% increase in lung cancer mortality per 10 mSv, se=0.16, likelihood ratio test (LRT)=5.84, 1 degree of freedom [df]); cumulative internal radiation dose exhibited a highly-imprecise negative association with lung cancer mortality. The positive association between external radiation dose and lung cancer mortality was primarily due to exposure occurring in the period 5-14 years after exposure (0.97% increase in lung cancer mortality rate per 10 mSv, se=0.28, LRT=6.35, 1 df). The association between external radiation dose and lung cancer mortality was negative for exposures occurring at ages<35 years and positive for exposures occurring at ages 35-50 and 50+years. There is evidence of a positive association between cumulative external radiation dose and lung cancer mortality in this population. However, a causal interpretation of this association is constrained by the uncertainties in external and internal radiation dose estimates, the lack of information about exposures to other lung carcinogens, and the limited statistical power of the study. Copyright (c) 2005 Wiley-Liss, Inc.
Background Although black women experienced greater cervical cancer incidence and mortality rate reduction in recent years, they continue to have higher incidence rates than whites. Great variations also exist among geographic regions of the US, with the South having both the highest incidence and mortality rates compared to other regions. The present study explores the question of whether living in the South is associated with greater racial disparity in cervical cancer incidence and mortality by examining race- and region-specific rates and the trend between 2000 and 2012. Methods The Surveillance, Epidemiology, and End Results (SEER) 18 Program data was used. Cervical cancer incidence and mortality rates, annual percent changes, and disparity ratios were calculated using SEER*Stat software and Joinpoint regression for four groups: US14-Non-Hispanic White (NHW), US14-Non-Hispanic Black (NHB), South-NHW, and South-NHB, where South included 4 registries from Georgia and Louisiana and US14 were 14 US registries except the four South registries. Results The average age-adjusted cervical cancer incidence rate was the highest among South-NHBs (11.1) and mortality rate was the highest among US14-NHBs (5.4). In 2012, the degree of racial disparities between South-NHBs and South-NHWs was greater in terms of mortality rates (NHB:NHW = 1.80:1.35) than incidence rates (NHB:NHW = 1.45:1.15). While mortality disparity ratios decreased from 2000–2012 for US14-NHB (APC: -1.9(-2.3,-1.4), mortality disparity ratios for South-NHWs (although lower than NHBs) increased compared to US14-NHW. Incidence rates for NHBs continued to increase with increasing age, whereas rates for NHWs decreased after age 40. Mortality rates for NHBs dramatically increased at age 65 compared to a relatively stable trend for NHWs. The increasing racial disparity with increasing age in terms of cervical cancer incidence rates became more pronounced when corrected for hysterectomy prevalence. Conclusions
Samson, Eric; Piot, Irwin; Zhivin, Sergey; Richardson, David B; Laroche, Pierre; Serond, Ana-Paula; Laurier, Dominique; Laurent, Olivier
Objectives The health effects of internal contamination by radionuclides, and notably by uranium, are poorly characterised. New cohorts of uranium workers are needed to better examine these effects. This paper analyses for the first time the mortality profile of the French cohort of uranium cycle workers. It considers mortality from cancer and non-cancer causes. Methods The cohort includes workers employed at least 6 months between 1958 and 2006 in French companies involved in the production of nuclear fuel. Vital status and causes of death were collected from French national registries. Workers were followed-up from 1 January 1968 to 31 December 2008. Standardised mortality ratios (SMRs) were computed based on mortality rates for the French general population. Results The cohort includes 12 649 workers (88% men). The average length of follow-up is 27 years and the mean age at the end of the study is 60 years. Large mortality deficits are observed for non-cancer causes of death such as non-cancer respiratory diseases (SMR=0.51 (0.41 to 0.63)) and circulatory diseases (SMR=0.68 (0.62 to 0.74)). A mortality deficit of lower magnitude is also observed for all cancers combined (SMR (95% CI): 0.76 (0.71 to 0.81)). Pleural mesothelioma is elevated (SMR=2.04 (1.19 to 3.27)). Conclusions A healthy worker effect is observed in this new cohort of workers involved in the uranium cycle. Collection of individual information on internal uranium exposure as well as other risk factors is underway, to allow for the investigation of uranium-related risks. PMID:27048635
Matthew B. Dickinson; Edward A. Johnson
We use two rate-process models to describe cell mortality at elevated temperatures as a means of understanding vascular cambium cell death during surface fires. In the models, cell death is caused by irreversible damage to cellular molecules that occurs at rates that increase exponentially with temperature. The models differ in whether cells show cumulative effects of...
Moreno, Ximena; Huerta, Martín; Albala, Cecilia
To explore the association between global self-rated health and mortality in older people. A systematic review was performed. The inclusion criteria were longitudinal studies that assessed self-rated health with a single general question and samples of community-dwelling persons aged 60 years or more. Electronic databases were searched and references were reviewed. We selected 18 studies published between 1993 and 2011. Six out of seven studies that analyzed men and women found a higher risk of dying among persons who rated their health as poor; the most frequent covariables were age, gender, chronic diseases, and functional status. Half of the studies that analyzed only men or women found a significant association. The effect of self-reported health on mortality was observed among people younger than 75 years. Results were not dependent on the length of follow-up. The results confirm previous findings suggesting that a negative self-rating of general health predicts mortality. The mechanisms through which this indicator may predict mortality among older people could differ in men and women and need to be elucidated. The role of depression should be investigated, considering that the effect of self-rated health on mortality was not present when depression was included. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Das, Adrian J.; Stephenson, Nathan L.
Tree growth rate is frequently used to estimate mortality probability. Yet, growth metrics can vary in form, and the justification for using one over another is rarely clear. We tested whether a growth index (GI) that scales the realized diameter growth rate against the potential diameter growth rate (PDGR) would give better estimates of mortality probability than other measures. We also tested whether PDGR, being a function of tree size, might better correlate with the baseline mortality probability than direct measurements of size such as diameter or basal area. Using a long-term dataset from the Sierra Nevada, California, U.S.A., as well as existing species-specific estimates of PDGR, we developed growth–mortality models for four common species. For three of the four species, models that included GI, PDGR, or a combination of GI and PDGR were substantially better than models without them. For the fourth species, the models including GI and PDGR performed roughly as well as a model that included only the diameter growth rate. Our results suggest that using PDGR can improve our ability to estimate tree survival probability. However, in the absence of PDGR estimates, the diameter growth rate was the best empirical predictor of mortality, in contrast to assumptions often made in the literature.
Weiland, S. K.; Straif, K.; Chambless, L.; Werner, B.; Mundt, K. A.; Bucher, A.; Birk, T.; Keil, U.
OBJECTIVES: To determine the cancer specific mortality by work area among active and retired male workers in the German rubber industry. METHODS: A cohort of 11,663 male German workers was followed up for mortality from 1 January 1981 to 31 December 1991. Cohort members were classified as active (n = 7536) or retired (n = 4127) as of 1 January 1981 and had been employed for at least one year in one of five study plants producing tyres or technical rubber goods. Work histories were reconstructed with routinely documented "cost centre codes" which were classified into six categories: I preparation of materials; II production of technical rubber goods; III production of tyres; IV storage and dispatch; V maintenance; and VI others. Standardised mortality ratios (SMRs) adjusted for age and calendar year and 95% confidence intervals (95% CIs), stratified by work area (employment in respective work area for at least one year) and time related variables (year of hire, lagged years of employment in work area), were calculated from national reference rates. RESULTS: SMRs for laryngeal cancer were highest in work area I (SMR 253; 95% CI 93 to 551) and were significant among workers who were employed for > 10 years in this work area (SMR 330; 95% CI 107 to 779). Increased mortality rates from lung cancer were identified in work areas I (SMR 162; 95% CI 129 to 202), II (SMR 134; 95% CI 109 to 163), and V (SMR 131; 95% CI 102 to 167). Mortality from pleural cancer was increased in all six work areas, and significant excesses were found in work areas I (SMR 448; 95% CI 122 to 1146), II (SMR 505; 95% CI 202 to 1040), and V (SMR 554; 95% CI 179 to 1290). CONCLUSION: A causal relation between the excess of pleural cancer and exposure to asbestos among rubber workers is plausible and likely. In this study, the pattern of excess of lung cancer parallels the pattern of excess of pleural cancer. This points to asbestos as one risk factor for the excess deaths from lung cancer among
Goussous, Naeem; Hosseini, Motahar; Sill, Anne M; Cunningham, Steven C
Minimally invasive surgery is increasingly used for gallbladder cancer resection. Postoperative mortality at 30 days is low, but 90-day mortality is underreported. Using National Cancer Database (1998-2012), all resection patients were included. Thirty- and 90-day mortality rates were compared. A total of 36 067 patients were identified, 19 139 (53%) of whom underwent resection. Median age was 71 years and 70.7% were female. Ninety-day mortality following surgical resection was 2.3-fold higher than 30-mortality (17.1% vs 7.4%). There was a statistically significant increase in 30- and 90-day mortality with poorly differentiated tumors, presence of lymphovascular invasion, tumor stage, incomplete surgical resection and low-volume centers (P<0.001 for all). Even for the 1885 patients who underwent minimally invasive resection between 2010 and 2012, the 90-day mortality was 2.8-fold higher than the 30-day mortality (12.0% vs 4.3%). Ninety-day mortality following gallbladder cancer resection is significantly higher than 30-day mortality. Postoperative mortality is associated with tumor grade, lymphovascular invasion, tumor stage, type and completeness of surgical resection as well as type and volume of facility. Copyright © 2017 The Editorial Board of Hepatobiliary & Pancreatic Diseases International. Published by Elsevier B.V. All rights reserved.
Levi, Fabio; Lucchini, Franca; Negri, Eva; Boyle, Peter; La Vecchia, Carlo
Mortality from prostate cancer (CaP) has increased throughout Europe until the early 1990s. Trends in 24 European countries, the European Union (EU), six selected Central and Eastern European countries, and the Russian Federation have been updated to 1999. Cancer death certification data for CaP were abstracted from the World Health Organization database. In the EU, the peak rate (15.7/100,000) was reached in 1993, followed by a leveling off and a decline to 14.1/100,000 in 1999. Age-standardized analysis for each subsequent age group of men aged 50 or over showed larger absolute falls in the elderly. CaP rates were lower in Central and Eastern European countries providing data, but showed a rise from 9.7/100,000 in 1980 to 11.3 in 1996, and leveled off thereafter. Rates were originally lower, but the rises larger in the Russian Federation (from 5.1/100,000 in 1980 to 8.1/100,000 in 1999). In the late 1990s, there was a threefold difference between the highest rates of 22/100,000 in Norway and those of 7.7 in Russia or 7.3 in Ukraine. Such a difference was, however, restricted to the elderly, since at age 35-64 the Russian rate (6.7/100,000) was the same as that of Norway, and only Greece and Italy had appreciably lower rates. The pattern of trends in CaP rates observed across Europe is consistent with a favorable role of improved diagnosis, but mainly of advancements of therapy (including more widespread adoption of radical prostatectomy and androgen blockage) on CaP mortality in Western Europe. Copyright 2004 Wiley-Liss, Inc.
Turner, Michelle C; Krewski, Daniel; Chen, Yue; Pope, C Arden; Gapstur, Susan M; Thun, Michael J
Radon is a known cause of human lung cancer. Previously, the authors observed a significant positive association between mean county-level residential radon concentrations and lung cancer mortality in the Cancer Prevention Study II (CPS-II), a large prospective study of nearly 1.2 million participants recruited in 1982 by the American Cancer Society. There was also a significant positive association with mortality from chronic obstructive pulmonary disease. Because it is unclear whether radon is associated with mortality from other malignant or nonmalignant disease, the authors examined the association between radon and nonrespiratory mortality in the CPS-II. Mean county-level residential radon concentrations (mean = 53.5 (standard deviation: 38.0) Bq/m(3)) were linked to participants by their zip code at enrollment. Cox proportional hazards regression models were used to estimate adjusted hazard ratios and 95% confidence intervals for all-cause (excluding lung cancer and respiratory mortality) and cause-specific mortality associated with radon concentrations. A total of 811,961 participants in 2,754 counties were analyzed, including 265,477 deaths through 2006. There were no clear associations between radon and nonrespiratory mortality in the CPS-II. These findings suggest that residential radon is not associated with any other mortality beyond lung cancer or chronic obstructive pulmonary disease.
Barth, Shannon K; Dursa, Erin K; Bossarte, Robert M; Schneiderman, Aaron I
Previous mortality studies of U.S. Gulf War veterans through 2000 and 2004 have shown an increased risk of brain cancer mortality among some deployed individuals. When veterans possibly exposed to environmental contaminants associated with demolition of the Khamisiyah Ammunition Storage Facility at Khamisiyah, Iraq, have been compared to contemporaneously deployed unexposed veterans, the results have suggested increased risk for mortality from brain cancer among the exposed. Brain cancer mortality risk in this cohort has not been updated since 2004. This study analyzes the risk for brain cancer mortality between 1991-2011 through two series of comparisons: U.S. Gulf War deployed and non-deployed veterans from the same era; and veterans possibly exposed to environmental contaminants at Khamisiyah compared to contemporaneously deployed but unexposed U.S. Gulf War veterans. Risk of brain cancer mortality was determined using logistic regression. Life test hazard models were created to plot comparisons of annual hazard rates. Joinpoint regression models were applied to assess trends in hazard rates for brain cancer mortality. U.S. Army veterans possibly exposed at Khamisiyah had similar rates of brain cancer mortality compared to those not possibly exposed; however, veterans possibly exposed had a higher risk of brain cancer in the time period immediately following the Gulf War. Results from these analyses suggest that veterans possibly exposed at Khamisiyah experienced different patterns of brain cancer mortality risk compared to the other groups. Published by Elsevier Ltd.
Chao, Tze-Fan; Liu, Chia-Jen; Tuan, Ta-Chuan; Chen, Su-Jung; Wang, Kang-Ling; Lin, Yenn-Jiang; Chang, Shih-Lin; Lo, Li-Wei; Hu, Yu-Feng; Chen, Tzeng-Ji; Chiang, Chern-En; Chen, Shih-Ann
Current American and European guidelines emphasize the importance of rate-control treatments in treating atrial fibrillation with a Class I recommendation, although data on the survival benefits of rate control are lacking. The goal of the present study was to investigate whether patients receiving rate-control drugs had a better prognosis compared with those without rate-control treatment. This study used the National Health Insurance Research Database in Taiwan. There were 43 879, 18 466, and 38 898 patients with atrial fibrillation enrolled in the groups receiving β-blockers, calcium channel blockers, and digoxin, respectively. The reference group consisted of 168 678 subjects who did not receive any rate-control drug. The clinical end point was all-cause mortality. During a follow-up of 4.9±3.7 years, mortality occurred in 88 263 patients (32.7%). After adjustment for baseline differences, the risk of mortality was lower in patients receiving β-blockers (adjusted hazard ratio=0.76; 95% confidence interval=0.74-0.78) and calcium channel blockers (adjusted hazard ratio=0.93; 95% confidence interval=0.90-0.96) compared with those who did not receive rate-control medications. On the contrary, the digoxin group had a higher risk of mortality with an adjusted hazard ratio of 1.12 (95% confidence interval=1.10-1.14). The results were observed consistently in subgroup analyses and among the cohorts after propensity matching. In this nationwide atrial fibrillation cohort, the risk of mortality was lower for patients receiving rate-control treatment with β-blockers or calcium channel blockers, and the use of β-blockers was associated with the largest risk reduction. Digoxin use was associated with greater mortality. Prospective, randomized trials are necessary to confirm these findings. © 2015 American Heart Association, Inc.
Andriole, Gerald L; Crawford, E David; Grubb, Robert L; Buys, Saundra S; Chia, David; Church, Timothy R; Fouad, Mona N; Gelmann, Edward P; Kvale, Paul A; Reding, Douglas J; Weissfeld, Joel L; Yokochi, Lance A; O'Brien, Barbara; Clapp, Jonathan D; Rathmell, Joshua M; Riley, Thomas L; Hayes, Richard B; Kramer, Barnett S; Izmirlian, Grant; Miller, Anthony B; Pinsky, Paul F; Prorok, Philip C; Gohagan, John K; Berg, Christine D
The effect of screening with prostate-specific-antigen (PSA) testing and digital rectal examination on the rate of death from prostate cancer is unknown. This is the first report from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial on prostate-cancer mortality. From 1993 through 2001, we randomly assigned 76,693 men at 10 U.S. study centers to receive either annual screening (38,343 subjects) or usual care as the control (38,350 subjects). Men in the screening group were offered annual PSA testing for 6 years and digital rectal examination for 4 years. The subjects and health care providers received the results and decided on the type of follow-up evaluation. Usual care sometimes included screening, as some organizations have recommended. The numbers of all cancers and deaths and causes of death were ascertained. In the screening group, rates of compliance were 85% for PSA testing and 86% for digital rectal examination. Rates of screening in the control group increased from 40% in the first year to 52% in the sixth year for PSA testing and ranged from 41 to 46% for digital rectal examination. After 7 years of follow-up, the incidence of prostate cancer per 10,000 person-years was 116 (2820 cancers) in the screening group and 95 (2322 cancers) in the control group (rate ratio, 1.22; 95% confidence interval [CI], 1.16 to 1.29). The incidence of death per 10,000 person-years was 2.0 (50 deaths) in the screening group and 1.7 (44 deaths) in the control group (rate ratio, 1.13; 95% CI, 0.75 to 1.70). The data at 10 years were 67% complete and consistent with these overall findings. After 7 to 10 years of follow-up, the rate of death from prostate cancer was very low and did not differ significantly between the two study groups. (ClinicalTrials.gov number, NCT00002540.) 2009 Massachusetts Medical Society
Lin, Yilan; Wu, Xiaoqing; Lin, Tianquan
In recent years, the incidence and mortality of lung cancer is rising. It has become the leading cause of death of malignant tumors in China. The aim of this study is to explore the trend of mortality and years of life lost due to lung cancer in residents in Xiamen, so as to provide the basis data on preventing lung cancer in Xiamen. The data of residents in Xiamen dying of lung cancer from 2005 to 2014 was collected and cleared up to calculate the evaluation indexes including the mortality rate, the average potential life lost (AYLL), and the average percentage change (APC) of mortality rate. GM(1,1) model was used to predict the future mortality and AYLL. From 2005 to 2014, the average mortality rate of lung cancer in residents in Xiamen was 28.58 per 100,000 persons, of which in male was 2.90 times as that in female. The APC was 4.86%. The AYLL, which was 7.8 years, had decline trend from 2005 to 2014. The mean absolute percentage errors between observed values and fitted values were 2.16%-8.83%. The mortality rate and AYLL of lung cancer in residents in Xiamen would increase from 2015 to 2019. The mortality of lung cancer increased year by year in Xiamen. There are both increasing trend of mortality and years of life lost in future. So we should pay more attentions on preventing and curing of lung cancer.
Smith, Lauren M; Kasser, Tim
Based on principles of terror management theory, the authors hypothesized that participants would distance more from a target person with terminal cancer than from a target with arthritis, and that this effect would be stronger following mortality salience. In Study 1, adults rated how similar their personalities were to a target person; in Study 2, participants arranged two chairs in preparation for meeting the target person. Both studies found that distancing from the person with terminal cancer increased after participants wrote about their own death (vs. giving a speech). Thus, death anxiety may explain why people avoid close contact with terminally ill people; further analyses suggest that gender and self-esteem may also influence such distancing from the terminally ill.
Luquero, Francisco J; Rondy, Marc; Boncy, Jacques; Munger, André; Mekaoui, Helmi; Rymshaw, Ellen; Page, Anne-Laure; Toure, Brahima; Degail, Marie Amelie; Nicolas, Sarala; Grandesso, Francesco; Ginsbourger, Maud; Polonsky, Jonathan; Alberti, Kathryn P; Terzian, Mego; Olson, David; Porten, Klaudia; Ciglenecki, Iza
The 2010 cholera epidemic in Haiti was one of the largest cholera epidemics ever recorded. To estimate the magnitude of the death toll during the first wave of the epidemic, we retrospectively conducted surveys at 4 sites in the northern part of Haiti. Overall, 70,903 participants were included; at all sites, the crude mortality rates (19.1-35.4 deaths/1,000 person-years) were higher than the expected baseline mortality rate for Haiti (9 deaths/1,000 person-years). This finding represents an excess of 3,406 deaths (2.9-fold increase) for the 4.4% of the Haiti population covered by these surveys, suggesting a substantially higher cholera mortality rate than previously reported.
Rondy, Marc; Boncy, Jacques; Munger, André; Mekaoui, Helmi; Rymshaw, Ellen; Page, Anne-Laure; Toure, Brahima; Degail, Marie Amelie; Nicolas, Sarala; Grandesso, Francesco; Ginsbourger, Maud; Polonsky, Jonathan; Alberti, Kathryn P.; Terzian, Mego; Olson, David; Porten, Klaudia; Ciglenecki, Iza
The 2010 cholera epidemic in Haiti was one of the largest cholera epidemics ever recorded. To estimate the magnitude of the death toll during the first wave of the epidemic, we retrospectively conducted surveys at 4 sites in the northern part of Haiti. Overall, 70,903 participants were included; at all sites, the crude mortality rates (19.1–35.4 deaths/1,000 person-years) were higher than the expected baseline mortality rate for Haiti (9 deaths/1,000 person-years). This finding represents an excess of 3,406 deaths (2.9-fold increase) for the 4.4% of the Haiti population covered by these surveys, suggesting a substantially higher cholera mortality rate than previously reported. PMID:26886511
Mokdad, Ali H; Dwyer-Lindgren, Laura; Fitzmaurice, Christina; Stubbs, Rebecca W; Bertozzi-Villa, Amelia; Morozoff, Chloe; Charara, Raghid; Allen, Christine; Naghavi, Mohsen; Murray, Christopher J L
Cancer is a leading cause of morbidity and mortality in the United States and results in a high economic burden. To estimate age-standardized mortality rates by US county from 29 cancers. Deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the Census Bureau, the NCHS, and the Human Mortality Database from 1980 to 2014 were used. Validated small area estimation models were used to estimate county-level mortality rates from 29 cancers: lip and oral cavity; nasopharynx; other pharynx; esophageal; stomach; colon and rectum; liver; gallbladder and biliary; pancreatic; larynx; tracheal, bronchus, and lung; malignant skin melanoma; nonmelanoma skin cancer; breast; cervical; uterine; ovarian; prostate; testicular; kidney; bladder; brain and nervous system; thyroid; mesothelioma; Hodgkin lymphoma; non-Hodgkin lymphoma; multiple myeloma; leukemia; and all other cancers combined. County of residence. Age-standardized cancer mortality rates by county, year, sex, and cancer type. A total of 19 511 910 cancer deaths were recorded in the United States between 1980 and 2014, including 5 656 423 due to tracheal, bronchus, and lung cancer; 2 484 476 due to colon and rectum cancer; 1 573 593 due to breast cancer; 1 077 030 due to prostate cancer; 1 157 878 due to pancreatic cancer; 209 314 due to uterine cancer; 421 628 due to kidney cancer; 487 518 due to liver cancer; 13 927 due to testicular cancer; and 829 396 due to non-Hodgkin lymphoma. Cancer mortality decreased by 20.1% (95% uncertainty interval [UI], 18.2%-21.4%) between 1980 and 2014, from 240.2 (95% UI, 235.8-244.1) to 192.0 (95% UI, 188.6-197.7) deaths per 100 000 population. There were large differences in the mortality rate among counties throughout the period: in 1980, cancer mortality ranged from 130.6 (95% UI, 114.7-146.0) per 100 000 population in Summit County, Colorado, to 386.9 (95% UI, 330.5-450.7) in North Slope
An epidemiological assessment of the status and trends of cancer mortality shows that Europe is still divided by the rate of cancer death. Overall, cancer mortality in Europe has been steadily decreasing since the early 1990s. However, when the data are broken down, the burden of cancer in the central-eastern European countries is substantial, and mortality has actually continued to increase. Differences in lifestyle and environmental exposure are the most likely causes, and these are inevitably linked to political, social, and economic inequalities. For the time being, improvements in the health of the population are not a high priority for the new democratic governments. Even if attempts at cancer prevention are eventually realised, a major cancer burden will persist for many decades to come.
Goto, Hitomi; Watanabe, Tomoyuki; Miyao, Masaru; Fukuda, Hiromi; Sato, Yuzo; Oshida, Yoshiharu
To compare cancer mortality among A-bomb survivors exposed as children with cancer mortality among an unexposed control group (the entire population of Japan, JPCG). The subjects were the Hiroshima and Nagasaki A-bomb survivor groups (0-14 years of age in 1945) reported in life span study report 12 (follow-up years were from 1950 to 1990), and a control group consisting of the JPCG. We estimated the expected number of deaths due to all causes and cancers of various causes among the exposed survivors who died in the follow-up interval, if they had died with the same mortality as the JPCG (0-14 years of age in 1945). We calculated the standardized mortality ratio (SMR) of A-bomb survivors in comparison with the JPCG. SMRs were significantly higher in exposed boys overall for all deaths, all cancers, leukemia, and liver cancer, and for exposed girls overall for all cancers, solid cancers, liver cancer, and breast cancer. In boys, SMRs were significantly higher for all deaths and liver cancer even in those exposed to very low doses, and for all cancers, solid cancers, and liver cancer in those exposed to low doses. In girls, SMRs were significantly higher for liver cancer and uterine cancer in those exposed to low doses, and for leukemia, solid cancers, stomach cancer, and breast cancer in those exposed to high doses. We calculated the SMRs for the A-bomb survivors versus JPCG in childhood and compared them with a true non-exposed group. A notable result was that SMRs in boys exposed to low doses were significantly higher for solid cancer.
Background Gastric cancer is the second leading cause of oncologic death worldwide. One of the most noteworthy characteristics of this tumor's epidemiology is the marked decline reported in its incidence and mortality in almost every part of the globe in recent decades. This study sought to describe gastric cancer mortality time trends in Spain's regions for both sexes. Methods Mortality data for the period 1976 through 2005 were obtained from the Spanish National Statistics Institute. Cases were identified using the International Classification of Diseases 9th and 10th revision (codes 151 and C16, respectively). Crude and standardized mortality rates were calculated by geographic area, sex, and five-year period. Joinpoint regression analyses were performed to ascertain whether changes in gastric cancer mortality trends had occurred, and to estimate the annual percent change by sex and geographic area. Results Gastric cancer mortality decreased across the study period, with the downward trend being most pronounced in women and in certain regions situated in the interior and north of mainland Spain. Across the study period, there was an overall decrease of 2.90% per annum among men and 3.65% per annum among women. Generally, regions in which the rate of decline was sharpest were those that had initially registered the highest rates. However, the rate of decline was not constant throughout the study period: joinpoint analysis detected a shift in trend for both sexes in the early 1980s. Conclusion Gastric cancer mortality displayed in both sexes a downward trend during the study period, both nationally and regionally. The different trend in rates in the respective geographic areas translated as greater regional homogeneity in gastric cancer mortality by the end of the study period. In contrast, rates in women fell more than did those in men. The increasing differences between the sexes could indicate that some risk factors may be modifying the sex-specific pattern of
Saurabh, Suman; Sarkar, Sonali; Pandey, Dhruv K
Educated women are known to take informed reproductive and healthcare decisions. These result in population stabilization and better infant care reflected by lower birth rates and infant mortality rates (IMRs), respectively. Our objective was to study the relationship of male and female literacy rates with crude birth rates (CBRs) and IMRs of the states and union territories (UTs) of India. The data were analyzed using linear regression. CBR and IMR were taken as the dependent variables; while the overall literacy rates, male, and female literacy rates were the independent variables. CBRs were inversely related to literacy rates (slope parameter = -0.402, P < 0.001). On multiple linear regression with male and female literacy rates, a significant inverse relationship emerged between female literacy rate and CBR (slope = -0.363, P < 0.001), while male literacy rate was not significantly related to CBR (P = 0.674). IMR of the states were also inversely related to their literacy rates (slope = -1.254, P < 0.001). Multiple linear regression revealed a significant inverse relationship between IMR and female literacy (slope = -0.816, P = 0.031), whereas male literacy rate was not significantly related (P = 0.630). Female literacy is relatively highly important for both population stabilization and better infant health.
Muñoz, Paula; Vidal, Carolina; Moya, Patricia; Hoffmeister, Lorena
Chile has the highest mortality rate for gallbladder cancer in the Andean region. The areas most affected by this cancer are found in southern Chile. To describe the mortality rate trends for gallbladder cancer in the Araucanía region between 2004 and 2014. Ecological observational descriptive study. The cases were identified by the codes ICD-10: C-23. The population at risk was obtained from the projections of the National Institute of Statistics of Chile. The mortality rate was modeled using the Poisson regression method, including age, time, and interaction between the two variables. The annual percentage change (APC) was used as a summary measure. In 2014, the Araucanía region had a standardized mortality rate of 10.36 per 100,000 inhabitants, while in the country it was 6.13 per 100,000. At the country level, the temporal evolution of mortality due to gallbladder cancer presented an annual percentage change of 9.1% (incidence rate ratio = 0.91 p-value <0.05), while in Araucanía the decrease was 7 % (incidence rate ratio = 0.93 p-value= 0.16), which is not statistically significant. The mortality rate was 2.68 times higher in women than in Araucanía men (p-value <0.05), a result similar to that of the country. At the national level, the trend according to age group shows a decrease for all groups, being the one of greater magnitude in those people from 45 to 54 years with an annual percent change of -5.36%, these results are not observed in the Araucanía. Mortality from gallbladder cancer shows a decreasing trend in the period studied for the whole country; however, this is not so for the Araucanía region, which maintains a higher mortality rate than that of the country.
Lim, Daroh; Ha, Mina; Song, Inmyung
Cancer is the leading cause of death in Korea. This study aims to examine changes in temporal trends in major cancer mortality. Mortality data for 1993-2012 were obtained from the Korean Statistics Information Service(KOSIS) database and age-standardized to the 2000 Korean population. Joinpoint analysis was used to identify significant changes in trends over time. The annual percentage rate change (APC) was computed for each segment of the trends. The age-standardized mortality rates (ASR) for all cancer sites combined decreased by 9.1% and 1.1% in men and women, respectively, from 1983 to 2012. ASRs from cancers of esophagus, stomach, and liver decreased substantially, whereas ASRs from cancer for all other sites increased markedly. ASRs for all cancer sites combined increased until 1994 and thereafter decreased significantly in both genders except for the period of 1998-2002 (APC: -5.5% for men [p<0.05] and 0.07% for women). ASRs for esophagus and liver cancers increased until the early 1990s and thereafter declined, leading to significant decreases [p<0.05] for esophagus cancer (APC: -1.85% for men and -3.82% for women) and liver cancer (APC: -1.55% for men and -0.56% for women) in 1983-2012. ASRs for stomach cancer declined (APC: -4.06% for men and -4.07% for women) except for 1990-1994. ASRs for uterine cancer peaked in 2003 and then declined (APC: 2.85%). ASRs increased significantly until 2002 for colorectal cancer in men (APC: 7.52%) and lung cancer in both genders. The most consistently upward trend was observed for non-Hodgkin's lymphoma (APC: 3.55% for men and 5.29% for women; number of joinpoints=0). The greatest ASR increase was seen for prostate cancer for which mortality increased until 2002 at an APC of 12.56%. While mortality decreased significantly for esophagus, stomach and liver cancers in recent decades in Korea, challenges still remain for many other cancers, especially pancreatic, breast, and prostate cancers and non-Hodgkin's lymphoma
... HPV-Associated Lung Ovarian Skin Uterine Cancer Home Prostate Cancer Rates by Race and Ethnicity Language: English Español ( ... Tweet Share Compartir The rate of men getting prostate cancer or dying from prostate cancer varies by race ...
Hoel, D.G.; Dinse, G.E. )
In this paper we combine Japanese data on radiation exposure and cancer mortality with U.S. data on cancer incidence and lethality to estimate the effects of ionizing radiation on cancer incidence. The analysis is based on the mathematical relationship between the mortality rate and the incidence and lethality rates, as well as on statistical models that relate Japanese incidence rates to U.S. incidence rates and radiation risk factors. Our approach assumes that the risk of death from causes other than the cancer does not depend on whether or not the cancer is present, and among individuals with the cancer, the risk of death attributable to the cancer is the same in Japan and the U.S. and is not affected by radiation exposure. In particular, we focus on the incidence of breast cancer in Japanese women and how this incidence is affected by radiation risk factors. The analysis uses Japanese exposure and mortality data from the Radiation Effects Research Foundation study of atomic bomb survivors and U.S. incidence and lethality data from the Surveillance, Epidemiology, and End Results Registry. Even without Japanese incidence data, we obtain reasonable estimates of the incidence of breast cancer in unexposed Japanese women and identify the radiation risk factors that affect this incidence. Our analysis demonstrates that the age at exposure is an important risk factor, but that the incidence of breast cancer is not affected by the city of residence (Nagasaki versus Hiroshima) or the time since exposure.
Antoni, Sebastien; Ferlay, Jacques; Soerjomataram, Isabelle; Znaor, Ariana; Jemal, Ahmedin; Bray, Freddie
Bladder cancer has become a common cancer globally, with an estimated 430 000 new cases diagnosed in 2012. We examine the most recent global bladder cancer incidence and mortality patterns and trends, the current understanding of the aetiology of the disease, and specific issues that may influence the registration and reporting of bladder cancer. Global bladder cancer incidence and mortality statistics are based on data from the International Agency for Research on Cancer and the World Health Organisation (Cancer Incidence in Five Continents, GLOBOCAN, and the World Health Organisation Mortality). Bladder cancer ranks as the ninth most frequently-diagnosed cancer worldwide, with the highest incidence rates observed in men in Southern and Western Europe, North America, as well in certain countries in Northern Africa or Western Asia. Incidence rates are consistently lower in women than men, although sex differences varied greatly between countries. Diverging incidence trends were also observed by sex in many countries, with stabilising or declining rates in men but some increasing trends seen for women. Bladder cancer ranks 13th in terms of deaths ranks, with mortality rates decreasing particularly in the most developed countries; the exceptions are countries undergoing rapid economic transition, including in Central and South America, some central, southern, and eastern European countries, and the Baltic countries. The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking, although infection with Schistosoma haematobium and other risk factors are major causes in selected populations. Differences in coding and registration practices need to be considered when comparing bladder cancer statistics geographically or over time. The main risk factor for bladder cancer is tobacco smoking. The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking
Enstrom, J E
Because of the recent concern over possible health effects associated with nuclear power plants, cancer mortality patterns in Southern California have been examined for time periods before the San Onofre nuclear power plant began commercial operation in 1968 and since then. This is one of America's older plants and is surrounded by major population centers in Orange, Riverside and San Diego Counties. Infant mortality rates and age-adjusted mortality rates for leukemia, lung cancer, all cancer, and all causes have been calculated and compared for Orange, Riverside, and San Diego Counties, for California, and for the United States during 1960-1978. In addition, childhood leukemia death rates and clusters have been examined in detail in the communities within 25 miles of San Onofre. The cancer and total mortality rates near San Onofre have remained essentially identical to the corresponding rates in California and United States from 1960 to 1978. There have been no significant radiation releases to the population surrounding the San Onofre plant and the cancer rates show no patterns which have been influenced by the presence of the plant. Although no radiogenic health effects would be expected, these results do provide a means of assessing overall mortality trends in the population. PMID:6848003
Because of the recent concern over possible health effects associated with nuclear power plants, cancer mortality patterns in Southern California have been examined for time periods before the San Onofre nuclear power plant began commercial operation in 1968 and since then. This is one of America's older plants and is surrounded by major population centers in Orange, Riverside and San Diego Counties. Infant mortality rates and age-adjusted mortality rates for leukemia, lung cancer, all cancer, and all causes have been calculated and compared for Orange, Riverside, and San Diego Counties, for California, and for the United States during 1960-1978. In addition, childhood leukemia death rates and clusters have been examined in detail in the communities within 25 miles of San Onofre. The cancer and total mortality rates near San Onofre have remained essentially identical to the corresponding rates in California and United States from 1960 to 1978. There have been no significant radiation releases to the population surrounding the San Onofre plant and the cancer rates show no patterns which have been influenced by the presence of the plant. Although no radiogenic health effects would be expected, these results do provide a means of assessing overall mortality trends in the population.
Because of the recent concern over possible health effects associated with nuclear power plants, cancer mortality patterns in Southern California have been examined for time periods before the San Onofre nuclear power plant began commercial operation in 1968 and since then. This is one of America's older plants and is surrounded by major population centers in Orange, Riverside, and San Diego Counties. Infant mortality rates and age-adjusted mortality rates for leukemia, lung cancer, all cancer, and all causes have been calculated and compared for Orange, Riverside, and San Diego Counties, for California, and for the United States during 1960-1978. In addition, childhood leukemia death rates and clusters have been examined in detail in the communities within 25 miles of San Onofre. The cancer and total mortality rates near San Onofre have remained essentially identical to the corresponding rates in California and United States from 1960 to 1978. There have been no significant radiation releases to the population surrounding the San Onofre plant and the cancer rates show no patterns which have been influenced by the presence of the plant. Although no radiogenic health effects would be expected, these results do provide a means of assessing overall mortality trends in the population.
Yedjou, Clement G; Tchounwou, Paul B; Payton, Marinelle; Miele, Lucio; Fonseca, Duber D; Lowe, Leroy; Alo, Richard A
Breast cancer is the second leading cause of cancer related deaths among women aged 40-55 in the United States and currently affects more than one in ten women worldwide. It is also one of the most diagnosed cancers in women both in wealthy and poor countries. Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic populations has continued to grow. The goal of the present review article was to highlight similarities and differences in breast cancer morbidity and mortality rates primarily among African American women compared to White women in the United States. To reach our goal, we conducted a search of articles in journals with a primary focus on minority health, and authors who had published articles on racial/ethnic disparity related to breast cancer patients. A systematic search of original research was conducted using MEDLINE, PUBMED and Google Scholar databases. We found that racial/ethnic disparities in breast cancer may be attributed to a large number of clinical and non-clinical risk factors including lack of medical coverage, barriers to early detection and screening, more advanced stage of disease at diagnosis among minorities, and unequal access to improvements in cancer treatment. Many African American women have frequent unknown or unstaged breast cancers than White women. These risk factors may explain the differences in breast cancer treatment and survival rate between African American women and White women. New strategies and approaches are needed to promote breast cancer prevention, improve survival rate, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities.
Castro, Ricardo A S; Oliveira, Pedro N; Silva Portela, Conceição; Camanho, Ana S; Queiroz e Melo, João
This paper proposes two new measures to assess performance of surgical practice based on observed mortality: reliability, measured as the area under the ROC curve and a living score, the sum of individual risk among surviving patients, divided by the total number of patients. A Monte Carlo simulation of surgeons' practice was used for conceptual validation and an analysis of a real-world hospital department was used for managerial validation. We modelled surgical practice as a bivariate distribution function of risk and final state. We sampled 250 distributions, varying the maximum risk each surgeon faced, the distribution of risk among dead patients, the mortality rate and the number of surgeries performed yearly. We applied the measures developed to a Portuguese cardiothoracic department. We found that the joint use of the reliability and living score measures overcomes the limitations of risk adjusted mortality rates, as it enables a different valuation of deaths, according to their risk levels. Reliability favours surgeons with casualties, predominantly, in high values of risk and penalizes surgeons with deaths in relatively low levels of risk. The living score is positively influenced by the maximum risk for which a surgeon yields surviving patients. These measures enable a deeper understanding of surgical practice and, as risk adjusted mortality rates, they rely only on mortality and risk scores data. The case study revealed that the performance of the department analysed could be improved with enhanced policies of risk management, involving the assignment of surgeries based on surgeon's reliability and living score.
Study finds that flexible sigmoidoscopy is effective in reducing the rates of new cases and deaths due to colorectal cancer. Researchers found that overall colorectal cancer mortality was reduced by 26 percent and incidence was reduced by 21 percent as a
Puigpinós, Rosa; Borrell, Carme; Antunes, José Leopoldo Ferreira; Azlor, Enric; Pasarín, M Isabel; Serral, Gemma; Pons-Vigués, Mariona; Rodríguez-Sanz, Maica; Fernández, Esteve
Background The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992–1994, 1995–1997, 1998–2000, and 2001–2003). Results Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer. PMID:19166582
Kelsh, Michael A; Morimoto, Libby; Lau, Edmund
To compare cancer mortality rates in Amazon cantons (counties) with and without long-term oil exploration and extraction activities. Mortality (1990 through 2005) and population census (1990 and 2001) data for cantons in the provinces of the northern Amazon Region (Napo, Orellana, Sucumbios, and Pastaza), as well as the province with the capital city of Quito (Pichincha province) were obtained from the National Statistical Office of Ecuador, Instituto Nacional del Estadistica y Censos (INEC). Age- and sex-adjusted mortality rate ratios (RR) and 95% confidence intervals (CI) were estimated to evaluate total and cause-specific mortality in the study regions. Among Amazon cantons with long-term oil extraction, activities there was no evidence of increased rates of death from all causes (RR = 0.98; 95% CI = 0.95-1.01) or from overall cancer (RR = 0.82; 95% CI = 0.73-0.92), and relative risk estimates were also lower for most individual site-specific cancer deaths. Mortality rates in the Amazon provinces overall were significantly lower than those observed in Pichincha for all causes (RR = 0.82; 95% CI = 0.81-0.83), overall cancer (RR = 0.46; 95% CI = 0.43-0.49), and for all site-specific cancers. In regions with incomplete cancer registration, mortality data are one of the few sources of information for epidemiologic assessments. However, epidemiologic assessments in this region of Ecuador are limited by underreporting, exposure and disease misclassification, and study design limitations. Recognizing these limitations, our analyses of national mortality data of the Amazon Region in Ecuador does not provide evidence for an excess cancer risk in regions of the Amazon with long-term oil production. These findings were not consistent or supportive of earlier studies in this region that suggested increased cancer risks.
This study test whether the availability of alcoholic beverages is a simple integrated dimension as implied by certain policy models and in its treatment by researchers. Factor analysis reveals two independent availability factors: on-premise and retail availability. A correlation analysis found that on-premise availability was related to cirrhosis mortality rates for the total population, White males, non-White males, and White females. It was not related to non-White female cirrhosis mortality. In contrast, retail availability was not related to any of cirrhosis mortality rates. Examination of the states with extremes of high and low on-premise availability indicates that this type of availability is not a manipulable control variable but an index of extant norms toward drinking. It is recommended that differential prevention strategies be adopted rather than a uniform policy prevention model. PMID:7315996
Rubin, Marcie S; Clouston, Sean; Link, Bruce G
This study examines how associations between socioeconomic status (SES) and lung and pancreatic cancer mortality have changed over time in the U.S. The fundamental cause hypothesis predicts as diseases become more preventable due to innovation in medical knowledge or technology, individuals with greater access to resources will disproportionately benefit, triggering the formation or worsening of health disparities along social cleavages. We examine socioeconomic disparities in mortality due to lung cancer, a disease that became increasingly preventable with the development and dissemination of knowledge of the causal link between smoking cigarettes and lung cancer, and compare it to that of pancreatic cancer, a disease for which there have been no major prevention or treatment innovations. County-level disease-specific mortality rates for those ≥45 years, adjusted for sex, race, and age during 1968-2009 are derived from death certificate and population data from the National Center for Health Statistics. SES is measured using five county-level variables from four decennial censuses, interpolating values for intercensal years. Negative binomial regression was used to model mortality. Results suggest the impact of SES on lung cancer mortality increases 0.5% per year during this period. Although lung cancer mortality rates are initially higher in higher SES counties, by 1980 persons in lower SES counties are at greater risk and by 2009 the difference in mortality between counties with SES one SD above compared to one SD below average was 33 people per 100,000. In contrast, we find a small but significant reverse SES gradient in pancreatic cancer mortality that does not change over time. These data support the fundamental cause hypothesis: social conditions influencing access to resources more greatly impact mortality when preventative knowledge exists. Public health interventions and policies should facilitate more equitable distribution of new health
Barton, Virginia; Armeson, Kent; Hampras, Shalaka; Ferris, Laura K; Visvanathan, Kala; Rollison, Dana; Alberg, Anthony J
Some reports suggest that a history of nonmelanoma skin cancer (NMSC) may be associated with increased mortality. NMSCs have very low fatality rates, but the high prevalence of NMSC elevates the importance of the possibility of associated subsequent mortality from other causes. The variable methods and findings of existing studies leave the significance of these results uncertain. To provide clarity, we conducted a systematic review to characterize the evidence on the associations of NMSC with: (1) all-cause mortality, (2) cancer-specific mortality, and (3) cancer survival. Bibliographic databases were searched through February 2016. Cohort studies published in English were included if adequate data were provided to estimate mortality ratios in patients with-versus-without NMSC. Data were abstracted from the total of eight studies from independent data sources that met inclusion criteria (n = 3 for all-cause mortality, n = 2 for cancer-specific mortality, and n = 5 for cancer survival). For all-cause mortality, a significant increased risk was observed for patients with a history of squamous cell carcinoma (SCC) (mortality ratio estimates (MR) 1.25 and 1.30), whereas no increased risk was observed for patients with a history of basal cell carcinoma (BCC) (MRs 0.96 and 0.97). Based on one study, the association with cancer-specific mortality was stronger for SCC (MR 2.17) than BCC (MR 1.15). Across multiple types of cancer both SCC and BCC tended to be associated with poorer survival from second primary malignancies. Multiple studies support an association between NMSC and fatal outcomes; the associations tend to be more potent for SCC than BCC. Additional investigation is needed to more precisely characterize these associations and elucidate potential underlying mechanisms.
Taghizadeh, Niloofar; Boezen, H Marike; Schouten, Jan P; Schröder, Carolien P; Elisabeth de Vries, E G; Vonk, Judith M
Body Mass Index (BMI) is known to be associated with cancer mortality, but little is known about the link between lifetime changes in BMI and cancer mortality in both males and females. We studied the association of BMI measurements (at baseline, highest and lowest BMI during the study-period) and lifetime changes in BMI (calculated over different time periods (i.e. short time period: annual change in BMI between successive surveys, long time period: annual change in BMI over the entire study period) with mortality from any cancer, and lung, colorectal, prostate and breast cancer in a large cohort study (n=8,645. Vlagtwedde-Vlaardingen, 1965-1990) with a follow-up on mortality status on December 31st 2008. We used multivariate Cox regression models with adjustments for age, smoking, sex, and place of residence. Being overweight at baseline was associated with a higher risk of prostate cancer mortality (hazard ratio (HR) =2.22; 95% CI 1.19-4.17). Obesity at baseline was associated with a higher risk of any cancer mortality [all subjects (1.23 (1.01-1.50)), and females (1.40 (1.07-1.84))]. Chronically obese females (females who were obese during the entire study-period) had a higher risk of mortality from any cancer (2.16 (1.47-3.18), lung (3.22 (1.06-9.76)), colorectal (4.32 (1.53-12.20)), and breast cancer (2.52 (1.15-5.54)). We found no significant association between long-term annual change in BMI and cancer mortality risk. Both short-term annual increase and decrease in BMI were associated with a lower mortality risk from any cancer [all subjects: (0.67 (0.47-0.94)) and (0.73 (0.55-0.97)), respectively]. In conclusion, a higher BMI is associated with a higher cancer mortality risk. This study is the first to show that short-term annual changes in BMI were associated with lower mortality from any type of cancer.
Taghizadeh, Niloofar; Boezen, H. Marike; Schouten, Jan P.; Schröder, Carolien P.; de Vries, E. G. Elisabeth; Vonk, Judith M.
Body Mass Index (BMI) is known to be associated with cancer mortality, but little is known about the link between lifetime changes in BMI and cancer mortality in both males and females. We studied the association of BMI measurements (at baseline, highest and lowest BMI during the study-period) and lifetime changes in BMI (calculated over different time periods (i.e. short time period: annual change in BMI between successive surveys, long time period: annual change in BMI over the entire study period) with mortality from any cancer, and lung, colorectal, prostate and breast cancer in a large cohort study (n=8,645. Vlagtwedde-Vlaardingen, 1965-1990) with a follow-up on mortality status on December 31st 2008. We used multivariate Cox regression models with adjustments for age, smoking, sex, and place of residence. Being overweight at baseline was associated with a higher risk of prostate cancer mortality (hazard ratio (HR) =2.22; 95% CI 1.19-4.17). Obesity at baseline was associated with a higher risk of any cancer mortality [all subjects (1.23 (1.01-1.50)), and females (1.40 (1.07-1.84))]. Chronically obese females (females who were obese during the entire study-period) had a higher risk of mortality from any cancer (2.16 (1.47-3.18), lung (3.22 (1.06-9.76)), colorectal (4.32 (1.53-12.20)), and breast cancer (2.52 (1.15-5.54)). We found no significant association between long-term annual change in BMI and cancer mortality risk. Both short-term annual increase and decrease in BMI were associated with a lower mortality risk from any cancer [all subjects: (0.67 (0.47-0.94)) and (0.73 (0.55-0.97)), respectively]. In conclusion, a higher BMI is associated with a higher cancer mortality risk. This study is the first to show that short-term annual changes in BMI were associated with lower mortality from any type of cancer. PMID:25881129
Williams, Graciëlle; Mans, Dennis R A; Garssen, Joop; Visser, Otto; Kramer, Daniëlle; Kunst, Anton E
It has been suggested that the cancer risk of migrants from low-income to high-income countries will converge toward the levels of their host country. However, comparisons with country of origin are mostly lacking. We compared cancer incidence and mortality rates of Surinamese migrants in the Netherlands to both native Dutch and Surinamese levels. Data covering the period 1995-2008 were obtained from Surinamese and Dutch national cancer registries and national cause-of-death registries. Cancer incidence was studied for 21 types of cancer and cancer mortality for nine types. We calculated age-standardized incidence/mortality ratios (SIR/SMR) for the Surinamese migrants and for Suriname, using the native Dutch population as reference. Significantly lower overall cancer incidence (SIR = 0.77, 95% CI = 0.69-0.84) and mortality rates (SMR = 0.63, 95% CI = 0.55-0.72) were found for Surinamese migrants compared to native Dutch. Generally, cancer risk was lower for most cancers (e.g., cancer of the breast, colon and rectum, lung), but higher for other cancers (e.g., cancer of the uterine cervix, liver). For most cancers, cancer risk of the Surinamese migrants was in-between Surinamese and native Dutch levels. Importantly, for many cancers, migrants' incidence and mortality rates had not closely approached native Dutch rates. For skin cancer, incidence levels for Surinamese migrants were lower than both Surinamese and native Dutch levels. The results suggest that cancer incidence and mortality rates of Surinamese migrants generally converge from Surinamese toward Dutch levels, though not for all cancer types. Overall, Surinamese migrants still had a much more favorable cancer profile than the native Dutch population.
Vioque, J; Bolumar, F
Lung cancer mortality rates in Spain were calculated for the years 1951 to 1980. Increasing age-standardised rates for men and levelled off ones for women were observed. Available cigarette consumption data suggest that these current trends could change at the beginning of the next century when there may be a levelling off of male rates and an "epidemic" of female lung cancer. PMID:3668465
Li, Qing; Fisher, Wayne W.; Peng, Chun-Zi; Williams, Andrew D.
Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers’ death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44–7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09–0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment. PMID:21710184
Li, Qing; Fisher, Wayne W; Peng, Chun-Zi; Williams, Andrew D; Burd, Larry
Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers' death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44-7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09-0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment.
Hammer, Gaël Paul; Blettner, Maria; Langner, Ingo; Zeeb, Hajo
Commercial airline pilots are exposed to cosmic radiation and other specific occupational factors, potentially leading to increased cancer mortality. This was analysed in a cohort of 6,000 German cockpit crew members. A mortality follow-up for the years 1960-2004 was performed and occupational and dosimetry data were collected for this period. 405 deaths, including 127 cancer deaths, occurred in the cohort. The mortality from all causes and all cancers was significantly lower than in the German population. Total mortality decreased with increasing radiation doses (rate ratio (RR) per 10 mSv: 0.85, 95 % CI: 0.79, 0.93), contrasting with a non-significant increase of cancer mortality (RR per 10 mSv: 1.05, 95 % CI: 0.91, 1.20), which was restricted to the group of cancers not categorized as radiogenic in categorical analyses. While the total and cancer mortality of cockpit crew is low, a positive trend of all cancer with radiation dose is observed. Incomplete adjustment for age, other exposures correlated with duration of employment and a healthy worker survivor effect may contribute to this finding. More information is expected from a pooled analysis of updated international aircrew studies.
Kim, Mi-Hyun; Kim, Bo-Kyoung; Park, Sung-Min; Ko, Gwang Pyo
Background Death from uterine cervical cancer could be preventable by an active participation of women at risk in a screening program such as the Papanicolaou test. In order to examine the presence of socioeconomic disparity in preventable deaths, we evaluated the time trends of cervical cancer mortality by socioeconomic status in Korean women. Methods We selected level of educational attainment and marital status as surrogate indices of socioeconomic status. Using death certificate data and Korean Population and Housing Census data from Korea National Statistical office, we calculated age-standardized yearly mortality rates from cervical cancer between 1998 and 2009 according to the level of education as well as marital status. Results Cervical cancer mortality peaked in 2003 and then decreased gradually over time. Cervical cancer mortality was the highest in the group with the lowest level of educational attainment in all age groups and the gap between the lowest and the highest educational level has increased over time. Cervical cancer mortality was lower in married women than unmarried women in all age groups, and the degree of difference did not change over time. Conclusion In the Korean population, socioeconomic differential in cervical cancer mortality has persisted over time. PMID:23904955
Kerger, Brent D; Butler, William J; Paustenbach, Dennis J; Zhang, JianDong; Li, ShuKun
This report is a further characterization of data from an ecological cancer mortality study of a population (about 10,000) exposed to groundwater contaminated by hexavalent chromium [Cr(VI)] up to 20 mg/L near JinZhou City in the LiaoNing Province of China between 1960 and 1978. Prior reports showed an elevation in all-cancer mortality from 1970 to 1978 averaged across five agricultural villages with Cr(VI) in groundwater relative to average cancer rates for the district and province. The current study compares the cancer rates during the same time period for the same five exposed villages to those of four nearby areas with no Cr(VI) in groundwater. The use of a local comparison group is considered superior to the use of district or province averages because of the expected improved similarity among unmeasured covariates in nearby areas. The average lung-, stomach-, and all-cancer mortality rates for the three agricultural villages without Cr(VI) in groundwater were not statistically different from those of the five agricultural villages with Cr(VI) in groundwater. Also, three surrogate measures of village drinking-water Cr(VI) dose did not significantly correlate with cancer mortality rates in the five exposed villages. Further, the industrial town in which the Cr(VI) source was located had different demographics and a different pattern of stomach and lung cancers compared to the adjacent agricultural villages, regardless of Cr(VI) groundwater exposure. The results of other local investigations on cancer mortality and genotoxicity in the exposed populations are reviewed. The overall findings in the studied population do not indicate a dose-response relationship or a coherent pattern of association of lung-, stomach-, or all-cancer mortality with exposure to Cr(VI)-contaminated groundwater.
Soto, Victoria Eugenia; Farfan, Maria Isabel; Lorant, Vincent
There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised. Copyright © 2012 Elsevier Ltd. All rights reserved.
Aragonés, Nuria; Ramis, Rebeca; Pollán, Marina; Pérez-Gómez, Beatriz; Gómez-Barroso, Diana; Lope, Virginia; Boldo, Elena Isabel; García-Pérez, Javier; López-Abente, Gonzalo
Background Oesophageal carcinoma is one of the most common cancers worldwide. Its incidence and mortality rates show a wide geographical variation at a world and regional level. Geographic mapping of age-standardized, cause-specific death rates at a municipal level could be a helpful and powerful tool for providing clues leading to a better understanding of its aetiology. Methods This study sought to describe the geographic distribution of oesophageal cancer mortality for Spain's 8077 towns, using the autoregressive spatial model proposed by Besag, York and Mollié. Maps were plotted, depicting standardised mortality ratios, smoothed relative risk (RR) estimates, and the spatial pattern of the posterior probability of RR being greater than 1. Results Important differences associated with area of residence were observed in risk of dying from oesophageal cancer in Spain during the study period (1989–1998). Among men, excess risk appeared across the north of the country, along a band spanning the length of the Cantabrian coastline, Navarre, the north of Castile & León and the north-west of La Rioja. Excess risk was likewise observed in the provinces of Cadiz and part of Seville in Andalusia, the islands of Tenerife and Gran Canaria, and some towns in the Barcelona and Gerona areas. Among women, there was a noteworthy absence of risk along the mid-section of the Cantabrian seaboard, and increases in mortality, not observed for men, in the west of Extremadura and south-east of Andalusia. Conclusion These major gender- and area-related geographical differences in risk would seem to reflect differences in the prevalence of some well-established and modifiable risk factors, including smoking, alcohol consumption, obesity and diet. In addition, excess risks were in evidence for both sexes in some areas, possibly suggesting the implication of certain local environmental or socio-cultural factors. From a public health standpoint, small-area studies could be very useful for
Pina, Francisco; Castro, Clara; Ferro, Ana; Bento, Maria J; Lunet, Nuno
There is a large geographical variability in prostate cancer incidence and mortality trends, mostly because of heterogeneity in control efforts across regions. We aimed to describe the time trends in prostate cancer incidence and mortality in Portugal, overall and by region, and to estimate the number of incident cases and deaths in 2020. The number of cases and incidence rates in 1998-2009 were collected from the Regional Cancer Registries. The number of deaths and mortality rates were obtained from the WHO mortality database (1988-2003 and 2007-2013) and Statistics Portugal (2004-2006; 1991-2013 by region). JoinPoint analyses were used to identify significant changes in trends in age-standardized incidence and mortality rates. Incidence and mortality predictions for 2020 were performed using Poisson regression models and population projections provided by Statistics Portugal. In Portugal, prostate cancer incidence has been increasing since 1998 (1.8%/year), with the exception of the North Region, with a decrease since 2006 (-3.2%/year). An overall mortality decline has been observed since 1997 (-2.2%/year), although there were two patterns of mortality variation at the regional level: one with an inflection point or significant variation in the rates and the other without significant variation. If these trends are maintained, ∼8600 incident cases and 1700 deaths may be expected to occur in Portugal in 2020. Despite the overall increasing incidence and decreasing mortality, there is a large heterogeneity across regions. Future studies should address regional differences in the trends of prostate specific antigen screening and in the effective management of prostate cancer.
Chung, Ya-Ling; Liaw, Yung-Po; Hwang, Bing-Fang; Cheng, Ya-Yun; Lin, Ming-Shian; Kuo, Yau-Chang; Guo, How-Ran
The association between exposure to arsenic in drinking water and lung cancer has been observed in some epidemiology studies, but dose-response data are limited. To assess the dose-response relationship and identify hot spots, we analyzed the national death registry data of Taiwan from 1971 to 2000. We adopted data on 311 townships gathered by a nationwide survey of drinking water and divided arsenic levels into three groups: below 0.05 mg/L, 0.05-0.35 mg/L, and above 0.35 mg/L. Using the direct standardization method to adjust for the effects of age, we calculated the standardized mortality rates of lung cancer in both genders and evaluated their associations with arsenic levels. We also used the geographical information system to identify the hot spots. During the 30-year study period, we identified 64,954 male and 27,039 female lung cancer deaths in the study townships. We found significant increases in lung cancer mortality associated with arsenic levels above 0.35 mg/L in both genders, but the increases associated with levels between 0.05 and 0.35 mg/L were statistically significant in men only. Using both 0.05 and 0.35 mg/L as the cut-offs, we found most of the hot spots were in the southwestern coast and northeastern areas, but the southwestern coast area had some hot spots where the percentages of high risk population were higher than any hot spots in the northeastern area.
Gupta, Bhawna; Kumar, Narinder
The incidence and mortality trends of oesophageal cancer are changing significantly across the world with considerable heterogeneity between sex, histological types, ethnic patterns and geographical distribution. Recent oesophageal cancer incidence and mortality trends have been analysed using data available from the WHO mortality database, the GLOBOCAN 2012 database and the Cancer Incidence in Five Continents database managed by the International Agency for Research on Cancer. Huge geographical variation is an epidemiological characteristic of oesophageal cancer, with the highest incidence rates observed in Eastern Asia and in Eastern and Southern Africa and the lowest rates observed in Western Africa. The variation is to the order of more than 21 times between the lowest-incidence and the highest-incidence countries. Although the incidence of squamous cell carcinoma is increasing globally, its incidence rates are decreasing in the USA and a few European countries. However, the decrease in the incidence of squamous cell carcinomas in these countries has been accompanied by a marked increase in adenocarcinoma incidence rates. There is a significant sex variation as well, with men being affected three to four times more commonly than women worldwide. The observed trends reflect significant global variations in the incidence and mortality of oesophageal cancers on the basis of sex, geographical distribution, ethnicity and histology. These epidemiological factors related to oesophageal cancers point out a possibly significant role of molecular epidemiological factors (genetic susceptibility and response to treatment) with major differences likely between the characteristics of Asian and Western populations.
Cantarutti, Anna; Bonn, Stephanie E; Adami, Hans-Olov; Grönberg, Henrik; Bellocco, Rino; Bälter, Katarina
Body Mass index (BMI) has been shown to affect risk and mortality of several cancers. Prostate cancer and obesity are major public health concerns for middle-aged and older men. Previous studies of pre-diagnostic BMI have found an increased risk of prostate cancer mortality in obese patients. To study the associations between BMI at time of prostate cancer diagnosis and prostate cancer specific and overall mortality. BMI was analyzed both as a continuous variable and categorized into four groups based on the observed distribution in the cohort (BMI < 22.5, 22.5 < 25, 25 < 27.5 and ≥27.5 kg/m2). The association between BMI and mortality was assessed using stratified Cox proportional hazards models and by fitting regression splines for dose response analysis in 3,161 men diagnosed with prostate cancer. After 11 years of follow up via linkage to the population-based cause of death registry, we identified 1,161 (37%) deaths off which 690 (59%) were due to prostate cancer. High BMI (BMI ≥ 27.5 kg/m2) was associated with a statistically significant increased risk of prostate cancer specific mortality (HR:1.44, 95% CI: 1.09-1.90) and overall mortality (HR:1.33, 95% CI: 1.09-1.63) compared to the reference group (BMI 22.5 < 25 kg/m2). Additionally, men with a low BMI (<22.5 kg/m2 ), had a statistically significant increased risk of prostate cancer specific mortality (HR:1.33, 95% CI: 1.02-1.74) and overall mortality (HR:1.36, 95% CI: 1.11-1.67) compared to the reference. However, this effect disappeared when men who died within the first two years of follow-up were excluded from the analyses while the increased risk of prostate cancer specific mortality and overall mortality remained statistically significant for men with a BMI ≥ 27.5 kg/m2 (HR:1.44, 95% CI: 1.09-1.90 and HR: 1.33, 95% CI: 1.09-1.63, respectively). This study showed that a high BMI at time of prostate cancer diagnosis was associated with increased overall mortality
Sharma, Jagannath Dev; Kataki, Amal Chandra; Barman, Debanjana; Sharma, Arpita; Kalita, Manoj
The aim of this study was to report cancer statistics in Kamrup Urban District, including incidence and, mortality. In the last five year PBCR-Guwahati witnessed a remarkable growth in cancer incidence cases. The number of new cases of all cancer was increased from 155.3 to 188.5 and 102.7 to 165.3 per 100,000 men and women respectively from the year 2007 to 2011 in KUD. The data from KUD also have shown that for some of the specific types of cancer are highest or some of the highest incidence in rates in the world; particularly cancers of upper aero-digestive tract consist of anatomical sites such as oral cavity, hypopharynx, larynx gallbladder, stomach, lung, prostate and oesophageal cancer. Age-standardized rates (ASR) (per 100,000 person-years) for incidence, mortality were calculated using the World Standard Population as proposed by Segi and modified by Doll et al. Descriptive statistics were presented by tables and figures. A total of 6623 number of cases (male = 3809, female = 2814) were diagnosed with cancer in the last five years (2007-2011) period of time. The overall age standardized cancer incidence rate is almost 21% higher in men than in women. The pooled ASR for the five year period is 175.2 and 144.7 per 100,000 men and women. Overall cancer incidence and mortality rates have increased since 2007.
Sun, Li-Min; Lin, Ming-Chia; Lin, Cheng-Li; Chang, Shih-Ni; Liang, Ji-An; Lin, I-Ching; Kao, Chia-Hung
Studies have suggested that statin use is related to cancer risk and prostate cancer mortality. We conducted a population-based cohort study to determine whether using statins in prostate cancer patients is associated with reduced all-cause mortality rates. Data were obtained from the Taiwan National Health Insurance Research Database. The study cohort comprised 5179 patients diagnosed with prostate cancer who used statins for at least 6 months between January 1, 1998 and December 31, 2010. To form a comparison group, each patient was randomly frequency-matched (according to age and index date) with a prostate cancer patient who did not use any type of statin-based drugs during the study period. The study endpoint was mortality. The hazard ratio (HR) and 95% confidence interval (CI) were estimated using Cox regression models. Among prostate cancer patients, statin use was associated with significantly decreased all-cause mortality (adjusted HR = 0.65; 95% CI = 0.60-0.71). This phenomenon was observed among various types of statin, age groups, and treatment methods. Analyzing the defined daily dose of statins indicated that both low- and high-dose groups exhibited significantly decreased death rates compared with nonusers, suggesting a dose-response relationship. The results of this population-based cohort study suggest that using statins reduces all-cause mortality among prostate cancer patients, and a dose-response relationship may exist.
Tsodikov, Alex; Mariotto, Angela; Szabo, Aniko; Falcon, Seth; Wegelin, Jake; diTommaso, Dante; Karnofski, Kent; Gulati, Roman; Penson, David F.; Feuer, Eric
Objective To quantify the plausible contribution of prostate-specific antigen (PSA) screening to the nearly 30% decline in the US prostate cancer mortality rate observed during the 1990s. Methods Two mathematical modeling teams of the US National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network independently projected disease mortality in the absence and presence of PSA screening. Both teams relied on Surveillance, Epidemiology, and End Results (SEER) registry data for disease incidence, used common estimates of PSA screening rates, and assumed that screening, by shifting disease from distant to local-regional clinical stage, confers a corresponding improvement in disease-specific survival. Results The teams projected similar mortality increases in the absence of screening and decreases in the presence of screening after 1985. By 2000, the models projected that 45% (Fred Hutchinson Cancer Research Center) to 70% (University of Michigan) of the observed decline in prostate cancer mortality could be plausibly attributed to the stage shift induced by screening. Conclusions PSA screening may account for much, but not all, of the observed drop in prostate cancer mortality. Other factors, such as changing treatment practices, may also have played a role in improving prostate cancer outcomes. PMID:18027095
Liaw, Jane; Marshall, Guillermo; Yuan, Yan; Ferreccio, Catterina; Steinmaus, Craig; Smith, Allan H.
Arsenic in drinking water is an established cause of lung, bladder and skin cancers in adults, and may also cause adult kidney and liver cancer. Some evidence for these effects originated from Region II of Chile which had a period of elevated arsenic levels in drinking water, in particular from 1958 to 1970. This unique exposure scenario provides a rare opportunity to investigate the effects of early-life arsenic exposure on childhood mortality; to our knowledge, this is the first study of childhood cancer mortality and high concentrations of arsenic in drinking water. In this paper, we compare cancer mortality rates under the age of 20 in Region II during 1950–2000 with those of unexposed Region V, dividing subjects into those born before, during or after the peak exposure period. Mortality from the most common childhood cancers, leukemia and brain cancer, were not increased in the exposed population. However, we found childhood liver cancer mortality occurred at higher rates than expected; for those exposed as young children liver cancer mortality between ages 0–19 was especially high: the relative risk (RR) for males born during this period was 8.9 (95% CI 1.7–45.8; p=0.009), for females the corresponding RR was 14.1 (95% CI 1.6–126; p=0.018), and for males and females pooled, the RR was 10.6 (95% CI 2.9–39.2; p<0.001). These findings suggest exposure to arsenic in drinking water during early childhood may result in an increase in childhood liver cancer mortality. PMID:18708388
Liaw, Jane; Marshall, Guillermo; Yuan, Yan; Ferreccio, Catterina; Steinmaus, Craig; Smith, Allan H
Arsenic in drinking water is an established cause of lung, bladder, and skin cancers in adults and may also cause adult kidney and liver cancers. Some evidence for these effects originated from region II of Chile, which had a period of elevated arsenic levels in drinking water, in particular from 1958 to 1970. This unique exposure scenario provides a rare opportunity to investigate the effects of early-life arsenic exposure on childhood mortality; to our knowledge, this is the first study of childhood cancer mortality and high concentrations of arsenic in drinking water. In this article, we compare cancer mortality rates under the age of 20 in region II during 1950 to 2000 with those of unexposed region V, dividing subjects into those born before, during, or after the peak exposure period. Mortality from the most common childhood cancers, leukemia and brain cancer, was not increased in the exposed population. However, we found that childhood liver cancer mortality occurred at higher rates than expected. For those exposed as young children, liver cancer mortality between ages 0 and 19 was especially high: the relative risk (RR) for males born during this period was 8.9 [95% confidence interval (95% CI), 1.7-45.8; P = 0.009]; for females, the corresponding RR was 14.1 (95% CI, 1.6-126; P = 0.018); and for males and females pooled, the RR was 10.6 (95% CI, 2.9-39.2; P < 0.001). These findings suggest that exposure to arsenic in drinking water during early childhood may result in an increase in childhood liver cancer mortality.
Schröder, Fritz H; Hugosson, Jonas; Roobol, Monique J; Tammela, Teuvo L J; Ciatto, Stefano; Nelen, Vera; Kwiatkowski, Maciej; Lujan, Marcos; Lilja, Hans; Zappa, Marco; Denis, Louis J; Recker, Franz; Páez, Alvaro; Määttänen, Liisa; Bangma, Chris H; Aus, Gunnar; Carlsson, Sigrid; Villers, Arnauld; Rebillard, Xavier; van der Kwast, Theodorus; Kujala, Paula M; Blijenberg, Bert G; Stenman, Ulf-Hakan; Huber, Andreas; Taari, Kimmo; Hakama, Matti; Moss, Sue M; de Koning, Harry J; Auvinen, Anssi
Several trials evaluating the effect of prostate-specific antigen (PSA) testing on prostate-cancer mortality have shown conflicting results. We updated prostate-cancer mortality in the European Randomized Study of Screening for Prostate Cancer with 2 additional years of follow-up. The study involved 182,160 men between the ages of 50 and 74 years at entry, with a predefined core age group of 162,388 men 55 to 69 years of age. The trial was conducted in eight European countries. Men who were randomly assigned to the screening group were offered PSA-based screening, whereas those in the control group were not offered such screening. The primary outcome was mortality from prostate cancer. After a median follow-up of 11 years in the core age group, the relative reduction in the risk of death from prostate cancer in the screening group was 21% (rate ratio, 0.79; 95% confidence interval [CI], 0.68 to 0.91; P=0.001), and 29% after adjustment for noncompliance. The absolute reduction in mortality in the screening group was 0.10 deaths per 1000 person-years or 1.07 deaths per 1000 men who underwent randomization. The rate ratio for death from prostate cancer during follow-up years 10 and 11 was 0.62 (95% CI, 0.45 to 0.85; P=0.003). To prevent one death from prostate cancer at 11 years of follow-up, 1055 men would need to be invited for screening and 37 cancers would need to be detected. There was no significant between-group difference in all-cause mortality. Analyses after 2 additional years of follow-up consolidated our previous finding that PSA-based screening significantly reduced mortality from prostate cancer but did not affect all-cause mortality. (Current Controlled Trials number, ISRCTN49127736.).
Two clinical series that assessed outcome of gastric cancer treated with gastrectomy and extended lymphadenectomy were reviewed using standard insurance medicine mortality abstract methods. The results were not conclusive; although they did suggest that extended level 2 (D2) lymphadenectomy may produce better long-term mortality outcomes than less extensive surgery in some circumstances.
Ytterstad, Elinor; Moe, Per C; Hjalmarsen, Audhild
Previous studies have relied on international spirometry criteria to diagnose COPD in patients with lung cancer without considering the effect lung cancer might have on spirometric results. The aim of this study was to examine the prevalence of COPD and emphysema at the time of primary lung cancer diagnosis and to examine factors associated with survival. Medical records, pulmonary function tests, and computed tomography scans were used to determine the presence of COPD and emphysema in patients diagnosed with primary lung cancer at the University Hospital of North Norway in 2008-2010. Among the 174 lung cancer patients, 69% had COPD or emphysema (39% with COPD, 59% with emphysema; male:female ratio 101:73). Neither COPD nor emphysema were significantly associated with lung cancer mortality, whereas patients with non-small-cell lung cancer other than adenocarcinoma and squamous cell carcinoma had a risk of lung cancer mortality that was more than four times higher than that of patients with small-cell lung cancer (hazard ratio [HR] 4.19, 95% confidence interval [CI] 1.56-11.25). Females had a lower risk of lung cancer mortality than males (HR 0.63, 95% CI 0.42-0.94), and patients aged ≥75 years had a risk that was twice that of patients aged <75 years (HR 2.48, 95% CI 1.59-3.87). Low partial arterial oxygen pressure (4.0-8.4 kPa) increased the risk of lung cancer mortality (HR 2.26, 95% CI 1.29-3.96). So did low partial arterial carbon dioxide pressure (3.0-4.9 kPa) among stage IV lung cancer patients (HR 2.23, 95% CI 1.29-3.85). Several patients with respiratory failure had previously been diagnosed with COPD. The observed prevalence of COPD was lower than that in previous studies. Neither COPD nor emphysema were significantly associated with lung cancer mortality.
Sanchez-Ramirez, Diana C.; Colquhoun, Amy; Parker, Sara; Randall, Jason; Svenson, Lawrence W.; Voaklander, Don
Background Cancer has been identified as a major cause of morbidity and mortality in Canada over the last decade. However, there is a paucity of information about cancer patterns in Aboriginal people, particularly for Métis. This study aims to explore cancer incidence and mortality burden among Métis and to compare disease estimates with non-Métis population. Methods This population-based descriptive epidemiological study used cancer incidence and mortality data from 2007 to 2012 obtained from Alberta Health Care Insurance Plan (AHCIP) – Central Stakeholder Registry – and Alberta Cancer Registry (ACR). To identify cancer cases in Métis, the ACR was linked with the Métis Nation of Alberta (MNA) Identification Registry. In Métis and non-Métis people, age-standardized cancer incidence and mortality rates were estimated and subsequently compared between both groups. Results A higher incidence of bronchus/lung cancer was found among Métis men compared with their non-Métis counterparts (RR=1.69, CI 1.28–2.09; p=0.01). No other statistically significant differences in cancer incidence or mortality were found between Métis and non-Métis people living in Alberta over the course of the 6 years studied. Conclusions Overall incidence and mortality associated with cancer were not higher among Métis people compared with non-Métis people. However, special efforts should be considered to decrease the higher incidence of bronchus/lung cancer in Métis men. Further development and maintenance of new and existing institutional collaborations are necessary to continue cancer research and health status surveillance in Métis population. PMID:26837668
Nguyen, Michelle-Linh T; Hu, Jiaqi; Hastings, Katherine G; Daza, Eric J; Cullen, Mark R; Orloff, Lisa A; Palaniappan, Latha P
Well-differentiated thyroid carcinoma has a favorable prognosis, but patients with multiple recurrences have drastically lower survival. Filipinos in the United States are known to have high rates of thyroid cancer incidence and disease recurrence. To the authors' knowledge, it is unknown whether Filipinos also have higher thyroid cancer mortality rates. The authors studied thyroid cancer mortality in Filipino, non-Filipino Asian (NFA), and non-Hispanic white (NHW) adults using US death records (2003-2012) and US Census data. Age-adjusted mortality rates and proportional mortality ratios (PMRs) were calculated. Sex, nativity status, age at death, and educational attainment also were examined. The authors examined 19,940,952 deaths. The age-adjusted mortality rates due to thyroid cancer were highest in Filipinos (1.72 deaths per 100,000 population; 95% confidence interval [95% CI], 1.51-1.95) compared with NFAs (1.03 per 100,000 population; 95% CI, 0.95-1.12) and NHWs (1.17 per 100,000 population; 95% CI, 1.16-1.18). Compared with NHWs, higher proportionate mortality was observed in Filipino women (3-5 times higher) across all age groups, and among Filipino men, the PMR was 2 to 3 times higher in the subgroup aged >55 years. Filipinos who completed a higher educational level had a notably higher PMR (5.0) compared with their counterparts who had not (3.5). Negative prognostic factors for thyroid cancer traditionally include age >45 years and male sex. The results of the current study demonstrate that Filipinos die of thyroid cancer at higher rates than NFA and NHW individuals of similar ages. Highly educated Filipinos and Filipino women may be especially at risk of poor thyroid cancer outcomes. Filipino ethnicity should be factored into clinical decision making in the management of patients with thyroid cancer. Cancer 2017. © 2017 American Cancer Society. © 2017 American Cancer Society.
We analyzed socioeconomic and racial/ethnic disparities in US mortality, incidence, and survival rates from all-cancers combined and major cancers from 1950 to 2014. Census-based deprivation indices were linked to national mortality and cancer data for area-based socioeconomic patterns in mortality, incidence, and survival. The National Longitudinal Mortality Study was used to analyze individual-level socioeconomic and racial/ethnic patterns in mortality. Rates, risk-ratios, least squares, log-linear, and Cox regression were used to examine trends and differentials. Socioeconomic patterns in all-cancer, lung, and colorectal cancer mortality changed dramatically over time. Individuals in more deprived areas or lower education and income groups had higher mortality and incidence rates than their more affluent counterparts, with excess risk being particularly marked for lung, colorectal, cervical, stomach, and liver cancer. Education and income inequalities in mortality from all-cancers, lung, prostate, and cervical cancer increased during 1979–2011. Socioeconomic inequalities in cancer mortality widened as mortality in lower socioeconomic groups/areas declined more slowly. Mortality was higher among Blacks and lower among Asian/Pacific Islanders and Hispanics than Whites. Cancer patient survival was significantly lower in more deprived neighborhoods and among most ethnic-minority groups. Cancer mortality and incidence disparities may reflect inequalities in smoking, obesity, physical inactivity, diet, alcohol use, screening, and treatment. PMID:28408935
Singh, Gopal K; Jemal, Ahmedin
We analyzed socioeconomic and racial/ethnic disparities in US mortality, incidence, and survival rates from all-cancers combined and major cancers from 1950 to 2014. Census-based deprivation indices were linked to national mortality and cancer data for area-based socioeconomic patterns in mortality, incidence, and survival. The National Longitudinal Mortality Study was used to analyze individual-level socioeconomic and racial/ethnic patterns in mortality. Rates, risk-ratios, least squares, log-linear, and Cox regression were used to examine trends and differentials. Socioeconomic patterns in all-cancer, lung, and colorectal cancer mortality changed dramatically over time. Individuals in more deprived areas or lower education and income groups had higher mortality and incidence rates than their more affluent counterparts, with excess risk being particularly marked for lung, colorectal, cervical, stomach, and liver cancer. Education and income inequalities in mortality from all-cancers, lung, prostate, and cervical cancer increased during 1979-2011. Socioeconomic inequalities in cancer mortality widened as mortality in lower socioeconomic groups/areas declined more slowly. Mortality was higher among Blacks and lower among Asian/Pacific Islanders and Hispanics than Whites. Cancer patient survival was significantly lower in more deprived neighborhoods and among most ethnic-minority groups. Cancer mortality and incidence disparities may reflect inequalities in smoking, obesity, physical inactivity, diet, alcohol use, screening, and treatment.
Hamashima, Chisato; Shabana, Michiko; Okada, Katsuo; Okamoto, Mikizo; Osaki, Yoneatsu
To evaluate mortality reduction from gastric cancer by endoscopic screening, we undertook a population-based cohort study in which both radiographic and endoscopic screenings for gastric cancer have been carried out. The subjects were selected from the participants of gastric cancer screening in two cities in Japan, Tottori and Yonago, from 2007 to 2008. The subjects were defined as participants aged 40-79 years who had no gastric cancer screening in the previous year. Follow-up of mortality was continued from the date of the first screening to the date of death or up to December 31, 2013. A Cox proportional hazards model was used to estimate the relative risk (RR) of gastric cancer incidence, gastric cancer death, all cancer deaths except gastric cancer death, and all-causes death except gastric cancer death. The number of subjects selected for endoscopic screening was 9950 and that for radiographic screening was 4324. The subjects screened by endoscopy showed a 67% reduction of gastric cancer compared with the subjects screened by radiography (adjusted RR by sex, age group, and resident city = 0.327; 95% confidence interval [CI], 0.118-0.908). The adjusted RR of endoscopic screening was 0.968 (95%CI, 0.675-1.387) for all cancer deaths except gastric cancer death, and 0.929 (95%CI, 0.740-1.168) for all-causes death except gastric cancer death. This study indicates that endoscopic screening can reduce gastric cancer mortality by 67% compared with radiographic screening. This is consistent with previous studies showing that endoscopic screening reduces gastric cancer mortality.
Ocaña-Riola, Ricardo; Montaño-Remacha, Carmen; Mayoral-Cortés, José María
The last published figures have shown geographical variations in mortality with respect to female breast cancer in European countries. However, national health policies need a dynamic image of the geographical variations within the country. The aim of this paper was to describe the spatial distribution of age-specific mortality rates from female breast cancer in the municipalities of Andalusia (southern Spain) and to analyze its evolution over time from 1981 to 2012. An ecological study was devised. Two spatio-temporal hierarchical Bayesian models were estimated. One of these was used to estimate the age-specific mortality rate for each municipality, together with its time trends, and the other was used to estimate the age-specific rate ratio compared with Spain as a whole. The results showed that 98% of the municipalities exhibited a decreasing or a flat mortality trend for all the age groups. In 2012, the geographical variability of the age-specific mortality rates was small, especially for population groups below 65. In addition, more than 96.6% of the municipalities showed an age-specific mortality rate similar to the corresponding rate for Spain, and there were no identified significant clusters. This information will contribute towards a reflection on the past, present and future of breast cancer outcomes in Andalusia. PMID:27879690
Ocaña-Riola, Ricardo; Montaño-Remacha, Carmen; Mayoral-Cortés, José María
The last published figures have shown geographical variations in mortality with respect to female breast cancer in European countries. However, national health policies need a dynamic image of the geographical variations within the country. The aim of this paper was to describe the spatial distribution of age-specific mortality rates from female breast cancer in the municipalities of Andalusia (southern Spain) and to analyze its evolution over time from 1981 to 2012. An ecological study was devised. Two spatio-temporal hierarchical Bayesian models were estimated. One of these was used to estimate the age-specific mortality rate for each municipality, together with its time trends, and the other was used to estimate the age-specific rate ratio compared with Spain as a whole. The results showed that 98% of the municipalities exhibited a decreasing or a flat mortality trend for all the age groups. In 2012, the geographical variability of the age-specific mortality rates was small, especially for population groups below 65. In addition, more than 96.6% of the municipalities showed an age-specific mortality rate similar to the corresponding rate for Spain, and there were no identified significant clusters. This information will contribute towards a reflection on the past, present and future of breast cancer outcomes in Andalusia.
Boice, John D; Mumma, Michael T; Blot, William J; Heath, Clark W
An unusual county-wide excess of childhood cancers of brain and other nervous tissue in the late 1990s in St Lucie County, Florida, prompted the Florida Department of Health to conduct a case-control study within the county assessing residential chemical exposures. No clear associations were found, but claims were then made that the release of radioactive substances such as strontium 90 from the St Lucie nuclear power station, which began operating in 1976, might have played a role. To test the plausibility of this hypothesis, we extended by 17 years a previous study of county mortality conducted by the National Cancer Institute. Rates of total cancer, leukaemia and cancer of brain and other nervous tissue in children and across all ages in St Lucie County were evaluated with respect to the years before and after the nuclear power station began operation and contrasted with rates in two similar counties in Florida (Polk and Volusia). Over the prolonged period 1950-2000, no unusual patterns of childhood cancer mortality were found for St Lucie County as a whole. In particular, no unusual patterns of childhood cancer mortality were seen in relation to the start-up of the St Lucie nuclear power station in 1976. Further, there were no significant differences in mortality between the study and comparison counties for any cancer in the time period after the power station was in operation. Relative rates for all childhood cancers and for childhood leukaemia were higher before the nuclear facility began operating than after, while rates of brain and other nervous tissue cancer were slightly lower in St Lucie County than in the two comparison counties for both time periods. Although definitive conclusions cannot be drawn from descriptive studies, these data provide no support for the hypothesis that the operation of the St Lucie nuclear power station has adversely affected the cancer mortality experience of county residents.
Alicandro, Gianfranco; Frova, Luisa; Sebastiani, Gabriella; El Sayed, Iman; Boffetta, Paolo; La Vecchia, Carlo
Large studies are needed to evaluate socioeconomic inequality for site-specific cancer mortality. We conducted a longitudinal census-based national study to quantify the relative inequality in cancer mortality among educational levels in Italy. We linked the 2011 Italian census with the 2012 and 2013 death registries. Educational inequality in overall cancer and site-specific cancer mortality were evaluated by computing the mortality rate ratio (MRR). A total of 35,708,445 subjects aged 30-74 years and 147,981 cancer deaths were registered. Compared to the lowest level of education (none or primary school), the MRR for all cancers in the highest level (university) was 0.57 (95% CI 0.55; 0.58) in men and 0.84 (95% CI 0.81; 0.87) in women. Higher education was associated with reduced risk of mortality from lip, oral cavity, pharynx, oesophagus, stomach, colon and liver in both sexes. Higher education (university) was associated with decreased risk of lung cancer in men (MRR: 0.43, 95% CI 0.41; 0.46), but not in women (MRR: 1.00, 95% CI 0.92; 1.10). Highly educated women had a reduced risk of mortality from cervical cancer than lower educated women (MRR: 0.39, 95% CI 0.27; 0.56), but they had a similar risk for breast cancer (MRR: 1.01, 95% CI 0.94; 1.09). Education is inversely associated with total cancer mortality, and the association was stronger in men. Different patterns and trends in tobacco smoking in men and women account for at least most of the gender differences.
Miller, Christopher P; Golinvaux, Nicholas S; Brubacher, Jacob W; Bohl, Daniel D; Deng, Yanhong; Grauer, Jonathan N
Cervical spine fractures can lead to many devastating consequences. However, mortality rates of older individuals with odontoid or subaxial spine fractures have not been definitively established. We conducted a retrospective review of all patients who underwent computed tomography of the cervical spine in the emergency department of a level I trauma center over 9 years to compare mortality rates after odontoid and subaxial fractures in elderly persons with those of the general population. We searched the National Death Index for patient death records, and compared mortality rates at 3 months, 1 year, and 2 years to sex- and age-matched data from the general population. Odontoid fracture survival was 84.4% at 3 months, 82.2% at 1 year, and 72.9% at 2 years. Male survival was significantly worse compared with age- and sex-matched counterparts (P < .001), but female survival was not (P = .568). In subaxial fractures, survival was 87.9% at 3 months and 85.7% at 1 and 2 years. Male survival was decreased compared with age- and sex-matched counterparts (P < .0001), whereas female survival was not (P = .554). In conclusion, the mortality of men with either fracture was greater compared with age-matched men initially, but this normalized. Female survival was not affected by either fracture.
Warner, Wayne A; Morrison, Robert L; Lee, Tammy Y; Williams, Tanisha M; Ramnarine, Shelina; Roach, Veronica; Slovacek, Simeon; Maharaj, Ravi; Bascombe, Nigel; Bondy, Melissa L; Ellis, Matthew J; Toriola, Adetunji T; Roach, Allana; Llanos, Adana A M
Breast cancer (BC) is the most common newly diagnosed cancer among women in Trinidad and Tobago (TT) and BC mortality rates are among the highest in the world. Globally, racial/ethnic trends in BC incidence, mortality and survival have been reported. However, such investigations have not been conducted in TT, which has been noted for its rich diversity. In this study, we investigated associations among ancestry, geography and BC incidence, mortality and survival in TT. Data on 3767 incident BC cases, reported to the National Cancer Registry of TT, from 1995 to 2007, were analyzed in this study. Women of African ancestry had significantly higher BC incidence and mortality rates ( 66.96; 30.82 per 100,000) compared to women of East Indian ( 41.04, MORTALITY: 14.19 per 100,000) or mixed ancestry ( 36.72, MORTALITY: 13.80 per 100,000). Geographically, women residing in the North West Regional Health Authority (RHA) catchment area followed by the North Central RHA exhibited the highest incidence and mortality rates. Notable ancestral differences in survival were also observed. Women of East Indian and mixed ancestry experienced significantly longer survival than those of African ancestry. Differences in survival by geography were not observed. In TT, ancestry and geographical residence seem to be strong predictors of BC incidence and mortality rates. Additionally, disparities in survival by ancestry were found. These data should be considered in the design and implementation of strategies to reduce BC incidence and mortality rates in TT. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Petti, Stefano; Scully, Crispian
The unclear association between different nation-based alcohol-drinking profiles and oral cancer mortality was investigated using, as observational units, 20 countries from Europe, Northern America, Far Eastern Asia, with cross-nationally comparable data. Stepwise multiple regression analyses were run with male age-standardised, mortality rate (ASMR) as explanatory variable and annual adult alcohol consumption, adult smoking prevalence, life expectancy, as explanatory. Large between-country differences in ASMR (range, 0.88-6.87 per 100,000) were found, but the mean value was similar to the global estimate (3.31 vs. 3.09 per 100,000). Differences in alcohol consumption (2.06-21.03 annual litres per capita) and in distribution between beverages were reported. Wine was the most prevalent alcoholic beverage in 45% of cases. Significant increases in ASMR for every litre of pure ethanol (0.15 per 100,000; 95 CI, 0.01-0.29) and spirits (0.26 per 100,000; 95 CI, 0.03-0.49), non-significant effects for beer and wine were estimated. The impact of alcohol on oral cancer deaths would be higher than expected and the drinking profile could affect cancer mortality, probably because of the different drinking pattern of spirit drinkers, usually consuming huge alcohol quantities on single occasions, and the different concentrations of ethanol and cancer-preventing compounds such as polyphenols, in the various beverages.
Katalinic, Alexander; Eisemann, Nora; Waldmann, Annika
Nationwide skin cancer screening was introduced in Germany in 2008. The positive results of a pilot project carried out in 2003-4 in the federal state of Schleswig-Holstein had implied that screening would lower the mortality from melanoma. Data on the incidence of invasive malignant melanoma of the skin (MM; ICD-10: C43) were extracted from the databases of the Association of Population-based Cancer Registries in Germany (GEKID) and from the Schleswig-Holstein cancer registry. Mortality rates were extracted from the official cause-of-death statistics. With the beginning of nationwide screening in 2008, the age-standardized incidence rate in Germany increased by approximately 28% to 18.2 cases per 100 000 persons in 2010. In Schleswig-Holstein, the incidence fell after the pilot project ended and has been comparable to the nationwide incidence since 2008. For Germany overall, there has been no downward trend in MM mortality since the introduction of nationwide screening; in 2013, the mortality rate was 2.3 deaths per 100 000 persons per year. In the area of the pilot study, mortality declined to a level of 1.0/100 000/year until 2008 and then began to rise again. At present, the mortality due to MM in Schleswig- Holstein is once again the same as that in Germany overall (2.4/100 000/year). The introduction of nationwide skin cancer screening in 2008 has not yet led to any measurable decline in mortality due to melanoma. The current method of screening seems to be less thorough than that used in the pilot project; this may explain the absence of a decline in MM-related mortality in Germany overall up to the year 2013, as well as the rising mortality in Schleswig-Holstein since the end of the pilot program. The generation of a robust set of data on how skin cancer screening can be optimized now seems urgently necessary.
Walker, J T; Burnett, C A; Lalich, N R; Sestito, J P; Halperin, W E
A cancer mortality study of 8,163 deaths occurring among persons formerly employed as laundering and dry cleaning workers in 28 states is described. Age-adjusted sex-race cause-specific proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed for 1979 through 1990, using the corresponding 28-state mortality as the comparison. For those aged 15-64 years, there were excesses in black men for total cancer mortality (PMR = 130, 95% confidence interval (CI) = 105-159) and cancer of the esophagus 1 (PMR = 215, 95% CI = 111-376), and in white men for cancer of the larynx (PMR = 318, 95% CI = 117-693). For those aged 65 years and over, there were statistically nonsignificant excesses for cancer of the trachea, bronchus, and lung in black women (PMR = 128, CI = 94-170) and for cancer of other and unspecified female genital organs in white women (PMR = 225, CI = 97-443). The results of this and other studies point to the need for the effective implementation of available control measures to protect laundry and dry cleaning workers.
Lope, Virginia; Pollán, Marina; Pérez-Gómez, Beatriz; Aragonés, Nuria; Vidal, Enrique; Gómez-Barroso, Diana; Ramis, Rebeca; García-Pérez, Javier; Cabanes, Anna; López-Abente, Gonzalo
Background Spain was the country that registered the greatest increases in ovarian cancer mortality in Europe. This study describes the municipal distribution of ovarian cancer mortality in Spain using spatial models for small-area analysis. Methods Smoothed relative risks of ovarian cancer mortality were obtained, using the Besag, York and Molliè autoregressive spatial model. Standardised mortality ratios, smoothed relative risks, and distribution of the posterior probability of relative risks being greater than 1 were depicted on municipal maps. Results During the study period (1989–1998), 13,869 ovarian cancer deaths were registered in 2,718 Spanish towns, accounting for 4% of all cancer-related deaths among women. The highest relative risks were mainly concentrated in three areas, i.e., the interior of Barcelona and Gerona (north-east Spain), the north of Lugo and Asturias (north-west Spain) and along the Seville-Huelva boundary (in the south-west). Eivissa (Balearic Islands) and El Hierro (Canary Islands) also registered increased risks. Conclusion Well established ovarian cancer risk factors might not contribute significantly to the municipal distribution of ovarian cancer mortality. Environmental and occupational exposures possibly linked to this pattern and prevalent in specific regions, are discussed in this paper. Small-area geographical studies are effective instruments for detecting risk areas that may otherwise remain concealed on a more reduced scale. PMID:18789142
Torabi, Mahmoud; Green, Christopher; Nugent, Zoann; Mahmud, Salaheddin; Demers, Alain; Griffith, Jane; Singh, Harminder
To investigate the geographical variation and small geographical area level factors associated with colorectal cancer (CRC) mortality. Information regarding CRC mortality was obtained from the population-based Manitoba Cancer Registry, population counts were obtained from Manitoba's universal health care plan Registry and characteristics of the area of residence were obtained from the 2001 Canadian census. Bayesian spatial Poisson mixed models were used to evaluate the geographical variation of CRC mortality and Poisson regression models for determining associations with CRC mortality. Time trends of CRC mortality according to income group were plotted using joinpoint regression. The southeast (mortality rate ratio [MRR] 1.31 [95% CI 1.12 to 1.54) and southcentral (MRR 1.62 [95% CI 1.35 to 1.92]) regions of Manitoba had higher CRC mortality rates than suburban Winnipeg (Manitoba's capital city). Between 1985 and 1996, CRC mortality did not vary according to household income; however, between 1997 and 2009, individuals residing in the highest-income areas were less likely to die from CRC (MRR 0.77 [95% CI 0.65 to 0.89]). Divergence in CRC mortality among individuals residing in different income areas increased over time, with rising CRC mortality observed in the lowest income areas and declining CRC mortality observed in the higher income areas. Individuals residing in lower income neighbourhoods experienced rising CRC mortality despite residing in a jurisdiction with universal health care and should receive increased efforts to reduce CRC mortality. These findings should be of particular interest to the provincial CRC screening programs, which may be able to reduce the disparities in CRC mortality by reducing the disparities in CRC screening participation.
Warner, Wayne A; Morrison, Robert L; Lee, Tammy Y; Williams, Tanisha M; Ramnarine, Shelina; Roach, Veronica; Slovacek, Simeon; Maharaj, Ravi; Bascombe, Nigel; Bondy, Melissa L; Ellis, Matthew J; Toriola, Adetunji T; Roach, Allana; Llanos, Adana A M
Breast cancer (BC) is the most common newly diagnosed cancer among women in Trinidad and Tobago (TT) and BC mortality rates are among the highest in the world. Globally, racial/ethnic trends in BC incidence, mortality and survival have been reported. However, such investigations have not been conducted in TT, which has been noted for its rich diversity. In this study, we investigated associations among ancestry, geography and BC incidence, mortality and survival in TT. Data on 3767 incident BC cases, reported to the National Cancer Registry of TT, from 1995 to 2007, were analyzed in this study. Women of African ancestry had significantly higher BC incidence and mortality rates (Incidence: 66.96; Mortality: 30.82 per 100,000) compared to women of East Indian (Incidence: 41.04, Mortality: 14.19 per 100,000) or mixed ancestry (Incidence: 36.72, Mortality: 13.80 per 100,000). Geographically, women residing in the North West Regional Health Authority (RHA) catchment area followed by the North Central RHA exhibited the highest incidence and mortality rates. Notable ancestral differences in survival were also observed. Women of East Indian and mixed ancestry experienced significantly longer survival than those of African ancestry. Differences in survival by geography were not observed. In TT, ancestry and geographical residence seem to be strong predictors of BC incidence and mortality rates. Additionally, disparities in survival by ancestry were found. These data should be considered in the design and implementation of strategies to reduce BC incidence and mortality rates in TT. PMID:26338451
Chemical and Engineering News, 1984
A study of white women members (N=347) of the American Chemical Society who died between 1925 and 1979 finds five times the expected rate of suicide, a higher risk for some forms of cancer, and a lower rate of heart disease. These and other findings are discussed. (JN)
Straif-Bourgeois, Susanne; Ratard, Raoult
This report is a descriptive study on suicide deaths in Louisiana occurring in the years 1999 to 2010. Mortality data was collected from death certificates from this 12-year period to describe suicide mortality by year, race, sex, age group, and methods of suicide. Data were also compared to national data. Rates and methods used to commit suicide vary greatly according to sex, race, and age. The highest rates were observed in white males, followed by black males, white females, and black females. Older white males had the highest suicide rates. The influence of age was modulated by the sex and race categories. Firearm was the most common method used in all four categories. Other less common methods were hanging/strangulation/suffocation (HSS) and drugs/alcohol. Although no parish-level data were systematically analyzed, a comparison of suicide rates post-Katrina versus pre-Katrina was done for Orleans Parish, the rest of the Greater New Orleans area, and a comparison group. It appears that rates observed among whites, particularly males, were higher after Katrina. Data based on mortality do not give a comprehensive picture of the burden of suicide, and their interpretation should be done with caution.
Carpenter, L. M.; Higgins, C. D.; Douglas, A. J.; Maconochie, N. E.; Omar, R. Z.; Fraser, P.; Beral, V.; Smith, P. G.
Cancer mortality in 40,761 employees of three UK nuclear industry facilities who had been monitored for external radiation exposure was examined according to whether they had also been monitored for possible internal exposure to tritium, plutonium or other radionuclides (uranium, polonium, actinium or other unspecified). Death rates from cancer were compared both with national rates and with rates in radiation workers not monitored for exposure to any radionuclides. Among workers monitored for tritium exposure, overall cancer mortality was significantly below national rates [standardized mortality ratio (SMR) = 83, 165 deaths; 2P = 0.02] and none of the cancer-specific death rates was significantly above either the national average or rates in non-monitored workers. Although the overall death rate from cancer in workers monitored for plutonium exposure was also significantly low relative to national rates (SMR = 89, 581 deaths; 2P = 0.005), mortality from pleural cancer was significantly raised (SMR = 357, nine deaths; 2P = 0.002); none of the rates differed significantly from those of non-monitored workers. Workers monitored for radionuclides other than tritium or plutonium also had a death rate from all cancers combined that was below the national average (SMR = 86, 418 deaths; 2P = 0.002) but prostatic cancer mortality was raised both in relation to death rates in the general population (SMR = 153, 37 deaths; 2P = 0.02) and to death rates in radiation workers who had not been monitored for exposure to any radionuclide [rate ratio (RR) = 1.65; 2P = 0.03]. Mortality from cancer of the lung was also significantly increased in workers monitored for other radionuclides compared with those of radiation workers not monitored for exposure to radionuclides (RR = 1.31, 164 deaths; 2P = 0.01). For cancers of the lung, prostate and all cancers combined, death rates in monitored workers were examined according to the timing and duration of monitoring for radionuclide
Leman, Richard F; Espey, David; Cobb, Nathaniel
Cervical cancer mortality rates among the American Indian and Alaska Native (AI/AN) population in North and South Dakota were five times the national average (15.6 per 100,000 vs. 3.1 per 100,000, age adjusted) when last evaluated (from 1989 through 1993). Our goals were to update the AI/AN population cervical cancer mortality rates and to present incidence rates for AI/AN women in the region. We reviewed charts for women diagnosed with invasive cervical cancer at Indian Health Service (IHS) facilities in North and South Dakota from 1994 through 1998 and collected information about cervical cancer screening and treatment history. Incidence and mortality rates were standardized to the 1970 U.S. population. Twenty-one cases of invasive cervical cancer and eight deaths were identified. Annualized incidence and mortality rates were 11.5 per 100,000 and 4.5 per 100,000. These compare with national all-race/ethnicity rates of 8.5 per 100,000 and 2.7 per 100,000 for incidence and mortality. Fifteen (71%) of 21 cases were diagnosed due to symptoms. While cervical cancer mortality rates have declined, incidence and mortality rates among AI/AN women remain higher than in the general U.S. population. Increased use of pap tests and careful follow-up of abnormal results should be aggressively promoted among AI/AN women in North and South Dakota.
Cocco, Pierluigi; Fadda, Domenica; Billai, Beatrice; D’Atri, Mario; Melis, Massimo; Blair, Aaron
Several studies have evaluated cancer risk associated with occupational and environmental exposure to dichlorodiphenyltrichloroethane (DDT). Results are mixed. To further inquire into human carcinogenicity of DDT, we conducted a mortality follow-up study of 4,552 male workers, exposed to DDT during antimalarial operations in Sardinia, Italy, conducted in 1946 to 1950. Detailed information on DDT use during the operations provided the opportunity to develop individual estimates of average and cumulative exposure. Mortality of the cohort was first compared with that of the Sardinian population. Overall mortality in the cohort was about as expected, but there was a deficit for death from cardiovascular disease and a slight excess for nonmalignant respiratory diseases and lymphatic cancer among the unexposed subcohort. For internal comparisons, we used Poisson regression analysis to calculate relative risks of selected malignant and nonmalignant diseases with the unexposed subcohort as the reference. Cancer mortality was decreased among DDT-exposed workers, mainly due to a reduction in lung cancer deaths. Birth outside from the study area was a strong predictor of mortality from leukemia. Mortality from stomach cancer increased up to 2-fold in the highest quartile of cumulative exposure (relative risk, 2.0; 95% confidence interval, 0.9–4.4), but no exposure-response trend was observed. Risks of liver cancer, pancreatic cancer, and leukemia were not elevated among DDT-exposed workers. No effect of latency on risk estimates was observed over the 45 years of follow-up and within selected time windows. Adjusting risks by possible exposure to chlordane in the second part of the antimalarial operations did not change the results. In conclusion, we found little evidence for a link between occupational exposure to DDT and mortality from any of the cancers previously suggested to be associated. PMID:16230425
Beaumont, J.J.; Sedman, R.M.; Reynolds, S.D.; Sherman, C.D.; Li, L.-H.; Howd, R.A.; Sandy, M.S.; Zeise, L.; Alexeeff, G.V.
BACKGROUND: In 1987, investigators in Liaoning Province, China, reported that mortality rates for all cancer, stomach cancer, and lung cancer in 1970-1978 were higher in villages with hexavalent chromium (Cr)-contaminated drinking water than in the general population. The investigators reported rates, but did not report statistical measures of association or precision. METHODS: Using reports and other communications from investigators at the local Jinzhou Health and Anti-Epidemic Station, we obtained data on Cr contamination of groundwater and cancer mortality in 9 study regions near a ferrochromium factory. We estimated:(1) person-years at risk in the study regions, based on census and population growth rate data, (2) mortality counts, based on estimated person-years at risk and previously reported mortality rates, and (3) rate ratios and 95% confidence intervals. RESULTS: The all-cancer mortality rate in the combined 5 study regions with Cr-contaminated water was negligibly elevated in comparison with the rate in the 4 combined study regions without contaminated water (rate ratio = 1.13; 95% confidence interval = 0.86-1.46), but was somewhat more elevated in comparison with the whole province (1.23; 0.97-1.53). Stomach cancer mortality in the regions with contaminated water was more substantially elevated in comparison with the regions without contaminated water (1.82; 1.11-2.91) and the whole province (1.69; 1.12-2.44). Lung cancer mortality was slightly elevated in comparison with the unexposed study regions (1.15; 0.62-2.07), and more strongly elevated in comparison with the whole province (1.78; 1.03-2.87). Mortality from other cancers combined was not elevated in comparison with either the unexposed study regions (0.86; 0.53-1.36) or the whole province (0.92; 0.58-1.38). CONCLUSIONS: While these data are limited, they are consistent with increased stomach cancer risk in a population exposed to Cr in drinking water. ?? 2008 Lippincott Williams & Wilkins, Inc.
Bao, H L; Liu, Y N; Wang, L J; Fang, L W; Cong, S; Zhou, M G; Wang, L H
Objective: To analyze the mortality of cervical cancer and its temporal trend in women in China between 2006 and 2012. Methods: The cause-of-death data about cervical cancer, which was abstracted from National Disease Surveillance Points and adjusted by special survey for underreporting, was used to analyze the age and area specific crude mortality rates of cervical cancer in China during 2006-2012. The age-standardized mortality rate was calculated by using world standardized population (Segi's). The Joinpoint regression model was used to obtain annual percentage change and 95%CI for assessing the time trend of mortality rate of cervical cancer from 2006 to 2012. Results: In 2012, the crude mortality rate of cervical cancer was 3.15 per 100 000 in women in China. The mortality rate in rural area (3.45/100 000) was higher than that in urban area (2.76/100 000), while the central area had the highest mortality rate of cervical cancer (3.77/100 000) compared with western area (3.23/100 000) and eastern area (2.54/100 000). The Segi's age-standardized mortality rate in eastern area increased by 2.9% (95%CI: 0.8%-5.0%) annually, an increase of 6.0% was observed in age group 30-59 years (95%CI: 1.6%-10.5%). However, the Segi's age-standardized mortality rate in central area declined by 4.6% (95%CI: -5.9% - -3.3%), where the declines of 3.2% and 5.7% were observed in age groups 30-59 years and ≥60 years (95%CI: - 5.0%-- 1.4% and 95% CI: - 9.3% --2.0%) and respectively. There was no significant change in cervical cancer mortality in western area. The similar trends were observed in the age-standardized mortality rate calculated according to the population of China. Conclusions: The decline of overall mortality rate of