Abstract Introduction Cancer incidence and mortality estimates for 25 cancers are presented for the 40 countries in the four United Nations-defined areas of Europe and for the European Union (EU-27) ...for 2012. Methods We used statistical models to estimate national incidence and mortality rates in 2012 from recently-published data, predicting incidence and mortality rates for the year 2012 from recent trends, wherever possible. The estimated rates in 2012 were applied to the corresponding population estimates to obtain the estimated numbers of new cancer cases and deaths in Europe in 2012. Results There were an estimated 3.45 million new cases of cancer (excluding non-melanoma skin cancer) and 1.75 million deaths from cancer in Europe in 2012. The most common cancer sites were cancers of the female breast (464,000 cases), followed by colorectal (447,000), prostate (417,000) and lung (410,000). These four cancers represent half of the overall burden of cancer in Europe. The most common causes of death from cancer were cancers of the lung (353,000 deaths), colorectal (215,000), breast (131,000) and stomach (107,000). In the European Union, the estimated numbers of new cases of cancer were approximately 1.4 million in males and 1.2 million in females, and around 707,000 men and 555,000 women died from cancer in the same year. Conclusion These up-to-date estimates of the cancer burden in Europe alongside the description of the varying distribution of common cancers at both the regional and country level provide a basis for establishing priorities to cancer control actions in Europe. The important role of cancer registries in disease surveillance and in planning and evaluating national cancer plans is becoming increasingly recognised, but needs to be further advocated. The estimates and software tools for further analysis (EUCAN 2012) are available online as part of the European Cancer Observatory (ECO) ( http://eco.iarc.fr ).
Background
Melanoma is a significant health problem in Caucasian populations. The most recently available data from cancer registries often have a delay of several months up to a few years and they ...are generally not easily accessible.
Objectives
To assess recent age‐ and sex‐specific trends in melanoma incidence and make predictions for 2010 and 2015.
Methods
A retrospective registry‐based analysis was performed with data from 29 European cancer registries. Most of them had data available from 1990 up to 2006/7. World‐standardized incidence rates (WSR) and the estimated annual percentage change (EAPC) were computed. Predictions were based on linear projection models.
Results
Overall the incidence of melanoma is rapidly rising and will continue to do so. The incidence among women in Europe was generally higher than in men. The highest incidence rates were seen for Northern and north‐western countries like the UK, Ireland and the Netherlands. The lowest incidence rates were observed in Portugal and Spain. The incidence overall remained stable in Norway, where, amongst young (25–49 years) Norwegian males rates significantly decreased (EAPC −2.8, 95% CI −3.6; −2.0). Despite a low melanoma incidence among persons above the age of 70, this age group experienced the greatest increase in risk during the study period.
Conclusions
Incidence rates of melanoma are expected to continue rising. These trends are worrying in terms of disease burden, particularly in eastern European countries.
We analysed trends in incidence for in situ and invasive melanoma in some European countries during the period 1995–2012, stratifying for lesion thickness.
Individual anonymised data from ...population-based European cancer registries (CRs) were collected and combined in a common database, including information on age, sex, year of diagnosis, histological type, tumour location, behaviour (invasive, in situ) and lesion thickness. Mortality data were retrieved from the publicly available World Health Organization database.
Our database covered a population of over 117 million inhabitants and included about 415,000 skin lesions, recorded by 18 European CRs (7 of them with national coverage). During the 1995–2012 period, we observed a statistically significant increase in incidence for both invasive (average annual percent change (AAPC) 4.0% men; 3.0% women) and in situ (AAPC 7.7% men; 6.2% women) cases.
The increase in invasive lesions seemed mainly driven by thin melanomas (AAPC 10% men; 8.3% women). The incidence of thick melanomas also increased, although more slowly in recent years. Correction for lesions of unknown thickness enhanced the differences between thin and thick cases and flattened the trends. Incidence trends varied considerably across registries, but only Netherlands presented a marked increase above the boundaries of a funnel plot that weighted estimates by their precision. Mortality from invasive melanoma has continued to increase in Norway, Iceland (but only for elder people), the Netherlands and Slovenia.
•This study is the most recent analysis of melanoma trends in Europe by lesion thickness.•We analysed about 415,000 cases incident between 1995 and 2012 from 13 European countries.•Results showed that the incidence of invasive melanoma continues to increase, mainly due to thin lesions.•There was a large variation in trends among countries, with the greatest increase in the Netherlands.•Mortality from invasive melanoma continued to increase in some countries.
Summary
Background
Nonmelanoma skin cancer (NMSC) is the most common cancer in white people, but is registered inconsistently by population‐based registries.
Objectives
To analyse the changing ...profile of NMSC in a national population, to interpret evolving patterns of sun exposure and to recommend measures to reduce risk.
Methods
We analysed trends in the demographic, clinical and socioeconomic profile of > 50 000 cases of NMSC registered between 1994 and 2011 by the Irish National Cancer Registry, which aims to register all episodes of NMSC in the Irish population to a high degree of completeness.
Results
The incidence of cutaneous basal cell (BCC) and squamous cell carcinoma (SCC) was stable from 1994 to 2002, but increased significantly (BCC more than SCC) in the subsequent decade. The largest relative increases in the incidence of BCC were in younger populations and in clothed body sites. The incidence of both cancers was lower in rural areas. Incidence of BCC and, to a lesser extent, of SCC, increased with increasing affluence in urban, but not in rural, areas.
Conclusions
Recent increases in skin cancers on the trunk and limbs in younger people appear to be related to increasing affluence and consequent leisure‐related, episodic sun exposure. This population is at high risk of subsequent skin cancers throughout life and will need active surveillance. As preventive programmes are cost‐effective in lowering the incidence of NMSC, they should be targeted at leisure exposure in young people. The recording of consistent international data on NMSC should also be a priority.
What's already known about this topic?
An increasing incidence of nonmelanoma skin cancer in more affluent populations has been linked to leisure exposure to ultraviolet radiation.
What does this study add?
This study shows, at a population level, a continuing increase in incidence of both BCC and SCC, with the largest increase in young populations.
There is a link between affluence and skin cancer, but only in urban populations.
Summary
Background
Accumulating evidence suggests smoking may adversely affect cancer patients’ outcomes. Previous studies of smoking and survival in colon cancer have been limited by size and/or ...lack of a population basis and results have been inconsistent.
Aim
To investigate in a large population‐based cohort whether smoking status at diagnosis is an independent prognostic factor for cancer‐specific survival in colon cancer and whether treatment modifies any impact of smoking.
Methods
Colon adenocarcinomas diagnosed between 1994 and 2012 were ed from the National Cancer Registry Ireland, and classified by smoking status at diagnosis. Cancer‐specific death rates over 5 years were compared in current, ex‐ and never smokers using multivariable Cox proportional hazards models, and subgroup analyses by treatment (combinations of cancer‐directed surgery and chemotherapy) were conducted.
Results
Of 18 166 colon cancers, 20% of patients were current smokers, 23% ex‐smokers and 57% never smokers. Compared to never smokers, current smokers had a significantly raised cancer death rate multivariable hazard ratio (HR) = 1.14, 95% CI: 1.07–1.12. There was a significant interaction between treatment and smoking (P = 0.03). In those who had cancer‐directed surgery only, but not other groups, current smokers had a significantly increased cancer death rate compared to never smokers (HR = 1.21, 95% CI: 1.09–1.34).
Conclusions
Smoking at diagnosis is an independent prognostic factor for colon cancer. The limitation of the association to surgically‐treated patients suggests that the underlying mechanism(s) may be related to surgery. While further research is needed to elucidate mechanisms, continued efforts to encourage smoking prevention and cessation may yield benefits in terms of improved survival from colon cancer.
Linked ContentThis article is linked to Ho and Lieberman paper. To view this article visit https://doi.org/10.1111/apt.13979.
Geriatric oncology guidelines state that fit older men with prostate cancer should receive curative treatment. In a population-based study, we investigated associations between age and non-receipt of ...curative treatment in men with localised prostate cancer, and the effect of clinical variables on this in different age groups.
Clinically localised prostate cancers (T1-T2N0M0) diagnosed from 2002 to 2008 among men aged ≥ 40 years, with hospital in-patient episode(s) within 1 year post-diagnosis, were included (n=5456). Clinical and socio-demographic variables were obtained from cancer registrations. Comorbidity was determined from hospital episode data. Logistic regression was used to investigate associations between age and non-receipt of treatment, adjusting for confounders; the outcome was non-receipt of curative treatment (radical prostatectomy or radiotherapy).
The percentage who did not receive curative treatment was 9.2%, 14.3%, 48.2% and 91.7% for men aged 40-59, 60-69, 70-79 and 80+ years, respectively. After adjusting for clinical and socio-demographic factors, age remained the main determinant of treatment non-receipt. Men aged 70-79 had a significant five-fold increased risk of not having curative treatment compared with men aged 60-69 (odds ratio (OR)=5.5; 95% confidence interval 4.7, 6.5). In age-stratified analyses, clinical factors had a higher weight for men aged 60-69 than in other age strata. Over time, non-receipt of curative treatment increased among men aged 40-59 and decreased among men aged 70-79.
Age remains the dominant factor in determining non-receipt of curative treatment. There have been some changes in clinical practice over time, but whether these will impact on prostate cancer mortality remains to be established.
Abstract Aim To provide insight into cancer registration coverage, data access and use in Europe. This contributes to data and infrastructure harmonisation and will foster a more prominent role of ...cancer registries (CRs) within public health, clinical policy and cancer research, whether within or outside the European Research Area. Methods During 2010–12 an extensive survey of cancer registration practices and data use was conducted among 161 population-based CRs across Europe. Responding registries (66%) operated in 33 countries, including 23 with national coverage. Results Population-based oncological surveillance started during the 1940–50s in the northwest of Europe and from the 1970s to 1990s in other regions. The European Union (EU) protection regulations affected data access, especially in Germany and France, but less in the Netherlands or Belgium. Regular reports were produced by CRs on incidence rates (95%), survival (60%) and stage for selected tumours (80%). Evaluation of cancer control and quality of care remained modest except in a few dedicated CRs. Variables evaluated were support of clinical audits, monitoring adherence to clinical guidelines, improvement of cancer care and evaluation of mass cancer screening. Evaluation of diagnostic imaging tools was only occasional. Conclusion Most population-based CRs are well equipped for strengthening cancer surveillance across Europe. Data quality and intensity of use depend on the role the cancer registry plays in the politico, oncomedical and public health setting within the country. Standard registration methodology could therefore not be translated to equivalent advances in cancer prevention and mass screening, quality of care, translational research of prognosis and survivorship across Europe. Further European collaboration remains essential to ensure access to data and comparability of the results.
It is generally agreed to centralise treatment of childhood cancers (CCs). We analysed (1) the degree of centralisation of CCs in European countries and 2) the relations between centralisation and ...survival.
The analysis comprised 4415 CCs, diagnosed between 2000 and 2007 and followed up to the end of 2013, from Belgium, Bulgaria, Finland, Ireland, the Netherlands and Slovenia. All these countries had national population-based cancer registries and were able to provide information on diagnosis, treatment, treatment hospitals, and survival. Each case was then classified according to whether the patient was treated in a high- or a low-volume hospital among those providing CC treatment. A Cox proportional hazard model was used to calculate the relation between volume category and five-year survival, adjusting by age, sex and diagnostic group.
The number of hospitals providing treatment for CCs ranged from six (Slovenia) to slightly more than 40 (the Netherlands and Belgium). We identified a single higher volume hospital in Ireland and in Slovenia, treating 80% and 97% of cases, respectively, and three to five major hospitals in the other countries, treating between 65% and 93% of cases. Outcome was significantly better when primary treatment was given in high-volume hospitals compared to low-volume hospitals for central nervous system tumours (relative risk RR = 0.71), haematologic tumours (RR = 0.74) and for all CC combined (RR = 0.83).
Treatment centralisation is associated with survival benefits and should be further strengthened in these countries. New plans for centralisation should include ongoing evaluation.
•The degree of centralisation of childhood cancers varied across six European countries.•Survival was higher for children treated at high-volume hospitals, especially for central nervous system tumours.•Centralisation of treatment should be improved.•Plan of centralisation, including evaluation, is needed.
Summary
Background Nonmelanoma skin cancer (NMSC) is the most common cancer in white populations worldwide. International comparisons in incidence are limited because few registries collect ...comprehensive population‐based data.
Objectives We describe spatial, urban/rural and socioeconomic variations in NMSC incidence in Ireland, overall and for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) separately.
Methods NMSC cases (n = 47 347) diagnosed during 1994–2003 were extracted from the National Cancer Registry. Each case was allocated to a small area (electoral district, ED) based on address at diagnosis. Standardized incidence ratios (SIRs) were calculated and smoothed using a Bayesian conditional autoregressive model. Associations between disease and census‐derived area‐based socioeconomic factors (unemployment, employment type, early school leavers, deprivation category, population density) were investigated using negative binomial regression.
Results The spatial and socioeconomic distributions differed by subtype, suggesting aetiological differences. For BCC, areas of higher risk were concentrated around the main cities, with small patches on the south and west coast. Higher risks for SCC were seen in the north‐east, on the south, mid and north‐west coast. BCC risk in males and females, and SCC in males, was significantly higher in those living in the least deprived areas. Risk of BCC and SCC in females was higher in the most densely populated areas.
Conclusions We observed striking geographical variation in NMSC incidence, which cannot be satisfactorily explained on the basis of known risk factors. Differences by deprivation category and population density may reflect better access to cancer surveillance or care, as well as differences in risk factor exposure.
This article is a review of the use of quantitative (and qualitative) structure-activity relationships (QSARs and SARs) by regulatory agencies and authorities to predict acute toxicity, mutagenicity, ...carcinogenicity, and other health effects. A number of SAR and QSAR applications, by regulatory agencies and authorities, are reviewed. These include the use of simple QSAR analyses, as well as the use of multivariate QSARs, and a number of different expert system approaches.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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