DOCSLIB.ORG

Occupational Cancer in Britain Remaining Cancer Sites: Brain, Bone, Soft Tissue Sarcoma and Thyroid

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Occupational Cancer in Britain Remaining Cancer Sites: Brain, Bone, Soft Tissue Sarcoma and Thyroid British Journal of Cancer (2012) 107, S85 – S91 & 2012 Cancer Research UK All rights reserved 0007 – 0920/12 www.bjcancer.com Full Paper Occupational cancer in Britain Remaining cancer sites: brain, bone, soft tissue sarcoma and thyroid Terry Brown3, Charlotte Young2 and Lesley Rushton*,1 with the British Occupational Cancer Burden Study Group 3 2 Institute of Environment and Health, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK; Health and Safety Laboratory, Harpur Hill, 1 Buxton, Derbyshire SK17 9JN, UK; Department of Epidemiology and Biostatistics, School of Public Health and MRC-HPA Centre for Environment and Health, Imperial College London, St Mary’s Campus, Norfolk Place, London W2 3PG, UK British Journal of Cancer (2012) 107, S85–S91; doi:10.1038/bjc.2012.124 www.bjcancer.com & 2012 Cancer Research UK Keywords: occupation; brain; bone; thyroid OVERVIEW OF CANCERS in men and 14% in women, with that for men showing a significant improvement since 1986–1990. This paper reviews the four cancer sites: brain, bone, sarcoma and thyroid, which do not fit readily into the organ-specific groups defined for the other papers in this supplement. Ionising radiation Bone cancer is a cause of cancers of both the bone and thyroid, and thus this exposure will be considered together in the relevant section. Cancers that arise in the bone or articular cartilage account for B0.5% of all malignant neoplasms in humans (Miller et al, 2006). In Britain, over recent years, the number of cancers registered has Brain and central nervous system (CNS) cancers been relatively stable, whereas the number of people who died Primary brain and CNS cancers are rare. Over the past 10 years in from the condition steadily increased between 1995 and 2004. Britain, brain cancers have accounted for about 1.8% of male and There are three main types of bone cancer: osteosarcoma (the most 1.4% of female cancers, being 20–50% more common in men than common), chondrosarcoma and Ewing’s sarcoma. Osteosarcoma women. Other cancers of the CNS have accounted for an additional peaks in adolescence (around 17 years) and later in life (around 80 0.3% of all male and female cancers. The most common types years), whereas chondrosarcoma is rare in childhood and rates rise of primary brain tumours are gliomas, meningiomas and astro- with advancing age (peaking between 70 and 80 years of age). cytomas (Kleihues and Cavanee, 2000). Ewing’s sarcoma has a similar age distribution to osteosarcoma for Age-specific incidence and mortality rates in both sexes have early years, but the condition is rare over 35 years of age. shown upward trends in all age groups (Preston-Martin et al, 2006) Survival rates have improved over the past 35 years, being since the 1970s and the 1950s, respectively (Quinn et al, 2005). consistently higher in females (Cancer Research UK, 2007a), and There have been few positive findings in searching for environ- cancer treatment is usually successful (two out of three people mental causal factors for brain cancer, probably because they cured) if the disease has not spread to other parts of the body. comprise a heterogeneous group of cancers with different Five-year survival rates generally vary between 10% and 90% aetiologies. The nature and magnitude of the risk factors for depending on the type, grade and stage of disease, as well as age at primary brain tumours are not clear (Wrensch et al, 2002), and the diagnosis. The main exposure that induces bone cancer is ionising definition and classification of these tumours often differ between radiation, with the exception of Ewing’s sarcoma (Miller et al, studies. Retrospective assessment of exposure along with unde- 2006). Occupational exposure to radium has been associated with fined latency periods for induction of these cancers has led to osteosarcoma, and osteosarcoma and chondrosarcoma have both imprecise risk estimates. Despite these limitations, exposure to been linked with exposure to plutonium. Other non-occupational inorganic lead, non-arsenical insecticides and work in petroleum risk factors for bone cancer include high-dose therapeutic refining have been identified as relevant occupational risk factors radiation, predisposing genetic factors and Paget’s disease. for brain cancer. Survival from brain cancer is low; 1-year relative survival for patients diagnosed during 1996–1999 was reported as 30.4% in Soft-tissue sarcoma (STS) men and 28.8% in women, and has shown little change over the Soft-tissue sarcoma arises in fibrous tissue, fat, muscle, blood and years (Rachet et al, 2008). Five-year survival was reported as 11.6% lymph vessels and cartilage, each with potentially distinct aetiologies (Berwick, 2006; Toro et al, 2006). In GB, there are *Correspondence: Dr L Rushton; E-mail: [email protected] B1200 new cases diagnosed and 660 STS-related deaths each year See Appendix for the members of the British Occupational Cancer (Swerdlow et al, 2001). In addition, about 90 men and women are Burden Study Group. diagnosed with Kaposi’s sarcoma, of which there are about eight Occupational cancer in Britain S86 deaths each year. There have been substantial increases in the accounting for about 60% of diagnosed cases (Cancer Research incidence of STS among adults (with the exception of an UK, 2007b). Thyroid cancer survival rates have improved over the unchanged rate in young women), which may largely be because past 35 years, with rates being consistently higher in women. of changes in reporting and coding (Swerdlow et al, 2001). For Survival rates generally depend on tumour histology, stage and age STS, overall the 5-year survival rate is between 50 and 60% (Storm at diagnosis. Anaplastic thyroid cancer has the lowest (10–20%) and Hat, 1998), with a wide variation depending on anatomical site 5-year survival rates, and papillary thyroid cancer has the best and tumour histology (Weitz et al, 2003; Mendenhall et al, 2005). 5-year survival rate (B100%) if diagnosed early. The aetiology of STS is difficult to study because of the relatively Radiation is one of the main risk factors clearly associated with low incidence and inherent misclassification of histology (Berwick, thyroid cancer (Ron and Schneider, 2006), and these risks are parti- 2006), with the different histological subtypes often grouped together cularly evident in those exposed during childhood. Well-differentiated masking more in-depth analysis. Occupational risk factors may not papillary cancer is the principal cell type induced by radiation, but an be uniform across these subtypes (Hoppin et al, 1999). increase in follicular and anaplastic carcinomas may occur as the population ages. Other non-occupational risk factors for thyroid Thyroid cancer cancer include a history of benign thyroid diseases, a family history of thyroid cancer and dietary factors, especially iodine deficiency. This cancer is relatively uncommon but is the most common malignancy of the endocrine system (Ron and Schneider, 2006) and is more common in women (2.1% of cancers in women) than in men (0.7% of cancers in men) (Parkin et al, 2001). In Britain, METHODS the numbers of registered cancers have steadily increased, Occupational risk factors although the number of deaths has been steady over recent years. There are four main types of thyroid cancer: papillary, follicular, Group 1 and 2A human carcinogens The agents that the International anaplastic and medullary, these being either well differentiated Agency for Research on Cancer (IARC) has classified as either definite (papillary, follicular and medullar) or poorly differentiated (i.e., (Group 1) or probable (Group 2A) human carcinogens for brain, bone, anaplastic). Papillary thyroid cancer is the most common, STS and thyroid cancer are summarised in Table 1. Table 1 Occupational agents, groups of agents, mixtures and exposure circumstances classified by the IARC monographs, vols 1–77 (IARC, 1972–2001), into Groups 1 and 2A, which target the brain, bone, soft-tissue sarcoma or thyroid and for which burden has been estimated Agents, mixture, Main industry, use Evidence of Source of data for Comments circumstance carcinogenicity estimation of numbers in human ever exposed over REP Group 1: Carcinogenic to humans Agents, groups of agents Ionising radiation Radiologists, technologists, nuclear workers, Bone sufficient CIDI radium-dial painters, underground miners, Thyroid sufficient LFS (male travel and plutonium workers, cleanup workers flight attendants) following nuclear accidents and aircraft British Airways Stewards & crew Stewardesses Union (1956 – 1995) 2,3,7,8-tetrachlorodibenzo- Production; use of chlorophenols and chloro- STS sufficient LFS para-dioxin (TCDD) phenoxy herbicides; waste incineration; PCB production; pulp and paper bleaching Group 2A: Probably carcinogenic to humans Agents, groups of agents Non-arsenical insecticides Production; pest control and agricultural Brain limited LFS workers; flour and grain mill workers Epichlorohydrin Production and use of resins, glycerine and Brain inadequate CAREX propylene-based rubbers; used as a solvent Inorganic lead Lead battery industry, demolition industry, Brain limited CAREX Industry sectors categorised as highly scrap industry, smelting, refining, alloying exposed were: metal ore mining, and casting, glass making manufacture of industrial and other chemical products, iron and steel basic industries, non-ferrous metal basic industries, manufacture of electrical machinery, apparatus, appliances and construction Exposure circumstances
Load more

Recommended publications
  • Cancer Survival in Qidong Between 1972 and 2011: a Population‑Based Analysis
    944 MOLECULAR AND CLINICAL ONCOLOGY 6: 944-954, 2017 Cancer survival in Qidong between 1972 and 2011: A population‑based analysis JIAN-GUO CHEN1,2, JIAN ZHU1, YONG-HUI ZHANG1, YI-XIN ZHANG2, DENG-FU YAO3, YONG-SHENG CHEN1, JIAN-HUA LU1, LU-LU DING1, HAI-ZHEN CHEN2, CHAO-YONG ZHU2, LI-PING YANG2, YUAN-RONG ZHU1 and FU-LIN QIANG2 1Qidong Cancer Registry, Qidong Liver Cancer Institute, Qidong, Jiangsu 226200; 2Nantong University Tumour Hospital/Institute, Nantong, Jiangsu 226361; 3Affiliated Hospital of Nantong University, Nantong, Jiangsu 226000, P.R. China Received May 17, 2016; Accepted March 7, 2017 DOI: 10.3892/mco.2017.1234 Abstract. Population-based cancer survival is an improved lung, colon and rectum, oesophagus, female breast and bladder index for evaluating the overall efficiency of cancer health cancer, as well as leukaemia and NHL. The observations of services in a given region. The current study analysed the the current study provide the opportunity for evaluation of observed survival and relative survival of leading cancer sites the survival outcomes of frequent cancer sites that reflects the from a population‑based cancer registry between 1972 and 2011 changes and improvement in a rural area in China. in Qidong, China. A total of 92,780 incident cases with cancer were registered and followed‑up for survival status. The main Introduction sites of the cancer types, based on the rank order of incidence, were the liver, stomach, lung, colon and rectum, oesophagus, Cancer survival is an index for evaluating the effect of treatment breast, pancreas, leukaemia, brain and central nervous system of patients in specific settings, whether used to define outcomes (B and CNS), bladder, blood [non‑Hodgkin's lymphoma in clinical trials or as an indicator of the overall efficiency of (NHL)] and cervix.
    [Show full text]
  • Cancers Unequal Burden
    The reality behind improving cancer survival rates April 2014 Cancer’s unequal burden – The reality behind improving cancer survival rates • Foreword • Executive summary • The reality behind improving cancer survival rates • Improving survival outcomes • Conclusion • References 3 Cancer’s unequal burden – The reality behind improving cancer survival rates in these areas has the potential to significantly reduce the overall cost of cancer care as well as greatly improving the lives of those with cancer. Routes from Diagnosis, developed in Survival rates for some cancers have soared over the past 40 years in England. partnership with strategy consultancy In the early 1970s, overall median survival time for all cancer types – the time Monitor Deloitte and Public Health by which half of people with cancer have died and half have survived – was just England’s National Cancer Intelligence i ii Network (NCIN), also shows us one year . Now it is predicted to be nearly six years , testament to the good work the value of linking and analysing of the NHS and advances in diagnosis, treatment and care. But there is a grim routinely collected NHS data. Only by reality hidden behind these numbers. combining data from cancer registries with hospital records have we been able to produce such a powerful picture of what happens to people New research led by Macmillan These new figures are taken from our after they are diagnosed with cancer Cancer Support reveals what happens groundbreaking Routes from Diagnosis and which groups of people in to people in England after they are research programme, which links particular need more support.
    [Show full text]
  • No. 59C November 27, 2014 (Sel) Largest Worldwide Study on Cancer
    No. 59c November 27, 2014 (Sel) Largest worldwide study on cancer survival rates reveals dramatic differences – Germany among the leading countries worldwide In a study called CONCORD-2, around 500 international scientists report on 5-year survival rates for about 25.7 million adult cancer patients suffering from one of the ten most common types of cancer (stomach, colon, rectum, liver, lung, breast, cervix, ovaries, prostate, leukemia) as well as for approximately 75,000 children who were diagnosed with acute lymphoblastic leukemia (ALL) between 1995 and 2009. In the study, the scientists drew on data from 279 cancer registries in 67 countries. It was analyzed using a method called period analysis, developed by Hermann Brenner from the German Cancer Research Center (DKFZ) in Heidelberg. This method delivers more up-to-date data on long-term survival than the rates obtained by conventional methods. The study was published in the journal “Lancet”. The scientists noted major differences in survival rates in various countries for specific cancer types. This also held true after taking into account regional differences in life expectancy due to other factors such as the age, gender or race of subjects in the study. Above all, they identified remarkable variations in 5-year survival rates for children with acute lymphoblastic leukemia: Rates ranged from 16-50% in countries such as Jordan, Lesotho, Tunisia, Indonesia, and Mongolia to over 90% in Canada, Austria, Belgium, Germany and Norway. In their report the scientists state that this shows large deficits in the management of a disease for which in fact there are effective treatments.
    [Show full text]
  • Breast Cancer Relative Survival 1985-2014
    No: 2018/02 Statistical series: 108 The Cancer Effect An “Exploring Cancer” Series Western Australia Breast Cancer Relative Survival 1985–2014 Western Australia Cancer Registry and the Epidemiology Branch WA Department of Health WA Cancer Registry The WA Cancer Registry is part of the Department of Health (WA). The Registry records all cancer notifications (i.e. cancer diagnoses) for WA residents. The notification (reporting) of cancers, by pathologists and radiation oncologists (amongst others), to the Department of Health has been a legal requirement under the Health (Miscellaneous Provisions) Act 1911 since 1981. These current regulations are available as Health (Western Australian Cancer Register) Regulations 2011. Acknowledgements The Epidemiology Branch of the Department of Health WA designed the analysis tools used in this relative survival analysis study as well as conducting the analysis. The Epidemiology Branch also provided the WA Cancer Registry feedback on the report. The WA Cancer Registry also extends thanks to the individuals across the WA Department of Health who contributed to the production of this report. Contact regarding enquiries and additional information Telephone: +61 (0) 08 9222 4022 Email: [email protected]. Recent releases 2017/01 ALL Cancers Survival 2010-2014 The Cancer Effect—Breast Cancer survival 2010-14 2 Contents 1.0 Introduction ............................................................................................. 4 2.0 Incidence of breast cancer in WA .........................................................
    [Show full text]
  • Influence of Tumour Stage at Breast Cancer Detection on Survival BMJ: First Published As 10.1136/Bmj.H4901 on 6 October 2015
    RESEARCH OPEN ACCESS Influence of tumour stage at breast cancer detection on survival BMJ: first published as 10.1136/bmj.h4901 on 6 October 2015. Downloaded from in modern times: population based study in 173 797 patients Sepideh Saadatmand,1 Reini Bretveld,2 Sabine Siesling,2,3 Madeleine M A Tilanus-Linthorst1 1Department of Surgery, ABSTRACT 2006-12 was 96%, improved in all tumour and nodal Erasmus University Medical OBJECTIVES stages compared with 1999-2005, and 100% in Centre - Cancer Institute, 3075 To assess the influence of stage at breast cancer tumours ≤1 cm. In multivariable analyses adjusted for EA, Rotterdam, Netherlands diagnosis, tumour biology, and treatment on survival age and tumour type, overall mortality was decreased 2Department of Research, Netherlands Comprehensive in contemporary times of better (neo-)adjuvant by surgery (especially breast conserving), Cancer Organization, 3511 DT, systemic therapy. radiotherapy, and systemic therapies. Mortality Utrecht, Netherlands DESIGN increased with progressing tumour size in both cohorts 3Department of Health (2006-12 T1c v T1a: hazard ratio 1.54, 95% confidence Technology and Services Prospective nationwide population based study. interval 1.33 to 1.78), but without a significant Research, MIRA Institute for SETTING Biomedical Technology and difference in invasive breast cancers until 1 cm Nationwide Netherlands Cancer Registry. Technical Medicine, University (2006-12 T1b v T1a: hazard ratio 1.04, 0.88 to 1.22), and of Twente, 7500 AE, Enschede, PARTICIPANTS independently with progressing number of positive Netherlands Female patients with primary breast cancer diagnosed lymph nodes (2006-12 N1 v N0: 1.25, 1.17 to 1.32).
    [Show full text]
  • Cancer in Australia 2019
    Cancer in Australia 2019 In 2019, the rate of new cancer cases in Australia is expected to reach 483 new cases per 100,000 people, while cancer-related deaths are expected to decrease to 159 per 100,000 people. From 1982 to 2019, thyroid cancer and liver cancer incidence rates increased more than for any other cancer. Although liver cancer survival has improved since 1982, with the increasing liver cancer incidence rate, liver cancer mortality rates also increased more than for any other cancer. aihw.gov.au Australasian Association of Cancer Registries Stronger evidence, better decisions, improved health and welfare Cancer in Australia 2019 The Australian Institute of Health and Welfare is a major national agency whose purpose is to create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians. © Australian Institute of Health and Welfare 2019 This product, excluding the AIHW logo, Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark, has been released under a Creative Commons BY 3.0 (CC BY 3.0) licence. Excluded material owned by third parties may include, for example, design and layout, images obtained under licence from third parties and signatures. We have made all reasonable efforts to identify and label material owned by third parties. You may distribute, remix and build upon this work. However, you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at www.aihw.gov.au/copyright/. The full terms and conditions of this licence are available at http://creativecommons.org/licenses/by/3.0/au/.
    [Show full text]
  • Study of a Five Years Survival Rate of Cancer in Sudanese
    Oncology and Radiotherapy © Vol.14 Iss. 3: 022-025 • Research Article Study of a five years survival rate of cancer in Sudanese Yousif M. Abdallah1,2, Mujtaba E Abdullah2, Tariq Alqahtani3, Nouf H. Abuhadi4 1 Radiological Science and Medical Imaging Department, College of Applied Medical Science, Majmaah University, Majmaah, 11952, Saudi Arabia 2 Radiotherapy and Nuclear Medicine Department, College of Medical Radiological Science, Sudan University of Science and Technology, Khartoum, Sudan 3 Department of Medical Equipment’s Technology, College of Applied medical Science, Majmaah University, Majmaah, 11952, Saudi Arabia 4 Department Diagnostic Radiology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia Background: The statistics nowadays are an important aspect of the fighting of the world against cancer. Unfortunately, there is no enough statistical INTRODUCTION information's about cancer incidence, epidemiology, or survival rates in Sudan, there are only a few knowledge's from the published studies. For decades, cancer has focused on scientific research. Increased SUMMARY Material and Methods: This retrospective study has been performed to understanding of the disease will improve the detection, estimate the overall 5-year cancer survival rate in Sudan was calculated and diagnosis, and treatment and enhance patient survival from the factors that could influence the rate were described. The study was based on data from the Radiation and Isotope Centre (RICK) of 160 adult patients death [1]. Most cancer therapy advances are the result of well- with different types of cancer. The patients have been followed up to 2013 organized, retrospective clinical trials (i.e., verified information with their treatment and death records.
    [Show full text]
  • July 2020 Dear Friends and Supporters, for Over 60 Years, The
    July 2020 Dear Friends and Supporters, For over 60 years, the Israel Cancer Association has been leading endless endeavors and tireless efforts in the fight against cancer, with the aim of reducing cancer morbidity and mortality. The ICA promotes the fight against cancer on all fronts by providing dozens of research grants each year, building and renovating oncology departments and breast centers, purchasing state-of-the-art medical equipment, carrying out awareness activities for early detection and prevention as well as promoting welfare and support programs. During our many years of activity, the ICA achieved impressive accomplishments, among them increased cure rates thanks to research, new treatment modalities and innovative drugs. Extensive activities in early detection of breast cancer, colorectal cancer and skin cancer ranked Israel 6th out of 85 countries worldwide in cancer survival rates. In addition, the ICA has succeeded in bridging the gaps between the diverse population segments in Israel. In the link to the 2019 annual report below, you can find more details about our projects and other highlights from the past year. Additional information can be found on our website, which enjoys about 1.5 million entries per year in the Hebrew version and is updated on a regular basis with diverse and extensive informational material. I wish to thank each and every one of you, dear active volunteers and supporters abroad, for your ongoing efforts and loyalty and for lending us a helping hand, enabling us to promote our many goals. Your support gives us the strength to continue our fight against the disease for the patients, survivors and their families.
    [Show full text]
  • Cancer Treatment & Survivorship Facts & Figures: 2014-2015
    Cancer Treatment & Survivorship Facts & Figures 2014-2015 Estimated Numbers of Cancer Survivors by State as of January 1, 2014 WA 332,920 NH 77,320 MT VT ME ND 52,030 31,850 79,400 35,200 OR MN 185,730 282,090 ID MA 364,460 66,600 WI SD NY 40,130 295,520 WY 960,920 MI RI 29,820 543,470 59,240 IA PA CT NE 181,830 NV 142,870 643,350 96,610 108,000 OH NJ 483,590 UT 555,740 IL IN DE 46,040 81,260 CA CO 578,840 279,420 MD 264,450 1,661,740 211,670 WV KS 101,060 VA DC 21,280 MO 319,080 142,700 281,330 KY 220,640 NC TN 348,850 AZ OK 241,560 348,720 NM 172,080 AR SC 80,080 107,500 226,420 GA MS AL 355,870 95,950 197,040 TX 929,970 LA AK 206,490 31,740 FL 1,222,960 US Total HI 14,483,830 60,380 Note: State estimates do not sum to US total due to rounding. Contents Introduction 1 Who Are Cancer Survivors? 1 How Many Cancer Survivors Are Alive in the US? 1 How Many Cancer Survivors Are Expected to Be Alive in the US in 2024? 2 Selected Cancers 3 Breast (Female) 3 Cancers in Children and Adolescents 8 Colon and Rectum 9 Leukemias and Lymphomas 10 Lung and Bronchus 13 Melanoma 14 Prostate 14 Testis 15 Thyroid 16 Urinary Bladder 17 Uterine Corpus 18 Navigating the Cancer Experience: Diagnosis and Treatment 19 Choosing a Doctor 19 Choosing a Treatment Facility 20 Choosing among Recommended Treatments 21 Barriers to Treatment and Cancer Disparities 21 Common Side Effects of Cancer and Its Treatment 22 Impairment-driven Cancer Rehabilitation 25 Palliative Care 25 The Recovery Phase 25 Long-term Survivorship 26 Quality of Life 26 Risk of Recurrence and Subsequent Cancers 27 Regaining and Improving Health through Healthy Behaviors 28 Concerns of Caregivers and Families 30 The American Cancer Society 32 How the American Cancer Society Saves Lives 32 Sources of Statistics 37 References 38 Acknowledgments 45 Corporate Center: American Cancer Society Inc.
    [Show full text]
  • 5.9. Screening, Survival and Mortality for Breast Cancer
    5. QUALITY OF CARE • CANCER CARE 5.9. Screening, survival and mortality for breast cancer Breast cancer is the most prevalent form of cancer in Coleman et al., 2008, 2011). The relative five-year breast women, accounting for almost 460 000 deaths worldwide cancer survival rates have improved in all countries in 2008 (WHO, 2011d). One in nine women will acquire between 1997-2002 and 2004-09 (Figure 5.9.2). Most OECD breast cancer at some point in her life and one in thirty will countries have survival rates of over 80%, with notable die from the disease. There are a number of risk factors increases in Ireland, the Czech Republic and Slovenia. that increase a person’s chance of getting this disease such Recent studies suggest that some of the differences in as age, family history of breast cancer, estrogen replace- survival rates could be due to variations in the implemen- ment therapy, alcohol use and others. Overall spending for tation of screening programmes and different improve- breast cancer care typically amounts to about 0.5-0.6% of ment rates between middle aged and elderly patients total health expenditure (OECD, 2003a). Variation in breast (Rosso et al., 2010). cancer care across OECD countries is indicated by mam- Mortality rates reflect the effect of improvements in early mography screening rates in women aged 50-69 years, detection and treatment of breast cancer. Overall, the relative survival rates, and mortality rates. breast cancer mortality rates have declined in most OECD The promotion of screening mammography (European countries over the past decade (Figure 5.9.3).
    [Show full text]
  • Study Protocol
    STUDY PROTOCOL Project: Prognosis, prognostic factors and predictive factors in centimeter or subcentimeter node-negative breast cancer Date: 140222 SPECIFIC AIMS Because of mammography screening increasingly more women are diagnosed with centimeter or subcentimeter node-negative breast cancer (i.e., T1abN0); these tumors account for approximately 19% of all newly diagnosed breast cancers in Sweden. Although the long term relapse-free survival rates among patients with such tumors is as high as ≥90%, some reports suggest that certain patient subgroups may have rates <75%.1 Firmly established prognostic and predictive factors for patients with T1abN0 tumors are, however, lacking. In Sweden, the treatment for T1abN0 tumors has changed over time and differs across health care regions with otherwise comparable health care systems. Leveraging these temporal and geographical differences, we propose to conduct a nationwide, register-based cohort study investigating long- term prognosis among patients with T1abN0 tumors. We aim to identify patient and tumor characteristics linked with poor prognosis, and to estimate the effect of adjuvant treatment on prognosis. Specifically, we will: 1. Estimate the risk of recurrence and survival among patients with T1abN0 tumors who have not received adjuvant systemic treatment. 2. Estimate the effect of radiotherapy versus no radiotherapy on risk of recurrence and survival among patients with T1abN0 tumors. 3. Estimate the effect of endocrine therapy versus no endocrine therapy on risk of recurrence and survival among patients with estrogen receptor (ER) positive T1abN0 tumors. 4. Estimate the effect of chemotherapy versus no chemotherapy on risk of recurrence and survival among patients with T1abN0 tumors. 5. Estimate the effect of trastuzumab versus no trastuzumab on risk of recurrence and survival among patients with human epidermal growth factor receptor 2 (HER2) positive T1abN0 tumors.
    [Show full text]
  • Cancer-Facts-And-Figures-Special-Section-Cancer-In-The-Oldest-Old-2019.Pdf
    Special Section: Cancer in the Oldest Old Introduction in the oldest age group. In 2016, there were 4.2 million women compared to 2.2 million men ages 85 and older, or Adults ages 85 and older are the fastest-growing 186 women for every 100 men. population group in the US. Sometimes referred to as the “oldest old,” the number of adults ages 85+ is expected to Cancer risk increases with age, peaking in men and nearly triple from 6.4 million in 2016 to 19.0 million by women in their 80s (Figure S2). The rapidly growing older 2060 (Figure S1).1 The growth of the older population is population will increase demand for cancer care in this primarily fueled by increasing life expectancy because of population, which will have a substantial impact on declines in all cause mortality due to less smoking and health care resource allocation. Diagnosis and treatment improvements in treatment. However, the obesity of cancer at older ages are often complicated by epidemic and persistent socioeconomic inequalities preexisting medical conditions (comorbidities), cognitive threaten to slow this progress.2-4 In addition, the delay in impairment, frailty, and other factors.5 Screening is not smoking cessation among women is expected to narrow recommended because current evidence suggests that the current gender gap. For example, by 2030, remaining the harms outweigh the benefits for adults older than 75 life expectancy at age 65 is projected to increase to 20 years of age. As a result, cancers in this age group are and 22 years in men and women, respectively, up from 18 often more advanced than those diagnosed at earlier and 21 years in 2010.4 As a result of the longer life ages.
    [Show full text]