[Trends in incidence of cancer in southeast North Brabant and North Limburg during 1975-1986; report from the IKZ/SOOZ cancer registration (Integrated Cancer Center South/Cooperative Organization Oncology Hospitals)]. / Trends in incidentie van kanker in Zuidoost-Noord-Brabant en Noord-Limburg in de periode 1975-1986; bericht uit de IKZ/SOOZ-kankerregistratie.

Trends in the incidence of cancer have been determined in the Southeast of the Netherlands from 1975 to 1986 inclusive by means of the regional SOOZ cancer registry. Age-adjusted registration rates of cancer in males rose rather steeply from more than 371 per 10(5) men-years to 424 in 1982-3 and fell thereafter to 407 per 10(5) in 1986. A similar changing pattern was seen in cancer of the lung, larynx, prostate and kidney and possibly also in cancer of the head and neck. The incidence of colorectal cancer had skin melanoma increased while that of cancer of the stomach fell. Age-adjusted incidence of cancer in females rose steadily from 266 to 290 per 10(5) woman-years. A steady increase was observed for cancer of the lung, breast, bladder and melanoma and temporarily for cancer of the kidney. The incidence of cancer of the stomach and gallbladder fell continuously. These changes in incidence generally corresponded with trends in cancer mortality as registered with the Central Bureau of Statistics. Bias from changes in data collection and coding appears to be negligible, but a certain influence on the registration rates from the markedly increased number of consultants managing cancer patients is likely. Contrasting trends in male and female rates of cancer of the airways illustrate the marked changes in smoking patterns since the sixties.

[Breast cancer in southeast North Brabant and in North Limburg; trends in incidence and earlier diagnosis in an unscreened female population, 1975-1986]. / Borstkanker in Zuidoost-Noord-Brabant en in Noord-Limburg; beloop van incidentie en vervroeging van de diagnose in een niet-gescreende vrouwelijke bevolking, 1975-1986.

Data on incidence, tumour size at diagnosis and mortality from breast cancer in the southeast of the Netherlands, collected by means of the SOOZ-cancer registry were studied in combination with data on patient management, collected through the regional tumour work group. Age-adjusted incidence increased by approx. 1% per year, especially in women less than 50 years and mortality showed a slight decrease in women less than 60 years. The proportion of patients with a tumour greater than 5 cm and with extension to chest wall or skin decreased from more than 40 to 15%. The proportion of tumours of 2.1-5 cm rose from 30 to 35% and that of less than or equal to 2 cm from 20 to almost 45%, in particular in younger women. The process of patient management changed by the shift to smaller tumours and the introduction of mammography, cytology and breast sparing treatment. These 'spontaneous' changes may have implications for the effectiveness of future breast cancer screening programs, which would only cover 35% of women with invasive breast cancer in this population.

[Survival chances of patients diagnosed with cancer in 1975-1985 in southeast Noord-Brabant and north Limburg]. / De overlevingskansen bij patiënten met kanker gediagnostiseerd in 1975-1985 in Zuidoost-Noord-Brabant en Noord-Limburg.

In order to determine the population-based survival of patients with cancer and changes over time, a follow-up study with the Eindhoven Cancer Registry was carried out in 11 hospitals in southeastern Noord Brabant and northern Limburg. Data were collected from medical records and supplemented with information on date of death as of 31 December, 1987, and the relative survival, the ratio of observed and expected survival and trends in age-specific cancer mortality were calculated. Of 22,833 patients diagnosed in the period 1975-85 22,744 could be evaluated; 22% were over 75 years of age and 13% did not receive primary treatment of the tumour. The 5 and 10-year cumulative relative survival rates were 33% and 27% for men and 51% and 44% for women, respectively. The 10-year relative survival rate was more than 50% for Hodgkin's disease, melanoma and cancer of the testis, breast, larynx, thyroid, uterine cervix and corpus; it was less than 20% for multiple myeloma, cancer of the oesophagus, stomach, gallbladder, pancreas, lung and brain. Comparison with 5-year relative survival rates for the various tumours reported in Finland, the Canton of Vaud (Switzerland) and the United States revealed only small differences. The 5-year relative survival rate remained unaltered for men and increased from 50% in the period 1975-79 to 52% in 1980-85 for women; it improved mainly in patients below 45 years, while cancer mortality also declined below this age. In conclusion, there was a slight increase of survival of cancer patients, mainly the young and women.

Improved prognosis of ovarian cancer in The Netherlands during the period 1975-1985: a registry-based study.

Survival of 568 patients with ovarian cancer, diagnosed in 1975-1985, was studied by means of a population-based registry in the Southeast Netherlands. Patients diagnosed in the period 1981-1985 had a significantly better prognosis than patients diagnosed in 1975-1980. This improvement of survival declined with advancing age of the patients. In women younger than 60 years, mortality from ovarian cancer decreased, while incidence remained stable. Apart from the effect of new treatment methods, consisting of more extensive tumor reduction and cisplatin-based combination chemotherapy, advances in supportive care as well as a trend toward earlier diagnosis, possibly in combination with an increasing proportion of less malignant tumors, may explain the improvement in prognosis. Survival was strongly related to stage at diagnosis and to age, the prognosis of younger patients being more favorable. Patients with tumors of either germ cell or stromal origin generally survived longer than patients with epithelial tumors, but this difference disappeared after adjustment for stage and age. Patients still alive after 6 years did not have a survival significantly different from that of the general female population.

Trends in the incidence of non-melanoma skin cancer in the SE Netherlands 1975-1988: a registry-based study.

The trends in the incidence and the sites of primary basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin were examined in a defined population of 650,000 persons in the SE Netherlands during the period 1975-88. The data was obtained from the Cancer Registry in Eindhoven and was from the dermatological and surgical clinics of 12 community hospitals. The incidence rates for BCC during this period rose from 42 to 53/100,000 person years for males and 24 to 38/100,000 person years for females. The rate of incidence for SCC varied with an increase mainly among males. In about 80% of the cases BCC and SCC occurred on the head and neck. Allowing for some detection bias a rise in the true incidence of BCC and SCC was observed, with an increase in SCC only since 1982. There was a marked decline in the incidence of SCC on the lips of males. These rates and trends fit into a pattern observed in other parts of Europe.