RESUMO
BACKGROUND: Since the early 2000s, overall and site-specific cancer survival have improved substantially in the Nordic countries. We evaluated whether the improvements have been similar across countries, major cancer types, and age groups. MATERIAL AND METHODS: Using population-based data from the five Nordic cancer registries recorded in the NORDCAN database, we included a cohort of 1,525,854 men and 1,378,470 women diagnosed with cancer (except non-melanoma skin cancer) during 2002-2021, and followed for death until 2021. We estimated 5-year relative survival (RS) in 5-year calendar periods, and percentage points (pp) differences in 5-year RS from 2002-2006 until 2017-2021. Separate analyses were performed for eight cancer sites (i.e. colorectum, pancreas, lung, breast, cervix uteri, kidney, prostate, and melanoma of skin). RESULTS: Five-year RS improved across nearly all cancer sites in all countries (except Iceland), with absolute differences across age groups ranging from 1 to 21 pp (all cancer sites), 2 to 20 pp (colorectum), -1 to 36 pp (pancreas), 2 to 28 pp (lung), 0 to 9 pp (breast), -11 to 26 pp (cervix uteri), 2 to 44 pp (kidney), -2 to 23 pp (prostate) and -3 to 30 pp (skin melanoma). The oldest patients (80-89 years) exhibited lower survival across all countries and sites, although with varying improvements over time. INTERPRETATION: Nordic cancer patients have generally experienced substantial improvements in cancer survival during the last two decades, including major cancer sites and age groups. Although survival has improved over time, older patients remain at a lower cancer survival compared to younger patients.
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Melanoma , Neoplasias , Masculino , Humanos , Feminino , Melanoma/epidemiologia , Melanoma/terapia , Taxa de Sobrevida , Fatores de Risco , Seguimentos , Países Escandinavos e Nórdicos/epidemiologia , Neoplasias/epidemiologia , Neoplasias/terapia , Neoplasias/diagnóstico , Sistema de Registros , Análise de Sobrevida , IncidênciaRESUMO
INTRODUCTION: A large increase in new cancer cases is predicted worldwide, due to population growth, ageing and increased cancer risk. The age distribution of the Icelandic population is different from the other Nordic countries. The purpose of this study was to predict the number of new cancer cases in Iceland and other Nordic countries, and cancer survivors in Iceland, up to the year 2040. MATERIALS AND METHODS: Information on cancer diagnoses was retrieved from The Icelandic Cancer Registry and information on population projections from Statistics Iceland. Well known methods for population projection were used to predict the number of new cancer cases in 2040, but adjusted to consider Icelandic circumstances. It is also based on more recent data than is accessible elsewhere. Three different methods were used to estimate the number of survivors in 2040 and are presented here for the first time. RESULTS: In 2040 the predicted yearly average number of new cancer cases in Iceland will be up to 2,903 [95% CI 2.841-2.956], a 57% increase compared with 2022. The increase is higher in Iceland than in other Nordic countries (Norway 41%, Sweden 24%, Denmark 23%, Finland 21%). In 2022, the number of cancer survivors was around 17,500 and is predicted to be between 24,500 and 31,000 in 2040. CONCLUSION: The main reason for the predicted increase of cancer cases and survivors is population trends, especially the ageing of the population. This expected increase in the number of cancer patients and improved survival will increase the demand for healthcare.
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Sobreviventes de Câncer , Neoplasias , Sistema de Registros , Humanos , Islândia/epidemiologia , Neoplasias/epidemiologia , Neoplasias/diagnóstico , Fatores de Tempo , Prevalência , Incidência , Distribuição por Idade , Previsões , Fatores de Risco , Pessoa de Meia-Idade , Masculino , Idoso , Feminino , Fatores Etários , AdultoRESUMO
BACKGROUND: To evaluate cancer incidence among licenced commercial pilots in association with cosmic radiation. METHODS: Cohort study where ionizing radiation dose of cosmic radiation was estimated from airline data and software program and cancer incidence was obtained by record linkage with nation-wide cancer registry. All licenced commercial male airline pilots were followed from 1955 to 2015, ever or never employed at airline with international routes. Standardized incidence ratios were calculated and relative risk by Poisson regression, to examine exposure-response relation. RESULTS: Eighty three cancers were registered compared with 92 expected; standardized incidence ratios were 0.90 (95% CI 0.71 to 1.11) for all cancers, 3.31 (95% CI 1.33 to 6.81) for malignant melanoma, and 2.49 (95% CI 1.69 to 3.54), for basal cell carcinoma of skin. The risk for all cancers, malignant melanoma, prostate cancer, basal cell carcinoma of skin, and basal cell carcinoma of trunk increased with an increase in number of employment years, cumulative air hours, total cumulative radiation dose, and cumulative radiation dose sustained up to age of 40 years. The relative risk for the highest exposure categories of cumulative radiation dose were 2.42 (95% CI 1.50 to 3.92) for all cancers, 2.57 (95% CI 1.18 to 5.56) for prostate cancer, 9.88 (95% CI 1.57 to 190.78) for malignant melanoma, 3.61 (95% CI 1.64 to 8.48) for all basal cell carcinoma, and 6.65 (95% CI 1.61 to 44.64) for basal cell carcinoma of trunk. CONCLUSIONS: This study was underpowered to study brain cancer and leukaemia risk. Basal cell carcinoma of skin is radiation-related cancer, and may be attributed to cosmic radiation. Further studies are needed to clarify the risk of cancers in association with cosmic radiation, other workplace exposure, host factors, and leisure sun-exposure, as clothes, and glass in cockpit windows shield pilots from the most potent ultraviolet-radiation.
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Neoplasias/epidemiologia , Pilotos/estatística & dados numéricos , Radiação Ionizante , Adulto , Aeronaves , Oceano Atlântico , Estudos de Coortes , Humanos , Islândia/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/etiologia , Risco , Raios Ultravioleta/efeitos adversosRESUMO
Dynamic models for toxic effects [toxicokinetic-toxicodynamic (TKTD) models] are increasingly used in the analysis of toxicity data for single-chemical exposure. However, these models also offer a natural extension to the effects of chemical mixtures. Here, we demonstrate how a simple model for the energy budget (DEBkiss) can be used to interpret the effects of cadmium and fluoranthene, in both single and mixed exposure, on the nematode Caenorhabditis elegans. The data for all time points and all end points (growth and reproduction) are combined into a single coherent framework. These modeling results are compared to a more traditional independent-action approach based on the dose-response curves for a single end point at a single time point. The analysis with DEBkiss does not lead to a radically different interpretation of the mixture effects, both indicating an antagonistic interaction in the mixture. The DEBkiss analysis does, however, provide much more insight into the relevant dynamic processes underlying the toxic effect on the organism and allows for the generation of mechanistic hypotheses that can be used to guide further research.
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Cádmio/toxicidade , Caenorhabditis elegans/efeitos dos fármacos , Fluorenos/toxicidade , Modelos Biológicos , Testes de Toxicidade , Animais , Caenorhabditis elegans/anatomia & histologia , Caenorhabditis elegans/embriologia , Caenorhabditis elegans/fisiologia , Desenvolvimento Embrionário/efeitos dos fármacos , Reprodução/efeitos dos fármacosRESUMO
Several studies have shown that attendance rates are lower among non-Western immigrants than among natives. As the Nordic countries have quite similar health systems and populations but also differences in the organisation of their organised mammography screening programmes, differences in attendance rates could highlight organisational factors that might increase the attendance rates. Mammography screening is offered free of charge in Denmark and Finland, but not in Iceland and Norway. Contrarily to the other countries, Iceland do not send out pre-booked appointment. The study population included natives and non-Western immigrants aged 50-69 years, who had at least one invitation to the national mammography screening programmes in Denmark (2008-2017), Finland (2001-2017), Iceland (2001-2020) or Norway (2001-2015). Relative risks (RRs) of attendance were estimated and adjusted for age group and calendar period. The study population included 116.033 non-Western immigrants and more than 2 million natives. The attendance rates were significantly lower among non-Western immigrants than among natives, with an adjusted relative risk of 0.81/0.80 in Denmark and Finland, 0.62 in Norway, and 0.40 in Iceland. The lower attendance rates among immigrants in Norway and Iceland did not seem to be due to differences in birth country, immigration age, or educational level, but might be explained by organisational factors. Offering free-of-charge mammography screening in Norway and Iceland and/or including a pre-booked appointment in the invitation letters in Iceland might increase the attendance rate among non-Western immigrants.