ABSTRACT
PURPOSE: Li-Fraumeni syndrome (LFS) is a rare genetic disease with strong predispositions to multiple early-onset neoplasms, mostly sarcomas, breast cancers, brain tumors and adrenocortical carcinomas (LFS core cancers). In most LFS families the germline mutations of TP53 tumor suppressor gene were found. Lung cancer does not belong to the core cancers of LFS, however its higher incidence is observed in families with TP53 mutations. Our aim was to search for TP53 mutations in female lung cancer patients whose clinico-demographic characteristics suggested a probable genetic predisposition to the disease. MATERIALS AND METHODS: The coding region of TP53 from blood DNA was sequenced using Sanger method. The functioning of detected mutation was tested by luciferase reporter assay. RESULTS: We found a nucleotide substitution c.569C>G, p.Pro190Arg, which was not described in the TP53 germline mutation database (http://p53.iarc.fr/TP53GermlineMutations.aspx). The mutation destroys the ability of p53 to transactivate BAX promoter and significantly reduces transactivation potential of p53 toward the promoter of MDM2 gen. CONCLUSION: We identified novel germline mutation of TP53.
Subject(s)
Biomarkers, Tumor/genetics , Breast Neoplasms/genetics , Genetic Predisposition to Disease , Germ-Line Mutation , Lung Neoplasms/genetics , Tumor Suppressor Protein p53/genetics , Breast Neoplasms/pathology , Female , Genotype , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Pedigree , Prognosis , Promoter Regions, GeneticABSTRACT
OBJECTIVES: To assess the extent to which stage at diagnosis and adherence to treatment guidelines may explain the persistent differences in colorectal cancer survival between the USA and Europe. DESIGN: A high-resolution study using detailed clinical data on Dukes' stage, diagnostic procedures, treatment and follow-up, collected directly from medical records by trained abstractors under a single protocol, with standardised quality control and central statistical analysis. SETTING AND PARTICIPANTS: 21 population-based registries in seven US states and nine European countries provided data for random samples comprising 12 523 adults (15-99 years) diagnosed with colorectal cancer during 1996-1998. OUTCOME MEASURES: Logistic regression models were used to compare adherence to 'standard care' in the USA and Europe. Net survival and excess risk of death were estimated with flexible parametric models. RESULTS: The proportion of Dukes' A and B tumours was similar in the USA and Europe, while that of Dukes' C was more frequent in the USA (38% vs 21%) and of Dukes' D more frequent in Europe (22% vs 10%). Resection with curative intent was more frequent in the USA (85% vs 75%). Elderly patients (75-99 years) were 70-90% less likely to receive radiotherapy and chemotherapy. Age-standardised 5-year net survival was similar in the USA (58%) and Northern and Western Europe (54-56%) and lowest in Eastern Europe (42%). The mean excess hazard up to 5 years after diagnosis was highest in Eastern Europe, especially among elderly patients and those with Dukes' D tumours. CONCLUSIONS: The wide differences in colorectal cancer survival between Europe and the USA in the late 1990s are probably attributable to earlier stage and more extensive use of surgery and adjuvant treatment in the USA. Elderly patients with colorectal cancer received surgery, chemotherapy or radiotherapy less often than younger patients, despite evidence that they could also have benefited.
ABSTRACT
Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.
Subject(s)
Breast Neoplasms/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Europe/epidemiology , Female , Follow-Up Studies , Humans , Middle Aged , Registries , United States/epidemiology , Young AdultABSTRACT
Polymorphisms in DNA repair genes may modulate not only an individual DNA repair capacity, DNA damage levels and cancer risk but also clinical outcome after DNA damage-inducing anticancer therapy. In this study, we analyzed the association between the XPA -4G>A, XPD Asp312Asn, hOGG1 Ser326Cys, XRCC1 Arg399Gln, XRCC2 -4234G>C, XRCC3 -4541A>G and Thr241Met polymorphisms and prognosis in 250 inoperable non-small cell lung cancer (NSCLC) patients treated with radiotherapy and platinum-based chemotherapy. In univariate model, the XPA-4A and XRCC1 399Gln alleles alone and in combination influenced survival only in stage III group. In multivariate analysis, the XPA-4 GA/AA was associated with poor survival (HR 1.55, p = 0.011 overall and HR 1.72, p = 0.008 in stage III). In chemoradiotherapy group, the XPA-4A carriers were at increased risk of death and progression (HR 1.73, p = 0.013 and HR 1.65, p = 0.016, respectively), especially in stage III (p = 0.008). Moreover, individuals with ≥ 2 XPA/XRCC1 adverse alleles showed a higher risk of death (HR 1.46, p = 0.036 overall; HR 1.85, p = 0.004 in stage III and HR 1.71, p = 0.022 in chemoradiotherapy group) and progression (HR 1.75, p = 0.011 overall and HR 1.93, p = 0.005 in stage III). The XPA-4 GA/AA genotype individually and together with the XRCC1 399Gln was an independent unfavorable prognostic factor in our study. Thus, our findings indicate a prognostic potential of the XPA-4G>A in unresected NSCLC treated with radiotherapy and chemoradiotherapy. The results require validation in an independent population.
Subject(s)
Carcinoma, Non-Small-Cell Lung/genetics , DNA Repair , Lung Neoplasms/genetics , Polymorphism, Genetic , Adult , Aged , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/therapy , Combined Modality Therapy , Female , Genotype , Humans , Kaplan-Meier Estimate , Lung Neoplasms/mortality , Lung Neoplasms/therapy , Male , Middle Aged , PrognosisABSTRACT
It is estimated that about 5-10% of ovarian and 2-5% of all breast cancer patients are carriers of a germline BRCA1 or BRCA2 gene mutation. Most families with detected BRCA1 or BRCA2 gene mutation are qualified for molecular testing on the basis of family history of breast or ovarian cancers. The purpose of our study was to establish the frequency of positive family history of cancer in a series of Polish consecutive breast and ovarian cancer patients in two groups, with and without the BRCA1 gene mutations. We analysed the prevalence of four of the most common BRCA1 mutations: 5382insC (c.5266dupC), 300T>G (p.181T>G), 185delAG (c.68_69delAG) and 3819del5 (c.3700_3704del5). The patient group consisted of 1,845 consecutive female breast and 363 ovarian cancer cases. 19 out of 37 (51%) of BRCA1-positive ovarian cancer patients and 21 out of 55 (39%) BRCA1-positive breast cancer had negative family history of breast and/or ovarian cancer among first- and second-degree relatives. In ovarian cancer patients, negative family history was more frequent in those with 300T>G BRCA1 gene mutation than in 5382insC carriers. This finding indicates the necessity of searching for 300T>G mutation in families with a single diagnosis of ovarian cancer in family. The high frequency of mutations detected in breast cancer patients lacking obvious family history shows that breast cancer patients should be qualified for genetic testing on the basis of wide clinical and pathological criteria.
Subject(s)
BRCA1 Protein/genetics , Breast Neoplasms/genetics , Mutation , Ovarian Neoplasms/genetics , Breast Neoplasms/epidemiology , Female , Genetic Testing , Humans , Ovarian Neoplasms/epidemiology , Pedigree , Poland , White People/geneticsABSTRACT
The purpose of our study was to establish the frequency and distribution of the four most common BRCA1 mutations in Polish general population and in a series of breast cancer patients. Analysis of the population frequency of 5382insC (c.5266dupC), 300T >G (p.181T >G), 185delAG (c.68_69delAG) and 3819del5 (c.3700_3704del5) mutations of the BRCA1 gene were performed on a group of respectively 16,849, 13,462, 12,485 and 3923 anonymous samples collected at birth in seven Polish provinces. The patient group consisted of 1845 consecutive female breast cancer cases. The most frequent BRCA1 mutation in the general population was 5382insC found in 29 out of 16,849 samples (0.17%). 300T >G and 3819del5 mutations were found in respectively 11 of 13,462 (0.08%) and four of 3923 (0.1%) samples. The population prevalence for combined Polish founder 5382insC and 300T >G mutations was 0.25% (1/400). The frequencies of 5382insC and 300T >G carriers among consecutive breast cancer cases were, respectively, 1.9% (35/1845) and 1.2% (18/1486). Comparing these data with the population frequency, we calculated the relative risk of breast cancer for 5382insC mutation at OR = 17 and for 300T >G mutation at OR = 26. Our results, based on large population studies, show high frequencies of founder 5382insC and 300T >G BRCA1 mutations in Polish general population. Carriage of one of these mutations is connected with a very high relative risk of breast cancer.
Subject(s)
BRCA1 Protein/genetics , Breast Neoplasms/epidemiology , Breast Neoplasms/genetics , Genes, BRCA1 , White People/genetics , Alleles , DNA/isolation & purification , Exons , Female , Gene Frequency , Genetic Predisposition to Disease , Humans , Mutation , Ovarian Neoplasms/genetics , Poland/epidemiology , Prevalence , Sequence Analysis, DNAABSTRACT
PURPOSE: Non-Hodgkin's lymphoma (NHL) is the most common hematologic malignant neoplasm in adults. Monitoring differential changes in population-based survival is across Europe and the United States (US) could point to progress attained and impact of application of novel treatments. PATIENTS AND METHODS: We examined trends in age-specific 5-year relative survival among patients with NHL age 15 years or older between 1990 and 1994 and 2000 and 2004, on the basis of follow-up data from 12 population-based cancer registries across Europe, using period analysis techniques and compared the results with similar trends of patients with NHL in the US, as recorded in the Surveillance, Epidemiology, and End Results database. RESULTS: By 2000 to 2004, overall 5-year relative survival of patients with NHL across Europe was between 37% and 62%, achieved by overall increases in 5-year relative survival ranging from 4% to 12% units between 1990 and 1994 and 2000 and 2004. Changes in age-specific survival ranged from -1% to 43% units during the same time interval. For patients with NHL older than age 55 years, relative survival in individual European registries for the whole period was between 8% and 36% units lower than in the US, theoretically representing a lag of 4 to 10 years of progress. CONCLUSION: Our analyses disclosed a strong and ongoing increase in long-term survival for patients with NHL in European populations. The geographic differences potentially indicate that further improvements could be possible, especially for patients age 55 years or older. The presumptive delay in improvement in survival among elderly patients with NHL in Europe remains to be clarified.
Subject(s)
Lymphoma, Non-Hodgkin/mortality , Adolescent , Adult , Age Factors , Aged , Europe/epidemiology , Humans , Lymphoma, Non-Hodgkin/therapy , Middle Aged , Survival Rate/trends , United States , Young AdultABSTRACT
INTRODUCTION: The aim of the study was to estimate smoking habits and their intensity among women from urban and rural residents of Malopolska voivodship. MATERIAL AND METHODS: A structured questionnaire was used by trained nurses who conducted personal interview. Questions regarding smoking referred to age of starting smoking, duration of smoking, average daily number of cigarettes smoked. The total number of collected interviews was 840. Lifetime exposure to cigarette smoking was expressed in pack-years. RESULTS: Data were collected among 602 urban and 238 rural women from Malopolska voivodship. In Malopolska, there are 23.4% current smokers among women, 21.7% are ex-smokers, and about 55% never smoked. The percentage of never smokers in women is significantly higher among the rural women group (67.3%) than urban women group (50.0%). Currently smoking are 25.9% urban inhabitans and 17.2% women from rural population. There were no significant differences in smoking habits among younger group of women (below 50 years) living in urban and rural areas. CONCLUSION: The present results indicate that female population in urban and rural areas need effective educational strategy associated with presenting negative consequences of tobacco smoking and support in quitting the addiction.
Subject(s)
Smoking/epidemiology , Adult , Age Distribution , Age of Onset , Female , Humans , Incidence , Middle Aged , Poland/epidemiology , Population Surveillance , Rural Population/statistics & numerical data , Sex Factors , Smoking Prevention , Surveys and Questionnaires , Urban Population/statistics & numerical dataABSTRACT
OBJECTIVE: To identify disparities in the management of colon and rectal cancer across Europe by assessing population-based information from 12 European cancer registries (CR) participating in EUROCARE, together with additional information obtained from individual clinical records. METHODS AND PATIENTS: We considered five indicators: (a) resection with curative intent; (b) post-operative mortality; (c) proportion of stage II/III colon cancer cases given adjuvant chemotherapy; (d) proportion of rectal cancer cases receiving radiotherapy; and (e) proportion of curative intent resections with 12 or more lymph nodes examined. RESULTS: A total of 6 871 colorectal cancer patients, diagnosed between 1996-1998, were examined. Overall 71% of patients received resection with curative intent, range 44-86% by CR; 46% of stage III colon cancer cases (range 24-73% by CR) and 22% of stage II cases (not then recommended) received adjuvant chemotherapy; 12% of rectal cancer cases received adjuvant radiotherapy, range < or =2% in five CRs to >51% in two CRs. For only 29% of curative intent resections were 12 or more lymph nodes examined. CONCLUSIONS: This study reveals that, although most patients received surgery with curative intent, disparities in treatment for colorectal cancer across Europe in the late 1990s were unexpectedly large, with many patients not receiving treatments indicated by published clinical trials. Consensus guidelines for CRC management are now becoming available and should be adopted across Europe. It is hoped that dissemination of guidelines will improve the use of scientifically proven treatments for the disease, but this should be monitored by further population-based studies.
Subject(s)
Chemotherapy, Adjuvant/statistics & numerical data , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Healthcare Disparities/statistics & numerical data , Lymph Nodes/surgery , Radiotherapy, Adjuvant/statistics & numerical data , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/mortality , Colorectal Neoplasms/radiotherapy , Europe/epidemiology , Female , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , RegistriesABSTRACT
On a population-based sample of 13,500 European breast cancer patients mostly diagnosed in 1996-1998 and archived by 26 cancer registries, we used logistic regression to estimate odds of conservative surgery plus radiotherapy (BCS+RT) versus other surgery, in T1N0M0 cases by country, adjusted for age and tumour size. We also examined: BCS+RT in relation to total national expenditure on health (TNEH); chemotherapy use in N+ patients; tamoxifen use in oestrogen-positive patients; and whether 10 nodes were examined in lymphadenectomies. Stage, diagnostic examinations and treatments were obtained from clinical records. T1N0M0 cases were 33.0% of the total. 55.0% of T1N0M0 received BCS+RT, range 9.0% (Estonia) to 78.0% (France). Compared to France, odds of BCS+RT were lower in all other countries, even after adjusting for covariates. Women of 70-99 years had 67% lower odds of BCS+RT than women of 15-39 years. BCS+RT was 20% in low TNEH, 58% in medium TNEH, and 64% in high TNEH countries. Chemotherapy was given to 63.0% of N+ and 90.7% of premenopausal N+ (15-49 years), with marked variation by country, mainly in post-menopause (50-99 years). Hormonal therapy was given to 55.5% of oestrogen-positive cases, 44.6% at 15-49 years and 58.8% at 50-99 years; with marked variation across countries especially in premenopause. The variation in breast cancer care across Europe prior to the development of European guidelines was striking; older women received BCS+RT much less than younger women; and adherence to 'standard care' varied even among countries with medium/high TNEH, suggesting sub-optimal resource allocation.
Subject(s)
Breast Neoplasms/drug therapy , Breast Neoplasms/surgery , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Breast Neoplasms/pathology , Combined Modality Therapy/methods , Europe , Female , Humans , Middle Aged , Neoplasm Staging , Quality of Health Care/standards , Regression Analysis , Young AdultABSTRACT
BACKGROUND: Wide geographic variations in survival for gastric cancer in Europe have been reported. The aim of this study was to analyse the effect of stage at diagnosis, treatment and cancer characteristics on long-term survival for gastric cancer in populations covered by cancer registries. METHODS: We analysed survival in 4620 cases of gastric cancer from 17 European population-based cancer registries from 8 countries. Univariate and multivariate regression of relative survival were performed. RESULTS: Five-year relative survival varied between 10.6% and 24.0%, while 10-year survival ranged from 7.7% to 23.0%. After adjustment for age and sex, the regional excess hazard ratio (EHR) of death was significantly higher in Ragusa, Granada, Yorkshire, Slovakia, Slovenia and Poland than in France, Northern Italy, The Netherlands and the Basque Country. After further adjustment for surgical resection versus no resection (a proxy of stage), the EHR of death remained significantly higher only in Granada and Yorkshire than in the reference country (France). After adjustment for stage, the EHR was significantly higher only in Yorkshire (EHR: 1.51; 95% confidence interval (CI): 1.29-1.77). The EHR in this area was limited to the first year following diagnosis. CONCLUSION: Differences across Europe in gastric cancer survival depend to a large extent on differences in stage at diagnosis. However they do not explain all variations. Quality of management and treatment can explain some differences.
Subject(s)
Early Detection of Cancer/mortality , Stomach Neoplasms/mortality , Aged , Aged, 80 and over , Analysis of Variance , Europe/epidemiology , Female , Humans , Male , Middle Aged , Neoplasm Staging , Quality of Health Care , Registries , Stomach Neoplasms/pathology , Survival AnalysisABSTRACT
BACKGROUND: There is wide variation in prostate cancer incidence and survival across Europe. In many countries incidence is rising sharply in relation to the introduction of prostate-specific antigen assay, and there is concern that patients may not be treated appropriately. We therefore aimed to characterize treatment for prostate cancer across Europe. METHODS: We performed a high resolution population-based study, collecting information on the treatment of 3 486 prostate cancer cases diagnosed in 1995-1999 in 11 cancer registries from six European countries. RESULTS: Overall, about one in three patients received radical treatment (prostatectomy 23% or radiotherapy 14%); about 60% of younger patients (<70 years) received radical treatment, while a similar proportion of older patients (> or =70 years) received palliation (transurethral prostatectomy or hormone treatment only). A considerable proportion (61%) of patients with apparently high-risk disease were treated radically within a year of diagnosis, with large variation between regions: >70% in Calvados, Haut-Rhin, Tarn and Eindhoven and <50% in Slovakia and Cracow. Overall 34% of patients with apparently low-risk disease received radical treatment, varying from 17% and 22% in Bas-Rhin and Granada, to 52% and 56% in Calvados and Eindhoven. CONCLUSIONS: Our data indicate wide variation in the treatment for prostate cancer even among patients with apparently similar disease, and further suggest a non-negligible proportion may be receiving inappropriate radical treatment for apparently low-risk disease. Current guidelines indicate active surveillance should become the main means of managing low-risk disease.
Subject(s)
Prostatectomy , Prostatic Neoplasms/therapy , Radiotherapy , Age Factors , Age of Onset , Aged , Aged, 80 and over , Combined Modality Therapy , Europe/epidemiology , Humans , Male , Middle Aged , Prognosis , Prostatic Neoplasms/epidemiology , RegistriesABSTRACT
A case-control study involving 1058 women with histologically confirmed lung cancer and 2116 healthy controls, was conducted in Poland between 2004 and 2007. The aim of this study was to examine of the role of familial aggregation of lung cancer in women. Multivariate analysis has shown that family history of lung cancer in a first-degree relative significantly increases the risk of lung cancer (OR=1.61, p=0.0003). For cases with early onset of the disease (<55 years) we observed significantly elevated risk of lung cancer (OR=2.48, p=0.0001). Results of our analysis confirmed synergistic influence of smoking and family history of lung cancer (OR=12.91, p=0.0000).
Subject(s)
Genetic Predisposition to Disease , Lung Neoplasms/epidemiology , Lung Neoplasms/genetics , Case-Control Studies , Female , Humans , Middle Aged , Pedigree , Poland/epidemiology , Risk FactorsABSTRACT
BACKGROUND: Poland has one of the highest death rates for stomach cancer in Europe. Moderate iodine deficiency and in consequence high goitre prevalence led to the implementation in 1996 of a very efficient mandatory model of iodine prophylaxis, based on household salt iodisation (30 +/- 10 mg KI/1 kg of salt). AIM OF THE STUDY: The aim of the study was evaluation of incidence rate of stomach cancer and its possible relation to increased iodine consumption in the years 1992-2004. METHODS: Iodine supply and effectiveness of iodine prophylaxis were evaluated on the basis of comparative analysis of goitre prevalence and ioduria in schoolchildren. To allow comparison between time periods with varying population age structures, the incidence rates of stomach cancer were standardized for age, using the "world standard population". The direct standardization method has been applied. For each sex, the time-trend of incidence rates was shown in graphs over the years 1991-2004. RESULTS: Evident increase in iodine consumption in this period of time was proved by rise in percentage of schoolchildren (6-8 years old) with ioduria above 100 microg/l from 11.4% in 1992-1993 to 52.9.1% in 2003. It was correlated with the decrease in goitre prevalence from 18.8% to 3.2% respectively. The 24-h thyroid uptake of (131)I in investigated population fell from 45.5% in 1986 to 26.8% in 1998. In Krakow the standardized incidence ratio of stomach cancer for men decreased from 19.1 per 100,000 to 15.7 per 100,000, and for women from 8.3 per 100,000 to 5.9 per 100,000 in the years 1992-2004. A significant decline of average rate of decrease was observed in men and women (2.3% and 4.0% per year respectively). CONCLUSION: Observed association between improved iodine supply and decrease of incidence of stomach cancer could indicate the protective role against stomach cancer of iodine prophylaxis in iodine deficient areas--further studies are necessary.
Subject(s)
Goiter/complications , Iodine/administration & dosage , Iodine/deficiency , Stomach Neoplasms/epidemiology , Thyroid Diseases/complications , Child , Female , Goiter/epidemiology , Goiter/prevention & control , Humans , Incidence , Iodine/urine , Male , Poland/epidemiology , Sodium Chloride, Dietary , Stomach Neoplasms/etiology , Stomach Neoplasms/mortality , Thyroid Diseases/epidemiology , Thyroid Diseases/prevention & controlABSTRACT
Effective treatments for testicular cancer have been available since the 1970s, yet EUROCARE uncovered marked inter-country survival differences for this disease. To investigate these differences, we reviewed clinical records of 1350 testicular cancer cases diagnosed during 1987-1992 from 13 population-based cancer registries in nine European countries. Patients were followed up for life status and relapse. Ten-year observed survival was estimated by the Kaplan-Meier method. Cox multivariable analyses were performed separately for seminomas and non-seminomas. Overall, 66% of seminomas and 36% of non-seminomas were limited to the testis. Ten-year survival was 63% (Estonia) to 94% (Switzerland, Slovenia) for seminoma; 47% (Estonia) to 90% (Yorkshire, UK, The Netherlands) for non-seminoma. Multivariable analysis adjusted for country, age and stage showed that hazard ratios (HRs) of death differed little between western European registries, and were mainly attributable to differing stage at diagnosis. Significantly higher than reference HRs in Estonia and Poland suggest inadequacy or unavailability of treatments.
Subject(s)
Neoplasm Recurrence, Local/mortality , Seminoma/mortality , Testicular Neoplasms/mortality , Adult , Aged , Europe/epidemiology , Humans , Male , Middle Aged , Registries , Risk Factors , Survival AnalysisABSTRACT
A high level of chromosomal aberrations in peripheral blood lymphocytes may be an early marker of cancer risk, but data on risk of specific cancers and types of chromosomal aberrations (chromosome type and chromatid type) are limited. A total of 6,430 healthy individuals from nine laboratories in Croatia, Hungary, Lithuania, Poland, and Slovakia, included in chromosomal aberration surveys performed during 1978-2002, were followed up for cancer incidence or mortality for an average of 8.5 years; 200 cancer cases were observed. Compared with that for the low-tertile level of chromosomal aberrations, the relative risks of cancer for the medium and high tertiles were 1.78 (95% confidence interval: 1.19, 2.67) and 1.81 (95% confidence interval: 1.20, 2.73), respectively. The relative risk for chromosome-type aberrations above versus below the median was 1.50 (95% confidence interval: 1.12, 2.01), while that for chromatid-type aberrations was 0.97 (95% confidence interval: 0.72, 1.31). The analyses of risk of specific cancers were limited by small numbers, but the association was stronger for stomach cancer. This study confirms the previously reported association between level of chromosomal aberrations and cancer risk and provides novel information on the type of aberrations more strongly predictive of cancer risk and on the types of cancer more strongly predicted by chromosomal aberrations.
Subject(s)
Chromosome Aberrations/statistics & numerical data , Chromosome Disorders/epidemiology , Cytogenetics , Lymphocytes , Neoplasms/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/blood , Chromosome Disorders/genetics , Europe, Eastern/epidemiology , Female , Health Surveys , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Neoplasms/genetics , Neoplasms/mortality , Occupational Exposure/adverse effects , Risk Assessment , Risk Factors , Smoking/adverse effectsABSTRACT
There were 30949 cancer cases registered in the Malopolska Province in the years 1999-2001; 15964 in males and 14985 in females. The average numbers of 5321 new cases in males and 4995 in females were registered every year. The average percentages of histologically confirmed cancer diagnoses were 60.4% in males and 65.5% in females. Generally, the highest cancer risk in males occurs in the North-West part of the Malopolska Province. The highest incidence rates were observed in Oswiecim County 376.5//100,000, and Wadowice County - 370.4/100,060. The age standardised cancer incidence in males in Malopolska was - 272.6/100 000. Similar to males, the highest cancer risk in females is observed in the North-West part of the Malopolska Province and also in the City of Cracow. The highest cancer incidence rates in women were observed in Oswiecim County - 229.7/100,000, Olkusz County - 227.5/100,000, Chrzanów County-223.7/100,000. The age standardised cancer incidence in females in Malopolska was 272.6/100,000.
Subject(s)
Neoplasms/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Catchment Area, Health , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Poland/epidemiology , Prevalence , Sex DistributionABSTRACT
Between 1994-1997 the Pain and Palliative Care Out-Patient Clinic founded by the Society of Friends of the Sick Hospicium in Kraków undertook hospice home care of 870 cancer patients. Retrospective evaluation of their files revealed that 48.2% of patients on admission were aware of their diagnosis and 61.2% of families did not discuss it with patients. During that time, 735 home care patients died and 83.5% of them died in their homes. During the same time, among the cancer patients not admitted to hospice home care in the city of Kraków, only 23.7% died at home and the rest in institutions. In spite of demonstrated adequate home care, 16.5% of home care patients were admitted to the local hospital, which suggests the need for stationary hospice or palliative care ward cooperation.
Subject(s)
Hospice Care/statistics & numerical data , Neoplasms/epidemiology , Neoplasms/nursing , Palliative Care/statistics & numerical data , Terminally Ill/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Female , Health Care Surveys , Home Care Services/statistics & numerical data , Humans , Male , Middle Aged , Patient Admission/statistics & numerical data , Poland/epidemiology , Retrospective StudiesABSTRACT
OBJECTIVE: To summarize the geographical and temporal variations in incidence of pleural mesothelioma in Europe, using the extensive data available from European general cancer registries, and consider these in light of recent trends in asbestos extraction, use and import in European countries. MATERIAL AND METHODS: The data were extracted from the European Cancer Incidence and Mortality database (EUROCIM). The inclusion criteria was acceptance in Volume VII of Cancer Incidence in Five Continents. Truncated age-standardized rates per 100,000 for the ages 40-74 were used to summarise recent geographical variations. Standardized rate ratios and 95% confidence intervals for the periods 1986-1990 and 1991-1995 were compared to assess geographical variations in risk. To investigate changes in the magnitude of most recent trends, regression models fitted to the latest available 10-year period (1988-1997) were compared with trends in the previous decade. Fitted rates in younger (40-64) and older adults (65-74) in the most recent period were also compared. RESULTS: There was a great deal of geographical variation in the risk of mesothelioma, annual rates ranging from around 8 per 100,000 in Scotland, England and The Netherlands, to lower than 1 per 100,000 in Spain (0.96), Estonia (0.85), Poland (0.85) and Yugoslavia, Vojvodina (0.56) among men. The rank of the rates for women was similar to that observed for men, although rates were considerably lower. Between 1978 and 1987, rates in men significantly increased in all countries (excepting Denmark). In the following 10 years, there was a deceleration in trend, and a significant increase was detectable only in England and France. In addition, the magnitude of recent trends in younger men was generally lower than those estimated for older men, in both national and regional cancer registry settings. CONCLUSIONS: While mesothelioma incidence rates are still rising in Europe, a deceleration has started in some countries. A decrease may begin in the next few years in certain European populations considering the deceleration of observed trends in mesothelioma and asbestos exposure, as well as the recent ban on its use.
Subject(s)
Mesothelioma/epidemiology , Pleural Neoplasms/epidemiology , Asbestos , Environmental Exposure/adverse effects , Europe/epidemiology , Forecasting , Humans , Incidence , Linear Models , Mesothelioma/etiology , Occupational Exposure/adverse effects , Pleural Neoplasms/etiology , Risk FactorsABSTRACT
The purpose of this case-control study was to examine the effect of usual diet, in relation to other risk factors, on the risk of different histologic types of lung cancer in women. A total of 242 women with histologically confirmed primary lung cancer and 352 healthy controls were enrolled in a study conducted in Cracow between 1991 and 1997. A multivariate analysis showed that frequent consumption of carrots (at least five times a week) significantly lowered the risk of lung cancer. The protective effects of carrots were statistically significant for squamous cell carcinoma, small cell carcinoma and adenocarcinoma. It was found that daily consumption of other vegetables had a significant protective effect against squamous cell carcinoma, and for all histologic types combined. Furthermore, a significantly reduced risk was observed in women who consumed margarine (at least three times a week). This effect was observed for all cell types. The results also suggest that frequent consumption of carrots and frequent consumption of margarine can have a protective influence against lung cancer irrespective of the number of cigarettes smoked and the amount of vodka drunk.