Survival of mycosis fungoides in patients in the Southeast of England.

BACKGROUND: Mycosis fungoides (MF) is the most common skin lymphoma. The aetiology of MF remains unknown, and no therapy has to date significantly altered patient survival. OBJECTIVE: The present study examines trends in survival of MF patients in a well-defined population-based disease group, namely patients registered over a 40-year period at the Thames Cancer Registry, Southeast England. METHODS: The Thames Cancer Registry is a population-based registry, covering a population of approximately 14 million people. Data were taken from the Surveillance, Epidemiology and End Results cancer registry programme and the National Centre for Health Statistics. The database was used to identify cases of MF diagnosed between 1961 and 2000. A total of 985 records were identified, 821 (83%) of which had complete information on age, sex, year of diagnosis and area of residence. The observed and relative survivals of patients diagnosed during the periods 1971-1975, 1981-1985 and 1991-1995 were examined over a 5-year period of follow-up, using the relsurv Stata program to perform Cox proportional hazard analysis. RESULTS: A total of 821 MF eligible patients were available with a median follow-up of 4.3 years and a maximum follow-up of 30 years. The overall 5-year relative survival rate was 80%, and there was marked improvement between 1971 and 1981. The prognostic factors leading to a significantly poorer survival were high age, male sex, the presence of the Sézary syndrome, the use of hormone treatment and radiotherapy. CONCLUSIONS: A statistically significantly better survival over the last 20 years was found. The prognosis is generally good for most patients but not all. The best survival was seen for the female patients under 45 years of age without the presence of the Sézary syndrome. This difference in survival may be partly due to a difference in the disease stage or different treatment, or to both.

Risk factors for oesophageal cancer in Linzhou, China: a case-control study.

Linzhou City has one of the highest incidences of oesophageal cancer in China, and in the world. A case-control study was here conducted to investigate potential risk factors in this area. Linzhou Cancer Registry was used to identify cases of oesophageal cancer, aged between 30 and 75, diagnosed between January 1998 and April 1999. Three neighbourhood controls were selected for each case, matched according to age, sex and village of residence. A total of 211 cases and 633 controls were interviewed. A strong association was found between socio-economic status and the risk of oesophageal cancer. Increased income, residential space and education were all significantly associated with a decreased risk (OR 0.54, 0.36 and 0.30 respectively). Using a drinking water source other than tap water was significantly associated with an increased risk (OR 5.49). The consumption of beans, vegetables and vinegar all showed a protective effect with odds ratios of 0.37, 0.44 and 0.37 respectively. Preferences for a low salt diet or a high salt diet were both associated with an increased risk. It can be concluded that in Linzhou, oesophageal cancer is a disease related to poverty. Having a drinking water source other than tap water increases the risk of oesophageal cancer. As in other populations, a high consumption of vegetables and beans are associated with a decreased risk and a preference for a high salt diet is associated with an increased risk.

Recent trends in prostate cancer incidence and mortality in southeast England.

OBJECTIVE: To investigate recent trends in prostate cancer incidence and mortality, with particular reference to changes in diagnostic techniques and treatment. METHODS: The Thames Cancer Registry was used to identify all men, resident in SE England, diagnosed with prostate cancer between 1990 and 1999. Information regarding prostate cancer mortality was obtained from the Office of National Statistics. Other data sources were used to ascertain the number of transurethral resections of the prostate (TURP) and open prostatectomies performed in SE England, and the number of prescriptions issued for the treatment of benign prostatic hyperplasia (BPH). RESULTS: There was a steady increase in the age-standardised incidence of prostate cancer from 1990, which then began to plateau in 1996. The increase was entirely restricted to localised tumours; non-localised tumours showed a slight downward trend over this period. Age-standardised mortality rates have remained constant, with a slight fall in 1997 corresponding to the decline in incidence rates. Medical treatment for BPH has increased, with a corresponding reduction in the number of TURPs. CONCLUSION: The change in occurrence of prostate cancer is entirely due to changes in the incidence of localised cases. Incidence of non-localised cases and mortality remained almost constant. The increasing tendency in incidence of localised prostate cancer is likely to be principally due to increased detection, through increased use of prostate-specific antigen (PSA) testing followed by radical resections of the prostate. The aggregate effect of PSA testing and medical treatment of BPH is a stabilisation in the incidence level of localised cases in recent years.

Residential Environment, Diet and Risk of Stomach Cancer: a Case-control Study in Linzhou, China.

A case-control study was conducted to investigate risk factors for stomach cancer in a rural population in China. Linzhou Cancer Registry was used to identify cases of stomach cancer, aged between 30 and 75 years, diagnosed between January 1998 and April 1999. Three neighbourhood controls were selected for each case, matched according to age, sex and village of residence. A total of 210 cases and 630 controls were interviewed. Conditional logistic regression was used to estimate odds ratios (OR) for factors associated with the risk of cancer. Among characteristics of the residential environment, significantly increased risk was found for: frequent irritation on eyes or throat by soot (OR 5.54, 95% CI 1.42-21.65, p for trend <0.01). This effect was particularly strong in women (OR 19.5, 95% CI 1.28-297.09, p for trend =0.01). Dietary factors that were significantly associated with an increased risk were food grains other than rice, wheat and maize (OR 2.93, 95% 1.16-7.38), pickled or salted vegetables (OR 3.99, 95% CI 1.63-9.75) and preference for a high salt diet (OR 2.58, 95% CI 1.56-4.26). The consumption of vegetables showed a protective effect with an odds ratio of 0.27 (95% CI 0.11-0.61). It follows that a developing economy and improvement in living standards, with associated increased intake of fruit and vegetables and reduced consumption of salt, can contribute to a reduction in the incidence of stomach cancer in the Linzhou population.