Demographic characteristics of patients with laryngeal cancer and their socioeconomic status.

PURPOSE: To define demographic characteristics of patients with laryngeal cancer in central Serbia, and to investigate possible relationships between their socioeconomical status and the appearance of laryngeal cancer. METHODS: 100 patients (cases) with histologically verified laryngeal cancer were investigated. The control group consisted of 100 patients (controls) having no cancer. A questionnaire was filled in by both cases and controls and comparison between the groups was carried out by individual matching of demographic characteristics and socioeconomical status. RESULTS: 91% of the cases and controls were male (mean age 60 years). Most of the cases had lower educational level and poorer socioeconomical status compared to controls, whilst no difference was found between the 2 groups concerning their living in urban or rural environment. CONCLUSION: It was not possible to correlate urban environment (air pollution) as risk factor. People of lower educational level and poor socioeconomical status had increased risk of getting laryngeal cancer.

Hemorrhagic fever with renal syndrome in Montenegro.

The objective of the study was to analyze the epidemiological features of hemorrhagic fever with renal syndrome (HFRS) in Montenegro. The study included 169 cases of HFRS diagnosed in the period between 1995 and 2005 according to the clinical symptoms and serological confirmation. For the analysis of the demographic characteristics of the cases, as well as of the chronological and topographical features of the disease, a descriptive epidemiological method was employed. The average incidence rate in the observed period was 2.6 per 100,000. In the observed period, 8 people died; the average case fatality rate was 4.8% (range: 0.1-15%). Among the diseased persons, 116 were males and 53 were females; most of the cases were adults. The greatest number of HFRS cases occurred during the summer months. The highest incidence rates were registered in the northeastern, rural part of the country. The most frequent type of hantaviruses in Montenegro were Dobrava-Belgrade and Hantaan, carried by rodent species, i.e., the yellow-neck mouse and the striped-field mouse. It is likely that HFRS in Montenegro will become more common in the near future, unless public health control measures are taken.

[Primary liver cancer mortality in Belgrade population]. / Mortalitet od primarnih malignih tumora jetre u populaciji Beograda.

The aim of this analysis was to estimate death rates for primary liver cancer (PLC) and their secular trends in the population of Belgrade during the period 1982-2001. Mortality data (number of deaths caused by PLC) in Belgrade were obtained from the Belgrade Municipal Institute of Statistics (unpublished data). Death rates per 100,000 population were adjusted by direct method using world population as a standard. Regression coefficient was assessed by Fisher's test., Average annual age-adjusted mortality rate for PLC in Belgrade was 5.7/100,000 (95%CI-confidence interval 5.3-6.0), for males 7.5/100,000 (95%CI 7.0-7.9), and for females 4.2/100,000 (95%CI 3.8-4.7). The lowest mortality for PLC was in the age up to 45 (bellow 1/100,000) for both sexes, and the highest values were registered in the age group over 75, 71.1/100,000 (95%CI 62.2-84.0) for males, and 52.9/100,000 (95%CI 45.6-60.3) for females. Mortality trends for PLC in Belgrade in the period 1982-2001 showed increasing tendency in males (y=7.079+0.039x, p=0.331) and decreasing tendency in females (y=4.747-0.048x, p=0.199).

The pattern of lung cancer mortality in Montenegro.

The aim of the study was to examine recent lung cancer mortality trends in Montenegro in the period 1976-2000, with special emphasis on correlation with tobacco consumption. A population-based study analysing lung cancer mortality in Montenegro in the period 1976-2000 was carried out. Mortality rates were adjusted by direct method. A cohort analysis of age-specific death rates was performed. The analysis of tobacco consumption (cigarettes consumption per capita) was based on the official data for the period 1965-1990. Linear regression coefficients in a time trends analysis of mortality rates and tobacco consumption were assessed using Fisher's test. The highest average standardized lung cancer mortality rates in Montenegro increased in each successive five-year period for both sexes from 1976 to 2000, with highest values in the last five years (1996-2000). In males the death rate has almost doubled, and in females it was nearly three-fold higher. In the cohort analysis of age-specific death rates, all age groups in the birth cohort born before 1911 had a higher lung cancer mortality risk than those in the birth cohort comprising those born between 1912 and 1931. The rates showed an increasing tendency in all age groups irrespective of sex, except in males in the 25-44 age group. The time analysis of lung cancer mortality rates for the period 1976-2000, revealed annual changes of 3% for males and 6.6% for females, respectively. During the period observed the consumption of cigarettes increased by 98.2% (from 1.064 kg per capita in 1965 to 2.109 kg per capita in 1990). The significant increasing tendency in cigarette consumption was registered (y=1.10+0.05x, P=0.001). A significant correlation between lung cancer mortality rates and cigarette consumption is also observed (r=0.427, P=0.037). Smoking trends up to the 1990s in Montenegro, indicate that one can expect lung cancer mortality rates to continue to increase in males but even more so in females.

Mortality trends of malignant tumours of digestive organs in Belgrade, Yugoslavia, 1975-1997.

AIM: To analyse mortality trends of malignant digestive tract tumours. MATERIAL AND METHODS: Population of Belgrade (Yugoslavia) in the period 1975-1997. Mortality rates were standardized by direct method using world population as the standard. For time series, exponential trends were calculated by the use of three-year moving average rates. RESULTS: In males, the highest mortality rate was for stomach cancer: 14. 6 per 100,000 (average for the period 1975-1997), followed by cancer of liver and cancer of colon: 8.4/100,000, cancer of rectum: 8.1/100,000, cancer of pancreas: 7.3/100,000, oesophageal cancer: 2.8/100,000 and gallbladder cancer: 2.0/100,000. In males, upward mortality trends for carcinomas of colon, rectum, pancreas, oesophagus, gallbladder and bile ducts were observed. The mortality rates series for stomach cancer and liver cancer did not fit any usual trend function. In females, the highest mortality rate was also for stomach cancer 7.7 per 100,000, then for cancer of colon: 6.0/100,000, cancer of rectum: 5.3/100,000, cancer of liver: 4.4/100,000, cancer of pancreas: 4.4/100,000, gallbladder cancer 3.4/100,000 and oesophageal cancer: 0.8/100,000. In females, upward mortality trends were observed for colon and rectal cancer, cancer of pancreas, and gallbladder and bile duct cancer. Downward mortality trends were present for stomach cancer and liver cancer. Mortality rates series for oesophageal cancer did not fit any usual trend function. CONCLUSIONS: In the majority of digestive tracts cancers, an upward mortality trend was observed which is in keeping with the mortality trends of these malignant tumours in many other countries.

Tuberculosis trends in Central Serbia in the period 1956-1996.

OBJECTIVE: To estimate tuberculosis incidence and mortality trends in Central Serbia (excluding Kosovo and Vojvodina provinces) in the period 1956-1996. DESIGN: The incidence and mortality data of tuberculosis in Central Serbia in the period 1956-1996 were analysed based on the annual reports of the Institute for Lung Diseases and Tuberculosis in Belgrade and the official data of the Republic Health Institute. RESULTS: During the period under observation, tuberculosis incidence decreased from 324.0 to 34.8/100 000 population, fitting the exponential model (y = 389.066e-(0.0689); F = 847.60; P = 0.000). Mortality rates decreased from 76.0 in 1956 to 0.9/100000 in 1982. Over the whole period (1956-1996) the decrease in mortality rates fitted the exponential model (y = 66.83e-(0.0922); F = 150.95; P = 0.000). The increase in mortality rates in the period 1982-1996 fitted cubic model (y = 7.647 - 2.674x + 0.359x(2)-0.013x(3); F = 12.17; P = 0.001). CONCLUSION: Decreasing trends in tuberculosis incidence are the result of good control programmes. Changes in mortality trends are related to migration from war zones and poor economic conditions which hinder the detection and treatment of tuberculosis.

[Mortality due to malignant tumors in children and adolescents in Belgrade 1980-1993]. / Mortalitet od malignih tumora kod dece i adolescenata u Beogradu od 1980. do 1993. godine.

In the period 1980-1993, in Belgrade, malignant tumors of the age group up to 24 years were 1.2% of the mortality structure of all cancers. The average standardized mortality rate (world standard population) of all cancers was 7.0 per 100,000 with a decreasing trend. In childhood and adolescence period, hematological malignancies (42.0%), brain tumors (23.0%) and soft tissue and bone tumors (10.5%) were the most frequent cancers for the observed period. The average standardized mortality rates for leukemia was 1.1/100,000, for non-Hodgkin's lymphomas 0.2/100,000 and -1.7/100,000 for Hodgkin's disease. The elevated mortality rates were registered for leukemia and non-Hodgkin's lymphomas, whereas a marked decreasing trend was present for Hodgkin's disease. For brain malignant tumors and soft tissue and bone tumors, a decreasing mortality rates were also observed.

[Mortality in Serbian males from the most common malignant tumors]. / Smrtnost muskaraca u Srbiji od najcescih malignih tumora.

The frequency and distribution of mortality of men in Serbia caused by the most frequent malignant tumors in the period from 1982. to 1991., were shown. Data were taken from the Republic Statistic Center. For the evaluation of the situation the descriptive epidemiological method was used. In that period men mostly died from lung, stomach, prostate, liver, rectum, pancreas, larynx, colon, brain and urinary bladder cancer. In the same period the mortality increase was observed in lung cancer, rectum, pancreas, colon, urinary bladder, brain, larynx and liver. For the cancer of prostate and stomach the decrease of mortality was noticed.

[Mortality in the most common malignant tumors in women in Serbia]. / Smrtnost od najcescih malignih tumora zena u Srbiji.

The incidence and mortality rate due to the most common malignant tumors in women in Serbia 1982-1991 were presented. Records from the Republic Institute of Statistics were used as the source of data. Descriptive method was used in epidemiological analysis. Within the period 1982-1991, women in Serbia had died most frequently due to malignant tumors of breast, lung, cervix, rectum, liver, colon, ovary, pancreas and uterine body. Tendency towards increased mortality rate due to the cancer of the breast, cervix, ovary, pancreas, rectum and colon has been registered in this period. Reduced mortality rate was observed in the cancers of uterine body, liver and stomach.

History of tonsillectomy and appendectomy in Hodgkin's disease.

The study comprised all 113 clinically and histologically confirmed cases of Hodgkin's disease aged 15-39 years who were treated at the Department of Hematology of the Faculty of Medicine in Belgrade from January, 1 to June, 30, 1987. For each patient, two individually matched controls were selected. Neighbourhood controls were the first neighbours of the same sex, age, and residence history. Hospital controls consisted of accidentally injured individuals, and they were matched in terms of sex, age, place of residence, and educational level. Comparison of cases and controls revealed that removal of the lymphoid tissue (either tonsils or appendix) did not affect the risk of developing Hodgkin's disease in any way. An association found by some previous studies has been explained by the confounding effect of socioeconomic status.

HIV seropositivity in a Yugoslav prison population.

An estimated number of HIV infected individuals in Yugoslavia might be about 3000. I.v. drug users are by far the most affected population group. Prevalence of HIV seropositivity among imprisoned drug users in Belgrade approaches 50%. An effective control of unvoluntary homosexual contacts in prisons is not feasible. Having in mind a moral obligation of the society to preserve the health of its confined members, we advocate the right of (voluntary or on request screened) HIV seronegative individuals to chose to share the cell with inmates shown to be HIV seronegative as well.

Balkan nephropathy and malignant tumors.

The question of whether the cancer death risk is higher in Balkan nephropathy (BN) foci has been approached by a comparison of 25 BN endemic municipalities with the same number of the group matched ones. It came out that the total cancer mortality was considerably higher, and mortality of nonurinary cancer slightly higher in BN endemic municipalities. The absence of a significant difference for the non-urinary cancer sites the authors explain by the fact that in municipalities designated as endemic only a part of the population lived in actual BN foci. They re-evaluated data published for Bulgarian BN endemic foci and concluded that, apart of a higher total cancer mortality, there was a significantly higher (although unrecognized) risk of nonurinary deaths in BN endemic settlements.

Attitudes of medical students in Belgrade, Yugoslavia, toward preventive medicine and epidemiology.

Medical students in Belgrade were interviewed regarding their opinions about the teaching of preventive medicine, with particular emphasis on epidemiology, at the beginning and at the end of the course. Results indicated that the course provoked no interest whatsoever in the disciplines of preventive medicine. A part of social factors influencing the motivation of students, the didactic approach to teaching and the strict division between preventive and clinical medicine were implicated as the main reasons for this lack of enthusiasm. The absence in this country of clear and generally accepted ideas regarding what a graduate student should know in order to meet optimally the health needs of the community has been assessed as the factor which obscures definition of the aims of teaching and, accordingly, the creation of purposeful syllabuses.