Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015.

BACKGROUND: Melanoma is a significant health problem in Caucasian populations. The most recently available data from cancer registries often have a delay of several months up to a few years and they are generally not easily accessible. OBJECTIVES: To assess recent age- and sex-specific trends in melanoma incidence and make predictions for 2010 and 2015. METHODS: A retrospective registry-based analysis was performed with data from 29 European cancer registries. Most of them had data available from 1990 up to 2006/7. World-standardized incidence rates (WSR) and the estimated annual percentage change (EAPC) were computed. Predictions were based on linear projection models. RESULTS: Overall the incidence of melanoma is rapidly rising and will continue to do so. The incidence among women in Europe was generally higher than in men. The highest incidence rates were seen for Northern and north-western countries like the UK, Ireland and the Netherlands. The lowest incidence rates were observed in Portugal and Spain. The incidence overall remained stable in Norway, where, amongst young (25-49 years) Norwegian males rates significantly decreased (EAPC -2.8, 95% CI -3.6; -2.0). Despite a low melanoma incidence among persons above the age of 70, this age group experienced the greatest increase in risk during the study period. CONCLUSIONS: Incidence rates of melanoma are expected to continue rising. These trends are worrying in terms of disease burden, particularly in eastern European countries.

Tobacco-related tumours of the lung, bladder and larynx: changes in Spain.

The association between tobacco use and lung cancer and other tumours has been confirmed by a large number of studies. In Spain, the prevalence of smoking has been declining since 1978. This study describes lung, bladder and laryngeal cancer mortality and incidence rates and their trends in Spain. Mortality data were furnished by the National Statistics Institute (2001-07) and incidence data by population-based cancer registries (1975-2004). Changes in rates were calculated using Poisson regression models, which enable trend changes to be estimated. In the case of lung cancer, mortality rates decreased among men [annual percentage change (APC) -1.3%] though not among women (APC 3.5%), whereas incidence rates increased in both sexes, overall and adjusted for registry, by 0.75% among men and 3.2% among women. Bladder cancer mortality rates decreased among men (APC -1.2%) and women (APC -0.8%), yet incidence rates increased across the sexes. While laryngeal cancer mortality rates decreased among men (APC -5.5%) and women (APC -0.03%) alike, incidence rates decreased (-1.28%) among men but not among women (3.95%). A decrease in male versus female mortality due to tobacco-related tumours is evident in Spain. Incidence rates are beginning to reflect the progressive cessation of smoking that has been observed among men rather than women.

Trends in oesophago-gastric cancer incidence in Spain: analysis by subsite and histology.

BACKGROUND: During recent decades, an increase in the incidence of certain oesophago-gastric cancer subtypes has been reported in some countries. This study sought to analyse oesophageal and gastric cancer incidence trends in Spain by sex, site and morphology for the period 1980-2004. PATIENTS AND METHODS: Oesophageal and gastric cancer cases were drawn from 13 Spanish population-based cancer registries. Time trends in sex- and age-standardised cancer incidence rates were analysed by subsite and histology over the study period, using change-point Poisson models. RESULTS: Age-standardised oesophageal cancer incidence rates failed to register a significant trend over the study period. Overall, gastric cancer decreased from 27.21 and 13.44 cases per 100,000 person-years in 1980-84 to 20.21 and 8.68 in 2000-04, among men and women, respectively. Whereas oesophageal adenocarcinomas increased by approximately 5% per annum in both sexes, gastric cardia cancer increased during the study period in males only, though this increase was less pronounced. Among men, oesophageal squamous cell cancer and non-cardia cancer rates declined steadily from the mid-1980s onwards. Over the same period, there was a marked decrease in the incidence of oesophago-gastric cancer presenting with unspecified subsite or morphology. CONCLUSIONS: Changes in the prevalence of the main risk factors for these tumours might only partly explain oesophageal and gastric cancer rate trends by subtype. Reclassification, however, would appear to account for most of the divergence in oesophageal and gastric cancer trends by subtype over the study period.

A comparative analysis of cancer prevalence in cancer registry areas of France, Italy and Spain.

A comparative analysis of cancer prevalence in France, Spain and Italy is presented as part of the EUROPREVAL project. The three countries are culturally and sociologically relatively homogeneous compared with Europe as a whole. However, in all three countries, the cancer registries (CRs) providing the data for prevalence calculation cover only small fractions of the populations, and have been operating for relatively short periods. This leads to problems of representativity and to prevalence underestimates as surviving cases diagnosed before operation of the CR are not recorded. Partial prevalences obtained directly from CR data were therefore corrected using a completeness index obtained by modelling to provide estimates of the complete prevalence. For CRs operating for only 5 years, only approximately half the prevalence was observed. Thus, due to the rather recent start of most of southern European CRs, the role of correction is very important. The prevalence of all cancers was highest in Italy for women and in France for men, while lowest in Spain. Differences in the age structures of the populations were the major cause of these discrepancies and after age adjustment only the prevalence of stomach cancer remained highest in Italy, although differences in incidence also contributed to the prevalence differences. Survival varied little between the three countries and differences in incidence are more important determinants of prevalence. Prevalence of cancer in the elderly represents an increasing load for the community, particularly for France, Italy and Spain due to the ageing population in these countries. Elderly patients with cancer frequently suffer from problems of co-morbidity and disability factors, thus placing a burden on the local medical system where this proportion is high. Prevalent cases diagnosed 1-5 years before the prevalence date formed approximately one-third of the total prevalence, with higher proportions for melanoma, and prostate cancer in males and breast and colorectal cancer in females, and lower proportions for uterine cancer. This subset of the prevalent population consists of those probably on intensive follow-up, or being treated for cancer recurrence or sequelae to primary therapy.

Epidemiological aspects of oral and pharyngeal cancers in the Basque Country.

Oral and pharyngeal cancer is an entity constituted by a group of tumours that arise in several heterogeneous anatomical sites, and for this reason it is difficult to establish comparisons. The aim of the study was to describe the characteristics of oropharyngeal cancer in the Basque Autonomous Community (BAC), to learn the incidence rate and to establish comparisons. Data of cases are from the Basque Country Cancer Registry for the period 1986-1994, and the methodology used is descriptive. We included 2548 cases, and the sex ratio was 7.4:1. Diagnosis was made by histology in most cases (99%). The crude incidence rate was 24.1/100,000 population for men and 3.1/100,000 for women. Higher incidence rates were found in the tongue (6.6), lip (5.8) and oropharynx (4.9). No variation was found in the incidence during the period. In comparison with other Spanish registries, there is a high incidence in men of cancer in the oral cavity. The results obtained show the characteristics of oral and pharyngeal cancer in the BAC and its magnitude, highlighting the importance of future preventive actions.