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2.
Lancet Oncol ; 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33556324

RESUMO

BACKGROUND: Screening for breast cancer and cervical cancer in the newly independent states of the former Soviet Union is largely opportunistic, and countries in the region have among the highest cervical cancer incidence in the WHO European Region. We aimed to compare the stage-specific distributions and changes over time in breast cancer and cervical cancer incidence in the newly independent states of the former Soviet Union. METHODS: We collected breast cancer and cervical cancer incidence data from official statistics from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, Ukraine, and Uzbekistan for the years 2008-17 by tumour, node, metastasis (TNM) stage, and by age where population-based cancer registry data were available. We used log-linear regression to quantify the changes over time in age-standardised rates. FINDINGS: During the period 2013-17, more than 50% of breast cancer cases across the analysed countries, and more than 75% of breast cancer cases in Belarus, Kazakhstan, and Ukraine, were registered at stages I-II. The proportion of stage I breast cancer cases was highest in the screening age group (50-69 years) compared with other ages in Moldova and the Russian registries, but was highest in those aged 15-49 years in Georgia and Ukraine. Breast cancer stage-specific incidence rates increased over time, most prominently for stage I cancers. For cervical cancer, the proportions of cancers diagnosed at a late stage (stages III and IV) were high, particularly in Moldova and Armenia (>50%). The proportion of stage I cervical cancer cases decreased with age in all countries, whereas the proportions of late stage cancers increased with age. Stage-specific incidence rates of cervical cancer generally increased over the period 2008-17. INTERPRETATION: Our results suggest modest progress in early detection of breast cancer in the newly independent states of the former Soviet Union. The high proportions of early-stage disease in the absence of mammography screening (eg, in Belarus) provide a benchmark for what is achievable with rapid diagnosis. For cervical cancer, there is a need to tackle the high burden and unfavourable stage-specific changes over time in the region. A radical shift in national policies away from opportunistic screening toward organised, population-based, quality-assured human papillomavirus vaccination and screening programmes is urgently needed. FUNDING: Union for International Cancer Control, WHO Regional Office for Europe, and Ministry of Health of Ukraine.

3.
Int J Cancer ; 2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33231289

RESUMO

Population-based cancer registries (PBCR) are the only means to provide reliable incidence and survival data as a basis for policy-making and resource allocations within cancer care. Yet less than 3% and 10% of the respective populations of Central America and South America are covered by high-quality cancer registries. The Global Initiative for Cancer Registry Development (GICR) provides support to improve this situation via the IARC Regional Hub for Latin America. In this paper, we summarize activities (advocacy, technical assistance, training and research) over the last five years, their impact and current challenges, including the implementation of new PBCR in four countries in the region. Despite the favorable political support to cancer registration in many countries, the sustainability of cancer registration remains vulnerable. Renewed efforts are needed to improve data quality in Latin America while ensuring maximum visibility of the data collected by disseminating and promoting their use in cancer control. This article is protected by copyright. All rights reserved.

4.
J Natl Cancer Inst ; 2020 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-32433739

RESUMO

The World Health Organization recently launched the Global Initiative for Childhood Cancer (GICC) aiming to substantially increase survival among children with cancer by 2030. The ultimate goal concerns particularly less developed countries where survival estimates are considerably lower than in high-income countries where children with cancer attain approximately 80% survival. Given the vast gap in high-quality data availability between more and less developed countries, measuring the success of the GICC will also require substantial support to childhood cancer registries to enable them to provide survival data at the population level. Based on our experience acquired at the International Agency for Research on Cancer in global cancer surveillance we hereby review crucial aspects to consider in the development of childhood cancer registration and present our vision on how the Global Initiative for Cancer Registry Development (GICR) can accelerate the measurement of the outcome of children with cancer.

5.
Int J Cancer ; 147(6): 1638-1648, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32150288

RESUMO

In May 2018, the World Health Organization (WHO) called for the elimination of cervical cancer. To monitor this initiative, we examined cervical cancer incidence and mortality in the Latin America and Caribbean (LAC) region using GLOBOCAN 2018, Cancer Incidence in Five Continents Series, and the WHO Mortality Database. We estimated the number of cases and age-standardized rates (ASRs) for cervical cancer incidence and mortality for 2018. We also presented the ASRs for recorded cervical cancer incidence from the period 2008 to 2012. We calculated annual rates and analyzed trends in cervical cancer incidence and mortality for all ages combined and for the following age groups: 0-29, 30-49, 50-64 and 65+. Finally, we calculated the estimated average annual percentage change in incidence and mortality rates for the past 10 years. In 2018, an estimated 56,000 new cervical cancer cases and 28,000 cervical cancer deaths occurred among women in LAC with great variations between subregions and countries/territories. Overall, trends in cervical cancer incidence and mortality have decreased over the past decade; however, the rates are still above the elimination threshold of 4 per 100,000 in most LAC countries/territories. Despite the encouraging trends observed, achieving the elimination of cervical cancer in the region still requests substantial political commitment and economic effort. Population-based cancer registries are critical in monitoring the elimination initiative.

6.
Int J Cancer ; 147(4): 978-989, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31922259

RESUMO

Trends in gallbladder cancer incidence and mortality in populations across the Americas can provide insight into shifting epidemiologic patterns and the current and potential impact of preventative and curative programs. Estimates of gallbladder and extrahepatic bile duct cancer incidence and mortality for the year 2018 were extracted from International Agency for Research on Cancer (IARC) GLOBOCAN database for 185 countries. Recorded registry-based incidence from 13 countries was extracted from IARCs Cancer Incidence in Five Continents series and corresponding national deaths from the WHO mortality database. Among females, the highest estimated incidence for gallbladder and extrahepatic bile duct cancer in the Americas were found in Bolivia (21.0 per 100,000), Chile (11.7) and Peru (6.0). In the US, the highest incidence rates were observed among Hispanics (1.8). In the Chilean population, gallbladder cancer rates declined in both females and males between 1998 and 2012. Rates dropped slightly in Canada, Costa Rica, US Whites and Hispanics in Los Angeles. Gallbladder cancer mortality rates also decreased across the studied countries, although rising trends were observed in Colombia and Canada after 2010. Countries within Southern and Central America tended to have a higher proportion of unspecified biliary tract cancers. In public health terms, the decline in gallbladder cancer incidence and mortality rates is encouraging. However, the slight increase in mortality rates during recent years in Colombia and Canada warrant further attention. Higher proportions of unspecified biliary tract cancers (with correspondingly higher mortality rates) suggest more rigorous pathology procedures may be needed after surgery.

7.
Salud Publica Mex ; 62(1): 96-104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31869566

RESUMO

OBJECTIVE: To briefly describe the process of establishment and preliminary results of the Mérida Population-based Cancer Registry (Mérida-PBCR). MATERIALS AND METHODS: Mérida-PBCR started in 2016 as a research project in the IMSS, with a gradual increase in its information sources. It covers a population of 908 536 inhabitants. Data collection is active and passive, international standards are used; CanReg5 software enables data entry, storage and analysis. RESULTS: Current data include 71.5% of sources. For the period 2015- 2016, a total of 2 623 new cancer cases were registered, the majority of these (60.1%) among females. 81.5% of the cases had morphological verification. Prostate (17.4%), colorectal (8.5%) and stomach (8.1%) cancers were the most common among males, and breast (31.6%), cervix (12%) and corpus uteri (7.6%) cancers, the most common among females. Ageadjusted cancer incidence rates (per 100 000) for all sites combined were 114.9 among males and 145.1 among females. CONCLUSIONS: The implementation of the Mérida-PBCR has followed particular parameters, with important efforts to include new information sources. Although the data are still preliminary and must be interpreted with great caution, the main cancers follow a similar pattern to that of the national and regional estimates.


Assuntos
Neoplasias/epidemiologia , Sistema de Registros/estatística & dados numéricos , Distribuição por Idade , Fatores Etários , Cidades/epidemiologia , Coleta de Dados/métodos , Coleta de Dados/normas , Feminino , Hospitais Privados/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Humanos , Incidência , Masculino , México/epidemiologia , Distribuição por Sexo , Software
8.
J Registry Manag ; 46(1): 15-18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31490917

RESUMO

Information on cancer stage at diagnosis is largely missing or poorly documented among population-based cancer registries in sub-Saharan Africa (SSA). In an early field trial of Essential TNM staging, it was observed that some training was needed to enable cancer registrars to abstract the correct TNM from case records. In November 2018, the Addis Ababa City Cancer Registry hosted a training course attended by 17 participants from 16 cancer registries in SSA. The participants were asked to stage 16 cancer cases (from anonymized photocopies of case records obtained from the Global Initiative for Cancer Registry Development) before and after the training. The discrepancy of the stages from before and after were scored and compared. Results showed that there was a substantial improvement in the participants' performance after the training. The application of the Essential TNM staging system, with training in its use, would allow cancer registrars in SSA to abstract cancer stage at diagnosis in a clinically recognized format, which is crucial for cancer control and public health care policy making.


Assuntos
Estadiamento de Neoplasias/normas , Neoplasias/classificação , Neoplasias/patologia , África , Avaliação Educacional , Humanos , Neoplasias/diagnóstico , Avaliação de Programas e Projetos de Saúde , Sistema de Registros
9.
Nat Rev Clin Oncol ; 16(12): 763-771, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31388125

RESUMO

Disease burden is the most important determinant of survival in patients with cancer. This domain, reflected by the cancer stage and codified using the tumour-node-metastasis (TNM) classification, is a fundamental determinant of prognosis. Accurate and consistent tumour classification is required for the development and use of treatment guidelines and to enable clinical research (including clinical trials), cancer surveillance and control. Furthermore, knowledge of the extent and stage of disease is frequently important in the context of translational studies. Attempts to include additional prognostic factors in staging classifications, in order to facilitate a more accurate determination of prognosis, are often made with a lack of knowledge and understanding and are one of the main causes of the inconsistent use of terms and definitions. This effect has resulted in uncertainty and confusion, thus limiting the utility of the TNM classification. In this Position paper, we provide a consensus on the optimal use and terminology for cancer staging that emerged from a consultation process involving representatives of several major international organizations involved in cancer classification. The consultation involved several steps: a focused literature review; a stakeholder survey; and a consultation meeting. This aim of this Position paper is to provide a consensus that should guide the use of staging terminology and secure the classification of anatomical disease extent as a distinct aspect of cancer classification.


Assuntos
Saúde Global/normas , Oncologia , Estadiamento de Neoplasias/métodos , Estadiamento de Neoplasias/normas , Neoplasias/patologia , Terminologia como Assunto , Centers for Disease Control and Prevention, U.S./normas , Compreensão , Consenso , Humanos , Internacionalidade , Oncologia/métodos , Oncologia/organização & administração , Oncologia/normas , National Cancer Institute (U.S.)/normas , Neoplasias/diagnóstico , Padrões de Prática Médica/normas , Prognóstico , Estados Unidos
10.
Salud Publica Mex ; 61(3): 219-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276337

RESUMO

OBJECTIVE: To present the most recent national estimates of lung cancer burden globally in 185 countries and tobacco smoking prevalence (%) by sex. MATERIALS AND METHODS: Estimates of lung cancer incidence and mortality for 2018 were extracted from the Globocan database; observed incidence, from the last volume of Cancer Incidence in Five Continents, and tobacco prevalence, from the World Health Observatory/WHO database. RESULTS: In 2018, over two million new lung cancer cases and 1.7 million deaths were estimated to occur worldwide, representing 14% of the new cancer cases and 20% of the cancer deaths. Incidence rates showed marked variation between countries. Stable or decreasing incidence rates were predominant among males, while among females increasing rates were common. CONCLUSIONS: The continuing rise in lung cancer among women reinforces the need for strengthening implementation of the preventive actions committed to by governments in the WHO Framework Convention for Tobacco Control.


Assuntos
Neoplasias Pulmonares/epidemiologia , Prevenção do Hábito de Fumar , Fumar/epidemiologia , Adolescente , Adulto , Feminino , Saúde Global , Humanos , Incidência , Masculino , Prevalência , Adulto Jovem
11.
Salud pública Méx ; 61(3): 219-229, may.-jun. 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1094459

RESUMO

Abstract: Objective: To present the most recent national estimates of lung cancer burden globally in 185 countries and tobacco smoking prevalence (%) by sex. Materials and methods: Estimates of lung cancer incidence and mortality for 2018 were extracted from the Globocan database; observed incidence, from the last volume of Cancer Incidence in Five Continents, and tobacco prevalence, from the World Health Observatory/WHO database. Results: In 2018, over two million new lung cancer cases and 1.7 million deaths were estimated to occur worldwide, representing 14% of the new cancer cases and 20% of the cancer deaths. Incidence rates showed marked variation between countries. Stable or decreasing incidence rates were predominant among males, while among females increasing rates were common. Conclusion: The continuing rise in lung cancer among women reinforces the need for strengthening implementation of the preventive actions committed to by governments in the WHO Framework Convention for Tobacco Control.


Resumen: Objetivo: Presentar las estimaciones nacionales más recientes de la carga del cáncer de pulmón a nivel mundial en 185 países y de prevalencia de tabaquismo (%) por sexo. Material y métodos: Las estimaciones de incidencia y mortalidad por cáncer de pulmón para el año 2018 se extrajeron de la base de datos Globocan, la incidencia observada del último volumen de Incidencia de Cáncer en Cinco Continentes y la prevalencia de tabaquismo del Observatorio Mundial de la Salud/OMS. Resultados: En 2018, se estimaron más de dos millones de nuevos casos de cáncer de pulmón y 1.7 millones de muertes a nivel mundial, que representan 14% de los casos nuevos y 20% de las muertes por cáncer. Las tasas de incidencia mostraron grandes variaciones entre países. En hombres, se observaron principalmente tasas de incidencia estables o decrecientes, mientras que en mujeres se observó con frecuencia un incremento. Conclusión: Los resultados en mujeres refuerzan la necesidad de fortalecer las acciones preventivas de los gobiernos en el Convenio Marco de la OMS para el Control del Tabaco.

12.
Cancer Causes Control ; 30(5): 489-499, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30895415

RESUMO

PURPOSE: Despite an increasing understanding of the pathology and genetics of non-Hodgkin lymphoma (NHL), global reports on variations in the incidence of NHL remain limited in their number and scope. METHODS: To provide a situation analysis, national incidence estimates for NHL in 185 countries for the year 2018 were obtained from the GLOBOCAN database. We also used recorded incidence data from Cancer Incidence in Five Continents (CI5) plus for years of diagnosis 1980-2012 to examine temporal trends. RESULTS: NHL ranked as the 5th to 9th most common cancer in most countries worldwide, with almost 510,000 new cases estimated in 2018. Observed incidence rates of NHL 2008-2012 varied markedly by world region: among males, rates were highest among Israel Jews [age-standardized (world) rate of 17.6 per 100,000), Australia (15.3), US whites (14.5), Canada (13.7), and Portugal (13.3)]. Where data were available, most populations exhibited stable or slightly increasing incidence rates; in North America, parts of Europe, and Oceania the rising incidence rates were generally observed until the 1990s, with a stabilization seen thereafter. CONCLUSION: Marked variations in NHL incidence rates remain in populations in each world region. Special attention should be given to further etiological research on the role of endemic infections and environmental exposures, particularly in Africa, Asia, and Latin America. To permit internationally comparable statistics, an equal focus on addressing the quality of hematological information in population-based registries is also warranted.


Assuntos
Saúde Global , Linfoma não Hodgkin/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
J Geriatr Oncol ; 10(5): 799-804, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30853302

RESUMO

OBJECTIVE: To describe the cancer burden in adults aged 65 years and older in Latin America and the Caribbean to serve as rational for improving cancer control planning among region's older population. MATERIALS AND METHODS: Using the up-to-date GLOBOCAN estimates for 2018, we describe the cancer burden including key patterns for the major cancer sites among adults aged 65 years and older in Latin America and the Caribbean. We also predict the future burden in 2040 by applying population projections, assuming no changes in incidence rates over time. RESULTS: In 2018, an estimated 679,000 new cancer cases occurred among older adults in LAC, representing almost half (48%) of the total incidence burden (43% in Central America, 49% in South America, and 52% in the Caribbean). Prostate, colorectum, and lung were the most common cancers among older males in South America and the Caribbean, with non-melanoma skin cancer ranking third in Central America. Among older females, the most common sites were breast, colorectum, and non-melanoma skin cancer, except in the Caribbean, where lung cancer ranked third. Overall, the number of new cancer cases among older adults in the region is expected to double by 2040, reaching 1.6 million new cases. CONCLUSION: Our findings highlight the need for an urgent adaptation of healthcare systems across LAC by improving training in geriatrics for the oncology workforce, and by including older adults in clinical guidelines, insurance schemes, and cancer prevention policies.


Assuntos
Expectativa de Vida , Neoplasias/epidemiologia , Dinâmica Populacional , Idoso , Idoso de 80 Anos ou mais , Região do Caribe , Neoplasias Colorretais/epidemiologia , Feminino , Planejamento em Saúde , Humanos , América Latina , Neoplasias Pulmonares/epidemiologia , Masculino , Neoplasias da Próstata/epidemiologia , Neoplasias Cutâneas/epidemiologia
14.
Lancet Oncol ; 20(2): e103-e111, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30712797

RESUMO

Accurate information on the extent of disease around the time of diagnosis is an important component of cancer care, in defining disease prognosis, and evaluating national and international cancer control policies. However, the collection of stage data by population-based cancer registries remains a challenge in both high-income and low and middle-income countries. We emphasise the lack of availability and comparability of staging information in many population-based cancer registries and propose Essential TNM, a simplified staging system for cancer registries when information on full Tumour, Node, Metastasis (TNM) is absent. Essential TNM aims at staging cancer in its most advanced disease form by summarising the extent of disease in the order of distant metastasis (M), regional lymph node involvement (N), and tumour size or extension, or both (T). Flowcharts and rules have been developed for coding these elements in breast, cervix, prostate, and colon cancers, and combining them into stage groups (I-IV) that correspond to those obtained by full TNM staging. Essential TNM is comparable to the Union for International Cancer Control TNM stage groups and is an alternative to providing staging information by the population-based cancer registries that complies with the objectives of the Global Initiative for Cancer Registry Development.


Assuntos
Estadiamento de Neoplasias/normas , Neoplasias/patologia , Sistema de Registros , Humanos , Metástase Neoplásica , Vigilância da População
15.
J Glob Oncol ; 4: 1-11, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30241165

RESUMO

The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer registries and have advanced significantly in pediatric cancer registration. The challenges common to each nation include the lack of national cancer control plans and departments, competing health priorities, lack of trained personnel, and sustainability strategies. General recommendations to address these challenges are outlined. The ongoing regional, international, and academic cooperation has proven helpful and is expected to continue to be a powerful instrument to contribute to the design and implementation of long-term national cancer control plans.


Assuntos
Confiabilidade dos Dados , Neoplasias/epidemiologia , América Central/epidemiologia , Efeitos Psicossociais da Doença , Demografia , Humanos , Incidência , Mortalidade , Neoplasias/prevenção & controle , Neoplasias/terapia , Prática Associada , Vigilância em Saúde Pública , Sistema de Registros
16.
J Glob Oncol ; 4: 1-11, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30241245

RESUMO

According to the Pan American Health Organization, noncommunicable diseases, including cancer, are the leading causes of preventable and premature death in the Americas. Governments and health care systems in Latin America face numerous challenges as a result of increasing morbidity and mortality from cancer. Multiple international organizations have recognized the need for collaborative action on and technical support for cancer research and control in Latin America. The Center for Global Health at the US National Cancer Institute (NCI-CGH) is one entity among many that are working in the region and has sought to develop a strategy for working in Latin America that draws on and expands the collaborative potential of engaged, skilled, and diverse partners. NCI-CGH has worked toward developing and implementing initiatives in collaboration with global partners that share the common objectives of building a global cancer research community and translating research results into evidence-informed policy and practice. Both objectives are complementary and synergistic and are additionally supported by an overarching strategic framework that is focused on partnerships and science diplomacy. This work highlights the overall strategy for NCI-CGH engagement in Latin America through partnerships and diplomacy, and highlights selected collaborative efforts that are aimed at improving cancer outcomes in the region.


Assuntos
Diplomacia , Cooperação Internacional , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Pesquisa , Animais , Financiamento de Capital , Saúde Global , Planejamento em Saúde , Humanos , América Latina/epidemiologia , Vigilância em Saúde Pública , Pesquisa/economia , Pesquisa/legislação & jurisprudência , Pesquisa/organização & administração
17.
Lancet Oncol ; 19(9): 1159-1169, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30098952

RESUMO

BACKGROUND: A deceleration in the increase in cancer incidence in children and adolescents has been reported in several national and regional studies in Europe. Based on a large database representing 1·3 billion person-years over the period 1991-2010, we provide a consolidated report on cancer incidence trends at ages 0-19 years. METHODS: We invited all population-based cancer registries operating in European countries to participate in this population-based registry study. We requested a listing of individual records of cancer cases, including sex, age, date of birth, date of cancer diagnosis, tumour sequence number, primary site, morphology, behaviour, and the most valid basis of diagnosis. We also requested population counts in each calendar year by sex and age for the registration area, from official national sources, and specific information about the covered area and registration practices. An eligible registry could become a contributor if it provided quality data for all complete calendar years in the period 1991-2010. Incidence rates and the average annual percentage change with 95% CIs were reported for all cancers and major diagnostic groups, by region and overall, separately for children (age 0-14 years) and adolescents (age 15-19 years). We examined and quantified the stability of the trends with joinpoint analyses. FINDINGS: For the years 1991-2010, 53 registries in 19 countries contributed a total of 180 335 unique cases. We excluded 15 162 (8·4%) of 180 335 cases due to differing practices of registration, and considered the quality indicators for the 165 173 cases included to be satisfactory. The average annual age-standardised incidence was 137·5 (95% CI 136·7-138·3) per million person-years and incidence increased significantly by 0·54% (0·44-0·65) per year in children (age 0-14 years) with no change in trend. In adolescents, the combined European incidence was 176·2 (174·4-178·0) per million person-years based on all 35 138 eligible cases and increased significantly by 0·96% (0·73-1·19) per year, although recent changes in rates among adolescents suggest a deceleration in this increasing trend. We observed temporal variations in trends by age group, geographical region, and diagnostic group. The combined age-standardised incidence of leukaemia based on 48 458 cases in children was 46·9 (46·5-47·3) per million person-years and increased significantly by 0·66% (0·48-0·84) per year. The average overall incidence of leukaemia in adolescents was 23·6 (22·9-24·3) per million person-years, based on 4702 cases, and the average annual change was 0·93% (0·49-1·37). We also observed increasing incidence of lymphoma in adolescents (average annual change 1·04% [0·65-1·44], malignant CNS tumours in children (average annual change 0·49% [0·20-0·77]), and other tumours in both children (average annual change 0·56 [0·40-0·72]) and adolescents (average annual change 1·17 [0·82-1·53]). INTERPRETATION: Improvements in the diagnosis and registration of cancers over time could partly explain the observed increase in incidence, although some changes in underlying putative risk factors cannot be excluded. Cancer incidence trends in this young population require continued monitoring at an international level. FUNDING: Federal Ministry of Health of the Federal German Government, the European Union's Seventh Framework Programme, and International Agency for Research on Cancer.


Assuntos
Neoplasias/epidemiologia , Adolescente , Distribuição por Idade , Idade de Início , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Neoplasias/diagnóstico , Sistema de Registros , Fatores de Risco , Fatores de Tempo , Adulto Jovem
18.
Cancer Epidemiol ; 55: 17-22, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29758490

RESUMO

BACKGROUND: Uruguay, a country with one of the highest lung cancer rates worldwide, initiated a series of comprehensive anti-smoking measures in 2005. We assess the tobacco control policies in the context of cohort-driven lung cancer incidence trends over a 25-year period, providing baseline predictions to 2035. METHODS: Using data from the National Cancer Registry of Uruguay, an age-period-cohort analysis of trends 1990-2014 was performed. The NORDPRED package was used to predict the annual number of new cases of lung cancer and incidence rates up to 2035. RESULTS: In men, age-standardised (world) rates declined from a peak of 165.6 in 1995 to 103.1 by 2014, translating to a 70% reduction in the risk of lung cancer in men born in 1970 relative to the early-1940s. In females, rates increased steadily from 18.3 in 1991 to 30.0 by 2014, with successive increases in risk among generations of women born 1940-1960. There is however evidence of a decline in observed rates in women born recently. Extrapolations of the trends indicate an 8% reduction in the mean number of new lung cancer cases in men by 2035, but a 69% increase in women. CONCLUSION: Despite observed and predicted reductions in lung cancer incidence in Uruguayan men, rates among women are set to continue to increase, with a large rise in the annual number of female lung cancer diagnoses expected before 2035. There are signals of a diminishing risk among recent generations of women born after 1960. The current analysis provides important baseline information in assessing the future impact of the recent tobacco control initiatives in Uruguay.


Assuntos
Neoplasias Pulmonares/epidemiologia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Uruguai/epidemiologia
19.
Lancet Haematol ; 5(1): e14-e24, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29304322

RESUMO

BACKGROUND: Leukaemia is a heterogeneous group of haemopoietic cancers that comprises a number of diverse and biologically distinct subgroups. We examine the leukaemia burden worldwide and highlight the distinct incidence patterns in order to elucidate explanatory factors that may support preventive measures and health resource planning. We aimed to estimate the global burden of leukaemia incidence according to the four major subtypes stratified by age and sex. METHODS: In this population-based study, we assessed leukaemia incidence for the major subtypes using the Cancer Incidence in Five Continents Volume X (CI5-X), which includes data from 290 cancer registries in 68 countries covering the diagnostic period 2003-07, for all ages and both sexes. We then extracted counts and incidence rates in 184 countries for the year 2012 from IARC's GLOBOCAN database of national estimates. We calculated age-specific incidence rates per 100 000 person-years and age-standardised rates (ASRs) using the world standard population by country, sex, age group, and where applicable, by major subtypes. We excluded from all analyses registries for which the total number of leukaemia cases was less than 100 or the proportion of microscopically verified (MV%) cases was less than 80% (2572 cases). FINDINGS: 717 863 cases between 2003-07 were included in this analysis. More than 350 000 new leukaemia cases were estimated in 2012. We observed substantial variation in incidence between and within world regions. The highest leukaemia incidence rates for both sexes were estimated in Australia and New Zealand (ASR per 100 000 11·3 in males and 7·2 in females), Northern America (10·5 in males and 7·2 in females), and western Europe (9·6 in males and 6·0 in females), and the lowest was in in western Africa (1·4 in males and 1·2 in females). Rates were generally higher in males than females with an overall male to female ratio of 1·4. In children, acute lymphoblastic leukaemia was the main subtype in all studied countries in both sexes, and characterised by a bimodal age-specific pattern. The subtype distribution was more diverse in adults, with a relatively higher proportion of chronic lymphocytic leukaemia in most European and North American countries, whereas rates of acute lymphoblastic leukaemia remained relatively high among adults in selected South American, Caribbean, Asian, and African populations. INTERPRETATION: Geographical disparities in leukaemia might partly be explained by quality of, and access to, health systems linked to resource levels, although there is probably a role for aetiological factors, including gene-environment interactions. The observed bimodal pattern could be due to different risk factors affecting different ages, and might include a genetic component. FUNDING: European Commission's FP-7 Marie Curie Actions-People-COFUND.


Assuntos
Leucemia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Internacionalidade , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Lancet Oncol ; 18(10): e573-e586, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28971824

RESUMO

Peru, like several other South American countries, is experiencing remarkable population growth, ageing, and urbanisation, which has given rise to profound changes in its epidemiological profile. Prostate and breast cancer are the most frequent cancers in men and women, respectively, in Lima and Arequipa, the two areas with population-based cancer registries. However, infection-associated cancers (cervix and stomach) are also common, and rank highest in the national cancer mortality profile. Although a foundation of surveillance informs cancer-control initiatives in Peru, improvements in the vital statistics system, and the quality and use of incidence data for the planning and assessment of cancer prevention and control actions, are needed. Existing population-based cancer registries in Lima and Arequipa, and linkages to the established national mandatory cancer reporting system, are crucial for the collection of high-quality data on national cancer incidence. The delivery of effective cancer prevention and control measures requires sustained investment in the collection of high-quality data capable of informing policies and driving research programmes.


Assuntos
Neoplasias/epidemiologia , Neoplasias/patologia , Sistema de Registros , Adulto , Distribuição por Idade , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Feminino , Previsões , Geografia , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Distribuição por Sexo , América do Sul/epidemiologia , Análise de Sobrevida
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