Population-based risk assessment of second primary cancers following a first head and neck cancer: patterns of association and difficulties of its analysis.

PURPOSE: The diagnosis of a second primary cancer (SPC) is a major concern in the follow-up of survivors of a primary head and neck cancer (HNC), but the anatomic subsites in the head and neck area are close, making it difficult to distinguish a SPC of a recurrence and therefore register it correctly. METHODS: We performed a retrospective cohort study using data from two population-based cancer registries in Catalonia, Spain: the Tarragona Cancer Registry and the Girona Cancer Registry. All patients diagnosed with HNC during the period 1994-2013 were registered and followed-up to collect cases of SPC. We analysed the standardized incidence ratio (SIR) and the excess absolute risk (EAR) to determine the risk of second malignancies following a prior HNC. RESULTS: 923 SPC were found in a cohort of 5646 patients diagnosed of a first head and neck cancer. Men had an increased risk of a SPC with a SIR of 2.22 and an EAR of 216.76. Women also had an increased risk with a SIR of 2.02 and an EAR of 95.70. We show the risk for different tumour sites and discuss the difficulties of the analysis. CONCLUSION: The risks of a SPC following a prior HNC in Tarragona and Girona are similar to those previously found in other similar cohorts. It would appear to be advisable to make a revision of the international rules of classification of multiple tumours, grouping the sites of head and neck area with new aetiological criteria to better determine and interpret the risks of SPC obtained in these studies.

A population perspective on the use of external beam radiotherapy in Catalonia, Spain.

PURPOSE: To assess the use of external beam radiotherapy in Catalonia (Spain), overall and by health management area. METHODS: We assessed radiotherapy treatments in a cohort of patients diagnosed with cancer from 2009 to 2011, using the population-based cancer registries in Girona and Tarragona. Participants had to have a minimum follow-up of 5 years from the time the cancer registry database was linked to the catalan health service database for financing radiation oncology. Outcomes included the proportion of patients receiving radiotherapy within 1 and 5 years of diagnosis. A log-binomial model was used to assess age-related trends in the use of radiotherapy by tumour site. Finally, we calculated the standardized utilization rate and 95% confidence intervals by health management area covered by the radiation oncology services, using indirect methods. RESULTS: At 1 and 5 years from diagnosis, 21.4 and 24.4% of patients, respectively, had received external beam radiotherapy. Patients aged 40-64 years had the most indications for the treatment, and there was a negative correlation between the patients' age and the use of radiotherapy for most tumour sites (exceptions were cervical, thyroid, and uterine cancers). There were no statistically significant differences in the use of radiotherapy according to th health management area. CONCLUSIONS: Population-based data show that external beam radiotherapy is underutilized in Catalonia. This situation requires a careful analysis to understand the causes, as well as an improvement of the available resources, oriented toward achieving realistic targets for the optimal use of external beam radiotherapy in our country.

Influence of source and ratio of xanthophyll pigments on broiler chicken pigmentation and performance.

One experiment was conducted using 960 1-d-old, sexed broilers of Ross 308 strain from 1 to 43 d to evaluate if one type of chemically isomerized marigold with 25% of xanthophylls as zeaxanthin (SME-25) could produce pigmentation equivalent to the current addition of conventional marigold with 10% of xanthophylls as zeaxanthin (SME-10) plus canthaxanthin (CTX) in practical broiler diets (maize-wheat-soybean). Birds were allocated in 32 pens, in a randomized complete block design (four blocks x four treatments). The treatments consisted of a nonpigmented control (T1), a combination of 35 ppm of yellow xanthophylls (YX) from SME-10 + 5 ppm of CTX (T2), a combination of 32 ppm of YX from SME-10 + 2 ppm of CTX (T4), and one treatment with 40 ppm of YX from a new SME-25 (T3). There were no significant treatment effects on chicken performance. All color parameters (Minolta coordinates, Roche color fan scores, Rank test) presented significant differences (P < 0.0001) because of dietary pigments on shanks and breast skin. Birds fed the SME-25 diet had less pigmentation than those fed equivalent quantities of a combination of SME-10 + CTX. The Minolta coordinate "b" measured in breast skin was a good indicator of YX content in feed, whereas the "a" coordinate measured on the shank showed a linear relationship with the dietary CTX level (r = 0.61, P < 0.0001). The same visual color classification of chickens was achieved irrespective of the rank test performed (by shank or carcass color). Lutein and zeaxanthin from the SME-25 product had lower deposition rates in skin and fat tissues than those from the SME-10 product. This finding seems to be related to the ratio of zeaxanthin stereoisomer RR (optically active) vs. RS that was found in tissues from the SME-10 product (97.8%:2.2%), whereas with SME-25 this ratio was 16.0:84.0%. These results suggest that inclusion of only the SME-25 product could not replace the current addition of SME-10 and CTX combinations.

The supplementation of low-P diets with microbial 6-phytase expressed in Aspergillus oryzae improves P digestibility in sows.

Two trials were conducted to evaluate a novel microbial 6-phytase expressed in Aspergillus oryzae (Ronozyme HiPhos; DSM Nutritional Products, Basel, Switzerland) in gestating and lactating sows. In the first trial, 24 sows (Duroc × Landrace; 223 kg BW) were offered, at 16 d of gestation, a low-P control diet (formulated to provide 4.0 g total P/kg; 1.5 g digestible P/kg) supplemented with 0, 500, or 1000 phytase activity (FYT)/kg of phytase. Two weeks later, fresh feces were sampled from all sows and the apparent total tract digestibility of P was measured using TiO(2) as indigestible marker. Phytase supplementation did not (P > 0.10) affect the total tract digestibility of P but reduced (P < 0.05) P concentration in feces (from 14.5 to 12.0 and 12.0 g/kg DM). In the second trial, 32 lactating sows (Duroc × Landrace; 282 kg BW) were used. They were offered, at 7 d of lactation, a low-P control diet (formulated to provide 6.1 g total P/kg; 3 g digestible P/kg) or the same diet supplemented with 500 FYT/kg of phytase. After 2 wk, fresh feces were sampled from all sows and the apparent total tract digestibility of P was measured using TiO(2) as indigestible marker. Phytase supplementation improved (P < 0.001) the apparent total tract digestibility of P from 27.5 to 38.7% and reduced (P < 0.001) P concentration in feces (from 27.5 to 21.4 g/kg DM). In conclusion, the microbial 6-phytase tested increased the apparent total tract digestibility of P in sows and reduced P excretion in feces.

Performance, breast meat yield and abdominal fat deposition of male broiler chickens fed diets supplemented with DL-methionine or DL-methionine hydroxy analogue free acid.

1. An experiment was conducted to compare the relative bioefficacy of DL-methionine hydroxy analogue free acid (DL-MHA-FA) with DL-methionine in broiler chickens. Responses used for comparison were weight gain and food efficiency between 7 and 35 d of age, and breast meat deposition, food cost per kg of breast meat, and abdominal fat at 41 d of age. 2. A total of 2160 seven-day-old male broiler chicks were used. The feeding programme consisted of a starter diet from 7 to 21 d, and a finisher diet till the end of the experiment. The starter basal diet contained 6.1 g/kg total sulphur-containing amino acids (TSAA), and an estimated metabolisable energy (ME) content of 13.2 MJ/kg. The finisher diet contained 5.8g/kg TSAA and an estimated ME content of 13.6 MJ/kg. Four concentrations of DL-methionine and DL-MHA-FA were added at 0.5 g/kg increments on an equimolar basis. Therefore, there were 9 experimental treatments which were each applied to 6 replicates of 40 chicks. Weight gain and food efficiency were determined at 35 d of age. Breast yield and carcase fat were measured at 41 d. 3. Significant responses to graded amounts of both methionine sources were observed in weight gain, food efficiency, breast meat percentage, and food cost per kg of breast meat. The responses fitted exponential regression curves. Based on the regression coefficients, equimolar bioefficacy of DL-MHA-FA relative to DL-methionine was 80% for daily gain, 83% for food efficiency, 51% for breast meat yield, and 66% for food cost per kg of breast meat. Differences between the 2 sources were significant (P < 0.05) for breast meat yield and food cost per kg of meat and (P < 0.10) for food efficiency.