RESUMEN
Data on 15,399 adolescents diagnosed with cancer at age 15-19 years during 1978-1997 in Europe were extracted from the database of the Automated Childhood Cancer Information System (ACCIS). Total incidence in Europe as a whole was 186 per million in 1988-1997. Incidence among males was 1.2 times that among females. Lymphomas had the highest incidence of any diagnostic group, 46 per million, followed by epithelial tumours, 41 per million; central nervous system (CNS) tumours, 24; germ cell and gonadal tumours, 23; leukaemias, 23; bone tumours, 14; and soft tissue sarcomas, 13 per million. Total incidence varied widely between regions, from 169 per million in the East to 210 per million in the North, but lymphomas were the most frequent diagnostic group in all regions. Cancer incidence among adolescents increased significantly at a rate of 2% per year during 1978-1997. Five-year survival for all cancers combined in 1988-1997 was 73% in Europe as a whole. Survival was highest in the North, 78%, and lowest in the East, 57%. Five-year survival was generally comparable with that in the Surveillance, Epidemiology, and End Results (SEER) registries of the United States of America (USA), but for Ewing's sarcoma it was below 45% in all European regions compared with 56% in the USA. Survival increased significantly during 1978-1997 for all cancers combined and for all diagnostic groups with sufficient registrations for analysis.
Asunto(s)
Bases de Datos Factuales/estadística & datos numéricos , Neoplasias/epidemiología , Adolescente , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , Masculino , Neoplasias/mortalidad , Sistema de Registros/estadística & datos numéricos , Características de la Residencia , Análisis de SupervivenciaRESUMEN
OBJECTIVE: To evaluate the early and long-term results after surgery for primary pulmonary sarcomas (PPS) and to compare them with those of patients with pulmonary carcinosarcomas (PCaSa). METHODS: During a 20-year period, 48 patients with PPS and 15 patients with PCaSa underwent surgery. There were 40 males and 23 females with a mean age of 52.1 years (range 13-78). The histologic diagnoses in PPS group were fibrosarcoma (15), fibroleiomyosarcoma (10), leiomyosarcoma (6), rhabdomyosarcoma (6), hemangiopericytoma (3), epitheloid hemangioendothelioma (3), malignant schwannoma (1), liposarcoma (1) and undifferentiated sarcoma (3). The following curative resections were carried out: lobectomy (36), including two sleeve lobectomies (in PPS group), pneumonectomy (15) and polysegmental resections (4). In four PPS cases, these procedures were extended to the thoracic wall, diaphragm or pericardium. An atypical resection was applied in one PPS patient (the tumor was falsely classified as benign on frozen section examination). Exploratory thoracotomy was performed in five of PPS patients (11%) and in two of those with PCaSa (13%). The majority of PPS patients were with low stages I and II (76%). The PCaSa patients were predominantly with stage IIIA (39%). RESULTS: No postoperative death was registered. Major complications included two localized empyemas (4.2%) in PPS and one reoperation for bronchial stump fistula (6.7%) in PCaSa groups. Local recurrences were operated on in one patient per group (2.1 and 6.7%, respectively). Follow-up was available on 57 patients and ranged from 4 to 148 months. The overall cumulative 5-year survival was 48.81% for PPS and 49.38% for PCaSa patients (P=0.9035). It was better in low vs. higher stage cases, statistically significant in PPS group (P=0.0005) and without significant difference in PCaSa cohort (P=0.11). CONCLUSIONS: Complete resection of PPS and PCaSa favors an acceptable survival, especially in low stages. There is no significant difference in the survival rates between PPS and PCaSa patients, despite the greater number of cases with higher stages in PCaSa group.
Asunto(s)
Neoplasias Pulmonares/cirugía , Sarcoma/cirugía , Adolescente , Adulto , Anciano , Carcinosarcoma/mortalidad , Carcinosarcoma/cirugía , Diafragma/cirugía , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Pulmón/cirugía , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Morbilidad , Pericardio/cirugía , Neumonectomía , Reoperación , Sarcoma/mortalidad , Tasa de Supervivencia , Pared Torácica/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Bulgaria has undergone considerable social changes in the last 40 years, including a transition from a 75% rural to a 75% urban population. These changes might be expected to be reflected in disease rates. The Bulgarian cancer registry has computerized data on cancer incidence throughout the country from 1981 onwards. METHODS: Incidence rates in Bulgaria from 1981 to 1990 of cancers of the lung, stomach, large bowel, prostate and bladder in males and of cancers of the breast, lung, stomach, large bowel, cervix and corpus uteri in females were analysed with particular attention to time trends, age-specific changes in rates and urban/rural differences. Poisson regression was used for statistical analysis. RESULTS: Male rates of cancers of the lung, large bowel, prostate and bladder increased significantly over the period, with average annual increases of 0.4%, 2.9%, 1.3% and 2.3% respectively. In females, rates of cancers of the breast, cervix and corpus uteri increased significantly, with average annual increases of 1.3%, 1.9%, and 2.9%. In both sexes, stomach cancer incidence declined significantly, by 3.0% per year for males and 3.6% per year for females. Rural rates were lower than urban rates for most cancers, particularly in the higher age groups. The decline in male stomach cancer rates was confined to rural areas. The increases in rates of lung cancer and prostate cancer in males and of colorectal cancer and breast cancer in females were most rapid in urban areas. CONCLUSIONS: Substantial changes in rates of various cancers have taken place from 1981 to 1990, in particular increases in rates of breast cancer and large bowel cancer in women resident in urban areas. It is suggested that dietary changes may be responsible for some of these changes.
Asunto(s)
Neoplasias/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Bulgaria/epidemiología , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Sistema de Registros/estadística & datos numéricos , Población Rural , Distribución por Sexo , Población UrbanaRESUMEN
The age- and residence-specific incidence rates of prostate cancer in Bulgaria have been studied for a fifteen-year period (1967-1981). Actual and standardized incidence and the cumulative incidence rates and risk have been determined and the secular trend of the standardized incidence rates has been defined by a linear regressive model. It has been found out that 90 percent of the new cases were over 60 years of age. The urban population was more strongly affected by the disease than the rural one, but the upward of the incidence rates was more pronounced among the latter. The annual increase in the incidence rates was 0.11 +/- 0.06 per 100,000 men. The risk of prostate cancer to the male population (cumulative risk) from 0 to 84 years of age was 2.54 percent, i.e. one out of forty men was at risk. The incidence rates were significantly higher in these districts of the country, where the largest and the most strongly industrialized towns were concentrated. The study gives the possibility to determine some characteristics of the incidence rates of prostate cancer in Bulgaria and hence to assess the efficiency of cancer control and to formulate some of its future trends.