RESUMO
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.
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Neoplasias/radioterapia , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Intervalos de Confiança , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Radioterapia/estatística & dados numéricos , Espanha/epidemiologia , Tempo para o TratamentoRESUMO
INTRODUCTION: Pediatric central nervous system tumors are one of the most frequent types of neoplasms in children but epidemiological data on these tumors have been sparsely reported in the medical literature. MATERIALS AND METHODS: We analyze the epidemiology of this type of tumors performing a retrospective population-based study in pediatrics and adolescent age in the population of Girona and compare them with series from Spain, Europe and worldwide. Cases were registered using the International Classification of Disease for Oncology, third edition and grouping according the International Classification of Childhood Cancer, third edition (ICCC-3). RESULTS: For all the histologies and the whole population between 0 and 19 years old, ASRw was 41.8 cases per million person-years. In children population, meaning under 14 years old, we found 104 cases with ASRw of 45.6. Males were the most affected by CNS tumors with a 1.2 sex ratio between 0 and 14 years old, and 1.1 between 0 and 19 years old. The analysis of trends in incidence did not find any statistically significant increase or decrease. Five-year observed survival was 68%, both for patients under 19 and 14 years of age. CONCLUSIONS: The incidence in our area was among the highest in Spain and worldwide, while survival was comparable to others reported.
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Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias do Sistema Nervoso Central/mortalidade , Sistema de Registros/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Agências Internacionais , Masculino , Prognóstico , Estudos Retrospectivos , Espanha/epidemiologia , Taxa de Sobrevida , Fatores de Tempo , Adulto JovemRESUMO
PURPOSE: We aim to comprehensively describe the incidence and mortality trends of ductal carcinoma in situ (DCIS) in the Girona province, Spain (1994-2013) and to estimate the all-cause mortality excess risk of diagnosed women. METHODS: Age-standardized rates of DCIS were estimated between 1994 and 2013. Standard mortality ratios (SMR) and absolute excess mortality were calculated overall and by tumor and patient characteristics. A sensitivity analysis was conducted excluding cases with a subsequent invasive breast cancer (sIBC). RESULTS: Of the 641 women included, 56 died (follow-up time: 8.4 person-years). Between 1994 and 2013, a significant increase in incidence and decrease in mortality was identified among women aged between 50 and 69 years old. Neoplasms and circulatory system disease were the most common causes of death. No excess risk of death was found overall, except for women aged < 50 years (SMR = 3.44, 95% CI 1.85; 6.40) and those with a sIBC (SMR = 2.51, 95% CI 1.26; 5.02), risk that lessened when cases with sIBC were excluded. Patients with sIBC also showed an excess risk (SMR = 2.29, 95% CI 1.03; 5.10). CONCLUSIONS: Among women aged 50-69 years old, incidence of DCIS has significantly increased yet mortality has decreased. Overall, the all-cause mortality risk of women diagnosed with DCIS remains similar to that of the general population except for women diagnosed before age 50 and those with sIBC, who showed a significant increased risk. Differential management of these patients should be considered.
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Neoplasias da Mama/mortalidade , Carcinoma Intraductal não Infiltrante/mortalidade , Sistema de Registros/estatística & dados numéricos , Medição de Risco/métodos , Fatores Etários , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Carcinoma Intraductal não Infiltrante/epidemiologia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Vigilância da População , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia , Taxa de SobrevidaRESUMO
INTRODUCTION: We conducted a population-based study on the Girona Cancer Registry (Spain) for the period 1994-2013 to determine patterns of change in the incidence of melanoma, which is increasing in many countries, and patient survival in our geographical area. MATERIALS AND METHODS: Using the standard registration rules for cancer registries, we calculated crude and standardized incidence rates as well as their trends. We also analysed the observed survival, 1-year conditioned survival and relative survival at 3, 5 and 10 years. RESULTS: Our crude incidence rate was 9.13 cases/100,000 inhabitants for invasive and 2.59 for "in situ" melanomas. A statistically significant increase in incidence was found for melanomas of less than 1 mm in Breslow index and in males. 10-year observed and relative survival rates were 64.1 and 83.1%, respectively. CONCLUSIONS: We found an increasing trend in the incidence of low-risk melanoma and a survival rate similar to that reported elsewhere in Europe.
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Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Espanha/epidemiologia , Adulto Jovem , Melanoma Maligno CutâneoRESUMO
INTRODUCTION: The diagnostic approach of Gastrointestinal Stromal Tumours (GIST) was established in 2002. Before this, GIST had been classified with a wide range of histological terms. This fact and the consideration of potential malignity of all these tumours led to a false perception of an increasing incidence. PURPOSE: This study aimed at evaluating the accuracy in registration of sarcoma of digestive tract and GIST and to elucidate the trends of incidence and survival of those. MATERIALS AND METHODS: We used data from two population-based cancer registries in Spain. In the Girona's Cancer Registry we previously reclassified all sarcoma of digestive tract performing c-kit to confirm GIST and analysed the time period 1994-2005. In Tarragona's Cancer Registry, where we analysed the time period 1981-2005, this reclassification was not done. RESULTS: We obtained a significant increasing trend in incidence of all sarcoma of digestive tract in the Tarragona Cancer Registry database, with an annual per cent of change of 3.87 but a non-statistically significant trend in incidence in the Girona Cancer Registry database. The incidence of GIST in Girona Cancer Registry was 1.24 cases/100,000 inhabitants/year. Survival rates did not change in time and was high in less aggressive GIST. The 5-year relative survival for low, intermediate and high risk of malignant behaviour GIST groups were, respectively, 80.5, 85.6 and 64.6 %. CONCLUSIONS: The increase in the incidence of GIST could be explained by the improvement in their diagnosis and registration. The survival of low and intermediate risk of malignant behaviour is high and close to normal population survival.