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Biomedical subjects

D M Parkin

Publications and source records attributed to D M Parkin.

At least 19 recordsLinked to original sources

Cancer in the European population of Harare, Zimbabwe, 1990-1992.

The data presented from the population-based cancer registry in Harare, Zimbabwe, represent the first information on the incidence of cancer in a population of European origin living in Southern Africa for over 30 years. Their cancer pattern is more or less typical of white populations of high socio-economic status living in Europe or North America, with elevated incidence rates of breast cancer, large-bowel cancer and, in women, lung cancer. However, there are also several unusual features, with extremely high incidence rates of skin cancers, including melanomas, and higher rates of liver and bladder cancer than normally seen in white populations.

Adolescent

Cancer in the African population of Harare, Zimbabwe, 1990-1992.

The data presented from the population-based cancer registry in Harare, Zimbabwe, represent the first information on the incidence of cancer in Southern Africa for almost 20 years. In the African population in Zimbabwe there are several features in common with other countries in sub-Saharan Africa: high rates of liver, prostate and cervix cancer, low rates of large-bowel cancer and breast cancer. Also, as reported from southern and south-eastern Africa, there are relatively high incidence rates of cancers of the oesophagus, bladder and (in men) lung. The AIDS epidemic has given rise to a striking increase in incidence of Kaposi's sarcoma (now the commonest cancer of African men), but there is not much evidence for an increase in incidence of non-Hodgkin lymphomas nor, although rates are very high, of cervical cancer.

Adolescent

Patterns of cigarette sales and lung cancer mortality in some central and eastern European countries, 1960-1989.

BACKGROUND: Remarkable increases in lung cancer risk recently have been observed in the Central and Eastern European (CEE) area. This study examines the patterns of lung cancer mortality rates and cigarette sales in 1960-1989 in seven CEE countries with a total population of 97.5 million and 43,000 deaths from lung cancer in the last year under study. METHODS: Trends in cigarette sales and mortality rates from lung cancer in seven CEE countries were compared for the years 1960-1989. RESULTS: Among males, recent lung cancer death rates were the highest in Europe, and trends by country largely reflected the varied prevalence and duration of smoking in previous decades. For females, lung cancer mortality rates were much lower, although there were exponential rate increases. In the more recent birth cohorts, there were some declines in mortality rates among males, but not among females. CONCLUSIONS: The rising cigarette consumption through the 1960s, 1970s, and, in some countries, the 1980s is accompanied in most of the countries by rising lung cancer mortality rates for young adults. This increasing cigarette consumption will determine future trends in lung cancer, which will increase well beyond the turn of the century and will continue longer for females than for males. This outlook underlines the urgent need for comprehensive lung cancer prevention with the concerted control of smoking as a priority. The role of cofactors and their interaction with smoking deserve further exploration.

Adolescent

Cancer survival in Khon Kaen Province, Thailand.

Thailand is one of the few developing countries for which population-based cancer survival data are available. Using clinical follow-up information and reply-paid postal enquiries, 10,333 residents of Khon Kaen province registered with cancer in the period 1985-1992 were followed-up to the end of 1993. The sites of the most common cancers in the province were liver (5-year relative survival rate 9.2%), cervix (60.1%), lung (15.4%), breast (48.1%) and large bowel (41.9%). Results for Khon Kaen were compared with age-standardized survival data for the US and Scotland. Survival was consistently higher for US whites compared to Khon Kaen residents for those cancers whose prognosis is associated with early diagnosis (breast, cervix and large bowel) or the availability of intensive therapy (leukaemia and lymphoma). The main implication of these results for cancer control in Thailand is that the interventions of greatest potential benefit are those designed to promote early detection. More than one-third of all cancers in Thailand are liver tumours: primary prevention through control of hepatitis-B infection and liver fluke infestation is the only effective strategy for their control.

Adult

Occupational risk factors for lung cancer in Tianjin, China.

Information about occupation and industry of cancer patients is routinely recorded in the Cancer Registry of Tianjin, People's Republic of China. Occupational risk factors of lung cancer for the period of 1981-1987 were assessed using other cancers as controls. For each occupation and industry, workers employed in it were considered exposed and were compared with all other workers. Elevated risks were found for a number of industries for both sexes, including, in particular, the textile, wood, metal, and construction industries. Results by occupation were similar to those by industry. Smoking scores were calculated for various occupations on the basis of a separate population survey in Tianjin. Smoking cannot explain the elevated odds ratios in males, while among females a strong correlation was observed between smoking scores and lung cancer odds ratios, suggesting a confounding effect.

Adult

Cancer mortality in Italian migrants and their offspring in Canada.

Studies on the offspring of migrants provide important information on the contribution of environmental and genetic factors in the etiology of various cancers. The aim of the present study is to analyze the cancer risk in Italian-migrants (Canadian residents born in Italy) and their offspring compared with the host population. Odds ratios (OR) and 95 percent confidence intervals (CI) by site and birthplace categories (migrants, pure and mixed Italian-parentage Canadians) were calculated by means of a case-control study using the 'other cancer deaths' as controls and taking the host population as the reference category. The study shows that Italian migrants retain a significantly low risk for a series of cancers: colon (OR = 0.9 in males and 0.7 in females); lung (OR = 0.8 in males and 0.5 in females); and breast (OR = 0.9). For all of these sites, risks in the offspring of Italian migrants were not different from those of the host population, with some differences between the genders with respect to cancer of the colon. Stomach cancer presents a significantly high rate in migrants (OR = 1.9 in males and 2.4 in females), consistent with the population of Italy; in their offspring, risks are similar to those in the host population. The risk of cancer in the offspring of migrants is, for many sites, intermediate between the host population and the Canadian residents born in Italy. This finding possibly is related to the larger integration of the offspring than their parents in the cultural and social environment of the host population.

Adolescent

Risk factors associated with oesophageal cancer in Bulawayo, Zimbabwe.

This report presents information on risk factors for oesophageal cancer in Bulawayo, Zimbabwe. The data analysed were from the Cancer Registry of Bulawayo for the years 1963-77, when all registered patients were interviewed using a standard questionnaire. The age-standardised incidence rates in the urban population of Bulawayo in the first 10 year period were 58.6 per 100,000 in men and 8.1 in women. The distribution of risk factors was assessed in 881 oesophageal cancer cases (826 male, 55 female) and a control group comprising other non-tobacco- and non-alcohol-related cancer (5238) cases. There was a marked geographical gradient in risk in both sexes, which remained after adjustment for lifestyle variables. In men tobacco smoking was significantly associated with risk of oesophageal cancer, with the relative risk rising to 5.7 among smokers of 15 or more g day-1; this effect is independent of alcohol drinking. Among women who had ever smoked tobacco, the relative risk was 4.0 compared with those who had never smoked. Alcohol intake showed no independent effect on risk. Low socioeconomic status [odds ratio (OR) = 1.5; confidence interval (CI) = 1.0-2.1] and working as a miner (OR = 2.5; CI = 1.5-4.2) conferred increased risks in comparison with men of high socioeconomic status.

Age Factors

Spectrum of childhood cancers in Malawi 1985-1993.

An analysis of seven hundred and ninety one children aged 0.2 to 14 years with confirmed malignant disease recorded by the Malawi National Cancer Registry over a period of 9 years is presented. Childhood cancer constituted 6.9% of all malignancies recorded during the study period. The top ten neoplasms in descending order of frequency were: non-Hodgkin's lymphoma 434 (54.9%), retinoblastoma 89 (11.3%), nephroblastoma 50 (6.3%), epithelial carcinoma 45 (5.7%), Hodgkin's disease 38 (4.8%), soft tissue sarcoma (excluding Kaposi): 34(4.3%), Kaposi's sarcoma 32 (4.0%), malignant tumours (not specified): 20 (2.5%), acute leukaemias 18(2.3%) and osteogenic sarcoma 16 (2.0%). Some differences noted in the pattern of neoplasms in this study from those of developed and developing African countries are discussed. The findings highlight the most common childhood malignancies in Malawi where intense research should be directed so that meaningful and cost effective therapeutic intervention programmes can be planned and developed.

Adolescent

[Cancer mortality among Swiss migrants in France].

Using French mortality data for the period 1979 to 1985, risks of death for cancer in Swiss migrants were calculated relative to these in the locally born. In the absence of valid population data for Swiss migrants, risks were estimated using a case-control approach, considering as cases cancer deaths at one specific site, and as controls all other deaths. In order to evaluate the change in risks after migration, death risks in Switzerland, compared to French natives, were calculated using a Poisson regression. For most of the cancer deaths, the risk in Swiss migrants is intermediate between that of their country of origin and that of the host country. Compared with French-born, Swiss migrants maintain however a significantly higher risk for lung cancer, urinary bladder cancer and melanoma in males, for breast cancer in females, and for non-Hodgkin lymphomas in both sexes. In contrast, the risk is significantly lower for liver cancer in male Swiss migrants. The observed differences are interpreted in the light of the available consumption data in both countries.

Adult

Bladder cancer: epidemiology and risk factors in Bulawayo, Zimbabwe.

The incidence of bladder cancer, and the importance of some selected risk factors in its etiology, were estimated from the data collected in the cancer registry of Bulawayo, Zimbabwe, during the period 1963-77. Cancer cases were interviewed with a standard questionnaire, and more than 70 percent of these were complete. Incidence rates in the urban population of Bulawayo in the first 10-year period were relatively high, with age standardized rates of 17.9 per 100,000 in men and 9.5 in women. Risk-factor distribution was compared in 680 bladder cancer cases (494 males, 186 females) and a control group comprising other cases with non-tobacco-related cancers (8,201). Seventy-one percent of bladder cancer cases were squamous cell carcinomas. The presence of schistosomiasis, evaluated from past history of bilharzia or hematuria, was associated with a significantly increased risk of bladder cancer in both genders (odds ratio [OR] = 3.9 for men, 5.7 for women), a result reflected in the differing risk by province of residence, which correlated with the prevalence of infection among cancer cases. The proportion of bladder cancer attributable to schistosomiasis was estimated to be 28 percent. Social status, as reflected by education level, also influenced risk (ORs for literate cf illiterate males = 0.6), but tobacco smoking in men had no effect on the risk of squamous cell tumors. For transitional cell carcinomas or adenocarcinomas, there was a nonsignificant increased risk of 2.0 in the highest smoking categories (15 g of tobacco per day), compared with non smokers.

Female

Cancer in developing countries.

The developing countries are represented by incidence and mortality datasets from 16 populations. Trends are studied using age specific data from six cancer registries (three in Asia, three in Latin America) and national mortality datasets from Central and South America (three), the Caribbean (two), Asia (two) and Mauritius. In Africa, three cancer registries (in Nigeria, Uganda and Zimbabwe) provide time series of 15 years or more. Systematic examination of time trends is confined to five major sites (stomach, lung, breast, cervix uteri and colon-rectum), with a comment on observed trends in the other important cancers of developing countries (mouth/pharynx, oesophagus and liver). Although uniformity is not to be expected in such diverse material, some overall patterns emerge. Stomach cancer, as in the developed world, appears to be declining in importance. Lung cancer rates are rising, although in males, the increases are most marked in the elderly, with more recent birth cohorts in several populations showing a decline in risk. Breast cancer incidence and mortality rates are rising in most populations, with changes usually more marked in younger women. Conversely, cervix cancer, at present the most common cancer of women in developing countries, shows declines in incidence and mortality in the majority of populations studied, although Africa is clearly an exception. Cancer of the large bowel is becoming more frequent, although there are exceptions (eg Bombay, Mauritius and Trinidad). In the highest risk population (Uruguay), mortality seems to have peaked around 1965 and has since declined.

Adolescent

International variations in the incidence of neuroblastoma.

The International Agency for Research on Cancer has coordinated a worldwide study of childhood cancer incidence, with data from over 50 countries. We present here the results for neuroblastoma. In predominantly white Caucasian populations the age-standardized rate was 7-12 per million, and 6-10% of all childhood cancers were neuroblastomas. Rates were highest in the first year of life (25-50 per million, 30% of total neuroblastoma incidence), and decreased with age to 15-20 per million (50% of the total) at age 1-4, 2-4 per million (15%) at 5-9 and 1-1.5 per million (5%) at 10-14. In the United States, black children had an incidence of 8.5 per million compared with 11.5 among Whites; Blacks tended to be older than Whites at diagnosis. The highest rate in Africa was in Bulawayo, Zimbabwe (8.0 per million) and the lowest in West Nile, Uganda, with no cases registered. Incidence in Israel was similar to that in many white populations, with Jews having a particularly high rate. In other parts of West Asia neuroblastoma had a low relative frequency, suggesting that incidence is low. Rates were also low throughout much of southern and eastern Asia, including India and China. Incidence in Japan was somewhat higher, though less than in Western countries, with the deficit most pronounced in the first year of life; these data relate to the period before mass screening of infants for neuroblastoma in the regions concerned. Incidence was generally higher in regions and among ethnic groups enjoying a higher standard of living, though previous studies within single countries had suggested that neuroblastoma is more common among less affluent groups. Blacks in Africa and the United States may have a weaker genetic predisposition to neuroblastoma, but some of the deficit in many developing countries is likely to be due to under-diagnosis.

Adolescent

The natural history of lung cancer estimated from the results of a randomized trial of screening.

The results from a randomized controlled trial of screening for lung cancer in Czechoslovakia have been used to estimate parameters of the natural history, using a model to simulate the disease process and the effects of screening. The results suggest that the period before clinical presentation during which lesions can be detected by screening is very short (seven to eight months). This implies that to detect three-quarters of all lung cancers by screening, two examinations per year are necessary, and that such a program would advance diagnosis by six months if there were complete participation. The results of the trial itself suggest that the benefit, in terms of a reduction in mortality from lung cancer, is likely to be very small.

Adult

Childhood leukaemia following the Chernobyl accident: the European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS).

The objective of the European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS) is to investigate trends in incidence rates of childhood leukaemia and lymphoma in Europe, in relation to the exposure to radiation which resulted from the accident at the Chernobyl nuclear power plant in April 1986. In this first report, the incidence of leukaemia in children aged 0-14 is presented from cancer registries in 20 European countries for the period 1980-1988. Risk of leukaemia in 1987-1988 (8-32 months post-accident) relative to that before 1986, is compared with estimated average dose of radiation received by the population in 30 geographic areas. The observed changes in incidence do not relate to exposure. The period of follow-up is so far rather brief, and the study is planned to continue for at least 10 years.

Accidents