Biomedical subjects

Donald M Parkin

Publications and source records attributed to Donald M Parkin.

7 recordsLinked to original sources

PubMed2006

Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-Cancer Registry Match Study.

Although more than 25 million people in sub-Saharan Africa have human immunodeficiency virus (HIV) infection, little is known regarding their cancer risk. We investigated cancer risk among persons with HIV/AIDS in Uganda using record-linkage. We linked records of 12,607 HIV-infected persons attending The AIDS Support Organization (TASO) in Kyadondo County from October 1988 through December 2002 to the Kampala Cancer Registry. We calculated standardized incidence ratios (SIRs) to identify increased cancer risks in the early (4-27 months after TASO registration), late (28-60 months), or combined (4-60 months) incidence periods. We identified 378 cancers (181 prevalent, 197 incident) among TASO participants. Of incident cancers, 137 (70%) were AIDS-defining cancers. Risk was increased in the early-incident period, compared to the general population, for the AIDS-defining cancers: Kaposi sarcoma (SIR 6.4, 95%CI 4.8-8.4), non-Hodgkin lymphoma (6.7, 1.8-17), and cervical carcinoma (2.4, 1.1-4.4). These three cancers were also increased in the combined periods. Risks of five non-AIDS-defining cancers were increased in the combined periods: Hodgkin lymphoma (5.7, 1.2-17) and cancers of the conjunctiva (SIR 4.0; 1.5-8.7), kidney (16, 1.8-58), thyroid (5.7, 1.1-16), and uterus (5.5, 1.5-14). Cancers of the breast, nasopharynx, and lung were increased either in the early or late incident periods only. Among 407 children, seven cancers were observed, of which five were Kaposi sarcoma. The application of a record-linkage design in Africa broadens the repertoire of epidemiological tools for studying HIV-infected populations. We confirm the increased risks of AIDS-defining cancers and report increased risks of a few non-AIDS-defining cancers.

Adolescent↗

PubMed2006

The evolution of the population-based cancer registry.

The idea of recording information on all cancer cases in defined communities dates from the first half of the twentieth century, and there has been a steady growth in the number of such cancer registries since. Originally, they were concerned primarily with describing cancer patterns and trends. Later, many were able to follow up the registered patients and calculate survival. In the last 20 years the role of registries has expanded further to embrace the planning and evaluation of cancer control activities, and the care of individual cancer patients. This Review looks at the current status of cancer registration practice and use from an international perspective, mindful that the registration of cancer has expanded into a global activity.

Humans↗

PubMed2006

Population-based incidence estimates of uveal melanoma in Germany. Supplementing cancer registry data by case-control data.

Valid incidence rates of uveal melanoma (UM) from German population-based cancer registries are currently not available due to under-reporting. We conducted two case-control studies on UM at a reference centre for eye tumours and show the influence on population-based incidences of UM when data from case-control studies are linked with a cancer registry. The first case-control study (1996-1998) recruited 13 UM cases aged 35-74 years and the second case-control study (2002-2003) recruited 20 UM cases aged 20-74 residing within the population covered by the Münster Cancer Registry. After record linkage, age-truncated and standardized (World Standard Population) incidences with and without the record linkage were compared. Incidence rates based on routine cancer registration increased by a factor of 1.7 (1996-1998, age group 35-74 years) and 3.7 (2002-2003, age group 20-74 years) after record linkage with the case-control data. The supplemented age-standardized incidence of UM is 8.6 per million (20-74 years, 2002-2003) compared with the unsupplemented incidence of 2.3 per million. UM unknown to the registry were less often morphologically verified than those known to the registry. Cancer registries relying on pathology reports underestimate UM incidences if eye-preserving treatments are introduced. Close co-operation between cancer referral centres and cancer registries can substantially improve the completeness of registration.

Adult↗

PubMed2004

International variation.

There were an estimated 10 million new cases, 6 million deaths and 22 million persons living with cancer in the year 2000. The most common cancers are, in terms of new cases, lung (1.2 million), breast (1.05 million), colon-rectum (945 000), stomach (876 000) and liver (564 000). The geographic distributions of some 20 types of cancer for which national estimates have been made are summarized. These patterns are examined with respect to the likely reasons in terms of variation in exposure to carcinogens (in the external environment or through lifestyle choices) or in genetic susceptibility to them. Related data from studies of migrant populations (that allow comparisons of genetically similar populations living in different environments) and from comparisons between different ethnic groups living in the same country are used to help in the interpretation of the geographic patterns. Information on the burden of disease also has a very important role in the planning and monitoring of programmes of cancer control.

Breast Neoplasms↗

PubMed2003

Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia.

We analyzed time trends in incidence of and mortality from malignant cutaneous melanoma in European populations since 1953. Data were extracted from the EUROCIM database of incidence data from 165 cancer registries. Mortality data were derived from the WHO database. During the 1990s, incidence rates were by far highest in northern and western Europe, whereas mortality was higher in males in eastern and southern Europe. Melanoma rates have been rising steadily, albeit with substantial geographic variation. In northern Europe, a deceleration in these trends occurred recently in persons aged under 70. Joinpoint analyses indicated that changes in these trends took place in the early 1980s. In western Europe, mortality rates have also recently leveled off [estimated annual percentage change (EAPC) from -13.6% (n.s.) to 3.3%], whereas in eastern and southern Europe both incidence and mortality rates are still increasing [incidence EAPCs 2.3-8.9%, mortality EAPCs -1.8% (n.s.) to 7.2%]. Models including the effects of age, period and birth cohort were required to adequately describe the rising incidence trends in most European populations, with a few exceptions. Time trends in mortality were adequately summarized on fitting either an age-cohort model (with the leveling off of rates starting in birth cohorts between 1930 and 1940) or an age-period-cohort model. The most plausible explanations for the deceleration or decline in the incidence and mortality trends in recent years in northern (and to a lesser extent western) Europe are earlier detection and more frequent excision of pigmented lesions and a growing public awareness of the dangers of excessive sunbathing.

Adult↗

PubMed2003

Time trends in cancer mortality in China: 1987-1999.

A first analysis of time trends in cancer mortality in China at the national level is presented. Using a joinpoint regression model, based on data from a national mortality routine reporting system in China (CHIS), time trends in mortality for 9 major cancers are analyzed. Between 1987 and 1999, the age-standardized mortality rates for all cancers combined declined slightly in rural areas but have increased since 1996 in urban areas. The mortality rates for cancers in oesophagus, stomach, cervix uteri, leukaemia (except for urban males after 1996) and nasopharynx declined, while lung cancer and female breast cancer showed significant increasing trends in both urban and rural areas and for both sexes. Cancers of the colon-rectum and liver had different trends in mortality in urban and rural populations. The trends in age-specific mortality rates suggest some different trends in the younger population, which may presage future overall trends, for example, increasing mortality from cancer of the cervix. The observed trends primarily reflect the dramatic changes in socioeconomic circumstances and lifestyles in China in the last 2 decades. Tobacco smoking remains a major problem, with increases in mortality from lung cancer. The improvements in socioeconomic status, diet and nutrition may be responsible for the declining risk of some cancers (oesophagus, stomach and nasopharynx), while increasing the risk for others (breast and colon-rectum). Screening programs (especially for cervix cancer), and more available and better facilities for cancer therapy, may have helped to reduce mortality for several cancers. The large increases in the absolute number of deaths that resulted from the increasing and aging population are much more important in determining the future cancer burden than any changes due to change in risk, emphasizing the increasing importance of cancer as a health problem in the 21st century in China.

Adolescent↗

PubMed2002

Practical implications of imposing a new world standard population.

OBJECTIVE: The World Health Organization (WHO) has recently introduced a new world standard population for the production of age-standardized rates. In this study we compare cancer rates standardized to this population with those computed using reference populations in current practice, particularly the world standard of Segi (1960), in order to evaluate their adequacy as estimators of relative risk in diverse population groups and over time. METHODS: Incidence and mortality rates standardized using these reference populations were calculated and compared for various cancers. Standardized rate ratios were compared with more efficient methods of approximating relative risk, the Mantel & Haenszel and maximum-likelihood estimators. The differences were tested by taking a synthesis of the relative risks and by taking into account whether effects were homogeneous across age strata or not. RESULTS: There were no statistically significant differences between the relative risk estimates based on direct standardization and those obtained using Mantel & Haenszel (p < 0.99), or maximum-likelihood techniques (p > 0.99), regardless of whether the Segi or the WHO world population was used as the standard. CONCLUSIONS: Ratios of rates age-standardized using the world standard of Segi approximate relative risk as precisely as the WHO standard. For this, and important practical reasons, it is considered unnecessary to replace the Segi standard population for comparisons between cancer rates.

Adolescent↗