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J W Coebergh

Publications and source records attributed to J W Coebergh.

At least 19 recordsLinked to original sources
PubMed2003

[Trends in the incidence and prevalence of cancer and in the survival of patients in southeastern Netherlands, 1970-1999].

OBJECTIVE: To describe the changes in incidence, mortality, survival and prevalence of cancer since 1970 in the south-eastern part of the Netherlands, the registration area of the Eindhoven Cancer Registry. DESIGN: Descriptive population-based study. METHOD: Data were collected on all patients diagnosed with cancer between 1970 and 1999 in the south-eastern part of the Netherlands, the registration area of the Eindhoven Cancer Registry. Trends in age-specific and age-adjusted incidence, mortality, prevalence and relative survival were calculated. The changes in incidence were compared with changes in exposure to risk factors, such as smoking, alcohol, diet, infections and sunlight, and with early detection. RESULTS: The incidence of cancer of the stomach and uterine cervix decreased in the study period. Among men, the incidence of lung cancer increased sharply until the mid 1980s, whereafter it decreased. Furthermore, the incidence of cancer of the oesophagus, colon, rectum, breast, prostate and lung (in women), cutaneous melanoma and non-Hodgkin's lymphoma also increased. The survival improved for patients with cancer of the rectum, breast, female genital tract, prostate, testis (non-seminoma), cutaneous melanoma and Hodgkin's disease. The improvement in survival could be explained in part by early detection and partly by the improvement in treatment strategies. The prevalence of the diagnosis 'cancer' in living subjects increased by almost 30%, which may be related to the increase in incidence and the improvement in survival. CONCLUSION: There was an alarming increase in tumours related to exposure to tobacco and alcohol, especially in women. Improved diagnostic techniques and treatment strategies coincided with improved prognosis. This was associated with an increased demand for health care.

Adolescent↗
PubMed2003

[Mortality due to smoking in the Netherlands: 1.2 million tobacco-related deaths between 1950 and 2015].

OBJECTIVE: To quantify the medical consequences of the tobacco use in the Netherlands for the past 50 years and the near future. DESIGN: Theoretical study based on the national death records and published risks by cause of death of tobacco use. METHOD: Observed lung cancer mortality (1950-1999) was related to birth cohort and age by a statistical model (according to Peto), and then projected into the near future. The smoking intensity was defined as the difference between the expected lung-cancer mortality if no one smoked and the observed lung-cancer mortality. Using this smoking intensity and published risks for other smoking-related causes of death, the model provided estimates of smoking-related mortality by age, sex and cause of death. RESULTS: In 1999, 18% (women) and 32% (men) of all mortality before the age of 70 was attributable to smoking. If no one had smoked, Dutch life expectancy for men and women would have been 3 years and 1 year higher, respectively. Between 1950 and 1999, 13% of all deaths were caused by smoking, the large majority (> 90%) of which occurred among men. Between 2000 and 2015, slightly more deaths are to be attributed to smoking (14%), 62% of which will be among men. In 2015, women will have caught up with men in terms of absolute numbers of lung-cancer mortality. CONCLUSION: Around one quarter of premature deaths were caused by smoking. In the near future, women of the baby-boom generation will have reached middle age and the highest (relative) smoking-related risks. It is important that clinical practice takes this increased risk of disease into account among middle-aged women who smoke.

Adult↗
PubMed2003

Differences in the epidemic rise and decrease of prostate cancer among geographical areas in Southern Europe. an analysis of differential trends in incidence and mortality in France, Italy and Spain.

This is a population-based study aimed at evaluating incidence and mortality trends for prostate cancer in France, Italy and Spain, during the prostate-specific antigen (PSA) era, considering elderly people aged 70 years and over and younger adults aged between 40 and 69 years. Trends were estimated by a log-linear Poisson regression model and expressed as an Estimated Annual Percent Change (EAPC). Incidence increased sharply in almost all areas. Spain showed the lowest increases. Incidence started to rise around 1985 in France and after 1990 in Italy and Spain. Mortality increased until the late 1980s in all countries, then declined in France and Italy (-2.5% in 40-69 year age group), but not in Spain. Younger people showed a much higher rise in incidence than the elderly, while mortality decreased mainly in the younger adults. The decrease in mortality was more marked in those areas and the younger age group where the rise in incidence was higher and started earlier, i.e. in France and in younger people, suggesting that the PSA test may have had a positive effect on mortality, although other clinical advances also have to be taken into account.

Adult↗
PubMed2001

The genetic epidemiology of glioma.

With traditional epidemiologic research designs, few environmental risk factors for malignant brain tumors have been revealed, and although syndromes exist where brain tumors occur frequently, these explain a small proportion of the overall incidence. In a similar way, the search for genetic causes has been thwarted by the rarity of families with multiple affected relatives, inhibiting genetic linkage, sib-pair, or even population-based association studies. Molecular genetic studies generally involve searching for candidate proto-oncogenes and tumor suppressor genes by comparing DNA from tumor material with constitutional (germline) DNA. However, it remains difficult to distinguish causative genetic aberrations from chaotic neoplastic processes, and studies so far have not yielded consistent information on the location of such causative genetic lesions. The current literature covering the molecular genetics of glioma is discussed herein and alternative approaches that can be used to identify genetic causes of glioma described.

Adult↗
PubMed2001

[Melanoma of the skin: excision policy and pathology report writing in the 'Integraal Kankercentrum Zuid' region is in accordance with the guideline in slightly more than half of the patients].

OBJECTIVE: To determine the extent to which the guidelines for cutaneous melanoma had been implemented in the diagnostic and treatment approach of general hospitals. DESIGN: Retrospective, descriptive. METHOD: Patients were selected via the cancer registration system of the 'Integraal Kankercentrum Zuid' (Integral Cancer Centre South, the Netherlands). They were submitted through the pathology laboratory by 1 of the 16 general hospitals in the region. Data was collected from the pathology (PA) reports of the 573 patients for whom a cutaneous melanoma was diagnosed in 1988, 1993 and 1997. The treatment policy and the PA reports were compared with the recommendations in the guidelines concerned and the revised versions of these published in 1985, 1990 and 1997. The patients studied were 212 men (37%) and 361 women (63%) with an average age of 51 years (range 13-96). RESULTS: A diagnostic excision was performed in 485/573 patients (85%). Invasiveness was assessed in 99% of the preparations; in 14% a melanoma was encountered in situ. Invasive melanomas were less often seen in the head and neck region than on the trunk or limb. Thickness of the tumour was not determined in 8% of all 493 invasive tumours and in 19% the pathology report did not state whether the diagnostic biopsy was performed radically. In accordance with the guidelines, diagnostic excision biopsy was first performed in 59% of patients with a subsequent re-excision if necessary; 77% of the PA reports satisfied the fundamental recommendations from the guidelines. For 55% of the patients the diagnostic and therapeutic procedures as well as the pathology report were completed in accordance with the guideline recommendations. Modest improvement occurred over time. CONCLUSION: The excision and re-excision policies as well as the pathology report writing concurred with the recommendations in the consensus for cutaneous melanoma in slightly more than half of the patients who were diagnosed within the IKZ region in the years 1988, 1993 and 1997.

Adolescent↗
PubMed2001

Tumor growth pattern and thymidine phosphorylase expression are related with the risk of hematogenous metastasis in patients with Astler Coller B1/B2 colorectal carcinoma.

BACKGROUND: The benefit of adjuvant chemotherapy appears to be limited for patients with Astler Coller B1/B2 colorectal carcinoma but may be better in a subgroup of patients with a high recurrence risk. In the current case-control analysis, the authors evaluated whether patients with a high risk of hematogenous metastasis could be identified by means of a thorough histologic and immunohistochemical examination of the resection specimens. METHODS: A database was built for all patients treated in a general teaching hospital for colorectal carcinoma between 1985 and 1995. From this database, all patients with an Astler Coller B1 or B2 tumor who subsequently had developed hematogenous metastases were taken as cases. For each case, three matched controls (age, Astler Coller, year of diagnosis) without metachronous metastases were selected. The resection specimens of cases and controls were blindly examined by two observers for the following: World Health Organization (WHO) classification; differentiation grade; growth pattern; lymphocytic, fibroblastic, and eosinophilic reaction; angioinvasion; number of lymph nodes examined; expression of E-cadherin, vascular endothelial growth factor and thymidine phosphorylase (TP); P53; microvessel density. RESULTS: Twenty-two cases and 65 controls were included in the analysis. Tumor growth pattern and tumor TP expression both independently contributed to recurrence risk. With these 2 variables, 4 subgroups could be identified with a recurrence risk ranging from 0% to 42%. CONCLUSIONS: Tumor growth pattern and degree of TP expression both appear to be related to the recurrence risk. Prospective trials should point out whether these variables can be implemented in the decision making concerning adjuvant chemotherapy.

Biomarkers, Tumor↗
PubMed2001

[Early diagnosis and prevention of malignant tumors in the head and neck region].

In the Netherlands more than 2000 new patients with head and neck cancer are diagnosed annually. Most of these cancers are squamous cell carcinomas. The use of tobacco and alcohol are well established aetiologic factors. Head and neck cancers usually affect patients above the age of 40 years and are somewhat more common in men than in women. The type of the initial symptoms of head and neck cancer depends largely on the exact location. Often, these symptoms are rather aspecific. However, laryngeal cancer is an exception. In this site cancer usually presents at an early stage with sudden hoarseness. Hoarseness of more than three weeks' duration requires laryngoscopic examination. Particularly the cancers of the floor of the mouth and the borders on the tongue can be detected early because of the accessibility of these sites, which allows proper inspection and palpation. The most common clinical manifestation of oral cancer is an indurated ulcer. An oral ulcer present for more than three weeks is an indication for biopsy. The prognosis of head and neck cancer in general depends largely on the stage at diagnosis. Small cancers carry a much better prognosis after surgical removal or radiotherapy than larger ones.

Alcohol Drinking↗
PubMed2001

Excess mortality from breast cancer 20 years after diagnosis when life expectancy is normal.

In a population-based study, causes of death were traced of 418 deceased breast cancer patients diagnosed in 1960-1979 who survived at least 10 years after diagnosis. The pattern of causes of death in these patients was compared with the general female population using standardized mortality ratios (SMRs). Of 418 patients surviving at least 10 years, 196 (47%) died from breast cancer and 50 (12%) died from another cancer. The SMR for breast cancer was 15.8 (95% CI: 13.1-18.8) 10-14 years after diagnosis; it was still 4.7 (95% CI: 2.6-7.8) after 20 years. Overall mortality was higher than expected 10-14 years after diagnosis (SMR: 1.3; 95% CI: 1.1-1.5), but lower after more than 20 years (SMR: 0.6; 95% CI: 0.4-0.7). Despite a normal (or even improved) life expectancy for breast cancer patients 20 years after diagnosis the risk of dying from this disease remained elevated.

Adult↗
PubMed2001

Cancer survival.

Explore the source record for details and available documents.

Humans↗
PubMed2001

Survival analysis in familial ovarian cancer, a case control study.

OBJECTIVE: familial ovarian cancer patients have been found to differ from sporadic cases, clinically as well as in the molecular make-up of the tumour. Here, a case control study is performed to analyse potential differences in survival. STUDY DESIGN: 31 families with a strong history of ovarian and/or breast cancer presenting to a family cancer clinic 44 ovarian cancer patients were included. Each patient was matched for age and stage with controls from a cancer registry. Survival rates and the effect of several prognostic factors were analysed. RESULTS: median survival in the study group differed significantly from controls. A survival benefit for familial cases was maintained up to 5 years after diagnosis. Long-term survival was equally poor in both groups. CONCLUSION: the difference in survival between familial ovarian cancer cases and matched controls may reflect differences in biological behaviour. This may have important implications for the management and prevention of familial ovarian cancer.

BRCA1 Protein↗
PubMed2001

Survival of childhood lymphomas in Europe, 1978--1992: a report from the EUROCARE study.

In most developed countries, malignant lymphomas account for 10--15% of all cancers occurring among children aged 0--14 years. The present study estimates survival after a diagnosis of lymphoma in childhood, based on the EUROCARE II database which includes 34 population-based cancer registries from 17 European countries. The survival pattern of children with malignant lymphoma diagnosed in 1985--1989 is reported, as well as the time trends since 1978. The analyses focus on Hodgkin's disease (HD, 1696 cases) and on non-Hodgkin's lymphoma (NHL, 2255 cases including Burkitt's lymphoma and unspecified lymphomas). For HD, the European weighted average 5-year survival rate was 93% (95% confidence interval (CI) 82--98) in 1985--1989. The survival rates were not affected by either age or gender. 5-year survival rates ranged from 68% (95% CI 34--90) in Estonia to 96% (95% CI 92--98) in Germany and 100% (95% CI 57--100) in Slovenia. Multivariate analyses for the time period 1978--1989 gave little suggestion of an improvement in survival over the later time periods of diagnosis. For NHL, the European weighted average 5-year survival rate was 74% (95% CI 67--80) in 1985--1989. Gender did not influence the survival rate. Children in the age group 0--4 years had a poorer prognosis compared with older cases (5-year rate: 66% versus 77% in the pool). 5-year survival rates ranged from 53% (95% CI 30--76) (Estonia) to 83% (95% CI 62--94) in France and 83% (95% CI 66--92) in Scotland. Multivariate analysis show a decreasing HR for the more recent periods of diagnosis from 1 in 1978--1981 to 0.67 (95% CI 0.56--0.79) in 1982--1985 to 0.48 (95% CI 0.40--0.57) in 1986--1989. Exploratory analysis, conducted including the cancer registries which provided cases diagnosed until 1992, show a positive trend over time for both types of lymphoma.

Adolescent↗
PubMed2001

Variation in survival of European children with acute lymphoblastic leukaemia, diagnosed in 1978--1992: the EUROCARE study.

The aim of this study was to provide a comparative description of geographical variations and time trends in the population-based survival of European children with acute lymphoblastic leukaemia (ALL). Data on 13344 newly diagnosed children (0--14 years) with ALL were included in the EUROCARE study and were collected were collected by 34 population-based cancer registries (four comprising only childhood malignancies), operating in 17 countries (four in Scandinavia, two in Southern Europe, three in Eastern Europe, six in Continental Europe and two in the UK). Age-specific crude survival rates were estimated for boys and girls according to country for the period 1985--1989 and in adjusted form to attain comparability. Overall pooled and weighted rates were estimated as European standards. Children dead at diagnosis or diagnosed only through a death certificate were excluded. Geographical variation was also estimated by calculating the relative death rate with respect to the pooled overall European rate. After adjustment for age, gender and country, a Cox regression analysis was used to estimate time trends in survival. Survival was compared with that in the USA, Japan, Canada and Australia. During 1985--1989, the 1-year survival rate varied from 99 to 79%, the 5-year survival rate from over 80 to 56% (with the exception of Estonia; 34%; 95% confidence interval (CI) 20--52) among the various countries; the European weighted means were 90 (95% CI 87--93) and 72% (95% CI 69--75), respectively. Survival was particularly favourable in (south) Sweden, Finland, Germany and The Netherlands and rather unfavourable in Estonia and (surprisingly) France, where only 4% of its population was covered by the participating registries. Compared with the period 1978--1981, the hazard ratio for the period 1986--1989 decreased to 0.59 (95% CI 0.54--0.64) and -- in a smaller set of registries -- to 0.49 (0.45--0.55) for 1990-1992, an annual decrease in this rate of approximately 3.5%. During 1985--1989, the 5-year survival rates for European children were largely similar to those found in the USA, Canada and Australia, but markedly better than those in Japan. Higher survival rates were found for countries with 'good' access to centrally organised diagnostic and treatment facilities which stimulated 'aggressive' treatments according to a protocol. However, a subdivision according to risk profiles, e.g. according to the initial white blood cell count at diagnosis, could not be made and this might have explained partially the geographical differences in survival, because a positive association appeared between incidence at age 1--4 years and 5-year survival in most countries.

Adolescent↗
PubMed2001

Childhood cancer survival in Europe: an overview.

Other articles in this issue of the European Journal of Cancer have described population-based survival analyses of specific types of childhood cancer included in the EUROCARE database, diagnosed since 1979. The present paper summarises the relevant estimates and comments on intercountry differences, focusing on possible distortions in the intercountry comparisons based on data produced by the cancer registries. Potential biases include a lack of exhaustiveness of both case ascertainment and follow-up for living status and also a lack of consistency in the use of classification of the childhood cancer types. Nevertheless, despite such biases, consistent differences are observed between European countries in the probability of survival following the diagnosis of a paediatric cancer. In most cases, poor population-based survival rates are probably explained by inadequacies in the adoption and implementation of therapeutic protocols that have been proved to be effective. In some instances, the cause of unsatisfactory estimates was the inclusion of a sizeable proportion of children with cancer in clinical trials which were found to be ineffective. A regression analysis of incidence, mortality and survival rates during 1978-1989 over the whole EUROCARE database strongly indicates that the prognostic improvements over time are real and cannot be attributed to changes in diagnostic procedures.

Adolescent↗
PubMed2001

Survival of children with Wilms' tumour in Europe.

A total 2535 cases of Wilms' tumours registered in children aged 0--14 years by 34 population-based cancer registries in 16 countries of Europe in 1978--1992 and followed-up until the end of 1994 were included in this EUROCARE study. Overall 5-year observed survival of all children diagnosed in 1985--1989 was 83%, 95% confidence interval (CI) 80--85. Relatively large differences were observed between the European countries, with significantly lower survival of patients registered in the formerly socialist countries, Estonia, Poland and Slovakia. Overall European survival was slightly lower in comparison with results reported from the USA and Australia, which demonstrate a potential for improvement. Over the study period, overall survival adjusted for age, sex and country has increased significantly. This favourable trend is attributed primarily to improvements in treatment, particularly to the introduction of new chemotherapeutic agents.

Adolescent↗
PubMed2001

Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer.

The aim of this study was to investigate the nature and severity of the arm complaints among breast cancer patients after axillary lymph node dissection (ALND) and to study the effects of this treatment-related morbidity on daily life and well-being. 400 women, who underwent ALND as part of breast cancer surgery, filled out a treatment-specific quality of life questionnaire. The mean time since ALND was 4.7 years (range 0.3-28 years). More than 20% of patients reported pain, numbness, or loss of strength and 9% reported severe oedema. None of the complaints appeared to diminish over time. Irradiation of the axilla and supraclavicular irradiation were associated with a 3.57-fold higher risk of oedema (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.66-7.69) causing many patients to give up leisure activities or sport. Women who underwent irradiation of the breast or chest wall more often reported to have a sensitive scar than women who did not receive radiotherapy. Women <45 years of age had an approximately 6 times higher risk of numbness of the arm (OR 6.49; 95% CI 2.58-16.38) compared with those > or = 65 years of age; they also encountered more problems doing their household chores. The results of the present study support the introduction of less invasive techniques for the staging of the axilla, sentinel node biopsy being the most promising.

Activities of Daily Living↗