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PubMed1998

[Pain therapy in tumor patients and in palliative medicine. 1: Drug therapy].

Like other industrial countries Germany experiences a significant increase of cancer prevalence. Recent advances in the treatment of various types of cancer resulted in prolonged survivaltimes of patients. Cancer--especially in advanced incurable stages--often is accompanied by severe pain. Therefore, the need for sufficient pain management and symptomcontrol is obvious. Throughout the last decades new drugs and techniques for the management of cancer-pain have been developed. Most cancer-patients should experience sufficient pain-management if existing recommendations for the pharmacological treatment of cancer-pain (e.g. WHO-guidelines) are followed consequently. In case of intractable pain or ongoing disabling symptoms despite proper therapy consultation of an expert in palliative medicine should always be considered as well as the option to refer the patient to a specialized pain-management center.

Analgesics↗
PubMed1990

Breast cancer incidence and prevalence estimated from survival and mortality.

Survival probability for female breast cancer patients was used to estimate incidence rates from breast cancer mortality data in Italy. The female breast cancer survival curve from the Lombardy Cancer Registry (LCR) was used to test the method on data from four local cancer registries, covering areas in different regions of Italy. In spite of the well known geographic variability of female breast cancer incidence and mortality, the results support the idea that survival probability does not change across the country and that the survival probability from the LCR is a good estimate of that in the country as a whole. Female breast cancer incidence and prevalence rates were then estimated for Italy, making use of a mathematical model specifically developed for chronic diseases. In 1985, crude incidence and prevalence rates of female breast cancer, for ages up to 74 years, were estimated as 71 and 701 per 100,000 women, respectively. Estimated incidence rates show a complex trend with age, increasing to a temporary pronounced peak at the age of 52. A marked cohort effect was found to increase significantly the risk of the disease from the 1886 to the 1930 birth cohorts by a factor of 2.9. After the 1930 cohort, risks have continued at a constant high level.

Adult↗
PubMed2006

Are there gender differences in colorectal cancer test use prevalence and correlates?

Despite evidence that screening tests reduce colorectal cancer incidence and mortality, screening prevalence is low. Gender differences in test uptake have been reported, but few studies examine correlates of test use by gender. Differences, if present, may inform strategies to increase test use. We examined gender differences in the prevalence and correlates of colorectal cancer test use [fecal occult blood test (FOBT) and endoscopy] using data from the 2002 to 2003 Health Information National Trends Survey. Male (n = 999) and female (n = 1687) respondents ages > or =50 years, without a personal history of colorectal cancer, were interviewed by telephone. Age-adjusted prevalence rates were reported for lifetime, recent, and repeat use by gender and test type. Multivariable logistic regression analyses were used to identify correlates of test use stratified by gender and colorectal cancer test type. More females reported only using FOBT in lifetime and in the past year, whereas more males reported repeat endoscopy use. The use of other tests or combinations of tests did not differ by gender. Consistent positive correlates of colorectal cancer test use for both genders included age, recent physician visits, recent breast or prostate cancer screening, and knowledge of test-specific screening intervals. Correlates that differed by gender included comparative perceived risk, belief that colorectal cancer testing was too expensive, fear of finding colorectal cancer if tested, and attention to and trust in media sources of health information. Such differences, if confirmed in future studies, may inform the use of gender-specific intervention strategies or messages to increase colorectal cancer test use.

Aged↗
PubMed1988

Prevalence of ovarian cancer found at the time of infertility microsurgery.

We found the prevalence of ovarian cancer in infertile women less than 40 years at the time of planned microsurgery for infertility to be 1 in 95. This may represent a greater prevalence of ovarian cancer than that of all women less than 40 years. Importantly, laparoscopy did not find the ovarian cancer in these women. In conclusion, laparoscopists and microsurgeons need to be aware of the possibility of finding ovarian cancer in these young, infertile women, and this knowledge should be used to counsel and manage the patient appropriately.

Adolescent↗
PubMed2006

Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world.

Efforts to reduce global cancer disparities begin with an understanding of geographic patterns in cancer incidence, mortality, and prevalence. Using the GLOBOCAN (2002) and Cancer Incidence in Five Continents databases, we describe overall cancer incidence, mortality, and prevalence, age-adjusted temporal trends, and age-specific incidence patterns in selected geographic regions of the world. For the eight most common malignancies-cancers of lung, breast, colon and rectum, stomach, prostate, liver, cervix, and esophagus-the most important risk factors, cancer prevention and control measures are briefly reviewed. In 2002, an estimated 11 million new cancer cases and 7 million cancer deaths were reported worldwide; nearly 25 million persons were living with cancer. Among the eight most common cancers, global disparities in cancer incidence, mortality, and prevalence are evident, likely due to complex interactions of nonmodifiable (ie, genetic susceptibility and aging) and modifiable risk factors (ie, tobacco, infectious agents, diet, and physical activity). Indeed, when risk factors among populations are intertwined with differences in individual behaviors, cultural beliefs and practices, socioeconomic conditions, and health care systems, global cancer disparities are inevitable. For the eight most common cancers, priorities for reducing cancer disparities are discussed.

Cost of Illness↗
PubMed2005

Case-control study of familial lung cancer risks in UK women.

Family history data from a case-control study of lung cancer conducted in the United Kingdom between 1999 and 2004 were analysed to estimate familial risks of the disease. Comparison of lung cancer prevalence in first-degree relatives of 1,482 female lung cancer cases and 1,079 female controls was undertaken using logistic regression adjusting for age and tobacco exposure. Overall, lung cancer in a first-degree relative was associated with a significant increase in the risk of lung cancer [odds ratio (OR) 1.49; 95% confidence interval (CI), 1.13-1.96]. For cases with early onset of the disease (< 60 years), the OR of lung cancer was 2.02 (95% CI, 1.22-3.34). Having 2 or more affected relatives was associated with an OR of 2.68 (95% CI, 1.29-5.55), with a significant trend in risk according to the number of relatives affected (p = 0.001). An increased risk of lung cancer associated with family history of the disease was observed when analysis was restricted to lifetime nonsmokers, although this did not reach significance (OR 1.23; 95% CI, 0.65-2.31). Results confirm previous findings and support the role of a familial predisposition to lung cancer.

Age of Onset↗
PubMed1995

Chemically induced mammary gland cancer in the National Toxicology Program's carcinogenesis bioassay.

Incidences of breast cancer change in populations as people migrate from one area of the world to another, suggesting that environmental factors contribute to this disease. There is a continuing effort to identify these environmental factors and the role that exposures to specific chemicals play in this disease. Results from experimental studies show that chemicals identified to cause mammary gland cancer in rodents are frequently mutagenic chemicals, suggesting that genetic damage is an important mechanism for the induction of this cancer. Prevalent classes of chemicals that were identified to cause mammary gland cancer in rodents in studies by the National Toxicology Program include halogenated hydrocarbons, aromatic amino/nitro compounds and epoxide-forming chemicals. Results from these experimental studies will help to elucidate mechanisms and possible causes of breast cancer in humans.

Animals↗
PubMed1992

Basal cell carcinoma in tropical Australia.

A survey of people with skin cancer in tropical Australia detected a change in site of the prevalent cancer. In the post-war generation more basal cell carcinomas are occurring on the back and fewer on the head and neck. A reversal of the sex ratio was also detected, with more women being afflicted.

Adult↗
PubMed2001

Effect of grape seed proanthocyanidins on colon aberrant crypts and breast tumors in a rat dual-organ tumor model.

Cancers of the colon and breast are two of the most prevalent cancers in developed countries. The present experiments were conducted to determine the influence of several dietary doses of grape seed proanthocyanidins on 7,12-dimethylbenz[a]anthracene-induced mammary tumorigenesis and azoxymethane (AOM)-induced colonic aberrant crypt foci (ACF) formation in a dual-organ tumor model. In addition, the effects of the grape seed proanthocyanidins on liver cytochrome P-450 1A and 2E1 and glutathione S-transferase activities and on colonic ornithine decarboxylase activity were examined to determine possible mechanisms of action. Feeding female rats diets containing 0.1-1.0% grape seed proanthocyanidins was associated with a significant 72-88% inhibition of AOM-induced aberrant crypt foci formation and a 20-56% inhibition of ornithine decarboxylase activity in the distal third of the colon. Feeding the grape proanthocyanidins resulted in no significant effect on the activity of liver cytochrome P-450 2E1. There was no effect of feeding these doses of proanthocyanidins on 7,12-dimethylbenz[a]anthracene-induced rat mammary tumorigenesis. This lack of action on mammary tumorigenesis in part may be due to lack of effect of dietary proanthocyanidins on the liver carcinogen-metabolizing enzymes cytochrome P-450 1A and glutathione S-transferase. These results indicate that grape polyphenolics warrant further evaluation as potential colon cancer chemopreventive agents.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed2000

[Basics of drug therapy of cancer pain].

Industrial countries experience a significant increase of cancer prevalence. Despite recent advances in the treatment of various types of cancer still most of the patients cannot be cured. Especially the advanced incurable stages of cancer, however, often are accompanied by severe pain. Therefore, the high demand for a sufficient pain management and symptom control seems obvious. Throughout the last decades new drugs and techniques for the management of cancer pain have been developed. Most cancer patients should experience sufficient pain-management if existing recommendations for the pharmacological treatment of cancer pain (e.g. WHO-guidelines) are followed consequently. If, nevertheless, intractable pain or ongoing disabling symptoms continue despite proper therapy, every doctor should feel himself obliged to consult an expert in palliative medicine, in order not to tolerate avoidable suffering of his patient.

Germany↗
PubMed1985

Estimation of the prevalence of occult cancer and its application to the epidemiology of multiple primary cancer.

This paper focused on methodological issues in the epidemiology of multiple primary cancer, especially on methods to evaluate the frequency of a second cancer. The incidence density is the most widely used measure in cancer epidemiology. However, the measure of incidence might be biased to some extent, because it might be affected by extraneous factors which are related to the detection of the second cancer. A better alternative is the measure of the prevalence of occult cancer. The authors have formulated the functional relationship between the prevalence of occult cancer and some variables which can be obtained from ordinary epidemiologic observations, such as the incidence density, the growth function, and the distribution of the diameters of the cancers which were clinically diagnosed. The formula was then applied to an epidemiologic study of multiple primary cancer in the digestive system. All the patients with cancer of the digestive system except the stomach treated in the National Cancer Center Hospital between 1962 and 1981 constituted the study group. Among 1,561 male and 714 female patients, gastric cancers were found as the second primary cancer in nine males and one female within 2 months after the first cancers were detected. All the first cancers in these 10 cases were esophageal cancers. The expected numbers of second gastric cancers were calculated as 4.55 in males and 1.20 in females by using the formula. The observed number exceeded significantly the expected number in males (p value = 0.042), which suggested that esophageal and gastric cancers might share some risk factor.

Adult↗
PubMed2005

An immunogenetic basis for the high prevalence of urogenital cancer in a free-ranging population of California sea lions (Zalophus californianus).

In response to an unprecedented prevalence of cancer recently identified in free-ranging populations of California sea lions [(CSL) (Zalophus californianus], we examined the role of the immunologically important major histocompatibility (MHC) genes in this disease epidemic. Associations between MHC genes and cancer have been well established in humans, but have never before been investigated in wildlife. Using a previously developed technique employing sequence-specific primer-based PCR with intercalating dye technology, MHC genotypes were examined from 27 cancer-positive and 22 cancer-negative CSL stranded along the California coastline. Analyses elucidated an underlying immunogenetic component to the high prevalence of urogenital cancer in sea lions. Furthermore, these results demonstrate the functional relevance of CSL class II MHC by revealing a non-random nature of cancer susceptibility associated with the presence of specific genes.

Animals↗
PubMed1991

Ultrasound screening for familial ovarian cancer.

We have used transvaginal ultrasonography to screen 776 asymptomatic women for familial ovarian cancer. Every woman had at least one first- or second-degree relative develop the disease (677, 87%; and 98, 13%, respectively). The mean age of the study population was 51 years (range, 24 to 78 years); 52% were premenopausal, 36% were naturally postmenopausal, and 12% had undergone a hysterectomy. Overall, 43 women (5.5%) were referred for surgical investigation and 39 had a laparatomy. Nineteen/thirty-nine (48%) had bilateral ovarian masses, and 15% of abnormal ovaries had more than one type of histopathology. Twenty-three tumors and thirty-two tumor-like conditions were detected. There were 3 cases of primary ovarian cancer (prevalence, 3.9/1000), all FIGO stage Ia. None of the women has developed ovarian cancer within the first year of the scan (giving a provisional detection rate of 100%). The false positive rate was 40/773 (5.2%), the predictive value of a positive screen result was 7.7%, and the odds in favor of finding any mass at laparotomy were about 19 to 1 or for any tumor, 1 to 1. At surgery the odds against finding primary ovarian cancer were 12 to 1. The positive predictive value of the screening procedure and the prevalence of the disease were significantly higher than the corresponding values from a previous population-based screening program.

Adult↗
PubMedDate not supplied

Duodenoesophageal reflux induces esophageal adenocarcinoma without exogenous carcinogen.

In the rat model, esophageal adenocarcinoma reproducibly develops following surgically induced duodenal reflux into the esophagus and administration of nitrosamine. In addition, decreasing gastric acid via partial or total gastrectomy increases the prevalence of adenocarcinoma in this model. We questioned whether carcinogen was necessary for cancer development in the gastrectomized model and whether esophageal acidification could reverse the effect of gastrectomy. Three groups of 26 rats each were randomized to a surgical procedure to produce one of the following reflux models: gastroduodenal reflux by esophagojejunostomy, duodenal reflux by total gastrectomy and esophagojejunostomy, or no reflux by Roux-en-Y reconstruction. In a second experiment, 42 rats were operated on to induce duodenal reflux. One week following surgery, they were randomized to receive acidified water (pH 1.8) or tap water. The animals were killed at 24 weeks of age, and the esophagus was evaluated histologically. All animals with reflux had severe esophagitis and 87% developed columnar lining of the distal esophagus. Nearly half (48%) developed adenocarcinoma at the anastomotic site 16 weeks postoperatively and without carcinogen administration. Cancer prevalence did not differ between animals with gastroduodenal or duodenal reflux but tended to be lower in animals receiving acidified water. Duodenoesophageal reflux is carcinogenic in the rat model. Exogenous carcinogen is not necessary for cancer development in gastrectomized rats.

Adenocarcinoma↗
PubMed1997

Testing for occult cancer in patients with idiopathic deep vein thrombosis--a decision analysis.

OBJECTIVE: To determine the effectiveness and cost-effectiveness of testing for occult cancer in idiopathic deep vein thrombosis (IDVT). DESIGN: Threshold analysis was performed on the risk-adjusted cancer prevalence in a cost-effectiveness model of ideal testing for selecting cancers with potentially desirable utility (candidate cancers). Decision analysis was employed to compare different testing programs for candidate cancers with that of no testing. Life expectancy (LE) of early- and late-detected cancers and costs of testing were the dimensions of utility. Cost-effectiveness was expressed as marginal cost per year of life saved. The perspective of the third payer was adopted, and a discount rate of 3% was applied to both costs and benefits. DATA SOURCES: Risk of cancer in IDVT, testing policies, test characteristics, and LE were gathered from literature. Costs were provided from our hospital rate book and accounting service. RESULTS: Ideal testing would support a gain of LE of 40 days or more for prostate, colon and bladder cancer in males and for colon, breast and endometrium cancer in females aged from 60 to 69 years. Testing females with colonoscopy and mammography in any sequence provides 70 days of life gained. Testing males with colonoscopy provides 27 days of life gained. Lower and older ages reduce testing effectiveness. The qualitative results are stable over plausible ranges of test characteristics, while variations in the value of benefit for early cancer diagnosis may modify the strategy. Incremental cost-effectiveness ranges from $1,789 to $ 6,979 per year of life gained. CONCLUSIONS: According to the effectiveness criterion adopted, the only worthwhile investigation strategy includes colon and breast cancer in females. Testing for colon cancer in males is desirable at a lower criterion of effectiveness. All the strategies are cost effective.

Aged↗
PubMed1981

Breast Cancer.

The pre-eminence of breast cancer as a significant cause of premature mortality and as the most prevalent cancer of women in North America justifies a major thrust in prevention. In the past, a number of hormonal risk factors were identified. Increasingly, evidence is being obtained to support the role of dietary risk factors and most particularly the total level of dietary fat. Overweight as a risk factor in postmenopausal women also points to the importance of dietary factors. It is concluded that the time is ripe for an active program of evaluating the effect of reduction in the consumption of total fat, particularly in adolescent, early adult and premenopausal women, and in reducing overweight in postmenopausal women, both as aspects of national policy and as special investigations in defined population groups.

Adolescent↗
PubMed2006

Systematic review: evidence-based management of hepatocellular carcinoma--an updated analysis of randomized controlled trials.

The treatment strategy of hepatocellular carcinoma applied following scientific guidelines is only supported by 77 randomized controlled trials published so far, a figure that clearly pinpoints hepatocellular carcinoma as an 'orphan' cancer in terms of clinical research when compared with other high-prevalent cancers worldwide. A systematic review analysing 61 randomized controlled trials (1978-2002) showed a modest survival benefit from chemoembolization in patients with intermediate tumours, and the lack of an effective first-line treatment option for patients with advanced disease. These conclusions have been endorsed by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases. The present updated evidence-based approach includes 16 randomized controlled trials published from 2002 to 2005 assessing percutaneous ablation (seven), other loco-regional therapies (three) and systemic therapies (six). Eight showed high-quality methodological profiles. Four randomized controlled trials demonstrated a better local hepatocellular carcinoma control in tumours larger than 2 cm treated by radiofrequency ablation compared with ethanol injection. No survival advantages were obtained from systemic treatments in patients with advanced hepatocellular carcinoma, an area that is an unmet need. Therefore, there is an urgent request to conduct well-designed phase III investigations in hepatocellular carcinoma patients.

Carcinoma, Hepatocellular↗