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PubMed1990

Geographic association of Helicobacter pylori antibody prevalence and gastric cancer mortality in rural China.

To examine the geographic association between Helicobacter pylori infection and gastric cancer, we have assessed the prevalence of IgG antibodies to H. pylori in plasma samples taken in 1983 from 1882 men, aged 35-64 years, in 46 rural counties of the People's Republic of China. The gastric cancer mortality rates in these countries in 1973-75 varied from 3 per 1,000 (cumulative rate, 0-64 years) to 69 per 1,000, while the proportions of the population positive for H. pylori antibodies (based on an average of about 41 men per county) varied from 28% to 96%. After correction for the limited number of blood samples per county, the estimated correlation between H. pylori antibody prevalence and gastric cancer mortality was 40% (p = 0.02). No other type of cancer showed a significant association with H. pylori.

Adult↗

PubMed2003

Breast cancer in Egypt: a review of disease presentation and detection strategies.

Carcinoma of the breast is the most prevalent cancer among Egyptian women and constitutes 29% of National Cancer Institute cases. Median age at diagnosis is one decade younger than in countries of Europe and North America and most patients are premenopausal. Tumours are relatively advanced at presentation. The majority of tumours are invasive duct subtype and the profile of hormone receptors is positive for estrogen receptors and/or progesterone receptors in less than half of cases. This overview examines genetic changes, potential and established predictive and prognostic markers and end results of surgery, radiotherapy and systemic therapy for early, locally advanced and metastatic disease stages. Disease presentations common to the region and early detection strategies are presented.

Age Distribution↗

PubMed2005

Predicting biopsy outcome after mammography: what is the likelihood the patient has invasive or in situ breast cancer?

BACKGROUND: As many as 1,000,000 breast biopsies are performed annually in the United States. Although substantial effort has been devoted to estimating breast cancer risk, there have been no studies to predict outcome in women undergoing breast biopsy. METHODS: A population-based study was undertaken to develop and test models for predicting the probability of invasive breast cancer and/or ductal carcinoma-in-situ in 7670 women undergoing breast biopsy after mammography. Logistical prediction models were developed by using data from 6129 randomly selected women and tested with data from the remaining women. RESULTS: The overall cancer prevalence among women undergoing biopsy was 22.4%. Prevalence in women with mammograms highly suggestive of malignancy (category 5) was 84.6%, with minimal variation in individual cancer probabilities due to age. A total of 24.6% of women with suspicious mammograms (category 4) had cancer, but individual probability estimates ranged from .01 to .86, depending on age, presence of a lump, previous biopsy, menopausal status, and use of postmenopausal hormone therapy. These variables also influenced biopsy outcome in women with other mammography assessments (categories 0-3), but the overall prevalence was lower (8.6%), and estimated probabilities ranged from .01 to .45. When cancer was present, the probability of invasive disease was influenced by mammogram assessment category, absence of mammogram calcifications, and presence of a lump. CONCLUSIONS: The probabilities of invasive cancer and ductal carcinoma-in-situ in women undergoing biopsy can be more accurately predicted by using clinical characteristics in addition to mammography findings. This information could potentially influence decisions regarding immediate biopsy or continued surveillance.

Adolescent↗

PubMedDate not supplied

Prevalence of self-reported illnesses in elderly Hispanic and non-Hispanic Whites in New Mexico.

OBJECTIVE: To report on the prevalences of self-reported illnesses from the New Mexico Elder Health Survey. DESIGN: Randomized community-based cross-sectional survey of elderly (> or = 65 years of age) Hispanics and non-Hispanic Whites. METHOD: Analysis of data from the 883 participants in the New Mexico Elder Health Survey. RESULTS: Complete data on 848 subjects were available for this analysis: Hispanic males, 212; Hispanic females, 189; non-Hispanic White males, 236; non-Hispanic White females, 211. The mean age was 74 years (age range 65-98). Hispanics had fewer years of school and lower income. Hispanics reported a significantly (P<.05) higher prevalence of type 2 diabetes; leg ulcers/pressure sores; and Parkinson's Disease. Non-Hispanic Whites reported a significantly (P<.05) higher prevalence of asthma; circulatory problems; stomach (not ulcers), intestinal or gallbladder disease; urinary tract disorders (other than kidney disease); and cancer. Prevalence odds ratios and confidence intervals were calculated. Hispanic males reported a higher prevalence of type 2 diabetes (OR 1.88, CI 1.10-3.26, P = .02), and lower prevalences of asthma (OR 0.43, CI 0.18-0.93, P = .04); urinary tract disorders, other than kidney disease (OR 0.59, CI 0.38-0.91, P = .01); and cancer (OR 0.31, CI 0.13-0.68, P = .005). Hispanic females reported a higher prevalence of diabetes (OR 3.01, CI 1.48-6.50, P = .003), and a lower prevalence of glaucoma (OR 0.48, CI 0.22-1.00, P = .05). These differences remained significant after adjustment for age, education, income, and language. CONCLUSION: There are significant differences in the prevalences of self-reported illnesses between Hispanic and non-Hispanic White elderly.

Aged↗

PubMed1999

Seroprevalence of cytotoxin-associated gene A positive Helicobacter pylori strains in Changle, an area with very high prevalence of gastric cancer in south China.

BACKGROUND: Helicobacter pylori, especially the CagA-positive strains, are closely associated with peptic ulcers and gastric cancers. We performed a large scale gastric cancer screening project and examined the prevalence of H. pylori and CagA-positive strains in Changle, China, an area with one of the World's highest gastric cancer mortality. We also compared the prevalence with that in Hong Kong which has one-tenth of the gastric cancer mortality of that in Changle. METHODS: A total of 2424 subjects in Changle and 523 subjects in Hong Kong had endoscopic examination and venesection. Sera were tested for anti-H. pylori antibody and anti-CagA antibody and correlated with endoscopic findings. RESULTS: In Changle, 80. 9% of the subjects were H. pylori carriers. Out of 551 carriers, 408 (74%) were positive for anti-CagA antibody. A total of 76% and 87% of the asymptomatic and gastric cancer patients were positive for anti-CagA antibody, respectively (P > 0.05). Compared to Hong Kong, there was a significantly (P < 0.0001) higher prevalence of CagA-positive strains in asymptomatic subjects in Changle (76%) than in Hong Kong (28%), but not in peptic ulcers or gastric cancers. CONCLUSIONS: Subjects in Changle had a high prevalence of H. pylori infection and a high prevalence of the CagA-positive strains. The contrast in the prevalence of CagA-positive strains, in asymptomatic subjects in two areas with differing gastric cancer mortality, supports the pathogenic role of CagA-positive strains in gastric carcinogenesis.

Adolescent↗

PubMed1996

Histopathological characteristics of childhood thyroid cancer in Gomel, Belarus.

We reviewed histopathologically 19 cases of childhood thyroid cancer occurring between 1991 and 1994 among 14,396 screening subjects in Gomel, Republic of Belarus, the region most severely radio-contaminated by the Chernobyl nuclear power plant accident in 1986. The patients were 13 girls and 6 boys with a mean age of 10.6 years. The mean age at the time of the accident was 3.2 years. Mean tumor diameter was 16 mm, and all cases were papillary carcinoma with various amounts of solid component. Psammoma bodies and stromal fibrosis were encountered to some extent in almost all cases. The tumors were highly prone to local invasion and regional lymph-node metastasis. No morphological evidence for radiation-induced cancer was obtained in these cases. 137Cs levels were relatively high in the patients' bodies and in the soil at the places of domicile. However, there was no dose-response relationship between cancer prevalence and radioactivity. These facts suggest that the incidence of aggressive pediatric thyroid cancer is extremely high in Gomel, where most of the children were exposed to a low level of radioactivity over a long time after the accident. At present, however, no definite conclusion can be drawn on the relationship between cancer occurrence and radioactive contamination.

Accidents↗

PubMed1988

Neoplastic disease in a medicolegal autopsy material. A retrospective study in northern Sweden.

Only a small fraction of sudden unexpected deaths are caused by neoplastic disease and thus subject ot medicolegal autopsy. The medicolegal autopsy forms an opportunity to study not only medically diagnosed and treated neoplasms, but also the natural evolution of untreated disease. In a series of 7,020 consecutive medicolegal autopsies in northern Sweden, we found 171 cases with malignant and/or intracranial neoplasms. In 41 cases, sudden death was caused by previously unknown tumors. The most common mechanisms of death in this group were disseminated cancer, intracranial tumors, pulmonary thromboembolism, hemoptysis, and aspiration of blood, and the most common locations were the bronchi and the lung. In some of these cases, the mechanism was sometimes dramatic, raising a question of violent death or intoxication. In 30 cases, sudden unexpected death was caused by previously known tumors, and also in this group disseminated cancer was the most common cause of death, and the most common locations were the bronchi and the lung. In 22 cases, tumors were found suicidal cases; in 14 of these, the tumor was considered to be a major causative factor to the suicide, while in eight cases the tumor was considered to be an incidental finding. The expected number of cancers in the 1,060 suicides investigated in this series was 27, according to the official cancer prevalence data. Thus, a possible over-representation of suicides among persons with cancer seems doubtful and needs further exploration.

Adult↗

PubMed2001

A prospective study of diet and stomach cancer mortality in United States men and women.

Frequent consumption of fruits, vegetables, and whole grains has been associated with a reduced risk of stomach cancer in the majority of case-control studies of these factors: however, prospective studies have been less consistent. We examined the association between selected major food groups (citrus fruits, vegetables, whole grains, and processed meats) and risk of fatal stomach cancer in the Cancer Prevention Study (CPS) II cohort of 1.2 million United States men and women. During 14 years of follow-up, we documented 439 stomach cancer deaths in women and 910 in men after exclusion of individuals with prevalent cancers, inadequate diet information, and recent weight loss at baseline in 1982. After controlling for other risk factors, none of the food groups examined were associated with risk of stomach cancer except for an unexpected increased risk with vegetable consumption in women [relative risk (RR) = 1.25; 95% confidence interval (CI), 0.99-1.58; highest versus lowest tertile, P = 0.06 for trend]. A high overall plant food intake (a sum of vegetables, citrus fruit, and whole grains) was associated with reduced risk in men (RR = 0.79; 95% CI, 0.67-0.93; highest versus lowest tertile, P = 0.003 for trend), but not in women (RR = 1.18; 95% CI, 0.93-1.50; P = 0.16 for trend). Of individual foods examined, liver consumption greater than twice/week was associated with an increased risk of fatal stomach cancer in women (RR = 1.96; 95% CI, 1.09-3.53) and men (RR = 1.63; 95% CI, 1.02-2.62) compared with nonconsumers. This study supports a modest role for plant foods in reducing the risk of fatal stomach cancer in men, but not in women.

Adult↗

PubMedDate not supplied

Epidemiological factors of cancer in California.

California has 12% of the U.S. population. In 1991, the newly diagnosed cancer cases in California represented 10% of all new cancer cases in the country, and the yearly toll was 10% of all cancer deaths. Relative to all new cancer cases in the U.S., California had 10, 9.8, 9.8, and 9.3% of breast, lung, prostate, and colorectal cancers, respectively. Because of its large population and cancer incidence, the epidemiology of cancer in California is of particular interest. Epidemiological factors reviewed in this article include ethnicity, lifestyle, occupation, and environmental conditions. Ethnic factors: There is an increased incidence of cervical and gallbladder cancer among Hispanic women, and of stomach cancer in Hispanic men and women. In U.S.-born Chinese men, the most prevalent cancers are those of the lung and colon, which is also seen in American white men. In U.S.-born Chinese women, there is an upward displacement of breast cancer incidence. In U.S.-born Japanese men and women, the mortality rate is closer to that of American whites. Life-style: Members of the Mormon Church and Seventh-Day Adventists have only 50% of the U.S. standardized mortality rate for cancer associated with smoking. Increased coffee consumption has been found to be associated with increased occurrence of colon and bladder cancer; alcohol use has been reported to have a positive association with colorectal cancer. The large AIDS population in San Francisco has a 144-fold odds ratio of Kaposi's sarcoma and a fivefold odds ratio of lymphoma when compared with the general U.S. population. Occupational factors: An increased incidence of mesothelioma in asbestos workers, of gastric cancer, skin cancer, and lymphoma in men working in dusty environments, and of astrocytoma in individuals with prolonged exposure to low-frequency electric and magnetic fields has been recorded. Environmental factors: The drinking-water pool in northern California is contaminated with asbestos of the serpentine type, which is associated with mesothelioma of the peritoneum and carcinoma of the lung, gallbladder, and pancreas. Petrochemical fumes in the heavily industrialized San Francisco Bay area have not been associated with an increased occurrence of cancer. No significant incidence in cancer has been noted in the counties surrounding the nuclear power plant at San Onofre during 18 years of close observation.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Occupational cancer in Denmark. Cancer incidence in the 1970 census population.

Data sources and creation of data files. The cohort of persons who were 20-64 years of age at the time of the 1970 census has been followed for cancer incidence for a ten-year period. The study was made by linkage of individual records from the 1970 census, the Central Population Register, death certificates, and cancer registrations. Data were included on individual characteristics recorded in the census on prevalent cancer cases at the time of the census and on deaths, emigrations, and incident cancer cases during the ten-year follow-up period. The study includes a total of 2.8 million persons, of whom 2.0 million were economically active at the time of the 1970 census. A total of 115,000 incident cancer cases were registered during the follow-up period, and 77,000 of these occurred in persons who were economically active in 1970. The classifications used in the census included 218 codes for occupation and 245 codes for industry. The Cancer Registry data included 639 codes for diagnosis. Cancer incidence by social groups in Denmark. The cancer incidence was tabulated across 32 socioeconomic groups for 43 cancer sites among the men and 45 cancer sites among the women. The study showed an almost twofold difference in the overall cancer incidence between the socioeconomic groups of the men. Self-employed farmers were at low risk (RR 0.68), and unskilled workers in shipping/fishing were at high risk (RR 1.28) when the cancer incidence among all economically active men was used for the comparison. The social pattern in cancer incidence correlated well with the pattern for cancer mortality among men. As a rough estimate, the cumulative incidence for all cancer among persons under 75 years of age could be reduced by 32% if all Danish men had the cancer incidence of farmers. There was a fivefold or larger difference between the socioeconomic groups in the incidence for nine cancer sites. These nine cancer sites together represented 7% of the cumulative incidence for all cancer. Estimated in a similar way, the cumulative incidence could be reduced by 44% if all Danish men had the site-specific cancer incidence of the respective low-risk groups. The overall cancer incidence among the women varied from a relative risk of 0.71 for unskilled workers in agriculture to a relative risk of 1.18 for self-employed women in other industries I (dentists, lawyers, etc) when the cancer incidence among all economically active women was used for the comparison.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed2004

Disparities in prevalence rates for lung, colorectal, breast, and prostate cancers in Medicaid.

BACKGROUND: Given previous reports of variations in prevalence of cancer in low-income individuals, we sought to determine if disparities in cancer prevalence existed in a similarly-insured Medicaid population. METHODS: Using Maryland Medicaid administrative claims data, prevalence rates of lung, colorectal, breast, and prostate cancers were calculated for Maryland Medicaid recipients who were continuously eligible during the period from January 1, 2000 to December 31, 2000. Chi-squared tests were used to test the differences across subgroups. Cancer prevalence data were age-adjusted using Maryland Medicaid enrollees as the standard population. RESULTS: The care prevalence rates for lung, colorectal, breast, and prostate cancers were 75/10,000, 63/10,000, 92/10,000, and 45/10,000, respectively. These rates were 1.2 to 5.2 times those reported at the national level. Generally, higher cancer prevalence rates in certain racial groups in Maryland Medicaid were consistent with previous studies. Regional differences in cancer prevalence existed for each cancer studied. CONCLUSIONS: Limiting our study sample to a population of uniformly low socioeconomic individuals did not eliminate the disparity in prevalence rates between blacks and whites. Different patterns of racial disparity across regions reported by previous researchers might be due to small area variation in addition to socioeconomic status.

Adult↗

PubMed1998

Breakthrough pain in cancer patients: characteristics, prevalence, and treatment.

"Breakthrough pain" is a common clinical term that has not been conclusively defined or described. Breakthrough pain is a transitory flare of pain experienced when baseline pain has been reduced to a mild or moderate level. Breakthrough pain may be characterized by its relationship to a fixed around-the-clock (ATC) opioid dose, rapid onset and short duration, precipitating events, predictability, pathophysiology (with nociceptive pain being most easily controlled), and etiology. The only prospective study of breakthrough pain conducted to date found a 63% prevalence of breakthrough pain in cancer patients referred to a pain service. Although prevalence figures from other studies vary widely, partly due to the populations chosen, all of the studies verify that breakthrough pain is a serious problem in cancer patients. In fact, several studies have listed incident pain, a subset of breakthrough pain, as a predictor of poor response to analgesic therapy. Breakthrough pain is currently managed with oral or parenteral breakthrough pain medications given in addition to the ATC analgesic regimen. The ATC dosage may also be increased until limited by side effects. Newer agents with a more rapid onset of analgesia and shorter duration of effect may help in the management of breakthrough pain.

Administration, Oral↗

PubMed2004

Burden of illness in cancer survivors: findings from a population-based national sample.

BACKGROUND: Population trends in aging and improved cancer survival are likely to result in increased cancer prevalence in the United States, but few estimates of the burden of illness among cancer survivors are currently available. The purpose of this study was to estimate the burden of illness in cancer survivors in a national, population-based sample. METHODS: A total of 1823 cancer survivors and 5469 age-, sex-, and educational attainment-matched control subjects were identified from the 2000 National Health Interview Survey. Multiple measures of burden, including utility, a summary measure of health, and days lost from work, were compared using two-sided tests of statistical significance for the two groups overall and for subgroups stratified by tumor site and time since diagnosis. RESULTS: Compared with matched control subjects, cancer survivors had poorer outcomes across all burden measures (P<.01). Cancer survivors had lower utility values (0.74 versus 0.80; P<.001) and higher levels of lost productivity and were more likely to report their health as fair or poor (31.0% versus 17.9%; P<.001) than matched control subjects. Cancer survivors reported statistically significantly higher burden than did control subjects across tumor sites and across time since diagnosis (i.e., within the past year, 2-5 years, 6-10 years, and > or =11 years for the majority of measures. CONCLUSIONS: Cancer survivors have poorer health outcomes than do similar individuals without cancer across multiple burden measures. These decrements are consistent across tumor sites and are found in patients many years following reported diagnosis. Improved measurement of long-term burden of illness will be important for future prospective research.

Activities of Daily Living↗

PubMed1990

The first 2 years of the Gambian National Cancer Registry.

We describe the creation, and the first 2 years experience, of the Gambian National Cancer Registry. The major problems involved in the creation of such a registry in a developing country are discussed. The data accumulated show a low overall rate of cancer incidence compared to more developed parts of the world and indicate that the prevalent cancers, hepatoma, carcinoma of the cervix and lymphoma, are likely to be due to infectious agents. It is hoped that immunisation of children under one year against hepatitis B will drastically reduce the incidence of hepatocellular carcinoma.

Adolescent↗

PubMedDate not supplied

Breast self-examination: knowledge, attitudes, and practices among female health care workers in Tehran, Iran.

A cross-sectional study was conducted to examine the knowledge of breast cancer, attitudes toward breast self-examination (BSE), and practice of BSE among a sample of female health care workers in Tehran, Iran. Using a purposed questionnaire, a total of 410 women from seven health centers completed the questionnaire. The mean age of the respondents was 32.9 years (SD = 9.5), most (58%) were married, and family history of breast cancer was reported by 11%. Seventy-five percent of the women knew about breast cancer prevalence, but only 27% knew that breast pain is not a symptom of breast cancer. Although 73% of women did know that contact with a relative with breast cancer could not lead to development of breast cancer, the respondents' knowledge of risk factors of breast cancer was not satisfactory. With regard to women's attitudes toward BSE, the majority believed that it is not difficult and time consuming or troublesome (63% and 72%, respectively). Sixty-three percent of the respondents claimed that they know how to examine their breasts, but only 6% performed BSE monthly. The practice of BSE was significantly associated with age (p = 0.01), the level of education (p < 0.0001), personal history of breast problems (p < 0.0001), and knowledge of how to examine the breasts (p < 0.0001). The study findings suggest that the knowledge and behaviors of female health care workers concerning breast cancer is relatively poor and it needs to be improved. Considering the role that health care workers may play in communicating health behaviors to the general public, planning health education interventions for this group of females is essential.

Adult↗

PubMed2006

A population-based study of skin cancer incidence and prevalence in renal transplant recipients.

BACKGROUND: Cancers occurring following solid organ transplantation are a rapidly growing public health concern. Defining the extent of the problem has been limited by surveillance systems with incomplete registration of cases and the paucity of reliable national incidence data. OBJECTIVES: To determine the incidence of all cancers following renal transplantation and to make a detailed examination of trends and patterns associated with postrenal transplant skin cancers. METHODS: Integration of data from the national renal transplant database and the national cancer registry in Ireland enabled accurate determination of the number of renal transplant recipients (RTRs) with skin cancers and other malignancies in the time period 1 January 1994 to 31 December 2001. RESULTS: We demonstrated a biphasic increase in skin cancer incidence following renal transplantation, determined by the age at transplantation. There was a steady increase in risk for older RTRs (age 50+ years) from year 2 post-transplant, whereas the increased risk in younger RTRs (age < 50 years) occurred later but much more significantly, reaching 200 times the risk for an age-matched nontransplanted population by year 6 post-transplant. The number of nonmelanoma skin cancers (NMSCs) registered in RTRs accounted for 1% of all NMSCs registered nationally over the study period. The standardized incidence rates for invasive NMSC (33-fold increase) and in situ carcinoma of the skin (65-fold increase) were significantly increased (P < 0.05). The risk for invasive squamous cell carcinoma (SCC) was increased 82-fold compared with the nontransplanted population. Male RTRs were at particular risk of invasive SCC at sun-exposed sites such as the scalp and the external ear. Risk of malignant melanoma and Kaposi sarcoma were also increased relative to the nontransplanted population. CONCLUSIONS: This comprehensive national study illustrates how rates of skin cancer in Irish RTRs have influenced the national incidence of skin cancer. The high incidence of SCC, basal cell carcinoma and Bowen's disease in the early post-transplant period for older patients and the cumulative risk in younger patients with increased duration of transplantation highlight the importance of implementing early and continued cancer surveillance regimens post-transplant.

Adult↗

PubMed2005

Comparison of iodine contents in gastric cancer and surrounding normal tissues.

It has been suggested that iodine plays an important role in gastric cancer. Gastric cancer ranks first among the cancers in the north-eastern Anatolia region, Turkey, where iodine deficiency is common. In this study, iodine levels were determined in gastric cancer and surrounding normal tissues in 19 patients with gastric cancer. Tissue iodine levels were determined by the Foss method based on the Sandell-Kolt-hoff reaction. Tissue iodine levels were lower in gastric cancer tissue (17.8+/-3.4 ng I/mg protein, mean+/-SEM) compared with surrounding normal tissue (41.7+/-8.0 ng I/mg protein) (p<0.001). There was positive correlation between the iodine levels in gastric cancer tissue and surrounding normal tissue (r = 0.845, p<0.001). There was no significant difference in iodine levels in cancer and surrounding normal tissue between male and female subjects. The iodine deficiency in our region may be one of the factors for increased gastric cancer prevalence. Our results support the hypothesis that iodine plays an important role in gastric cancer development.

Adult↗

PubMed1990

Clinical evidence for and implications of the multistep development of prostate cancer.

Based upon a large body of experimental and clinical data, it is evident that multiple malignant events are necessary for a normal cell to give rise to a fully malignant cancer cell. A critical issue with regard to human prostatic carcinogenesis is the clinical significance of the large number of cancers that are present histologically in the elderly male prostate gland. A possibility is that these histological prostate cancers already have undergone all of the malignant events necessary to produce clinically manifest cancer and, thus, only further tumor growth is required to produce a clinical tumor. Alternatively, these histological cancers may have undergone some but not all of the events necessary to produce clinical disease and, therefore, despite host longevity the cancer will remain clinically silent as long as no further malignant changes occur. This issue has importance clinically with respect to the diagnosis, therapy and possible prevention of prostatic cancer. Clinical observations and the mathematical relationship between prostate cancer prevalence and host age (time) support the fact that, in addition to growth, histological prostate cancer requires further malignant events to produce clinical disease. A better understanding of the events involved in prostate cancer development will be necessary to have a greater impact on this disease in the future.

Adult↗