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PubMed2002

Prevalence-corrected prostate cancer incidence rates and trends.

A correction is made of prostate cancer incidence rates based on data from the Surveillance, Epidemiology, and End Results Program of the United States National Cancer Institute. Unlike conventional incidence rates reported by the Program, corrected rates remove from the population the estimated number already diagnosed with the disease. The corrected rates reflect the average prostate cancer risk for men in the at-risk population. Because of the high incidence of and relatively good survival for prostate cancer, the prevalence of this disease is high. Corrected prostate cancer incidence rates were higher in magnitude, particularly in older age groups and among Black men. For example, in 1997 for Whites, the corrected rates were 3.8 percent higher in cases aged 60-69 years, 9.3 percent higher in cases aged 70-79, and 13.1 percent higher in cases aged 80 or more. Corresponding percentages for Blacks were 5.9, 18.9, and 16.9 percent, respectively. Percent changes over calendar time were very similar between corrected and uncorrected prostate cancer incidence rates according to age and race (White and Black). Failure to account for high levels of prostate cancer prevalence in conventional incidence rates of the disease results in underestimation of the rates but little temporal difference in the trends.

Black or African American↗

PubMed1980

Breast cancer incidence, prevalence, mortality, and survivorship in Rochester, Minnesota, 1935 to 1974.

The epidemiologic features of breast cancer in Rochester, Minnesota, were studied over the 40-year period 1935 to 1974. During this time, the age-adjusted incidence rate increased 25% to 82.7 per 100,000 person-years. Most of the increase occurred among women 45 to 64 years of age. Overall, the incidence of breast cancer increased with advancing age, as did breast cancer prevalence, which was 901.4 per 100,000 women on Jan. 1, 1975. Age-adjusted mortality rates declined slightly from 24.9 to 23.3 per 100,000 person-years during the study period. Survival after the diagnosis of breast cancer seemed to improve somewhat among women who were less than 45 or more than 65 years old at the time of diagnosis. This was associated with a decline in the proportion of these women with regional lymph node involvement or distant metastases present at the time of initial diagnosis.

Adenocarcinoma↗

PubMed1992

The prevalence of cancer among adults in the United States: 1987.

No national data exist on the prevalence of cancer in the United States population. The authors report the first estimates of prevalence rates of cancer from a population-based sample of the adult population of the United States. Estimates are based on responses collected from the Cancer Control Supplements of the National Health Interview Survey, a population-based sample survey of all people older than 17 years of age in the United States in 1987. Of 44,123 adults questioned, 1593 said they had a nonskin cancer. In 1987, after adjustments, the overall prevalence rate of all types of cancer, excluding nonmelanoma skin cancer, was 3230 per 100,000 adults; the rates for men and women were 1930 and 4412, respectively. The authors estimate that, in 1987, 5.7 million adults in the United States were survivors of nonskin cancer, 3.3% of the adult population. Approximately 89,000 adults had cancer during childhood, or 1.6% of the total. Approximately 3.6 million people were at least 5-year survivors and 900,000 adults had their disease diagnosed during the year before interview. Despite the potential for underreporting and misclassification, these national estimates are in general accord with figures estimated from other sources. Increasing survival after cancer, especially childhood and adolescent cancer, indicates the importance of continued monitoring to provide information needed to plan for adequate health services.

Adult↗

PubMed2003

Prevalence of cancer in follicular thyroid nodules: is there still a role for intraoperative frozen section analysis?

The optimal surgical management of follicular thyroid nodules and the effectiveness of frozen section (FS) analysis in planning the operation are still controversial. In this study, we reviewed the prevalence of cancer in 309 consecutive patients (230 females, 79 males, aged 42 +/- 13 years) with follicular nodules at fine-needle aspiration cytology (FNAC) and the efficacy of FS evaluation in selecting cancers. On the whole, the prevalence of cancer was 20.1%; the occurrence of follicular variants of papillary cancer (14.9%) was threefold higher than follicular cancers (5.2%). The presence of atypical features at FNAC selected nodules with a significantly higher prevalence of cancer (46.7%, p = 0.01). FS analysis was performed in 142 patients and recognized only 8 of 27 (30%) cancers, one fourth of them with atypia at FNAC. In conclusion, this study confirms a 20% overall prevalence of malignancy in patients with follicular thyroid nodules. The association of cell atypia with a follicular pattern may define a subgroup of nodules more likely to be malignant. FS was seldom effective in recognizing cancer confirming the doubt on its cost effectiveness in planning the surgical approach. Protocols aimed at a better cytologic identification of follicular variants of papillary cancer should be considered.

Adult↗

PubMed2004

Cost-effectiveness of photodynamic therapy for high-grade dysplasia in Barrett's esophagus.

BACKGROUND: Photodynamic therapy appears to be effective in ablating high-grade dysplasia in Barrett's esophagus. Our aim was to identify the most effective and cost-effective strategy for managing high-grade dysplasia in Barrett's esophagus without associated endoscopically visible abnormalities. METHODS: By using decision analysis, the lifetime costs and benefits of 4 strategies for which long-term data exist were estimated by us: esophagectomy, endoscopic surveillance, photodynamic therapy, followed by esophagectomy for residual high-grade dysplasia; and photodynamic therapy followed by endoscopic surveillance for residual high-grade dysplasia. It was assumed by us that there was a 30% prevalence of cancer in high-grade dysplasia patients and a 77% efficacy of photodynamic therapy for high-grade dysplasia and early cancer. RESULTS: Esophagectomy cost 24,045 dollars, with life expectancy of 11.82 quality-adjusted life years. In comparison, photodynamic therapy followed by surveillance for residual high-grade dysplasia was the most effective strategy, with a quality-adjusted life expectancy of 12.31 quality-adjusted life years, but it also incurred the greatest lifetime cost (47,310 dollars) for an incremental cost-effectiveness of 47,410 dollars/quality-adjusted life years. The results were sensitive to post-surgical quality of life and survival, and to cancer prevalence if photodynamic therapy efficacy for cancer was less than 50%. CONCLUSIONS: Photodynamic therapy followed by endoscopic surveillance for residual high-grade dysplasia appears to be cost effective compared with esophagectomy for patients diagnosed with high-grade dysplasia in Barrett's esophagus. Clinical trials directly comparing these strategies are warranted.

Adenocarcinoma↗

PubMed2003

[Prevalence of cancer in the Guadalajara health area].

OBJECTIVE: To quantify the prevalence of cancerand its distribution in adults. DESIGN: Descriptive study of point prevalence through research into primary and secondary sources. SETTING: Primary care, Guadalajara Health Region. 133 539 people over 14 years old. PARTICIPANTS: Patients previously diagnosed with cancer, who had a health card in the health area in June 1999. MEASUREMENTS: Demographic and diagnostic details (location according to CIE-9, date and diagnostic method). DATA SOURCES: primary care clinical records, cancer morbidity records and attendance orders. Overall crude and adjusted rates, in function of sex and age group, and specific to locations, were calculated. They were compared with data from other studies and data calculated for Spain on the basis of WHO information. RESULTS: 2717 tumours (2595 patients). Mean age, 68.2 (95% CI, 67.6-68.7); diagnostic age, 62.8 (95% CI, 62.1-63.5), in both cases higher in men (P<.01). Most common tumours: prostate, bladder, colon and lung (men); breast, colon, endometrium and ovaries (women). Crude prevalence: men, 2303.8/100 000; women, 1763.8. Adjusted to world population: 1394.2 and 1227.4/100 000, respectively (prevalence ratio, 1.14; 95% CI, 1.03-1.25). Truncated rate higher in women than in men (1638/100 000 against 1308). Five-year period with highest prevalence: 75-79 years old in men (8763.5/100 000) and 80-84 in women (4558.7/100 000). CONCLUSIONS: Cancer prevalence in adults is slightly above 2%. Once adjusted for age, values are similar to other studies and as expected for our country. The most common tumours are in the digestive apparatus, breast and the genito-urinary system. The man/woman proportion is higher than that described in other studies.

Humans↗

PubMed2002

Stereotactic large core needle biopsy for all nonpalpable breast lesions?

BACKGROUND: Stereotactic large-core needle biopsy (SLCNB) is a minimally invasive method for histological diagnosis of nonpalpable breast disease. We studied differences in cancer prevalence between a group of women referred through the national screening program and a non-screening group, and assessed whether the validity of SLCNB differed between these groups. METHODS: A group of non-selective, consecutive patients presenting with a nonpalpable mammographic lesion, who participated in a recently conducted multicenter study regarding the accuracy of SLCNB in The Netherlands, were the basis for this study. Prevalence of carcinoma, predictive value of a benign diagnosis, sensitivity, and specificity rate of SLCNB were compared between the two groups. RESULTS: Of the 1029 lesions in 972 patients included, 858 were evaluable. In 850/858 lesions (99.1%) the reason for referral was clear. The prevalence of cancer in the screening group (n = 511 lesions) was 64.0% (95%CI 59.8-68.2), versus 49.6% in the non-screening group (n = 339) (95%CI 44.2-54.9). Respective predictive values of a benign diagnosis on SLCNB were 97.0 versus 94.8% (non-significant). The sensitivity rates of SLCNB were 98.5% (screening; 95%CI 96.5-99.5) versus 95.2% (non-screening; 95%CI 90.8-97.9). Specificity rates were 97.8 (95%CI 94.5-99.4) and 99.4% (95%CI 96.8-100), respectively. CONCLUSION: Despite a significant difference in the prevalence of carcinoma, the accuracy of SLCNB did not show a statistically significant difference between both patient groups. Therefore, SLCNB appears accurate in diagnosing nonpalpable breast lesions both in screening and non-screening patient groups.

Aged↗

PubMed1987

Feasibility study of a statewide pathology-based cancer surveillance system in Minnesota. I. Information characteristics.

The Minnesota Department of Health has completed a 2-year feasibility study comparing the completeness and accuracy of information from pathology-based cancer ascertainment with that of the traditional surveillance method based on hospital discharge records. Overall, for incident cancers, the primary site designation of the pathology-based system was correct for 94.5% of the cancers, and the histologic designation was correct for 97.0% of the cancers. For prevalent cancers the accuracy of both site and histology designation was inadequate at 81.0 and 76.8% respectively. Pathology-based ascertainment was more complete than discharge-based surveillance (98.4% vs. 96.6%), which reflected the growing number of cancers diagnosed in hospital outpatient departments and medical clinics. The major limitation of the pathology-based system was the inability to determine from written pathology reports whether the cancer was newly diagnosed. However, when asked, pathologists correctly determined the incidence status for approximately 75% of the cancers. In light of the results of the feasibility study, Minnesota is implementing a pathology-based system as a cost-effective, scientifically valid method to meet the state's current and future needs for cancer surveillance.

Data Collection↗

PubMed1980

[Evaluation of the comprehensiveness of a cancer register from death certificates].

The comparison of cancer prevalence with cancer mortality can lead under some hypotheses to an estimate of registration rate. A method is proposed, where the cases with cancer as a cause of death are divided into 3 categories: (1) cases already known by the registry (2) unknown cases having occured before the registry creation date (3) unknown cases occuring during the registry operates. The estimate is then the number of cases in the first category divided by the total of those in categories 1 and 3 (these only are to be registered). An application is performed on the data of the Canton de Vaud. Survival rates of the Norvegian Cancer Registry are used for computing the number of unknown cases to be included in second and third category, respectively. The discussion focusses on the possible determinants of the obtained comprehensiveness rates for various cancer sites.

Humans↗

PubMed1999

Racial differences in the androgen/androgen receptor pathway in prostate cancer.

Pathologic and epidemiologic data suggest that while little racial variation exists in prostate cancer prevalence ("autopsy cancer"), striking racial variation exists for the clinically diagnosed form of the disease. A review of the available literature was performed to define whether racial differences in serum androgen levels or qualitative or quantitative differences in the androgen receptor were correlated with prostate cancer incidence or severity. Black men were found to be exposed to higher circulating testosterone levels from birth to about age 35 years. Such differences were not consistently noted among older men. Significant differences also were found for dihydrotestosterone metabolites among black, white, and Asian men. Unique racial genetic polymorphisms were noted for the gene for 5 alpha-reductase type 2 among black and Asian men. Novel androgen receptor mutations recently have been described among Japanese, but not white, men with latent prostate cancer. Finally, androgen receptor gene polymorphisms leading to shorter or longer glutamine and glycine residues in the receptor protein are correlated with racial variation in the incidence and severity of prostate cancer. This same polymorphism also could explain racial variation in serum prostate-specific antigen levels. Collectively, these data strongly suggest racial differences within the androgen/androgen receptor pathway not only exist but could be one cause of clinically observed differences in the biology of prostate cancer among racial groups.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

PubMed1997

Estimating the completeness of prevalence based on cancer registry data.

Prevalence data provided by cancer registries are generally biased, since the patients that were diagnosed before the starting of the registry's activity cannot be included in the statistics. The relevance of this incompleteness bias is estimated in this paper. Incidence and relative survival are modelled as parametric functions describing a wide class of cancer diseases. Prevalence estimates are then computed considering different hypotheses on disease reversibility. The ratio between the prevalence observed by the registry and the total estimated prevalence is used as an index of completeness. An analytical evaluation of this ratio, as a function of the parameters characterizing the observational process and the biological behaviour of the disease, is given.

Adult↗

PubMed2005

Barrett's surveillance is worthwhile and detects curable cancers. A prospective cohort study addressing cancer incidence, treatment outcome and survival.

OBJECTIVES: To establish whether Barrett's surveillance is worthwhile in terms of incident cancers and whether outcomes are favourable. METHODS: A prospective non-randomized single centre Barrett's surveillance programme commencing 1 January 1992 through 1 April 2001 (112 months). Oesophagectomy recommended for high-grade dysplasia or carcinoma. RESULTS: Of 23 725 patients, 506 were diagnosed as Barrett's oesophagus and 24 (5%) had carcinoma at diagnosis (prevalence cancers). One hundred and twenty-six patients had at least one surveillance endoscopy; 248 surveillance endoscopies were performed spanning 338 patient years. Thirteen surveillance (incidence) cancers were detected. In the prevalence cancer group 12 of the 24 patients underwent oesophagectomy. Lymph nodes showed evidence of metastases in 10 of the 12 resections. In the surveillance group 10 patients underwent oesophagectomy. Lymph nodes showed evidence of metastases in one of the 10 resections. One patient in the prevalence cancer group (4% of group; 8% of those operated) and seven patients in the surveillance cancer group (54% of group; 70% of those operated) remain disease-free more than 2 years post-oesophagectomy. The cost per cancer cured is 7546 pounds. One curable cancer was detected per 48 patient years of surveillance. CONCLUSIONS: Few Barrett's surveillance studies have addressed treatment outcomes and survival. In our study 5% of Barrett's patients undergoing endoscopy have prevalent cancers. If surveillance is performed, 4% per year develop cancer and 2% per year are cured of their cancers. Most surveillance cancers are operable and of those undergoing surgery 70% are cured. Barrett's surveillance is cost-effective compared with other cancer screening or surveillance initiatives.

Adenocarcinoma↗

PubMed2005

Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial.

BACKGROUND: Interval colorectal cancer (CRC) occasionally is detected in patients who have recently undergone colonoscopy. Systematic evaluation of CRC detected after colonoscopy could identify ways to improve the quality and the outcome of colonoscopy. METHODS: This study examined cancer diagnoses in the course of the dietary Polyp Prevention Trial, a randomized study of a dietary intervention on recurrence of adenomatous polyps. An algorithm was developed to classify each cancer into one of 4 etiologies: (1) incomplete removal (cancer at the site of previous adenoma), (2) failed biopsy detection (cancer in an area of suspected neoplasia with negative biopsy specimens), (3) missed cancer (large, advanced stage cancer found at a short interval after colonoscopy), or (4) new cancer (small, early stage cancer after a longer time interval). RESULTS: Of 2079 patients, 13 had cancer detected over 5810 person years of observation (PYO) (2.2 cases/1000 PYO); 7/13 or 53.8% of patients had either a potentially "avoidable" cancer or one detectable at an earlier time interval because of incomplete removal (4/13) or missed cancer (3/13). CONCLUSIONS: Interval cancer occurs despite colonoscopy. Improved quality of colonoscopy may have reduced cancer prevalence or resulted in earlier cancer detection in over 50% of prevalent cancers in the dietary Polyp Prevention Trial.

Aged↗

PubMed1994

Oncogene overexpression in non-small-cell lung cancer tissue: prevalence and clinicopathological significance.

In contrast to small-cell lung cancer, few data are available on the role of oncogene overexpression in non-small-cell lung cancers (NSCLC). To determine the prevalence and extent of the transcriptional activation of cancer genes in NSCLC we investigated the level of mRNA of the three important cellular oncogenes--erbB2, Ki-ras, and c-myc--in 39 surgically or endoscopically obtained tumor samples and 24 samples of normal bronchopulmonary tissue taken from the same patients. Tissue RNA was prepared and the specific mRNA analyzed by the highly sensitive nuclease S1 protection assay. Oncogene mRNA in the tumors was quantified by comparison with the homogeneously weak signals in normal lung tissue preparations with densitometry. The presence of two- to four-fold excess RNA was defined as moderate and a greater than fourfold RNA amount as strong gene overexpression. In contrast to normal tissue the oncogene mRNA amount varied considerably among tumors, showing increases up to 64-fold in erbB2, 13-fold in Ki-ras, and 57-fold in c-myc. Moderate and strong (in brackets) mRNA overexpression occurred with 33% (33%) in erbB2, 36% (18%) in Ki-ras, and 18% (23%) in c-myc. Simultaneous overexpression of two genes was observed with 41% and increased mRNA of all genes tested with 20% of the NSCLC samples. Augmented oncogene mRNA was observed most frequently in large-cell carcinoma. The c-myc overexpression was significantly more prevalent in large-cell cancer than in adenocarcinoma. Tumor differentiation was negatively correlated with c-myc mRNA amounts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

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↗

PubMed2000

Ovarian cancer epidemiology in Thrace, Greece.

PURPOSE OF INVESTIGATION: To report the differences in ovarian cancer prevalence between the two major ethnic groups (Christian Orthodox and Muslims) in Thrace, Greece. METHOD: We carried out a retrospective study on 57 patients, aged 16-79 years, who were treated in our clinic for ovarian cancer. RESULTS: The cumulative ovarian cancer prevalence in Thrace was 6.8/100,000 (5.5/100,000 for Christian Orthodox and 1.3/100,000 for Muslims). There were no statistically significant differences in most variables affecting the tumour itself. The statistical analysis of demographic risk factors revealed that the Christian population was more of a middle class profile, while the Muslim lifestyle sustained its cultural characteristics, a difference that could be related to the discrepancy observed in ovarian cancer prevalence among them. CONCLUSIONS: The overall ovarian cancer prevalence in Thrace is lower than that reported for most developed countries and higher than that for most Asian countries. The variance in prevalence between Christian Orthodox and Muslims could possibly be attributed to the different major parameters in lifestyles.

Adolescent↗

PubMed1997

[Prevalence of cancer, health care and daily life assistance in people aged 75 or over living in the Tarn area (France)].

The association between cancer and dependence was estimated using a cross-sectional study among persons 75 years of age or-older in Tarn county (area with a cancer registry recognized by the National Committee of Registries). A representative random sample stratified on age, sex, and size of district, was drawn using the electoral registers. Each person randomly selected answered the questions of a surveyor about previous history of cancer, aid in daily life activities and use of health care. Among 5,161, the questionnaire was filled for 3,368 persons (participation: 65.3%). Only 2.3% declared a past history of cancer (cancers diagnosed before 1982 and cancers of the skin excluded). After verification 12.6% of the men and 5.2% of the women in the sample were found in the registry. This result shows a very high tendency for people not to declare their disease. From 75 years of age, 1 man among 8, and 1 woman among 20 suffer or have suffered from a cancer during the last 12 years. Only a weak association between prevalence of cancer and aid in daily life activities could be found, probably explained by the important polymorbidity existing in this age group. The persons who suffered from cancer, are not more often confined in bed or in old people's home. Regarding use of health care, they see a nurse or their general practitioner more frequently, they have been operated or admitted in the hospital more frequently than persons without a past history of cancer. Persons with a past history of ear-nose-throat cancer differ from other cancers by needing more aid to go out of their home, and by taking medical advice more frequently. Except for the ear-nose-throat cases, cancer (aside from the acute stage) does not generate more dependence or hinder the quality of survival, in comparison to those of people of the same age.

Aged↗

PubMed1989

The prevalence of cancer in Sweden 1984.

A total of 772,492 (99.3%) of all patients with a newly diagnosed malignant disease notified to the National Swedish Cancer Registry during 1958 through 1984 could be followed up with respect to survival or emigration by means of computerized record linkages. The number of cancer patients still alive on December 31, 1984, totalling 194,389, was divided by the appropriate population denominator. The crude prevalence rate in Sweden of individuals who have or have had any cancer was 1,840 per 10(5) in males and 2,808 per 10(5) in females. At ages 40 through 59, the rates in females were 2.2 to 2.5 times higher than those in males, whereas after the age of 75 cancer was more prevalent in males. Prostate cancer was the most common tumour in males, 24.5% of the crude prevalence rate (451 per 10(5), followed by colorectal cancer, cancer of the bladder and malignant melanoma. In females, the breast was the dominating cancer site, accounting for 32.7% (917 per 10(5), followed by cancer of the large bowel, uterine corpus and uterine cervix. We conclude that prevalence rates provide important information about the magnitude of the cancer problem over and above that revealed by incidence and mortality statistics. The high, and probably increasing, prevalence rates over time emphasize that important savings in economic and other resources can be achieved by strictly evaluated and cost-effective regimens for follow-up.

Adolescent↗