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PubMedDate not supplied

Correcting the completeness bias of observed prevalence.

AIMS AND BACKGROUND: The cancer prevalence in given areas can be estimated on the basis of data supplied by cancer registries. As the obtained estimate of prevalence depends on the length of the cancer registry's observation period, it is generally lower than the total prevalence in the considered area. In the present work we propose a method to calculate a correction factor of this bias in order to obtain an approximation to the total prevalence. METHODS & STUDY DESIGN: The method is based on the relationship between relative survival and incidence by age for a specific cancer site. RESULTS AND CONCLUSIONS: We provide values of the correction factor, the completeness index R, relative to the most important cancer sites, for specific ages and periods of observation of the cancer registries in Italy. In addition, we provide indications for extended use of the index when substantial variations from the basic pattern of relative survival are observed in practical situations. Furthermore, we give helpful suggestions to obtain approximate values of the correction factor to be used for ages and periods of observation that are intermediate between the ones presented in this paper.

Adult↗
PubMedDate not supplied

[Renal transplantation and malignancies: A single-centre experience (25 years)].

BACKGROUND: The prevalence of post-transplant malignancies, in renal transplant recipients, is higher than that expected in age and sex-matched controls from the general population, and there is a markedly increased incidence of certain cancers. METHODS: In 1137 renal transplant recipients (1020 from cadaveric and 117 from living donors, M/F 771/366) performed at the S. Orsola Renal Transplantation Centre since 10/1976 to 9/2001, we studied the post-transplant cancer prevalence, the correlation between cancer prevalence and population characteristics, the risk factors (smoke, cancer history, positive HBsAg and antiHCV infection) and the immunosuppressive therapy. RESULTS AND CONCLUSIONS: The prevalence of malignancies was 3.86% (52 malignancies in 44 patients). The period between transplant and diagnosis of malignant disease was 59 +/- 85 months. Skin cancer was the most common (n=16; 30.7%), followed by lymphoproliferative disorders (n=8; 15.4%), Kaposi s sarcoma (n=6; 11.5%), uterine cancer (n=6; 11.5%), renal carcinoma of native kidney (n=5; 9.6%), cancer of breast/stomach/pancreas and urinary bladder (n=2; 3.8%) and other cancers (n=5; 9.6%). The mean duration of dialysis before transplantation was longer in cancer patients (41+/- 32.1 vs. 33.5 +/- 32.4 months). We found a correlation between types of malignancies and viral infection in NH-lymphoma (EBV positive 4/4) and skin cancer (HZV positive 13/16). We also detected a correlation between Aza and skin cancer (16/22) and CyA and lymphoproliferative disorders (7/8).

Adult↗
PubMed2002

Breakthrough cancer pain: prevalence and characteristics in patients in Catalonia, Spain.

Breakthrough pain (BTP), a transitory exacerbation of pain superimposed on a background of persistent, usually adequately controlled pain, has been reported to occur in 50% to 75% of cancer patients. However, a 23% prevalence of BTP was recently reported in a study of Spanish patients with advanced cancers, showing probably a low detection rate of this clinical problem. The purpose of the present study was to determine the prevalence of BTP among oncology patients managed by palliative care teams in Catalonia, Spain, and to characterize the frequency, intensity, and treatment of BTP episodes. Sixty-two teams studied 397 patients on a predetermined index day. BTP was reported by 163 (41%) patients, with a total of 244 episodes (mean 1.5 episodes/patient/day). Mean (SD) intensity of BTP episodes was 7.3 (2.0), compared with 2.9 (2.7) for persistent pain (both 0-10 scales). Morphine was used to treat 52% of BTP episodes, while 25% were untreated. These findings indicate that BTP remains underrecognized and undertreated in Spain.

Adolescent↗
PubMed1996

[Mammographic screening in the municipality of Copenhagen. Results of the first screening round].

The aim of the study was to evaluate the results from the prevalence round of the mammography screening programme in the Municipality of Copenhagen. All women who by 1 April 1991 were 50-69 years old, and who lived in the Municipality of Copenhagen, were during the period 1 April 1991-24 April 1993 offered a mammography. Those with suspect findings were recalled for further examination and possible biopsy. Women with breast cancer were offered treatment according to the standard national protocols (DBCCG). The participation rate was 71% (30,416/43,087). Among these 2043 (6.7%) were re-examined and 592 (1.9%) underwent surgical biopsy. Breast cancer was revealed in 359 (1.2%) women, of whom 88% had an invasive breast cancer. Prevalence of breast cancer increased significantly with increasing age. The positive predictive value for breast cancer among those re-examined was 18% and for those who had a surgical biopsy 61%. Among women with an invasive breast cancer 41% had a tumour of 10 mm or less, 80% had negative lymph node status and 56% had breast conserving surgery. During the following 12 months 14 women with a normal mammogram at the screening round developed breast cancer giving a sensitivity of 96%. It is concluded that the first mammography screening in Denmark showed the highest breast cancer prevalence published so far. A possible explanation could be a high sensitivity of the screening method, indicated by a relatively high frequency of small cancers. The screening programme was fully comparable with international standards.

Aged↗
PubMed1997

Polymorphism of metabolizing genes and lung cancer histology: prevalence of CYP2E1 in adenocarcinoma.

The relationship between genetic predisposition and development of specific cancers has not been adequately elucidated. In this study, the involvement of three polymorphic genes (CYP2E1, GSTM1, and GSTT1) in the development of different histological types of lung cancer was investigated. DNA was extracted from peripheral blood lymphocytes of lung cancer patients who have been long-term cigarette smokers (n = 52). Allelic variants of CYP2E1 were detected using PCR followed by PstI restriction enzyme digest and RFLP analysis, which detects a specific mutation causing over-expression of the gene. GSTM1 and GSTT1 genotypes were detected using two separate differential PCR methods. Our results indicate a 13.5% allele frequency for the CYP2E1 rare PstI site among the lung cancer patients which represents a 3.4-fold increase over the normal controls (OR = 3.5, 95% CL = 0.65-25.8). A novel observation is that all the patients with this polymorphism had adenocarcinomas only, resulting in a significant association between them (OR = 16.17, 95% CL = 0.95-73, P = 0.02). The frequency of the null GSTM1 gene was 42.3% among the lung cancer patients with no preferential tendency towards developing squamous cell carcinoma versus adenocarcinoma (OR = 1.10, 95% CL = 0.3-4.14, P = 0.5). The GSTT1 gene was absent in 21.1% of the patients with a non-significant tendency towards developing squamous cell carcinoma (OR = 1.23, 95% CL = 0.25-6.1, P = 0.5). Another important observation is the significant predominance of the three predisposing polymorphic alleles among the adenocarcinoma patients (OR = 3.4, 95% CL = 0.78-16.1, P = 0.05) compared with the squamous cell carcinoma patients. The results of this study indicate that the inheritance of several polymorphic metabolizing genes, particularly the CYP2E1 gene, contributes not only to the development of lung cancer but also to the development of specific types of cancer.

Adenocarcinoma↗
PubMed1997

Prevalence and contribution of BRCA1 mutations in breast cancer and ovarian cancer: results from three U.S. population-based case-control studies of ovarian cancer.

We investigate the familial risks of cancers of the breast and ovary, using data pooled from three population-based case-control studies of ovarian cancer that were conducted in the United States. We base estimates of the frequency of mutations of BRCA1 (and possibly other genes) on the reported occurrence of breast cancer and ovarian cancer in the mothers and sisters of 922 women with incident ovarian cancer (cases) and in 922 women with no history of ovarian cancer (controls). Segregation analysis and goodness-of-fit testing of genetic models suggest that rare mutations (frequency .0014; 95% confidence interval .0002-.011) account for all the observed aggregation of breast cancer and ovarian cancer in these families. The estimated risk of breast cancer by age 80 years is 73.5% in mutation carriers and 6.8% in noncarriers. The corresponding estimates for ovarian cancer are 27.8% in carriers and 1.8% in noncarriers. For cancer risk in carriers, these estimates are lower than those obtained from families selected for high cancer prevalence. The estimated proportion of all U.S. cancer diagnoses, by age 80 years, that are due to germ-line BRCA1 mutations is 3.0% for breast cancer and 4.4% for ovarian cancer. Aggregation of breast cancer and ovarian cancer was less evident in the families of 169 cases with borderline ovarian cancers than in the families of cases with invasive cancers. Familial aggregation did not differ by the ethnicity of the probands, although the number of non-White and Hispanic cases (N = 99) was sparse.

Adult↗
PubMed2003

Complementary therapies in cancer patients: prevalence and patients' motives.

BACKGROUND: Data relating to the use of complementary/alternative medicine (CAM) in cancer patients have been published for a number of European countries. No recent data are available for Austria. AIM: To ascertain the extent of CAM use by cancer patients, what patients' motives are, what methods are used and who the CAM providers are. DESIGN: Self-administered questionnaire; cross-sectional study. PATIENTS AND METHODS: A sample of 231 cancer patients who had consulted the Viennese Cancer League. Chi-square and Mantel-Haenszel tests were used for the statistical evaluation. RESULTS: 27.3% of the cancer patients had received CAM therapy: 33.1% of the female and 20.5% of the male participants (p = 0.045). Those who were below the median of the age categories (53.8 years) had used CAM to a statistically higher degree (35.5% vs. 21.1%; p = 0.023). The most important motives were the enhancement of "nature" and the GPs' recommendation. CAM was administered in 44.4% of cases by the family doctor, in 39.7% by patients themselves, in 6.3% by a hospital doctor, in 6.3% by a lay-practitioner or "non-medical practitioner against payment" and in 4.8% of cases by a practising oncologist. CONCLUSION: From the high percentage of patients who use CAM without consulting a physician or who follow the advice of others, it would seem highly probable that conventional and complementary methods are rarely effectively coordinated. To rectify this we conclude that oncologists and GPs should have a basic knowledge of CAM and address the issue when counselling their cancer patients.

Adolescent↗
PubMed1994

Pain in ovarian cancer patients. Prevalence, characteristics, and associated symptoms.

BACKGROUND: The prevalence, characteristics, and impact of pain and other symptoms have not been studied systematically in women with ovarian cancer. Anecdotally, pain has been associated with the onset of the disease and is a common problem among those with advanced cancer; symptoms other than pain appear to be highly prevalent. Given the profound influence of pain and other symptoms on quality of life, the evaluation of these phenomena could provide data relevant to the clinical management of these patients and advance quality of life research in the area of symptom assessment. METHODS: Questionnaires were completed by 111 inpatients and 40 outpatients with ovarian cancer who were undergoing treatment at a cancer center. Measures included a comprehensive pain questionnaire; the Rand Mental Health Inventory, Functional Living Index--Cancer; and the Memorial Symptom Assessment Scale. RESULTS: The sample (N = 151) represented 74% of the eligible patients. The median age was 55 years (range, 23-86), 82% had Stage III or IV disease at presentation, and 69% had active disease at the time of the survey. Pain, fatigue, and psychologic distress were the most prevalent symptoms. Sixty-two percent (N = 94) described a pain syndrome that preceded the onset or recurrence of the disease, and 42% (N = 63) reported "persistent or frequent pain" during the preceding 2 weeks. The latter pain had a median duration of 2 weeks (range, less than 1 to 756 weeks) and usually was in the abdominopelvic region (80%), frequent or almost constant (66%), and moderate to severe. Most patients reported moderate or greater pain-related interference with various aspects of function, particularly activity (68%), mood (62%), work (62%), and overall enjoyment of life (61%). Performance status, inpatient status, and unmarried status were significant predictors of pain presence or intensity, and both performance status and extent of tumor were significant predictors of pain interference with function. CONCLUSIONS: Among those with ovarian cancer, greater than 40% experienced pain that substantially undetermined function in one half to two thirds of these patients. Impaired performance status is associated most strongly with pain. The onset or recurrence of disease often is heralded by a stereotypic pain syndrome.

Adult↗
PubMed2005

Epidemiology and outcomes of serious influenza-related infections in the cancer population.

BACKGROUND: Although patients with cancer generally respond favorably to vaccination, they may not receive annual influenza vaccinations. The current population-based study described the epidemiology and outcomes of potentially preventable, serious influenza-related infections in patients with cancer. METHODS: From the Nationwide Inpatient Sample, the authors created a subsample that included discharges with any International Classification of Diseases, ninth revision, diagnosis code for cancer and principal diagnosis code for influenza, bronchopneumonia, or pneumonia caused by an unspecified organism. From the latter two diagnosis codes, the authors estimated excess cases during the influenza season for each year and stratum, then selected a random sample from fall and winter discharges. Subset analyses included weighted sample means, frequencies, and analysis of variance values. The authors converted charges to costs using cost-to-charge ratios and inflated these to 2003 U.S. dollars. Hospitalization and mortality rates were calculated using 5-year cancer prevalence estimates. RESULTS: The estimated mean annual hospital discharges of patients with cancer with potentially preventable, serious influenza-related infections numbered 16,000. The average length and cost per stay were 6 days and > USD 6300, respectively. Approximately 9% of patients died in the hospital and 31% needed further skilled care. The estimated age-specific rates for hospitalization and death per 100,000 in the prevalent cancer population were 219 and 17.4, respectively, for patients age < 65 years and 623 and 59.4, respectively, for those age > or = 65 years. Hospitalization costs averaged USD 1300 more for patients age < 65 years. CONCLUSIONS: Death from influenza-related infections occurred in an estimated 9% of patients with cancer hospitalized for such. Using recommended vaccination schedules for patients with cancer and their contacts reduced hospitalizations, treatment delays, and deaths in this highly susceptible population.

Adolescent↗
PubMed1986

Estimation of the number of cancer survivors in Japan.

Cancer prevalence statistics are necessary for cancer control programs. Although a long-term cancer registry keeps files which cover incidence, prevalence and cured cases, the latter two categories are difficult to distinguish from each other. The Connecticut and the Finnish Cancer Registries therefore defined the sum of these two groups as "prevalence." The authors estimated the numbers and rates of survivors from cancer ("prevalence") in Japan as of January 1, 1985, based on the number of cancer patients for all sites diagnosed since 1960. The number of cancer patients in Japan diagnosed during the period from 1960 to 1984 was estimated to be 4,686,352 (both sexes). Of these, the number of cancer survivors as of January 1, 1985 was estimated to be 952,870 (both sexes). Among the survivors, 430,940 were diagnosed in the final five years from 1980-84. The results were compared with those reported from the USA and Finland.

Age Factors↗
PubMed2000

Familial breast cancer in southern Finland: how prevalent are breast cancer families and can we trust the family history reported by patients?

We evaluate the validity of the family history of breast cancer reported by the patient and the number of families and individuals at risk and potentially benefiting from surveillance. Family history of cancer was systematically screened in three different series of breast cancer patients. Breast cancer families were defined by the selection criterion of at least three first- or second-degree relatives with breast or ovarian cancer (including the proband) and their genealogy and cancer diagnoses were confirmed. Family history of breast or ovarian cancer was reported by approximately 30% of the patients and 7-9% were classified as breast cancer families. On average, there were 3.1 healthy female (age: 20-70 years) first degree relatives per family potentially at high risk. Index patients reported 87% of all confirmed diagnoses and the primary site was correct in 93-95% of the reported cases. The incompleteness and errors in accuracy should be considered in epidemiological studies and verification of the diagnoses is important when deciding clinical management.

Adult↗
PubMed2006

Co-overexpression of fibroblast growth factor 3 and epidermal growth factor receptor is correlated with the development of nonsmall cell lung carcinoma.

BACKGROUND: Lung cancer is a prevalent cancer with a poor prognosis. To develop a useful in vitro cell model, a cell line of lung squamous cell carcinoma (SCC-35) was established. METHODS: The SCC-35 cell was characterized by comparative genomic hybridization (CGH) and spectral karyotyping (SKY). Chromosome microdissection, fluorescence in situ hybridization (FISH), and Southern and Northern blots analyses were used to study target genes. RESULTS: Two amplicons were found at chromosomes 7p12 and 11q13. Amplification and overexpression of epidermal growth factor receptor (EGFR) at 7p12 and fibroblast growth factor 3 (FGF3) at 11q13 were found. To understand the correlation between these two genes in nonsmall cell lung carcinoma (NSCLC) more comprehensively, overexpression of FGF3 and EGFR was investigated by immunohistochemistry with a tissue microarray containing 406 NSCLC samples. Cytoplasmic overexpression of FGF3 and EGFR was detected in 61% and 69% NSCLC cases, respectively. More interestingly, a significant correlation between overexpression of FGF3 and EGFR was found in NSCLC. CONCLUSION: These results suggest that co-overexpression of FGF3 and EGFR may play an important role in the pathogenesis of lung carcinoma.

Carcinoma, Non-Small-Cell Lung↗
PubMed2001

[Improvement of palliative outpatient treatment of terminally ill cancer patients - SUPPORT as example - The ethically preferable alternative to euthanasia].

INTRODUCTION: Industrial countries are experiencing substantial increases in cancer prevalence. While advanced cancer therapies resulted in prolonged survival most neoplasms still are incurable. Especially advanced stages of cancer are often accompanied by severe pain and other disabling symptoms. Sufficient pain and symptom control is needed to maintain a decent quality of life for cancer patients. However, expert palliative care for patients suffering from cancer pain is still insufficient. These deficits have encouraged pro-euthanasia pressure groups demanding legitimation of physician-assisted-suicide in Germany. Acting under the guise of promoting patient's autonomy these groups are gaining additional momentum from similar legislation passed in the Netherlands. METHODS: Hospice movement and specialists in palliative medicine reject euthanasia as unethical and instead push for the global development of palliative care services. To address these issues the project SUPPORT was established in the Southern part of Lower-Saxony in 1996 with approval by the local ethics committee and sponsored by the German Ministry of Health. A palliative-care-team (PCT) of nurses and physicians with expert knowledge in palliative medicine supports patients after discharge from hospital by providing state-of-the-art palliative care at home. The PCT is available as a 24/7 standby service and can be called on demand by general practitioners, members of outpatient nursing services as well as by patients and their relatives. By cooperating with the PCT these professional and lay caregivers improve their knowledge and skills regarding pain and symptom control for terminally ill patients. RESULTS: During almost 4 years of practical work more than 50 % of the patients enrolled in the project died at home compared to about 20 % under regular conditions. These data point out quite impressively that due to the PCT-interventions recurrent hospitalisations in a majority of cancer pain patients can be avoided when expert knowledge and help is available at home for patients, their relatives and caregivers whenever needed. CONCLUSION: When sufficiently supported at home by palliative experts the number of patients dying at home is reasonably higher than the rate observed under regular conditions. This would also comply with the wishes of most patients who prefer to die in the privacy of their own home. The project data suggest that the concept of SUPPORT should be capable to improve the current state of palliative medicine in other areas of Germany as well.

Caregivers↗
PubMed1997

Science, medicine, and the future. Lung cancer.

Lung cancer, the most prevalent cancer in the Western world, is mainly caused by smoking. Nevertheless, only 20% of smokers develop lung cancer and while prevention is important, environmental factors are expected to contribute to the predicted rise in the incidence of lung cancer in the next 25 years. Survival of lung cancer is still poor, and new treatments are urgently needed. This review examines potential new therapeutic developments which have arisen from a greater understanding of the molecular and cellular biology of lung cancers.

Drug Resistance, Neoplasm↗
PubMed1996

Cancer genetics and cell and molecular biology. Is this the way forward?

Lung cancer, the most prevalent cancer in the western world, is predominantly caused by smoking and thus perceived as a "self-inflicted" disease. Nevertheless, only 20% of smokers develop lung cancer. This review examines the concept of high-risk populations and screening. It looks at developments in the molecular epidemiology of the disease that shed new light on genetic changes that may predispose individuals to malignancy. Improvements in existing drug therapy are discussed as well as important new therapeutic developments, including antigrowth factors (antagonists G and D), antimetastatic agents (matrix metalloproteinase inhibitors), and natural products, arising from a greater understanding of signal transduction pathways and the process of cell metastasis.

Antihypertensive Agents↗
PubMed1989

Illness-related worry among cancer patients: prevalence, severity, and content.

The present study assessed the prevalence, severity, and other parameters of illness-related worry among 83 cancer patients receiving active treatment for their illness. Participants completed questionnaires assessing a variety of worry dimensions. In addition, a family member of each patient completed a brief questionnaire regarding their perception of the patient's illness-related worry. Nurse ratings of patients' clinic-related behaviors were obtained. Fifty-one percent (n = 43) of patients reported worry to be at least "somewhat of a problem." Fifteen percent (n = 12) reported it to be a significant to severe problem. Significant correlations included patients self-rating of worry and: nurse rating of clinic behavior, total score on a Worry Content Scale, ability to stop worrying once started, and impact of worry on mood and functioning. Rating by the significant other of how much of a problem worry was for the patient and whether the patient was a worrier preillness was also significantly correlated. There were no significant differences between "worriers" and "nonworriers" on demographic or disease variables. A logistic regression model using the categories of "worries" or "nonworriers" as a dependent variable found that women and patients reporting poor social support were more likely to report a problem with worry. However, a large amount of the variance remained unexplained.

Adult↗
PubMed2006

Treatment of prostate cancer in obese patients.

Obesity is a complex, chronic disease that has reached epidemic proportions in the United States. Obesity is now linked with numerous health conditions, including many oncologic diagnoses. Its association with prostate cancer, the most prevalent cancer in men, has also been investigated, with studies suggesting a direct relationship between increasing obesity and prostate cancer mortality. Outcomes data for specific interventions in obese patients with prostate cancer have only recently begun to emerge. Surgery, while feasible even in the very obese, may result in less than optimal cancer control rates. Brachytherapy data are emerging, and are promising. No outcomes data are available for the use of external-beam radiation in obese patients. Long-term data for external-beam radiation, as well as for surgery and brachytherapy, are required to determine the most appropriate treatment for obese patients with prostate cancer. These data, coupled with a more thorough understanding of the biochemical relationship between obesity and prostate cancer, will be necessary to make optimal management decisions for obese patients with prostate cancer in the future.

Body Mass Index↗