Cancer Incidence among Adolescents and Young Adults in Urban Shanghai, 1973-2005

Background

Lack of cancer incidence information for adolescents and young adults led us to describe incidence trends within the young population of 15 to 49 year-olds in urban Shanghai between 1973 and 2005.

Methods

During 1973 to 2005, data on 43,009 (45.8%) male and 50,828 (54.2%) female cancer cases aged 15–49 years from the Shanghai Cancer Registry were analyzed. Five-year age-specific rates, world age-standardized rates, percent change (PC), and annual percent change (APC) were calculated using annual data on population size and its estimated age structure.

Results

During the 33-year study period, overall cancer incidence of adolescents and young adults among males marginally decreased by 0.5% per year (P<0.05). However, overall cancer incidence for females slightly increased by 0.8% per year (P<0.05). The leading cancer for males in rank were liver, stomach, lung, colorectal, and nasopharyngeal cancers and for females were breast, stomach, colorectal, thyroid, and ovarian cancers. Among specific sites, incidence rates significantly decreased for cancers of the esophagus, stomach, and liver in both sexes. In contrast, incidence rates significantly increased for kidney cancers, non-Hodgkin lymphoma, and brain and nervous system tumors in both sexes and increased for breast and ovarian cancers among females.

Conclusions

Overall cancer incidence rates of adolescents and young adults decreased in males whereas they increased in females. Our findings suggest the importance of further epidemiology and etiologic studies to further elucidate factors contributing to the cancer incidence trends of adolescents and young adults in China.     

Increasing incidence and survival of paediatric and adolescent thyroid cancer in Cyprus 1998–2017: A population-based study from the Cyprus Pediatric Oncology Registry

BackgroundPaediatric and adolescent thyroid cancer incidence rates are increasing in many countries. We determined incidence rates, temporal trends and survival from thyroid cancer diagnosed in childhood and adolescence in Cyprus during 1998−2017.MethodsPatients aged 0–19 years, diagnosed with thyroid cancer in the Pediatric Oncology Registry of Cyprus were included. Crude incidence rates, age standardized rates, time trends and overall survival were analysed. Annual rates and temporal trends were calculated using Microsoft Excel 2016 and Joinpoint regression analysis.ResultsEighty-one cases (76.5 % female, 23.5 % male) were identified. The crude rates (per 100,000 persons) were for both sexes 2.00 (95 % CI 1.61, 2.49), females 3.15 (95 % CI 2.45, 4.03) and males 0.92 (95 % CI 0.58, 1.44). The annual percentage changes of crude and standardised rates were 7.5 % (p < 0.05) and 7.6 % (p < 0.05). The annual percentage changes of crude rates were for females 5.1 % (p = 0.1), males 8.4 % (p < 0.05) and 15−19-year-olds 7.6 % (p < 0.05). The female to male rate ratio was 3.42 (95 % CI 2.06, 5.74). Papillary thyroid carcinoma represented 86.4 % of all cases. There was only one case after previous cancer therapy. The rate ratio of 2nd (2008−2017) to 1st (1998−2007) periods for metastatic (regional) stages was 3.76 (95 % CI 1.74, 8.31). Survival until 2018 was 100 %.ConclusionThis population-based study demonstrated that thyroid cancer incidence rates in 0–19-year-olds in Cyprus was among the world’s highest. Increasing trends mainly affected males and females aged 15−19 years with papillary thyroid carcinoma, the dominant type. Cases after previous cancer therapy didn’t contribute to increasing rates. The increase of metastatic cases suggests a true increase of thyroid cancer rather than overdiagnosis. Although prognosis is excellent with 100 % survival, the rising incidence rate is unexplained, indicating the need to identify causes.     

Incidence and survival for hepatic, pancreatic and biliary cancers in England between 1998 and 2007

Introduction: Hepatic, pancreatic and biliary (HPB) cancers are a group of diverse malignancies managed ideally in specialist centres. This study describes recent patterns in the incidence and survival of HPB cancers in England over a ten year period (1998–2007). Methods: Data on 99,379 English patients (50,656 males; 48,723 females) diagnosed with HPB cancers between 1998 and 2007 were extracted from the National Cancer Data Repository. Data were divided into six site-specific cancer groups; pancreas, ampulla of Vater, biliary tract, primary liver, gallbladder and duodenum. Age-standardised incidence rates (per 100,000 European standard population, (ASR(E))) were calculated for each of the six groups by year of diagnosis and by socioeconomic deprivation. Survival was estimated using the Kaplan–Meier method. Results: The largest group was pancreatic cancers (63%), followed by primary liver (14%) and biliary cancers (13%). ASR(E) were highest for pancreatic and primary liver cancers whereas cancers of the gallbladder, duodenum and ampulla of Vater had a very low incidence. Over time the incidence of all six groups remained relatively stable, although primary liver cancer increased slightly in males. Incidence rates were higher in males than in females in all groups except gallbladder cancer, and all six groups had a higher incidence in the more deprived quintiles. Overall survival was poor in each of the HPB cancer groups. Conclusions: HPB tumours are uncommon and are associated with poor long term survival reflecting the late stage at presentation. Incidence patterns suggest variable rates linked to socioeconomic deprivation and highlight a male predominance in all sites except the gallbladder. Identification of high risk populations should be emphasised in initiatives to raise awareness and facilitate earlier diagnosis.     

Cancer incidence in Nigeria: A report from population-based cancer registries

Introduction: Cancer has become a major source of morbidity and mortality globally. Despite the threat that cancer poses to public health in sub-Saharan Africa (SSA), few countries in this region have data on cancer incidence. In this paper, we present estimates of cancer incidence in Nigeria based on data from 2 population-based cancer registries (PBCR) that are part of the Nigerian national cancer registry program. Materials and methods: We analyzed data from 2 population based cancer registries in Nigeria, the Ibadan Population Based Cancer Registry (IBCR) and the Abuja Population Based Cancer Registry (ABCR) covering a 2 year period 2009-2010. Data are reported by registry, gender and in age groups. We present data on the age specific incidence rates of all invasive cancers and report age standardized rates of the most common cancers stratified by gender in both registries. Results: The age standardized incidence rate for all invasive cancers from the IBCR was 66.4 per 100000 men and 130.6 per 100000 women. In ABCR it was 58.3 per 100000 for men and 138.6 per 100000 for women. A total of 3393 cancer cases were reported by the IBCR. Of these cases, 34% (1155) were seen among males and 66% (2238) in females. In Abuja over the same period, 1128 invasive cancers were reported. 33.6% (389) of these cases were in males and 66.4% (768) in females. Mean age of diagnosis of all cancers in men for Ibadan and Abuja were 51.1 and 49.9 years respectively. For women, mean age of diagnosis of all cancers in Ibadan and Abuja were 49.1 and 45.4 respectively. Breast and cervical cancer were the commonest cancers among women and prostate cancer the most common among men. Breast cancer age standardized incidence rate (ASR) at the IBCR was 52.0 per 100000 in IBCR and 64.6 per 100000 in ABCR. Cervical cancer ASR at the IBCR was 36.0 per 100000 and 30.3 per 100000 at the ABCR. The observed differences in incidence rates of breast, cervical and prostate cancer between Ibadan and Abuja, were not statistically significant. Conclusion: Cancer incidence data from two population based cancer registries in Nigeria suggests substantial increase in incidence of breast cancer in recent times. This paper highlights the need for high quality regional cancer registries in Nigeria and other SSA countries.     

Profile of cancer in the Eastern Mediterranean region: The need for action

BackgroundMany countries in the Eastern Mediterranean region (EMR) are undergoing marked demographic and socioeconomic transitions that are increasing the cancer burden in region. We sought to examine the national cancer incidence and mortality profiles as a support to regional cancer control planning in the EMR.MethodsGLOBOCAN 2012 data were used to estimate cancer incidence and mortality by country, cancer type, sex and age in 22 EMR countries. We calculated age-standardized incidence and mortality rates (per 100,000) using direct method of standardization.ResultsThe cancer incidence and mortality rates vary considerably between countries in the EMR. Incidence rates were highest in Lebanon (204 and 193 per 100,000 in males and females, respectively). Mortality rates were highest in Lebanon (119) and Egypt (121) among males and in Somalia (117) among females. The profile of common cancers differs substantially by sex. For females, breast cancer is the most common cancer in all 22 countries, followed by cervical cancer, which ranks high only in the lower-income countries in the region. For males, lung, prostate, and colorectal cancer in combination represent almost 30% of the cancer burden in countries that have attained very high levels of human development.ConclusionsThe most common cancers are largely amenable to preventive strategies by primary and/or secondary prevention, hence a need for effective interventions tackling lifestyle risk factors and infections. The high mortality observed from breast and cervical cancer highlights the need to break the stigmas and improve awareness surrounding these cancers.     

Cancer Incidence and Survival among Adolescents and Young Adults in Korea

Background

In Korea, cancer is the third leading cause of death among adolescents and young adults (AYAs). However, cancer incidence and survival trends among AYAs (15–29 years) have never been studied in Korea. Therefore, this study aimed to investigate the incidence and relative survival rates and their trends among AYAs in Korea.

Materials and Methods

Cancer incidence data from 1999–2010 were obtained from the Korea Central Cancer Registry (KCCR). Each cancer was classified into subgroups according to the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) AYA site recode. Percent distributions, age-specific incidence rates, age-standardized incidence rates per million, and annual percent changes (APCs) were calculated for AYAs according to sex. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2010 and followed up to 2011.

Results

The age-standardized incidence rates of all cancers combined were 196.4 and 367.8 per million for males and females, respectively (male-to-female (M/F) ratio: 0.5). The age-standardized incidence rates increased from 208.7 per million in 1999 to 396.4 per million in 2010, and the APC was 6.3% (P<0.001). The five most common cancers among AYAs were thyroid carcinoma, non-Hodgkin lymphoma, stomach carcinoma, breast carcinoma, and acute myeloid leukemia. In males, the 5-year relative survival rate improved, from 46.5% in 1993–1995 to 75.9% in 2006–2010. In females, the 5-year relative survival rate also improved, from 66.7% in 1993–1995 to 89.1% in 2006–2010.

Conclusions

Our study showed increases in cancer incidence and improvements in the 5-year relative survival rate among Korean AYAs. This study also provides additional data regarding temporal and geographic trends in cancer that may enhance future efforts to identify factors affecting cancer incidence and responses to treatment among AYAs.     

Trends in cancer incidence in the Republic of Mauritius, 1991–2015

IntroductionMauritius, a small state, is among the few African countries where cancer registration is population based and nationwide. We reported trends in cancer incidence for twenty five years as well as the mortality to incidence ratio (MIR) as main quality indicator of the Mauritius National Cancer Registry (MNCR).Materials and methodsWe calculated age standardised incidence rates (ASRs) of cancers by sex and by 5 year age group for five successive year periods from 1991 to 2015. The average annual percentage change (AAPC) were determined by sex and cancer sites. MIRs were compared for the period 2001–2004 and 2012–2015.ResultsIn males, the most common cancer sites (in terms of ASRs per 100,000) were those of the colon-rectum (17.0), prostate (16.5), trachea-bronchus-lung (13.0), stomach (8.4) and lip-oral cavity-pharynx (7.7). The AAPC were +3.9%, +4.2%, +0.5%, -0.1% and -1.3% respectively. In females, the most frequent sites were breast (53.7), colon-rectum (13.2), cervix uteri (11.2), corpus uteri (7.7) and ovary (5.7). The AAPC were +3.4%, +4.4%, -2%, +5.2% and -0.1% respectively. The most significant decrease in MIRs among males were liver (1.9 to 1.0), stomach (1.3 to 0.8) and lung (1.7 to 1.2) cancers while among females, they were pancreas (3.4 to 1.3), liver (1.8 to 1.2) and stomach (1.5 to 0.8) cancers.ConclusionThe most common cancers were those associated with 'westernisation' of lifestyle. Our figures contrast with other Sub-Saharan Africa countries where infection related cancers are most predominant. The MNCR has also improved its data quality over time.     

Incidence Trends of Urinary Bladder and Kidney Cancers in Urban Shanghai, 1973-2005

Objectives

We examined the incidence trends of bladder and kidney cancers using a population-based cancer registration data.

Methods

Age-standardized incidence rates were analyzed using data from the Shanghai Cancer Registry during 1973 to 2005. Annual percentage changes and 95% confidence intervals were calculated to evaluate the incidence changes. Age-period-cohort analysis was further implemented to assess the contributions of age, period and cohort effects to the trends using the intrinsic estimator method.

Results

In total, 12,676 bladder and 5,811 kidney cancer patients were registered in urban Shanghai. The age-standardized rates of bladder cancer in males increased from 6.39 to 7.66 per 100,000, or 0.62% per year, whereas the rates in females increased from 1.95 to 2.09 per 100,000, or 0.33% per year. For kidney cancer, the age-standardized rates in males increased from 1.20 to 5.64 per 100,000, or 6.98% per year. Similarly in females, the rates increased from 0.85 to 3.33 per 100,000, or 5.93% per year. Age-period-cohort analysis showed increasing curves of age and period effects but generally decreasing cohort effects for bladder and kidney cancers.

Conclusions

Our results show increasing incidence trends of bladder and kidney cancers in Chinese men and women, especially for kidney cancer.     

Incidence,trends, and survival of oropharyngeal squamous cell cancer in Aotearoa New Zealand, 2006–2020

BackgroundAn increasing trend of oropharyngeal cancer (OPC) has been reported in several countries with different demographic characteristics, and often attributed to increases in human papillomavirus (HPV) infection. The survival of patients with OPC has steadily improved, especially for those with positive HPV status. This study assessed the incidence, trends, and survival of OPC in Aotearoa New Zealand (NZ) by age at diagnosis, sex and ethnicity.MethodsThe study included all 2109 patients resident in NZ with a primary diagnosis of oropharyngeal squamous cell carcinoma from 2006 to 2020, identified from the National Cancer Registry. We assessed age-standardised incidence rate (ASR), annual percent change (APC) and overall and relative survival rates.ResultsThe average annual incidence of OPC was 2.2 per 100,000 population. There was a steady increase of 4.9% per year over 15 years. Although the incidence rates were higher in males over the study period, the overall rate of increase was similar in males (4.9%) and in females (4.3%). The incidence was highest in the 50–69-year group (8.8/100,000 population). This age group had an incidence that increased by 7.5% per year to 2018, and then declined. The main increase in rates was seen between the birth cohort of 1946–50 and that of 1956–60. The increase in incidence was seen in Māori and Pākehā/European populations, but no increase was seen in Pacific or Asian populations. The 5-year overall relative survival rate improved from 69% in 2006‐13 to 78% in 2014–20. Survival rates were lower in older patients, females, and Māori patients.ConclusionThis study confirmed a substantial increase in OPC incidence in NZ, with some evidence to suggest a recent slowing in this increase. Māori and Pākehā/European had the highest incidence, while Pacific and Asian populations showed the lowest rates and no increase over the study period. Survival rates have improved over time, but remained lower in some demographic groups.     

Trends in Cancer Incidence in Maputo,Mozambique, 1991–2008

Background

Very limited information is available regarding the incidence of cancer in sub-Saharan Africa. We analyzed changes in cancer patterns from 1991 to 2008 in Maputo (Mozambique).

Methods

We calculated the rates of incidence of different cancer sites by sex in the 5-year age-group of the population of Maputo city as well as age-standardized rates (ASRs) and average annual percentage changes (AAPC).

Results

Over the 18-year study period a total of 12,674 cases of cancer (56.9% females) were registered with an overall increase in the risk of cancer in both sexes. In males, the most common cancers were those of the prostate, Kaposi sarcoma (KS) and the liver. Prostate cancer showed the most dramatic increase over the whole study period (AAPC +11.3%; 95% CI: 9.7–13.0), with an ASR of 61.7 per 10⁵ in 2003–2008. In females, the most frequent cancers were of the uterine cervix, the breast and KS, with the former increasing along the whole study period (AAPC + 4.7%; 95% CI: 3.4–6) with an ASR of 62.0 per 10⁵ in 2003–2008 as well as breast cancer (AAPC +6.5%; 95%CI: 4.3–8.7).

Conclusions

Overall, the risk of cancer rose in both sexes during the study period, particularly among cancers associated with westernization of lifestyles (prostate, breast), combined with increasingly rising incidences or limited changes in cancers associated with infection and poverty (uterine cervix, liver). Moreover, the burden of AIDS-associated cancers has shown a marked increase.     

Seasonality of retinal detachment incidence and its associations with climate: an 11-year nationwide population-based study

This study aimed to examine the seasonal variability of retinal detachment (RD) in Taiwan by using an 11-yr nationwide population database. This study also investigated the association of weather conditions, i.e., ambient temperature, relative humidity, rainfall, monthly hours of sunshine, and atmospheric pressure, with RD. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. The study sample included 23 718 RD hospitalizations between January 1999 and December 2009. The incidence rate of RD/100 000 people over the 132 months was computed according to sex and age groupings of <20, 20-39, 40-59, and ≥60 yrs. Then, the association between climatic factors and the monthly RD incidence rate was examined. The ARIMA (autoregressive integrated moving average) method was also employed to test the seasonality of RD incidence rates and their association with climatic factors. The annual RD incidence rates were between 7.8 and 10.8 cases/100 000 people during the study period. A fairly similar seasonal pattern of monthly RD incidence rates was apparent for males and females and males and females combined. Rates were highest August through October, decreasing in November, and lowest in February. After adjusting for time, trend, and month, the ARIMA regression models for the male, female, and males and females combined consistently revealed the monthly RD incidence rate was significantly and positively associated with ambient temperature, but negatively associated with atmospheric pressure. The authors conclude that the monthly RD incidence rates were significantly associated with seasonality. The monthly RD incidence rates were positively associated with ambient temperature and negatively associated with atmospheric pressure.     

Comparison of oropharyngeal and oral cavity squamous cell cancer incidence and trends in New Zealand and Queensland,Australia

BackgroundIncreases in the incidence of squamous cell oropharyngeal cancer (OPC) have been reported from some countries, but have not been assessed in Australia or New Zealand. This study examines trends for squamous cell OPC and squamous cell oral cavity cancer (OCC) in two similarly sized populations, New Zealand and Queensland, Australia.MethodsIncidence data for 1982–2010 were obtained from the respective population-based cancer registries for squamous cell OPC and OCC, by subsite, sex, and age. Time trends and annual percentage changes (APCs) were assessed by joinpoint regression.ResultsThe incidence rates of squamous cell OPC in males in New Zealand since 2005 and Queensland since 2006 have increased rapidly, with APCs of 11.9% and 10.6% respectively. The trends were greatest at ages 50–69 and followed more gradual increases previously. In females, rates increased by 2.1% per year in New Zealand from 1982, but by only 0.9% (not significant) in Queensland. In contrast, incidence rates for OCC decreased by 1.2% per year in males in Queensland since 1982, but remained stable for females in Queensland and for both sexes in New Zealand. Overall, incidence rates for both OCC and OPC were substantially higher in Queensland than in New Zealand. In males in both areas, OPC incidence is now higher than that of OCC.ConclusionsIncidence rates of squamous cell OPC have increased rapidly in men, while rates of OCC have been stable or reducing, showing distinct etiologies. This has both clinical and public health importance, including implications for the extension of human papilloma virus (HPV) vaccination to males.     

Cancer incidence and mortality in the Greater Poland Region—Analysis of the year 2010 and future trends

Background and aim

The Greater Poland Region is one of the most industrialised areas of Poland, with a high rate of cancer incidence and mortality. The present report estimated incidence and mortality data for Greater Poland in the year 2010.

Methods

Statistical reports in this study include absolute number of cases and crude incidence rates. The derived age-, sex-, and site specific rates were age-standardised (ASRs per 100,000 person-years) using the European (ASRE) standard population.

Results

In 2010, a total 13,581 new cancer cases were reported to the Greater Poland Cancer Registry. The number of new cases increased by 24% compared to 2001. Greater Poland has the second-highest ASR for both females and males among the 16 regions in Poland. The most common cancers are similar to those in other Western European countries. Among men, the most common cancers are lung (C34), colorectal (C18-C21), and prostate (C61) cancer. In women, breast cancer is the most common (C50), followed by colon (C18-C21) and lung (C34) cancer. Lung cancer in males accounts for more than one-third of all cancer-related deaths in Greater Poland. As in 2009, lung cancer is the leading cause of death in women.

Conclusions

Given the ageing of the population, the incidence of chronic diseases, including cancer, is expected to grow. These data indicate that cancer will continue to represent an important challenge both to local health authorities and the National Health Fund, which will need to meet the growing demand for cancer care.     

Is poliomyelitis a serious problem in developing countries?--lameness in Ghanaian schools.

A postal survey of lameness in schools throughout Ghana showed an estimated prevalence of lameness attributable to poliomyetitis of 5-8 per 1000 school-aged children and an estimated mean annual incidence of paralytic poliomyelitis of 23 per 100 000 population. Official reported incidence rates range from 0-1 to 2-1 per 100 000 population, indicating that at least 90% of cases are not reported. No evidence of epidemics was found to account for these high rates. These suggest that mean annual incidence rates in tropical endemic countries have always been as great, if not greater, than those experienced by temperate countries during epidemic periods in the twentieth century and that the total number of cases of paralytic poliomyelitis occurring in the world each year has been reduced by only 25% since the advent of polio vaccine. Immunisation against poliomyelitis must have a high priority in Ghana and other tropical countries where the disease is endemic.     

Cancer incidence among nuclear workers in Russia based on data from the Institute of Physics and Power Engineering: a preliminary analysis

One group that has the potential to be exposed to radiation is workers in the nuclear industry. Results of a systematic medical follow-up and dosimetric monitoring of these workers can form the basis for a study of the relationship between cancer incidence and radiation dose. As part of such efforts in Russia, a major institution of the nuclear industry with an established medical care unit, archiving capabilities, and dosimetry department was selected: the Institute of Physics and Power Engineering (IPPE) in Obninsk. In the study, a comparative analysis of cancer incidence rates for the IPPE workers and for the general population of Russia in 1991-1997 was carried out. The subjects were the IPPE workers hired before 1981. This restriction was imposed to reduce the uncertainty associated with the possible latent period in the development of solid cancers. Thus the possibility of including persons who already had the disease at the time when they were hired was minimized. The analysis is based on information about 158 cancer cases, including 24 cancers in persons under individual dosimetric monitoring. A statistically significant excess in cancer incidence was found among the IPPE workers compared with a comparison population (the general population of Russia) for some types of cancers. The SIR values for all cancers (ICD-9: 140-208) is 0.93 (95% CI 0.76, 1.12) for males and 1.42 (95% CI 1.06, 1.87) for females. A statistically significant excess for all cancers was also observed for residents of Obninsk compared to the control comparison population. The corresponding SIR value was 1.20 (95% CI 1.12, 1.28) for males and 1.58 (95% CI 1.49, 1.69) for females. An important reason for the observed excess in cancer incidence compared to the control population may be the higher level of health care in the so-called nuclear cities of Russia which may have resulted in increased diagnosis and registration of cancers. A statistically significant dependence of the cancer incidence on the dose of ionizing radiation was not established. The excess relative risk per gray for all types of cancer was 0.91 (95% CI -2.75, 4.61) for males and 0.40 (95% CI -6.94, 7.83) for females. These estimates should be considered to be preliminary, as the number of cases considered in the analysis of the dose response is small (17 males and 7 females).     

Increasing burden of melanoma in Croatia

Melanoma consists 4-5% of all skin cancers, but it contributes to 71-80% of skin cancers deaths. It is controversial whether worldwide increases in melanoma incidence represent a true epidemic but at the same time that dramatic increase in incidence occur in setting of relatively stable mortality trends, observed in Croatia also. The majority of authors accept that main risk factors for melanoma relate to environmental exposure and genetics with epidemiologic studies linking sun exposure to melanoma development. Data were obtained from Croatian cancer register for patients diagnosed between 1999 and 2008, for malignant melanoma of the skin (ICD-10 code C43) at national level and from 2003 to 2008, at the County level (Primorsko-goranska County). Melanoma incidence nearly doubled in males from 8.75 to 13.4/10(5) per year, fold in females from 9.1 at the start of observation to the end of 12.0/10(5) per year in Croatia. Melanoma incidence rates were much more higher for Primorsko-goranska County with range from 10.1 to 17.5/10(5) per year. The greatest increase of melanoma incidence rates was in males 60 years and over year group at diagnosis. National comparison of variation in cancer incidence by region and age can provide basis for public health prevention. It requires the integration of information on risk factors, incidence that could help to reduce regional inequalities in incidence and reduce the future cancer incidence.     

A reanalysis of liver cancer incidence in Danish patients administered thorotrast using a two-mutation carcinogenesis model

In recent years, a two-mutation carcinogenesis (TMC) model has been used to analyze epidemiological data and estimate the radiation risks at low doses for the organs affected. Here the TMC model was used to reanalyze the liver cancer incidence in the Danish population in general and in patients administered Thorotrast, and to estimate the radiation risks for the liver. The data for 807 patients for whom sufficient data on the injected volumes of Thorotrast were available were used in this reanalysis. These data were combined with data on liver cancer incidence in the Danish population as the baseline or background incidence. Because males and females show different baseline liver cancer incidences, separate fits were made for males and females. The fits showed that the radiation effect could be ascribed entirely to the radiation dependence of the first mutation rate of the TMC model, which was higher for females than for males. The second mutation rate was not significantly dependent on dose. The radiation risks for the liver were calculated on the basis of the model parameters. These risks for lifetime exposures are about the same for males and females and are between a factor of 2 and 10 higher than current estimates. The discrepancy between the model results and previous risk estimates probably arises because the model calculations give more complete lifetime radiation risk estimates. For short-term exposures of the liver to ionizing radiation, the maximum radiation-induced excess liver cancer risk per unit dose applies to exposures at the age of about 10; exposures at ages above 35 have a radiation effect of less than approximately 15% of this maximum.     

Effects of radiation on incidence of primary liver cancer among atomic bomb survivors.

We describe the radiation risk for primary liver cancers between 1958 and 1987 in a cohort of atomic bomb survivors in Hiroshima and Nagasaki, Japan. The analysis is based on a comprehensive pathology review of known or suspected liver neoplasms that generated 518 incident, first primary cases, mostly hepatocellular carcinoma. Excess relative risk from atomic bomb radiation was linear: 0.81 per sievert weighted liver dose (95% CI [0.32, 1.43]; P < 0.001). Males and females had similar relative risk so that, given a threefold higher background incidence in males, the radiation-related excess incidence was substantially higher in males. Excess risk peaked for those with age at exposure in the early 20s; there was essentially no excess risk in those exposed before age 10 or after age 45. Whether this was due to a difference in sensitivity or possible confounding by other factors could not be addressed retrospectively in the full cohort. A paucity of cholangiocarcinoma and hemangiosarcoma cases suggested that they are not significantly associated with whole-body radiation exposure, as they are with the internal alpha-particle-emitting radiological contrast medium Thorotrast. Because most of the radiation-related excess cases occurred among males, it is important to ascertain what factors put men at greater risk of radiation-related liver cancer.     

Incidence of multiple myeloma in Kailuan cohort: A prospective community-based study in China

BackgroundPrevious retrospective studies showed that the incidence and mortality rates for MM in China were lower than those in western countries. A large-scale prospective study on incidence and mortality rates of MM is still lacking.MethodsBased on the prospective Kailuan Cohort study in China, we included all patients with MM in Kailuan Cohort from June 1, 2008 to December 31, 2016. Using the numbers of diagnosed cases and deaths during the study period as the numerators and the corresponding observed person-years as the denominators respectively, we calculated crude incidence and mortality rates. The 95% confidence intervals for crude incidence rate and mortality rate were estimated base on Poisson distribution. Rates were standardized by direct standardization according to the China population in 2000 and Segi’ world standard population.ResultsA total of 22 members from Kailuan Cohort were first diagnosed with MM between 2008 and 2016. The calculated crude incidence rates were 2.8 (95% CI, 1.7–4.2) per 100,000 person-years for all participants. The standardized incidence rate was 0.9 per 100,000 person-years (95% CI, 0.5–2.1) when standardized by 2000 China population census data, and 1.0 per 100,000 person-years (95% CI, 0.6–1.8) when standardized by Segi’s world standard population (WSP). The calculated crude mortality rates were 2.3 (95% CI, 1.4–3.6) per 100,000 person-years. The mortality standardized by 2000 China population census data was 0.7 per 100,000 person-years (95% CI, 0.3–1.9), and 0.9 per 100,000 population (95% CI, 0.5–1.7) when standardized by Segi’s WSP. Both incidence and mortality for males were higher than that for females almost in all age groups. Both rates increased steadily with age.ConclusionIn this community-based prospective cohort study, we found that the incidence of MM in China was far lower than that in American and Europe.