ABSTRACT
South Australian registry data were used to investigate trends in laryngeal cancer age-standardised incidence, mortality and disease-specific survival from 1977 to 2005. Incidence rates decreased by 32% from 1980-84 to 2000-05, affecting both sexes and ages under 70 years. There were concurrent reductions in mortality, although statistical significance was not achieved with the numbers of deaths examined (p>0.05). More than other cancers, laryngeal cancers presented in: the 50-79 year age range; males, particularly those born in Southern Europe; UK/Irish migrants; and residents of lower socio-economic areas. Compared with other cancers, laryngeal cancers were less common in more recent diagnostic periods. The ratio of glottis to other laryngeal cancers was higher in males, older patients, and those born in Southern Europe, UK/Ireland and Western Europe. A secular increase in this ratio was evident. The five-year survival from laryngeal cancer was 68%, with poorer outcomes applying for older patients, non-metropolitan residents, patients with cancers of laryngeal sub-sites other than glottis, and potentially patients born in Southern Europe. Secular changes in survival were not observed. Reductions in incidence are attributed to decreases in tobacco smoking in males and reductions in per capital alcohol consumption since the 1970s. The higher ratio of glottis to other laryngeal cancer sub-sites in males may indicate a greater contribution made by tobacco, as opposed to alcohol, in males. The lower survival observed in non-metropolitan patients may reflect poorer access to radiation oncology and other specialist services, although delays in diagnosis for other reasons may have contributed.
ABSTRACT
Secular trends in Clark level were investigated by Breslow category for 8,432 invasive cutaneous melanomas diagnosed in South Australia in 1980-2000. More recently diagnosed lesions were found to have deeper levels. After adjusting for age at diagnosis, tumour site, histology, and thickness measured in half millimetres, the relative odds (95% confidence limits) of penetration to the reticular dermis or subcutaneous fat were 1.99 (1.59, 2.50) for the 1987-93 diagnostic period, and 2.82 (2.25, 3.54) for 1994-2000, when compared with 1980-86. After adjusting for melanoma thickness, the secular trends for deeper lesions applied to a broad cross-section of socio-demographic sub-groups, tumour sites, and histological types. While this similarity in trend would be consistent with a measurement effect, a real change cannot be ruled out and increased emphasis on earlier detection may be warranted. The prognostic implications of changes in inter-relationships between measures of thickness and level require periodic re-evaluation.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Melanoma/diagnosis , Middle Aged , Odds Ratio , Skin Neoplasms/diagnosisABSTRACT
Secular trends and epidemiological characteristics of 1,581 oesophageal cancers, diagnosed in South Australian residents in 1977-2000, were analysed by histological type and diagnostic period, using multivariable Poisson regression and logistic regression. The age-adjusted incidence of squamous cell carcinoma did not vary significantly by diagnostic period, either in males (p = 0.195) or females (p = 0.087). By comparison, variations were observed for adenocarcinomas in males (p<0.001) and females (p = 0.015), with an increase in age-adjusted incidence of 169% for males and 150% for females between 1977-81 and 1997-2000. Most of these increases occurred in the 1990s. Secular differences were not evident for tumours of other or unknown histological type. The ratio of adenocarcinomas to squamous cell carcinomas was higher in patients who were aged 80 years or more, male, residents of high socio-economic areas, and those born in the United Kingdom/Ireland. Conversely, relatively low ratios presented for patients born in Southern and other parts of Europe. These differences by country of origin accord with differences between the national incidence rates for these countries, as indicated by international data. Differences in secular trend and country of birth between adenocarcinomas of the oesophagus and gastric cardia suggest that they are not expressions of the same disease. Preventive implications of these results are discussed.