[The risk of cancer in the Netherlands]. / De kans op kanker voor Nederlanders.

OBJECTIVE: Calculation of valid and detailed risks of cancer from, and up to, specific ages for inhabitants of the Netherlands. DESIGN: Secondary analyses of cancer incidence and mortality rates. METHOD: Gender and age-specific incidence rates of 56 different types of cancer were obtained from the Netherlands Cancer Registry. Gender and age-specific mortality rates were obtained from Statistics Netherlands. Using survival charts, risks of cancer were calculated from all ages and up to all ages, in steps of 5 years. The US National Cancer Institute's software programme DevCan was used for analyses. RESULTS: One out of every 2.3 newborn males (43.9%) and one out of every 2.6 newborn females (38.1%) in the Netherlands will develop cancer sometime during their life. The risk of developing cancer before the age of 80 is 35.9% for newborn males and 30.2% for newborn females. Women run the greatest risk of developing breast cancer (almost 13%). 50-year-old women have a risk of almost 3% of being diagnosed with breast cancer before the age of 60. Men have the greatest risk of a diagnosis of prostate cancer (almost 10%). The risk for a 50-year-old man of being diagnosed with prostate cancer within the subsequent 10 years however is less than 1%. CONCLUSION: Detailed rates of risks of cancer are useful for policy issues such as decisions to implement screening programmes, for public education, and for patient counselling, as in the field of clinical genetics. The routinely reported risks for newborns developing cancer before the age of 75 lack the necessary detail for such use.

Skin cancer prevention: behaviour and motives of Dutch adolescents.

Skin cancer incidence is rising in the Netherlands and prevention programmes are needed. We analysed sun protection behaviours and beliefs in 500 adolescents aged 15-20 years using the Integrated Model for Change. The results show that adolescents with the fairest skin type exposed themselves significantly less to the sun, but had more burns than groups with a darker skin type. Sunscreen was the most commonly used method by adolescents to protect themselves and 77% of adolescents frequently used this strategy. Sunscreen use was also higher in females than in males. Wearing protective clothing (34%) and seeking shade between 1200 and 1500 h (26%) were less popular and used by adolescents in our study. Frequent use of sunscreen was most strongly predicted by positive intentions to use sunscreen, parental support, a positive attitude towards using sunscreen, support of friends and perceiving skin cancer risks. Wearing protective clothing was predicted most strongly by parental support, having a positive attitude towards wearing protective clothing, seeking shade, support of friends, high self-efficacy levels, low exposure to the sun and being male. Seeking shade was most strongly predicted by a positive attitude towards seeking shade, support of friends, using protective clothing, high self-efficacy, parental support, a negative attitude towards tanning, and perceiving skin cancer risks. Implications for Dutch skin cancer prevention programmes are that the efficacy and advantages of all protective methods need to be outlined more clearly in health education programmes on skin cancer prevention.

Psychosocial care in family cancer clinics in The Netherlands: a brief report.

The present survey was undertaken to obtain a better understanding of the organisation of standard psychosocial services at the family cancer clinics in The Netherlands. Colleagues at the nine family cancer clinics in The Netherlands completed a brief questionnaire. It was found that all clinics offered professional psychosocial support for asymptomatic women from hereditary breast-ovarian cancer (HBOC) families. On average, one half-time psychosocial worker (usually a social worker and/or a psychologist) was involved in the genetic counselling. All clinics have developed education material about HBOC independently. As a result of the survey, an effort is made to coordinate the development of education material. Furthermore, it is concluded that more attention should be paid to symptomatic mutation carriers and those individuals, who receive inconclusive genetic test results. These subgroups are usually excluded from the protocols for psychosocial care in genetic counselling.

The DOM project for the early detection of breast cancer, Utrecht, The Netherlands.

This report describes the short-term results of a population-based screening programme--the DOM project--during the years 1975-1980. Screening was offered to all women in the city of Utrecht (The Netherlands) and 11 neighbouring areas who were born between 1911 and 1925. Further evaluation will be reported in future publications. The programme was organised by the Department of Epidemiology, Institute of Social Medicine (now renamed The Institute of Public Health and Epidemiology), University of Utrecht, which established a screening centre--The Preventicon--in a new commercial and shopping centre with good public transport facilities. The study population was between 50 and 65 years old at intake, a decision based on results obtained in the H.I.P. study in New York. Women resident in the city of Utrecht (n = 14,697 at intake) were screened four times, with intervals of 12, 18 and 24 months respectively between the first and fourth examinations. Women resident in the other areas (n = 8814) were screened twice with an interval of 18 months. Screening consisted of a clinical examination (inspection, palpation) and xero-mammography. An important role was played by paramedical personnel, who performed the examination and had a degree of responsibility in reading the mammograms. Initially the radiation dose per breast was about 1 rad, but from 1977 onwards this was reduced to 0.4 rad per exposure; for women living in Utrecht (4 screenings) the total dose was less than 5 rad over the 5-year period. Referral policy was based on a set of three types of "signal" to general practitioners (who coordinated specialist services): 1. Recommendation for biopsy; 2. Suggested repeat examination after 6 months; 3. Brief note on palpable abnormalities, considered likely to be benign. In Section II the response of the invited population is analysed. The response rate for the first screening was 72% in the city of Utrecht and 68% in the other areas. Variation in response rates can only be explained to a minor degree by measured demographic and sociological variables, age being the most important determinant. Women were asked to contribute D.fl. 12.50 (approx. US $5) per screening cycle to meet part of the expenses, the rest being paid by public health research funds. A total number of 61,649 examinations was performed in 23,511 women. In Section III the immediate results of screening are presented. An analysis is made of the cancer yield of the 3 signals mentioned above.(ABSTRACT TRUNCATED AT 400 WORDS)