Changes in incidence, survival and mortality of prostate cancer in Europe and the United States in the PSA era: additional diagnoses and avoided deaths.

BACKGROUND: We describe changes in prostate cancer incidence, survival and mortality and the resulting impact in additional diagnoses and avoided deaths in European areas and the United States. METHODS: Using data from 12 European cancer registries and the Surveillance, Epidemiology and End Results program, we describe changes in prostate cancer epidemiology between the beginning of the PSA era (USA: 1985-1989, Europe: 1990-1994) and 2002-2006 among patients aged 40-64, 65-74, and 75+. Additionally, we examine changes in yearly numbers of diagnoses and deaths and variation in male life expectancy. RESULTS: Incidence and survival, particularly among patients aged <75, increased dramatically, yet both remain (with few exceptions in incidence) lower in Europe than in the United States. Mortality reductions, ongoing since the mid/late 1990 s, were more consistent in the United States, had a distressingly small absolute impact among patients aged 40-64 and the largest absolute impact among those aged 75+. Overall ratios of additional diagnoses/avoided deaths varied between 3.6 and 27.6, suggesting large differences in the actual impact of prostate cancer incidence and mortality changes. Ten years of remaining life expectancy was reached between 68 and 76 years. CONCLUSION: Policies reflecting variation in population life expectancy, testing preferences, decision aids and guidelines for surveillance-based management are urgently needed.

Low frequency of the CHEK2*1100delC mutation among breast cancer probands from three regions of Poland.

The 1100delC germline mutation of the CHEK2 gene appears to contribute significantly to the overall breast cancer incidence in some West and North European countries, but seems to be much less frequent among breast cancer patients from other regions of Europe. In the present study we found, respectively, 3/487, 1/296 and 0/279 carriers of this mutation among breast cancer patients from the East-Central, South-East and West-Central regions of Poland. Two carriers of the 1100delC mutation were found among 120 patients with bilateral breast cancer, but only one had a previous family incidence of breast cancer. We found no carriers among 182 patients with unilateral breast cancer with family history of this tumor and among 64 patients with breast cancer and a second primary tumor at an other site. We conclude that the 1100delC mutation of the CHEK2 gene contributes little to the overall breast cancer burden in Poland, including familial cases of this malignancy. Further studies are still needed to evaluate the contribution of this mutation to the development of bilateral breast tumors.

A case-control study of lung cancer in Polish women.

This study was undertaken to examine the influence of active and passive smoking, cancer family history, occupational exposure, usual diet and alcohol consumption on female lung cancer risk. A total of 242 women with histologically confirmed primary lung cancer and 352 healthy controls were involved in the study. All subjects were interviewed in the hospital. Data were analysed using multivariate logistic regression. Multivariate analysis has shown that smoking was the most strongly active risk factor in female lung cancer. Positive dose-response relationship was observed between lung cancer risk and number of pack-years. Passive smoking exposure during childhood significantly increased the risk (OR=2.65). There was also observed a significantly increased risk of lung cancer among women who had siblings with history of cancer (OR=3.42). Occupational exposure to coal dust, acid fumes (sulphuric and/or hydrochloric) and materials used for rubber making significantly increased the risk. Frequent intake of carrots (at least five times a week) and also daily intake of other vegetables significantly lowered the risk (OR=0.13, OR=0.24). A significant protective effect was also observed in women frequently using margarine on bread (OR=0.14). Vodka drinkers showed significantly higher risk than non-drinking women. The analysis of dose-response relationship in reference to vodka drinking also confirmed significant influence of this factor on the risk.

[Epidemiology of thyroid cancer in Poland]. / Epidemiologia raka tarczycy w Polsce.

The aim of the paper is to analyse the epidemiological situation of thyroid cancer in Cracow region from 1986 to 1999 and to review regional thyroid cancer registers in Poland (including 43.7% of the Polish population) in 1999. The standardized register was based upon assumptions: 100% of histopathological verification according to ICD-10, the register ascertainment in at least 80%, the demographic area not smaller than 100,000 inhabitants, the incidence rate (IR) calculated as the newly diagnosed cases number per 100,000 inhabitants in a calendar year. Since 1990 a statistically significant rise of the thyroid cancer incidence affecting mainly women > 40 years of age have been observed. From 1998-1999 the cancer morbidity was reduced. Within the last 5 years in the Cracow area the follicular carcinoma incidence has decreased significantly, which has been associated with effective iodine prophylaxis. The highest incidence values have been observed in Cracow and Olsztyn, showing a territorial relationship with the highest thyroid irradiation doses after Chernobyl accident. The mean IR value has been 3.86 (1.48 men, 6.08 women), which corresponds to about 1500 newly diagnosed cases in Poland in 1999. The follicular to papillary carcinoma ratio has been 5.32. The major etiological factors have been iodine deficiency and ionising radiation. The present data have indicated that iodine prophylaxis should be continued and that the population should be protected against ionising radiation.

Risk factors for lung cancer among women in Poland.

A total of 118 women with histologically confirmed lung cancer and 141 healthy controls, were involved in a case-control study conducted in Cracow between 1991 and 1994. The aim of this study was to examine the role of smoking, alcohol consumption, and diet in female lung cancer risk. Multivariate analysis has shown that cigarette smoking was the most strongly active risk factor in female lung cancer. Vodka drinkers showed significantly higher risk than non-drinking women. Frequent intakes of carrots (at least three times a week) significantly lowered the risk. The significant protective effect was also observed in women using margarine on bread. The analysis of dose-response relationship in reference to cigarette smoking, vodka drinking and consumption of carrots also confirmed significant influence of these factors on risk.

Evaluation of certain risk factors for lung cancer in Cracow (Poland)--a case-control study.

The relationship of lung cancer risk to cigarette smoking, occupational exposure, air pollution at permanent residence and usual frequency of consumption of fruits and vegetables was analysed in a case control study in Cracow, Poland. The cases were 176 male lung cancer patients diagnosed in 1992-1994 with histological confirmation of the diagnosis, obtained from the population-based Cracow Cancer Registry, and 341 controls randomly selected from the general population. Classification of exposure to outside air pollution was based on measured level of total suspended particular matter and sulphur dioxide by particular districts of town (from 1973 to 1980). Except calculation of odds ratios for male lung cancer associated with exposures among all study subjects, the association between lung cancer risk and frequency of consumption of fruit and vegetables was examined among drinkers of vodka above average. Risk of lung cancer was increased significantly with increasing number of pack-years of smoking (OR = 18.7 for more than 40 pack-years). The significant inverse association of frequent usual consumption of boiled vegetables was present both among all subjects and among vodka drinkers (OR = 4.6 and 12.5, respectively, for a rare consumption). The risk of male lung cancer was negatively associated with the level of air pollution but positively with the percentage of occupationally exposed. Our study provides no evidence of a significant harmful effect of air pollution and found a strong inverse association between frequent fruit and vegetables consumption and lung cancer risk.

Dietary factors and risk of prostate cancer in Poland. Results of case-control study.

The relationship between cigarette smoking, vodka drinking and consumption of 44 food items typical of the Polish diet were analyzed in a case-control study performed in Cracow, Poland, among 76 cases of prostate cancer and 152 controls. Cigarette smoking and drinking of vodka were not significantly influencing the prostate cancer. The men who ate smoked or fried fish or liver at least once per week had almost half of the risk of prostate cancer of the men who ate those food rarely.

[Ovarian cancer and selected life style habits]. / Rak jajnika a wybrane elementy stylu zycia.

Analysis of population based case-control study performed in Cracow Poland in 1988-1990 on 81 cases of histologically proven epithelial ovarian cancer and 162 age matched controls have shown that frequent consumption of legumes was associated with significantly decreased risk. Smoking and drinking of vodka were not significant related to ovary cancer risk.

[Second primary malignant neoplasms in patients treated radically for carcinoma of oral cavity, larynx and lungs]. / Drugie pierwotne nowotwory zlosliwe u chorych leczonych radykalnie z powodu raka jamy ustnej, krtani i pluca.

About 1% of the patients with oral cavity, larynx, and lung cancer get second primary malignant neoplasms every year. For laryngeal cancer the percentage exceeds 10. Second primary tumors in oral cavity, larynx, and lung cancer patients are also tobacco-related neoplasms. Smoking cessation by patients with oral cavity, larynx, and lung cancer may have significant influence on the prognosis. Vitamin A (retinol) and its analogues are promising for human cancer prevention.

[Results of delayed treatment of patients with malignant tumors of the lymphatic system]. / Przyczyny opóznienia leczenia chorych na zlosliwe nowotwory ukladu limfatycznego.

The causes, with considerably influence the advancement of cancer process have been investigated in patients with lymphatic system tumours admitted to the Department of Chemotherapy at the Center of Oncology in Cracow. It has been revealed, that the delay in the treatment was mainly due to false first diagnosis as well as the negligence of the symptoms by the patients themselves and also to consulting medically unrecognized "healers" before undertaking proper, specialized treatment. It has been observed, that more than every fourth patient took advice of "non-doctors", i.e. bioenergy-therapists, incompetent healers, herbalists and so forth. These factors by influencing further delay in the treatment, diminish its chances.

[Causes of delayed treatment of patients with small cell lung cancer]. / Przyczyny opóznienia w leczeniu chorych na drobnokomórkowego raka pluca.

An analysis of factors producing advanced small cell lung cancer in 57 patients from the Chemotherapy Department of the Oncological Center in Cracow. The main reason for delay in chemotherapy in small cell lung cancer were diagnostic mistakes. Almost 40% of the patients were treated with improper diagnoses for a mean period of 6 months. Although 28.3% seeked non-medical help this did not effect nor delay chemotherapy.

The results of Vepesid therapy in the treatment of malignant lymphomas.

Twenty-three patients with Hodgkin's disease and non-Hodgkin's lymphomas were treated by Vepesid. The dose of the drug was 150 mg/m2 daily for 5 consecutive days. This schedule was repeated every 3 weeks. The percentage and response were estimated according to WHO scale. There were complete responses and 6 partial responses lasting 13.7 and 5 months, respectively, on the average. The results of Vepesid therapy depended on the efficiency of previous treatment.

[Assessment of causes for delayed treatment in patients with malignant neoplasms ]. / Ocena przyczyn opóznionego leczenia chorych na nowotwory zlosliwe.

Investigation of the causes of delay in the treatment of patients with malignant neoplasms indicates that medium time of delay caused by patient has been 7 months, and caused by physician 9 months. Investigations indicate also that time of waiting for admission to the Oncology Center has been averaging 3 weeks. It has been found that every 9-th patient has been under non medical care for average period of 7 months.

A case-control study of dietary factors and stomach cancer risk in Poland.

We report results from a case-control study on stomach cancer conducted in 1980-81 in Cracow, Poland, where the risk of this disease is among the highest reported world-wide. One hundred and ten cases from a surgical clinic were matched by age and sex to the same number of controls from the same hospital. A matched series from a population-based health survey was also considered. After adjusting for residency, smoking and various food items, cases and hospital controls showed significant differences in consumption of fruits (RR rarely vs. daily: 3.24; 95% CI: 1.56-6.77), joint consumption of vegetables, salads and fruits (RR low vs. high: 4.23; 95% CI: 1.41-12.63), and consumption of protein-containing foods (RR low vs. high: 0.23; 95% CI: 0.08-0.61). Consumption of strong alcoholic beverages on an empty stomach (before breakfast) was associated with an RR of 2.09 (1.04-4.22). The findings are discussed in relation to the apparent urban/rural difference in stomach cancer incidence in Poland and the possible underlying etiological factors involved.