[Tobacco consumption and bladder cancer mortality in Spain]. / Consumo de tabaco y mortalidad por cáncer vesical en España.

OBJECTIVES: To establish the trend of the bladder cancer adjusted mortality and its correlation with tobacco consumption in different Spanish Autonomic Communities over a 15 year period. METHODS: We evaluate the trends of mortality rates associated with bladder cancer between January 1st 1989 and December 31st 2002 in the geographic area of Spain, as well as the tendency of tobacco consumption. Demographic and mortality data were obtained from the National Institute of Statistics, and consumption data were obtained from the Commissioner for the Tobacco Market in the Spanish Economics and Finances Ministry. We calculate the average number of cigarettes (1 package = 20 cigarettes) consumed per person; we also calculate bladder cancer adjusted mortality rates, presented as number of deaths for that cause per 100.000 persons year, and the ratio between number of packages of cigarettes consumed and adjusted mortality rate. We determine the yearly percentage increase over the whole period of study for both the mortality rate and tobacco consumption, and evaluate their correlation by the Spearman's coefficient. RESULTS: Mean adjusted bladder cancer mortality rate over the period of study was 9.4 deaths per 100.000 habitants year, and mean tobacco consumption was 109.7 packages per person year. There has been a 2.05% yearly increase of bladder cancer associated mortality, mean cigarette consumption has diminished 1.3% per year. The Spearman's test did not show any correlation between both factors (p = 0.722). CONCLUSIONS: Despite preventive measures for tobacco addiction in our country, there is an important continuous consumption. The increase in the incidence of bladder cancer does not seem to be related with higher tobacco consumption currently, therefore it may be related with other genetic or environmental factors.

[Renal cell renal carcinoma. Analysis of incidence and survival in a 90.000 citizens healthcare area]. / Carcinoma renal de células claras. Análisis de incidencia y supervivencia en un area sanitaria de 90,000 habitantes.

OBJECTIVES: To evaluate the most relevant epidemiological and survival data of the renal cell carcinoma (RCC) in a 90.000 citizens geographic area, as well as its association with risk factors such as tobacco or diuretic drugs use. METHODS: All patients with the pathologic diagnosis of renal cell carcinoma between January 1st 1987 and January 31st 2004 were included in the study. Adjusted incidence rates (standardized) per 100.000 inhabitants year, annual percentage increase, and epidemic index in the health-care area VIII in Ciudad Real (90.000 inhabitants) were calculated. For the population adjustment we used the data Published by the National Institute of Statistics. We evaluated the differences in mortality between males/females, as well as in relation to tobacco consumption, using the chi-square test or the Fisher exact test, and the overall survival by a Cox regression model. RESULTS: Thirty-eight RCC were diagnosed, with a maximum incidence of 7.21 cases per 100.000 inhabitants year. There was an annual percentage increase of 2.06% over the whole period. There were no statistically significant differences in gender-associated mortality (p = 0.1), tumor stage (p = 0.063), tobacco consumption (p = 0.13), diuretic drugs consumption (p = 0.69), or both (p = 0.5). Mortality was significantly higher during the first 5 years after surgery. CONCLUSIONS: The incidence of RCC is progressively increasing, and it is predictable that this trend will be maintained in the next years. Overall mortality (any cause) associated with RCC is higher in the first five years after diagnosis.

Carcinoma de células claras. Análisis de incidencia y supervivencia en un área sanitaria de 90.000 habitantes / Renal cell renal carcinoma. Analysis of incidence and survival in a 90.000 citizens healthcare area

OBJETIVOS: Evaluar los datos epidemiológicos y de supervivencia más relevantes del carcinoma renal de células claras (CCR) en un área geográfica de 90,000 habitantes, así como su asociación a factores de riesgo como el tabaco o el uso de diuréticos. MÉTODOS: Se incluyeron todos los pacientes con diagnóstico histológico de carcinoma renal de células claras, entre el 1 de Enero de 1987 y el 31 de Enero de 2004. Se calcularon las tasas de incidencia ajustada (estandarizada) por 100.000 habitantes y año en el área sanitaria VIII de Ciudad Real (90.000 habitantes), el incremento porcentual anual y el índice epidémico. Para el ajuste poblacional se utilizaron los datos publicados por el Instituto Nacional de Estadística. Se evaluarán las diferencias de mortalidad entre ambos sexos, así como en función del consumo de tabaco, diuréticos o ambos, mediante el test de chi-cuadrado, o test exacto de Fischer,y la supervivencia global mediante un modelo de regresión de Cox. RESULTADOS: Se diagnosticaron 38 CCR, con una incidencia máxima de 7,21 casos por 100,000 habitantes y año. Se produjo un incremento porcentual anual durante todo el periodo de un 2,06%. No existieron diferencias estadísticamente significativas en la mortalidad asociada al sexo (p= 0,1), estadio tumoral (p=0,063), consumo de tabaco (p=0,13), diuréticos (p=0,69) o ambos (p=0,5). La mortalidad fue significativamente superior durante los primeros 5 años tras la intervención quirúrgica. CONCLUSIONES: La incidencia del CCR está aumentando de forma progresiva, y es de preveer que esta tendencia se mantenga al alza en los próximos años. La mortalidad global (por cualquier causa) asociada al CCR es superior los primeros 5 años tras el diagnóstico

OBJECTIVES: To evaluate the most relevant epidemiological and survival data of the renal cell carcinoma (RCC) in a 90.000 citizens geographic area, as well as its association with risk factors such as tobacco or diuretic drugs use. METHODS: All patients with the pathologic diagnosis of renal cell carcinoma between January 1st 1987 and January 31st 2004 were included in the study. Adjusted incidence rates (standardized) per 100.000 inhabitants year, annual percentage increase, and epidemic index in the health-care area VIII in Ciudad Real (90.000 inhabitants) were calculated. For the population adjustment we used the data Published by the National Institute of Statistics. We evaluated the differences in mortality between males/females, as well as in relation to tobacco consumption, using the chi-square test or the Fisher exact test, and the overall survival by a Cox regression model. RESULTS: Thirty-eight RCC were diagnosed, with a maximum incidence of 7.21 cases per 100.000 inhabitants year. There was an annual percentage increase of 2.06% over the whole period. There were no statistically significant differences in gender-associated mortality (p = 0.1), tumor stage (p = 0.063), tobacco consumption (p = 0.13), diuretic drugs consumption (p = 0.69), or both (p = 0.5). Mortality was significantly higher during the first 5 years after surgery. CONCLUSIONS: The incidence of RCC is progressively increasing, and it is predictable that this trend will be maintained in the next years. Overall mortality (any cause) associated with RCC is higher in the first five years after diagnosis

Consumo de tabaco y mortalidad por cáncer vesical en España / Tobacco consumption and bladder cancer mortality

OBJETIVO: Determinar la tendencia de la mortalidad ajustada por cáncer vesical y establecer una correlación con el consumo de tabaco en las diferentes Comunidades españolas a lo largo de un periodo de quince años.MÉTODOS: Se evaluarán las tendencias de mortalidad asociada al cáncer vesical en el periodo comprendido entre el 1 de Enero de 1989 y el 31 de Diciembre de 2002, en el área geográfica de España, así como las tendencias en el consumo de tabaco durante el mismo periodo. Los datos demográficos y de mortalidad se obtuvierondel Instituto Nacional de Estadística y los datos de consumo de tabaco se obtuvieron del Comisionado para el Mercado de Tabacos del Ministerio de Economiay Hacienda.Se calcularán el número medio de cajetillasde cigarrillos (1 cajetilla equivale a 20 cigarrillos) consumidas por persona; así como las tasas de mortalidadajustadas por cáncer de vejiga expresada como fallecimientos por dicha causa por 100.000 personas y año, y el ratio entre las cajetillas de cigarrillos consumidosy la tasa de mortalidad ajustada.Se determinará el incremento porcentual anual durante todo el periodo, tanto para la tasa de mortalidad como para el consumo de tabaco, y se evaluará la correlación entre ambas tendencias mediante el coeficiente de Spearman.RESULTADOS: Durante todo el periodo a estudio, la tasa media de mortalidad ajustada por cáncer vesical fue de 9,4 fallecidos por cada 100,000 habitantes y año, y el consumo medio de tabaco fue de 109,7 cajetillas por persona y año. Se ha producido un incremento de la mortalidad asociada a cáncer vesical de un 2,05 % anual, mientras que el consumo de cigarrillos ha disminuidoun 1,3 % al año. El test de Spearman no muestra correlación entre ambos factores (p=0,722).CONCLUSIONES: A pesar de las medidas de prevencióndel tabaquismo en nuetro medio, continúa produciéndoseun importante consumo del mismo. El incrementoen la incidencia de cáncer vesical no parece estar en relación con un mayor consumo de tabaco en la actualidad, por lo que puede estar en relación con otros factores genéticos o ambientales

OBJECTIVES: To establish the trend of the bladder cancer adjusted mortality and its correlation with tobacco consumption in different Spanish Autonomic Communities over a 15 year period. METHODS: We evaluate the trends of mortality rates associated with bladder cancer between January 1st 1989 and December 31st 2002 in the geographic area of Spain, as well as the tendency of tobacco consumption. Demographic and mortality data were obtained from the National Institute of Statistics, and consumption data were obtained from the Commissioner for the Tobacco Market in the Spanish Economics and Finances Ministry. We calculate the average number of cigarettes (1 package = 20 cigarettes) consumed per person; we also calculate bladder cancer adjusted mortality rates, presented as number of deaths for that cause per 100.000 persons year, and the ratio between number of packages of cigarettes consumed and adjusted mortality rate. We determine the yearly percentage increase over the whole period of study for both the mortality rate and tobacco consumption, and evaluate their correlation by the Spearman’s coefficient. RESULTS: Mean adjusted bladder cancer mortality rate over the period of study was 9.4 deaths per 100.000 habitants year, and mean tobacco consumption was 109.7 packages per person year. There has been a 2.05% yearly increase of bladder cancer associated mortality, mean cigarette consumption has diminished 1.3% per year. The Spearman’s test did not show any correlation between both factors (p = 0.722). CONCLUSIONS: Despite preventive measures for tobacco addiction in our country, there is an important continuous consumption. The increase in the incidence of bladder cancer does not seem to be related with higher tobacco consumption currently, therefore it may be related with other genetic or environmental factors

Análisis epidemiológico del carcinoma epidermoide de pene en un área sanitaria de 90.000 habitantes / Epidemiological analysis of the squamous cell carcinoma of the penis in a 90.000 inhabitant health area

OBJETIVOS: Establecer los aspectos epidemiológicosmás relevantes (incidencia absoluta, ajustaday acumulada, densidad de incidencia e índiceepidémico) del carcinoma epidermoide de pene, asícomo la supervivencia derivada de dicha patología.MÉTODO: Se incluyeron todos los pacientes diagnosticadosde carcinoma epidermoide de pene en el áreasanitaria VIII de Ciudad Real (90,000 habitantes) entreEnero de 1981 y Diciembre de 2003. Para el ajustepoblacional se tomaron los datos aportados por elInstituto Nacional de Estadística. Para el estudio desupervivencia se aplicará un modelo de regresión deCox. RESULTADOS: La incidencia del cáncer epidermoidede pene se ha incrementado durante los últimos años(incremento anual del 5,86 %), con una elevada mortalidaddentro del primer año (mediana de supervivenciade 407 días).CONCLUSIONES: Sería recomendable la intensificaciónde las medidas preventivas para tratar de frenar elincremento en su incidencia, así como tratamientosadyuvantes de éxito que incrementen la supervivenciacáncer específica

OBJECTIVES: To establish the most relevant epidemiological features of the squamous cell carcinoma of the penis (absolute, adjusted and accumulated incidence, incidence density, and epidemic index), as well as its related survival. METHODS: We included all patients with the diagnosis of squamous cell carcinoma of the penis in the health area No. VIII of Ciudad Real (90,000 inhabitant) between January 1981 and December 2003. Data from the national Institute of Statistics were used for population adjustments. A Cox regression model was applied for survival analysis. RESULTS: The incidence of squamous cell carcinoma of the penis has increased over the last years (yearly increase 5.86%) with a high mortality rate within the first year (median survival 407 days) CONCLUSIONS: it would be recommendable to intensify preventive measures to try a stop the increase in incidence, as well as successful adjuvant treatments to increase cancer specific survival

[Transrectal prostatic biopsy management policy for patients older than 50 years in relation to PSA values elaborated by a mathematical decision tree]. / Política de actuación de la biopsia transrectal prostática, en mayores de 50 años, en función del valor del PSA, elaborado mediante un arbol de decisión matemático.

OBJECTIVES: To decide the action politics (to perform or not transrectal prostatic biopsy) for a PSA cut point of 4 and 10 ng/ml through the construction of a mathematical decision tree. METHODS: We calculate the usefulness of the biopsy through a subjective score, from 0 to 10, established after a survey of the 20 staff members of the health-care area, applying an global analysis with creation of total profile cards through an orthogonal design. RESULTS: The main usefulness of prostate cancer screening would be not to perform transrectal prostatic biopsies when PSA is lower than 4 ng/ml.

[Synchronous renal clear-cell carcinoma and ipsilateral transitional-cell carcinoma: case report and bibliographic review]. / Carcinoma renal de células claras y carcinoma urotelial ipsilateral sincrónicos: aportación de un nuevo caso y revisión de la literatura.

OBJECTIVES: We report a new case of simultaneous renal cell adenocarcinoma and ipsilateral multifocal transitional cell carcinoma. METHODS: 73-year-old man with initial diagnosis of transitional cell carcinoma of the urinary tract whose pathological report showed a asynchronous renal cell carcinoma. RESULTS: We present microphotographs of both tumors after radical surgery. CONCLUSIONS: The presentation of both tumors in the same kidney is unusual, although there are around 47 cases in the bibliography worldwide, 8 of them in Spanish. Presentation of both tumors altogether does not worsen prognosis.

Política de actuación de la biopsia transrectal prostática, en mayores de 50 años, en función del valor del PSA, elaborado mediante un árbol de decisión matemático / Transrectal prostatic biopsy guidelines for patients older than 50 years in relation to PSA elaborated by a mathematical decision tree

OBJETIVO: Determinar la política deactuación (realizar o no biopsia transrectal prostática)para un punto de corte de PSA de 4 y 10 ng/mmediante la elaboración de un árbol de decisión matemático.MÉTODOS: Se calculará la utilidad de la biopsia a travésde una puntuación subjetiva de 0 a 10, establecidamediante una encuesta realizada sobre 20 miembrosdel personal facultativo del área sanitaria, aplicándoseun análisis conjunto con elaboración de tarjetasde perfil total a través de un diseño ortogonal.RESULTADOS/CONCLUSIÓN: La principal utilidadencontrada para la realización de screening de cáncerde próstata sería la no realización de biopsia transrectalprostática cuando el PSA sea menor de 4 ng/m

OBJECTIVES: To decide the action ;;politics (to perform or not transrectal prostatic biopsy) for ;;a PSA cut point of 4 and 10 ng/ml through the ;;construction of a mathematical decision tree. ;;METHODS: We calculate the usefulness of the biopsy ;;through a subjective score, from 0 to 10, established ;;after a survey of the 20 staff members of the health-care ;;area, applying an global analysis with creation of total ;;profile cards through an orthogonal design. ;;RESULTS: The main usefulness of prostate cancer ;;screening would be not to perform transrectal prostatic ;;biopsies when PSA is lower than 4 ng/ml

Carcinoma renal de células claras y carcinoma urotelial ipsilateral sincrónicos: aportación de un nuevo caso y revisión de la literatura / Synchronic renal cell carcinoma and ipsilateral transitional cell carcinoma: case report and bibliographic review

OBJETIVO: Presentamos un nuevo caso deaparición simultanea de adenocarcinoma de célulasrenales y carcinoma transicional multifocal ipsilateral.MÉTODO: Varón de 73 años con diagnóstico inicial decarcinoma urotelial de vía urinaria que presenta en el estudioanatomopatológico un carcinoma renal asociado.RESULTADOS: Después de tratamiento radical se muestraen imágenes microscópicas la aparición de ambos tiposde tumores.CONCLUSIONES: La revisión de la literatura indica quela aparición sincrónica de ambos tumores en un mismopaciente es un hecho poco frecuente, aunque ya han sidopublicados entorno a 47 casos en la literatura mundial delos cuales 8 fueron publicados en español. Este tipo desincronismo tumoral no ensombrece el pronóstico

OBJECTIVES: We report a new case of simultaneous renal cell adenocarcinoma and ipsilateral multifocal transitional cell carcinoma. METHODS: 73-year-old man with initial diagnosis of transitional cell carcinoma of the urinary tract whose pathological report showed a asynchronous renal cell carcinoma. RESULTS: We present microphotographs of both tumors after radical surgery. CONCLUSIONS: The presentation of both tumors in the same kidney is unusual, although there are around 47 cases in the bibliography worldwide, 8 of them in Spanish. Presentation of both tumors altogether does not worsen prognosis

[Epidemiological analysis of the squamous cell carcinoma of the penis in a 90,000 inhabitant health area]. / Análisis epidemiológico del carcinoma epidermoide de pene en un area sanitaria de 90,000 habitantes.

OBJECTIVES: To establish the most relevant epidemiological features of the squamous cell carcinoma of the penis (absolute, adjusted and accumulated incidence, incidence density, and epidemic index), as well as its related survival. METHODS: We included all patients with the diagnosis of squamous cell carcinoma of the penis in the health area No. VIII of Ciudad Real (90,000 inhabitant) between January 1981 and December 2003. Data from the national Institute of Statistics were used for population adjustments. A Cox regression model was applied for survival analysis. RESULTS: The incidence of squamous cell carcinoma of the penis has increased over the last years (yearly increase 5.86%) with a high mortality rate within the first year (median survival 407 days) CONCLUSIONS: It would be recommendable to intensify preventive measures to try a stop the increase in incidence, as well as successful adjuvant treatments to increase cancer specific survival.

[Prostatic epidermoid carcinoma: report of a new case an review of the literature]. / Carcinoma epidermoide prostático: aportación de un nuevo caso y revisión de la literatura.

OBJECTIVES: To study and to review the squamous cell carcinoma of the prostate (SCCP). METHODS: We report one case of squamous cell carcinoma of the prostate. RESULTS: A 78-year-old patient was diagnosed of having a squamous cell carcinoma of the prostate. Clinically, the patient presented with severe irritative lower urinary tract symptoms. Treatment was performed by local radiotherapy and response was poor, as it usually happens in this type of tumors. Patient survived seven months after diagnosis. We present the clinical case and a bibliographic review. CONCLUSIONS: SCCP is a rare, difficult to diagnose and poor in prognosis tumor with very few therapeutic options.

Carcinoma epidermoi de prostático: aportación de un nuevo caso y revisión de la literatura / Squamous cell carcinoma of the prostate: report of a new case and bibliographic review

OBJETIVO: Estudio y revisión del carcinoma epidermoide prostático. MÉTODOS: Presentación de un caso clínico de carcinoma epidermoide prostático. RESULTADOS: Paciente de 78 años de edad diagnosticado de carcinoma epidermoide prostático. Clínicamente debutó como un síndrome prostático irritativo severo. El paciente fue tratado con radioterapia local con respuesta pobre como ocurre en este tipo de tumores, presentado el paciente una supervivencia de siete meses después del diagnóstico.Se presenta el caso clínico y se realiza una revisión de la literatura publicada al respecto. CONCLUSIONES: El carcinoma epidermoide prostático es un tumor poco frecuente, de difícil diagnóstico y de mal pronóstico con escasas posibilidades terapéuticas (AU)

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