Trends in Type 1 diabetes incidence in the UK in 0- to 14-year-olds and in 15- to 34-year-olds, 1991-2008.

AIM: To describe Type 1 diabetes incidence trends in the UK between 1991 and 2008 in children aged 0-14 years and in young adults aged 15-34 years. METHODS: Data from the UK General Practice Research Database were analysed, including 3002 individuals (1565 aged 0-14 years and 1437 aged 15-34 years) newly diagnosed with Type 1 diabetes. Poisson regression was used to model annual incidence increases and seasonality effects. RESULTS: Type 1 diabetes incidence increased from 11 to 24/100,000 person-years in boys and from 15 to 20/100,000 person-years in girls. In adults, the incidence rate increased from 13 to 20/100,000 person-years (men) and from 7 to 10/100,000 person-years (women). Annual incidence increases tended to be greater in children (4.1%, 95% CI 3.0-5.2%) compared with 15- to 34-year-olds (2.8%, 95% CI 1.6-3.9%). There was evidence of higher incidence rates during autumn and winter in children, but not in adults. CONCLUSIONS: A continuing increase in Type 1 diabetes incidence was shown that was greater in children than in young adults. Seasonal variation was observed in children only.

Improvements in breast cancer survival over time, related to adjuvant treatment and node status.

BACKGROUND: There has been an increase in the use and effectiveness of adjuvant treatment for operable breast cancer and the aim of this study was to examine whether this has resulted in improved survival for all prognostic groups. METHODS: A retrospective study of 1517 patients with invasive breast cancer treated between 1980 and 2002 was carried out. The use of adjuvant treatment was compared between two time periods in patients based on nodal status, and survival was calculated by Kaplan-Meier life table analysis. Independent predictors for recurrence-free survival (RFS) were determined by Cox regression analysis. RESULTS: The use of adjuvant therapy increased for all prognostic groups. On multivariate analysis the use of radiotherapy and endocrine therapy was positively associated with RFS which was significant in the second time period. Outcome in node positive patients improved: five-year RFS from 59% to 76%, p<0.01 and breast cancer specific survival (BCSS) from 70% to 83%, p<0.01. However, there was no survival improvement in the larger group of node negative patients; BCSS 93% versus 95%, p=0.99. Within the node negative group, patients with tumours >or= 2 cm had an improved RFS from 80% to 88%, p=0.02. CONCLUSION: The increased use of adjuvant therapy was associated with an improved outcome in node positive patients. For node negative patients with good prognostic features the evidence of benefit was marginal.