Trends in suicide mortality, 1955-1989: America, Africa, Asia and Oceania.
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Aged↗
Biomedical subjects
F Levi
Publications and source records attributed to F Levi.
Trends in cancer mortality in young adults in Europe, 1955-1989.
Trends in mortality in the age group 20-44 years for the 16 most common cancers or groups of cancer in young adults are presented for 24 European countries (i.e. those with > or = 1,000,000 inhabitants). The largest (up to 9-fold) and most frequent increases were recorded for cancer of the mouth and pharynx (> or = 2-fold increase from 1955-1959 to 1985-1989 in 10 countries), and oesophagus (in eight countries) in males, and for cancer of the skin, chiefly of melanomatous type, in males and females (in nine and eight countries, respectively). Consistent declines were observed for cancer of the stomach and uterus (chiefly, cervix), and for Hodgkin's disease, most notably in northern European countries. Little change emerged in the last 30 years or so in young adult mortality rates for cancer of the colon-rectum, pancreas, non-Hodgkin's lymphoma, leukaemias and cancers of the breast and ovaries in women. More than 2-fold elevations in lung cancer mortality rates in men aged 20-44 years were found only in a few previously non-market economy countries, and in Spain and Portugal. In some northern European countries, favourable downward trends in young males were accompanied by more than 2-fold increases in lung cancer mortality rates in young women. Overall, total cancer mortality rates in women at aged 20-44 years have declined over the last 35 years by more than 20% in 12 countries, and have not increased anywhere. Total cancer mortality rates in young males showed similar decreases in nine northern European countries, but increases of the same magnitude were also observed in most formerly non-market economy countries, and in Spain and Portugal.
Adult↗
Estimating the incidence of cancers in Switzerland: 1983-1987.
Estimates have recently been made of the incidence of cancers in the countries of the European Community. Similar estimates are given for Switzerland, based on data from the six Swiss cantonal cancer registries, all of which have been operating for at least 12 years. These registries cover Basel, Geneva, Neuchatel, St Gall and Appenzell, Vaud and Zurich, which account for about 50% of the Swiss population as a whole. Two different methods were used to extrapolate from the incidences observed in the regions covered by cancer registration to the entire country. The first method is based solely on the distribution of populations according to the country's main linguistic groups, whereas the second relies on mortality data. Estimates obtained by the second approach are presented and their reliability is discussed. Comparison of the age incidence curve with that of Denmark tends to confirm the validity of the estimations. Estimated standardised rates (world population) for all sites except nonmelanomatous skin cancer are 294.3 for males and 214.2 for females. Comparisons with other European countries show that in males, lung cancer is relatively less common in Switzerland, whereas in females, breast cancer is relatively more frequent.
Adolescent↗
Worldwide patterns and trends in mortality from liver cirrhosis, 1955 to 1990.
Trends in mortality rates for liver cirrhosis between 1955 and 1990 have been analyzed for 38 countries (two from North America, six from Latin America, five from Asia, 23 from Europe, and Australia and New Zealand) on the basis of official death certification data derived from the World Health Organization database. Chile and Mexico had exceedingly high rates (around 60/100,000 males and 15/100,000 females in the late 1980s), while in Canada, the United States, and Latin American countries that provided data, cirrhosis death rates were between 5 and 17/100,000 males and 3 and 5/100,000 females over the same calendar period. The pattern of trends was, however, similar in all American countries, with some increase between the 1950s and the 1970s, and declines thereafter. A similar trend was observed in Japanese males, whose rate was 13.6 in 1990. Conversely, cirrhosis mortality declined steadily from 8.0 to 4.6 in Japanese females. Appreciable downward trends were observed in Hong Kong and Singapore, whereas mortality increased in Thailand. In Europe, in the late 1950s, the highest rates were registered in Portugal (33.6/100,000 males and 14.6/100,000 females), followed by France (31.8/100,000 males and 14.1/100,000 females), Austria, Italy, Spain, and Germany. Most of these countries, however, after some further rise up to the 1970s, showed reversal of the trends over most recent years. Thus, in the late 1980s or early 1990s, only Austria, Italy, and Portugal had cirrhosis mortality around 30/100,000 males and 10/100,000 females. Britain, Ireland, and Nordic countries started from much lower values (2 to 4/100,000 males), but showed some, although discontinuous, upward trend.(ABSTRACT TRUNCATED AT 250 WORDS)
Female↗
Incidence, mortality and survival from invasive cervical cancer in Vaud, Switzerland, 1974-1991.
BACKGROUND: Several factors have contributed to the substantial decline in mortality from cervical cancer registered in most areas of the world, i.e., improved sexual hygiene, changes in reproductive factors, cervical screening, and, possibly, improved treatment. Each of these components is evaluated through a systematic inspection of trends in incidence, mortality and survival rates registered for a well-defined population. PATIENTS AND METHODS: Trends in incidence, mortality and survival from invasive cervical cancer over the period 1974-1991 were analysed for three separate age groups (< 55, 55-64, > or = 65 years), histological type and stage using data from the Cancer Registry of the Swiss Canton of Vaud. RESULTS: Below age 55, the age-standardized (world standard) incidence rate was 9.3/100,000 women in 1974-76, it declined steadily thereafter down to 2.9 in 1986-88, but increased to 4.3 in 1989-91. In the age group 55-64, cervical cancer incidence remained around 40/100,000 to the end of the 1970s, but thereafter declined to 10.9 in 1989-91. No consistent trend was observed in elderly women, and the rate in 1989-91 (26.7/100,000) was similar to that in 1974-76 (33.7). The overall age-standardized cervical cancer incidence declined from 13.5/100,000 in 1974-76 to 5.8 in 1986-88, but rose to 6.4 in 1989-91. A similar pattern was observed for mortality, with a fall in rates in younger women between 1974 and 1985 (from 2.1 to 0.6/100,000), and a subsequent rise to 1.1/100,000 in 1989-91. A substantial decline in mortality was observed in women aged 55 to 64 since the early 1980's, from 17.2 in 1980-82 to 3.3 in 1989-91. No clear mortality trend was evident in older women. Overall, cervical cancer mortality declined from 4.3/100,000 in 1974-76 to 2.3 in 1989-91. The five-year relative survival rates were around 0.70-0.75 for younger women, around 0.60 for those aged 55 to 64, and 0.50 for elderly ones. In a Cox proportional hazard model, age and clinical stage were significantly related to survival, but not histological type and calendar period of diagnosis. No substantial change in survival from invasive cervical cancer was observed over the 18-year period considered, nor was there any notable change in the stage distribution over time. The proportion of adenocarcinomas, however, appears to have increased in the most recent calendar period. CONCLUSIONS: These data reflect the impact of screening on cervical cancer rates, which, however, appeared restricted to women below age 65. An upward trend in cervical cancer incidence and mortality rates for younger women was also apparent, and there was no indication from these data of an improved survival for invasive cervical cancer patients over the last two decades. Extention of screening to elderly women appears to be a priority for reducing cervical cancer rates in this population.
Adenocarcinoma↗
Worldwide patterns of cancer mortality, 1985-89.
Histograms of all age-standardized death certification rates from 26 cancers or groups of cancers and total cancer mortality for the most recent calendar quinquennium (generally 1985-89) were produced for 55 countries: 26 in Europe, the former Soviet Union (USSR), three in North America, 13 in Latin America and the Caribbean, two in Africa, eight in Asia and two in Oceania, providing interpretable data to the World Health Organization database. Major differences were observed for all common cancer sites, including stomach (49/100,000 males in Costa Rica, 38 in the USSR and Japan vs 5/100,000 in the United States), intestines (over 25/100,000 males in Czechoslovakia, Hungary and New Zealand vs 10-15/100,000 in Japan and Southern Europe and less than 5/100,000 in most Latin American and Asian countries), lung (over 70/100,000 in Belgium, Scotland, The Netherlands, Czechoslovakia and Hungary, and less than 20/100,000 in most Latin American and Asian countries; over 20/100,000 females in Britain, Hong Kong, the United States and Denmark vs less than 5/100,000 in France, Spain and again most areas of Asia and Africa providing data; breast (over 25/100,000 females in Great Britain, New Zealand, Belgium, The Netherlands and Uruguay, vs less than 10/100,000 in Japan, Hong Kong and most Latin American countries). Thus, there was over a fivefold variation in total cancer mortality for both sexes, the highest rates being in Hungary (237/100,000) and Czechoslovakia (229/100,000) for males, and in Denmark (142/100,000) and Scotland (138/100,000) for females. Although problems of validity and reliability of cancer death certification, mostly in developing countries, may in part explain this variation, these substantial differences are at least in part real and essentially reflect, besides the impact of breast cancer in females and of stomach and colorectal cancer in both sexes, the different spectrum of the tobacco-related lung cancer epidemic in the two sexes and in various areas of the world.
Africa↗
Comparison of cancer mortality trends in major European areas, 1960-89.
In the prospect of a political and economic 'harmonization' of the European Economic Community (EEC) and, possibly, all Europe, the identification of differences in cancer frequencies and trends in major European areas (ie EEC, non-EEC western countries, and eastern European countries) can help to set health priorities. From 1960-64 to 1985-89 all-age mortality rates of some common cancers (mouth or pharynx, pancreas, lung, kidney, prostate and skin) increased substantially especially in East Europe. Conversely, mortality rates from cancer of the stomach, uterus, testis and from Hodgkin's disease declined, but, again, trends in East Europe were less favourable. Some elevations in rare malignancies (non-Hodgkin's lymphomas, multiple myeloma and connective and soft-tissue sarcomas) emerged rather uniformly in Europe, especially in elderly people. Most favourable trends in total cancer mortality were apparent among females in the EEC (minus 7%) and non-EEC western countries (minus 14%). The picture becomes gradually less favourable with respect to non-EEC western European males and eastern European females (virtually no change) and EEC males (plus 13%). With a 25% increase in total cancer mortality rates in the past 30 years, males in East Europe emerge as the 'problem' group. The even wider gap between West and East Europe in cancer rates in young males leaves no hope for future improvements in the absence of effective interventions. Raising public awareness (especially with respect to smoking and alcohol consumption), and increasing motivation and quality controls among health professionals are badly needed in disadvantaged European areas.
Adult↗
Epidemiology of gastric cancer in Europe.
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Case-Control Studies↗
Worldwide trends in suicide mortality, 1955-1989.
Patterns and trends in suicide mortality for the period 1955-89 for 57 countries (28 from Europe, the former Soviet Union, Canada, the United States, 14 Latin American countries, 8 from Asia and 2 from Africa, Australia and Oceania) were analyzed on the basis of official death certification data included in the World Health Organization mortality database. Over the most recent calendar quinquennium (1985-1989), Hungary had the highest rate for men (52.1 per 100,000, all ages, world standard), followed by Sri Lanka (49.6), Finland (37.2) and a number of central European countries. North American, Japan, Australia and New Zealand and several European countries had intermediate suicide rates (between 15 and 25 per 100,000), whereas overall mortality from suicide was low in the United Kingdom, southern Europe, Latin America and reporting countries and areas from Africa and Asia, except Japan, Singapore and Hong Kong. The pattern for women was similar, although the absolute values were considerably lower. The highest values were in Sri Lanka (19.0 per 100,000), followed by Hungary (17.6) and several other central European countries, with rates between 9 and 15 per 100,000. Female suicide rates were comparatively elevated in Japan, Hong Kong, Singapore and Cuba. With respect to trends over time, the figures were relatively favourable in less developed areas of the world, including Latin America and several countries from Asia, with the major exception of Sri Lanka. Of concern are, in contrast, the upward trends, particularly for elderly men in Canada, the United States, Australia and New Zealand and, mostly, the substantial rises over most recent decades of suicide rates in young cohorts of males in Japan and several European countries, Australia and New Zealand. These trends were often in contrast with more favourable patterns in women, and can be discussed in terms of ethnic, cultural and socioeconomic factors, aspects of psychiatric care or availability of instruments and methods of suicide.
Adult↗
Trends in cerebrovascular mortality in western and eastern Europe.
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Adult↗
International Variations and Trends in the Incidence of Breast Cancer in Older Women.
This article explores age-related variations in breast cancer mortality in the western world and analyzes potential risk factors for older women. The highest breast cancer mortality rates are observed in England, Wales, and Denmark; the United States, Canada, Sweden, central and southern Europe have intermediate mortality rates; and Latin America and Russia have the lowest rates. Three case-control studies involving over 4000 Italian women demonstrate that age at menarche is a risk factor only for premenopausal women; multiparity (>5 births) increases the risk of breast cancer for women under age 35 years but reduces the risk of breast cancer for older women. Obesity is a risk factor only for postmenopausal women, and the influence of other risk factors, such as age at first birth, family history and late menopause, does not show age-related variations. The influence of diet and steroidal contraceptives on the breast cancer rate in older women is not established.
Journal Article↗
[Sacral chordoma: a consideration in low back pain].
We present the case of a sacral chordoma (S3-S5). Its diagnostic problems as well as its pathological properties and the epidemiologic situation are discussed. The therapy and the surgical procedure are outlined.
Adult↗
Incidence of colorectal cancer following adenomatous polyps of the large intestine.
An association between adenomatous polyps of the large bowel and colorectal cancer has been reported, in the absence, however, of population-based estimates of risk. Subjects with histologically confirmed first diagnosis of large-bowel polyps notified to the population-based Cancer Registry of the Swiss Canton of Vaud (about 600,000 inhabitants) during the calendar period 1979-1990 were actively followed up to the end of 1990 for the subsequent occurrence of malignant neoplasms. Among 2,496 individuals with intestinal polyps, followed for a total of 10,310 person-years at risk (6,201 among males and 4,109 among females), 150 malignant neoplasms were registered versus 152 expected. Thus, the standardized incidence ratio (SIR) for all cancers combined was 0.99. A significant excess was observed for colorectal cancer, with 35 cases observed (19 males, 16 females) versus 17.0 expected (SIR = 2.1; 95% CI: 1.5-3.0). There was also an excess, although not significant, for small-bowel cancer (2 cases observed vs. 0.4 expected; SIR = 5.4). In none of the other cancer sites was SIR significantly or appreciably elevated: in subjects with colorectal polyps the SIR was 1.6 for stomach, 1.0 for lung, 0.9 for breast and 1.2 for prostate. The SIR of colorectal cancer was 3.1 in the first year since polyp registration, and declined thereafter to 1.8, in the absence, however, of any further trend with time since diagnosis. The cumulative risk of colorectal cancer in subjects with colorectal polyps was 2% at 5 years and 3% at 10 years. The quantitative estimates of this study are of interest for their population-based nature, and are potentially useful for defining and targeting screening colonoscopy programmes.
Adult↗
Incidence of infiltrating cancer following superficial bladder carcinoma.
Patients with histologically confirmed first diagnosis of superficial bladder carcinoma notified to the population-based cancer registry of the Swiss Canton of Vaud during the calendar period 1974-90 were actively followed-up to December 31, 1990 for the occurrence of a subsequent invasive tumour of the urinary bladder. Among 1,012 incident cases of superficial bladder neoplasms, followed for a total of 6,286 person/years at risk, 93 infiltrating tumours of the urinary bladder were diagnosed. Only 5.3 cases were expected on the basis of the general population of the canton. The overall standardized incidence ratio (SIR) was 17.5 (95% confidence interval, CI: 14.2-21.7). The SIR was significantly greater for females than for males. The SIR was highest between 1 and 4 years following registration of non-infiltrating cancer, and declined thereafter. The cumulative risk of invasive bladder cancer was 7%, 13%, and 16%, after 5, 10 and 15 years, respectively. This work provides population-based, accurate and reliable estimates of the risk of invasive bladder cancer following non-infiltrating cancers. Although the overall relative risk was almost 20-fold higher than in the general population, the cumulative risk of developing an invasive bladder cancer was only 16% at 15 years.
Adult↗
Trends in diet-related cancers in Japan: a conundrum?
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Adult↗
Descriptive epidemiology of bladder cancer in Egypt.
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Egypt↗
Survival after ovarian cancer treatment.
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Female↗
Trends in subsite distribution of colorectal cancers and polyps from the Vaud Cancer Registry.
BACKGROUND: Changes in the subsite distribution of malignant and benign colorectal tumors over the last few years have been reported in several series. They may be related to changes in diagnostic accuracy or to real changes in incidence. METHODS: Trends in incidence and subsite distribution of colorectal cancers and polyps between 1978 and 1988 have been analyzed using data from the Cancer Registry of the Canton Vaud, Switzerland (530,000 inhabitants in 1981), which has adopted standardized methods for identification and registration not only of malignant, but also of benign colorectal lesions. RESULTS: Age-standardized incidence rates for malignant tumors of the ascending colon in men increased from 4.6/100,000 in 1978-80 to 6.4/100,000 in 1987-88, and in women from 4.9 to 6.5. Incidence was approximately stable for transverse, descending, and sigmoid colon, whereas a decline was observed for "other and unspecified" colon cancers. Rates for rectal cancer declined by over 10% in both sexes, although the trends were not linear across calendar periods in each sex. Overall colorectal cancer incidence was relatively stable in both sexes in the Vaud population. In terms of proportional distribution, the percentage of cases in the ascending colon increased from 27% in 1978-83 to 33% 1984-88 (P < 0.05). Reliable incidence data for polyps were available for 1979 and from 1982 to 1988. Rates for ascending colon polyps increased from 1.0/100,000 in 1979-83 to 5.0/100,000 in 1987-88 in men, and from 0.4 to 2.7 in women. Incidence rates were higher, although to a lesser extent, for transverse colon and for descending colon polyps in men only. As in the case of malignant tumors, incidence rates declined between the early and the late 1980s for rectal polyps as well as for "other and unspecified" colon polyps. Overall, colorectal polyp incidence was stable around 45/100,000 for men but increased from 19 to 27/100,000 for women. With reference to proportional distributions, significant increases were observed for ascending (from 8.4% to 16.8%) and, to a lower degree, transverse colon (from 8.4% to 11.0%). No appreciable change was observed for any other subsite, except a decline for "other and unspecified" colonic polyps. CONCLUSIONS: The observation of similar changes in distribution for benign and malignant tumors may suggest the importance of improved diagnostic accuracy (particularly total colonoscopy) for lesions arising in the proximal colon.
Colorectal Neoplasms↗