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PubMed2004

Association of ampullary and colorectal malignancies.

BACKGROUND: Because of the similarities in terms of carcinogenesis and natural history between cancer of the ampulla of Vater and colorectal cancer, the authors examined whether ampullary and colorectal malignancies occur in the same individuals at increased rates. METHODS: We used data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute for the period from January 1973 through December 1999. Person-years of follow-up for patients with ampullary (or colorectal) cancer were used to calculate the expected number of cases of colorectal (or ampullary) cancer as a second primary malignancy. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated using Byar limits and assuming a Poisson distribution. RESULTS: The authors identified 2043 white patients with ampullary cancer who were included in the SEER registry between 1973 and 1999. Over an aggregate 5674 person-years of follow-up, 30 patients, compared with an expected 14, developed colorectal cancer, yielding an overall SIR of 2.14 (95% CI, 1.45-3.06). Similarly, 57 of 262,066 white patients with colorectal cancer developed ampullary cancer over an aggregate 1,270,255 person-years of follow-up, yielding an SIR of 2.18 (95% CI, 1.69-2.85). CONCLUSIONS: Patients with ampullary cancer are at increased risk for a second primary colorectal malignancy, and patients with colorectal cancer are at increased risk for a second primary ampullary malignancy. These findings suggest that ampullary and colorectal malignancies share common environmental and/or genetic risk factors.

Age Distribution↗
PubMed1988

Incidence of cutaneous melanoma in the United States by histology with special reference to the face.

Cutaneous melanoma has been classified into three distinct histological subtypes based on histopathological and clinical features. The incidence of the least common type, lentigo maligna melanoma, has been most strongly associated with chronic sunlight exposure as its cause, especially lesions presenting on the face area. The relationship of sunlight exposure to the other two major subtypes, superficial spreading melanoma and nodular melanoma, is unclear. Based on over 13,000 cases of cutaneous melanoma collected by the Surveillance, Epidemiology, and End Results (SEER) program of the NCI, we report histological-specific incidence rates within four major anatomic sites: face, trunk, arm and shoulder, and leg and hip. The anatomic distribution for all histologies combined was the same as often reported with a male preponderance of melanomas on the face and trunk and female preponderance on the arm and leg. Age-specific incidence for melanoma of the face increased steadily with age in both genders, whereas it did not for the other three sites. The nine SEER areas were divided into North, Central, and South based on the UV index for each area. For melanomas of the face, lentigo maligna melanoma was higher in the Central and South than the North for both genders and increased with age. For superficial spreading melanoma, the pattern of occurrence was different. Incidence was higher in the Central than the North and for males it increased with age. There was a smaller increase for females. This study documents the incidence of cutaneous melanoma by histological subtype within four anatomic sites. The different shapes of the age-incidence curves suggest that different histologies may react differently to sunlight exposure as an etiological factor. Our findings strongly support the importance of considering histological subtypes of cutaneous melanoma in future etiological studies.

Adult↗
PubMed1998

Mammography use helps to explain differences in breast cancer stage at diagnosis between older black and white women.

BACKGROUND: Older black women are less likely to undergo mammography and are more often given a diagnosis of advanced-stage breast cancer than older white women. OBJECTIVE: To investigate the extent to which previous mammography explains observed differences in cancer stage at diagnosis between older black and white women with breast cancer. DESIGN: Retrospective cohort study using the Linked Medicare-Tumor Registry Database. SETTING: Population-based data from three geographic areas of the United States included in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program (Connecticut; metropolitan Atlanta, Georgia; and Seattle-Puget Sound, Washington). PARTICIPANTS: Black and white women 67 years of age and older in whom breast cancer was diagnosed between 1987 and 1989. MEASUREMENTS: Medicare claims were used to classify women according to mammography use in the 2 years before diagnosis as nonusers (no previous mammography), regular users (> or =2 mammographies done at least 10 months apart), or peri-diagnosis users (mammography done only within 3 months before diagnosis). Information on mammography use was linked with SEER data to determine cancer stage at diagnosis. Stage was classified as early (in situ or local) or late (regional or distant). RESULTS: Black women were more likely to not undergo mammography (odds ratio [OR], 3.00 [95% CI, 2.41 to 3.75]) and to be given a diagnosis of late-stage disease (OR, 2.49 [CI, 1.59 to 3.92]) than white women. When women were stratified by previous mammography use, the black-white difference in cancer stage occurred only among nonusers (adjusted OR, 2.54 [CI, 1.37 to 4.71]). Among regular users, cancer was diagnosed in black and white women at similar stages (adjusted OR, 1.34 [CI, 0.40 to 4.51]). In logistic modeling, previous mammography alone explained about 30% of the excess late-stage disease in black women. In a separate model, previous mammography explained 12% of the excess late-stage disease among black women after adjustment for sociodemographic and comorbidity information. CONCLUSION: Differences in breast cancer stage at diagnosis between older black and white women are related to previous mammography use. Increased regular use of mammography may result in a shift toward earlier-stage disease at diagnosis and narrow the observed differences in stage at diagnosis between older black and white women.

Black or African American↗
PubMed1991

Racial differences in the risk of invasive squamous-cell cervical cancer.

To investigate reasons for the higher rates of invasive squamous-cell cervical carcinoma among Blacks than Whites in the United States, we examined data from a case-control study of cervical cancer conducted in five geographic areas of the US, supplemented by incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program, and hysterectomy prevalence data from the Cancer and Steroid Hormone Study. We observed only minor differences between Blacks and Whites in the magnitude of relative risks associated with a long interval since last Pap smear, multiple sexual partners, cigarette smoking, a higher number of births, and low levels of income and education. Thus, differences in the strength of associations contributed little to the higher incidence rare in Blacks, but the prevalence of these risk factors, except for cigarette smoking, was higher in Blacks than Whites. The SEER incidence rate ratio of 2.3 for Blacks compared to whites was increased to 2.7 when incidence rates utilized denominators corrected for prevalence of hysterectomy, while the rate difference increased from 14.9 to 25.8 cases per 100,000 person-years (PY). We estimated further that, after adjustment for prevalence of hysterectomy, the incidence rate for women at the lowest levels of exposure to the risk factors evaluated was 2.2 times higher in Blacks than Whites, but that the corresponding rate difference was only 2.2 cases per 100,000 PYs. Thus, our results suggest that racial differences in the prevalence of exposure to identified risk factors account for most of the difference in incidence rates. It remains to be determined what, as yet unidentified, aspects of lower socioeconomic status contribute to the higher incidence rate in Blacks.

Adult↗
PubMed1999

Incidence of breast carcinoma in women with thyroid carcinoma.

BACKGROUND: Breast carcinoma and differentiated thyroid carcinoma(the most common endocrine malignancy) occur predominantly in women. An association between the two tumors has been suggested by some investigators, but the potential impact of treatment of one of these diseases on the development of the other remains unclear. The authors examined the relation between the occurrence of these two tumors. METHODS: There were 41,686 patients with breast carcinoma and 3662 with thyroid carcinoma who registered at The University of Texas M. D. Anderson Cancer Center between March 1944 and April 1997. Women who received both diagnoses since 1976 were identified and incidence rates and relative risks of secondary tumor development were calculated. Surveillance, Epidemiology and End Results (SEER) program data on the age-adjusted incidences of these diseases during the same time period were used for the expected incidences in the same population. RESULTS: Among 18,931 women with a diagnosis of breast carcinoma since 1976, 11 developed differentiated thyroid carcinoma > or = 2 years after the diagnosis of breast carcinoma. These breast carcinoma patients contributed 129,336 person-years of follow-up; the observed incidence of thyroid carcinoma in this group was not different from that in a similar age group of women in the SEER database. Among 1013 women with a diagnosis of thyroid carcinoma since 1976, 24 developed breast carcinoma > or = 2 years after the diagnosis of thyroid carcinoma. These thyroid carcinoma patients contributed 8380 person-years of follow-up; the observed incidence of breast carcinoma in women ages 40-49 years was significantly higher than the expected incidence for women in the same age group in the SEER database. CONCLUSIONS: Breast carcinoma developing after thyroid carcinoma was diagnosed more frequently than expected in young adult women seen at the study institution since 1976. This potential association and plausible mechanisms of breast carcinoma development after thyroid carcinoma should be evaluated in larger cohorts of patients.

Adenocarcinoma, Follicular↗
PubMed1991

Projections of the incidence of non-Hodgkin's lymphoma related to acquired immunodeficiency syndrome.

Advances in antiretroviral therapy and treatment or prophylaxis against opportunistic infection have resulted in prolongation of the survival of patients with acquired immunodeficiency syndrome (AIDS). Previous research has demonstrated an association between AIDS and risk of non-Hodgkin's lymphoma (NHL). In addition to the approximately 3% of individuals found to have NHL at the time of AIDS onset, others continue to develop NHL following AIDS diagnosis. Data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute demonstrated a sharply increasing incidence of NHL among men in the age range 20-49 years since 1983 in the United States. Based on new data on the risk of NHL following AIDS diagnosis, on estimates of improved survival following AIDS diagnosis, and on projections of future AIDS incidence, we considered four sets of assumptions and estimated the number of AIDS-related NHL cases in 1992 to be between 2900 and 9800. Three of these projections were higher than the estimate of 4700 cases obtained by linear extrapolation of SEER incidence trends. These projections of AIDS-related NHL incidence suggest that between 8% and 27% of all NHL cases that occur in the United States in 1992 will arise as a consequence of infection with the human immunodeficiency virus (HIV), imposing a substantial health care burden. More research into the pathogenesis of lymphoma and new approaches to antiretroviral and antilymphoma therapy will be necessary to prevent and treat this formidable complication of infection with HIV.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Impact of breast carcinoma on African-American women: the Detroit experience.

BACKGROUND: National and regional population-based data have demonstrated substantially worse outcome in African-American patients with breast carcinoma when compared with white patients, as well as a younger age distribution among African-American patients with breast carcinoma. The extent to which various socioeconomic, environmental, lifestyle, and genetic factors interact to account for this ethnicity-related disparity in survival is poorly understood. Greater than one-half of the inner-city population of Detroit, Michigan is African American, and greater metropolitan Detroit has been one of the contributing registries for the Surveillance, Epidemiology, and End Results (SEER) program since its inception in 1973. The impact of breast carcinoma on African Americans in the Detroit area is therefore well documented and provides significant insight into the history, epidemiology, and biology of this major public health care problem. METHODS: A review of the medical literature published over the past 20 years regarding African-American patients with breast carcinoma was performed. The pertinent findings were summarized in the context of advances made in breast carcinoma screening, treatment, and risk reduction during that period. RESULTS: The large African-American population of Detroit is a major factor contributing to the excessive breast carcinoma mortality rate reported for this city, which is one of the highest in the United States. Improvements in early detection of breast carcinoma by using screening mammography have been apparent in the earlier stage distributions of breast carcinoma observed in both white and African-American patients; however, progress has lagged substantially for the latter group. Detroit SEER registry data also have shown a younger age distribution of African-American patients with breast carcinoma and higher rates of estrogen receptor negative tumors. Finally, preliminary data from health maintenance organizations have suggested improved breast carcinoma outcome for African Americans who possess greater socioeconomic benefits, but disparities in disease stage at presentation persist. CONCLUSIONS: The diverse Detroit community is ideally suited for breast carcinoma screening programs and clinical investigations that seek to address and overcome ethnicity-related survival disparities and barriers to health care. Findings from these studies can be correlated with results from similar projects in other geographic areas.

Black or African American↗
PubMed1992

The prognostic significance of race and survival from laryngeal carcinoma.

Surveillance, Epidemiology, and End Results (SEER) program data suggest that blacks with laryngeal carcinoma have a significantly lower 5-year survival rate than whites. Most of this difference persists despite adjustment for "crude stage." To evaluate possible factors contributing to this residual survival deficit, 190 white and 23 black patients treated at the Martinez Veterans Administration Hospital between 1968 and 1988 were studied. The independent impact of race on survival rate was analyzed with respect to various prognostic factors including treatment delay, elapsed time (diagnosis to treatment), age, stage, cancer subsites, and type of therapy. No independent prognostic significance could be attributed to race. The differences noted in SEER data probably reflect a tendency for the use of crude stage to underestimate the impact of prognostic groups within the categories of "local" and "regional" disease, the independent prognostic significance of subsites (glottic versus supraglottic), and the variable distribution of these subsites in different populations. This study suggests that when stage, subsite, and quality of care are adequately considered, survival from laryngeal cancer in blacks is comparable to that of whites.

Adult↗
PubMed1988

Breast cancer incidence and mortality in the breast cancer detection demonstration project [published errtum appears in J Natl Cancer Inst 1989 Oct 4;81(19):1513].

The Breast Cancer Detection Demonstration Project (BCDDP) was a program of five annual screening examinations for breast cancer that was conducted at 29 centers in the United States. This report presents data on breast cancer incidence and mortality among the participants. A total of 283,222 women were enrolled. Our analysis is based on 55,053 white women who were 35-74 years of age at entry and who were selected for follow-up. For the first 9 years after entry, the cumulative incidence of breast cancer was estimated as 243.6 per 10,000, which is 1.34 times the expected incidence derived by use of data from the Surveillance, Epidemiology, and End Results (SEER) program. In contrast, 9-year cumulative mortality from breast cancer was only 79.6% of that expected in women with the age distribution of BCDDP participants who did not have diagnosed breast cancer at the start of observation. The ratio of observed to expected breast cancer mortality was 0.89 for women 35-49 years of age at entry, 0.76 for women 50-59 years of age at entry, and 0.74 for women 60-74 years of age at entry. Breast cancer incidence and mortality were lower for women who entered the BCDDP for routine screening than they were for women who entered for a reason such as concern about breast disease, family history of breast cancer, or a physician's recommendation. Among cases diagnosed within 5 years of entry, the 5-year case fatality attributed to breast cancer was 8.5%. Case fatality for all stages combined was greater than 50% lower for cases that were screen-detected than it was for cases that were not screen-detected. Case fatality was lower for cases diagnosed within the first 5 years of entry (which encompassed the period of screening) than it was for cases diagnosed in the sixth or seventh years.

Adult↗
PubMed1996

Underreporting and misclassification of urinary tract cancer cases on death certificates.

We compared the diagnoses for decreased cases with urinary tract cancer reported to the Surveillance, Epidemiology, and End Results (SEER) program with their underlying cause of death reported on death certificates. Deaths for a substantial proportion of cases were ascribed to noncancer causes (bladder, 48%; kidney, 28%; renal pelvis, 37%; and other urinary tract, 38%), which decreased with advancing stage at diagnosis and increased with length of survival. In general, cancer deaths were more likely to be recorded to the predominant subsite within an organ. Only 5.5% of renal pelvis cancer patients were recorded to have died of their illness, whereas 33.7% of their deaths were reported as due to kidney cancer. On the other hand, over 85% of urinary tract cancer deaths reported on the death certificates were confirmed by SEER diagnosis, although the extent of agreement varied by stage at diagnosis and age at death for kidney and renal pelvis cancers.

Adult↗
PubMed1994

Risk of other cancers following Kaposi's sarcoma: relation to acquired immunodeficiency syndrome.

To evaluate the risk of another cancer among persons who initially developed Kaposi's sarcoma, the authors used data from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute for the years 1973-1990. In persons under 70 years of age, 4,946 cases of Kaposi's sarcoma were observed during the period 1980-1990 (6,217 person-years of follow-up). On the basis of rates seen during the period prior to the epidemic of acquired immunodeficiency syndrome (AIDS), 169 cases were expected. Therefore, cases of Kaposi's sarcoma in this group were assumed to be AIDS-related, while cases occurring in older persons or during the 1970s were assumed to be non-AIDS-related. Rates were compared with the numbers of cases expected overall and by site on the basis of age-, sex-, and calendar year-specific rates from the SEER data. Among the 4,946 persons with AIDS-related Kaposi's sarcoma, the risk of developing non-Hodgkin's lymphoma through 1990 was increased 198-fold (95% confidence interval 169-232). However, the risk of all other cancers was only marginally increased (1.5-fold; 95% confidence interval 0.95-2.3), a risk that was probably biased upward because of ascertainment and misclassification. Among 491 persons with non-AIDS-related Kaposi's sarcoma, the relative risk of all cancers, including non-Hodgkin's lymphoma, was 0.9 (upper 95% confidence limit 1.2), and the risk of non-Hodgkin's lymphoma alone was 0.6 (upper 95% confidence limit 3.3). As of 1990, the risk of having another cancer following Kaposi's sarcoma was increased only in persons infected with human immunodeficiency virus, who were at high risk of non-Hodgkin's lymphoma but probably not of other cancers as a whole.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Occurrence of primary cancers in association with multiple myeloma and Kaposi's sarcoma in the United States, 1973-1995.

The causes of multiple myeloma (MM) are obscure, but a laboratory association was recently reported between MM and human herpesvirus 8 (HHV-8), the probable etiologic agent of Kaposi's sarcoma (KS). Although there has been some additional laboratory corroboration, most laboratory studies have found no association between MM and HHV-8. We looked for indirect evidence of an HHV-8/MM association by evaluating whether MM is associated with KS in the United States. Cancer incidence and survival data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program for the years 1973-1995. Strength of association was assessed for a number of cancer pairs using standardized incidence ratios (SIRs) (observed/expected double cancers). KS was strongly associated (SIR > 15) with non-Hodgkin's lymphoma and anal cancer, was modestly associated (2.5 < SIR < 5.5) with MM, Hodgkin's disease, and testicular cancer and was not significantly associated with 6 other cancers. Besides being associated with KS, MM was weakly associated (1.7 < SIR < 2.3) with Hodgkin's disease and testicular cancer. The SIRs for 7 other cancers paired with MM were all less than 1.6. Factors that might be responsible for the KS/MM association include MM-related immune dysfunction, HIV and HHV-8, but the role of these factors cannot be directly assessed through the SEER database. Although we cannot rule out the possibility that HHV-8 is linked to a small proportion of MM cases, the modest KS/MM association is evidence that the vast majority of MM cases are not likely to be associated with HHV-8.

Adolescent↗
PubMedDate not supplied

Improved survival among children with acute leukemia diagnosed in the 1970s.

Improvements in survival were observed among white children less than 15 years of age diagnosed with acute lymphocytic leukemia (ALL) between 1973 and 1978 in nine of the areas covered by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Significant increases were noted between the 3-year survival rate for children diagnosed in 1973-1975 (59%) and the rate for those diagnosed in 1976-1978 (74%). The 5-year survival rate for children diagnosed with ALL in 1973-1975 was nearly 50%. Survival of female children exceeded that for males, and younger children 1-4 years of age diagnosed with ALL had a better prognosis than older children 5-14 years of age. Both sexes and age groups showed increases in survival between 1973-1975 and 1976-1978. Improvements in survival during these time periods were not observed for children diagnosed with acute granulocytic (myelogenous) leukemia. Between 1973 and 1979, the age-adjusted incidence rate for all childhood leukemias remained fairly constant in the SEER areas, ranging from 3.7 per 100,000 population less than 15 years of age in 1973 to 3.5 per 100,000 in 1979. Reflecting observed improvements in childhood leukemia survival, the corresponding mortality rates fell from 2.2 to 1.7 per 100,000 in this same time period.

Acute Disease↗
PubMed1983

Childhood cancer incidence: geographical and temporal variations.

Data from the first four volumes of Cancer Incidence in Five Continents (CI-5) and from the first 5 years of the US Surveillance, Epidemiology and End Results (SEER) program were analyzed for evidence of geographical and temporal variations in the incidence of selected childhood tumors. Only lymphoid leukemia and glial neoplasms are common enough for the observed differences between US registries to be distinguished from sampling variation. Internationally, kidney and eye tumors and leukemia show less geographical variation than do lymphomas and brain tumors, but for none of the tumors examined is the incidence constant. Wilms' tumor rates among Japanese, Singapore Chinese and Indians (Bombay) are approximately 60% of the rates in North America and Britain, whereas in Scandinavia the rates are up to 30% higher. This lessens the status of Wilms' tumor as an "index tumor" of childhood. Areas or countries with especially high or low rates of other tumors are identified. Rates for glial neoplasms (SEER data) and Hodgkin's disease (CI-5) are increasing with time in the US, while brain tumors are being diagnosed more frequently worldwide. However, the results for brain tumors may largely reflect changes in pathology diagnosis or reporting practices, and those for Hodgkin's disease may reflect improvements in case ascertainment. Otherwise, there is a remarkable stability in the incidence of selected childhood cancers over time.

Adolescent↗
PubMed2001

Factors associated with missing birthplace information in a population-based cancer registry.

Differences in cancer occurrence within a racial/ethnic group may be influenced by migrant status or level of acculturation, which can indicate variations in environmental exposures. When immigration and acculturation data on individual patients are not available, birthplace may serve as a proxy. As part of a larger study intended to assess the utility of the birthplace variable in the Greater Bay Area Cancer Registry (GBACR), part of the Surveillance, Epidemiology, and End Results (SEER) program, we measured its completeness, and determined whether missing birthplace is associated with patient and hospital reporting source characteristics. Subjects were persons diagnosed with cancer within the GBACR surveillance area during the period 1988-1996. Of the 204,553 subjects, 67% had birthplace recorded in the registry. Deceased persons were 10 times more likely than living persons to have data on birthplace. Racial/ethnic groups which included more foreign-born persons, such as Southeast Asians, tended to have more complete birthplace information than did groups with fewer foreign-born, such as Japanese and Hispanics. The effects of patient and reporting source characteristics on birthplace completeness differed across racial/ethnic groups. These data indicate that completeness of the birthplace variable in the GBACR is biased, and that investigators considering birthplace in analyses of SEER data should consider these biases. For birthplace data to be useful, completeness needs to be improved at the level of the diagnosing facility.

Adolescent↗
PubMed1988

Survival patterns for malignant mesothelioma: the SEER experience.

Statistical analyses of 1,475 histologically confirmed cases of malignant mesothelioma ascertained through the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute for the years 1973-1984 showed age at diagnosis, sex, stage of disease, type of treatment, and geographic area of residence to be important predictors of patient survival, although type of treatment may be confounded with prognostic factors (patients selected for surgical treatment tended to have better performance status than other patients). Women below the age of 50 had an unusually long survival, even after adjustment for the effects of other variables in the model. A relatively large proportion of female cases had site of disease designated as peritoneum, but site was not a significant prognostic factor. These results suggest that age, gender and stage of disease should be carefully considered in designing and analyzing clinical trials for persons with mesothelioma. Survival was shorter in the 4 SEER registries which had shipbuilding as a major industry than in the others with less potential asbestos exposure, offering weak support for the hypothesis that asbestos-exposed cases of mesothelioma have worse survival experience than other cases.

Adult↗
PubMed2002

Cancer risk estimates for BRCA1 mutation carriers identified in a risk evaluation program.

BACKGROUND: Increasing numbers of BRCA1 mutation carriers are being identified in cancer risk evaluation programs. However, no estimates of cancer risk specific to a clinic-based population of mutation carriers are available. These data are clinically relevant, because estimates based on families ascertained for linkage studies may overestimate cancer risk in mutation carriers, and population-based series may underestimate it. Wide variation in risk estimates from these disparate ascertainment groups makes counseling in risk evaluation programs difficult. The purpose of this study was to estimate BRCA1-related cancer risks for individuals ascertained in a breast cancer risk evaluation clinic. METHODS: Cumulative observed and age-adjusted cancer risk estimates were determined by analyzing 483 BRCA1 mutation carriers in 147 families identified in two academic breast and ovarian cancer risk evaluation clinics. Cancer risks were computed from the proportion of individuals diagnosed with cancer during a 10-year age interval from among the total number of individuals alive and cancer-free at the beginning of that interval. Age-of-diagnosis comparisons were made using two-sided Student's t tests. RESULTS: By age 70, female breast cancer risk was 72.8% (95% confidence interval [CI] = 67.9% to 77.7%) and ovarian cancer risk was 40.7% (95% CI = 35.7% to 45.6%). The risk for a second primary breast cancer by age 70 was 40.5% (95% CI = 34.1% to 47.0%). We also identified an increased risk of cancer of the colon (twofold), pancreas (threefold), stomach (fourfold), and fallopian tube (120-fold) in BRCA1 mutation carriers as compared with Surveillance, Epidemiology, and End Results (SEER) Program population-based estimates. CONCLUSION: The estimates for breast and ovarian cancer risk in BRCA1 mutation carriers is higher than population-based estimates but lower than estimates based on families ascertained for linkage studies. These cancer risk estimates may most closely approximate those faced by BRCA1 mutation carriers identified in risk evaluation clinics.

Adult↗
PubMed1993

[Epidemiologic observations on prostate cancer based on tumor volumes].

Using the SEER Program of the NCI, and the U.S. total mortality rates, we calculated the probability at birth of being diagnosed with prostate cancer within one's lifetime to be 8.8%, and we subtracted the microscopic stage A cancers too small to ever be of clinical significance which gave a final probability of 8%. Prostates were examined in 139 consecutive, unselected cystoprostatectomies from patients with bladder cancers who were unknown to have prostate cancer. Prostate cancer was found in 55 patients (40%); the volume of the largest cancer in each of these 55 prostates was determined by histologic morphometry. We identified the 8% of these 139 cystoprostatectomies with the largest volume of prostate cancer. The largest 11 of the 55 cancers represented 7.9% of the 139 cystoprostatectomies. These cancers ranged in volume from 0.5 cc to 6.1 cc, representing only 20% of all patients with prostate cancer. Thus, if one accepts the strong evidence that cancer progression is proportional to cancer volume, we conclude that prostate cancers larger than 0.5 cc appear to correspond to the 8% of men who will be diagnosed with a clinically significant carcinoma, as derived from SEER data. Conversely, those 80% of prostate cancers under 0.5 cc are probably not destined to reach clinically significant size in view of the very long doubling time of this cancer.

Adult↗