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PubMed2006

Lifestyle-related cancer death rates in Ireland: decreasing or increasing?

We examined death patterns of tobacco-related cancers (lung, oesophagus, larynx, and pharynx) and of non-tobacco related cancers (breast and prostate) from 1972 to 2001 in Ireland, utilizing the WHO Cancer Mortality Database. Estimated-annual-percent-changes (EAPC) in age-adjusted cancer death rates (standardised to world standard population) were calculated by age (10-year groups), period (10-year intervals) and sex. Overall, EAPCs of all the cancer sites studied showed a declining trend in the most recent period (1992-2001), with male oesophageal cancer rates showing a deceleration between 1992 and 2001. In 1992-2001, the youngest age-group studied (45-54 year-olds) showed a statistically significant declining annual rate particularly for lung cancer (males), breast and laryngeal cancer (females); prostate cancer death rates have slowed down in the youngest adults (45-54 year-olds); and the oldest age-groups studied (75-84 year-olds) are also showing an annual deceleration in some cancer sites, with a significant declining annual rate for breast cancer. In conclusion, the current and the future cancer death rates of some common life-style related cancers in Ireland are encouraging.

Databases as Topic↗
PubMed2006

Modelling predictions of cancer deaths in Northern Ireland.

BACKGROUND: An ageing population has service planners concerned about future levels of disease which are age dependent. Predictions of mortality for colorectal, lung and breast cancers, which account for 30% of cancer cases and 40% of cancers deaths, were calculated for 2010 and 2015, based on trends in death rates and the predicted change in the demography of the Northern Ireland population. METHODS: The U.S. National Cancer Institute's "Joinpoint" program was used to check for structural breaks in the time series of cancer death rates from 1984 to 2004. The prediction models applied to the data allowed variations in trends across age groups to be taken into account. A linear model was used for increasing or constant trends and a log linear model was used where the trend was decreasing. The models assume the number of deaths in each stratum, defined by age-sex and time-period, is Poisson distributed, with the average value determined by a log or linear function. RESULTS: Recent trends in rates of cancers studied were downwards except for female lung. Predictions include decreased colorectal cancer deaths in females and lung cancer deaths in males. In females, lung cancer deaths are predicted to more than double by the year 2015 (473 deaths), based on the 1984 level. Colorectal death rates in males are predicted to drop, but the number of deaths will increase by more than 10%, due to demographic change. Numbers of breast cancer deaths are likely to rise slightly, despite falling age standardised death rates, due to an ageing population. CONCLUSIONS: This work has provided estimates of early future trends, useful to service planners, and highlights the need for tobacco control, to reduce numbers of lung cancer deaths in females. The recently announced control of environmental tobacco legislation is one welcome development which should reduce lung cancer mortality in Northern Ireland.

Adolescent↗
PubMed1991

Trends in the methods used for suicide in Northern Ireland.

As domestic gas was made less toxic in Northern Ireland during the period 1960-1988, it was used less often for suicide. During the same period, as car ownership increased, the use of car exhaust for suicide increased in popularity without there being a corresponding decrease in the use of other methods. Part of the temporal variation in suicide rates in Northern Ireland may be accounted for by the relative availability of lethal methods for suicide.

Data Collection↗
PubMed2006

Vocational training in Ireland: an overview.

Vocational training in dentistry in Ireland was first established in 1999 to introduce new graduates to the practice of dentistry and to provide general dental training. The Vocational Dental Practitioner (VDP) spends two days per week in private practice, two days in the health board and one day on day-release attending lectures. Their salary is paid by the Health Service Executive (HSE). The VDP completes a portfolio book throughout the year to demonstrate their progress. Vocational training is not currently mandatory in Ireland. However it does come highly recommended as an excellent start to any dental career.

Education, Dental↗
PubMed1991

New evidence on the fertility transition in Ireland 1880-1911.

Recent analyses of Ireland's marital fertility transition based on the Princeton Ig and the Stanford CPA measures are reassessed. Revised county estimates of Ig are subjected to regression analysis, and added insight into CPA is offered by comparing Ireland with Scotland and applying the measure to three specially constructed local data sets.

Adult↗
PubMed1991

Hepatitis delta virus infection in Northern Ireland 1970-1989.

The incidence of hepatitis delta virus (HDV) infection in Northern Ireland (1970-1989) was tested by enzyme linked immunosorbent assay in 401 hepatitis B surface antigen (HBsAg) positive sera. Hepatitis delta antigen (HDAg) was tested in 388 patients and antibody to delta antigen (anti-HD) in 401 patients. Four patients (1.03%) were HDAg positive. Nine patients (2.24%) were positive for anti-HD and after acid pre-treatment of sera from eight of these patients, five were positive for HDAg. The overall incidence of HDV markers was 3.27%, which reflects the low incidence in HBsAg carriers in Northern Ireland (who were in high risk groups for delta hepatitis). The use of acid treatment of the sera to break up antigen/antibody complexes has been a useful technological improvement in the identification of this virus.

Adult↗
PubMed1990

Clinical Q fever in Northern Ireland 1962-1989.

Q fever was diagnosed in 443 patients in Northern Ireland between 1962 and 1989. From 1986 onwards there was an increase, which peaked in 1989 with 107 cases of whom 47 were infected in Ballycastle, Co Antrim. There were three outbreaks and 21 clusters of patients with Q fever. Most cases were in April and May which correlated with the peak lambing and calving season. Q fever mainly affected males in the 40-49 year old age group. County Antrim had the highest prevalence rate of 40/100,000 population and also had the most sheep. The number of sheep in Northern Ireland has doubled in the past ten years. Q fever was strongly associated with occupation and animal contact. Eighty-seven patients (19.6%) drank unpasteurized milk. The commonest presenting illnesses were pneumonia (62.8%), influenza-like illness (24.6%), involvement of the heart (9.0%) and hepatitis (1.6%). Thirty-two patients (7.2%) had endocarditis, 20 of whom had prosthetic valves and three of whom died. Coxiella burnetii was present on valves removed from seven patients.

Adolescent↗
PubMed1990

Incidence and site distribution of colorectal cancer in Northern Ireland.

Death rates from colorectal cancer in Northern Ireland are higher than in most of the rest of the United Kingdom. Although local surgeons have recognised this problem for some time it has remained unclear whether this reflects a greater underlying incidence or a worse mortality. We have reviewed all histological diagnoses of colorectal cancer in the province over a three year period and we report the incidence and site distribution for this disease in this population of one and a half million. With the exception of rectal cancer in females the incidence of colorectal cancer, whether histologically diagnosed or registered, is higher than in England, Wales or Scotland. The site distribution accords with that in other high risk countries. These results indicate that Northern Ireland has the highest underlying incidence of colorectal cancer in the United Kingdom.

Adult↗
PubMed1990

Ascertainment and natural history of treated acromegaly in Northern Ireland.

The prevalence of known cases of acromegaly in Northern Ireland in 1984 was 6.3 per 100,000 population. The incidence of newly-diagnosed cases over the preceding 25 years was 5.5 patients per year, or 0.4 patients per 100,000 population per year. This rate would be equivalent to about 200 new cases per year in the United Kingdom. Four options have been available to most of these patients--surgical hypophysectomy (transfrontal or transsphenoidal), pituitary radiotherapy (usually external cobalt beam), drug treatment with bromocriptine, or no treatment. Choice of treatment has been mainly influenced by tumour size, with the larger pituitary adenomas having surgery initially. No single form of treatment has been successful in achieving a clinical remission or cure in more than a minority of cases. The most successful outcome has been where total pituitary ablation has been achieved. Life-table analysis for the whole group shows life expectancy which is not markedly different for that of an age-matched population from Northern Ireland. Morbidity related to long term osteoarthritis and treatment complications remain a major problem. The incidence of malignant tumours is higher than would be expected.

Acromegaly↗
PubMed1989

Sexual attitudes and practices of selected groups in Northern Ireland since the emergence of AIDS.

One hundred and seventeen heterosexual males and females attending a sexually transmitted disease clinic and 57 homosexual males from a local "gay" club were asked to complete a questionnaire regarding their attitudes and sexual practices since the emergence of AIDS. The results show a trend towards increasing partner change rate among heterosexual males. There has been an increase in the practice of insertive anal intercourse by homosexual men with Northern Ireland contacts but no corresponding increase with contacts outside Northern Ireland. The practice of receptive anal intercourse has remained constant. Significant differences in attitudes between homosexual and heterosexual males were expressed with regard to testing of 'at risk groups' (p less than 0.001), in the uptake of testing (p less than 0.01), and in attitudes to sexual practices if they themselves became HIV positive. There was a low level of anxiety amongst heterosexuals regarding risk of HIV infection in the future. Less than 50% of the heterosexual patients attending this clinic use condoms, though more claim to intend to use them in future.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The identification of drugs of abuse in the Republic of Ireland during the years 1968-1978.

A survey of the composition of 4,933 exhibits submitted for laboratory analysis by the Drug Squad of the Irish police during the years 1968-1978 indicated an increase in the level of non-medical drug consumption in the Republic of Ireland. Cannabis was the most widely encountered drug. Barbiturates constituted a considerable proportion. Amphetamines were rarely found; this was attributed to the unique legislation controlling the storage and sale of amphetamines. Various substances were sold as drugs of abuse. For example, Datura was sold as cannabis which caused a considerable concern because of its toxicity. The recognition of a drug-related problem of some significance in Ireland during 1968 led to the formation of a drug squad in the Irish police. Since that time a total of 4,933 exhibits arising from arrests and drug seizures have been submitted for laboratory analyses. These exhibits ranged from "normal" pharmaceutical formulations (tablets, ampoules, etc.) to unknown powders and a large number of more unusual items (table 1). The drugs were identified using an appropriate combination of microscopic, chromatographic and spectroscopic techniques (1, 2).

Amphetamines↗
PubMed1989

Metastatic brain tumours in Northern Ireland: a retrospective review in a closed community with emphasis on short term quality of life.

One hundred and nineteen consecutive patients with metastatic brain tumours who presented to the Provincial Neurosurgical Service in Northern Ireland were studied. The detection rate doubled after computerised tomography became available though the population in Northern Ireland over the years of study stayed relatively stable. Multiple tumours accounted for 38% while solitary tumours occurred mainly in the cerebellum or parietal lobe. Whereas 70% of patients presented with features of increased intracranial pressure and or lateralizing neurological signs, 20% had only vague symptoms. The primary site was lungs in a third of cases but in 33 cases (27.5%), the site of origin remained unknown. 42% of those 76 cases operated were adenocarcinoma. More than 80% of these patients in whom excision of the tumours were done, had a better quality of life at one month compared with improvement in only a third after biopsy.

Adenocarcinoma↗
PubMed1989

Fluoridation of water supplies in Ireland--1978-1987.

Following the enactment of the Health (Fluoridation of Water Supplies) Act, 1960, one hundred and ninety five public water supplies have been fluoridated in the Republic of Ireland during the period 1964-1987, serving more than 60% of the population. The effectiveness of fluoridation in Ireland, as determined by the level of fluoride ion in the various water distribution systems throughout the country during the period 1978-1987, was investigated. Under the Health (Fluoridation of Water Supplies) Act, 1960, it is a mandatory requirement to obtain a monthly sample for each fluoridated water scheme, and to have the fluoride ion concentration determined by distillation test by the public analyst. In this study the percentage of available results varied from 64 for 1978 to 94 for 1987. The fluoride levels of these monthly samples are shown as a percentage of the available results. Out of 16,095 monthly distillation tests, 7,578 (47%) were within the recommended range of 0.8-1.0 p.p.m., with 5,877 (37%) below 0.8 p.p.m. 2,640 (16%) of the readings were greater than 1.0 p.p.m.

Fluoridation↗
PubMed1989

Acute pancreatitis as a cause of sudden or unexpected death in Northern Ireland.

Utilising incomplete data supplied by the Hospital Inpatient Analysis, the annual incidence of acute pancreatitis in Northern Ireland was estimated to be about 170 cases per million population. The annual mortality rate for the years 1974-1983, using figures obtained from the Registrar-General for Northern Ireland, was 12.3 cases per million. An increase in both incidence and mortality from acute pancreatitis was demonstrated during the study. There was 191 deaths from pancreatitis during the study period and in 27 of these the diagnosis was made only at postmortem examination. Of the undiagnosed fatalities, 10 occurred in individuals with a history of alcohol abuse. Eight of the 27 undiagnosed cases had not sought medical attention, five had presented with a systemic complication of acute pancreatitis, and a further five had only minor gastrointestinal tract symptoms prior to death. The diagnosis of acute pancreatitis requires a high index of suspicion and should be considered in acutely ill patients, particularly those with a history of alcohol abuse, who fail to respond to appropriate therapy.

Acute Disease↗
PubMed1989

Hepatitis B virus infection in Northern Ireland 1970-1987.

In the 18 years between 1970 and 1987, 504 patients were found to have hepatitis B surface antigen (HBsAg) in their blood. Acute hepatitis was present in 184 patients and six died (3.3%). The annual incidence of acute hepatitis B virus infection in Northern Ireland was about one-quarter that of England and Wales. A decrease in acute infection occurred in 1986-87, while in England and Wales acute infection has fallen by more than half since the peak in 1984. Hepatitis B virus infection in health care staff and patients in high risk groups were reviewed: 32% were in those of foreign origin or who had known foreign contacts. In blood donors there was a marked fall in incidence of hepatitis B surface antigen carriage from 1982 onwards: the incidence in antenatal patients and those screened for rubella antibody (mainly females) was half that of new blood donors in 1972-81. Carrier rates in blood donors and antenatal patients were less than those from other parts of the United Kingdom. All indices show that Northern Ireland has a lower incidence of hepatitis B virus infection than the rest of the United Kingdom.

Adolescent↗
PubMed1988

Anxiety and aspects of health behavior among adolescents in Northern Ireland.

A sample of 238 15- to 16-year-old secondary school students from Northern Ireland answered a questionnaire in their schools about the level of anxiety and some aspects of their health behavior. Analysis of the findings showed that these teenagers had no higher anxiety than a Northern American sample of teenagers. In addition, anxiety was clearly correlated with a variety of health complaints and with use of the health service. The findings are discussed with reference to previous research on adolescent health and on stress in Northern Ireland.

Adolescent↗
PubMed1988

The Northern Ireland Cancer Registry.

The Northern Ireland Cancer Registry was evaluated using a 5% sample of all cancers diagnosed histologically in 1983 as the standard for comparison. The overall registration rate was low. Two years following histological diagnosis only 63% of the cancers were registered and 19% of these were notified solely by the Registrar General's office. In a subgroup of patients who were known to have died by the time of the study, only 49% of the cancers were registered while the patient was alive. A further 30% of cases were registered only after death and 21% of cases went unregistered. There was no significant variation in registrations by area, by hospital or by age group. There was a considerable variation in registration rate by disease group. A low level of awareness among hospital doctors about the Northern Ireland Cancer Registry was postulated as a reason for the low levels of registrations received. This was investigated through a postal questionnaire. A response rate of 51% was achieved after two postings. Both the response rate and level of knowledge varied by grade and specialty of the doctor. Only 43% of responders knew of the existence of the cancer registry and only 2% registered patients more often than once a year. Possible methods for improving the system are discussed.

Data Interpretation, Statistical↗
PubMedDate not supplied

Arterial assessment before carotid endarterectomy: current practice in Great Britain and Ireland.

A survey of the management of patients with putative carotid artery disease by 245 vascular and neurosurgeons in Great Britain and Ireland was conducted with a 96 per cent response. Ninety-six (41%) surgeons performed at least one carotid endarterectomy in 1984 and a total of 1374 such operations were carried out in that year. Of the 40 surgeons who performed more than ten operations in 1984, 95 per cent generally employed a screening technique which was less invasive than conventional angiography in their management. Techniques based on ultrasonography were more popular than those based on digital subtraction angiography (DSA) in this respect. If carotid endarterectomy were to be undertaken, 63 per cent of surgeons required pre-operative conventional angiograms. Of the 38 per cent who did not routinely use conventional angiography, all but one used digital subtraction angiography. Ultrasonography and DSA have had a significant impact on the management of carotid artery disease in Great Britain and Ireland and their individual places in such management are becoming clear.

Carotid Arteries↗