We analyzed socioeconomic, rural-urban, and racial inequalities in US mortality from all cancers, lung, colorectal, prostate, breast, and cervical cancers. A deprivation index and rural-urban continuum were linked to the 2003&#8211;2007 county-level mortality data. Mortality rates and risk ratios were calculated for each socioeconomic, rural-urban, and racial group. Weighted linear regression yielded relative impacts of deprivation and rural-urban residence. Those in more deprived groups and rural areas had higher cancer mortality than more affluent and urban residents, with excess risk being marked for lung, colorectal, prostate, and cervical cancers. Deprivation and rural-urban continuum were independently related to cancer mortality, with deprivation showing stronger impacts. Socioeconomic inequalities existed for both whites and blacks, with blacks experiencing higher mortality from each cancer than whites within each deprivation group. Socioeconomic gradients in mortality were steeper in nonmetropolitan than in metropolitan areas. Mortality disparities may reflect inequalities in smoking and other cancer-risk factors, screening, and treatment.

Gopal K. Singh

Shanita D. Williams

Mohammad Siahpush

Aaron Mulhollen

Socioeconomic, Rural-Urban, and Racial Inequalities in US Cancer Mortality: Part I&#8212;All Cancers and Lung Cancer and Part II&#8212;Colorectal, Prostate, Breast, and Cervical Cancers

Purpose. The aim of this study was to assess the impact of immunohistochemical- (IHC-) studies on incidence and survival of lung cancer histotypes. Patients and Methods. Lung cancers occurred in southern Switzerland between 1996 and 2010 were selected by the Ticino Cancer Registry and categorised into adenocarcinoma (AC), squamous-cell-carcinoma (SqCC), small-cell-carcinoma (SmCC), and large-cell carcinoma/non-small-cell lung cancer (LCC/NSCLC). Incidence rates, annual-percentage-change (APC), and two-year overall survival (OS) (follow-up: 31.12.2010) were performed. Results. 2467 cases were selected: 997 (40.4%) AC; 522 (21.2%) LCC/NSCLC, 378 (15.3%) SmCC, and 570 (23.1%) SqCC. Trend-analysis showed significant increase in AC (APC: 4.6; 95% CI: 3.1; 6.0) and decrease of LCC/NSCLC, with significant joinpoint in 2003 (APC: &#x2212;14.7; 95% CI: &#x2212;21.6; &#x2212;7.1). Improved OS and decreased OS were detected in SqCC and LCC/NSCLC, respectively. Conclusions. This study highlights that diagnosis with ancillary immunohistochemical studies will change incidence and survival of precisely defined lung cancer subtypes. It calls attention to the need for cautious interpretation of studies and clinical trials, where the diagnosis was based on histology unaccompanied by IHC studies, and to the need of standardised diagnostic procedures.

Andrea Bordoni

Massimo Bongiovanni

Luca Mazzucchelli

Alessandra Spitale

Impact of Histopathological Diagnosis with Ancillary Immunohistochemical Studies on Lung Cancer Subtypes Incidence and Survival: A Population-Based Study

Carcinoma of the colon and rectum is the 2nd commonest cancer in the United States; the leading cancer being lung cancer. It has been estimated that 130,200 new cases of colorectal cancer will be diagnosed annually while 56,300 sufferers will die from the disease (Murphy et al., 2000). In developing countries especially West Africa, the rate has not yet reached such magnitude. This suggests that there may be factors either anthropomorphic or environmental which may be responsible for this. The paper acknowledges the reduced incidence of colorectal cancer in native West Africans living in Africa and endeavours to highlight the various factors that produce this observation in medical literature. A diligent search through available literature on the aetiology, epidemiology and comparative anthropology of colorectal cancer was done. Internet search using Pubmed, British library online and Google scholar was also utilized. The rarity of adenomatous polyposis syndromes in the native West African contributes to the reduced incidence of colorectal cancer. Cancer prevention and cancer-protective factors are deemed to lie in the starchy, high-fiber, spicy, peppery foodstuff low in animal protein which many West African nations consume.

David Omoareghan Irabor

Colorectal Carcinoma: Why Is There a Lower Incidence in Nigerians When Compared to Caucasians?

Cancer survivorship research includes the study of physical, psychosocial, and economic consequences of cancer diagnosis and treatment among pediatric and adult cancer survivors. Historically, the majority of cancer survivorship studies were from the United States, but survivorship issues are increasingly being addressed in other developed countries. Cross-cultural studies remain, however, scarce. The degree to which knowledge attained may or may not be transferred across cultures, countries, or regions is not known. Some important challenges for comparative research are therefore discussed in a cross-cultural perspective. Several substantive and methodological challenges that complicate the execution of cross-cultural cancer survivorship research are presented with examples and discussed to facilitate comparative research efforts in the establishment of new survivorship cohorts and in the planning and implementation of survivorship studies. Comparative research is one key to understanding the nature of cancer survivorship, distinguishing modifiable from nonmodifiable factors at individual, hospital, societal, and system levels and may thus guide appropriate interventions. Lastly, suggested future courses of action within the field of comparative cancer survivorship research are provided.

Astri Syse

Berta Geller

A Cross-Cultural Perspective on Challenges Facing Comparative Cancer Survivorship Research

Objective. To describe the epidemiological and histological aspects of cancers in Togo. Materials and Methods. We made a retrospective review of the epidemiological and pathological features of cancers observed from 1984 to 2008 at the laboratory of pathology of CHU-TOKOIN in Lomé, Togo. Results. During our study period, we found 5251 cases of cancers with an annual average frequency of 210 cases. The sex ratio, male/female, was 0.9 and the average age of occurring was 45.3 years. This average age was 46.9 years for men and 43.8 years for women. The most frequent cancers for men were prostate cancer (12.9%), nonmelanoma skin cancer (10.4%), and gastric cancer (10.3%). For women it was breast cancer (27.1%), cervix cancer (11.2%) and non-Hodgkin lymphoma (6.3%). Histologically, it was carcinomas in 68.1% of the cases, sarcomas in 11% of the cases and non-Hodgkin lymphomas in 12.6% of the cases. Children cancers were primarily Burkitt lymphoma (27.9% of cases) and retinoblastoma (8.5% of cases). Conclusion. This study shows that cancers are frequent in Togo and emphasizes on the necessity of having a cancer register for the prevention and the control of this disease in Togo.

Koffi Amégbor

Tchin Darre

Koffi Didier Ayéna

Essohana Padaro

Kodjo Tengué

Anani Abalo

Gado Napo-Koura

Cancers in Togo from 1984 to 2008: Epidemiological and Pathological Aspects of 5251 Cases

Background. Traditional methods for identifying comorbidity data in EMRs have relied primarily on costly and time-consuming manual chart review. The purpose of this study was to validate a strategy of electronically searching EMR data to identify comorbidities among cancer patients. Methods. Advanced stage NSCLC patients (<svg style="vertical-align:-1.59705pt;width:73.75px;" id="M1" height="13.1625" version="1.1" viewBox="0 0 73.75 13.1625" width="73.75" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D441" d="M857 650l-6 -28q-44 -4 -61.5 -16.5t-29.5 -48.5q-11 -32 -37 -166l-78 -399h-29l-351 537h-4l-56 -276q-24 -120 -24 -164q0 -35 17.5 -46t75.5 -15l-6 -28h-245l7 28q41 2 62 14t31 44q10 30 41 171l53 245q8 44 6.5 60.5t-14.5 33.5q-10 15 -27 19.5t-64 6.5l6 28h153&#xA;l350 -516h5l48 257q25 131 25 171q0 34 -17.5 45t-77.5 15l7 28h240z" /></g><g transform="matrix(.017,-0,0,-.017,19.628,11.112)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,34.332,11.112)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g><g transform="matrix(.017,-0,0,-.017,42.491,11.112)"><path id="x2C" d="M95 130q31 0 61 -30t30 -78q0 -53 -38 -87.5t-93 -51.5l-11 29q77 31 77 85q0 26 -17.5 43t-44.5 24q-4 0 -8.5 6.5t-4.5 17.5q0 18 15 30t34 12z" /></g><g transform="matrix(.017,-0,0,-.017,49.206,11.112)"><path id="x35" d="M153 550l-26 -186q79 31 111 31q90 0 141.5 -51t51.5 -119q0 -93 -89 -166q-85 -69 -173 -71q-32 0 -61.5 11.5t-41.5 23.5q-18 17 -17 34q2 16 22 33q14 9 26 -1q61 -50 124 -50q60 0 93 43.5t33 104.5q0 69 -41.5 110t-121.5 41q-53 0 -102 -20l38 305h286l6 -8&#xA;l-26 -65h-233z" /></g><g transform="matrix(.017,-0,0,-.017,57.365,11.112)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g><g transform="matrix(.017,-0,0,-.017,65.525,11.112)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g></svg>) who received chemotherapy from 7/1/2006 to 6/30/2008 were identified using iKnowMed, US Oncology's proprietary oncology-specific EMR system. EMR data were searched for documentation of comorbidities common to advanced stage cancer patients. The search was conducted by a series of programmatic queries on standardized information including concomitant illnesses, patient history, review of systems, and diagnoses other than cancer. The validity of the comorbidity information that we derived from the EMR search was compared to the chart review gold standard in a random sample of 450 patients for whom the EMR search yielded no indication of comorbidities. Negative predictive values were calculated. Results. The overall prevalence of comorbidities of 22%. Overall negative predictive value was 0.92 in the 450 patients randomly sampled patients (36 of 450 were found to have evidence of comorbidities on chart review). Conclusion. Results of this study suggest that efficient queries/text searches of EMR data may provide reliable data on comorbid conditions among cancer patients.

Catherine E. Muehlenbein

J. Russell Hoverman

Stephen K. Gruschkus

Michael Forsyth

Clara Chen

William Lopez

Anthony Lawson

Heather J. Hartnett

Gerhardt Pohl

Evaluation of the 
                        Reliability of Electronic Medical Record 
                        Data in Identifying Comorbid Conditions 
                        among Patients with Advanced Non-Small Cell Lung Cancer

This paper aims to provide evidence-based recommendations for health professionals, to develop a comprehensive cervical cancer program for a clinic, a community, or a country. Ensuring access to healthcare is the responsibility of all societies, and the Asia Oceania Research Organisation in Genital Infections and Neoplasia (AOGIN) is committed to working collaboratively with governments and health professionals to facilitate prevention programs, to protect girls and women from cervical cancer, a disease that globally affects 500,000 and kills nearly 300,000 women annually, just over half of whom are in the Asia Oceania region. We share the vision that a comprehensive program of vaccination, screening, and treatment should be made accessible to all girls and women in the world.
The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed.

Hextan Y. S. Ngan

Suzanne M. Garland

Neerja Bhatla

Sonia R. Pagliusi

Karen K. L. Chan

Annie N. Y. Cheung

Tang-Yuan Chu

Efren J. Domingo

You Lin Qiao

Jong Sup Park

Eng Hseon Tay

Wisit Supakarapongkul

Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

Objective. Use of cancer cases from registries and PMSI claims database to estimate D&#xe9;partement-specific incidence of four major cancers. Methods. Case extraction used principal diagnosis then surgery codes. PMSI cases/registry cases ratios for 2004 were modelled then D&#xe9;partement-specific incidence for 2007 estimated using these ratios and 2007 PMSI cases. Results. For 2007, only colon-rectum and breast cancer estimations were satisfactorily validated for infranational incidence not ovary and kidney cancers. For breast, the estimated national incidence was 50,578 cases and the incidence rate 98.6 cases per 100,000 person per year. For colon-rectum, incidence was 21,172 in men versus 18,327 in women and the incidence rate 38 per 100,000 versus 24.8. For ovary, the estimated incidence was 4,637 and the rate 8.6 per 100,000. For kidney, incidence was 6,775 in men versus 3,273 in women and the rate 13.3 per 100.000 versus 5.2. Conclusion. Incidence estimation using PMSI patient identifiers proved encouraging though still dependent on the assumption of uniform cancer treatments and coding.

Nicolas Mitton

Marc Colonna

B&#xe9;atrice Trombert

Fr&#xe9;d&#xe9;ric Olive

Fr&#xe9;d&#xe9;ric Gomez

Jean Iwaz

St&#xe9;phanie Polazzi

Anne-Marie Schott-Petelaz

Zo&#xe9; Uhry

Nadine Bossard

Laurent Remontet

A Suitable Approach to Estimate Cancer Incidence in Area without Cancer Registry

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Journal of Cancer Epidemiology publishes studies related to population-based research on cancer etiology, prevention, surveillance, and survivorship and in the areas of descriptive, analytical, and molecular epidemiology etc.

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Journal of Cancer Epidemiology - Table of contents 2011

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Journal of Cancer Epidemiology publishes studies related to population-based research on cancer etiology, prevention, surveillance, and survivorship and in the areas of descriptive, analytical, and molecular epidemiology etc.

Journal of Cancer Epidemiology