Geographical pathology of gastric carcinoma: histological types among Chileans

Nine hundred and twenty-three Chilean cases of gastric carcinoma who had received surgical resection of the stomach were histologically classified. In both males and females, diffuse carcinoma was a common type among younger patients, while adenocarcinoma was predominant in elderly patients. Statistical analysis demonstrated identical type distributions in all age groups in the Chilean series, as was seen in other ethnic groups surveyed previously.

Geographical pathology of gastric carcinoma: a comparative study on histological types between high and low mortality areas in Japan

A histological comparison of 1,687 cases of gastric carcinoma in Niigata, a high mortality prefecture for this cancer, and 954 cases in Kagoshima, a low mortality area, was carried out in order to investigate whether or not this difference in mortality reflects any change of histological type of gastric carcinoma. In both series, in both males and females , the proportion of adenocarcinoma increased with increase of the patients' age, while that of diffuse carcinoma decreased. When data from the two prefectures were compared, there was no significant difference in age group distribution of each histological type. It appears that the same histological types of gastric carcinoma occur throughout Japan.

Colorectal cancer in Jordan and Nova Scotia: a comparative epidemiologic and histopathologic study

A comparative study of colorectal adenocarcinoma was undertaken among the populations of Jordan and Nova Scotia, Canada. The incidence of this cancer was 13 (colon 6, rectum 7) and 53 (colon 31, rectum 22) per 100,000 males aged 35--64 years, respectively. Colonic tumors (excluding rectosigmoid) showed left-sided preponderance in Jordanians and right-sided preponderance in Nova Scotians. Age average at diagnosis was 49 years in Jordanians (colon 47 years and rectum 50 years) and 66 years in Nova Scotians (colon 67 years and rectum 63 years), with peaks in the fifth and seventh decades and a male to female ratio of 1.3:1 and 1:1, respectively. The mucinous type accounted for 31 and 13% of colorectal adenocarcinomas in Jordanians and Nova Scotians, respectively, of which the signet-cell type accounted for 14 and 2% of the total number, respectively. The actual incidence rate of mucinous carcinoma, however, was higher among Nova Scotians. In both groups, mucinous carcinoma showed predilection for females and rectal signet-cell carcinoma showed bias toward younger females. The authors believe that the significantly different epidemiologic and morphologic features of colorectal cancer demonstrated in these two communities could shed light on possible etiologic influences, such as dietary habits or other environmental factors.

A comparative study of some pathologic features of mammary carcinoma in Tokyo, Japan and New York, USA

Epidemiologic and clinical studies conducted in the past 15 years have demonstrated striking differences in the biology of mammary carcinoma among Japanese and American women living in their native countries. These variations have, in part, been related to some differences in the characteristics of the primary tumors between the two groups. As part of a collaborative study we have had an opportunity to compare the stage of disease and to examine and compare histological sections of patients with breast carcinoma treated in 1973-74 at the National Cancer Center Hospital (NCH) in Tokyo and in 1974 at the Memorial Hospital (MH) in New York. The former group consisted of 216 and the latter of 555 carcinomas. Fewer patients in each group had axillary metastases than reported in a prior study of patients treated at MSKCC and in Tokyo 20 to 30 years earlier. Negative axillary nodes were now found in 58% of the MH patients and in 63% of women treated at the NCH. The magnitude of improvement in stage relative to the prior report was similar in both groups. However, it would appear that the change occurred mainly from the mid-1950s to the 1960s in New York and approximately 10 years later in Tokyo. Results of this study confirming prior reports were: (1) higher frequency of colloid and of medullary carcinoma with lymphoid stroma and lesser frequency of lobular carcinoma in the Japanese patients; (2) more intense lymphoid infiltrate in and around primary tumors in Japanese women; (3) higher frequency of rounded or circumscribed tumors in Japanese women; and (4) the more frequent occurrence of intralymphatic tumor emboli within the breast in American women. The difference in the frequency of lobular carcinoma was less striking when comparison was limited to patients with unilateral carcinoma.

Cancer of the large bowel in the African: a 15-year survey at Kinshasa University Hospital, Zaïre

In a 15-year survey at Kinshasa University Hospital, 954 solid cancers were recorded. Among these, 46 malignant tumours arose in the colon, rectum and anal canal, a proportion of 4-8 per cent. A review of the patients' age and clinical presentation, and pathology and aetiology of the tumours revealed that: 1. The incidence of this cancer in young Africans is higher than in Western countries. 2. The clinical presentation of this illness in young people is frequently unusual, but older African patients commonly present with classic symptoms. 3. The incidence of mucous carcinoma tends to be higher, but could be explained by the larger number of young people suffering from the condition. 4. Intestinal amoebiasis was associated with cancer in 3 cases. Its significance remains uncertain.

The epidemiology of cancer of the breast

A summary of the most relevant facts and hypotheses concerning breast cancer epidemiology is made. It is suggested that the statistical associations with suspected etiologic factors might be diluted by the heterogeneity of the disease. It is suggested that breast cancer is composed of several epidemiologic sub-entities determined by such factors as familial aggregation, histology and hormone profile.

Prognosis of mammary carcinoma in young women

One hundred and sixty-two women with carcinoma of the breast, age 40 years or younger, were treated from 1950 to 1969. Mammary cancer is not uncommon in this age group. The 5 year survival rate among our operable patients was about 50 percent. The 5 year survival rate among patients 20 to 35 years of age was slightly higher than that in patients 36 to 40 years old. In stage B and more advanced breast cancer in young women, the outlook was poorer than in women 41 years and older. When axillary involvement is present during gestation or in the immediate postpartum period, the prognosis is especially poor. Young women have an unusually high proportion (35 percent) of low-grade, infrequently metastasizing tumors, such as medullary, intraductal, papillary, and lobular carcinomas. The presence of cancer in the axillary nodes at operation is the most important factor affecting prognosis in mammary cancer. From this study we can see no reason to consider carcinoma of the breast in young women a more lethal disease than that seen in their older counterparts.

Clinical diagnosis of breast cancer

Breast cancer is the most common malignant neoplasm in women, and 6% will develop it during their normal life expectancy. There is a group who have a high risk of developing breast cancer. The recent improvement in cure rates seems to be jue chiefly to earlier diagnosis rather than to improved methods of therapy. The physician, by careful periodic breast examinations and by the judicious use of diagnostic aids such as mammography and thermography, especially in the high risk group, has a golden opportunity to pick up cancer in a localized stage where the prognosis for cure with appropriate therapy is excellent. A tentative diagnosis of breast cancer (Table XI) can be made with a fair degree of accuracy by taking a careful history, utilizing and combining available statistics about the frequency, median age, characteristic symptom complexes of the common breast lesions and factors related to a high mammary carcinoma risk, and by a systematic and thorough breast examination supplemented with diagnostic aids when appropriate. However, biopsy and histologic examination is mandatory in all patients with a) true, three dimentional, dominant lumps even if diagnostic aids are negative except for cysts which can be safely aspirated under controlled conditions; b) suspicious lesions found by diagnostic aids even though there are no clinical findings; c) serous, serosanguineous, bloody, or watery nipple discharge; and d) other signs of cancer, i.e. eczema of the nipple, axillary adenopathy, etc., in order to determine with absolute accuracy whether the lesion is benign or malignant.

Carcinoma of the stomach

Seventy-five cases of stomach carcinoma were analyzed. The incidence was highest between 41 and 50 years of age. Male to female ratio was 4:1. The average duration of symptoms was one year. There was no correlation between incidence and the dietary and smoking habits of the patients. Epigastric pain was the commonest complaint followed byanorexis, vomiting and loss of weight. Anemia was the commonest finding. Epigastric mass was present in nearly 50% of cases. Pyloric obstruction was common. Upper gastrointestinal x-ray studies were rewarding. Occult blood was often found in the stools. The majority of patients were about equally distributed between blood groups A and O. Many patients had no or low acid levels but 7.5% had normal or high acid levels. At operation, the growth was commonly found near the pylorus. Diffuse involvement was infrequent. Curative surgery could be done in only 20% of cases. One-third of the patients had palliative gastrojejunostomy. The operative mortality and morbidity were high. The overall five-year survival was only 5%.

Carcinoma of the large bowel in the Sudan

Large bowel cancer is not common but is showing increased frequency in the northern part of the Sudan. It is relatively uncommon among southerners, which may be due to the socio-economic factors prevailing in the Sudan. The disease affected our population at a younger age than has been generally reported in the literature, and the lesions in nearly 30 per cent were of the mucoid and undifferentiated types. The incidence in young adults is difficult to explain in the absence of precancerous lesions, and there is not enough evidence to incriminate parasitic infestation.