Cancer mortality in young adults: Italy 1955-1985

Rising trends in oral cancer mortality in Spain, 1975-94

BACKGROUND

Epidemiological studies have shown that the worldwide incidence and mortality rates for oral cancer have increased considerably over the last decade. This study investigates the Spanish trend in mortality of oral cancer from 1975-94.

METHODS

Age-standardized, truncated, cumulative, age-specific and potential years of life lost (PYLL) rates were calculated by gender. Poisson regression models allowed the measurement of age and period effects.

RESULTS

Age-standardized and cumulative mortality rates increased in males, while truncated and PYLL rates doubled. Changes were less marked in females. There were annual increases in oral cancer mortality from 1975-94, of 25% and 9% in males and females, respectively. In males there was an interaction between age and period. There was also an increase in age-specific mortality rates in males.

CONCLUSIONS

Mortality from oral cancer rose substantially in males, with concomitant changes in the age-distribution pattern of mortality. Increases were less marked in females, with some minor modifications to the age-distribution pattern of mortality.

Solitary cerebral metastasis from melanoma: value of the 'en bloc' resection

The authors report 19 cases of solitary cerebral metastases from malignant melanoma. In 15 patients, the primary lesion was known at the time the metastasis was diagnosed; deltoid-scapular in 4 cases, thoracic in 5, inguinal in 4 and neck in 2. The primary location was unknown in 4 patients. Presenting symptoms were: epileptic seizures in 9 cases, headache in 8, strength deficit of the limbs in 2. In 3 patients (16%) neurological symptoms were the first clinical sign of the systemic tumor; in 16 cases (84%) there was a long interval between treatment of the primary and appearance of the cerebral metastasis (average 3.8 years; median 3.4 years). All patients were submitted to surgery and radiotherapy (whole-brain in 14 and radiosurgery in 5). In 10 cases the lesion was removed 'en bloc' (no internal touch technique). Average survival was 9 months (median 8 months) and was influenced by 'en bloc' resection and whole-brain irradiation. None of the patients operated by the 'no touch technique' presented a recurrence.

Toward assessing trends in oral mucosal lesions: lessons learned from oral cancer

Trend data on oral mucosal lesions are limited. The literature is comprised of a large number of studies documenting the prevalence of various lesions in different populations. Trend data on cancers of the oral cavity and pharynx are the exception. An overview of the international epidemiologic studies of these cancers is provided. General conclusions across studies and countries for trend data of these cancers cannot easily be drawn, since variations exist in data collection methods, risk factors, and other characteristics of the study populations. This paper also reviewed the available prevalence data for oral mucosal lesions in general as well as data on leukoplakia, recurrent herpes labialis, and recurrent aphthous ulcers. A few studies of the incidence of leukoplakia are described. In order to explore the potential for future trend data on oral mucosal lesions, this paper discusses issues related to the feasibility and structure of monitoring these lesions. Criteria that could be used to identify which conditions should be monitored in the future were discussed, such as, those that present a public health problem, those that are sentinel events for serious conditions, and infectious lesions. Once lesions are identified, it is clear that international consensus for diagnostic criteria of these lesions is needed in order to permit comparisons to be made among studies. Finally, strategies for monitoring these conditions and factors that may affect future trends are reviewed.

Cancer mortality in young adults in Switzerland, 1951-1989

Trends in mortality from all neoplasms and major cancer sites in Switzerland among populations aged between 20 and 44 years are presented. In men total cancer mortality was approximately constant around 270/10(6) between 1951 and 1965, but declined appreciably thereafter to 217 per million in 1980-1989. The overall fall was 20%. The pattern of trends was similar for women, although a modest decline was already apparent in the earlier calendar period, and the overall fall was 29% (from 303 to 215/10(6)). These favourable trends reflect therapeutic advancements for Hodgkin's disease, leukaemias, testis and (chiefly non-epithelial) ovarian cancer, better control of cervical cancer, the long-term decline in gastric cancer, but also the downward trends in cancer of the intestines and a few less common sites, such as gallbladder and thyroid neoplasms for reasons that are not yet clear. Appreciable rises were observed for lung and other tobacco-related sites in women, for the oral cavity in men and (in earlier calendar periods) cutaneous melanoma in both sexes. Although restricted to a selected number of sites, these rises are discouraging, since the causes of these neoplasms have long been recognized. Somewhat discouraging also is the absence of decline in male lung cancer. These problems notwithstanding, the overall pattern of trends in cancer mortality in young Swiss adults over the last few decades is still reassuring, particularly in comparison with those observed in other European countries, and in the more general framework of the debate on the perspectives of progress in cancer control. Although restricted to a small proportion of all cancer deaths, in fact, trends in young adults offer useful indications on the likely future trends in the same generations in the near future, since they reflect more recent changes in the pattern of exposure. The size of the changes, however, will probably differ, since the prevalent cancers in middle age are different from those in the young.