Potential impact of interventions resulting in reduced exposure to ultraviolet (UV) radiation (UVA and UVB) on skin cancer incidence in four European countries, 2010-2050

BACKGROUND

Behavioural interventions to reduce exposure to ultraviolet radiation (UVR) can reduce risk of skin cancer.

OBJECTIVES

To integrate the data and to evaluate the impact of interventions to limit exposure to UVR on skin cancer incidence in four selected countries.

METHODS

Using PREVENT, a dynamic simulation model, we modelled the potential for skin cancer prevention in four European countries under various scenarios to avoid damage by UVR.

RESULTS

In general, the most effective interventions were those aimed at protecting people during outdoor work and outdoor hobbies against the harmful effects of UVR, and combinations of several interventions. These could in theory lead to reductions of up to 45% in skin cancer cases projected for the year 2050.

CONCLUSIONS

The scope for prevention depends on the prevalence of the risk factors in the different countries, as well as the associated risk factors and time lags modelled.

A uniform histological cluster scheme for ICD-O-coded primary central nervous system tumors

Comparability of population-based measures of risk and prognosis for primary central nervous system (CNS) tumors, which exhibit marked histological diversity, may be hampered by differences in detection and case ascertainment and by the lack of unequivocal and uniform histological criteria for pathological diagnoses. Furthermore, many cancer registries do not include benign tumors as defined by the International Classification of Diseases for Oncology (ICD-O), such as meningiomas, schwannomas and pituitary adenomas. We propose both a detailed and a rough uniform histological cluster scheme for data coded according to the first or second edition of the ICD-O, published in 1976 and 1990, respectively. Primary CNS tumors, typed and graded according to (modified) classification systems of Bailey and Cushing, Kernohan, Ringertz, the WHO and Daumas-Duport, are clustered as clinically relevant entities on the basis of the second edition of the WHO classification system, published in 1993. The proposed scheme identifies some of the (potential) pitfalls in the descriptive epidemiology of CNS tumors and may facilitate temporal and geographical comparability of population-based data.

Incidence of primary central nervous system cancers in South and East Netherlands in 1989-1994

About 2,000 patients with primary CNS cancers, as defined by the ICD-O, were registered in four adjacent cancer registries in South and East Netherlands in 1989-1994, covering a population of more than 5 million people. About 85% of the patients were registered through pathological laboratories, concentrated in four centers for neurosurgery. Patients with a clinical-radiological diagnosis only (about 50% in the age-group of 75 years and older) were mainly identified through medical records of hospitalized patients. World-standardized incidence rates of 6.5 and 4.4 per 100,000 person-years for males and females, respectively, were similar to those reported in other European cancer registries. Eighty-five percent of histologically verified primary CNS cancers were of glial origin, 6% were lymphomas and 4% embryonal tumors. Gliomas were mainly of astrocytic (about 85%) and oligodendroglial or mixed type (about 10%). Without additional review most astrocytic tumors could be classified into high-grade (70-75%) and low-grade astrocytomas (20-25%). Different grading systems were used for gliomas, but the dichotomy of astrocytomas according to differentiation grade seemed to correspond well with the definition of the WHO. Age-specific incidence rates for low-grade astrocytomas were remarkably constant. The incidence of high-grade astrocytomas increased sharply with age and declined after the age of 70, whereas the incidence of clinically diagnosed tumors continued to increase. Male/females-ratios were relatively high for these tumor types (1. 6-1.7). We conclude that the registration of primary CNS cancers in the Netherlands may be almost complete and valid for gliomas, embryonal tumors and lymphomas.