Cancer Epidemiology Dr Jesme Baird The Roy Castle Lung Cancer Foundation, UK and ECPC.
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Transcript of Cancer Epidemiology Dr Jesme Baird The Roy Castle Lung Cancer Foundation, UK and ECPC.
Cancer EpidemiologyCancer Epidemiology
Dr Jesme BairdDr Jesme BairdThe Roy Castle Lung Cancer Foundation, The Roy Castle Lung Cancer Foundation, UKUKand ECPC.and ECPC.
Projected numbers of cancer cases and Projected numbers of cancer cases and deaths from cancer in Europedeaths from cancer in Europe
20102010 20202020
CasesCases DeathsDeaths CasesCases DeathsDeaths M M 1,652,2831,652,283 1,090,1981,090,198 1,859,9101,859,910
1,241,8601,241,860 F F 1,405,6171,405,617 803,250803,250 1,504,9901,504,990
880,531880,531
B B 3,057,9003,057,900 1,893,4481,893,448 3,364,900 3,364,900 2,122,3912,122,391
Globocan 2002Globocan 2002
Cases of cancer by age and sex in Cases of cancer by age and sex in Europe in 2002Europe in 2002
MalesMales FemalesFemales
-14 15-44 45-54 55-64 65+-14 15-44 45-54 55-64 65+
Globocan 2002
Cancer deaths attributed to various factorsCancer deaths attributed to various factors
TobaccoTobacco 3030 25 - 4025 - 40AlcoholAlcohol 3 3 2 - 4 2 - 4DietDiet 3535 10 - 7010 - 70Food aditivesFood aditives <1<1 -5 - 2-5 - 2Reproductive and sexual Reproductive and sexual 7 7 1 - 13 1 - 13 behaviourbehaviourOccupationOccupation 4 4 2 - 8 2 - 8PollutionPollution 2 2 1 - 5 1 - 5Industrial productsIndustrial products <1<1 <1 - 5<1 - 5Medicines and m. proceduresMedicines and m. procedures 1 1 0.5 - 30.5 - 3Geophysical factorsGeophysical factors 3 3 2 - 4 2 - 4InfectionInfection 10?10? 1 - ? 1 - ?UnknownUnknown ? ?
Doll and Peto 1981Doll and Peto 1981
Factor or class of factorsFactor or class of factors
Percentage of all cancer deathsPercentage of all cancer deaths
Best estimateBest estimate Range of acceptableRange of acceptable
estimatesestimates
North-Western and Central-Eastern North-Western and Central-Eastern EuropeEurope
Mortality (ASR)Mortality (ASR)Incidence (ASR)Incidence (ASR)
Cancer in Europe: males, 2002Cancer in Europe: males, 2002
Globocan 2002Globocan 2002
Incidence of cancer in Europe: males 2002 Incidence of cancer in Europe: males 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Globocan 2002Globocan 2002
Mortality from cancer in Europe: males, Mortality from cancer in Europe: males, 20022002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Globocan 2002Globocan 2002
Cancer in Europe: females, 2002Cancer in Europe: females, 2002
Incidence (ASR)Incidence (ASR) Mortality (ASRMortality (ASR)
Globocan 2002Globocan 2002
Incidence of cancer in Europe: females Incidence of cancer in Europe: females 20022002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Globocan Globocan 20022002
Mortality from cancer in Europe: females Mortality from cancer in Europe: females 20022002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Globocan 2002Globocan 2002
Trends in cancer mortality (ASR) in EUTrends in cancer mortality (ASR) in EU
100
150
200
250
300
350
Year
MALE; EU members before May 2004
MALE; EU members since May 2004
FEMALE; EU members before May 2004
FEMALE; EU members since May 2004
WHO HFA DB 2005WHO HFA DB 2005
Most common cancer sites: estimated Most common cancer sites: estimated new cases in males, Europe 2002new cases in males, Europe 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Bladder8%
Colon and
rectum13%
Lung17%
Other sites38%
Prostate19%
Stomach5%
Prostate7%
Stomach11%
Colon and
rectum12%
Bladder6%
Lung26%
Other sites38%
Globocan 2002Globocan 2002
Most common cancer sites: estimated Most common cancer sites: estimated deaths in males, Europe 2002deaths in males, Europe 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Stomach6%
Colon and rectum11%
Prostate11%
Lung27%
Other sites41%
Pancreas4%
Prostate5%
Colon and
rectum10%
Stomach13%
Lung30%
Other sites38%
Pancreas4%
Globocan 2002Globocan 2002
Most common cancer sites: estimated Most common cancer sites: estimated new cases in females, Europe 2002new cases in females, Europe 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Breast30%
Colon and
rectum14%
Lung6%
Ovary4%
Corpus uteri5%
Other sites41%
Cervix uteri7%
Stomach8%
Corpus uteri7%
Colon and
rectum13%
Breast23%
Other sites42%
Globocan 2002Globocan 2002
Most common cancer sites: estimated Most common cancer sites: estimated deaths in females, Europe 2002deaths in females, Europe 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Stomach11%
Colon and
rectum14%
Breast16%
Other sites45%
Lung8%
Cervix uteri6%
Lung11%
Colon and rectum14%
Other sites46%
Breast17%
Pancreas6%
Ovary6%
Globocan 2002Globocan 2002
Trends in mortality from Trends in mortality from lung cancerlung cancer (ASR) in (ASR) in malesmales in selected European in selected European countriescountries
WHO HFA DBWHO HFA DB
Trends in mortality from Trends in mortality from lung cancerlung cancer (ASR) in (ASR) in femalesfemales in selected European in selected European countriescountries
WHO HFA DBWHO HFA DB
25-30% of all cancer sites in the 25-30% of all cancer sites in the developed world are causally linked to developed world are causally linked to smoking :smoking :
Lung (87-91% in males and 57-86% in Lung (87-91% in males and 57-86% in females)females)
Oral cavity (including lip and tongue)Oral cavity (including lip and tongue)
Nasal cavity and paranasal sinusesNasal cavity and paranasal sinuses
LarynxLarynx
Pharynx and oesophagusPharynx and oesophagus
StomachStomach
LiverLiver
PancreasPancreas
Urinary tract (bladder, ureter and renal Urinary tract (bladder, ureter and renal pelvis)pelvis)
Uterine cervixUterine cervix
Myeloid leukaemiaMyeloid leukaemia IARC 2002
Trends in incidence of colon cancer in Trends in incidence of colon cancer in selected European countries, 1953-97selected European countries, 1953-97
Five-year (relative, age Five-year (relative, age standardised) survival (%) for colon standardised) survival (%) for colon cancer by sexcancer by sex
EUROCARE-3 StudyEUROCARE-3 Study
Nordic countriesSouth and West EuropeUK (presented for England, Scotland, Wales)Eastern EuropeData covering less than 100% of country
MalesMales FemalesFemales
Diet, overwight and physical activityDiet, overwight and physical activity
A A poor dietpoor diet, often combined with , often combined with sedentary sedentary lifestylelifestyle and and obesity,obesity, increase the risk of increase the risk of colon, breast, prostate, endometrial and other colon, breast, prostate, endometrial and other cancerscancers
Up to 30% of cancers probably related to diet and Up to 30% of cancers probably related to diet and nutritionnutrition
World Cancer Report 2003World Cancer Report 2003
Incidence of and mortality (ASR, 2002) Incidence of and mortality (ASR, 2002) from breast cancer in selected European from breast cancer in selected European countriescountries
Globocan 2002Globocan 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Trends in incidence of breast cancer (ASR) Trends in incidence of breast cancer (ASR) in selected European countriesin selected European countries
Risk factors associated with the Risk factors associated with the development of breast cancerdevelopment of breast cancer
family history and genetic factorsfamily history and genetic factorsprevious history of breast cancer in one breastprevious history of breast cancer in one breastfibrocystic disease (atypical hyperplasia)fibrocystic disease (atypical hyperplasia)ionizing radiationionizing radiation
age at menarche and menopauseage at menarche and menopauseage at first delivery, number of childrenage at first delivery, number of childrennulliparitynulliparityoral contraceptives and hormone replacement oral contraceptives and hormone replacement therapytherapy
Risk factors associated with the Risk factors associated with the development of breast cancerdevelopment of breast cancer
dietdietalcoholalcoholphysical activityphysical activity
Life-style related factorsLife-style related factors
Nordic countriesSouth and West EuropeUK (presented for England, Scotland, Wales)Eastern EuropeData covering less than 100% of country
Five-year (relative, age Five-year (relative, age standardised) survival (%) for breast standardised) survival (%) for breast cancercancer
EUROCARE-3 StudyEUROCARE-3 Study
Incidence of and mortality (ASR, 2002) from Incidence of and mortality (ASR, 2002) from cervical cancer in selected European cervical cancer in selected European countriescountries
Globocan 2002Globocan 2002
North-Western EuropeNorth-Western Europe Central-Eastern EuropeCentral-Eastern Europe
Differences between NW and CE Differences between NW and CE EuropeEurope (1) (1)
Incidence of cancer in men is higher in Incidence of cancer in men is higher in NWEurope, but mortality is higher in NWEurope, but mortality is higher in CEEurope.CEEurope.
In females, incidence is higher in NWEurope, In females, incidence is higher in NWEurope, but mortality is similar in both regions.but mortality is similar in both regions.
Mortality in NWEurope has been decreasing Mortality in NWEurope has been decreasing since mid-1980s, it started to decline in since mid-1980s, it started to decline in CEEurope only recently.CEEurope only recently.
Differences between NW and CE Differences between NW and CE EuropeEurope (2) (2)
Differences in the common cancer Differences in the common cancer sitessites
In CEEurope, the most important causes of In CEEurope, the most important causes of cancer deathcancer death
In Men - In Men - lunglung, stomach and colorectal cancer, stomach and colorectal cancer
In females - In females - breastbreast, stomach, colorectal and , stomach, colorectal and cervical cancercervical cancer
Mortality from cancer (ASR, both sexes) Mortality from cancer (ASR, both sexes) in three neighbouring countries in Europein three neighbouring countries in Europe