Trends in incidence of and mortality from cancer in The Netherlands in the period 1989-1998.
ABSTRACT This paper summarises the population-based major trends in cancer incidence and mortality in the period 1989-1998 in The Netherlands. Trends of the European age-adjusted incidence and mortality rates were estimated by the Estimated Annual Percentage Change (EAPC) method. Increases in incidence were found for cancer of the breast and lung for females. For males, an increase was observed for cancer of the prostate, colon, rectum and testis. In both groups, oesophageal and pharyngeal cancer increased, but that of stomach and gallbladder cancer decreased. The main increases in mortality were found for pharyngeal cancer in males, lung in females and oesophageal cancer in both sexes. Decreases were shown for stomach cancer for both sexes and lung cancer for males. Trends in incidence may be a result of changes in behaviour, smoking habits in preceding decades are related to the increase in lung cancer for females, and early detection, screening programmes increased the incidence for breast and prostate cancers. Decreases in mortality may be related to more successful treatment of leukaemia, Hodgkin's lymphoma, colorectal and testicular cancers. Primary prevention of cancer remains important.
Article: The cost-effectiveness of 18FDG-PET in selecting patients with suspicion of recurrent laryngeal carcinoma after radiotherapy for direct laryngoscopy[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to estimate the cost-effectiveness of 18FDG-PET in the selection for direct laryngoscopy in patients with suspicion of recurrent laryngeal carcinoma after radiotherapy. The direct medical costs of 30 patients with suspicion of a recurrence were calculated from the first visit where suspicion was raised until one year after. A conventional strategy, in which all these patients underwent direct laryngoscopy, was compared to an 18FDG-PET strategy in which only patients with a positive or equivocal 18FDG-PET underwent direct laryngoscopy. A sensitivity analysis was performed to examine the influence of the type of camera and ‘setting’. The mean costs of an 18FDG-PET strategy were €399 less than a direct laryngoscopy strategy. The type of camera and setting had no influence. In patients with suspicion for recurrent laryngeal carcinoma after radiotherapy, 18FDG-PET seems to be effective and less costly in selecting patients for direct laryngoscopy.Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 04/2012; 266(9):1441-1448. · 1.29 Impact Factor
Article: 2-Deoxy-2[F-18]FDG-PET for detection of recurrent laryngeal carcinoma after radiotherapy: interobserver variability in reporting.[show abstract] [hide abstract]
ABSTRACT: To evaluate accuracy and interobserver variability in the assessment of 2-deoxy-2[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) for detection of recurrent laryngeal carcinoma after radiotherapy. Eleven experienced nuclear physicians from eight centres assessed 30 FDG-PET scans on the appearance of local recurrence (negative/equivocal/positive). Conservative (equivocal analysed as negative) and sensitive (equivocal analysed as positive) assessment strategies were compared to the reference standard (recurrence within 6months after PET). Seven patients had proven recurrences. For the conservative and sensitive strategy, the mean sensitivity was 87% and 97%, specificity 81% and 63%, positive predictive values 61% and 46% and negative predictive values 96% and 99%, respectively. Interobserver variability showed a reasonable relation in comparison to the reference standard (kappa = 0.55). FDG-PET has acceptable interobserver agreement and yields good negative predictive value for detection of recurrent laryngeal carcinoma. It could therefore be used as first diagnostic step and may reduce futile invasive diagnostics.Molecular Imaging & Biology 08/2008; 10(5):294-303. · 3.84 Impact Factor
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ABSTRACT: Incidence of cancer may vary within a country and over time because of previous differences in exposure to risk factors or interventions for early detection (screening). This study describes time-space trends of incidence of common cancer sites across the Netherlands during the period 1989-2003 and speculates on the reasons for the observations. From the Netherlands Cancer Registry, World standardized incidence rates per municipality were smoothed calculating weighted averages for each 2 km by 2 km grid of the population mid-points of neighbouring municipalities and presented as map animations. Spatial relative changes in incidence were estimated by comparing the periods 1989-1994 and 1998-2003. Complete time-space trends can be found as map animations on http://maps.ikcnet.nl. The incidence of cervical and stomach cancer (for both sexes) decreased, being higher in the cities than in the rural areas during all periods and contrasting the trends in colorectal and breast cancer. The relative increase in incidence of lung cancer among females was highest in the rural north, but the incidence remained higher in the cities of the mid-west Netherlands. For males, there was a marked decrease in lung cancer incidence across the country since 1991. Incidence of melanoma increased, rates being twice as high in the coastal area than in the cities. Prostate cancer maps largely replicated the known history of PSA-testing in the Netherlands. Time-space cancer incidence patterns gave insight into effects of changes in exposure to risk determinants and early detection. The maps illustrate marked potential for cancer prevention at the national and regional level.International Journal of Cancer 06/2008; 122(9):2106-14. · 5.44 Impact Factor