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Cancer epidemiology. 04/2013;
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ABSTRACT: Esophageal adenocarcinoma has one of the fastest rising incidence rates and one of the lowest survival rates of any cancer type in the Western world. However, in many countries, trends in esophageal cancer differ according to tumour morphology and anatomical location. In Canada, incidence and survival trends for esophageal cancer subtypes are poorly known.
Cancer incidence and mortality rates were obtained from the Canadian Cancer Registry, the National Cancer Incidence Reporting System and the Canadian Vital Statistics Death databases for the period from 1986 to 2006. Observed trends (annual per cent change) and five-year relative survival ratios were estimated separately for esophageal adenocarcinoma and squamous cell carcinoma, and according to location (upper, middle, or lower one-third of the esophagus). Incidence rates were projected up to the year 2026.
Annual age-standardized incidence rates for esophageal cancer in 2004 to 2006 were 6.1 and 1.7 per 100,000 for males and females, respectively. Esophageal adenocarcinoma incidence rose by 3.9% (males) and 3.6% (females) per year for the period 1986 to 2006, with the steepest increase in the lower one-third of the esophagus (4.8% and 5.0% per year among males and females, respectively). In contrast, squamous cell carcinoma incidence declined by 3.3% (males) and 3.2% (females) per year since the early 1990s. The five-year relative survival ratio for esophageal cancer was 13% between 2004 and 2006, approximately a 3% increase since the period from 1992 to 1994. Projected incidence rates showed increases of 40% to 50% for esophageal adenocarcinoma and decreases of 30% for squamous cell carcinoma by 2026.
Although esophageal cancer is rare in Canada, the incidence of esophageal adenocarcinoma has doubled in the past 20 years, which may reflect the increasing prevalence of obesity and gastroesophageal reflux disease. Declines in squamous cell carcinoma may be the result of the decreases in the prevalence of smoking in Canada. Given the low survival rates and the potential for further increases in incidence, esophageal adenocarcinoma warrants close attention.
Canadian journal of gastroenterology = Journal canadien de gastroenterologie 10/2012; 26(10):723-7. · 1.21 Impact Factor
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ABSTRACT: Cancer prevalence trends are rarely reported in the published literature, and until now, have not been reported for Canada.
Based on incidence data from the Canadian Cancer Registry linked with mortality data from the Canadian Vital Statistics Death Database, trends in prevalence proportions overtime were calculated by time since diagnosis for a large number of the most common cancers.
Statistically significant increases in prevalence proportions were observed for most individual cancers, and most prevalence durations studied. Aging of the population contributed to these increases. Relatively large increases were observed for liver and thyroid cancer, while decreases occurred for cancers of the larynx and cervix uteri.
Information on how and why trends vary by cancer can inform resource allocation planning.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 03/2012; 23(1):7-16. · 3.26 Impact Factor
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ABSTRACT: Survival estimates measured from the time cancer diagnosis become less informative after one or two years' survival. Using records from the Canadian Cancer Registry linked to the Canadian Vital Statistics Death Database, five-year conditional relative survival ratio (RSR) estimates were derived for a large number of cancers. For each cancer with an initial five-year RSR of at least 80% (except breast cancer), a conditional five-year RSR of 95% or more was achieved after five years' survival. Among cancers with initial five-year RSRs of 50% to 79%, a five-year conditional RSR of 95% or more was observed for cancers of the cervix uteri and colon after five years. There was no apparent improvement in survival prospects during the first five years after diagnosis for chronic lymphocytic leukemia (CLL). Despite initial prognoses of less than 50%, a conditional five-year RSR of at least 90% five years after diagnosis was achieved for stomach cancer and leukemia (excluding CLL).
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 06/2011; 22(2):21-5. · 3.26 Impact Factor
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Canadian Medical Association Journal 11/2010; 183(3):E187-94. · 8.22 Impact Factor
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Larry F Ellison
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ABSTRACT: In survival analyses using cancer registry data, second and subsequent primary cancers diagnosed in individuals are typically excluded. However, this approach may lead to biased comparisons of survival between cancer registries, or over time within a single registry. Purpose: To examine the impact of including multiple primary cancers in the derivation of survival estimates using data from a population-based national cancer registry.
Five-year relative survival estimates for persons aged 15-99 years at diagnosis were derived using all eligible primary cases from the Canadian Cancer Registry (CCR)-a population-based registry containing information on cases diagnosed from 1992 onward-and then again using first primary cases only. Any pre-1992 cancer history of persons on the CCR was obtained by using auxiliary information.
The inclusion of multiple cancers resulted in lower estimates of 5-year relative survival for virtually all cancers studied. The effect was somewhat attenuated by age-standardization (e.g., from 1.3% to 1.0% for all cancers combined), and was greatest for bladder cancer (-2.4%) followed by oral cancer (-1.9%)-cancers that had the first and third lowest proportions of first cancers, respectively. For the majority of cancers the difference was less than 1.0%. Cancers for which there was virtually no difference (e.g., lung, pancreatic, ovarian and liver) tended to be those with a poor prognosis.
Inclusion of second and subsequent primary cancers in the analysis tended to lower estimates of relative survival, the extent of which varied by cancer and age and depended in part on the proportion of first primary cancers.
Cancer epidemiology. 10/2010; 34(5):550-5.
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ABSTRACT: Statistics Canada routinely produces cohort-based estimates for cancer survival; the most recent were based on cases diagnosed from 1992-2000. This report provides predicted survival estimates for cases diagnosed more recently. Using records from the Canadian Cancer Registry linked to the Canadian Vital Statistics Death Data Base, cancer- and age-specific estimates of relative survival have been calculated for 2004-2006. The five-year relative survival ratio (RSR) for all cancers combined was 62%, and ranged from 6% for pancreatic cancer to 98% for cancer of the thyroid. The RSR was typically higher at younger than older ages, with exceptions for some common cancers. From 1992-1994 to 2004-2006, the five-year RSR for a number of cancers increased--usually slightly, but in some cases, appreciably (for example, the age-standardized RSR for non-Hodgkin lymphoma rose from 51% to 63%; for leukemia, from 44% to 54%; and for liver, 9% to 17%).
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 09/2010; 21(3):55-60. · 3.26 Impact Factor
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ABSTRACT: The rising numbers of cancer diagnoses, together with improvements in survival, have led to increases in the prevalence of cancer in Canada. This article provides more precise and detailed estimates of cancer prevalence than have been available previously.
Based on incidence data from the Canadian Cancer Registry linked with mortality data from the Canadian Vital Statistics Death Database, direct estimates of cancer prevalence as of January 1, 2005 were calculated for an extensive list of cancers, by time since diagnosis, age and sex.
Two-, five- and ten-year cancer prevalence counts were 217,089 (675 per 100,000), 454,149 (1,412 per 100,000) and 722,833 (2,248 per 100,000), respectively. Breast (20.6% of ten-year prevalent cases), prostate (18.7%) and colorectal cancer (12.9%) were the most prevalent, together accounting for just over half of all cases. Prevalence proportions for all cancers combined increased dramatically with age, peaking at ages 80 to 84; proportions were higher in females than in males before age 60, and higher in males thereafter.
Prevalence data tabulated according to type of cancer, age and time since diagnoses provide important information about the demand for cancer-related health care and social services.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 04/2009; 20(1):7-19. · 3.26 Impact Factor
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Canadian Medical Association Journal 03/2009; 180(4):422-4. · 8.22 Impact Factor
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Canadian Medical Association Journal 04/2008; 178(6):677-8. · 8.22 Impact Factor
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ABSTRACT: This study provides up-to-date estimates of childhood and adolescent (ages 0-19) cancer survival in Canada using data from the Canadian Cancer Registry (CCR). Cases were classified according to the third edition of the International Classification of Childhood Cancer classification scheme. Follow-up for vital status was determined through record linkage to the Canadian Mortality Data Base, and from information reported by provincial/territorial cancer registries. Observed survival proportions (OSPs) were based on period analysis (1999-2003). The 1-, 3- and 5-year OSPs for all cancers combined were 92%, 85% and 82%, respectively. Among diagnostic groups, five-year survival estimates were highest for retinoblastoma (99%), carcinomas and other malignant epithelial neoplasms and malignant melanomas (91%) and for renal tumours (91%); they were poorest for hepatic tumours (68%) and for malignant bone tumours (68%). Survival for childhood and adolescent cancer in Canada has improved substantially since last reported.
European Journal of Cancer 10/2007; 43(13):1967-75. · 5.54 Impact Factor
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Larry F Ellison
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ABSTRACT: To provide an empirical evaluation of the performance of period analysis in comparison to traditional methods of survival analysis for predicting future 5-year cancer survival using data from the Canadian Cancer Registry.
5-year relative survival estimates were derived by period and traditional methods of analysis using data available at the conclusion of 1997. The extent to which these estimates agreed with survival later observed for cancer cases diagnosed in 1997 was quantified by calculating the squared difference of the estimate to the corresponding relative survival ratio actually observed.
Period analysis was observed to be superior to, or comparable with, cohort analysis in predicting the average 5-year relative survival observed later for virtually all individual cancer sites studied. The improvement in survival estimation was most pronounced for prostate cancer. Where period estimates did not match the eventually observed value, they were predominantly on the lower side. Complete analysis estimates were generally observed to be in between the cohort and period values.
The period method of survival analysis provides more up-to-date estimates of 5-year survival than do traditional cohort-based methods.
Annals of Epidemiology 04/2006; 16(3):191-6. · 3.21 Impact Factor
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ABSTRACT: Changes in five-year relative survival ratios for prostate, breast, colorectal and lung cancer cases are examined. Ratios for cases diagnosed in the 1985-1987 period are compared with those for 1992-1994. Incidence and mortality rates between 1985 and 1999 are compared with changes in relative survival.
Data are from the Canadian Cancer Registry, the National Cancer Incidence Reporting System, the Canadian Mortality Data Base, and life tables.
Analysis was conducted using the maximum likelihood method of Esteve. Age-standardized ratios for a given cancer were calculated by weighting age-specific ratios to the age distribution of patients diagnosed with that cancer. Statistical tests were used to compare corresponding age-specific and age-standardized ratios across the two periods. National estimates exclude Québec and New Brunswick.
Between the 1985-1987 period and the 1992-1994 period, increases in five-year age-standardized relative survival ratios were dramatic for prostate cancer, large for breast cancer, and somewhat smaller for colorectal cancer. There was little absolute change in the ratios for lung cancer.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 04/2004; 15(2):19-32. · 3.26 Impact Factor
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ABSTRACT: Background The rising numbers of cancer diagnoses, together with improvements in survival, have led to increases in the prevalence of cancer in Canada. This article provides more precise and detailed estimates of cancer prevalence than have been available previously. Data and methods Based on incidence data from the Canadian Cancer Registry linked with mortality data from the Canadian Vital Statistics Death Database, direct estimates of cancer prevalence as of January 1, 2005 were calculated for an extensive list of cancers, by time since diagnosis, age and sex. Results Two-, five- and ten-year cancer prevalence counts were 217,089 (675 per 100,000), 454,149 (1,412 per 100,000) and 722,833 (2,248 per 100,000), respectively. Breast (20.6% of ten-year prevalent cases), prostate (18.7%) and colorectal cancer (12.9%) were the most prevalent, together accounting for just over half of all cases. Prevalence proportions for all cancers combined increased dramatically with age, peaking at ages 80 to 84; proportions were higher in females than in males before age 60, and higher in males thereafter. Interpretation Prevalence data tabulated according to type of cancer, age and time since diagnoses provide important information about the demand for cancer-related health care and social services.
