Sabine Luttmann

Leibniz-Institute of Prevention Research and Epidemiology, Bremen, Bremen, Germany

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Publications (11)27.58 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Hintergrund Die Inzidenz von Schilddrüsenkrebs (SDK), einem seltenen Malignom, ist in den letzten Jahrzehnten stark gestiegen. Als mögliche Ursachen für den Inzidenzanstieg werden eine Zunahme der diagnostischen Aktivität, oberirdische Kernwaffentests seit dem Zweiten Weltkrieg sowie die Tschernobyl-Katastrophe diskutiert. Zielsetzung Darstellung der Inzidenzentwicklung von SDK in Deutschland in den Jahren 2003 bis 2008 separat nach Tumorhistologie und Geschlecht sowie der SDK-Inzidenz nach Kreisen und Geschlecht in Deutschland. Methoden Sämtliche Neuerkrankungen an SDK (ICD-10 Schlüssel, C73) aus den Jahren 2003 bis 2008 werden vom Zentrum für Krebsregisterdaten am Robert Koch-Institut bezogen sowie amtliche Bevölkerungs- und Mortalitätsdaten verwendet. Altersspezifische und altersstandardisierte Inzidenzraten (ASIR) werden separat nach Geschlecht und Tumorhistologie berechnet. Ergebnisse Die ASIR von SDK stieg zwischen 2003 bis 2008 von 2,7 auf 3,4 (Männer) sowie von 6,5 auf 8,9 (Frauen) pro 100.000 pro Jahr an. Dieser Anstieg ist nahezu ausschließlich auf die Zunahme der Inzidenz des papillären SDK zurückzuführen, vor allem der Kategorie TNM-T1. Die Inzidenzverteilung in Deutschland ist durch einen deutlichen Nord-Süd-Anstieg gekennzeichnet. Diskussion Die Ursache für den erheblichen Anstieg der beobachteten SDK-Inzidenz in den letzten Jahrzehnten ist unbekannt. Der beobachtete Nord-Süd-Anstieg der SDK-Inzidenz in Deutschland könnte zum Teil auf langfristige Unterschiede in der Jodversorgung der Bevölkerung zurückzuführen sein. Schlussfolgerung Eine epidemiologische Studie zur Erforschung der Ursachen für den Anstieg der SDK-Inzidenz sowie für die regionalen Unterschiede in Deutschland wird empfohlen.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2014; 57(1). · 0.72 Impact Factor
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    ABSTRACT: The incidence of thyroid cancer (TC), a rare malignancy, has strongly risen in recent decades. Possible causes of this rise include increasing diagnostic activity, nuclear tests after World War II, and the Chernobyl disaster. This article presents the time trends of TC incidence between 2003 and 2008 in Germany according to histological tumor type and sex, and provides a description of TC incidence according to districts (Kreise) and sex in Germany. Data on persons newly diagnosed with thyroid cancer (ICD-10 code, C73) between 2003 and 2008 were obtained from the Center of Cancer Registry Data at the Robert Koch Institute. Official population and mortality data were used. Age-specific and age-standardized incidence rates (ASIR) were calculated according to sex and tumor histology. Between 2003 and 2008, the ASIR of TC rose from 2.7 to 3.4 (men) and from 6.5 to 8.9 (women) per 100,000 per year. This rise can be almost completely attributed to the rising incidence of papillary TC. The steepest rise in frequency was observed in TNM-T1 tumors. A positive north-south gradient of TC incidence was found. The cause of the marked rise of TC incidence in recent decades is unknown. The positive north-south gradient of the TC incidence may possibly be attributed in part to long-standing differences of iodine intake between different German regions. An epidemiological study of the possible causes of the rising TC incidence and of the regional differences of TC incidence in Germany is recommended.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2014; 57(1):84-92. · 0.72 Impact Factor
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    ABSTRACT: Serious concern arose in the scientific literature about the state of and progress in cancer survival among adolescent and young adult patients (AYA) in the recent years. We provide an up-to-date international comparison of survival among AYA patients. Using population based cancer data from 11 German cancer registries and the SEER Program of the United States (covering populations of 39 and 33 million people, respectively), standardized tumor group classifications, period analysis and modeling, we compared the 5-year relative survival of AYA patients in the age groups 15-29 and 30-39 to survival seen among adults aged 40-49 for the 2002-06 period. Additionally, we also provide an age specific survival comparison between the 2 countries. In 2002-06, for the overwhelming majority of the more than 30 types of cancer examined, AYA patients aged both 15-29 and 30-39 years had higher or similar survival than patients in the age group 40-49 in both countries. A numerically large and statistically significant survival deficit among AYA patients was only found for breast carcinomas in both populations, and colorectal and stomach carcinoma in the US for the age group 15-29. Overall, results of the country specific comparisons did not indicate systematic differences. With very few exceptions, no survival deficit between AYA patients and adults aged 40-49 years was found in either of the examined countries in the first decade of the 21(st) century. © 2013 Wiley Periodicals, Inc.
    International Journal of Cancer 04/2013; · 6.20 Impact Factor
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    ABSTRACT: Abstract Purpose. Population-based studies on cervical cancer providing survival estimates by age, histology, and stage have been sparse. We aimed to derive most up-to-date and detailed survival estimates for cervical cancer patients in Germany. Methods. We used a pooled German national dataset including data from 11 cancer registries covering a population of 33 million people. Included were 15 685 patients diagnosed with cervical cancer from 1997 to 2006. Period analysis was performed to calculate the five-year relative survival (RS) 2002-2006. Trends in survival between 2002 and 2006 were examined using model-based period analysis. Age-adjustment was done using five age groups (15-44, 45-54, 55-64, 65-74, and 75 + years). Results. Overall, age-adjusted five-year relative survival in 2002-2006 was 64.7%. A strong age gradient was observed, with five-year RS decreasing from 81.7% in age group 15-49 years to 46.3% in age group 70 + years. Prognosis furthermore strongly varied by stage, with age-adjusted five-year RS reaching 84.6% for localized, 48.2% for regional, and 17.9% for distant stage. From 2002 to 2006, a significant improvement (4.7 percent units) in overall age-adjusted five-year RS was seen. The improvement was most pronounced for age groups 55-64 years (from 54.2 to 65.6%) and 65-74 years (from 50.0 to 58.1%). Conclusion. In this first comprehensive population-based study from Germany, prognosis of cervical cancer strongly varied by age and stage. Prognosis continued to improve, in particular in age range 55-74 years, in the five-year period assessed.
    Acta oncologica (Stockholm, Sweden) 08/2012; 51(7):915-921. · 2.27 Impact Factor
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    ABSTRACT: Population-based studies on ovarian cancer providing survival estimates by age, histology, laterality, and stage have been sparse. We aimed to derive the most up-to-date and detailed survival estimates for ovarian cancer patients in Germany. We used a pooled German national dataset including data from 11 cancer registries covering 33 million populations. A total of 21 651 patients diagnosed with ovarian cancer in 1997-2006 were included. Period analysis was carried out to calculate the 5-year relative survival (RS) for the years 2002-2006. Trends in survival between 2002 and 2006 were examined using model-based period analysis. Age adjustment was performed using five age groups (15-44, 45-54, 55-64, 65-74, and 75+ years). Overall, the age-adjusted 5-year RS in 2002-2006 was 41%. A strong age gradient was observed, with a decrease in the 5-year RS from 67% in the age group 15-49 years to 28% in the age group 70+ years. Furthermore, the prognosis varied markedly by histology, laterality, and stage, with the age-adjusted 5-year RS ranging from 25% (for carcinoma not otherwise specified) to 81% (for stromal cell carcinoma), reaching 46% for unilateral and 32% for bilateral carcinoma and reaching 82% for Federation of Gynecology and Obstetrics (FIGO) stages I and II, 36% for FIGO stage III, and 18% for FIGO stage IV. No improvement in survival could be observed for any of the subgroups in the period between 2002 and 2006. Our analyses suggest that an improvement in the 5-year RS for ovarian cancer may have stagnated in the early 21st century and underline the need for a more effective translation of therapeutic innovation into clinical practice.
    European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP) 06/2012; · 2.21 Impact Factor
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    ABSTRACT: Prior analyses of survival of patients with primary cutaneous malignant melanoma from Germany were based only on small populations and need to be updated. We give a detailed overview of relative 5-year survival by sex, age group, histology, tumour stage and body site, and of time trends in a population of 33 million (40% of Germany), and compare survival in the federal states. Conventional and model-based period analysis using the Ederer II method was applied to patients with melanoma diagnosed during 1997-2006 in Germany to assess 5-year relative survival (RS) rates and time trends. In total, 37,155 melanoma cases were included. Overall age-adjusted 5-year RS for the time period 2002-2006 was 91·9% for women and 87·0% for men. Survival differences by age group, histology, tumour stage and body site were found. No significant overall trend (2002-2006) was seen either in women or in men. Differences in survival between federal states were small; no clear pattern was seen. Based on the most recent and high-quality data from population-based cancer registries a comprehensive picture on melanoma survival in Germany was given. Survival from cutaneous malignant melanoma was high compared with other cancer sites and did not change during the analysed period 2002-2006. Patterns in melanoma survival by sex, age, tumour stage, histology and body site were in good agreement with previously published findings. No relevant differences between federal states were found.
    British Journal of Dermatology 05/2012; 167(3):606-12. · 3.76 Impact Factor
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    ABSTRACT: Abstract Background. Esophagus and stomach cancers are associated with poor prognosis. But most published population-based cancer survival estimates for stomach and esophagus cancer refer to survival experience of patients diagnosed in the 1990s or earlier years. The aim of this study was to provide up-to-date survival estimates and trends for patients with stomach and esophagus cancer in Germany. Material and methods. Our analysis is based on data from 11 population-based cancer registries, covering 33 million inhabitants. Patients diagnosed with stomach and esophagus cancer in 1997-2006 were included. Period analysis was used to derive five-year relative survival estimates and trends by age, sex, cancer subsite, and stage for the time period of 2002-2006. German and US survival estimates were compared utilizing the SEER 13 database. Results. Overall age-standardized five-year relative survival was 31.8% and 18.3% for stomach and esophagus cancer, respectively, compared to 27.2% and 17.4% in the US. Survival was somewhat higher among female than among male patients for both cancer sites (33.6% vs. 30.6% and 21.5% vs. 17.5%, respectively) and much higher for non-cardia stomach cancer (40.4%) than for cardia cancer (23.4%). From 2002 to 2006, a moderate increase in five-year relative survival by 2.7 percent units was observed for non-cardia stomach cancer patients in Germany (p < 0.001). Conclusion. Five-year relative cancer survival has reached levels around 40% for patients with non-cardia stomach cancer in Germany in the early 21st century, whereas it remained at lower levels around 20% for patients with esophagus and cardia cancer.
    Acta oncologica (Stockholm, Sweden) 04/2012; 51(7):906-914. · 2.27 Impact Factor
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    ABSTRACT: Until recently, population-based data of cancer survival in Germany mostly relied on one registry covering ∼1 million people (1.3% of the German population). Here, we provide up-to-date cancer survival estimates for Germany based on data from 11 population-based cancer registries, covering 33 million people and compare them to survival estimates from the United States. Cancer patients diagnosed in 1997-2006 were included. Period analysis was employed to calculate 5-year relative survival for 38 cancers for 2002-2006. German and USA survival rates were compared utilizing the Surveillance, Epidemiology and End Results 13 database. Five-year relative survival >80% was observed for testicular cancer (93.5%), skin melanoma (89.4%), cancers of the prostate (89.1%) and thyroid (87.8%), Hodgkin's lymphoma (84.5%) and cancers of the breast (83.7%) and endometrium (81.0%), which together account for almost 40% of cases. For the majority of cancers, German survival estimates were close to or below those in the United States. Exceptions with higher survival in Germany were cancers of the stomach, pancreas and kidney and Hodgkin's lymphoma. German cancer survival estimates are mostly higher than the 2000-2002 pan-European estimates. Further research is needed to investigate causes responsible for differences between German and USA cancer survival rates.
    Annals of Oncology 05/2011; 23(2):472-9. · 7.38 Impact Factor
  • Gesundheitswesen. 01/2010; 72.
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    ABSTRACT: Aim: Several international studies have already investigated the influence of socioeconomic factors on the risk of cancer. For Germany, however, the data are still insufficient. We examined the effects of social differences on cancer incidence and mortality on the population of Bremen, a town in northwest Germany. Subjects and methods: Data were obtained from the Bremen Cancer Registry, a population-based registry. The database comprised 27,430 incident cases, newly diagnosed between 2000 and 2006. The allocation of social class for each patient was based on the home address at the time of diagnosis, which led to the corresponding town district, which again could be linked to the “Bremen discrimination index.” Based on this index, cases were allocated to five categories, for which we compared standardized incidence ratios (SIR) and mortality ratios (SMR) for different cancers: prostate, breast, lung, colorectal, bladder, uterine, ovarian, cervical, malignant melanoma of the skin, non-melanoma skin cancer and all cancer sites summarized. Results: The influence of social status was observed for different cancer sites. An inverse association was ascertained for all cancer sites (only men) and for tumors of the oral cavity and pharynx, and for lung, cervical and bladder cancers. A positive correlation was observed for female breast cancer, malignant melanoma, non-melanoma skin tumors and prostate cancer. Conclusions: In spite of the methodical restrictions, our analyses suggest an association between social factors and cancer incidence and mortality. The results are in agreement with international studies. Many of the observed social class differences could probably be explained by known risk factors, such as smoking, alcohol consumption, diet and physical activity.
    Journal of Public Health 01/2010; · 2.06 Impact Factor
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    ABSTRACT: Weltweit erkranken jedes Jahr etwa 12,4 Millionen Menschen neu an einer Krebserkrankung, über 7,6 Millionen Menschen sterben an Krebs. Die epidemiologischen Krebsregister in Deutschland können ein umfassendes Bild zum aktuellen Krebsgeschehen liefern. Die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (GEKID) präsentiert dazu aktuelle Daten in einem interaktiven Atlas der Krebsinzidenz und Krebsmortalität. Nach einer Hochrechnung der GEKID gab es im Jahr 2007 rund 460.000 neue bösartige Tumorerkrankungen in Deutschland. Räumlich betrachtet zeigt die Krebsinzidenz deutliche regionale Unterschiede, z.B. eine hohe Brustkrebsinzidenz im Nordwesten Deutschlands und eine niedrige in Ostdeutschland. In der zeitlichen Betrachtung ergeben sich unterschiedliche Trends, so hat sich z.B. Prostatakrebs sseit 1980 mehr als verdoppelt, Magenkrebs dagegen halbiert. Mit solchen Zahlen lässt sich Präventionsbedarf im Bereich von Krebserkrankungen spezifischer und zielgerichteter ableiten als bisher. Angesichts des demographischen Wandels in Deutschland mit weiter steigenden Erkrankungszahlen für Krebs ist eine Stärkung der Krebsprävention zur Verminderung der Krankheitslast Krebs dringend angezeigt. World wide about 12.4 million new cancer cases appear each year, 7.6 million people die of cancer. Population-based cancer registries in Germany can give a comprehensive picture on the actual burden of cancer. The association of population-based cancer registries in Germany (GEKID) presents actual data on cancer incidence and mortality with an interactive cancer atlas. An estimate of cancer incidence in Germany gives a number of 460.000 new cancer cases in 2007. Spatial analyses reveal clear differences within Germany, e.g. high breast cancer incidence in North-West Germany and low rates in East Germany. There are different time trends for single cancers, e.g. a doubling of prostate cancer since 1980 or a halving of stomach cancer. Using such figures the need of prevention can be addressed much more precisely. In the light of the demographic change in Germany with increasing numbers of cancer cases a strengthening of cancer prevention is needed to lower the current and future burden of cancer.
    Prävention - Zeitschrift für Gesundheitsförderung. 33(4):99-102.

Publication Stats

46 Citations
27.58 Total Impact Points


  • 2014
    • Leibniz-Institute of Prevention Research and Epidemiology
      Bremen, Bremen, Germany
  • 2012–2013
    • German Cancer Research Center
      • Division of Clinical Epidemiology and Aging Research
      Heidelberg, Baden-Wuerttemberg, Germany
    • Zhejiang University
      • School of Public Health
      Hangzhou, Zhejiang Sheng, China
  • 2010
    • Universität Bremen
      • Bremen Institute for Prevention Research and Social Medicine (BIPS)
      Bremen, Bremen, Germany