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  • 1
    ISSN: 1432-0851
    Keywords: Lymphocyte subsets ; phytohemagglutinin ; Helper T cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mononuclear cells from 12 normal controls (co), 10 advanced untreated (c1), and 6 advanced treated cancer patients (c2) have been isolated. The numbers of mononuclear cells bearing Leu1, Leu2, Leu3, Leu2/HLA-DR and LeuM3 were measured with a fluorescence-activated cell sorter. Only the quantity of helper T cells (Leu3) was decreased in cancer patients (co: 0.89, c1: 0.32, c2: 0.44 × 109/1). Expression of all other markers, including activated suppressor T cells (Leu2/HLA-DR), did not differ significantly from the control. The proliferation of the lymphocytes was determined in a phytohemagglutininculture assay. The cancer groups showed a significantly decreased response (co: 95.8 × 109, cl: 28.7 × 109, c2: 25.7 × 109 cpm). These values correlated with the number of helper T cells but not with the suppressor T cells. Monocytes of cancer patients adsorbed significantly more immunoglobulins than the monocytes of controls. The addition of indomethacin or isoprinosine to phytohemagglutinin-culture assay increased the proliferation of lymphocytes from both the cancer patients and normal controls.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7225
    Keywords: breast cancer ; early detection ; incidence ; mammography ; mortality ; SEER ; survival ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Breast cancer incidence in the United States has been rising dramatically since 1982, as shown in data collected by the Surveillance, Epidemiology, and End Results (SEER) Program. In women aged 50 and older, incidence rates for in situ and localized invasive tumors have increased over the period 1982–86, while rates for regional and distant tumors have remained stable. The incidence of localized tumors 〈1.0 cm, 1.0–1.9 cm, and 2.0–2.9 cm in size has increased more rapidly than that of tumors 3.0 cm or more in size among women over age 50. Survival rates also have improved among cases diagnosed over this time period. These data suggest that early detection may be playing a role in the recent increase in female breast cancer incidence, though other factors cannot be ruled out. Conclusions regarding improved cancer control await confirmation by reduced breast cancer mortality.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7225
    Keywords: Age-cohort model ; breast cancer incidence ; lead-time effect ; secular trend ; screening-mammography ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A number of studies have attributed much of the sharp increase in breast cancer incidence in the United States during the 1980s to the increased detection through mammography. The most recent breast cancer data from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program show that the incidence trend has slowed, while results from the National Health Interview Survey (NHIS) of 1987 and 1990 indicate that the percentage of women receiving mammograms continues to increase. This phenomenon suggested the need to reassess the relationship between increasingly early detection of breast cancer and overall incidence trends. A polynomial age-cohort model was used to establish the secular trend in incidence rates excluding the impact of recent increases in detection due to the rising use of mammography. Based on the model, the incidence trend in the youngest age group (40 to 49 years) would peak and then begin to decline in the early 1980s. This pattern would manifest itself later in successively older age groups as these younger cohorts age. Breast cancer trends are seen to be generally consistent with the impact of the increased use of mammography when its effect is superimposed upon the background of declining or slowing secular trends. These results support previous reports linking incidence rates with the increase in screening-mammography.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Cancer causes & control 7 (1996), S. 544-552 
    ISSN: 1573-7225
    Keywords: Hysterectomy ; incidence ; lifetime risk ; prevalence ; United States ; uterine cancers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A risk-adjusted method is proposed for estimating cancer incidence rates from data collected by the Surveillance, Epidemiology, and End Results (SEER) program of the US National Cancer Institute. Unlike the conventional incidence-rate estimates reported by SEER, this method considers only the first primary cancer, and adjusts for population-based cancer prevalence, as well as for surgical procedures which remove an individual from risk of developing a given cancer. Thus, risk-adjusted incidence-rates more accurately reflect the average cancer risk for individuals in the cancer-free, at-risk population. The results of the analysis indicate that, in general, incidence-rate estimates are fairly similar between the conventional and risk-adjusted methods. However, this is not the case for certain cancer sites which may have: (i) a high number of subsequent primary cancers (e.g., melanomas—skin); (ii) a high cancer prevalence proportion (e.g., prostate cancer); (iii) a high number of subsequent primary cancers and prevalence proportion (e.g., female breast); or (iv) a high prevalence of removal of the organ in question (e.g., cervical and uterine cancers). For example, by applying the risk-adjusted incidence method for in situ and invasive cervical cancer, we found that in the period 1990–92 the age-adjusted incidence-rate estimate increased from 57.8 to 66.3 (15 percent) per 100,000 person-years; the greatest increase in the incidence-rate estimate occurred for women aged 65 to 69 years, from 40.1 to 63.2 (58 percent) per 100,000 person-years; and the lifetime risk of developing cervical cancer increased from 4.6 (1 in 22) to 5.5 (1 in 18) percent.
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  • 5
    ISSN: 1573-7225
    Keywords: age-adjusted rates ; cancer mortality ; linear models ; regression analysis ; surveillance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Surveillance of chronic diseases includes monitoring trends in age-adjusted rates in the general population. Statistics that are calculated to describe and compare trends include the annual percent change and the percent change for a specified time period. However, it is also of interest to determine the contribution specific diseases make to an overall trend in order to better understand the impact of interventions and changes in the prevalence of risk factors. The objective here is to provide a method for partitioning a linear trend in age-adjusted rates into disease-specific components. Methods: The method presented is based on linear regression. The decreasing trend in age-adjusted cancer mortality rates for the total United States during the period 1991–96 is analyzed to illustrate the method. Results: Trends in mortality for cancers of the colon/rectum, breast, lung/bronchus, and prostate are found to be responsible for 75% of the decreasing trend in cancer mortality. Conclusions: It is possible to partition an overall trend in age-adjusted rates under the assumption that it and the trends for all mutually exclusive and exhaustive subgroups of interest are linear.
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  • 6
    ISSN: 1573-7225
    Keywords: Population-based sample ; prevalent tests ; Prostate cancer ; serum prostate-specific antigen (PSA)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Trends in first-time and later PSA procedure rates are ascertained using longitudinal data from a population-based cohort. These trends are compared to trends in prostate cancer incidence to determine the role of PSA in the recent decline in prostate cancer incidence. Methods: Medicare data were linked with tumor registry data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. A 5 percent random sample (n=39985) of Medicare beneficiaries from the SEER areas without a previous diagnosis of prostate cancer as of January 1, 1988 was followed through 1994. Trends in first-time PSA use were distinguished from those of second or later for men without diagnosed prostate cancer. Results: Trends in the rate of first-time PSA procedures track closely with trends in prostate cancer incidence rates, increasing until 1992 and decreasing thereafter. Similar patterns were observed by race and age group. Geographic variability in the dissemination of PSA screening was observed, yet the association between testing and incidence remained. Men in the cohort had a 4.7 percent chance of being diagnosed within three months of an initial PSA test, with the percentage falling for subsequent tests. Conclusions: It is informative to distinguish first from later tests when assessing the effect of the diffusion of a test in a population. Taking this approach was useful in illuminating the role of PSA testing in a reversal of a long-term increase in prostate cancer incidence rates.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1572-9249
    Keywords: Life table ; incidence ; cancer prevalence ; hysterectomy prevalence ; corpus and uterus NOS cancers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Notes: Abstract Lifetime and age-conditional risk estimates of developing cancer provide a useful summary to the public of the current cancer risk and how this risk compares with earlier periods and among select subgroups of society. These reported estimates, commonly quoted in the popular press, have the potential to promote early detection efforts, to increase cancer awareness, and to serve as an aid in study planning. However, they can also be easily misunderstood and frightening to the general public. The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute and the American Cancer Society have recently begun including in annual reports lifetime and age-conditional risk estimates of developing cancer. These risk estimates are based on incidence rates that reflect new cases of the cancer in a population free of the cancer. To compute these estimates involves a cancer prevalence adjustment that is computed cross-sectionally from current incidence and mortality data derived within a multiple decrement life table. This paper presents a detailed description of the methodology for deriving lifetime and age-conditional risk estimates of developing cancer. In addition, an extension is made which, using a triple decrement life table, adjusts for a surgical procedure that removes individuals from the risk of developing a given cancer. Two important results which provide insights into the basic methodology are included in the discussion. First, the lifetime risk estimate does not depend on the cancer prevalence adjustment, although this is not the case for age-conditional risk estimates. Second, the lifetime risk estimate is always smaller when it is corrected for a surgical procedure that takes people out of the risk pool to develop the cancer. The methodology is applied to corpus and uterus NOS cancers, with a correction made for hysterectomy prevalence. The interpretation and limitations of risk estimates are also discussed.
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