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Sankaranarayanan R.,International Agency for Research on Cancer | Swaminathan R.,Cancer Institute WIA | Brenner H.,German Cancer Research Center | Chen K.,Tianjin Medical University | And 25 more authors.
The Lancet Oncology | Year: 2010

Background: Population-based cancer survival data, a key indicator for monitoring progress against cancer, are not widely available from countries in Africa, Asia, and Central America. The aim of this study is to describe and discuss cancer survival in these regions. Methods: Survival analysis was done for 341 658 patients diagnosed with various cancers from 1990 to 2001 and followed up to 2003, from 25 population-based cancer registries in 12 countries in sub-Saharan Africa (The Gambia, Uganda), Central America (Costa Rica), and Asia (China, India, Pakistan, Philippines, Saudi Arabia, Singapore, South Korea, Thailand, Turkey). 5-year age-standardised relative survival (ASRS) and observed survival by clinical extent of disease were determined. Findings: For cancers in which prognosis depends on stage at diagnosis, survival was highest in China, South Korea, Singapore, and Turkey and lowest in Uganda and The Gambia. 5-year ASRS ranged from 76-82% for breast cancer, 63-79% for cervical cancer, 71-78% for bladder cancer, and 44-60% for large-bowel cancers in China, Singapore, South Korea, and Turkey. Survival did not exceed 22% for any cancer site in The Gambia; in Uganda, survival did not exceed 13% for any cancer site except breast (46%). Variations in survival correlated with early detection initiatives and level of development of health services. Interpretation: The wide variation in cancer survival between regions emphasises the need for urgent investments in improving awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources. Funding: Association for International Cancer Research (AICR; St Andrews, UK), Association pour la Recherche sur le Cancer (ARC, Villejuif, France), and the Bill & Melinda Gates Foundation (Seattle, USA). © 2010 Elsevier Ltd. All rights reserved.


Law S.C.,Hong Kong Cancer Registry
IARC scientific publications | Year: 2011

The Hong Kong cancer registry was established in 1963, and cancer registration is done by passive and active methods. The registry contributed data on 45 cancer sites or types registered during 1996-2001 for this survival study. Follow-up has been carried out by passive methods with median follow-up ranging from 4-60 months. The proportion of cases with histologically verified cancer diagnosis ranged from 38-100%; death certificates only (DCOs) ranged from 0-11%; 83-99% of total registered cases were included for survival analysis. The 5-year age-standardized relative survival exceeded 100% for lip and non-melanoma skin followed by thyroid (94%) and testicular (92%) cancers. The corresponding survival for common cancers were breast (90%), colon (61%), liver and Lung (22%), nasopharynx (70%), rectum (59%) and stomach (39%). The 5-year relative survival by age group showed a decreasing trend with increasing agegroups for most cancers. A decreasing survival with increasing clinical extent of disease was noted.


Mang O.W.-K.,Hong Kong Cancer Registry | Yue L.,Workplace Safety and Insurance Board
European Journal of Cancer | Year: 2013

Background: Nasopharyngeal carcinoma (NPC) shows a male predominance in incidence while the underlying reasons have rarely been explored. Methods: We analysed incident cases of NPC recorded in Hong Kong Cancer Registry during the period 1983-2008. All cases were divided into 5-year age groups. Age group specific incidence rates of NPC by sex and male to female ratios in incidence rate by age group were calculated. A curve fitting approach was taken to quantitatively describe the age-specific incidence rates of NPC using non-linear regressions. Results: During the period 1983-2008, a total of 27,579 new cases of NPC were identified (20,060 males and 7519 females) in Hong Kong. The overall male to female ratio of the annual age-standardised incidence rates of NPC ranged 2.2-3.1. The male to female ratio of NPC incidence increased with age until peaking at ages 55-59 years and showed a decline thereafter. An additional minor increase at ages 15-19 years was also observed. Modelling of the age-specific incidence curves suggested divergent slopes for men and women and a delay in increasing incidence with age among females, by around 5-10 years before menopause ages. Conclusion: The age-dependent pattern of the sex difference in the incidence of NPC could not be completely explained by known risk factors for NPC. The contributions of intrinsic exposures, such as sex hormones, merit consideration and further investigations. © 2012 Elsevier Ltd. All rights reserved.


Kwong A.,University of Hong Kong | Mang O.W.K.,Hong Kong Cancer Registry | Wong C.H.N.,University of Hong Kong | Chau W.W.,University of Hong Kong
Annals of Surgical Oncology | Year: 2011

Background: Cancer registries have been set up worldwide to provide information for cancer health planning. There are known variations in breast cancer incidence and mortality worldwide. However, breast cancer incidence, pathological characteristics, and survival data is still underreported in Asian countries. This is the first comprehensive population-based breast cancer study performed using population database of the Hong Kong Cancer Registry. Methods: A retrospective review of medical records of 8,961 subjects who were diagnosed with breast cancer between January 1, 1997 to December 31, 2001 and followed up to December 31, 2007. Descriptive statistics were employed to analyze the epidemiological and clinical data. Estimates of overall, disease-free, and cancer-specific survival at 5 years were estimated by the Kaplan-Meier method and stage-specific relative survival rates were calculated. Results: A total of 7,630 breast cancer patients' medical records and dataset were available during this period, and 7,449 subjects were eligible for the final analysis. Median follow-up was 84 months. A total of 47.4% were diagnosed with breast cancer at age 49 years and younger;22.2%, 46.9%, 10.8%, and 4.1% presented at stages I, II, III, and IV, respectively. A total of 53.5% had ER-positive cancer, and 20.3% had HER2-positive cancers;13.4% had triplenegative cancers. The relative, cancer-specific, and diseasefree survival rates at 5 years were 84%, 85.2%, and 81.2%, respectively. Discussion. We performed the first comprehensive population-based breast cancer epidemiology study in Southern China using the Hong Kong Cancer Registry database. This provides a baseline study cohort for comparative studies with other Asian countries and Chinese who have migrated to the West. © The Author(s) 2011. This article is published with open access at Springerlink.com.


Shin H.-R.,International Agency for Research on Cancer | Shin H.-R.,National Cancer Center | Joubert C.,International Agency for Research on Cancer | Boniol M.,International Agency for Research on Cancer | And 18 more authors.
Cancer Causes and Control | Year: 2010

Background: Incidence of breast cancer is rising in Asian countries, and breast cancer is the most common cancer among Asian women. However, there are few recent descriptive reports on the epidemiology of breast cancer among Eastern and Southeastern Asian populations. Methods: We examined incidence trends for invasive breast cancer in women aged ≥20 years from 15 registries in Eastern (China, Japan, the Republic of Korea, Taiwan) and Southeastern Asia (the Philippines, Singapore, Thailand) for the period 1993-2002 mainly using data from Cancer Incidence in Five Continents, Volumes VIII and IX. We compared trends in annual incidence rates and age-specific incidence curves over a 10-year period. We also compared the incidence rates of Asian-Americans with the rates of their Asian counterparts. Results: Breast cancer incidence rates increased gradually over time in all study populations. Rates were relatively high in Southeastern Asia and became progressively lower along a south-to-north gradient, with a fourfold geographic variation within the study populations. Age-specific incidence curves showed patterns that gradually changed according to incidence rates. Breast cancer incidence among Asian women living in the United States was 1.5-4 times higher than the corresponding incidence rate in the women's respective countries of origin. Conclusion: Breast cancer incidence is expected to continue to increase for the next 10 years in Asia and may approach rates reported among Asian-Americans. The number and mean age of breast cancer cases is expected to increase as the female Asian population ages, the prevalence of certain risk factors changes (early menarche, late menopause, low parity, late age at first live birth, and low prevalence of breastfeeding), and as Asian countries introduce mass screening programs. © 2010 Springer Science+Business Media B.V.

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