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Hertrampf K.,University of Kiel | Wiltfang J.,University of Kiel | Katalinic A.,Institute for Cancer Epidemiology | Wenz H.-J.,University of Kiel
Journal of Cancer Research and Clinical Oncology | Year: 2012

Purpose: Oral and pharyngeal cancer is the seventh leading tumour in Europe. In Germany, more than 10,000 new cancer cases are diagnosed each year. This populationbased project evaluated the available data to develop a more detailed epidemiological profile of oral and pharyngeal cancer. Methods: The data on incidence and mortality rates of the population-based Cancer Registry of Schleswig-Holstein were evaluated according to tumour sites, tumour stages and residential areas by age groups and gender from 2000 to 2006 and the tumour stages from 2000 to 2007. Results: From 2000 to 2006, 3,127 new cases of oral and pharyngeal cancer (72% in men vs. 28% in women) were registered. About 50% of all cases, in men and women, were between 60 and 79 years. This detailed analysis of tumour sites and tumour stages showed interesting differences and revealed considerable variations. The highest incidence rates for both men and women were diagnosed in stage IV for older people, in women for oral cancer and men for pharyngeal cancer. The highest incidence and mortality trends were observed in urban areas. Conclusions: Detailed population-based results described important variations with regard to tumour sites, stages and areas. These data play a central role as they provide the epidemiological profile of a tumour. This profile, together with possible targeted knowledge evaluations of the public and the health care providers involved, can be used as a prerequisite for health care activities and for the development of preventive strategies for targeted public awareness campaigns. © Springer-Verlag 2011.

PubMed | Institute for Cancer Epidemiology
Type: Journal Article | Journal: European journal of epidemiology | Year: 2010

Leukemia is the most frequent malignancy in children under the age of 15 years. The question of whether childhood leukemia has a tendency for clustering or forms clusters has been studied for several decades. The environmental risk factor discussed most often is infection, which might result in spatial clustering and space-time clusters. The German Childhood Cancer Registry provided data on 11,946 children with leukemia diagnosed during 1987-2007, as classified in the International Classification for Childhood Cancer (third edition), aggregated by municipality. We used the Potthoff-Whittinghill model to test for a general trend for clustering and the spatial scan statistic to search for localized clusters. No evidence of global clustering was found, neither for the whole study population nor in sub-groups by age, period or population density, or for different types of leukemia. A similar result was found for localized clusters. The analysis shows no evidence of a tendency to clustering, however, aggregation of data at the municipality level might have diluted small localized clusters. The results of this study do not provide support for the hypothesis of an infectious or a spatial environmental etiology of childhood leukemia.

The purpose of this register-based study was to identify factors related to disease, treatment, sociodemographics and comorbidity associated with taking early retirement among women treated for breast cancer, and to evaluate the risk for taking early retirement among breast cancer survivors who attended a six-day rehabilitation course.The study population consisted of 856 women who attended the rehabilitation course and a comparison group of 1 805 women who did not attend the course identified through the Danish Breast Cancer Cooperative Group. We obtained information on receipt of unemployment benefits, sickness benefits and early retirement pension for each of the years 1996-2007. Multivariate cox-regression models were used to analyze disease-specific, treatment-related, comorbidity and sociodemographics factors associated with early retirement after breast cancer and to evaluate the effect of attending a rehabilitation course on taking early retirement.The rate of retirement was higher for women with somatic comorbidity (hazard ratio [HR], 1.91; 95% CI, 1.3; 2.9 for score 1, and HR 1.42; 95% CI, 0.7; 2.7 for score 2), previous depression (HR, 2.29; 95% CI, 1.7; 3.2) or having received sickness benefits in the year before their breast cancer diagnosis (HR, 3.75; 95% CI, 1.8; 7.8). Living with a partner was associated with a reduced hazard ratio for taking early retirement (HR, 0.70; 95% CI, 0.5-0.9). Having received chemotherapy, alone or in combination with anti-hormone treatment, reduced the hazard ratio (HR, 0.49; 95% CI, 0.3; 0.8 and HR, 0.5; 95% CI, 0.3; 0.8, respectively). The rate of retirement was higher for women the year after attending the rehabilitation course but returned to unity by three years.The results of this study contribute to the identification of at-risk women and point to the need for tailored rehabilitation to avoid unnecessary marginalization of breast cancer survivors due to permanent labor market withdrawal.

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