Population based Cancer Registry Bavaria

Erlangen, Germany

Population based Cancer Registry Bavaria

Erlangen, Germany
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Braisch U.,Population Based Cancer Registry Bavaria | Meyer M.,Population Based Cancer Registry Bavaria | Radespiel-Troger M.,Population Based Cancer Registry Bavaria
BMC Cancer | Year: 2012

Background: With the prospect of increasing prevalence of cancer, the issue of multiple primary cancers becomes more relevant. The aim of this study was to estimate the risk of developing a tobacco-related subsequent primary cancer (TRSPC) in persons with a tobacco-related first primary cancer (TRFPC) compared with the general population in Bavaria, Germany.Methods: Using data from the Population-Based Cancer Registry Bavaria, we analyzed TRFPC and TRSPC diagnosed in Bavaria between 2002 and 2008 to estimate the relative and absolute risk of developing TRSPC using standardized incidence ratios (SIR) and excess absolute risks (EAR).Results: 121,631 TRFPC in men and 75,886 respective cancers in women were registered, which in 2.5% of male and 1.2% of female cancer patients were followed by at least one TRSPC. In both males and females, the highest increased risks compared to the general population were found within the group of cancer in the mouth/pharynx, oesophagus, larynx, and lung/bronchus.Conclusions: With respect to cancer in the mouth/pharynx, oesophagus, larynx, lung/bronchus, kidney, urinary bladder and urinary tract, smoking was confirmed as a shared risk factor based on our finding of mutually significantly increased risks of TRSPC. The results of this study illustrate the importance of smoking cessation and of continued follow-up care especially of smokers with the aforementioned TRFPC to detect TRSPC at an early stage. © 2012 Braisch et al.; licensee BioMed Central Ltd.


Braisch U.,Population Based Cancer Registry Bavaria | Meyer M.,Population Based Cancer Registry Bavaria | Radespiel-Troger M.,Population Based Cancer Registry Bavaria
European Journal of Cancer Prevention | Year: 2012

As the prevalence of prostate cancer in Germany is increasing, the issue of subsequent primary cancer (SPC) becomes more relevant. The aim of this study was to estimate the risk and its changes over time of developing SPC among prostate cancer patients compared with the general male population in Bavaria, southern Germany. Utilizing data from the Population-Based Cancer Registry Bavaria, the risk of SPC was evaluated in 59 259 men with prostate cancer diagnosed between 2002 and 2008 who contributed 159 892 person-years. The relative and absolute risk of developing SPC were calculated using the standardized incidence ratio (SIR) and the excess absolute risk. Changes in the risk were examined by plotting the SIR and its 95% confidence interval against time after the diagnosis of prostate cancer. The overall risk of SPC was significantly increased by 14% compared with the general male population. With regard to specific cancer types, a significantly increased risk of SPC was found for the urinary bladder, kidney, pancreas, melanoma of skin, leukemia, myeloma, brain/nervous system, renal pelvis/ureter, thyroid, and the small intestine. The absolute risk of SPC for most cancer types, however, was below 10 cases per 10 000 person-years. A significantly decreased risk of SPC was found in the lung/bronchus and the liver. Although detection bias cannot be excluded as a contributing factor for our results, we recommend continuing follow-up care of prostate cancer patients particularly with respect to SPC of the urinary system as a precaution. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Keller A.K.,Friedrich - Alexander - University, Erlangen - Nuremberg | Uter W.,Friedrich - Alexander - University, Erlangen - Nuremberg | Pfahlberg A.B.,Friedrich - Alexander - University, Erlangen - Nuremberg | Radespiel-Troger M.,Population based Cancer Registry Bavaria | And 2 more authors.
Melanoma Research | Year: 2015

Seasonal variation in melanoma diagnoses has been observed in numerous studies that used calendar time indicators. Depending on the latitude (and altitude) of the study region, the magnitude of seasonal and year-to-year variation of ultraviolet radiation (UVR) is neglected in these studies. An alternative approach comprises the direct incorporation of UVR measurements into such analyses. The aim of this investigation is a comparative evaluation of these approaches. The population-based Bavarian cancer registry recorded 11 901 incident melanoma cases between 2003 and 2008 that were used for the analysis. UVR intensity data for the same period were available from the solar radiation station at Munich-Neuherberg. Negative binomial regression modelling yielded adjusted relative risks (RR) controlled for year of diagnosis and age in 16 subgroups defined by sex, Breslow thickness and localization. Overall, the analyses showed slightly differing yet consistent results for exposure effects in subgroups. Melanoma evolving on the extremities showed the most pronounced association with increasing level of the UV index among men [e.g. RR=1.086, 95% confidence interval (CI) 1.0541.119, and RR=1.102, 95% CI 1.0461.161, for thin and thick melanoma on the upper limbs, respectively] and women (e.g. RR=1.088, 95% CI 1.0581.119, and RR=1.056, 95% CI 1.0101.103, for thin and thick melanoma on the lower limbs, respectively). Our analysis provides a benchmark for international comparisons and synthesis of epidemiologic evidence of seasonal variability in melanoma diagnoses. Future studies should use direct UVR measures to enable pooling of risk estimates and resolve remaining inconsistencies potentially resulting from latitudinal differences in exposure between international studies. © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Chen T.,Zhejiang University | Chen T.,German Cancer Research Center | Jansen L.,German Cancer Research Center | Gondos A.,German Cancer Research Center | And 6 more authors.
European Journal of Cancer Prevention | Year: 2013

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. © 2012 Lippincott Williams & Wilkins.


Keller A.K.,Friedrich - Alexander - University, Erlangen - Nuremberg | Uter W.,Friedrich - Alexander - University, Erlangen - Nuremberg | Pfahlberg A.B.,Friedrich - Alexander - University, Erlangen - Nuremberg | Radespiel-Troger M.,Population Based Cancer Registry Bavaria | Gefeller O.,Friedrich - Alexander - University, Erlangen - Nuremberg
Melanoma Research | Year: 2013

Ultraviolet radiation is an established skin carcinogen. By analysing the seasonality of melanoma diagnoses, the effect of this risk factor can be examined indirectly. However, previous studies yielded conflicting results, because of vastly differing analytical methods and diverse study designs. Therefore, to validate the findings by Chaillol and colleagues based on 3868 melanoma diagnoses from Northern Ireland, we used an identical methodology to examine the seasonal effects on monthly incidences of 11 901 cutaneous malignant melanoma cases registered from 2003 until 2008 in Bavaria, Germany. Multivariable regression models for count data were used to estimate the effect of seasons while taking into account sex, age, year of diagnosis, Breslow thickness and anatomical site. Point and interval estimates of the adjusted relative risks associated with seasons were compared with the findings of the Irish study. Both analyses demonstrated a promoting effect of intermittent ultraviolet radiation on cutaneous melanoma of a thickness of 2 mm or less evolving on the extremities, whereas no seasonality for melanomas on the trunk was evident. Differences were identified with regard to thick melanomas. In the present analysis, only melanomas with a Breslow thickness of more than 2 mm were also found to be associated with season, in particular, the melanomas on the limbs. Hence, in contrast to the data of, and to the interpretation by, Chaillol and colleagues, an effect of ultraviolet radiation on melanoma progression from thin to thick cannot be excluded. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Geiss K.,Population Based Cancer Registry Bavaria | Meyer M.,Population Based Cancer Registry Bavaria
Computer Methods and Programs in Biomedicine | Year: 2013

Standardized mortality ratios and standardized incidence ratios are widely used in cohort studies to compare mortality or incidence in a study population to that in the general population on a age-time-specific basis, but their computation is not included in standard statistical software packages. Here we present a user-friendly Microsoft Windows program for computing standardized mortality ratios and standardized incidence ratios based on calculation of exact person-years at risk stratified by sex, age and calendar time. The program offers flexible import of different file formats for input data and easy handling of general population reference rate tables, such as mortality or incidence tables exported from cancer registry databases. The application of the program is illustrated with two examples using empirical data from the Bavarian Cancer Registry. © 2013 Elsevier Ireland Ltd.


Radespiel-Troger M.,Population based Cancer Registry Bavaria | Meyer M.,Population based Cancer Registry Bavaria
International Archives of Occupational and Environmental Health | Year: 2013

Objective: To evaluate the possible association between uranium (U) content in public drinking water on the one hand and the risk of cancer of the colorectum, lung, female breast, prostate, kidney, and urinary bladder, total cancer, and leukemia on the other hand in Bavaria, an ecologic study on the level of municipalities was performed. Methods: Cancer incidence data for the years 2002-2008 were obtained from the population-based cancer registry Bavaria according to sex. Current U content data of public drinking water on the level of municipalities were obtained from a publicly available source. The possible association between drinking water U content and cancer risk adjusted for average socio-economic status was evaluated using Poisson regression. Results: Drinking water U content was below 20 μg/L in 458 out of 461 included municipalities. We found a significantly increased risk of leukemia in men in the intermediate (U level, 1.00-4.99 μg/L; relative risk [RR], 1.14) and in the highest U exposure category (U level, ≥5 μg/L; RR, 1.28). Moreover, in women, a significantly elevated risk was identified with respect to kidney cancer in the highest exposure category (RR, 1.16) and with respect to lung cancer in the intermediate exposure category (RR, 1.12). Conclusion: The slightly increased risk of leukemia in men, kidney cancer in women, and lung cancer in women may require further investigation. If an increased cancer risk is confirmed, preventive measures (e.g., introduction of U filters in public water systems) may be considered. © 2012 Springer-Verlag.


Radespiel-Troger M.,Population Based Cancer Registry Bavaria | Meyer M.,Population Based Cancer Registry Bavaria | Fenner M.,Friedrich - Alexander - University, Erlangen - Nuremberg
Journal of Cranio-Maxillofacial Surgery | Year: 2012

Objective: To examine possible geographic differences and time trends of intraoral cancer (IOC) incidence and mortality in Bavaria between 2002 and 2008. Methods: Incidence data for IOC (ICD-10 codes, C01-C06) were obtained from the population-based cancer registry Bavaria. Age-specific and age-standardised IOC incidence and mortality rates in Bavaria and its regions were calculated separately by sex and year of diagnosis. Results: We found an excess incidence of 34% and 25% among men and women in Upper Franconia compared to Bavaria. Incidence and mortality related to IOC in Bavaria are comparable to those found in other European cancer registries. IOC mortality appears to decrease over time in both sexes, whereas IOC incidence appears to decrease only in men. Conclusions: The observed geographic differences with respect to IOC incidence and mortality in Bavaria may possibly be explained in part by socioeconomic differences. © 2011 European Association for Cranio-Maxillo-Facial Surgery.


PubMed | Population Based Cancer Registry Bavaria
Type: Journal Article | Journal: European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) | Year: 2012

As the prevalence of prostate cancer in Germany is increasing, the issue of subsequent primary cancer (SPC) becomes more relevant. The aim of this study was to estimate the risk and its changes over time of developing SPC among prostate cancer patients compared with the general male population in Bavaria, southern Germany. Utilizing data from the Population-Based Cancer Registry Bavaria, the risk of SPC was evaluated in 59 259 men with prostate cancer diagnosed between 2002 and 2008 who contributed 159 892 person-years. The relative and absolute risk of developing SPC were calculated using the standardized incidence ratio (SIR) and the excess absolute risk. Changes in the risk were examined by plotting the SIR and its 95% confidence interval against time after the diagnosis of prostate cancer. The overall risk of SPC was significantly increased by 14% compared with the general male population. With regard to specific cancer types, a significantly increased risk of SPC was found for the urinary bladder, kidney, pancreas, melanoma of skin, leukemia, myeloma, brain/nervous system, renal pelvis/ureter, thyroid, and the small intestine. The absolute risk of SPC for most cancer types, however, was below 10 cases per 10 000 person-years. A significantly decreased risk of SPC was found in the lung/bronchus and the liver. Although detection bias cannot be excluded as a contributing factor for our results, we recommend continuing follow-up care of prostate cancer patients particularly with respect to SPC of the urinary system as a precaution.


PubMed | Population based cancer registry Bavaria
Type: Journal Article | Journal: International archives of occupational and environmental health | Year: 2013

To evaluate the possible association between uranium (U) content in public drinking water on the one hand and the risk of cancer of the colorectum, lung, female breast, prostate, kidney, and urinary bladder, total cancer, and leukemia on the other hand in Bavaria, an ecologic study on the level of municipalities was performed.Cancer incidence data for the years 2002-2008 were obtained from the population-based cancer registry Bavaria according to sex. Current U content data of public drinking water on the level of municipalities were obtained from a publicly available source. The possible association between drinking water U content and cancer risk adjusted for average socio-economic status was evaluated using Poisson regression.Drinking water U content was below 20 g/L in 458 out of 461 included municipalities. We found a significantly increased risk of leukemia in men in the intermediate (U level, 1.00-4.99 g/L; relative risk [RR], 1.14) and in the highest U exposure category (U level, 5 g/L; RR, 1.28). Moreover, in women, a significantly elevated risk was identified with respect to kidney cancer in the highest exposure category (RR, 1.16) and with respect to lung cancer in the intermediate exposure category (RR, 1.12).The slightly increased risk of leukemia in men, kidney cancer in women, and lung cancer in women may require further investigation. If an increased cancer risk is confirmed, preventive measures (e.g., introduction of U filters in public water systems) may be considered.

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