The Cancer Registry of Norway

Oslo, Norway

The Cancer Registry of Norway

Oslo, Norway
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van Luijt P.A.,Erasmus University Rotterdam | Heijnsdijk E.A.M.,Erasmus University Rotterdam | van Ravesteyn N.T.,Erasmus University Rotterdam | Hofvind S.,The Cancer Registry of Norway | de Koning H.J.,Erasmus University Rotterdam
Journal of Medical Screening | Year: 2017

Objective: Fluctuations in the incidence of breast cancer in Norway in the last three decades are partly explained by the use of hormone replacement therapy and mammography screening, but overdiagnosis has also been suggested as a cause.We assessed the trends in breast cancer incidence and overdiagnosis in Norway. Methods:We calibrated our microsimulation model to Norwegian Cancer Registration data. The model takes into account the use of mammography (both within and outside the Norwegian Breast Cancer Screening Programme) and of hormone replacement therapy.We obtained a proper fit of breast cancer incidence in recent years, when assuming an increase in the background risk for breast cancer, and estimated overdiagnosis. Results: We estimated a 2% overdiagnosis rate as a fraction of all cancers diagnosed in women aged 50-100, and a 3% overdiagnosis rate as a fraction of all cancers diagnosed in women aged 50-70 (i.e. screening age). If all of the increased incidence would be the result of the detection of slow growing tumours, these estimates were 7% and 11%, respectively. Conclusion: Besides mammography and hormone replacement therapy use, additional risk factors contributed to the sudden increase in breast cancer incidence in Norway. Overdiagnosis estimates due to screening were within the range of international plausible estimates. © The Author(s) 2016.


Lind G.E.,University of Oslo | Danielsen S.A.,University of Oslo | Ahlquist T.,University of Oslo | Merok M.A.,University of Oslo | And 12 more authors.
Molecular Cancer | Year: 2011

Background: The presence of cancer-specific DNA methylation patterns in epithelial colorectal cells in human feces provides the prospect of a simple, non-invasive screening test for colorectal cancer and its precursor, the adenoma. This study investigates a panel of epigenetic markers for the detection of colorectal cancer and adenomas.Methods: Candidate biomarkers were subjected to quantitative methylation analysis in test sets of tissue samples from colorectal cancers, adenomas, and normal colonic mucosa. All findings were verified in independent clinical validation series. A total of 523 human samples were included in the study. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the biomarker panel.Results: Promoter hypermethylation of the genes CNRIP1, FBN1, INA, MAL, SNCA, and SPG20 was frequent in both colorectal cancers (65-94%) and adenomas (35-91%), whereas normal mucosa samples were rarely (0-5%) methylated. The combined sensitivity of at least two positives among the six markers was 94% for colorectal cancers and 93% for adenoma samples, with a specificity of 98%. The resulting areas under the ROC curve were 0.984 for cancers and 0.968 for adenomas versus normal mucosa.Conclusions: The novel epigenetic marker panel shows very high sensitivity and specificity for both colorectal cancers and adenomas. Our findings suggest this biomarker panel to be highly suitable for early tumor detection. © 2011 Lind et al; licensee BioMed Central Ltd.


PubMed | The Cancer Registry of Norway and University of Oslo
Type: Journal Article | Journal: Cancer medicine | Year: 2016

Chronic lymphocytic leukemia is a disease of the elderly, and despite major advances in treatment, remains incurable. The Cancer Registry of Norway has registered data on patients with chronic lymphocytic leukemia since 1953. We aimed to analyze trends in incidence and survival of chronic lymphocytic leukemia in Norway. We identified 7664 patients reported with chronic lymphocytic leukemia to the registry between 1953 and 2012. We gathered information on sex, age at diagnosis, date of death and basis for diagnosis. The age-standardized incidence increased from 0.6/100.000 person-years in 1953 to 3.1/100,000 person-years in 2012. We found a significant decrease in median age between 1993-2002 and 2003-2012 (75 vs. 72years, 95%CI: 2.52-3.98, P<0.001). Men were diagnosed at a significantly younger age than women. Immunophenotyping has become the most important diagnostic method after 2002. Median observed survival increased from 3years in 1952-1963 to 8.5years in 2003-2012. Five- and 10-year age-standardized net survival increased throughout the whole period across age groups and reached 79% and 57%, respectively. Median observed survival was significantly shorter in men than in women in 1993-2002 (4.9 vs. 6.1years, P<0.001). The gap between survival rates for men and women was diminishing in 2003-2012 in patients younger than 60years while it remained considerable in older patients. Despite an aging Norwegian population, chronic lymphocytic leukemia (CLL) patients become younger at diagnosis. A fourfold increase in incidence, a prolonged survival, and major changes in diagnostic methods in Norway were observed.


PubMed | Karolinska Institutet, Danish Cancer Society, Copenhagen University, University of Zürich and 5 more.
Type: Journal Article | Journal: Oncotarget | Year: 2016

Knowledge on the role of genetic polymorphisms in the etiology of pediatric brain tumors (PBTs) is limited. Therefore, we investigated the association between single nucleotide polymorphisms (SNPs), identified by candidate gene-association studies on adult brain tumors, and PBT risk.The study is based on the largest series of PBT cases to date. Saliva DNA from 245 cases and 489 controls, aged 7-19 years at diagnosis/reference date, was genotyped for 68 SNPs. Data were analyzed using unconditional logistic regression.The results showed EGFRrs730437 and EGFRrs11506105 may decrease susceptibility to PBTs, whereas ERCC1rs3212986 may increase risk of these tumors. Moreover, stratified analyses indicated CHAF1Ars243341, CHAF1Ars2992, and XRCC1rs25487 were associated with a decreased risk of astrocytoma subtype. Furthermore, an increased risk of non-astrocytoma subtype associated with EGFRrs9642393, EME1rs12450550, ATMrs170548, and GLTSCRrs1035938 as well as a decreased risk of this subtype associated with XRCC4rs7721416 and XRCC4rs2662242 were detected.This study indicates SNPs in EGFR, ERCC1, CHAF1A, XRCC1, EME1, ATM, GLTSCR1, and XRCC4 may be associated with the risk of PBTs. Therefore, cell cycle and DNA repair pathways variations associated with susceptibility to adult brain tumors also seem to be associated with PBT risk, suggesting pediatric and adult brain tumors might share similar etiological pathways.


PubMed | University of California at San Francisco, Copenhagen University, Masaryk University, University of Vermont and 12 more.
Type: Journal Article | Journal: European journal of cancer (Oxford, England : 1990) | Year: 2014

Ductal carcinoma in situ (DCIS) incidence has grown with the implementation of screening and its detection varies across International Cancer Screening Network (ICSN) countries. The aim of this survey is to describe the management of screen-detected DCIS in ICSN countries and to evaluate the potential for treatment related morbidity.We sought screen-detected DCIS data from the ICSN countries identified during 2004-2008. We adopted standardised data collection forms and analysis and explored DCIS diagnosis and treatment processes ranging from pre-operative diagnosis to type of surgery and radiotherapy.Twelve countries contributed data from a total of 15 screening programmes, all from Europe except the United States of America and Japan. Among women aged 50-69 years, 7,176,050 screening tests and 5324 screen-detected DCIS were reported. From 21% to 93% of DCIS had a pre-operative diagnosis (PO); 67-90% of DCIS received breast conservation surgery (BCS), and in 41-100% of the cases this was followed by radiotherapy; 6.4-59% received sentinel lymph node biopsy (SLNB) only and 0.8-49% axillary dissection (ALND) with 0.6% (range by programmes 0-8.1%) being node positive. Among BCS patients 35% received SLNB only and 4.8% received ALND. Starting in 2006, PO and SLNB use increased while ALND remained stable. SLNB and ALND were associated with larger size and higher grade DCIS lesions.Variation in DCIS management among screened women is wide and includes lymph node surgery beyond what is currently recommended. This indicates the presence of varying levels of overtreatment and the potential for its reduction.


PubMed | Regional Reference Center for Breast Cancer Screening, University of California at San Francisco, Copenhagen University, Masaryk University and 13 more.
Type: Journal Article | Journal: European journal of cancer (Oxford, England : 1990) | Year: 2013

There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative analysis to determine variation in DCIS detection.Data were collected during 2004-2008 on number of screening examinations, detected breast cancers, DCIS cases and Globocan 2008 breast cancer incidence rates derived from national or regional cancer registers. We calculated screen-detection rates for breast cancers and DCIS.Data were obtained from 15 screening settings in 12 countries; 7,176,050 screening examinations; 29,605 breast cancers and 5324 DCIS cases. The ratio between highest and lowest breast cancer incidence was 2.88 (95% confidence interval (CI) 2.76-3.00); 2.97 (95% CI 2.51-3.51) for detection of breast cancer; and 3.49 (95% CI 2.70-4.51) for detection of DCIS.Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.


PubMed | University of Aarhus, The Cancer Registry of Norway and University of Oslo
Type: Journal Article | Journal: British journal of cancer | Year: 2016

We aimed to estimate the effect of organised mammography screening on breast cancer stage distribution by comparing changes in women eligible for screening, based on birth cohort, to the concurrent changes in younger, ineligible women.In an open cohort study in Norway, which introduced national mammography screening county-by-county from 1995 to 2004, we identified women (n=49883) diagnosed with in situ or invasive breast cancer (ICD10 codes: D05 or C50) during the period 1987-2011 and born between 1917 and 1980. We estimated relative incidence rate ratios (rIRRs) comparing the development in the screening vs historic group to the younger vs younger historic group.Including the compensatory drop, eligible women experienced a 68% higher increase in localised cancers (rIRR=1.68, 95% confidence interval (CI): 1.51-1.87) than younger women, while the increase in incidence of advanced cancers was similar (rIRR=1.11, 95% CI: 0.90-1.36). Excluding the prevalence round, eligible women experienced a 60% higher increase in localised cancers (rIRR=1.60, 95% CI: 1.42-1.79), while the increase in incidence of advanced cancers remained similar (rIRR=1.08, 95% CI: 0.86-1.35).Introduction of organised mammography screening was followed by a significant increase in localised and no change in advanced-stage cancers in women eligible for screening relative to younger, ineligible women.


PubMed | Karolinska Institutet, Danish Cancer Society, National Institute of Occupational Health, Finsen Center and 6 more.
Type: Journal Article | Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology | Year: 2016

Previous studies have evaluated the effect of medical diagnostic radiation on brain tumors. Recent cohort studies have reported an increased risk associated with exposure to head CT scans.Information regarding medical conditions, including prenatal and postnatal exposure to medical diagnostic radiation, was obtained from CEFALO, a multicenter case-control study performed in Denmark, Norway, Sweden, and Switzerland through face-to-face interview. Eligible cases of childhood and adolescent brain tumors (CABT) were ages 7 to 19 years, diagnosed between January 1, 2004 and August 31, 2008, and living in the participating countries (n = 352). The cases were matched by age, sex, and region to 646 population-based controls.Prenatal exposure to medical diagnostic radiation and postnatal exposure to X-rays were not associated with CABTs. A higher risk estimate of CABTs, although not statistically significant, was found for exposure to head CT scan (OR, 1.86; 95% confidence interval, 0.82-4.22). The associations with head injury, febrile seizure, fever in the first 12 weeks, and general anesthesia were close to unity.Prenatal or postnatal medical conditions, including medical diagnostic radiation, were not associated with CABTs. On the basis of small numbers of exposed children, we observed a nonsignificant increased risk for CT scans of the head.We have presented additional evidence, suggesting that exposure to head CT scan may be associated with the occurrence of CABTs. Cancer Epidemiol Biomarkers Prev; 26(1); 110-5. 2016 AACR.


Haraldstad K.,Oslo University College | Haraldstad K.,University of Bergen | Sorum R.,The Cancer Registry of Norway | Eide H.,Oslo University College | And 2 more authors.
Scandinavian Journal of Caring Sciences | Year: 2011

Background: Pain problems in children and adolescents have increased during the last 20years and have been identified as an important public health problem. Aims: The specific aims of the study were to study the prevalence of pain, its association with age, gender, and socio-demographics, its frequency, duration, and type. A further aim is to describe the impact of pain on daily living, perceived triggers of pain, and correspondence between parents' and children's perceptions of pain. Design: A cross-sectional study, with a descriptive, exploratory design. Settings and participants: A cluster sample of children and adolescents (age 8-18years N=1238,) and parents (n=828), from 20 randomly selected schools in a region of Norway. Methods: Data were collected using a structured self-report questionnaire, the Lübeck Pain-Screening Questionnaire (LPQ). The children filled in the questionnaires at school, while the parents completed the questionnaires at home. Results: Sixty per cent of the children and adolescents reported pain within the previous 3months. Pain increased with age, where girls aged 16-18years reported the most pain. Total prevalence of chronic pain was 21%. Children reported impact on social life; inability to pursue hobbies, disturbed sleep, absence from school, and inability to meet friends because of pain. The girls reported significantly more frequently disturbed sleep, loss of appetite, and use of medication, compared to the boys. There was little agreement between parents and children regarding pain. Conclusions: Pain is a common problem and influences the daily lives of children and adolescents. Many parents are unaware of the pain experienced by their children. There is a need for preventive programmes that also involve parents, school nurses, and teachers. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.


De Vogel S.,University of Bergen | Meyer K.,BEVITAL AS | Fredriksen A.,BEVITAL AS | Ulvik A.,BEVITAL AS | And 8 more authors.
International Journal of Epidemiology | Year: 2013

Background Although individual studies have been inconsistent, meta-analyses of epidemiological data suggest that high folate and vitamin B12 levels may be associated with increased prostate cancer risk. Methods Within JANUS, a prospective cohort in Norway (n=317 000) with baseline serum samples, we conducted a nested case-control study among 3000 prostate cancer cases and 3000 controls, matched on age and time at serum sampling, and county of residence. Using conditional logistic regression, odds ratios (OR) and 95% confidence intervals (CI) for prostate cancer risk were estimated according to quintiles of serum folate, vitamin B12, methylmalonic acid (MMA), total homocysteine (tHcy) and methionine, and according to MTHFR 677C→T genotypes. To correct for degradation during sample storage, folate concentration was measured as p-aminobenzoylglutamate (pABG) equivalents following oxidation and acid hydrolysis. Results We observed a weak positive association between folate concentration and prostate cancer risk [OR highest vs lowest quintile=1.15 (0.97-1.37), P-trend=0.04], which was more pronounced among individuals ≥50 years at inclusion [OR 1.40 (1.07-1.84), P-trend=0.02]. tHcy showed an inverse trend with risk [OR 0.92 (0.77-1.10), P-trend=0.03]. Vitamin B12, MMA and methionine concentrations were not associated with prostate cancer risk. Compared with the MTHFR 677CC genotype, the CT and TT variants, both of which were related to lower folate concentrations, were associated with reduced prostate cancer risk [OR 0.82 (0.72-0.94) and OR 0.78 (0.64-0.94), respectively]. Conclusion This large-scale population-based study suggests that high serum folate concentration may be associated with modestly increased prostate cancer risk. We did not observe an association between vitamin B12 status and prostate cancer risk. © The Author 2013; All rights reserved.

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