• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.157-162
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• 2015

The descriptive epidemiological study aimed to analyse the mortality trends from gynaecological cancer in Serbia. Average annual percentage of change (AAPC) and the corresponding 95% confidence intervals (CIs) were computed for trend using joinpoint regression analysis. Nearly 25,000 gynaecological cancer deaths occurred in Serbia during the 1991-2010 period, with the average annual age-standardised mortality rate being 17.2 per 100,000 women. Increase of mortality was observed for cancer of the vulva and vagina (AAPC=+1.3%, 95% CI=0.1 to 2.6), ovarian cancer (AAPC=+0.8%, 95% CI=0.4-1.3) and for cervical cancer (AAPC=+0.7%, 95% CI=0.3 to 1.1). Mortality rates for gynaecological cancer overall declined in women aged 30-39 years, but mortality was increased in middle-aged women (for cervical cancer) and in the elderly (for ovarian cancer). Improvements to and implementation of the national cervical cancer screening programme conducted in 2013 and expected to be finalised in the following years throughout Serbia should contribute to improvement.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7759-7763
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• 2015

Background: Leukemia accounts for 8% of total cancer cases and involves all age groups with different prevalence and incidence rates in Iran and the entire world and causes a significant death toll and heavy expenses for diagnosis and treatment processes. This study was done to evaluate epidemiology and morphology of blood cancer during 2003-2008. Materials and Methods: This cross-sectional study was carried out based on re-analysis of the Cancer Registry Center report of the Health Deputy in Iran during a 6-year period (2003 - 2008). Statistical analysis for incidence time trends and morphology change percentage was performed with joinpoint regression analysis using the software Joinpoint Regression Program. Results: During the studied years a total of 18,353 hematopoietic and reticuloendothelial system cancers were recorded. Chi square test showed significant difference between sex and morphological types of blood cancer (P-value<0.001). Joinpoint analysis showed a significant increasing trend for the adjusted standard incidence rate (ASIR) for both sexes (P-value<0.05). Annual percent changes (APC) for women and men were 18.7 and 19.9, respectively. The most common morphological blood cancers were ALL, ALM, MM and CLL which accounted for 60% of total hematopoietic system cancers. Joinpoint analyze showed a significant decreasing trend for ALM in both sexes (P-value<0.05). Conclusions: Hematopoietic system cancers in Iran demonstrate an increasing trend for incidence rate and decreasing trend for ALL, ALM and CLL morphology.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7569-7573
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• 2014

The main objective of this study was to analyze the mortality trends of female breast cancer in Turkey between the years 1987-2008. The rates per 100,000 age-standardized to the European standard population were assessed and time trends presented using joinpoint regression analysis. Average annual percent change (AAPC), anual percent change (APC) and 95% confidence interval (CI) was calculated. Nearly 23,000 breast cancer deaths occurred in Turkey during the period 1987-2008, with the average annual age-standardized mortality rate (ASR) being 11.9 per 100,000 women. In the last five years, significant increases were observed in all age groups, but there was no significant change over the age of 65. In this period, the biggest significant increase was in the 45-54 age group (AAPC=4.3, 95%CI=2.6 to 6.0).

• Journal of Gastric Cancer
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• 제17권4호
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• pp.319-330
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• 2017

Introduction: The extent of lymphadenectomy in the surgical treatment of gastric cancer is a topic of controversy among surgeons. This study was conducted to analyze the American National Cancer Database (NCDB) and conclude the optimal extent of lymphadenectomy for gastric adenocarcinoma. Methods: The NCDB for gastric cancer was utilized. Patients who received at least a partial gastrectomy were included. Patients with metastatic disease, unknown TNM stages, R1/R2 resection, or treated with a palliative intent were excluded. Joinpoint regression was used to identify the extent of lymphadenectomy that reflects the optimal survival. Cox regression analysis and Bayesian information criterion were used to identify significant survival predictors. Kaplan-Meier was applied to study overall survival and stage migration. Results: 40,281 patients of 168,377 met the inclusion criteria. Joinpoint analysis showed that dissection of 29 nodes provides the optimal median survival for the overall population. Regression analysis reported the cutoff ${\geq}29$ to have a better fit in the prognostic model than that of ${\geq}15$. Dissection of ${\geq}29$ nodes in the higher stages provides a comparable overall survival to the immediately lower stage. Nonetheless, the retrieval of ${\geq}15$ nodes proved to be adequate for staging without a significant stage migration compared to ${\geq}29$ nodes. Conclusion: The extent of lymphadenectomy in gastric adenocarcinoma is a marker of improved resection which reflects in a longer overall survival. Our analysis concludes that the dissection of ${\geq}15$ nodes is adequate for staging. However, the dissection of 29 nodes might be needed to provide a significantly improved survival.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1393-1397
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• 2016

Background: Breast cancer is the most common cancer and the first cause of cancer death in women worldwide, with infiltrating duct carcinoma as the most common morphology. This study aimed to investigate trend of breast cancer incidence by age groups and histological changes in Iranian women between 2003 and 2008. Materials and Methods: This is analytic study, carried out based on re-analysis of the Cancer Registry Center report of health deputy for women's breast cancer in Iran during a 6-year period (2003-2008). Statistical analysis for incidence time trends and morphology change percentage carried out joinpoint regression analysis using the software Joinpoint Regression Program. Results: A total of 36,340 cases were reported for Iranian women in the six years. Analytical trend showed an increasing incidence trend with significant annual percentage change (APC) of 15.2 (CI: 11.6 to 18.8). The lowest and highest significant increased trend were related to age groups of 40 to 44 years and above 85 years, respectively; with APCs of 13.0 and 25.1, respectively. Of total cases, 78.7% of cases were infiltrating duct carcinoma, decreasing from 82.0% in 2003 to 76.6% in 2008, which was significant with an APC equal to -1.76 (CI:-2.7 to -0.8). Conclusions: The incidence trend of breast cancer is rising in Iranian women. The highest incidence was observed in the age groups 45-65 and 80-85. In conclusion, to reduce breast cancer incidence and its burden, preventive and screening programs for breast cancer, especially in young women, are recommended in Iran.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1493-1498
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• 2016

Background: Breast cancer is the most common cancer in women worldwide with a rising incidence rate in most countries. Considering the increase in life expectancy and change in lifestyle of Iranian women, this study investigated the age-adjusted trend of breast cancer incidence during 2000-2009 and predicted its incidence to 2020. Materials and Methods: The 1997 and 2006 census results were used for the projection of female population by age through the cohort-component method over the studied years. Data from the Iranian cancer registration system were used to calculate the annual incidence rate of breast cancer. The age-adjusted incidence rate was then calculated using the WHO standard population distribution. The five-year-age-specific incidence rates were also obtained for each year and future incidence was determined using the trend analysis method. Annual percentage change (APC) was calculated through the joinpoint regression method. Results: The bias adjusted incidence rate of breast cancer increased from 16.7 per 100,000 women in 2000 to 33.6 per 100,000 women in 2009. The incidence of breast cancer had a growing trend in almost all age groups above 30 years over the studied years. In this period, the age groups of 45-65 years had the highest incidence. Investigation into the joinpoint curve showed that the curve had a steep slope with an APC of 23.4% before the first joinpoint, but became milder after this. From 2005 to 2009, the APC was calculated as 2.7%, through which the incidence of breast cancer in 2020 was predicted as 63.0 per 100,000 women. Conclusions: The age-adjusted incidence rate of breast cancer continues to increas in Iranian women. It is predicted that this trend will continue until 2020. Therefore, it seems necessary to prioritize the prevention, control and care for breast cancer in Iran.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3951-3955
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• 2015

Background: Colorectal cancer mortality has started to decrease in several developed countries in Asia. The current study aimed to present the long-term trends in colorectal cancer mortality in Korea using joinpoint analysis and age-period-cohort modeling. Materials and Methods: The number of colorectal cancer deaths and the population for each 5-year age group were obtained from Statistics Korea for the period 1984-2013 for adults 30 years and older. Joinpoint regression analysis was conducted to determine changes in trends in age-standardized mortality rates, and age-period-cohort analysis was performed to describe trends in colorectal cancer mortality using the intrinsic estimator method. Results: In men, the age-standardized mortality rate for colorectal cancer increased from 1984 to 2003, and the mortality rates stabilized thereafter, whereas the mortality rate of colorectal cancer in women has decreased since 2004. The age-specific mortality rate of colorectal cancer increased in both men and women over time, whereas decreases in the age-specific mortality rate in younger cohorts were observed. In the age-period-cohort analysis, old age and recent period were associated with higher mortality for both men and women. The birth cohort born after 1919 showed reduced colorectal cancer mortality in both men and women. Conclusions: Our study showed a recent decreasing trend in colorectal cancer mortality in women and a stable trend in men after 2003-2004. These changes in colorectal cancer mortality may be attributed to birth cohort effects.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.10003-10008
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• 2014

Background: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. Objectives: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. Materials and Methods: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. Results: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. Conclusions: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3911-3916
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• 2012

Background: The objective of this study WAS to describe cancer incidence rates and trends among THE Hong Kong population for the period 1983-2008. Methods: Incident cases and population data from 1983 to 2008 were obtained from the Hong Kong Cancer Registry and the Census and Statistics Department, respectively. Agestandardized incidence rates (ASIR) were estimated and joinpoint regression was applied to detect significant changes in cancer morbidity. Results: For all cancers combined, the ASIR showed declining trends (1.37% in men, 0.94% in women), this also being the case for cancers of lung, liver, nasopharynx, stomach, bladder, oesophagus for both genders and cervix cancer for women. With cancer of thyroid, prostate, male colorectal, corpus uteri, ovary and female breast cancer an increase was evident throughout the period. The incidence for leukemia showed a stable trend since early 1990s, following an earlier decrease. Conclusion: Although overall cancer incidence rates and certain cancers showed declining trends, incidence trends for colorectal, thyroid and sex-related cancers continue to rise. These trends in cancer morbidity can be used as an important resource to plan and develop effective programs aimed at the control and prevention of the spread of cancer amongst the Hong Kong population. It is particularly useful in allowing projection of future burdens on the society with the increase in certain cancer incidences.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.566-573
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• 2016

대한민국은 2011년을 정점으로 대장암의 연령표준화 발생률이 감소 추세이다. 그러나 제주도 대장암의 연령표준화 발생률은 1999년부터 2013년까지 계속 증가하고 있다. 제주도는 전국 16개 주요 시도와 비교할 때 암검진율이 낮고, 음주율과 비만율이 높은 지역이다. 본 연구는 제주도 대장암 발생률을 낮추는 데 필요한 통계적 기초 자료를 파악하기 위하여 제주 지역 암센터의 암등록 사업을 통해서 조사한 1999년부터 2013년까지의 자료를 Joinpoint Regression program(Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute) Version 4.2.0 - April 2015를 이용 국가 발생률과 이원비교 일치도 분석을 했다. 제주도는 남자 결장암 연평균 변화율이 8.422%(p-value<0.000), 여자 결장암의 연평균 변화율 6.136%(p-value<0.000), 남자 직장암의 연평균 변화율 4.221%(p-value 0.003)의 영향으로 대장암 발생률이 지속해서 증가하고 있다. 연령대는 50세 이상의 결장암이 연평균 변화율 7.986%(p-value<0.000)로 중요한 변수이다. 따라서 제주도 대장암 발생률을 낮추기 위해서는 남자 직장암에 대한 전암 단계의 치료와, 50세 이상 남녀 결장암 발생률을 낮추는 것이 중요하다.