1999-2009 Cancer Statistics Released (U.S.)

1999-2009 Cancer Statistics Released


Centers for Disease Control and Prevention (CDC) sent this bulletin at 01/09/2013 11:51 AM EST

The United States Cancer Statistics (USCS): 1999–2009 Incidence and Mortality Web-based Report marks the eleventh time that the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) have jointly produced official federal cancer incidence statistics for each state having high-quality cancer data. The report is produced in collaboration with the North American Association of Central Cancer Registries.
This year's report features information on more than one million invasive cancer cases diagnosed during 2009 among residents of 49 states, six metropolitan areas, and the District of Columbia. Incidence data are from CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology and End Results (SEER) Program. Data from population-based central cancer registries in these states and metropolitan areas meet the selected criteria for inclusion in this report.
The report also provides cancer mortality data collected and processed by CDC's National Center for Health Statistics (NCHS). Mortality statistics, based on records of deaths that occurred during 2009, are available for all 50 states and the District of Columbia.

Report Highlights

• Cancer rates by race and ethnicity (all cancers combined)
• Cancer rates by state (all cancers combined)
• Cancer among men
• Cancer among women
• Racial or ethnic variations
• Geographic variations

DNA pioneer James Watson takes aim at cancer establishments

http://mobile.reuters.com/article/idUSBRE90805N20130109?irpc=932


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THEONCOLOGIST : Is Renal Thrombotic Angiopathy an Emerging Problem in the Treatment of Ovarian Cancer Recurrences?

Is Renal Thrombotic Angiopathy an Emerging Problem in the Treatment of Ovarian Cancer Recurrences?

http://m.theoncologist.alphamedpress.org/content/17/12/1534.full

The Oncologist, discusses a series of articles on pegylated liposomal doxorubicin (PLD) and its relation to ovarian cancer and other cancers.

Dr. Bruce A. Chabner, Editor-in-Chief of The Oncologist, discusses a series of articles on pegylated liposomal doxorubicin (PLD) and its relation to ovarian cancer and other cancers.

Ovarian cancer is the second most common gynecological cancer in women and is often not diagnosed until it's at stage III. Most patients require surgery, along with chemotherapy, but in a majority of patients, the cancer still recurs. Additional preventative maintenance with pegylated liposomal doxorubicin (PLD) can be prescribed long-term to try to avert such recurrence. However, critical side effects are emerging, providing a significant opportunity for researchers to examine the safety versus the efficacy of PLD. Specifically, chronic kidney disease (CKD), as well as oral squamous cell carcinoma (SCC) have been noted in patients who have received long-term treatment with PLD.   Go to the special series on PLD >>>   This special series includes two research articles and three letters to the Editor, all published in the December issue of The Oncologist.

http://m.theoncologist.alphamedpress.org/site/misc/PLD_articles.xhtml?utm_source=iContact&utm_medium=email&utm_campaign=Newsletter@The%2520Oncologist.com&utm_content=December+Newsletter+In+Production

Tumour DNA alone doesn’t explain cancer, study shows - The Globe and Mail

http://m.theglobeandmail.com/life/health-and-fitness/health/conditions/tumour-dna-alone-doesnt-explain-cancer-study-shows/article6333442/?service=mobile


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Ovarian Cancer and Us - blogger's note: future blog postings

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PET/CT Pinpoints Physiological Evidence of Chemo Brain : IMNG Oncology Report

PET/CT Pinpoints Physiological Evidence of Chemo Brain : IMNG Oncology Report

open access: Clear Cell Carcinomas of the Mullerian System: Does the Pathogenesis Vary Depending on Their Nuclear Grade and Their Association with Endometriosis? An Immunohistochemical Analysis abstract & full text

Clear Cell Carcinomas of the Mullerian System: Does the Pathogenesis Vary Depending on Their Nuclear Grade and Their Association with Endometriosis? An Immunohistochemical Analysis

Abstract:
 Clear cell carcinomas (CCC) of the mullerian system are considered high grade tumors, but morphologically, the cells of CCC show both low and high grade features. The aims of the current study were to categorize CCC into low and high nuclear grade types, correlate their association with endometriosis, and then observe possible variations in pathogenesis based on their expression of p53 and Ki-67.
    We studied 41 pure mullerian CCCs and designated each as either a high (HNG) or low (LNG) nuclear grade tumor. Morphologically, 17 (41%) CCCs were LNG and 24 (59%) were HNG. Nine (38%) HNG and 2 (12%) LNG tumors showed positive immunostaining with p53. Endometriosis was associated with 8 (47%) LNG tumors and 8 (33%) HNG CCCs. Of the 11 cases with p53 alteration, 4 (1 LNG and 3 HNG) were associated with endometriosis.

Conclusions:

HNG CCCs, irrespective of their association with endometriosis, have alterations of p53. In general, LNG ovarian and endometrial CCCs, irrespective of their association with endometriosis/adenomyosis, are less likely to show p53 alteration. It appears that mullerian CCCs may have variable pathogenesis depending on their nuclear grade and association with endometriosis. A larger study is needed to validate these findings.

Improving detection of Lynch syndrome using a reflex immunohistochemistry algorithm for all patients with newly diagnosed colorectal cancer. ASCO Meeting Abstracts

Improving detection of Lynch syndrome using a reflex immunohistochemistry algorithm for all patients with newly diagnosed colorectal cancer.


Conclusions: Our system-based screening algorithm using reflex immunohistochemistry of four MMR proteins has resulted in excellent detection rate of approximately 4% to 5% (5 out of 116 cases), consistent with the expected Lynch syndrome prevalence rate in the population. This represents a marked improvement over our previous family history-based approach in Lynch syndrome screening.

Abstract presentation from the 2012 ASCO Quality Care Symposium

Research Participants' High Expectations of Benefit in Early-Phase Oncology Trials: Are We Asking the Right Question?

Research Participants' High Expectations of Benefit in Early-Phase Oncology Trials: Are We Asking the Right Question?

Conclusion In early-phase oncology trials, patients' reported expectations of benefit differed according to how patients were queried and were associated with patient characteristics. These findings have implications for how informed consent is obtained and assessed. 

open access: Clinical Cancer Advances 2012: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology

Blogger's Note: see section on gynecologic cancers; also genitourinary cancers (Lynch syndrome patients) including BRCA's; notable absence of specific Lynch Syndrome mutations (via search)

Clinical Cancer Advances 2012: Annual Report onProgress Against Cancer From the American Society ofClinical Oncology

open access: PLOS ONE: Drug Cocktail Optimization in Chemotherapy of Cancer

 Blogger's Note: focus is on leukemia however many drugs discussed are used in other cancers including solid tumors

PLOS ONE: Drug Cocktail Optimization in Chemotherapy of Cancer

Background

In general, drug metabolism has to be considered to avoid adverse effects and ineffective therapy. In particular, chemotherapeutic drug cocktails strain drug metabolizing enzymes especially the cytochrome P450 family (CYP). Furthermore, a number of important chemotherapeutic drugs such as cyclophosphamide, ifosfamide, tamoxifen or procarbazine are administered as prodrugs and have to be activated by CYP. Therefore, the genetic variability of these enzymes should be taken into account to design appropriate therapeutic regimens to avoid inadequate drug administration, toxicity and inefficiency.

Objective

The aim of this work was to find drug interactions and to avoid side effects or ineffective therapy in chemotherapy.

Data sources and methods

Information on drug administration in the therapy of leukemia and their drug metabolism was collected from scientific literature and various web resources. We carried out an automated textmining approach. Abstracts of PubMed were filtered for relevant articles using specific keywords. Abstracts were automatically screened for antineoplastic drugs and their synonyms in combination with a set of human CYPs in title or abstract.

Results

We present a comprehensive analysis of over 100 common cancer treatment regimens regarding drug-drug interactions and present alternatives avoiding CYP overload. Typical concomitant medication, e.g. antiemetics or antibiotics is a preferred subject to improvement. A webtool, which allows drug cocktail optimization was developed and is publicly available on http://bioinformatics.charite.de/chemoth​erapy.

Editor: Daotai Nie, Southern Illinois University School of Medicine, United States of America
Received: August 6, 2012; Accepted: October 29, 2012; Published: December 7, 2012

Funding: This work was supported by Berliner Krebsgeselleschaft, DFG Graduate School 1776, BMBF MedSys, EU SynSys. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Shooting down the (Toronto) Star's story on breakthrough breast cancer drug

Shooting down the Star's story on breakthrough breast cancer drug

open access: Fertility Preservation and Pregnancy in Women With and Without BRCA Mutation–Positive Breast Cancer

Fertility Preservation and Pregnancy in Women With and Without BRCA Mutation–Positive Breast Cancer

Access to Palliative Care Before Death Among Patients Treated at a Comprehensive Cancer Center

Access to Palliative Care Before Death Among Patients Treated at a Comprehensive Cancer Center

MedBlog » Social Security’s complete list of diseases and conditions under Compassionate Allowances program

194. Ureter cancer – with distant metastases or inoperable, unresectable or recurrent

http://blog.chron.com/medblog/2012/12/social-securitys-complete-list-of-diseases-and-conditions-that-fall-under-compassionate-allowances-program/

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Patient Reported Outcomes of a Randomized, Placebo-Controlled Trial of Bevacizumab in the Front-Line Treatment of Ovarian Cancer: A Gynecologic Oncology Group Study

Patient Reported Outcomes of a Randomized, Placebo-Controlled Trial of Bevacizumab in the Front-Line Treatment of Ovarian Cancer: A Gynecologic Oncology Group Study

Available online 4 December 2012
Publication year: 2012
Source:Gynecologic Oncology

Purpose To analyze quality of life (QOL) in a randomized, placebo-controlled phase III trial concluding that the addition of concurrent and maintenance bevacizumab (Arm 3) to carboplatin and paclitaxel prolongs progression-free survival in front-line treatment of advanced ovarian cancer compared to chemotherapy alone (Arm 1) or chemotherapy with bevacizumab in cycles 2-6 only (Arm 2). Patients and Methods The Trial Outcome Index of the Functional Assessment of Cancer Therapy-Ovary (FACT-O TOI) was used to assess QOL before cycles 1, 4, 7, 13, and 21; and 6 months after completing study therapy. Differences in QOL scores were assessed using a linear mixed model, adjusting for baseline score, and age. The significance level was set at 0.0167 to account for multiple comparisons. Results 1693 patients were queried. Arm 2 (p<0.001) and Arm 3 (p<0.001) reported lower QOL scores than those in Arm 1. The treatment differences were observed mainly at cycle 4, when the patients receiving bevacizumab (Arm 2 and Arm 3) reported 2.72 points (98.3% CI: 0.88 ~ 4.57; effect size=0.18) and 2.96 points (98.3% CI: 1.13~4.78; effect size=0.20) lower QOL respectively, than those in Arm 1. The difference in QOL scores between Arm 1 and Arm 3 remained statistically significant up to cycle 7. The percentage of patients who reported abdominal discomfort dropped over time, without significant differences among study arms. Conclusion The small QOL difference observed during chemotherapy did not persist during maintenance bevacizumab.

Highlights

► Quality of life in a 3 arm randomized, placebo-controlled phase III trial of bevacizumab plus chemotherapy was analyzed. ► 1,693 patients were queried. Arm 2 (p<0.001) and Arm 3 (p<0.001) reported lower QOL scores than Arm 1 (placebo). ► These differences were not clinically meaningful

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Gene expression microarray-based assay to determine tumor site of origin in a series of metastatic tumors to the ovary and peritoneal carcinomatosis of suspected gynecologic origin

Gene expression microarray-based assay to determine tumor site of origin in a series of metastatic tumors to the ovary and peritoneal carcinomatosis of suspected gynecologic origin

January 2013
Publication year: 2013
Source:Human Pathology, Volume 44, Issue 1

The origin of the primary tumor is sometimes difficult to determine in peritoneal and ovarian metastases. A series of 25 metastatic tumors to the ovary and 7 cases of peritoneal carcinomatosis of suspected gynecologic origin were collected. Total RNA was extracted from frozen tumor tissue and studied by the Tissue of Origin-Frozen test, a microarray-based gene expression test from Pathwork Diagnostics (Redwood City, CA). Independently, formalin-fixed, paraffin-embedded tumor tissue was subjected to pathologic analysis. Immunohistochemical stains included keratins 7 and 20, estrogen and progesterone receptors, CDX2, villin, CEA, WT-1, TTF-1, mammoglobin, GCDF-15, and CD31. Clinical data were considered as gold standard, and after clinicopathologic evaluation, the tissue of origin was found in 29 cases. The Tissue of Origin-Frozen test correctly identified the ovary as site of origin in 7 of 7 peritoneal carcinomatosis cases, whereas immunohistochemical stains only allowed appropriate recognition in 5. In addition, the Tissue of Origin-Frozen test identified correctly the site of origin in 18 of the 22 metastatic tumors to the ovary with known origin. In the remaining 4 tumors, the correct origin was the second option in 2 cases and was not determined in the other 2. Immunohistochemistry correctly identified the site of origin in 17 of these 22 ovarian metastases. A combination of Tissue of Origin-Frozen and immunohistochemistry correctly identified the site of origin in 19 of 22 ovarian metastases of known origin. Although conventional pathologic examination and immunohistochemistry are commonly used for assessing the tumor site of origin, Tissue of Origin testing can be useful in difficult cases.

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Is ATP7B a Predictive Marker in Patients With Ovarian Carcinoma Treated With Platinum-Taxane Combination Chemotherapy?

Is ATP7B a Predictive Marker in Patients With Ovarian Carcinoma Treated With Platinum-Taxane Combination Chemotherapy?

Objective: This study examined the prognostic significance of copper-transporting P-type adenosine triphosphatase (ATP7B) expression in patients with ovarian carcinoma treated with platinum-taxane combination chemotherapy.
Methods: Expression of ATP7B in ovarian carcinoma was assessed by immunohistochemistry and clinical data collected by retrospective review of medical charts.
Results: Overexpression of ATP7B was identified in 25 (29.1%) of 86 ovarian carcinomas. The frequency of ATP7B expression in clear cell carcinomas was significantly higher than that in serous high-grade carcinomas (P < 0.05). We observed no statistically significant correlations between high ATP7B protein expression and either disease-free survival (P = 0.722) or overall survival (P = 0.389).
Conclusions: Our study is the first to demonstrate a lack of statistically significant differences between ATP7B positive and negative cases with respect to prognosis of patients with ovarian carcinoma treated with a platinum-taxane combination regimen. However, that ATP7B expression in clear cell carcinomas was significantly higher than that in serous carcinomas may partially explain the difference in chemotherapeutic response and prognosis between patients with these 2 types of carcinomas.
Copyright (C) 2012 by IGCS and ESGO

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Prognostic Role of Hormone Receptors in Ovarian Cancer: A Systematic Review and Meta-Analysis

Prognostic Role of Hormone Receptors in Ovarian Cancer: A Systematic Review and Meta-Analysis

Objective: The aim of this study was to summarize the global predicting role of hormone receptors for survival in ovarian cancer.
Methods: Eligible studies were identified and assessed for quality through multiple search strategies. Data were collected from studies comparing overall or progression-free/disease-free/relapse-free survival in patients with elevated levels of estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER2) with those in patients with lower levels. Studies were pooled, and combined hazards ratios (HRs) of ER, PR, and HER2 for survival were calculated, respectively.
Results: A total of 35 studies were included for meta-analysis (23 for ER, 19 for PR, and 8 for HER2). For overall survival, the pooled HR of PR reached 0.88 [95% confidence interval (CI), 0.82-0.95], which means that elevated PR level could significantly indicate better survival. In contrast, elevated levels of HER2 could predict worse outcome with an HR of 1.41 (95% CI, 1.05-1.89). Increased level of ER was not significantly prognostic (HR, 0.94; 95% CI, 0.87-1.01). For progression-free survival/disease-free survival/recurrence-free survival, elevated PR level also had predictive value for better outcome with a pooled HR of PR of 0.80 (95% CI, 0.67-0.95). Oppositely, elevated HER2 level could predict poorer outcome with an HR of 1.55 (95% CI, 1.11-2.16). Estrogen receptor failed to predict outcome with an HR of 0.90 (95% CI, 0.78-1.03).
Conclusions: In patients with ovarian cancer, elevated level of PR predicted favorable survival, and elevated level of HER2 was associated with worse survival.
Copyright (C) 2012 by IGCS and ESGO

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Complications of lymphadenectomy for gynecologic cancer

Complications of lymphadenectomy for gynecologic cancer

January 2013
Publication year: 2013
Source:European Journal of Surgical Oncology (EJSO), Volume 39, Issue 1

Introduction Symptomatic postoperative lymphocysts (SPOLs) and lower-limb lymphedema (LLL) are probably underestimated complications of lymphadenectomy for gynecologic malignancies. Here, our objective was to evaluate the incidence and risk factors of SPOLs and LLL after pelvic and/or aortocaval lymphadenectomy for gynecologic malignancies. Methods Single-center retrospective study of consecutive patients who underwent pelvic and/or aortocaval lymphadenectomy for ovarian cancer, endometrial cancer, or cervical cancer between January 2007 and November 2008. The incidences of SPOL and LLL were computed with their 95% confidence intervals (95%CIs). Multivariate logistic regression was performed to identify independent risk factors for SPOL and LLL. Results We identified 88 patients including 36 with ovarian cancer, 35 with endometrial cancer, and 17 with cervical cancer. The overall incidence of SPOL was 34.5% (95%CI, 25–45) and that of LLL was 11.4% (95% confidence interval [95%CI], 5–18). Endometrial cancer was independently associated with a lower risk of SPOL (adjusted odds ratio [aOR], 0.09; 95%CI, 0.02–0.44) and one or more positive pelvic nodes with a higher risk of SPOL (aOR, 4.4; 95%CI, 1.2–16.3). Multivariate logistic regression failed to identify factors significantly associated with LLL. Conclusion Complications of lymphadenectomy for gynecologic malignancies are common. This finding supports a more restrictive use of lymphadenectomy or the use of less invasive techniques such as sentinel node biopsy.

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Risks of Less Common Cancers in Proven Mutation Carriers With Lynch Syndrome [Epidemiology]

Risks of Less Common Cancers in Proven Mutation Carriers With Lynch Syndrome [Epidemiology]

Purpose

Patients with Lynch syndrome are at high risk for colon and endometrial cancer, but also at an elevated risk for other less common cancers. The purpose of this retrospective cohort study was to provide risk estimates for these less common cancers in proven carriers of pathogenic mutations in the mismatch repair (MMR) genes MLH1, MSH2, and MSH6.

Patients and Methods

Data were pooled from the German and Dutch national Lynch syndrome registries. Seven different cancer types were analyzed: stomach, small bowel, urinary bladder, other urothelial, breast, ovarian, and prostate cancer. Age-, sex- and MMR gene–specific cumulative risks (CRs) were calculated using the Kaplan-Meier method. Sex-specific incidence rates were compared with general population incidence rates by calculating standardized incidence ratios (SIRs). Multivariate Cox regression analysis was used to estimate the impact of sex and mutated gene on cancer risk.

Results

The cohort comprised 2,118 MMR gene mutation carriers (MLH1, n = 806; MSH2, n = 1,004; MSH6, n = 308). All cancers were significantly more frequent than in the general population. The highest risks were found for male small bowel cancer (SIR, 251; 95% CI, 177 to 346; CR at 70 years, 12.0; 95% CI, 5.7 to 18.2). Breast cancer showed an SIR of 1.9 (95% CI, 1.4 to 2.4) and a CR of 14.4 (95% CI, 9.5 to 19.3). MSH2 mutation carriers had a considerably higher risk of developing urothelial cancer than MLH1 or MSH6 carriers.

Conclusion

The sex- and gene-specific differences of less common cancer risks should be taken into account in cancer surveillance and prevention programs for patients with Lynch syndrome.

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Email for clinical communication between patients/caregivers and healthcare professionals - The Cochrane Library

Email for clinical communication between patients/caregivers and healthcare professionals - The Cochrane Library

Plain language summary

Using email for patients/caregivers and healthcare professionals to contact each other

Email is widely used in many sectors and lots of people use it in their day to day lives. The use of email in health care is not yet so common, although one use for it is for patients/caregivers and healthcare professionals to contact each other. This review examines how patients, healthcare professionals and health services may be affected by using email in this way. We looked for trials examining the use of email for patients/caregivers and healthcare professionals to contact each other and found nine trials with 1733 participants in total.
Eight of the trials looked at email compared with standard methods of communication. Where email was compared to standard methods of communication we found that we could not properly determine what effect email was having on patient/caregiver outcomes, as there were missing data and the results of the different studies varied. For health service use outcomes the situation was the same, but some results seemed to show that an email intervention may lead to an increased number of emails and telephone calls being received by healthcare professionals.
One of the trials looked at email counselling compared with telephone counselling. We found that it only looked at patient outcomes, and found few differences between groups. Where there were differences these showed that telephone counselling leads to greater changes in lifestyle than email counselling.
None of the trials measured how email affects healthcare professionals and only one measured whether email can cause harm. All of the trials were biased in some way and when we measured the quality of all of the results we found them to be of low or very low quality. As a result the results of this review should be viewed with caution.
The nature of the results means that we cannot make any recommendations for how email might best be used in clinical practice. Future research should make allowances for how quickly technology changes, and should consider how much email would cost to introduce and what effect it has on the use of healthcare resources. Research reports should be sure to clearly report their methods and findings, and researchers interested in carrying out research in this area should be assisted in developing ideas and put them into action.

Class of Drugs Widely Prescribed for Insomnia and Anxiety Associated With Increased Risk of Fatal « news@JAMA

Class of Drugs Widely Prescribed for Insomnia and Anxiety Associated With Increased Risk of Fatal « news@JAMA