Epidemiology of invasive cutaneous melanoma

Data are presented on the current incidence of melanoma with recent and predicted future trends illustrating a likely continuing increase in incidence. Risk factors for developing melanoma are discussed, including current known melanoma susceptibility genes. Phenotypic markers of high-risk subjects include high counts of benign melanocytic naevi. Other risk factors considered include exposure to natural and artificial ultraviolet radiation, the effect of female sex hormones, socioeconomic status, occupation, exposure to pesticides and ingestion of therapeutic drugs including immunosuppressives and non-steroidal anti-inflammatory drugs. Aids to earlier diagnosis are considered, including public education, screening and use of equipment such as the dermatoscope. Finally, the current pattern of survival and mortality is described

Exhumation of the Inyo Mountains, California: Implications for the Timing of Extension along the Western Boundary of the Basin and Range Province and Distribution of Dextral Fault Slip Rates across the Eastern California Shear Zone

New geologic mapping, tectonic geomorphologic, 10Be terrestrial cosmogenic nuclide, and (U-Th)/He zircon and apatite thermochronometric data provide the first numerical constraints on late Cretaceous to late Quaternary exhumation of the Inyo Mountains and vertical slip and horizontal extension rates across the eastern Inyo fault zone, California. The east-dipping eastern Inyo fault zone bounds the eastern flank of the Inyo Mountains, a prominent geomorphic feature within the western Basin and Range Province and eastern California shear zone. (U-Th)/He zircon and apatite thermochronometry yield age patterns across the range that are interpreted as indicating: (1) two episodes of moderate to rapid exhumation associated with Laramide deformation during the late Cretaceous/early Tertiary; (2) development of a slowly eroding surface during a prolonged period from early Eocene to middle Miocene; (3) rapid cooling, exhumation, and initiation of normal slip along the eastern Inyo fault zone, accommodated by westward tilting of the Inyo Mountains block, at 15.6 Ma; and (4) rapid cooling, exhumation, and renewed normal slip along the eastern Inyo fault zone at 2.8 Ma. Fault slip continues today as indicated by fault scarps that cut late Pleistocene alluvial fan surfaces. The second episode of normal slip at 2.8 Ma also signals onset of dextral slip along the Hunter Mountain fault, yielding a Pliocene dextral slip rate of 3.3 ± 1.0 mm/a, where a is years. Summing this dextral slip rate with estimated dextral slip rates along the Owens Valley, Death Valley, and Stateline faults yields a net geologic dextral slip rate across the eastern California shear zone of 9.3 + 2.2/–1.4 to 9.8 + 1.4/–1.0 mm/a

Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Background Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. Methods Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995-99, 2000-04, and 2005-09), sex, and age at diagnosis (< 1, 1-4, 5-9, and 10-14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Findings We analysed data from 89 828 children from 198 registries in 53 countries. During 1995-99, 5-year agestandardised net survival for all lymphoid leukaemias combined ranged from 10.6% (95% CI 3.1-18.2) in the Chinese registries to 86.8% (81.6-92.0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005-09, when age-standardised survival for lymphoid leukaemias ranged from 52.4% (95% CI 42.8-61.9) in Cali, Colombia, to 91.6% (89.5-93.6) in the German registries, and for AML ranged from 33.3% (18.9-47.7) in Bulgaria to 78.2% (72.0-84.3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000-04 and 2005-09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1-4 and 5-9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. Interpretation Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood survival

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2)

Objective Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis. We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role this may play in international variation in survival. Methods The CONCORD programme is the largest population-based study of global trends in cancer survival. Data on 681,759 women diagnosed during 1995â\u80\u932009 with cancer of the ovary, fallopian tube, peritoneum and retroperitonum in 51 countries were included. We categorised ovarian tumours into six histological groups, and explored the worldwide distribution of histology. Results During 2005â\u80\u932009, type II epithelial tumours were the most common. The proportion was much higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America (65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time. Conclusions The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions

40Ar/39Ar geochronology of mafic volcanism in the back-arc region of southern Puna plateau, Argentina

Late Cenozoic back-arc mafic volcanism in the southern Puna plateau of Argentina offers insights into the state of the mantle under the world’s second largest continental plateau. Previous studies of the mafic magmas in this region proposed a scenario of mantle melting due to lithospheric delamination and/or steepening of the subducting slab. However, few of the centers have been precisely dated, which limits any geodynamic interpretation. We present results of laser incremental-heating 40Ar/39Ar dating of 22 back-arc centers in the southern Puna, with emphasis on the Salar de Antofalla region where volcanic activity was most intense. Three localities yielded ages between 7.3 and 7.0 Ma which, along with 2 previous 7 Ma ages, firmly establishes that back-arc activity began as early as late Miocene. Volcanism continued through the Pleistocene but the peak was in the early Pliocene. This result has important tectonic implications. If, as previously suggested, magma genesis is related to lithospheric delamination, this process was underway by the latest Miocene in the southern Puna. Furthermore, since the mafic back-arc volcanism is considered to mark a change in fault kinematics from compressional to transtensional, the new age constraints indicate that this change took place in the early Pliocene. The spatial and age distributions of the mafic centers indicate that magmatism began, and remained focussed in, a region between Salar de Antofalla and Cerro Galán. This concentration is probably structurally controlled, as it corresponds to the intersection of the NW–SE striking Archibarca lineament zone and the sets of NNE–SSW faults that run parallel to the Salar de Antofalla basin