Cancer patterns in four districts of the Transkei region 1991-1995

Background. Oesophageal cancer (OC) is an important public health problem among the Xhosa-speaking people of the Transkei region in the Eastern Cape Province, South Africa, with incidence rates for males among the highest in the world.Objectives. To record the occurrence of cancer among men and women of all ages in four districts in the Transkei during the period 1991 - 1995, to identify common cancers and to compare the variations in cancer incidences in this region with incidences in Africa and the rest of the world.Design. Cancer registration of cases reported from all clinics and hospitals was conducted in the four selected districts.Setting. The districts included Centane (Kentani), Butterworth, Bizana and Lusikisiki in the Transkei region.Methods. Active and passive methods were used to collect data, which were analysed using the Statistical Analyses Systems (SAS) package.Results. The mean annual number of all cancer cases reported was 310, with age-standardised incidence rates (ASIRs, world standard) of 98.2/100 000 and 74.3/100 000 for males and females, respectively. The most frequently reported cancer was OC, with mean annual ASIRs of 76.6/100 000 and 36.5/100 000 for males and females, respectively, with a male/female ratio of 2:1.Conclusion. The present data confirm previous reports that OC rates in Centane have consistently remained very high, whereas time-dependent changes in the incidence of OC have occurred in Butterworth, Bizana and Lusikisiki suggesting changes in the risk determinants in these districts

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)

Background: Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods: We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results: The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines