Differences in Prostate Cancer Incidence and Mortality in Lower Saxony (Germany) and Groningen Province (Netherlands):Potential Impact of Prostate-Specific Antigen Testing

BACKGROUND: Prostate cancer (PCa) is the most frequent cancer among men in Europe. Differences in PCa incidence around the world can be partly explained by variations in recommendations for prostate-specific antigen (PSA), particularly for early detection. For example, the PSA testing policy is more conservative in the Netherlands than in Germany. To better understand the relationship between PSA testing recommendations and PCa incidence, stage distribution, and mortality, we compared these variables over time between Lower Saxony in northwestern Germany and the neighboring province of Groningen in the Netherlands. METHODS: Population data, tumor stage- and age group-specific PCa incidence (ICD-10 C61) and mortality rates for Lower Saxony and Groningen were obtained from the Lower Saxony Epidemiological Cancer Registry, the Netherlands Comprehensive Cancer Organization, and Statistics Netherlands for 2003–2012. Incidence and mortality rates per 100,000 person-years were age-standardized (ASR, old European standard). Trends in age-standardized incidence rates (ASIR) and mortality rates (ASMR) for specific age groups were assessed using joinpoint regression. RESULTS: The mean annual PCa ASIR between 2003 and 2012 was on average 19.9% higher in Lower Saxony than in Groningen (120.5 vs. 100.5 per 100,000), while the mean annual ASMR was on average 24.3% lower in Lower Saxony than in Groningen (21.5 vs. 28.4 per 100,000). Between 2003 and 2012, the average annual percentage change (AAPC) in PCa incidence rates did not change significantly in either Lower Saxony (−1.8%, 95% CI −3.5, 0.0) or Groningen (0.2%, 95% CI −5.0, 5.7). In contrast, the AAPC in mortality rate decreased significantly during the same time period in Lower Saxony (−2.5%, 95% CI −3.0, −2.0) but not in Groningen (0.1%, 95% CI −2.4, 2.6). CONCLUSIONS: Higher PCa incidence and lower PCa-related mortality was detected in Lower Saxony than in Groningen. Although recommendations on PSA testing may play a role, the assessed data could not offer obvious explanations to the observed differences. Therefore, further investigations including data on the actual use of PSA testing, other influences (e.g., dietary and ethnic factors), and better data quality are needed to explain differences between the regions

Changes in food and nutrient intake of 6- to 17-year-old Germans between the 1980s and 2006

Objective: To compare the food consumption and nutrient intakes of German children and adolescents in the 1980s with present dietary habitsDesign: Two cross-sectional representative surveys, the German National Food Consumption Study (Nationale Verzehrsstudie, NVS) from 1985-8 and the nutrition module 'EsKiMo' of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2006, were analysed for differences in food and nutrient intakes stratified by age and sex groups. Setting: Secondary analyses of data from representative observational studies. Subjects: Children and adolescents aged 6-17 years living in Germany in the 1980s (n 2265) and in 2006 (n 2506). Results: Food consumption was characterised by higher amounts of vegetables/pulses, fruits/nuts and beverages and less meat products/sausages, butter, fats/oils, potatoes/potato products and bread/pastries in 2006 than in 1985-8. The overall changes in food intake were reflected in improvements of macronutrient composition, increased water intake and lower energy density of the diet. Intake of most vitamins and minerals increased in relation to energy intake, but the nutrient density of the diet for vitamins B12 and D decreased. The most critical nutrients observed in NVS and EsKiMo were folate, vitamin D, vitamin A, vitamin E, Ca and Fe. In addition, dietary fibre intake was relatively low and fatty acid and carbohydrate compositions were not favourable. Conclusions: Further efforts will be necessary to improve dietary habits among children and adolescents

Trinkverhalten von Jugendlichen in Deutschland

Die regelmäßige und ausreichende Flüssigkeitszufuhr ist wesentlicher Bestandteil einer gesunden Ernährung und insbesondere in der Wachstumsphase von großer Bedeutung. Getränke haben je nach Art und Häufigkeit des Konsums unterschiedlichsten Einfluss auf die Gesundheit. Repräsentative Daten aus EsKiMo (Ernährungsstudie als KiGGS-Modul) geben einen aktuellen Einblick in das Trinkverhalten der Jugendlichen in Deutschland. Die Ergebnisse der 1272 Teilnehmer zwischen 12 und 17 Jahren werden hier vorgestellt. Im Durchschnitt liegen die Flüssigkeitsmengen, die mit nichtalkoholischen Getränken aufgenommen werden, bei diesen Jugendlichen über den DGE-Empfehlungen. Erfreulicherweise werden hauptsächlich Mineral- bzw. Leitungswasser getrunken. Vor allem die über 15-Jährigen trinken – was allerdings nicht erwünscht ist – ebenfalls große Mengen Softdrinks. Die Mittelwerte für die Aufnahme alkoholischer Getränke sind insbesondere bei den 16- bzw. 17-jährigen Jungen mit 179 bzw. 285 ml/Tag hoch und resultieren größtenteils aus dem Konsum von Bier.A regular and adequate intake of liquids is an essential part of a healthy diet and is particularly important during the growth stage. Depending on the type and the frequency of consumption, different beverages impact on health in different ways. Representative data collected in EsKiMo (Eating Study as a KiGGS Module) provide an up-to-date overview of drinking behaviour among adolescents in Germany. The results collected from 1272 participants aged between 12 and 17 years are presented in this paper. The median intake of nonalcoholic liquids from these adolescents exceeds the current German recommendations. It is pleasing to report that the main drinks in the study population are mineral water and tapwater. Those aged 15 and over also consume large quantities of soft drinks, however, which is not desirable. The average intake of alcoholic drinks is high among boys of 16 and 17, at 179 ml and 285 ml per day, respectively, mainly in the form of beer

Supplementenkonsum bei Jugendlichen in Deutschland

Im Jahr 2006 nahmen 20 % der Jugendlichen im Alter von 12–17 Jahren Supplemente ein. Supplemente wurden häufiger von körperlich-sportlich Aktiven sowie von Gymnasiasten eingenommen. Ein Großteil der Supplementnehmer verwendete ein einziges Präparat mit nur einem Nährstoff. Es war aber auch häufig die Einnahme eines Präparates mit mehreren Nährstoffen festzustellen. Am meisten wurde Vitamin C supplementiert, gefolgt von Magnesium, B-Vitaminen, Vitamin E und Kalzium.In 2006, 20 % of adolescents aged 12–17 years used dietary supplements. Persons with high physical activity levels as well as those with high education levels consumed dietary supplements more often than others. Many supplement users used only one single-nutrient supplement. A similarly large proportion of users consumed one supplement with multiple nutrients. Most often supplements containing vitamin C, magnesium, B-vitamins, vitamin E and calcium were used

EsKiMo – Das Ernährungsmodul im Kinder- und Jugendgesundheitssurvey (KiGGS)

Im Rahmen des bundesweiten Kinder- und Jugendgesundheitssurveys (KiGGS) wurde von Januar bis Dezember 2006 in einem Modul das Ernährungsverhalten von 6- bis 17-Jährigen erfasst. Die Studie mit dem Namen EsKiMo (Ernährungsstudie als KiGGS-Modul) wurde vom Robert Koch-Institut (RKI) gemeinsam mit der Universität Paderborn, Fachgruppe Ernährung und Verbraucherbildung, durchgeführt und vom Bundesministerium für Ernährung, Lebensmittel und Verbraucherschutz finanziert. Die Eltern der teilnehmenden Kinder unter 12 Jahren wurden gebeten, gemeinsam mit ihrem Kind ein 3-Tage-Verzehrsprotokoll zu führen. Die älteren Kinder wurden persönlich mit Hilfe von DISHES (Dietary Interview Software for Health Examination Studies) zu ihrer Ernährung in den letzten 4 Wochen befragt. Außerdem sollten sie einen bereits im KiGGS eingesetzten Ernährungsfragebogen (Food Frequency Questionnaire) ein zweites Mal ausfüllen. Zusätzlich kam bei allen Teilnehmern ein Kurzfragebogen zum Einsatz, in dem unter anderem soziodemographische Daten, Aspekte der Freizeitgestaltung, Supplementeinnahme, Verpflegung in der Schule sowie Körpergröße und -gewicht erhoben wurden. Die Studie wird aktuelle, repräsentative Daten zur Ernährung von Kindern und Jugendlichen in Deutschland liefern. Diese werden sowohl hinsichtlich der Lebensmittelverzehrsmengen als auch Nährstoffversorgung ausgewertet. Durch die Verbindung der Ernährungsdaten mit den im KiGGS erhobenen Gesundheitsdaten sind außerdem umfangreiche Analysen zum Zusammenhang zwischen Ernährung und Gesundheit möglich. Schlüsselwörter Gesundheitssurvey - Kinder - Jugendliche - Ernährungsepidemiologie - ErnährungserhebungsmethodenIn a module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), the dietary behaviour of 6–17-year-olds was assessed from January to December 2006. The study, named EsKiMo (Eating Study as a KiGGS Module), was performed by the Robert Koch Institute together with the division of nutrition and consumer education at the University of Paderborn. It was funded by the Federal Ministry of Food, Agriculture and Consumer Protection. Parents of participants younger than 12 years were asked to conduct a 3-day dietary record. Participants of 12 years and older were personally interviewed about their eating behaviour during the last four weeks using DISHES (Dietary Interview Software for Health Examination Studies). In addition, they were asked to fill in the KiGGS food frequency questionnaire a second time. Furthermore, all participants were asked about their socio-demographic background, leisure time activities, supplement use, meals at school, body weight and height. The study will provide up-to-date, representative data on the nutrition of children and adolescents in Germany. The analyses will include the amounts of foods and food groups consumed as well as the nutrient intake. By connecting these nutrition data with other health data from KiGGS, comprehensive analyses of relationships between nutrition and health are possible. Keywords Health survey - Children - Adolescents - Nutritional epidemiology - Dietary assessment method

Survival of malignant mesothelioma and other rare thoracic cancers in Germany and the United States: A population‐based study

Evidence on survival of malignant mesothelioma (MM) and other rare thoracic cancers is limited due to the rarity of these cancer sites. Here, we provide a comprehensive overview of MM incidence and survival after MM and other rare thoracic cancers in Germany and the United States (US). Incidence was estimated from a German National Cancer Database and from the Surveillance, Epidemiology and End Results (SEER) 18 database for 2000–2014. Patients diagnosed in 1997–2013 with malignant epithelial tumors of the trachea (Etra), epithelial tumors of the thymus (Ethy) and MM were extracted from a German cancer survival database and from the SEER 13 database. Period analysis was employed to compute 5‐year relative survival (RS). During 2000–2014, an annual average of 0.9 and 0.6 MM cases per 100,000 person‐years was diagnosed in Germany and the US. Rates decreased in Germany and in the US. Patients with Ethy had highest 5‐year RS with US patients surviving longer (69.1% compared to 63.7%, p = 0.02). Survival after Etra was comparable in both countries (Germany 33.6%, US 34.4%, p = 0.07). Survival in MM patients was poor overall (Germany 11.8%, US 12.1%, p < 0.01). Survival improvements were only observed in MM patients in Germany (10.8% [2002–2007] vs. 13.0% [2008–2013], p < 0.01). The lack of progress in survival for Etra and Ethy patients underlines the need of novel preventive, therapeutic and diagnostic approaches. MM incidence significantly decreased in Germany and in the US. Further monitoring of MM incidence is warranted given that a peak in incidence is expected in 2020–2030 in Western countries