Sarkis'siz Sarkis tartışması

Taha Toros Arşivi, Dosya No: 454-Sarkisİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Halk resmi, minyatür geleneği ve Gül Derman'ın yapıtları

Taha Toros Arşivi, Dosya No: 10-Gül Dermanİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Cancer recording and mortality in the General Practice Research Database and linked cancer registries.

PURPOSE: Large electronic datasets are increasingly being used to evaluate healthcare delivery. The aim of this study was to compare information held by cancer registries with that of the General Practice Research Database (GPRD). METHODS: A convenience sample of 101 020 patients aged 40+ years drawn from GPRD formed the primary data source. This cohort was derived from a larger sample originally established for a cohort study of diabetes. GPRD records were linked with those from cancer registries in the National Cancer Data Repository (NCDR). Concordance between the two datasets was then evaluated. For cases recorded only on one dataset, validation was sought from other datasets (Hospital Episode Statistics and death registration) and by detailed analysis of a subset of GPRD records. RESULTS: A total of 5797 cancers (excluding non-melanomatous skin cancer) were recorded on GPRD. Of these cases, 4830 were also recorded on NCDR (concordance rate of 83.3%). Of the 976 cases recorded on GPRD but not on NCDR, 528 were present also in the hospital records or death certificates. Of the 341 cases recorded on NCDR but not on GPRD, 307 were recorded in these other two datasets. Rates of concordance varied by cancer type. Cancer registries recorded larger numbers of patients with lung, colorectal, and pancreatic cancers, whereas GPRD recorded more haematological cancers and melanomas. As expected, GPRD recorded significantly more non-melanomatous skin cancer. Concordance decreased with increasing age. CONCLUSION: Although concordance levels were reasonably high, the findings from this study can be used to direct efforts for better recording in both datasets

The relationship of malignant melanoma, basal and squamous skin cancers to indoor and outdoor work.

An analysis of occupational incidence data for malignant melanomas and squamous-and basal-self carcinomas of the skin in England and Wales from 1970 to 1975 is reported. The occupational pattern for melanomas of the trunk and limbs differed markedly from the pattern for melanomas of the head, face and neck. Office work was associated with a large excess of melanomas of the trunk and limbs. In contrast, outdoor work was associated with an excess of melanomas of the head, face and neck; and was also associated with an excess of squamous-and basal-cell carcinomas of the skin. This suggests that prolonged occupational exposure to sunlight is an important cause of squamous-and basal-cell carcinomas and of melanomas of the head, face and neck, but not of melanomas on other parts of the body. The high rate of lesions on the trunk and limbs in office workers may reflect their sunbathing or other recreational habits; but it contrasts clearly with other indoor work, where there is a generally low rate of all forms of skin cancer

Breast cancer mortality rates are levelling off or beginning to decline in many western countries: analysis of time trends, age-cohort and age-period models of breast cancer mortality in 20 countries.

Age-standardised mortality rates for breast cancer were examined for 20 countries in Europe, North America, Australia and New Zealand from 1950 to 1992 and age-birth cohort and age-period of death models were fitted to the data. Breast cancer mortality rates generally increased in the earlier decades, but more recently rates have levelled off or begun to decline in most countries. Only in 4 of the 20 countries studied, Belgium, Hungary, Poland and Spain, was there no evidence of a decline or leveling off or mortality in recent birth cohorts or in recent years. In the other countries the decline in mortality appeared to be in part due to birth cohort effects and in part due to period effects. The birth cohort effects were suggestive of a decline in breast cancer rates among women born after about 1920 and were evident in many countries especially Canada, The Netherlands, The United Kingdom and the United States. The decline in mortality in women born after 1920 appeared to be in part related to a reduction in childlessness and a reduction in age at first birth in those generations. As well as the birth cohort effects, there was some evidence of a recent overall decline in mortality rates in several countries, e.g. Austria, FRG, Greece and the UK, and this may be due to an increase in survival resulting from improved management and treatment of women with breast cancer