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End Results Program (end + result_program)
Selected AbstractsBreast cancer in men in the United States,CANCER, Issue 15 2010A population-based study of diagnosis, survival, treatment Abstract BACKGROUND: Breast cancer in men is rare, so clinical trials are not practical. Recommendations suggest treating men who are diagnosed with breast cancer using the guidelines for postmenopausal women; however, to date, no population-based studies have evaluated patterns of care. METHODS: To examine characteristics, treatment, and survival among men with newly diagnosed breast cancer, in 2003 and 2004, 512 men were identified from the Surveillance, Epidemiology and End Results Program. Data were reabstracted and therapy was verified through the patients' treating physicians. RESULTS: The majority of men (79%) were diagnosed through discovery of a breast lump or other signs/symptoms. Among men who had invasive disease, 86% underwent mastectomy, 37% received chemotherapy, and 58% received hormone therapy. In multivariate analysis, tumor size (P = .01) and positive lymph node status (P < .0001) were associated positively with the use of chemotherapy, whereas age group (P < .0001) and current unmarried status (P = .01) had negative associations. Among men who had invasive, estrogen receptor (ER)-positive/borderline tumors, the use of tamoxifen or aromatase inhibitors (AIs) was associated with age group (P = .05). Among men who had invasive disease, cancer mortality was associated with tumor size (P < .0001). Among men with ER-positive/borderline disease, increased cancer mortality was associated with tumor size (P < .0001), current unmarried status (P = .04), and decreased mortality with tamoxifen (P = .04). CONCLUSIONS: Tumor characteristics and marital status were the primary predictors of therapy and cancer mortality among men with breast cancer. Although AIs are not currently recommended, they are commonly prescribed. However, their use did not result in a decrease in cancer mortality. Research must examine the efficacy of AIs with and without gonadotropin-releasing hormone analogues. Cancer 2010. © 2010 American Cancer Society. [source] Incidence and mortality rates for colorectal cancer in Puerto Rico and among Hispanics, non-Hispanic whites, and non-Hispanic blacks in the United States, 1998-2002CANCER, Issue 13 2009Marievelisse Soto-Salgado MS Abstract BACKGROUND: Colorectal cancer (CRC) is the second most commonly diagnosed cancer in Puerto Rico (PR). In the United States, the incidence and mortality rates of CRC have great variation by sex and race/ethnicity. Age-standardized incidence and mortality rates of CRC in PR were assessed and compared with the rates among US Hispanics (USH), non-Hispanic whites (NHW), and non-Hispanic blacks (NHB) in the United States for the period from 1998 through 2002. Incidence and mortality trends and relative differences among racial/ethnic groups by sex and age were determined. METHODS: Age-standardized rates using the world standard population (ASR[World]) were based on cancer incidence and mortality data from the PR Central Cancer Registry and from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program using the direct method. The annual percentage changes (APC) and relative risks (RR) were calculated using Poisson regression models. RESULTS: During 1998 through 2002, the APC of CRC incidence and mortality increased for men in PR, whereas descending trends were observed for other racial/ethnic groups. Overall period rates indicated that, in both sexes, Puerto Ricans had CRC incidence and mortality rates similar to those for USH, but their rates were lower than those for NHW and NHB. However, Puerto Rican men and women ages 40 years to 59 years had the greatest risk of incidence and mortality compared with their USH counterparts. CONCLUSIONS: Areas of concern include the increasing trends of CRC in PR and the higher burden of the disease among young Puerto Ricans compared with the USH population. The authors concluded that further research should be performed to guide the design and implementation of CRC prevention and education programs in PR. Cancer 2009. © 2009 American Cancer Society. [source] Breast cancer incidence among American Indian and Alaska Native women: US, 1999,2004,,§CANCER, Issue S5 2008Phyllis A. Wingo PhD Abstract BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race. METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region. RESULTS. Breast cancer incidence rates among AI/AN women varied nearly 3-fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease. CONCLUSIONS. To the authors' knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening. Cancer 2008;113(5 suppl):1191,202. Published 2008 by the American Cancer Society. [source] Improved survival time: What can survival cure models tell us about population-based survival improvements in late-stage colorectal, ovarian, and testicular cancer?,CANCER, Issue 10 2008Lan Huang PhD Abstract BACKGROUND The objective of the current study was to investigate the long-term impact of treatment advances on the survival of patients with late-stage ovarian, colorectal (American Joint Committee on Cancer stage III, men), and testicular cancers by estimating the increase in the percentage cured from their disease and the change in survival time of uncured patients. METHODS Cause-specific survival data from 1973 to 2000 were obtained from the Surveillance, Epidemiology, and End Results Program. Survival cure models were fit and were used to estimate the gain in life expectancy (GLE) attributed to an increase in the fraction of cured patients and to prolonged survival among noncured patients. RESULTS Treatment improvement for ovarian cancer resulted in a total GLE of 2 years, and 80% of that GLE was because of an extension of survival time in uncured patients (from 0.9 years to 2.1 years) rather than an increased cure fraction (from 12% to 14%). In contrast, the cure rate rose from 29% to 47% for colorectal cancer, representing 82% of a 2.8-year GLE, and from 23% to 81% for testicular cancer, representing 100% of a 24-year GLE. CONCLUSIONS The current results suggested that treatment benefits for testicular and colorectal cancer in men with late-stage disease primarily are the result of increases in cure fraction, whereas survival gains for ovarian cancer occur despite persisting disease. Cure models, in combination with population-level data, provide insight into how treatment advances are changing survival and ultimately impacting mortality. Survival patterns reflect the underlying biology of response to cancer treatment and suggest promising directions for future research. Cancer 2008. Published 2008 by the American Cancer Society. [source] Age and comorbidity impact surgical therapy in older bladder carcinoma patients,,CANCER, Issue 8 2005A population-based study Abstract BACKGROUND Bladder carcinoma often occurs in older patients who also may have other comorbid conditions that could influence the administration of surgical therapy. The current study was conducted to describe the distribution of comorbid conditions in patients with bladder carcinoma and ascertain whether these conditions, as grouped by the American Society of Anesthesiologists physical status classification, affected the choice of surgical therapy. METHODS The authors examined six population-based cancer registries from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program in 1992. A total of 820 individuals age 55 years and older was found. A random sample of newly diagnosed bladder carcinoma patients were stratified according to registry, age group (ages 55,64 yrs, ages 65,74 yrs, and age 75 yrs and older), and gender. Data regarding comorbid conditions were abstracted from the medical records and merged with routinely collected cancer registry data. The main outcome measures were the prevalence and distribution of comorbid conditions, American Society of Anesthesiologists physical status classification, and the receipt of cystectomy in patients with muscle invasion. RESULTS Hypertension, chronic pulmonary disease, arthritis, and heart disease were found to affect at least 15% of the study population. Approximately 38% of patients were current or former smokers. Greater than 90% of patients with superficial disease were treated with transurethral resection alone. Among those patients with muscle invasion, only 55% of those ages 55,59 years underwent cystectomy; this percentage dropped to 4% in patients age 85 years and older. Among patients with an American Society of Anesthesiologists physical status classification of 0,2, the cystectomy rate ranged from 53% in those ages 55,59 years to 9% in those age 85 years and older. CONCLUSIONS There were no significant treatment differences noted with regard to age among patients with superficial disease. Among those patients with muscle invasion, those age 75 years and older were less likely to undergo radical cystectomy (14%) compared with patients ages 55,64 years (48%) and those ages 65,74 years (43%). Patient age may contribute to treatment decisions in patients with muscle-invasive disease, even when comorbidity is taken into account. Cancer 2005. © 2005 American Cancer Society. [source] Complications from treatment for prostate carcinoma among men in the Detroit areaCANCER, Issue 1 2002Kendra Schwartz M.D., M.S.P.H. Abstract BACKGROUND Aggressive treatment of early stage prostate carcinoma (PC) is limited primarily to two modalities: radical prostatectomy (RP) and external beam radiation therapy (RT). The authors conducted a population-based study of Detroit area men with localized PC to determine the outcome of bowel, urinary, and sexual function after aggressive treatment. METHODS Men with PC were identified through the Metropolitan Detroit Cancer Surveillance System, a member of the National Cancer Institute Surveillance, Epidemiology, and End Results Program. Patients participated in interviews about their pretreatment bowel, urinary, and sexual function approximately 9 months after treatment. The same men were asked identical questions about their function an average of 2 years after treatment. Treatment outcomes were compared for men who underwent RP and men who received RT. RESULTS Of 501 men, 398 (79.4%) participated in both interviews, 304 of whom (76.4%) had localized PC and had been treated at least 1 year previously (median, 688 days). One hundred thirty men underwent RP, and 115 men received RT. The proportion of men in the RP group who reported an increase in incontinence symptoms was significant (53.8% compared with 19.2% in the RT group; P < 0.001). Men in the RT group reported increased loose stools between the pretreatment and post-treatment interviews (5.2% vs. 29.6%; P < 0.001). Men in both the RT group and the RP group reported increases in impotence from 40% to > 75% (P < 0.001 for both). Men in the RT group were 3.6 times more likely to have bowel incontinence compared with men in the RP group (odds ratio [OR], 3.61; 95% confidence interval [95% CI], 1.54,8.47). Urinary incontinence (OR, 2.87; 95% CI, 1.52,5.44) and erection difficulty (OR, 3.98; 95% CI, 1.35,11.70) were more likely among men in the RP group. CONCLUSIONS Although patients may have recalled their baseline function as better than it was, the current results are consistent with other population-based studies of treatment outcomes among men with localized PC. They indicate that the side effects associated with treatment are greater than those based on case series. Physicians and patients should be aware of these population-based outcomes and should use them as part of the decision-making process regarding the treatment options for men with PC. Cancer 2002;95:82,9. © 2002 American Cancer Society. DOI 10.1002/cncr.10650 [source] Cancer incidence patterns among Vietnamese in the United States and Ha Noi, Vietnam,INTERNATIONAL JOURNAL OF CANCER, Issue 4 2002Gem M. Le Abstract Nearly 600,000 persons have immigrated to the United States from Vietnam since the end of the Vietnam War. Despite the rapid growth of the U.S. Vietnamese population, little is known about cancer incidence in this migrant group. Using population-based data from the Surveillance, Epidemiology and End Results program, California Cancer Registry and International Agency for Research on Cancer, we compared cancer incidence rates for Vietnamese in the United States (1988,1992) to rates for residents of Ha Noi, Vietnam (1991,1993); non-Hispanic whites were included to serve as the U.S. reference rates. Lung and breast cancers were the most common among Vietnamese males and females, respectively, regardless of geographic region. Rates of cancers more common to U.S. whites, such as breast, prostate and colon cancers, were elevated for U.S. Vietnamese compared to residents in Ha Noi but still lower than rates for U.S. whites. Rates of cancers more common to Asian countries, such as stomach, liver, lung and cervical cancers, were likewise elevated for U.S. Vietnamese compared to residents of Ha Noi and exceeded corresponding rates for whites. Incidence patterns for stomach, liver, lung and cervical cancers may reflect increased risk of exposures in this migrant population and should be further explored to uncover the relative contributions of environmental and genetic factors to cancer etiology. © 2002 Wiley-Liss, Inc. [source] Comparing children and adults with synovial sarcoma in the Surveillance, Epidemiology, and End Results program, 1983 to 2005CANCER, Issue 15 2009An analysis of 1268 patients Abstract BACKGROUND: Synovial sarcoma (SS) is a typical soft tissue sarcoma subtype crosswise between the pediatric and the adult age groups. Less satisfactory overall outcome has been recorded in adult series. METHODS: This study compares clinical features and outcomes of SS across the different age groups, by analyzing 1268 cases, 213 children/adolescents (,18 years) and 1055 adults, registered in the Surveillance, Epidemiology, and End Results (SEER) 17 database from 1983 to 2005. Cancer-specific survival estimates were compared with univariate and multivariate models. RESULTS: No major differences in stage distribution (localized, regional, and distant stage) were observed comparing the 2 age groups. The estimated 5-year cancer-specific survival was 83% for children/adolescents and 62% for adults (P < .001). Female sex, nonblack race, tumors located in the extremities, localized tumors, and tumors <5 cm in size were associated with better survival. In multivariate analysis, adult patients had significantly higher mortality rates than children after adjusting for other variables. CONCLUSIONS: Children and adults with SS have a similar clinical presentation but a dissimilar outcome, suggesting that factors other than unfavorable clinical features might be involved in the unsatisfactory outcome of adult SS patients. It remains to be ascertained whether this difference is related to biological variables or to historically different treatment approaches adopted in pediatric versus adult patients. Cancer 2009. © 2009 American Cancer Society. [source] Differences in colorectal carcinoma stage and survival by race and ethnicityCANCER, Issue 3 2005Chloe Chien M.S. Abstract BACKGROUND In the United States, blacks with colorectal carcinoma (CRC) presented with more advanced-stage disease and had higher mortality rates compared with non-Hispanic whites. Data regarding other races/ethnicities were limited, especially for Asian/Pacific Islander and Hispanic white subgroups. METHODS Using data from 11 population-based cancer registries that participate in the Surveillance, Epidemiology and End Results program, the authors evaluated the relation among 18 different races/ethnicities and disease stage and mortality rates among 154,103 subjects diagnosed with CRC from 1988 to 2000. RESULTS Compared with non-Hispanic whites, blacks, American Indians, Chinese, Filipinos, Koreans, Hawaiians, Mexicans, South/Central Americans, and Puerto Ricans were 10,60% more likely to be diagnosed with Stage III or IV CRC. Alternatively, Japanese had a 20% lower risk of advanced-stage CRC. With respect to mortality rates, blacks, American Indians, Hawaiians, and Mexicans had a 20,30% greater risk of mortality, whereas Chinese, Japanese, and Indians/Pakistanis had a 10,40 % lower risk. CONCLUSIONS The authors observed numerous racial/ethnic disparities in the risks of advanced-stage cancer and mortality among patients with CRC, and there was considerable variation in these risks across Asian/Pacific Islander and Hispanic white subgroups. Although the etiology of these disparities was multifactorial, developing screening and treatment programs that target racial/ethnic populations with elevated risks of poor CRC outcomes may be an important means of reducing these disparities. Cancer 2005. © 2005 American Cancer Society. [source] Mortality trends for cervical squamous and adenocarcinoma in the United States,CANCER, Issue 6 2005Relation to incidence, survival Abstract BACKGROUND In the United States, detection of squamous carcinoma in situ (CIS) by screening has led to reduced rates for invasive squamous carcinoma and lower mortality. Adenocarcinoma in situ (AIS) rates also have increased, but invasive cervical adenocarcinoma rates have not declined similarly. To make inferences about the effectiveness of screening, the authors assessed mortality trends for squamous and adenocarcinoma in relation to incidence of these tumors, incidence of their precursors and survival. METHODS Using data from the Surveillance, Epidemiology, and End Results program (SEER), the authors tabulated incidence per 105 woman-years for invasive carcinomas (1976,2000) and for CIS and AIS (1976,1995) by age (< 50 years, , 50 years) and race (whites, blacks). Cumulative relative survival rates were tabulated for 1976,1995 and mortality rates were estimated for 1986,2000. RESULTS Among all groups, CIS rates approximately doubled whereas rates for invasive squamous carcinoma declined. Among younger whites, mortality declined from 1.12 to 0.93, and for older whites, mortality decreased from 5.02 to 3.82. Among younger blacks, mortality for squamous carcinoma decreased from 2.69 to 1.96. Among older blacks, the mortality rates declined from 14.88 to 9.15. Although AIS rates have increased dramatically among whites (all ages) and younger blacks, adenocarcinoma incidence and mortality rates have not changed greatly. Survival for patients did not change greatly within these age-race groups. CONCLUSIONS The authors concluded that increases in CIS seemed disproportionately large compared with improvements in mortality rates for squamous carcinoma. Despite increased reporting of AIS, declines in mortality for cervical adenocarcinoma have not been demonstrated conclusively. However, future analyses are required to evaluate these trends more completely. Cancer 2005. Published 2005 by the American Cancer Society. [source] Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus,CANCER, Issue 1 2003Mark E. Sherman M.D. Abstract BACKGROUND In the United States, incidence rates for malignant tumors of the uterine corpus are lower among blacks than among whites, whereas mortality rates are higher among blacks. Reasons for the higher level of mortality among blacks have been debated. METHODS Using data from the Surveillance, Epidemiology, and End Results program, the authors compared incidence rates by histopathologic type for malignant tumors of the uterine corpus (including uterus, not otherwise specified) during the period 1992,1998 among white Hispanic, black, and white non-Hispanic patients. The authors also compared cumulative relative survival rates for blacks and whites by histopathologic type and by other factors, and they calculated estimated type-specific mortality rates. RESULTS Overall incidence (per 100,000 woman-years) of corpus malignancy was significantly lower among white Hispanics (14.04; 95% confidence interval [CI], 13.39,14.72) and blacks (15.31; 95% CI, 14.61,16.04) compared with white non-Hispanics (23.43; 95% CI, 23.06,23.81). Compared with white non-Hispanics, blacks had significantly higher incidence rates of serous/clear cell carcinoma (rate ratio, 1.85; 95% CI, 1.61,2.12), carcinosarcoma (rate ratio, 2.33; 95% CI, 1.99,2.72), and sarcoma (rate ratio, 1.56; 95% CI, 1.31,1.86). Survival was worse for blacks than for whites in every histopathologic category and in ,usual' types of endometrial adenocarcinoma, stratified by stage, grade, and age. Rare aggressive tumor types accounted for 53% of mortality among blacks, compared with 36% among whites. CONCLUSIONS Less favorable outcomes for usual types of endometrial adenocarcinoma and for rare aggressive tumors contribute equally to the relatively high mortality due to corpus cancer among black women. Cancer 2003;98:176,86. Published 2003 by the American Cancer Society.* DOI 10.1002/cncr.11484 [source] | ||||||||||