tailieunhanh - ESMO Hb Cancer Prevention

Prostate cancer is a major cause of death among men in European countries, with nearly 145 000 cases and 56 000 deaths in the European Union in 1998. Rates of incidence vary considerably among countries (Table 1), and appear to be increasing because of more frequent and better diagnostic tests, an aging population and probably a true increase in incidence (1). There are no obvious strategies to prevent this disease, so screening has been considered as a possible intervention to reduce the number of deaths. “Screening” means applying a test to a defined group of persons in order to. | 01-ESMO-Cancer 2 12 2007 1 47 PM Page 1 Cancer epidemiology M Primic-Zakelj Institute of Oncology Ljubljana Epidemiology and Cancer Registry Lubljana Slovenia 1 Introduction Cancer epidemiology studies the distribution of cancer in populations and its changes over time and looks at characteristics of different population groups not only those who get the disease but also those who do not to find out how these groups differ. It evaluates the associations between different exposures and diseases to decide whether the observed relationships are likely to be causal. Its ultimate goal is to identify risk factors that may lead to the introduction of effective preventive measures. Although cancer epidemiology is not a new science it has matured only in the last half of the 20th century when communicable diseases underwent a sharp and sustained fall. The development and growth in the field of vital statistics made it possible to study the patterns of cancer mortality. Unfortunately mortality data published nowadays by the World Health Organization WHO are of different quality and may have several biases coverage of the population is incomplete as mortality rates are implausibly low in some countries validity of the cause of death information is low in some countries. The need for more accurate data on cancer patients and the relatively clearcut pathological case confirmation led to the development of hospital- and population-based cancer registries. Hospital-based registries are concerned with recording of information on cancer patients seen in a particular hospital. The main purpose of such registries is to contribute to patient care by providing readily accessible information on all cancer patients seen in this hospital the treatment they had 1 01-ESMO-Cancer 2 12 2007 1 47 PM Page 2 received and its result. These registries cannot provide measures of the occurrence of cancer in a defined population because their catchments .