EPIDEMIOLOGY OF CANCER IN THE COUNTY OF VLCEA BETWEEN 2003-2007

AUTHOR: CRISTINA MUNTEAN

SCIENTIFIC COORDINATOR: ASSIST. PROF. DR. ANDA CRISAN

COAUTHORS: ADRIAN DOBRICEANU, CRISTIAN NINULESCU, MIHNEA IOAN IONESCU

UNIVERSITY OF MEDICINE AND PHARMACY OF CRAIOVA, ROMANIA

Neoplasic disease = a national and international public health problem

WHO malignant disease 12,5% of the deaths in the entire world

(more than the combined mortality of AIDS, tuberculosis and malaria)

84 million persons will be diagnosed with cancer in the next 10 years worldwide

Romania: the cancer incidence is increasing

2000 - 43941 new cases

2001 - 57863 new cases

2002 - 58251 new cases

An estimated increase of approximately 2000 new cases/ year will occur in the following years

(40477 new cases diagnosed in 1994 68317 in 2011)

INTRODUCTION

INTRODUCTION

The most frequent localisations of neoplasias :

-lung (bronchopulmonary) cancer

-breast cancer

-gastric and colorectal cancer

-uterine cervix cancer

-prostate cancer

-ENT cancers

YEARNEW CASES/YEAR200394820041013200510052006101720071039

INCIDENCE AND PERCENTAGE OF THE FREQUENT LOCALISATIONS OF MALIGNANCIES

TYPE OF MALIGNANCYNEW CASESBRONCHOPULMONARY128BREAST103UTERINE CERVIX80COLORECTAL 74GASTRIC73ENT43PROSTATE40OTHER407TOTAL948

INCIDENCE AND PERCENTAGE OF THE FREQUENT LOCALISATIONS OF MALIGNANCIES

INCIDENCE OF MALIGNANCYLUNGGASTRICCRBREASTCERVIXENTPROSTATEOTHERTOTAL2004166111100747455433901013200513994120926857363991005

INCIDENCE AND PERCENTAGE OF THE FREQUENT LOCALISATIONS OF MALIGNANCIES

INCIDENCE OF MALIGNANCYLUNGCRBREASTGASTRICENTUTERINE CERVIXPROSTATEOTHERTOTAL200614312788807053424141017200715412399777461593921039

EPIDEMIOLOGY OF BRONCHOPULMONARY NEOPLASIA

EPIDEMIOLOGY OF BRONCHOPULMONARY NEOPLASIA

SOCIAL BACKGROUND: PREDOMINANTLY RURAL AREAS

MORE FREQUENT>50 YEARS OF AGE

BP10-1920-2930-3940-4950-5960-69>7020031 ( 0,78%)7 (5,46%)35 (27,34%)41 (32,03%)44 (34,37%)20042 (1,20%)16 (9,63%)33 (19,87%)66 (39,75%)49 (29,51%)20051 (0,71%)16 (11,51%)35 (25,17%)48 (34,53%)39 (28,05%)20061(0,69%)1 (0,69%)13 (9,09%)46 (32,16%)43 (30,06%)39 (27,27%)20072 (1,29%)6 (3,89%)8 (5,19%)43 (27,92%)54 (35,06%)41 (26,62%)YEARRural background200357%200458,4%200556,48%200663,79%200761,11%

EPIDEMIOLOGY OF GASTROINTESTINAL TRACT

SINCE 2004 DECREASE OF THE GASTRIC NEOPLASM INCIDENCE INCREASE IN THE INCIDENCE OF THE COLORECTAL NEOPLASM

Gastric neoplasm in males

Colorectal cancer:

slightly equal incidence

in males and females

EPIDEMIOLOGY OF THE GASTROINTESTINAL TRACT CANCERS

EPIDEMIOLOGY OF GASTROINTESTINAL TRACT CANCERS

GASTRIC CANCER :

IN PATIENTS FROM

RURAL AREAS

COLORECTAL NEOPLASM:

SMALL DIFFERENCE

BETWEEN URBAN AND RURAL

AREAS

EPIDEMIOLOGIY OF GASTROINTESTINAL TRACT NEOPLASIAS

THE AGE OF REPORTING A GASTRIC

AND COLORECTAL CANCER IS FREQUENTLY OVER 60 YEARS

COLORECTAL10-1920-29YEARS30-39YEARS40-49YEARS50-59YEARS60-69YEARS>70YEARS20035 (6,75 %)15 (20,27%)17 (23%)37 (50%)20043 (3%)9 ( 9% )14 (14%)35 (35%)39 (39%)20051(0,83%)5 (4,16%)6 (5%)16 (13,33%)42 (35%)50 (41,66%)20065(3,93%)6 (4,72%)17(13,38% )43 (33,85%)56 ( 44,09% )20075 (4,06%)7 (5,69%)30 (24,39%)37 (30,087%)44 (35,77%)Gastric10-1920-29YEARS30-39YEARS40-49YEARS50-59YEARS60-69YEARS>70YEARS20031 (1,36%)4 (5,47 %)9 (12,32%)27 (36,98%)32 (43,83%)20041 (0,90%)1 (0,90%)4 ( 3,60% )17 (15,31%)38 (34,23%)50 (45,04%)20051(1,06%)2 (2,12%)2 (2,12%)13 (13,82%)25 (26,60%)51 (54,25%)20061 (1,25%)1 (1,25%)14 (17,5% )32 (40% )32 ( 40% )20073 (3,90%)4 (5,19%)19 (11,68%)20 (25,97%)41 (53,24%)

EPIDEMIOLOGY OF GENITAL CANCERS IN WOMEN

EPIDEMIOLOGY OF GENITAL CANCER IN WOMEN

BREAST CANCER IN URBAN AREAS

UTERINE CERVIX CANCER IN RURAL AREAS

YEAR2003200420052006200755,33%55,4%59,78%59,09%65,65%YEAR2003200420052006200750%51,35%50%62,26%60,65%

EPIDEMIOLOGY OF GENITAL NEOPLASIAS IN WOMEN

Age of reporting breast cancer is frequently over 50 years

Most uterine cervix cancers are reported at ages ranging from 40-59 years

Breast cancer10-1920-29years30-39years40-49years50-59years60-69years>70years20031(0,97%)5 (4,85%)25 (24,27 %)25 ( 24,27%)17 (16,50%)30 (29,12%)20046 (8,1%)8 (10,8% )19 (25,67%)17 (22,97%)24 (32,43%)20051 (1,08%)2 (2,17%)18 (19,56%)25 (27,17%)24(26,08%)22 (23,91%)20068(9,09%)13 (14,77%)25 (28,40% )19(21,59% )23 (26,13% )20079 (9,09%)14 (14,14%)21 (21,21%)28 (28,28%)27 (27,27%)Cervix 10-1920-29ani30-39ani40-49ani50-59ani60-69ani>70ani20034 (5%)11 (13,75%)20 (25 %)16 (20%)13 (16,25%)16 (20%)20047 (9,45%)22 (29,72% )18 (24,32%)13 (17,56%)14(18,91%)20051(1,47%)2(2,94%)5 (7,35%)18 (26,47%)20 (29,41%)11 (16,17%)11(16,17%)20065(9,43%)15 (28,30)21 (39,62% )7 (13,20% )5( 9,43% )20071 (1,67%)18 (29,50%)17 (27,86%)14 (22,95%)11(18,03%)

EPIDEMIOLOGY OF ENT CANCERS

Incidence is rising

Predominantly in males

PREDOMINANTLY IN

PATIENTS

FROM RURAL AREAS

Most frequent in patients

aged 50-69 years

EPIDEMIOLOGY OF THE ENT CANCERS

ENT cancers10-1920-29years30-39years40-49years50-59years60-69years>70years20032 (4,65%)3 (6,97 %)14 ( 32,55%)13 (30,23%)11 (25,58%)20041(1,81%)13(23,63% )9 (16,36%)22 (40%)10 (18,18%)20058 (14%)14 (47,60%)23 (40,40%)12 (21%)20061 (1,42%)2(2,86%)12 (17,14%)19 (27,14% )23(32,85% )13 (18,60% )20072 (2,70%)9 (12,16%)26 (35,13%)20 (27%)17 (23%)

EPIDEMIOLOGY OF PROSTATE CANCER

Absent < 50 years of age

Predominant in patients over 60 years old

Social background: predominantly rural

Prostate cancer50-59years60-69years>70years20032(5%)1(2,5%)28 (70%)20042(4,65%)7 (16,27)33 (76,74%)20052 (5,55%)19 (52,77%)14 (38,88%)200616(38,09% )23 (54,76% )20073 (5,08%)18 (30,50%)38 (64,40%)YearRural200355%200458,13%200555,55%200652,38%200759,32%

DEATHS DUE TO CANCER BETWEEN 2003-2007

YEARLungGastricCRBreastENTCervixProstateOtherTotal200312117,38%8912,78%588,33%476,75%365,17%294,16%233,30%29342,09%696200413021,66%10217%579,5%396,5%427%294,83%233,83%17829,66%600200514318,33%9211,79%779,87%395%354,48%273,46%253,20%34243,84%780200612315,12%718,73%718,73%445,41%415,04%303,69%242,95%40950,30%813200712412,02%716,88%595,72%393,78%393,78%302,90%282,71%63561,59%1031

CONCLUSIONS

Incidence increasing during 2003-2007 for most of the studied localisations of the malignancy, except gastric cancer, which is decreasing since 2004

Social background predominantly rural

(except breast cancer predominantly urban)

Localisations of cancers that can affect both males and females

males were predominantly affected, except colorectal cancer, more frequent in females in 2003

Can affect patients of any age predominantly patients over 50 years old

EPIDEMIOLOGY OF CANCER IN THE COUNTY OF VLCEA BETWEEN 2003-2007

20032004200520062007

Incidence of Neoplasias in 2003

Other

42.93%

BP

13.50%

Breast

10.86%

Uterine cervix

8.43%

CR

7.80%

Gastric

7.70%

Prostate

4.21%

ENT

4.53%

Incidence of Neoplasias in 2005

ENT

5.67%

Prostate

3.58%

Uterine cervix

6.76%

Breast

9.15%

Gastric

9.35%

CR

11.94%

BP

13.83%

Other

39.70%

Incidence of Neoplasias in 2006

Uterine Cervix

5.21%

Prostate

4.12%

ENT

6.88%

Gastric

7.86%

Breast

8.65%

CR

12.48%

BP

14.06%

Other

40.70%

Incidence of Neoplasiasin 2007

Other

37.72%

BP

14.82%

CR

11.83%

Breast

9.52%

Gastric

7.41%

ENT

7.12%

Prostate

5.67%

Uterine cervix

5.87%

83,6%

16,4%

68,08%

31,92%

77,70%

22,3%

81,12%

18,88%

81,81%

18,19%

0

20

40

60

80

100

20032004200520062007

INCIDENCE OF LUNG CANCER DEPENDING ON SEX

BETWEEN 2003-2007

MEN

WOMEN

2003

2004

2005

2006

2007

128

166

139

143

154

INCIDENCE OF LUNG CANCER BETWEEN 2003-

2007

2003

2004

2005

2006

2007

73

111

94

80

77

74

100

120

127

123

INCIDENCE OF THE GASTRIC AND COLORECTAL

CANCER BETWEEN 2003-2007

COLORECTAL CANCER

GASTRIC CANCER

47,3

52,7

56

44

53,33

46,66

55,12

44,88

52,84

47,16

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

90,00%

100,00%

20032004200520062007

Sex distribution of colorectal cancer between

2003-2007

males

females

63,02

36,98

62,16

37,84

60,63

39,36

68,75

31,25

58,44

41,55

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

90,00%

100,00%

20032004200520062007

Sex distribution of gastric cancer between 2003-2007

males

females

SOCIAL BACKGROUND OF PATIENTS WITH

COLORECTAL CANCER DURING 2003-2007

55,40%

50,00%

40,00%

51%

44,60%

50,00%

60,00%

49%

44,72%

55,28%

2003

2004

2005

2006

2007

urban

rural

SOCIAL BACKGROUND OF PATIENTS WITH

GASTRIC CANCER DURING 2003-2007

65,76%

59,46%

57,45%

73%

68,84%

34,24%

40,54%

42,55%

27%

34,16%

2003

2004

2005

2006

2007

urban

rural

BREAST CANCER INCIDENCE BETWEEN 2003-

2007

99

88

92

103

74

20032004200520062007

UTERINE CERVIX CANCER

INCIDENCE BETWEEN 2003-2007

61

53

68

80

74

20032004200520062007

74

70

57

43

55

20032004200520062007

86%

14%

92,73%

7,27%

82,45%

17,55%

94,28%

5,71%

87,83%

12,17%

0

20

40

60

80

100

20032004200520062007

Sex distribution of ENT cancers between 2003-2007

males

females

65,11%

34,89%

52,72%

47,28%

61,40%

38,60%

52,86%

47,14%

58,1%

41,89%

0

10

20

30

40

50

60

70

20032004200520062007

Incidence of ENT cancers depending on the social background

rural

urban

59

42

36

40

43

20032004200520062007

Incidence of Neoplasias in 2004

ENT

5.42%

Prostate

4.24%

Uterine Cervix

7.30%

Breastr

7.30%

CR

9.87%

Gastric

10.95%

BP

16.38%

Other 38.50%