Objective: To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. Design: Retrospective cohort study. Setting: University Hospital, Helsinki, Finland. Partici...Objective: To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. Design: Retrospective cohort study. Setting: University Hospital, Helsinki, Finland. Participants: 7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up through the Finnish cancer registry until 2003. Main outcome measures: Standardised incidence ratio for cervical cancer and other cancers. Results: During follow-up 22 cases of invasive cervical cancer occurred in women treated for cervical intraepithelial neoplasia (standardised incidence ratio 2.8, 95%confidence interval 1.7 to 4.2). The highest risk was during the second decade (10 cases observed: 3.1, 1.5 to 5.7). The standardised incidence ratio for cervical intraepithelial cancer type 1 was 3.1 (1.4 to 6.2) and for type 2 was 3.7 (0.9 to 10.7). Conclusions: The risk of cervical cancer in the first 20 years after treatment for cervical intraepithelial neoplasia is higher than in the average population. The risk of smoking related cancers is also increased.展开更多
Background & Aims: Mutations in the mismatch repair genes cause hereditary nonpolyposis colorectal cancer (HNPCC) syndrome and convey high lifetime cancer risks for colorectal (CRC) and endometrial cancer. Current...Background & Aims: Mutations in the mismatch repair genes cause hereditary nonpolyposis colorectal cancer (HNPCC) syndrome and convey high lifetime cancer risks for colorectal (CRC) and endometrial cancer. Currently, cancer risks for individuals with HNPCC are based on data from clinically ascertained families. The purpose of this study was to re-examine the penetrance in HNPCC using a comprehensive dataset from a geographically defined region. Methods: A combined dataset of 70 HNPCC families ascertained by traditional high-risk criteria and by molecular screening comprising 88 probands and 373 mutation-positive family members was used. Statistical methods were modified survival analysis techniques. Results: In mutation-positive relatives (excluding probands), the median age at diagnosis of CRC was 61.2 years (confidence interval [CI], 56.3- 68.0 y). The lifetime risk for CRC was 68.7% (CI, 58.6% - 78.9% ) for men and 52.2% (CI, 37.6% - 66.9% ) for women. Considering only probands, the median age at diagnosis of CRC was 44.0 years (CI, 41.0- 46.3 y). Median age of onset of EC was 62.0 years (CI, 55.9 y to an upper limit too high to calculate)with a lifetime cancer risk of 54% (CI, 41.9% - 66.1% ). Conclusions: A markedly later age of onset for CRC at 61 y than previously reported (? 44 y) is suggested, resulting mainly from a more rigorous method of analysis in which all gene-positive individuals (both affected and unaffected with cancer) are considered. Lifetime cancer risks may be lower for CRC and endometrial cancer than presently assumed. If confirmed, these data suggest a need to alter counseling practices, and to consider HNPCC in older individuals than before.展开更多
Background: Worldwide survival data for ductal adenocarcinorna of the pancrea s are the lowest among the 60 most frequent types of organ cancers. Hence publis hed data on long time survivors of this disease are contro...Background: Worldwide survival data for ductal adenocarcinorna of the pancrea s are the lowest among the 60 most frequent types of organ cancers. Hence publis hed data on long time survivors of this disease are controversial. We performed a nationwide study comprising all Finnish patients diagnosed with pancreatic can cer in the period 1990- 1996 who survived for at least five years after diagnos is. Methods: Data on patients registered as five year survivors of pancreatic ca ncer were obtained from the Finnish Cancer Registry and Statistics Finland. Slid es or paraffin blocks were collected from patients recorded as having histologic ally proven pancreatic ductal adenocarcinorna (PDAC) and were re- evaluated in a double blind fashion by three pathologists with special expertise in pancreati c pathology. Results: Between 1990 and 1996, the Finnish Cancer Registry recorde d 4922 pancreatic cancer patients, 89 of whom survived for at least five years. Reviewing this series of patients revealed 45 (49% ) non- PDACs and 18 cases w ithout histological verification. In 26 patients recorded as having histological ly proven PDAC, re- evaluation of histological specimens confirmed PDAC in only 10 patients. Conclusions: This study indicates that (1) the prognosis of PDAC r emains poor and (2) careful histopathological review of all patients with pancre atic cancer is mandatory if survival data are to be meaningful.展开更多
文摘Objective: To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. Design: Retrospective cohort study. Setting: University Hospital, Helsinki, Finland. Participants: 7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up through the Finnish cancer registry until 2003. Main outcome measures: Standardised incidence ratio for cervical cancer and other cancers. Results: During follow-up 22 cases of invasive cervical cancer occurred in women treated for cervical intraepithelial neoplasia (standardised incidence ratio 2.8, 95%confidence interval 1.7 to 4.2). The highest risk was during the second decade (10 cases observed: 3.1, 1.5 to 5.7). The standardised incidence ratio for cervical intraepithelial cancer type 1 was 3.1 (1.4 to 6.2) and for type 2 was 3.7 (0.9 to 10.7). Conclusions: The risk of cervical cancer in the first 20 years after treatment for cervical intraepithelial neoplasia is higher than in the average population. The risk of smoking related cancers is also increased.
文摘Background & Aims: Mutations in the mismatch repair genes cause hereditary nonpolyposis colorectal cancer (HNPCC) syndrome and convey high lifetime cancer risks for colorectal (CRC) and endometrial cancer. Currently, cancer risks for individuals with HNPCC are based on data from clinically ascertained families. The purpose of this study was to re-examine the penetrance in HNPCC using a comprehensive dataset from a geographically defined region. Methods: A combined dataset of 70 HNPCC families ascertained by traditional high-risk criteria and by molecular screening comprising 88 probands and 373 mutation-positive family members was used. Statistical methods were modified survival analysis techniques. Results: In mutation-positive relatives (excluding probands), the median age at diagnosis of CRC was 61.2 years (confidence interval [CI], 56.3- 68.0 y). The lifetime risk for CRC was 68.7% (CI, 58.6% - 78.9% ) for men and 52.2% (CI, 37.6% - 66.9% ) for women. Considering only probands, the median age at diagnosis of CRC was 44.0 years (CI, 41.0- 46.3 y). Median age of onset of EC was 62.0 years (CI, 55.9 y to an upper limit too high to calculate)with a lifetime cancer risk of 54% (CI, 41.9% - 66.1% ). Conclusions: A markedly later age of onset for CRC at 61 y than previously reported (? 44 y) is suggested, resulting mainly from a more rigorous method of analysis in which all gene-positive individuals (both affected and unaffected with cancer) are considered. Lifetime cancer risks may be lower for CRC and endometrial cancer than presently assumed. If confirmed, these data suggest a need to alter counseling practices, and to consider HNPCC in older individuals than before.
文摘Background: Worldwide survival data for ductal adenocarcinorna of the pancrea s are the lowest among the 60 most frequent types of organ cancers. Hence publis hed data on long time survivors of this disease are controversial. We performed a nationwide study comprising all Finnish patients diagnosed with pancreatic can cer in the period 1990- 1996 who survived for at least five years after diagnos is. Methods: Data on patients registered as five year survivors of pancreatic ca ncer were obtained from the Finnish Cancer Registry and Statistics Finland. Slid es or paraffin blocks were collected from patients recorded as having histologic ally proven pancreatic ductal adenocarcinorna (PDAC) and were re- evaluated in a double blind fashion by three pathologists with special expertise in pancreati c pathology. Results: Between 1990 and 1996, the Finnish Cancer Registry recorde d 4922 pancreatic cancer patients, 89 of whom survived for at least five years. Reviewing this series of patients revealed 45 (49% ) non- PDACs and 18 cases w ithout histological verification. In 26 patients recorded as having histological ly proven PDAC, re- evaluation of histological specimens confirmed PDAC in only 10 patients. Conclusions: This study indicates that (1) the prognosis of PDAC r emains poor and (2) careful histopathological review of all patients with pancre atic cancer is mandatory if survival data are to be meaningful.
