Tag Archives: epidemiology

Global Magnitude of Mesothelioma

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Park EK, Takahashi K, Hoshuyama T, et al.
Global magnitude of reported and unreported mesothelioma.
Environ Health Perspect. 2011 Apr;119(4):514-8.
PubMed PMID: 21463977

Investigators at University of Occupational and Environmental Health (Japan), University of Birmingham (UK), and National Taiwan University estimated the global magnitude of mesothelioma, accounting for reported and unreported cases.

Noting that malignant mesothelioma – a rare form of cancer caused specifically by exposure to asbestos – is a major public health concern because it “is difficult to diagnose, has extremely poor prognosis, and is on the increase, and that “epidemics of mesothelioma have been reported nationally and regionally,” the authors point out that current epidemiological data are “biased toward developed countries and regions with the resources to diagnose asbestos-related diseases and with known historical use of asbestos” and that “mesothelioma is grossly underreported in many developing countries, including some with known extensive use of asbestos.”

From the conclusion:

“We estimated the 15-year cumulative frequency of mesothelioma during 1994–2008 in the 56 countries reporting mesothelioma to be 174,300. Using cumulative asbestos use to predict cumulative mesothelioma frequency at national levels, we predicted the 15-year cumulative frequency of mesothelioma during 1994–2008 in the 33 countries that do not report mesothelioma to be 38,900. Thus, globally, for every four to five reported cases of mesothelioma, one case has been overlooked. These estimates support the need for countermeasures at national, regional, and international levels.”

The authors observe that the world has “nearly doubled cumulative use of asbestos from 65 million metric tons up until 1970, to 124 million metric tons since then,” and that in particular, Russia, China, Kazakhstan, Japan, the United States, Brazil, Germany, India, and Thailand “should anticipate the need to deal with a very high burden of mesothelioma in the immediate decades ahead.”

They urge that “developed countries share experience and technology to enable developing countries to promote accurate diagnosis, reporting, and management of [asbestos-related diseases]” and that “political will is essential to ensure that asbestos use ceases globally.”

Free full text is available via PubMed.

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Diabetes and Cancer: ADA/ACS Consensus Report

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Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010 Jul;33(7):1674-85. PubMed PMID: 20587728; PubMed Central PMCID: PMC2890380. [Free full text]

A consensus statement from the American Diabetes Association and the American Cancer Society. A review of evidence concerning “the association between diabetes and cancer incidence or prognosis, risk factors common to both diabetes and cancer, possible biologic links between diabetes and cancer risk, and whether diabetes treatments influence risk of cancer or cancer prognosis.

Key findings and recommendations:

  • Diabetes (primarily type 2) is associated with increased risk for some cancers (liver, pancreas, endometrium, colon and rectum, breast, bladder). Diabetes is associated with reduced risk of prostate cancer. For some other cancer sites there appears to be no association or the evidence is inconclusive.
  • The association between diabetes and some cancers may partly be due to shared risk factors between the two diseases, such as aging, obesity, diet, and physical inactivity.
  • Possible mechanisms for a direct link between diabetes and cancer include hyperinsulinemia, hyperglycemia, and inflammation.
  • Healthful diets, physical activity, and weight management reduce risk and improve outcomes of type 2 diabetes and some forms of cancer and should be promoted for all.
  • Patients with diabetes should be strongly encouraged by their health care professionals to undergo appropriate cancer screenings as recommended for all people in their age and sex.
  • The evidence for specific drugs affecting cancer risk is limited, and observed associations may have been confounded by indications for specific drugs, effects on other cancer risk factors such as body weight and hyperinsulinemia, and the complex progressive nature of hyperglycemia and pharmacotherapy in type 2 diabetes.
  • Although still limited, early evidence suggests that metformin is associated with a lower risk of cancer and that exogenous insulin is associated with an increased cancer risk. Further research is needed to clarify these issues and evaluate if insulin glargine is more strongly associated with cancer risk compared with other insulins.
  • Cancer risk should not be a major factor in choosing between available diabetes therapies for the average patient. For selected patients with very high risk for cancer occurrence (or for recurrence of specific cancer types), these issues may require more careful consideration.

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Increased Bladder Cancer Risk among Hairdressers – Meta-Analysis

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Harling M, Schablon A, Schedlbauer G, et al. Bladder cancer among hairdressers: a meta-analysis. Occup Environ Med. 2010 May;67(5):351-8. Review. PubMed PMID: 20447989; PubMed Central PMCID: PMC2981018. [Free full text via PubMed.]

Epidemiologists at the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services and the University Medical Center Hamburg-Eppendorf conducted a meta-analysis of 42 studies to determine summary risk ratios for the risk of bladder cancer among hairdressers.

The researchers found an increased risk for bladder cancer, in particular for hairdressers in jobs held for more than 10 years. They noted, however, that they could not rule out residual confounding by smoking and that it is still an open question whether hairdressers working before and after 1980 (when some aromatic amines were banned as hair dye ingredients in the European Union) have the same risk for bladder cancer.

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Global cancer burden to double, prevention urged

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Thun MJ, DeLancey JO, Center MM, et al. The global burden of cancer: priorities for prevention. Carcinogenesis. 2010 Jan;31(1):100-10. [open access]

Researchers from the American Cancer Society project that cancer deaths will more than double worldwide over the next 20-40 years, with the increase driven largely by growth and aging of populations in economically developing countries, in combination with tobacco use, an increase in obesity and physical inactivity, and prevalent chronic infections.

The authors recommend a number of preventive measures, including strengthened efforts in international
tobacco control and increased availability of vaccines against hepatitis B virus and human papilloma virus, along with “action-oriented translational research to adapt programs that have proven to be effective in high-income countries to every setting in which they are needed.”