• Cancer at ages 15-29 years: the contrasting incidence in India and England.

      Arora, R; Alston, R; Eden, Tim O B; Moran, Anthony; Geraci, M; O'Hara, Catherine; Birch, J; Cancer Research UK Paediatric and Familial Cancer Research Group, University of Manchester, Manchester, UK. reemaraman@doctors.org.uk (2012-01)
      There has been a steady increase in published research from Europe and North America on the epidemiology of cancers in young people. There are limited data from the developing world. We contrast the incidence of cancer at ages 15-29 years in India and England.
    • Changes in cancer incidence in teenagers and young adults (ages 13 to 24 years) in England 1979-2003.

      Alston, Robert D; Geraci, Marco; Eden, Tim O B; Moran, Anthony; Rowan, Steve; Birch, Jillian M; Cancer Research UK Pediatric and Familial Cancer Research Group, Royal Manchester Children's Hospital, University of Manchester, Stancliffe, Manchester, United Kingdom. robert.d.alston@manchester.ac.uk (2008-11-15)
      BACKGROUND: Cancer for teenagers and young adults represents a major source of morbidity and mortality. Trends in cancer incidence can provide pointers concerning how changes in the environment and in personal behavior affect cancer risks. METHODS: Data on 39,129 neoplasms in individuals ages 13 to 24 years who were diagnosed in England from 1979 to 2003 were analyzed. Variability in incidence by time period and differences in the time trends by age group, sex, and geographic region were analyzed using generalized linear models. RESULTS: Incidence rates of leukemias, lymphomas, central nervous system, bone, and germ cell tumors; melanoma; and carcinomas of the thyroid, ovary, cervix, and colon/rectum increased over time (all P < .01); whereas the incidence of carcinomas of the stomach and bladder decreased (both P < .01). These changes were consistent by age, sex, and region for most neoplasms. Melanoma incidence stabilized in southern England by 1993 but continued to increase in northern England (P = .001). The increase in non-Hodgkin lymphoma was greater in individuals ages 20 to 24 year than in younger individuals, but the increase in Hodgkin lymphoma was confined to individuals ages 13 to 14 years. CONCLUSIONS: The changes in incidence rates may have been caused in part by environmental changes and in part by behavioral changes in young individuals. Some of these results can be used to inform public health campaigns, which can be constructed to encourage better lifestyle choices by young individuals.
    • High cancer mortality rates in the elderly in the UK.

      Moller, Holger; Flatt, Gavin; Moran, Anthony; North West Cancer Intelligence Service, Christie NHS Foundation Trust, 63-65 Palatine Road, Manchester M20 3LJ, United Kingdom. (2011-10)
      Cancer is largely a disease of older individuals. We compared UK cancer mortality rates with those for other countries to assess progress.
    • Risk of cancer other than breast or ovarian in individuals with BRCA1 and BRCA2 mutations.

      Moran, Anthony; O'Hara, C; Khan, S; Shack, Lorraine G; Woodward, E; Maher, E R; Lalloo, F; Evans, D G R; North West Cancer Intelligence Service, The Christie NHS Foundation Trust, Manchester, M20 3LJ, UK. (2011-12-21)
      The risks of cancers other than breast and ovarian amongst BRCA1 and BRCA2 mutation carriers are based on relatively few family based studies with the risk of specific cancers tested in population based samples of cancers from founder populations. We assessed risks of "other cancers" in 268 BRCA1 families and 222 BRCA2 families using a person years at risk analysis from 1975 to 2005. Cancer confirmations were overall higher than in previous family based studies at 64%. There was no overall increase in risk for BRCA1 carriers although oesophagus had a significant increased RR of 2.9 (95% CI 1.1-6.0) and stomach at 2.4 (95% CI 1.2-4.3), these were based mainly on unconfirmed cases. For BRCA2 increased risks for cancers of the pancreas (RR 4.1, 95% CI 1.9-7.8) and prostate (RR 6.3, 95% CI 4.3-9.0) and uveal melanoma (RR 99.4, 95% CI 11.1-359.8) were confirmed. Possible new associations with oesophagus (RR 4.1, 95% CI 1.9-7.8) and stomach (RR 2.7, 95% CI 1.3-4.8) were detected but these findings should be treated with caution due to lower confirmation rates. In contrast to previous research a higher risk of prostate cancer was found in males with mutations in the BRCA2 OCCR region. The present study strengthens the known links between BRCA2 and pancreatic and prostate cancer, but throws further doubt onto any association with BRCA1. New associations with upper gastro-intestinal malignancy need to be treated with caution and confirmed by large prospective studies.
    • Survival from cancer in teenagers and young adults in England, 1979-2003.

      Birch, Jillian M; Pang, Dong; Alston, Robert D; Rowan, Steve; Geraci, Marco; Moran, Anthony; Eden, Tim O B; Cancer Research UK, Paediatric and Familial Cancer Research Group, University of Manchester, Royal Manchester Children's Hospital, Stancliffe, Hospital Road, Manchester M27 4HA, UK. jillian.birch@manchester.ac.uk (2008-09-02)
      Cancer is the leading cause of disease-related death in teenagers and young adults aged 13-24 years (TYAs) in England. We have analysed national 5-year relative survival among more than 30,000 incident cancer cases in TYAs. For cancer overall, 5-year survival improved from 63% in 1979-84 to 74% during 1996-2001 (P<0.001). However, there were no sustained improvements in survival over time among high-grade brain tumours and bone and soft tissue sarcomas. Survival patterns varied by age group (13-16, 17-20, 21-24 years), sex and diagnosis. Survival from leukaemia and brain tumours was better in the youngest age group but in the oldest from germ-cell tumours (GCTs). For lymphomas, bone and soft tissue sarcomas, melanoma and carcinomas, survival was not significantly associated with age. Females had a better survival than males except for GCTs. Most groups showed no association between survival and socioeconomic deprivation, but for leukaemias, head and neck carcinoma and colorectal carcinoma, survival was significantly poorer with increasing deprivation. These results will aid the development of national specialised service provision for this age group and identify areas of clinical need that present the greatest challenges.