b>General descriptive studies (00350):Analyses of SEER incidence data revealed that esophageal squamous cell carcinoma rates, highest among blacks, have been declining not only among blacks and whites but also Hispanics and Asians. Stomach carcinoma incidence patterns differed by histologic type, anatomic site, race, gender, and age, suggesting that etiologic heterogeneity should be pursued in future research. Cervical cancer rates by histologic type were found to vary considerably among six Asian ethnic groups, non-Hispanic whites and blacks, and Hispanics, suggesting that early detection and prevention efforts require targeted strategies. Our analysis of the rising thyroid cancer incidence rates, which had been attributed to heightened medical surveillance and the use of improved diagnostics, revealed that rates were increasing not only for localized stage and small tumors but also for large tumors and non-localized stage, suggesting that surveillance and diagnostic procedures cannot completely explain the trends and other possible explanations should be explored. Further analysis of the gender and age-specific thyroid papillary cancer incidence patterns confirmed the well-established excess among females overall and found that the female-to-male rate ratio declined quite consistently from more than five at ages 20-24 to about one at ages 80+, without a clear difference between the childbearing, premenopausal, or postmenopausal years. Cutaneous adenoid cystic carcinomas were found to be rare appendageal tumors that affect males and females equally, predominate on the face/head/neck, usually present at a localized stage, and are associated with favorable survival. Our analysis of cutaneous lymphoma incidence patterns found that 71% were T-cell and 29% were B-cell type, in contrast to nodal lymphomas, and the rates varied markedly by race and sex, supporting the notion that they represent distinct disease entities. The risk factors and co-factors for sporadic childhood Burkitt lymphoma in the United States are unknown, and we found that early childhood exposures, male sex, and white race may raise risk. Further analysis of the Burkitt lymphoma incidence rates over the entire age range revealed clear childhood and geriatric peaks among both males and females, corresponding to the endemic and sporadic patterns, and a distinct third peak among adult males. Plasmacytoma incidence rates overall and by site were compared with those for multiple myeloma, and variations in the patterns according to race, gender, and age suggested underlying differences in clinical detection, susceptibility, disease biology and/or etiologic heterogeneity. Our evaluation of sex disparities in cancer incidence found that the male-to-female rate ratio ranged from 29 for Kaposi sarcoma, to 7 for lip cancer, 4 for bladder cancer, and 3 for tonsil cancer;only 5 cancers had a higher incidence in females: breast, thyroid, gallbladder, anus, and peritoneum. Several chapters were prepared focusing on the descriptive epidemiology of head and neck cancers and esophageal cancer.
Special descriptive studies (10348): It is widely recognized that breast cancer incidence rates overall are higher among White than Black women. However, it is not generally appreciated that age-specific incidence rates are higher for Black women aged <40 years and higher for White women aged >40 years. This so-called Black to White ethnic crossover has been well-described, not fully understood, and sometimes viewed as an artifact. We used data from the National Cancer Institutes SEER database to assess the validity of the Black to White ethnic crossover in the United States. The Black and White ethnic crossover was a robust feature in the SEER database. Amidst recent declines for female breast cancer, age-adjusted incidence rates may be increasing for male breast cancer in the United States (US) and elsewhere. However, age-adjusted temporal trends reflect an age-specific weighted average, which may be confounded with age-related biological and/or temporal effects (period and/or cohort). We, therefore, supplemented the descriptive epidemiology of male and female breast cancer with age-period-cohort (APC) models, simultaneously adjusted for age, calendar-period, and birth-cohort effects. Results showed that male and female breast cancers demonstrated similar secular trends but different age-related biology;i.e., relatively more late-onset, low grade and ER positive tumors among men than women. A large-scale population-based comparison of male and female breast cancers demonstrated three intriguing results. Age-specific incidence patterns showed that the biology of male breast cancer resembled the late-onset type of female breast cancer. Similar breast cancer incidence trends among men and women suggested that there are common breast cancer risk factors that affect both sexes, especially estrogen receptor positive breast cancer. Finally, breast cancer mortality and survival rates have improved significantly over time for male breast cancer, but progress has lagged behind for men compared to women. We examined the relationship between endometrial cancer risk and reproductive characteristics in a population-based cohort of 2,674,465 Swedish women, 20-72 years of age. Compared to uniparous women, nulliparous women had a significantly elevated endometrial cancer risk. Endometrial cancer risk decreased with increasing parity.
SEER special studies (00316): In 2001, the SEER program supplemented three tumor registries (Iowa, LA, and Hawaii) to collect discarded formalin-fixed, paraffin-embedded tissue blocks from pathologic laboratories within their catchment areas. In a demonstration project, we validated the utility of SEERs Residual Tissue Repository for molecular markers, using an existing set of breast cancer tissue microarrays (TMAs). Our 2nd SEER Residual Tissue Project will assess the population-based estimates for ovarian epithelial cancers (OEC). We will build the arrays for ovarian cancer, following a systematic pathologic review of all available ovarian cancer cases, i.e., approximately 1600.br>
Mortality Rate Generator Software (00390): The online version of the Atlas of Cancer Mortality in the United States, 1950-94, published in 1999, is available at www.nci.nih.gov/atlasplus. Users can create customized maps according to cancer, age groups, sex, and race. The website has been updated to include data through 2004. Maps have been generated incorporating the new data and are being scrutinized by DCEG researchers.
Record Linkage Studies: Veterans Administration hospitalization database, Patient Treatment File, and Outpatient Clinic File (00580): A large study of medical risk factors for multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) in the Veterans Administration (VA) inpatient hospitalization database found increased risk associated with broad categories of autoimmune disorders, infectious diseases and inflammatory disorders.br>
US Military Cancer Institute (USMCI)/NCI Collaborative Research Program (10382): DCEG and USMCI researchers are analyzing data on more than 9 million active and retired military personnel and their families to estimate cancer rates as well as study the effects of occupational exposures and lifestyle factors on cancer risk. Comparison of incidence rates in the U.S. active military population with those in the population-based SEER program found that rates were significantly lower in the military population for colorectal cancer in white men, lung cancer in white and black men and white women, and cervical cancer in black women.
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