Kirstine Karnov

Increasing incidence and survival in oral cancer: a nationwide Danish study from 1980 to 2014

Abstract Background: Oral carcinomas (OCs) make up a significant proportion of head and neck carcinomas (HNCs) and are an important cause of morbidity and mortality globally. The purpose of this population-based study was to determine trends in incidence and survival in OC in the Danish population from 1980 to 2014. Material and methods: This study covered all patients registered in the nationwide Danish cancer registry (DCR) in the period 1980–2014. Age-adjusted incidence rate (AAIR) per 100,000 and annual percentage change (APC) were evaluated. Also, 5-year overall survival (OS) was calculated with Cox regression analysis in relation to location, gender, age, and calendar year at diagnosis. Results: Altogether, 8299 patients with oral cancer were identified, 5062 (61%) of whom were males and 3237 (39%) were females. The median age at diagnosis was 63 years. The AAIR of patients with OC increased from 1.9 per 100,000 in 1980 to 3.5 per 100,000 in 2014, and we observed a significant increase in 5-year OS of 12% points (a relative increase of 38%) from the period 1980–1984 to 2005–2009. Women were found to have a better prognosis than men. Conclusions: We found an unexpected increase in the age-standardized incidence of OC during the last 30 years in Denmark, and also an improvement in survival. The 5-year OS was significantly better in recent years even when we adjusted the analysis for relevant covariates.

Increasing incidence and survival of head and neck cancers in Denmark: a nation-wide study from 1980 to 2014

Abstract Background: The purpose of the study was to determine trends in age-adjusted incidence rates (AAIR) and survival probability in head and neck cancers (HNCs) in the Danish population from 1980 to 2014. Material and methods: All patients registered with HNC in the nationwide Danish Cancer Registry from 1980 to 2014 were included. We evaluated the AAIR per 100,000 and the average annual percent change (AAPC). The relative survival probability at 5 years was calculated in relation to gender, anatomical location and histology, and we constructed age-period-cohort models of incidence. Results: About 34,606 patients were included (64.7% men). The AAIR increased from 9.1 per 100,000 in 1980 to 17.4 per 100,000 in 2014 with an AAPC of 2.1%. The greatest incidence increase was observed in oropharyngeal cancer (AAPC: 5.4%) followed by hypopharyngeal cancer (AAPC: 4.2%). Adenocarcinomas had the highest AAPC (5.0%) followed by squamous cell carcinomas (AAPC: 2.0%). The AAPC was significantly higher in women (2.4%) compared with men (1.6%). For all HNC patients, the relative survival at 5 years rose significantly from 49.0% in 1980–1984 to 62.4% in 2010–2014. Women had a significantly higher survival than men with a relative survival of 61.7% compared to 50.0% in men. Laryngeal cancer had the best survival probability of cancers in the upper aerodigestive tract with hypopharyngeal cancer having the poorest survival. Conclusion: This nation-wide study showed a significant rise in incidence of HNC for men and women along with a significant increase in relative survival. Oropharyngeal cancer had the highest increase in incidence followed by hypopharyngeal cancer which showed the poorest survival of HNCs.

Incidence and survival of oropharyngeal cancer in Denmark: a nation-wide, population-based study from 1980 to 2014

Abstract Background: Oropharyngeal carcinomas (OPCs) constitute a significant and increasing proportion of head and neck carcinomas and are an important global cause of morbidity and mortality. The purpose of this study was to determine trends in incidence and survival in OPC in the Danish population from 1980 to 2014. Methods: This study included all patients registered in the nationwide Danish Cancer Registry over the period 1980–2014. The age-adjusted incidence rates (AAIR) per 100,000, annual percentage change (APC) and average annual percent change (AAPC) were evaluated. Five-year relative survival (RS) was calculated with Cox regression analyses in relation to gender, anatomical location and histology. Results: A total of 6555 patients (69% male) were included, with a median age at diagnosis of 60 years. The AAIR of patients with OPC increased from 0.815 per 100,000 in 1980 to 4.51 per 100,000 in 2014 with an AAPC of 5.3. The 5-year RS increased significantly from 33.1% over the period 1980–1984 to 58.5% (25.4% points) over the period 2010–2014. With no significant difference stratified for gender. Tumors located at the palatine tonsils (nu2009=u20093333) and salivary gland OPC (nu2009=u200990) had significantly better survival compared with other sub-locations and histology subtypes. In the APC model the birth cohort effect rate ratio increased until 1925 and then decreased until 1935 from which point it increased in the last cohorts. Conclusions: In this population-based study, we observed a significant increase in the incidence of OPCs and in the RS for OPC. We also identified a profound birth cohort effect on the incidence.

Trends in thyroid cancer: Retrospective analysis of incidence and survival in Denmark 1980–2014

BACKGROUNDnThyroid cancer incidence has been reported to be increasing since the 1970u202fs. The aim of this study was to investigate the change in incidence and survival from 1980 to 2014 in Denmark.nnnMETHODSnWe identified patients registered with thyroid cancer in the period 1980-2014. We evaluated the age-adjusted incidence rate (AAIR) and the average annual percentage change (AAPC), constructed age-period-cohort models (APCs), and evaluated relative survival (RS).nnnRESULTSnWe included 5139 patients. The AAIR was 1.6 cases per 100,000 in 1980 and 4.5 cases in 2014 with an AAPC of 3.4%. The AAIR for papillary carcinomas (nu202f=u202f2864) quintupled in the study period, and accounts for most of the observed increase in incidence with an AAPC of 4.9%. Follicular carcinomas (nu202f=u202f920) nearly tripled in AAIR and had the second greatest increase in AAPC. Papillary carcinomas had the best prognosis with 1-year and 5-year RSs of 95% and 91%, followed by the follicular carcinomas with 1-year and 5-year RSs of 90% and 80%, respectively. Anaplastic carcinomas (nu202f=u202f320) had the worst prognosis with 1-year and 5-year RSs of 18% and 12%. We found a significant age effect in the APC model for the incidence of thyroid cancer but no significant cohort or period effects.nnnCONCLUSIONnThe incidence of thyroid cancer is rising. This is primarily attributable to an increase in papillary carcinomas. The relative survival has improved significantly in Denmark since 1980. The cause of the increasing incidence remains to be established, but enhanced diagnostic scrutiny and increased iodine intake may be influential.

Incidence and survival in sinonasal carcinoma: a Danish population-based, nationwide study from 1980 to 2014

Abstract Background: Sinonasal cancers are rare and comprise <1% of all malignancies. This study describes incidence and survival in sinonasal carcinomas in Denmark from 1980 to 2014. Methods: All patients registered in the Danish Cancer Registry in the period were included. Age-adjusted incidence rate, average annual percentage change, and relative survival were calculated. Age-period-cohort models were constructed. Results: 1,720 patients with sinonasal carcinoma (median age 67 years, 63% males) were identified. There was no significant change in age-adjusted incidence; 0.70 in 1980 to 0.43 per 100,000 in 2014 (pu2009>u2009.05). Relative 5- and 10-year survival were 52% and 40% for men, 58% and 42% for women. An increase in 5-year survival from 1980 to 2014 from 46% to 65% (pu2009<u2009.05) was found. Nasal carcinomas had a significantly better relative survival compared to sinus carcinoma, as did squamous cell carcinomas when compared to neuroendocrine malignancies. Conclusion: In Denmark between 1980 and 2014, the incidence of sinonasal carcinomas has been stable and the relative survival has increased significantly.

The Integumentary System

The skin is a large organ covering the exterior of the human body. It consists of two distinct layers: an epithelial barrier, the epidermis, and a strong and elastic layer of connective tissue, the dermis. The skin is attached to underlying structures by the subcutaneous tissue, which contains various amounts of adipose tissue. Associated with the skin are “epidermal derivatives”: hair follicles, nails, and sweat and sebaceous glands.

The Digestive System II: The Associated Organs

The salivary glands, the liver, the gallbladder, and the pancreas constitute the accessory organs of the digestive system. These organs have exocrine secretion that chemical breakdown ingested food to facilitate digestion. Furthermore, the liver and pancreas have multiple other functions essential for homeostasis, e.g., the endocrine function of the pancreas that regulates blood glucoses’ level and the detoxification function of the liver.

The Respiratory System

The respiratory system consists of conductive airways, paired lungs, and a ventilation mechanism. The respiration mechanism, an exchange of gases between inhaled air and the blood of the pulmonary capillaries, takes place in the alveoli. Apart from gas exchange, the respiratory system also filters and temperates inhaled air and contributes to production of speech (larynx), to sense of smell (nasal cavities), and to maintenance of the pH homeostasis (bicarbonate buffer system of the blood).

The Urinary System

The paired kidneys, the urine bladder, and the urethra constitute the urinary system. The kidneys remove waste products from the body, conserve water, and reabsorb electrolytes and metabolic substances. Furthermore, they are essential for maintenance of the pH homeostasis, the blood pressure, and the volume and composition of the extracellular fluid. The urine is transported from the kidneys to the urinary bladder via the paired ureters, and after storage in the urinary bladder, the urine is discharged via the urethra.

The Male Reproductive System

The male reproductive system consists of external reproductive organs, penis and scrotum, and internal reproductive organs: testes, a duct system, and accessory glands. The adult, paired testes produce both male sex hormones (androgens) and sperm cells (spermatogenesis). Androgens, primarily testosterone, are necessary for development and maintenance of male behavioral and physical manifestations and for spermatogenesis.