Nikolaus Becker

Atlas of cancer mortality in Poland 1975-1979.

The atlas sums up the epidemiological situation of cancer in Poland over a period spanning from 1963-1982. In 82 colored maps the geographical distribution of about 20 main cancer sites is presented based on 49 voivodships the basic administrative units of Poland. (EXCERPT)

Brain — ICD 191

This analysis is based on data from the period 1970–1979 due to the changes in the ICD. Mortality rates analysed from a small number of cases tend to show greater annual variability. In the years mentioned, the rates remained at an unchanged level in men and women. The mortality age curve has one peak in childhood, then the mortality rate decreases until the age of about 30. The curve for men peaked with 14 deaths per 100000 and eight for women in 1979. In 1978 countries with the highest mortality rates for cancer of the brain were Greece (6.1) and Denmark (5.8) for men, and Iceland (4.5), Denmark (4.1), Sweden and Greece (3.6 each) for women. The lowest rates for both sexes were recorded in the Federal Republic of Germany (1.1, 0.7, respectively) and in Bulgaria (2.0,1.5, respectively). The mortality in Poland was at a medium level with 3.7 and 2.5, respectively.

Non-Hodgkin’s Lymphoma — ICD 200 and 202

The term “non-Hodgkin’s lymphoma” covers the neoplasms of the lymphoreticular systems. The ASMR was 0.7 in 1963 and 1.1 in 1982 in men, while the respective figures for women were 0.4 and 0.4. The time trend for all age groups shows an increase in risk in the years 1963–1975, followed by a substantial decline during the years 1976–1982, which was similar, although in different ways, in both sexes. The 35–64 age group appears to have a similar time trend. Deaths from non-Hodgkin’s lymphoma occur in childhood, after which its frequency declines a little until the age of 40–50 when there is another rise. The peak value in 1982 was about six deaths in men and three deaths in women, both sexes aged about 70.

Rectum — ICD 154

The ASMR in men was 3.1 in 1963 and 7.9 in 1982, while the respective figures for women were 2.2 and 5.6. The mortality rate increased rapidly in the period 1963–1982 with the annual average increase rate being 9.8% for men and 8.8% for women. This was one of the sharpest increases of all cancer sites. The mortality rate increases with age starting about the age of 30–40, to reach its maximal values of over 80 deaths per 100000 men and 60 per 100000 women. It increases with calendar time in all age groups and in both sexes. The birth cohort evaluation also shows a very significant increase of risk over the successive birth cohorts.

Kidney — ICD 189

The ASMR for renal cancer in men was 1.6 in 1963 and 3.8 in 1982, while the respective figures for women were 1.0 and 2.0. The mortality rates increase exponentially from the age of 35–40 years to reach the highest value of 23 deaths per 100000 in men aged about 70 and 11 deaths per 100000 in women aged 70–80. The mortality rates increased throughout the period 1963–1982 at a constant mean annual rate of 8.21% in men and 4.69% in women. This increase occurred in all age groups and successive birth cohorts. In 1978 cancer of the kidney occurred most frequently in European men in Iceland and Czechoslovakia (6.8) and in Sweden (6.6). For women, it was most frequent in Denmark (4.0) and Sweden (3.7). Men had the lowest mortality rates in Bulgaria (1.3), Greece and Yugoslavia (1.7), while women’s rates were lowest in Greece (0.8), Bulgaria and Spain (1.0). With a rate of 3.3 for men and 1.8 for women Poland is a medium-risk country.

Stomach — ICD 151

The ASMR for men was 44.9 in 1963 and 28.4 in 1982, while the respective figures for women were 21.7 and 10.8. The time trend for both sexes in 1963–1982 shows a significant decline in the mortality rate, averaging 1.9% in men and 2.8% in women annually. The increase of risk begins after the age of 45–50 and it reaches a maximum of 420 cases per 100000 men and 220 per 100000 women. The calendar time trend in individual age groups of both sexes also shows a steep decline. The annual decrease is similar in all age groups. The cohort analysis is marked by a declining risk of cancer of the stomach. The cohort born about 1940 faces a 70%–90% lower risk than the one born about 1890.

Malignant Neoplasms — ICD 140–209

The ASMR for men was 133.9 in 1963 and 183.0 in 1982. The mortality of women suffering from all malignant neoplasms in the period 1963–1982 did not change significantly and remained steady at about 100. The mortality rate increased substantially from the age of about 40. The highest value was slightly less than 1500 deaths per 100000 men aged about 75, which was much higher in 1982 than in 1963. The highest value for women was about 800 deaths per 100000 women also aged 75, but it changed little over the period 1963–1982. Mortality rates in men increased with calendar time in all the analogous age groups. The time trend for age-specific mortality rates for women does not show significant changes either. The cohort effect was observed in men, who had a greater risk of dying from any cancer in successive birth cohorts, whereas no such phenomenon was found in women.

Leukaemias — ICD 204–207

The ASMR for leukaemias in 1963 was 4.8 for men and 3.5 for women, while the respective figures for 1982 were 5.8 and 3.7. A slight increase was observed in the frequency of deaths from leukaemias, especially in men, caused by the substantial increase in the mortality of people aged 55 and over. Having peaked in the first years of life, the age-specific mortality rates decline until the age of 20–30 years, and then a nearly exponential increase begins. The men’s highest value in 1982 was 40 deaths per 100000 and 19 per 100000 women aged 80. The highest mortality rates for men in European countries were recorded in Czechoslovakia (7.5), France (7.1) and Finland (7.1); the lowest in Spain (4.7), and Bulgaria (4.7). Women had the highest mortality rates in Sweden (4.6), Czechoslovakia (4.6), Greece, Norway and Denmark (4.5 each), and the lowest in Luxembourg (2.6) and Iceland (3.3). Outside Europe, high values were found in Israel (7.3 for men and 6.9 for women) and also in Costa Rica (7.0 and 5.6, respectively). With rates of 5.5 for men and 3.9 for women, Poland was among the countries with a medium risk of leukaemias.

Thyroid Gland — ICD 193

The ASMR for cancer of the thyroid gland in men was 0.4 both in 1963 and in 1982, while the respective figures for women were 0.6 and 0.7. The mortality rates show no clear increase in time either in the individual age groups or in all of them together. The mortality rate increases exponentially with age from 45–50 onwards, and the steepness of the curve is greater in women than in men.

Testis — ICD 186

The ASMR for cancer of the testis was 0.7 in 1970 and 0.9 in 1982. This period saw a rapid increase in the mortality rates. The annual increase of 8.57% was the third-highest of all cancer sites under study. The mortality/age curve displays a bimodal pattern. The frequency increases after the age of about 15 years to reach a first peak at the age of 25–30 after which it declines until the age of about 45. The second part of the curve increases again starting from the age of 50–55 years. The shapes of the mortality/age curves for the years 1970 and 1982 are different, especially in younger age groups. The increase in the mortality rate was faster in young age groups. In 1978, the mortality rate for testicular cancer fluctuated between 1.8 in the German Democratic Republic and 1.5 in Hungary, to 0.3 in Finland, Greece, Spain and 0.0 in Iceland. With a rate of 0.8 Poland is a medium-risk country.