Explore the vast range of titles available.

At 23 years of follow-up in the SPCG-4 trial, mortality among men who underwent radical prostatectomy was 11.7 percentage points lower than that among men whose condition was managed by watchful waiting. Radical prostatectomy was associated with a mean of nearly 3 years of extra life.

This analysis of Norwegian registry data suggests that colonoscopic surveillance during the 8 years after removal of low-risk adenomas is not required for a reduction in colorectal-cancer mortality. Screening programs for colorectal cancer are currently implemented in many Western populations 1 , 2 because randomized trials have documented an association between screening and a sustained reduction in colorectal-cancer mortality. 3 The benefit is most likely due to early detection of cancer, endoscopic removal of adenomas, and surveillance of patients who are considered to be at high risk for the development of new neoplastic lesions. 4 , 5 However, precise quantification of the risk of death from cancer after adenoma removal has been hampered by the scarceness of large, population-based studies with long follow-up periods. Previous studies were performed in populations undergoing intensive surveillance, . . .

In this randomized trial involving 84,585 participants in Poland, Norway, and Sweden, the risk of colorectal cancer at 10 years was lower among those invited to undergo screening colonoscopy than among those assigned to no screening.

The randomized Swedish trial of prostatectomy versus watchful waiting in disease detected mainly clinically (not by PSA screening) continues to show a benefit for early prostatectomy. The number of men younger than 65 needed to treat to prevent one death is now four. The Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4), a randomized trial of radical prostatectomy versus watchful waiting in men with localized prostate cancer diagnosed before the era of prostate-specific antigen (PSA) testing, showed a survival benefit of radical prostatectomy as compared with observation at 15 years of follow-up. 1 By contrast, the Prostate Cancer Intervention versus Observation Trial (PIVOT), initiated in the early era of PSA testing, showed that radical prostatectomy did not significantly reduce prostate cancer–specific or overall mortality after 12 years. 2 PSA screening profoundly changes the clinical domain of study. Among other considerations, the substantial additional lead time . . .

Objective About 20 years ago, the scientific community was first alerted to an enigmatic increase of oesophageal adenocarcinomas in the UK and USA. Subsequently, a virtual epidemic—still unexplained—was confirmed in several western countries. Detailed descriptive data might provide clues to its causes. Design We collected data on incident cases of oesophageal adenocarcinoma from population-based cancer registries in Australia, Europe, North America and Asia. We calculated age-standardised incidence rates and fitted log-linear Poisson models to assess annual rate of increase and to disentangle age-period-cohort effects, linear spine models to estimate rate of increase since 1985, and Joinpoint models to identify possible inflection points. Results With considerable between-registry variation in magnitude and timing, we found a consistent dramatic increase in incidence with an observed or estimated start between 1960 and 1990. The average annual increase ranged from 3.5% in Scotland to 8.1% in Hawaii with similar proportional increase among men and women in most registries and a maintained three to sixfold higher incidence among men. Generally, calendar period was a more important determinant of incidence trends than birth cohort. Where possible to conduct, Joinpoint analyses indicated that the onset of the epidemic varied considerably even between neighbouring countries. Conclusions Given the preponderant period effect and the abrupt onset observed or inferred in most populations, the epidemic appears to be caused by some exposure that was first introduced around 1950. At least 30 years' variation in estimated time of onset opens prospects for hypothesis-generating ecological analyses.

The etiology of Parkinson's disease (PD) is not well understood but likely to involve both genetic and environmental factors. Incidence and prevalence estimates vary to a large extent—at least partly due to methodological differences between studies—but are consistently higher in men than in women. Several genes that cause familial as well as sporadic PD have been identified and familial aggregation studies support a genetic component. Despite a vast literature on lifestyle and environmental possible risk or protection factors, consistent findings are few. There is compelling evidence for protective effects of smoking and coffee, but the biologic mechanisms for these possibly causal relations are poorly understood. Uric acid also seems to be associated with lower PD risk. Evidence that one or several pesticides increase PD risk is suggestive but further research is needed to identify specific compounds that may play a causal role. Evidence is limited on the role of metals, other chemicals and magnetic fields. Important methodological limitations include crude classification of exposure, low frequency and intensity of exposure, inadequate sample size, potential for confounding, retrospective study designs and lack of consistent diagnostic criteria for PD. Studies that assessed possible shared etiological components between PD and other diseases show that REM sleep behavior disorder and mental illness increase PD risk and that PD patients have lower cancer risk, but methodological concerns exist. Future epidemiologie studies of PD should be large, include detailed quantifications of exposure, and collect information on environmental exposures as well as genetic polymorphisms.

Cancer survivorship has traditionally received little prioritisation and attention. For a long time, the treatment of cancer has been the main focus of healthcare providers’ efforts. It is time to increase the amount of attention given to patients’ long‐term well‐being and their ability to return to a productive and good life. This article describes the current state of knowledge and identifies research areas in need of development to enable interventions for improved survivorship for all cancer patients in Europe. The article is summed up with 11 points in need of further focus. Cancer survivorship has traditionally received little attention. It is time to increase the amount of attention given to patients’ long‐term well‐being and their ability to return to a productive and good life. This article describes the current state of knowledge and identifies research areas in need of development to enable interventions for improved survivorship for all cancer patients in Europe.

Assessment of the effect of breast-cancer screening has been hampered by difficulty in measuring secular trends. In this study, data from a cancer registry were used to determine secular trends and to evaluate the effect of screening on breast-cancer mortality. On the basis of several randomized clinical trials, 1 – 3 the World Health Organization concluded in 2002 that screening mammography for women between the ages of 50 and 69 years reduced the rate of death from breast cancer by 25%. 4 Nevertheless, the use of screening mammography is still debated, chiefly because of concern regarding methodologic limitations in some of the randomized trials. 5 In addition, the benefit of mammography when implemented in a population-based service program remains poorly quantified. Therefore, continued evaluation of breast-cancer screening programs is warranted. 6 The main challenge in quantifying the reduction in mortality from nonrandomized screening programs is . . .

In this study of more than 6 million Swedes during 1991–2006, patients were at increased risk for suicide or death from cardiovascular causes after a diagnosis of cancer. Risks were especially high immediately after diagnosis and for cancers with a poor prognosis. Alarge body of evidence suggests high levels of distress and psychiatric symptoms among patients who receive a diagnosis of cancer. 1 – 9 Patients with cancer have been shown to be at increased risk for suicide 10 – 17 and cardiovascular events. 18 – 22 However, most results have been interpreted to be consequences of treatment or the burden of living with a progressing cancer. The psychological stress induced by the diagnosis itself may also give rise to such serious consequences. However, only a few studies have explored the period immediately after a cancer diagnosis. 13 , 14 , 23 We recently observed that patients with prostate cancer both . . .

After about 13 years of follow-up, men <65 years of age with prostate cancer diagnosed on the basis of obstructive urinary symptoms (rather than elevated prostate-specific antigen levels) and assigned to radical prostatectomy, as compared with watchful waiting, have improved survival. The randomized Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) showed that radical prostatectomy decreased the risk of metastases, the rate of death from prostate cancer, and the rate of death from any cause. 1 – 3 Although the participants in SPCG-4 were predominantly men whose cancers were detected on the basis of symptoms, rather than by elevated prostate-specific antigen (PSA) levels, prostate-cancer events have also accumulated during an extended follow-up period in a subgroup of men with low-risk disease. Determining whether there is a survival benefit for men with low-risk disease is relevant in light of the risk of overdiagnosis resulting . . .