INTRODUCTION: The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on the risk of malignancy (ROM) in fine-needle aspiration cytology (FNAC) per The Bethesda System for Reporting Thyroid Cytopathology has not been well reported in Singapore. METHODS: We retrospectively identified 821 thyroid nodules with preoperative FNAC from 788 patients out of 1,279 consecutive thyroidectomies performed between January 2010 and August 2016 in a tertiary general hospital in Singapore. Possible cases of NIFTP were reviewed for reclassification and the impact of NIFTP on ROM was analysed. RESULTS: The incidence of NIFTP was 1.2% (10 out of 821). If NIFTP is considered benign, ROM in Bethesda I through VI were 8.6%, 3.5%, 26.3%, 20.0%, 87.7%, 97.0% versus 8.6%, 4.2%, 28.1%, 26.7%, 89.2% and 100% if NIFTP is considered malignant. Eight patients with NIFTP had follow-up of 15 to 110 months. One had possible rib metastasis as evidenced by I131 uptake but remained free of structural or biochemical disease during a follow-up period of 110 months. None had lymph node metastasis at presentation, nor locoregional or distant recurrence. CONCLUSION Classifying NIFTP as benign decreased ROM in Bethesda II through VI, but the benignity of NIFTP requires more prospective studies to ascertain. The impact of NIFTP on ROM in our institution also appears to be lower than that reported in the Western studies.
Adenocarcinoma, Follicular/epidemiology* ; Humans ; Prospective Studies ; Retrospective Studies ; Singapore/epidemiology* ; Thyroid Neoplasms/epidemiology*

BACKGROUND: Adenocarcinoma of the esophagus has been reported to be increasing in incidence in a number of regions throughout the world, while the incidence of squamous cell carcinoma (SCCA) of the esophagus is mostly stable or decreasing. To evaluate the increasing tendency of adenocarcinoma of the esophagus. METHODS: we studied retrospectively the records of patients with histologically proven esophageal cancer between 1970 and 1999 at the Yonsei Medical Center. RESULTS: Total cases of esophageal cancer were 969 patients of which the cases of adenocarcinoma and SCCA were 27 patients and 918 patients, respectively. The ratio of esophageal adenocarcinoma to SCCA was 0.0375 in the 1970s, 0.0241 in the 1980s and 0.0292 in the 1990s. There was no statistical difference (p=0.811) in the ratios of adenocarcinoma of the esophagus between the three consecutive 10-year groups. CONCLUSION: In conclusion, unlike the US and other western countries, it seems that the ratio of esophageal adenocarcinoma compared to SCCA has not increased among patients with esophageal carcinoma at the Yonsei Medical Center.
Adenocarcinoma/*epidemiology ; Carcinoma, Squamous Cell/*epidemiology ; Chi-Square Distribution ; Esophageal Neoplasms/*epidemiology ; Human ; Korea/epidemiology ; Middle Age ; Prevalence ; Retrospective Studies

With the development of population aging in our country, the incidence of gastrointestinal cancer is increasing. The risk of developing gastrointestinal cancer in elderly over 75 years was 5-6 times and the risk of death of gastrointestinal cancer was 7-8 times of the general population. As compared to non-elderly, the incidence of gastric cancer was not decreased obviously but the total incidence of colorectal cancer was increased more quickly. Therefore, screening of gastrointestinal cancer should be performed in the elderly for early discovery, diagnosis and treatment. Because of the insidious onset of the illness in elderly patients, gastrointestinal cancers are mostly diagnosed at advanced or late stage (stage III or IV). Well differentiated cancer is more common, such as papillary or tubular adenocarcinoma. Lauren type, Borrmann II or III are more common in gastric cancer, which are relatively favorable. Compared with non-elderly patients, many elderly patients also suffer from comorbid diseases with higher operation risk and postoperative complication rates. Therefore, we must pay great attention to the perioperative management and the surgical operation for the elderly patients. In this paper, several key issues involved the development trend of incidence and mortality of gastrointestinal cancer, the clinicopathological characteristics, the comorbidity and surgical treatment in the elderly patients with gastrointestinal cancer will be elaborated, aiming at promoting further attention to the clinical therapeutic strategies, management measures and prognostic factors for the elderly patients with gastrointestinal cancer.
Adenocarcinoma ; epidemiology ; surgery ; Aged ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; surgery ; Comorbidity ; Humans ; Postoperative Complications ; Stomach Neoplasms ; epidemiology ; surgery

OBJECTIVETo study the time trends during 1973 - 2004 and the current characteristics of gastric cancer incidence in Shanghai and to develop strategies for control and prevention.

METHODSAll data from the Malignant Cancer Registry System of Shanghai were retrieved and time trends of male and female incidence rates for gastric cancer in urban population from 1973 to 2004 were assessed by annual percentage change (APC) of the crude rates and age-adjusted rates. The APC was calculated by fitting a least squares regression line to the natural logarithm of the rates, using the calendar year as a regressor variable. Based on the computerized data from 2002 to 2004, the current characteristics of urban gastric cancer incidence were analyzed regarding sex, age, stage at diagonsis, histopathologic type and location of the tumor (s). The number and structure of population were obtained from Shanghai Municipal Public Security Bureau. The incidence rates were standardized under the world population. The constituent ratios were analyzed by Chi-square test. Statistical analyses were performed with the SPSS software package for Windows, version 10.0.

RESULTSSubstantially and continuously decreasing trends were noticed in gastric cancer incidence during the past 32 years in urban Shanghai, both in males and in females. The age-standardized rates (ASR) dropped 54.4% in males and 37.6% in females. From 2002 to 2004, 7630 new cases of gastric cancer were registered in urban Shanghai with the ASRs of male and female gastric cancer as 27.4 and 14.0 per 100 000. Under the age of 40, the age-specific incidence was quite low that no differences were found between men and women. However, the incidence increased significantly after age of 40 and differences of increase were shown between the two sexes. About 46.1% of all the cases had detailed records of TNM stage, in which IV stage was the majority while I stage the least. About 74.1% of all the cases were diagnosed histopathologically and 71.7% of all had detailed records on histopathologic types. Adenocarcinoma was the most common type (76.8%), followed by signet ring cell carcinoma (9.4%). The proportions of adenocarcinoma and tubular adenocarcinoma were higher in males than in females while signet ring cell cancer was higher in females than in males. Intestinal type gastric cancer was the most prominent type in Lauren system. The proportion of male was higher than female in intestinal type whereas female was higher than male in diffused type. In lesion location, the antrum was the most common tumor site. The gastric antrum cancer of females was more common than males while the gastric cardia cancer presented quite the contrary. The proximal gastric cancer was more prevalent in males than in females whereas the distal gastric cancer was in opposite pattern.

CONCLUSIONA dramatic decreasing trend during 1973 - 2004 and several current and interesting characteristics in view of gender, age, stage at diagnosis, histopathologic type and tumor location of gastric cancer in urban Shanghai were determined in this study, which might contribute to the development of control and prevention strategy for gastric cancer.

Adenocarcinoma ; epidemiology ; Carcinoma, Signet Ring Cell ; epidemiology ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Regression Analysis ; Stomach Neoplasms ; epidemiology ; Urban Population

No abstract available.
Adenocarcinoma, Follicular/*epidemiology ; *Diet ; Female ; Humans ; *Iodine ; Male ; *Nutritional Status ; Thyroid Neoplasms/*epidemiology

BACKGROUND: Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors. METHODS: Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models. RESULTS: A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants. CONCLUSIONS The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation.
Male ; Humans ; Female ; Lung Neoplasms/epidemiology* ; China/epidemiology* ; Adenocarcinoma ; Carcinoma, Squamous Cell ; Coal

Although there is a controversy, several reports have shown that gastric cardia cancer has tended upwards in recent years. The aim of this study was to investigate the changing trend of stomach cancer according to the location of cancer and histologic type in Korea, where is known to be one of the most prevalent areas for gastric cancer. All the patients newly diagnosed as gastric cancer from 1991 through 2000 were recruited in Hallym University Medical Center. The periods were divided into the first (1991 through 1995) and the second (1996 through 2000) period. We analyzed the characteristics of cancer in the aspects of age, sex, tumor locations (cardia and non-cardia), and tumor grade of differentiation (well, moderate, and poor differentiated type). The number of cases was 2,395 and that of cardia cancer was 158 (6.6%). There was no evidence about the changes in the incidence of cardia cancer and histologic differentiation between two periods. The development of cardia cancer was not associated with the factors of age and sex with having no difference in the point of tumor grade. We could not find an upward tendency of cardia cancer development in recent 10 yr in Korea.
Adenocarcinoma/epidemiology* ; Adenocarcinoma/pathology ; Cardia* ; Cell Differentiation ; Comparative Study ; Female ; Human ; Incidence ; Korea/epidemiology ; Male ; Morbidity/trends ; Retrospective Studies ; Stomach Neoplasms/epidemiology* ; Stomach Neoplasms/pathology

OBJECTIVETo describe the incidence trends and pathological characteristics of lung cancer in urban Beijing, China.

METHODSA total of 32 845 medical records of the residents diagnosed as lung cancer in urban Beijing from 1998 to 2007 were retrieved through the cancer registry system of Beijing Cancer Registry. Crude incidence rate, age-specific incidence rate, adjusted incidence rate by world standardized population, annual percentage change (APC) and histological categorized incidence rate by world standardized population were calculated in order to compare the differences of the incidence trends in different time periods, or among different gender and age groups.

RESULTSA total of 32 845 newly diagnosed lung cancer patients between 1998 and 2007 were included in our study. The crude incidence rate was 47.81/100 000 (32 845/68 704 429), increasing by 38.80% from 39.30/100 000 in 1998 to 54.55/100 000 in 2007 with APC at 3.35% in urban Beijing (Z = 9.984, P < 0.001). While it changed to 28.95/100 000 with an APC at 0.27% (Z = 0.846, P = 0.422) when adjusted by world standardized population. For male, the crude incidence rate was 58.28/100 000 (20 342/34 906 580, adjusted rate at 37.03/100 000, APC at 0.38%, Z = 1.008, P = 0.343); while for female, the crude incidence rate was 36.99/100 000 (12 503/33 797 849, adjusted rate at 21.48/100 000, APC at 0.14%, Z = 0.431, P = 0.678). 17 920 lung cancer patients being diagnosed according to histological evidence, accounted for 54.56%. The respective proportion of the patients with histological diagnosis was 43.14% (1095/2538) in 1998 and 65.55% (2641/4029) in 2007, with a 51.95% increase (χ(2) = 859.152, P < 0.001) in decade. In terms of subtypes of lung cancer, the proportion of squamous cell carcinoma decreased annually, from 30.41% (333/1095) in 1998 to 24.16% (638/2641) in 2007; while the proportion of adenocarcinoma increased from 42.83% (469/1095) to 46.80% (1236/2641). As a result, the squamous cell carcinoma to adenocarcinoma ratio declined from 0.71 (333/469) to 0.52 (638/1236) (χ(2) = 50.214, P < 0.001). For women, the ratio declined more significantly and the proportion of the squamous cell carcinoma and adenocarcinoma were 14.77% (925/6262) and 60.83% (3809/6262), respectively in the period between 1998 and 2007.

CONCLUSIONNo significant change was found in the incidence trend of lung cancer after the incidence rate adjusted by world standard population, but the proportion of the subtypes of lung cancer categorized by histological evaluation changed apparently.

Adenocarcinoma ; epidemiology ; pathology ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Lung Neoplasms ; epidemiology ; pathology ; Male ; Middle Aged

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

The materials used in this study consist 744 gastric resections removed subtotally at the Yonsei University College of Medicine and Severance Hospital during the last 11 years from Jan. 1. 1959 to Dec. 31, 1969. Among these, 446 cases of gastric carcinoma were diagnosed at the Department of Pathology Yonsei University College of Medicine for this same duration. Histopathological studies as well as clinical study on all cases were performed. Summary: 1. Among 744 gastric resections examined during the last 11 years, gastric carcinoma was found in 446 cases, giving an incidence of 59.95% for subtotally removed stomachs. 2. Male to female ratio was 2.28 to 1. The peak age incidence is between 50 and 59 years and accounted for 172cases(35.77%). 3. There is no relation between blood group and incidence of gastric carcinoma. 4. Clinical symptoms in order of frequency were as follows: epigastric discomfort and pain(86%), indigestion(66.67%), weight loss(35.67%), nausea and vomiting(35.33%) and palpable epigastric mass(23.33%). The duration of the chief complaints was usually within six months(54.66%). 5. The gastric acidity disclosed that achlorhydria was found in 36.21%, hypochlorhydria in 32.26% and hyperchlorhydria in 2.15%. 6. The location of the tumor was as follows: 44.86% at the pyloric canal, and 26.53% at the antrum. The size of the tumor varied in diameter. The most frequent size was 3-5cm (43.43%) and 6-10cm(42.90%). 7. On the macroscopical examination, the classification based on Borrmann's gross types and their incidences were as follows: Type I(3.71%), type II(11.22%), type III(62.18%), and type IV(23.64%). 8. On the histological classification, 70% of the cases were adenocarcinomas. Serosal involvement was found in most cases(86.89%). 9. Metastasis to the regional lymphnodes was found in 68.84%, and direct extension of the omentum was 21.39%. 10. According to the relationship between regional lymphnode metastases and lymphatic permeation, and relationship between lymphatic permeation and histologic type, the degree of lymphatic permeation is more, the more metastases to regional lymphnode is found. And metastasis to regional lymphnode and lymphatic permeation is more common in adenocarcinoma than other types. 11. There is no relationship between intestinal metaplasia and histologic type. But each histologic type was accompanied by intestinal metaplasia frequently. In conclusion based on the above findings, it can be stated that gastric carcinoma among Koreans exhibited a far advanced stage, both clinically and morphologically.
Adenocarcinoma/pathology* ; Adenocarcinoma, Mucinous/pathology* ; Adult ; Aged ; Carcinoma/pathology* ; Female ; Human ; Korea ; Male ; Metaplasia/epidemiology ; Middle Age ; Neoplasm Metastasis ; Sex Factors ; Statistics ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/pathology*