Cancer patients who were pregnant at the time of cancer diagnosis were identified by the National Cancer Registry of the German Democratic Republic for the years 1970 through 1979. A total of 355 such cases occurred in women aged 15-44, and during the same period 2, 103, 112 live births were registered. Rank by site in order of decreasing frequency was cervix, breast, ovary, lymphoma, melanoma, brain and leukemia. On the basis of general female population rates, 555.8 cases were expected, giving a significantly reduced observed to expected ratio (O/E) of 0.64. O/E ratios rose with age. The O/E for invasive carcinoma of the cervix was significantly elevated at 1.15; carcinoma in situ of the cervix occurred significantly less frequently than expected (O/E = 0.57). For breast, brain, melanoma and leukemia, significantly fewer cases were observed than expected. Explanations considered for the low number of pregnancy-associated incident cancer cases include underreporting of pregnancy-associated cancer, altered tumor progression in pregnancy or decreased fertility in women with early neoplastic disease.

SUMMARY The presence of a pregnancy at the time of the initial diagnosis of an intracranial neoplasm was studied using material from a population-based tumour registry. Seventeen malignant neoplasms of the brain (ICD 191), three meningiomas, three acoustic neurinomas and a pituitary adenoma associated with pregnancy were reported to the National Cancer Registry of the GDR from [1961][1962][1963][1964][1965][1966][1967][1968][1969][1970][1971][1972][1973][1974][1975][1976][1977][1978][1979]. Observed cases were compared with those expected based on the number of births and the incidence rates for intracranial tumours among women of childbearing age during the same time period. Observed to expected ratios were substantially reduced for malignancy of the brain and meningioma but not for acoustic neurinoma. Review of this uniformly collected material did not provide support for the view that intracranial neoplasms present more often during pregnancy.The diagnosis of a brain tumour in a pregnant patient is a dramatic event for the patient, her family and for the attending physicians. The nature and timing of therapy directed at the brain tumour are affected by the existence of the pregnancy. Similarly, decisions about whether to continue the pregnancy and the selection of the best means of delivery are critically influenced by the nature and prognosis of the mother's intracranial lesion. In addition the question of a causal link between pregnancy and the development or progression of the tumour is inevitably raised. The present work approached the problem of the association of brain tumour with pregnancy from the epidemiologic point of view.The literature concerning pregnancy and intracranial neoplasms consists largely of case reports, case series and reviews of previously collected material.' Cases may have come from one or several referral centres and, in some instances, have been collected over decades.2 Different definitions are used by each author in the selection and review of cases. Depending on the criteria, patients may be included in whom brain tumour symptoms or diagnosis occurred before, during or after pregnancy. Given such diverse methods of case selection, the assessAddress for reprint requests: Prof. Dr W Janisch,

An epidemiologic investigation of true neoplasms of the central nervous system in fetuses and infants in the German Democratic Republic (GDR) was undertaken. Since all fetal deaths and all deaths in the first year of life are subject to a full postmortem examination and since all cancer cases or deaths are reported to a central registry, the prerequisites for a valid assessment of the incidence of these tumors are present. During the years 1960-1979, 55 histopathologically verified tumors of the central nervous system were identified in the GDR, a frequency of approximately 1.1 per 100 000 births. Unexpectedly, medulloblastoma (13 cases) was the most frequent tumor type.

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In Central Europe and in South Africa duodenal ulcer disease has been reported to occur twice as often in migrant workers as in the indigenous population. To investigate the reasons for this phenomenon the joint effect of occupation and nationality on the prevalence of gastric and duodenal ulcer was studied in a survey of 73 000 active members of the German workforce. Non-ulcer dyspepsia and gastric, but not duodenal, ulcer were found more frequently in migrant than in indigenous workers. Manual workers were more prone to develop gastric and duodenal ulcer and non-ulcer dyspepsia than sedentary workers. The seemingly increased prevalence of duodenal ulcer in migrant workers observed by other authors may be due to migrant workers being employed predominantly in manual labour which bears a twofold risk of developing duodenal ulcer.