Thyroid cancer incidence has been rising in the United States, and this trend has often been attributed to heightened medical surveillance and the use of improved diagnostics. Thyroid cancer incidence varies by sex and race/ethnicity, and these factors also influence access to and utilization of healthcare. We therefore examined thyroid cancer incidence rates by demographic and tumor characteristics based on 48,403 thyroid cancer patients diagnosed during 1980 -2005 from the Surveillance, Epidemiology and End Results program of the National Cancer Institute. The rates varied by histologic type, sex, and race/ ethnicity. Papillary carcinoma was the only histologic type for which incidence rates increased consistently among all racial/ethnic groups. Subsequent analyses focused on the 39,706 papillary thyroid cancers diagnosed during this period. Papillary carcinoma rates increased most rapidly among females. Between 1992 -1995 and 2003 -2005, they increased nearly 100% among White non-Hispanics and Black females but only 20% to 50% among White Hispanics, Asian/ Pacific Islanders, and Black males. The increases were most rapid for localized stage and small tumors; however, rates also increased for large tumors and tumors of regional and distant stage. Since 1992 -1995, half the overall increase in papillary carcinoma rates was due to increasing rates of very small (V1.0 cm) cancers, 30% to cancers 1.1 to 2 cm, and 20% to cancers >2 cm. Among White females, the rate of increase for cancers >5 cm almost equaled that for the smallest cancers. Medical surveillance and more sensitive diagnostic procedures cannot completely explain the observed increases in papillary thyroid cancer rates. Thus, other possible explanations should be explored. (Cancer Epidemiol Biomarkers Prev 2009;18(3):784 -91)

Soft tissue sarcomas (STS) are a heterogeneous group of uncommon tumors that show a broad range of differentiation that may reflect etiologic distinction. Routine tabulations of STS are not morphology-specific. Further, the lack of inclusion of sarcomas arising in all organs in most standard evaluations underestimates the true rates. We analyzed the 1978-2001 Surveillance, Epidemiology and End Results program incidence rates of STS regardless of primary site, except bones and joints, using the 2002 criteria of the WHO classification. There were 26,758 cases available for analysis. Leiomyosarcomas accounted for 23.9%, malignant fibrous histiocytomas 17.1%, liposarcomas 11.5%, dermatofibrosarcomas 10.5%, rhabdomyosarcomas 4.6% and angiosarcomas 4.1%. Almost half (47.9%) of the sarcomas arose in the soft tissues, 14.0% in the skin and 7.0% in the uterus. Overall, incidence rates were highest among black women (6.26/100,000 womanyears) and the lowest among white women (4.60/100,000). Ageadjusted rates increased at 1.2% and 0.8% per year among white males and females, respectively, both trends statistically significant, while rates among blacks declined slightly. About 40% of leiomyosarcomas among women were uterine in origin, with a black/white rate ratio of 1.7. This rate ratio increased to 2.0 when we accounted for the lower prevalence of intact uteri among black compared to white women. Total STS rates rose exponentially with age. Rates for both uterine leiomyosarcoma and dermatofibrosarcoma increased rapidly during the childbearing years, peaking at about age 40 and 50, respectively. Incidence patterns of STS varied markedly by histologic type, supporting the notion that these tumors may be etiologically distinct. ' 2006 Wiley-Liss, Inc.Key words: soft tissue sarcomas; SEER; incidence; leiomyosarcoma; WHO; dermatofibrosarcoma; liposarcoma; rhabdomyosarcoma; angiosarcoma; malignant fibrous histiocytoma Soft tissue sarcomas (STS) represent less than 1% of malignant tumors, and little is known about their etiology or incidence patterns.1,2 This heterogeneous group of mesenchymal neoplasms are relatively rare and may arise in soft tissue, skin or various organs, and show a broad range of differentiation, such as smooth muscle (leiomyosarcoma), adipocyte (liposarcoma), striated muscle (rhabdomyosarcoma), endothelium (angiosarcoma) or fibroblast (e.g., dermatofibrosarcoma).3 Standard Surveillance, Epidemiology and End Results (SEER) program tabulations of STS only include sarcomas arising in soft tissue, but not those arising in specific organs such as the skin and organ sites.4,5 Therefore, the SEER tabulations of STS underestimate the true rates. In the 1993, the national estimate of STS was 6,000 cases per year, which rose to 11,400 when sarcomas arising in specific organs were included.6 At that time, rising incidence rates for STS were attributed to increases in Kaposi sarcoma (KS), with STS trends flat when KS was excluded.Recent reports 7-15 have linked specific genetic, immunodeficiency, viral infection and e...

Background: Using data from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results program, we analyzed stomach carcinoma incidence patterns by both histologic type and anatomic site.

Importance Treatment options for young-onset colon cancer patients remain to be defined and their effects on prognosis are unclear. Objective To investigate receipt of adjuvant chemotherapy by age category (18-49, 50-64, and 65-75) and assess if age differences in chemotherapy matched survival gains among patients diagnosed with colon cancer in an equal access healthcare system. Design A cohort study was conducted based on cancer registry and administrative medical claims data. Setting This study was based on linked and consolidated data from the U.S. Department of Defense’s Central Cancer Registry and Military Heath System medical claims databases. Participants Participants were 3,143 patients ages 18 to 75 with histologically confirmed primary colon adenocarcinoma diagnosed between 1998 and 2007. Exposures Patients who underwent surgery and postoperative systemic chemotherapy. Main Outcomes and Measures The primary outcome measure of the study was overall survival of patients who only received surgery and those who received both surgery and post-operative systemic chemotherapy. Results Young and middle aged patients were two to eight times more likely to receive postoperative systemic chemotherapy as compared to older patients, across all tumor stages. Middle-aged patients with stage I (OR 5.04, 95% CI 2.30-11.05) and II (OR 2.42, 95% CI 1.58-3.72) disease were more likely to receive postoperative chemotherapy as compared to older patients. Both groups were two and a half times more likely to receive multi-agent chemotherapy than older patients. Among patients who received surgery and post-operative systemic chemotherapy, no significant differences were observed in survival between age groups. Conclusions and Relevance In an equal access healthcare system, we found potential overuse of chemotherapy among young and middle-aged adults with colon cancer. The addition of postoperative systemic chemotherapy did not result in matched survival improvement.