TATITIC HEALTH AND DIEAE 2003:11 Cancr Incidnc in wdn 2002 Cntr for Epidmiology
tatistics - Halth and Disass Cancr Incidnc in wdn 2002 Th National Board of Halth and Wlfar Cntr for Epidmiology OFFICIAL TATITIC OF WEDEN For information: Lotti Barlow Th Cancr Rgistry, Cntr for Epidmiology Tlphon: +46-8-555 530 00 Publishd at Intrnt: http://www.sos.s/sos/statisti.htm - Dcmbr 2003 Artiklnr. 2003-42-11 IN 91-7201-829-1 ocialstyrlsn klassificrar från och md år 2001 sin utgivning i olika dokumnttypr. Dtta är statistik. Dt innbär att rapportn innhållr siffruppgiftr som ocialstyrlsn samlat in, rgistrrat, barbtat, sammanställt, analysrat och/llr kommntrat. Uppgiftrna bskrivr läg, tillstånd och/llr utvckling. 2
Prfac Th wdish Cancr Rgistry was stablishd in 1958. In this publication th Cntr for Epidmiology (EpC) at th National Board of Halth and Wlfar prsnts its 45th rport on th incidnc and prvalnc of cancr in wdn. It compriss th matrial for 2002 and a dscription of trnds covring th priod of 1960-2002. In th prsnt rport th rats ar ag standardizd according to th population Dcmbr 31, 2000. A comparison btwn diffrnt ag standardization ar shown in Figur A. Th cumulativ probability to dvlop cancr is prsntd in chaptr 8.Th prvalnc of cancr in wdn is prsntd in chaptr 9. it and histopathology ("morphology") of th tumors has bn codd in th ICD-O-2/ICD-10 systms of topography and morphology as of January 1st 1993. With ths systms, a mor dtaild information is obtaind (spcially with rgard to th morphology) than was prviously possibl with th ICD-7/WHO/H/ CANC/24.1 coding principls; furthr, th coding systms in th Cancr Rgistry will in th futur b comparabl with ICD-10 whn usd in its clinical contxt. In th prsnt publication, ICD-O-2/ICD-10 figurs for coding sit hav bn translatd to comply with arlir ICD-7 praxis, and ar prsntd in th main tabls according to ICD-7. Tabl W1 and Tabl W2 show that, for all practical purposs, such a translation is fasibl. tockholm Dcmbr 2003 Krstin Wigzll Dirctor Gnral National Board of Halth and Wlfar Måns Rosén Profssor and Had Cntr for Epidmiology National Board of Halth and Wlfar 3
Profssional taff of th Cancr Rgistry Ptra Ottrblad Olausson, Dputy Had of Division Mdical consultativ staff: Jan Ericsson, MD Lars Holmbrg, MD Barbro Lundh-Rozll, MD tatistical and administrativ staff: hiva Ayoubi Lotti Barlow Vilhlm Gustafsson Mats Talbäck Ulla Trsmdn For information: Lotti Barlow wdish Cancr Rgistry Cntr for Epidmiology National Board of Halth and Wlfar E-106 30 TOCKHOLM WEDEN Tlphon: +46-8 - 555 530 00 Fax: +46-8 - 555 533 27 E-mail: cancrrgistrt@sos.s Wb sit: http://www.sos.s/pc/cancr/introcan.htm 4
Contnts Pag Matrial 7 Information availabl in th Cancr Rgistr 8 Rporting procdurs and controls of th matrial 9 Validity of th data 10 tatistical trms 12 Th population of wdn 13 Total cancr incidnc 2002 15 Cumulativ probability to dvlop cancr 20 Th prvalnc of cancr in wdn 22 Trnds in th cancr incidnc 24 Coding according to ICD-O-2/ICD-10, and translation to arlir ICD vrsions: 107 Tabl W1 Translation of sit cods from ICD-O-2/ICD-10 to ICD-7 and ICD-9 108 Tabl W2 Translation of sit cods from ICD-O-2/ICD-10 to ICD-7 and ICD-9, 115 including rlvant morphology cods FIGURE Figur A Comparison btwn diffrnt mthods of calculating 15 incidnc rats pr 100 000, by sx, 1960-2002 Figur B Th tn most frqunt spcifid cancr sits, by sx 16 Figur C Ag-spcific incidnc rats pr 100 000. All sits, by sx 16 Figur D Groupd cancr sits, by sx 17 Figur E All sits. Nw cass, 1960-2002 27 Figur F1 All sits. Ag standardizd, 1960-2002 27 Figurs F2-28 Ag standardizd cancr incidnc rats pr 100 000, by sit and sx 1960-2002 28 TABLE Tabl A1 Main cancr sits in not autopsid cass in th Caus of Dath Rgistr 2001 11 but not in th Cancr Rgistr 1958-2001 Tabl A2 Main cancr sits in autopsid cass in th Caus of Dath Rgistr 2001 11 but not in th Cancr Rgistr 1958-2001 Tabl B lctd population data for wdn 2002, by sx 13 Tabl C Th man population of wdn 2002, by sx and ag 13 Tabl D Th man population of wdn 2002, by sx and domicil 14 Tabl E Total numbrs and total rats pr 100 000, by sx 15 Tabl F Prcntag distribution of th nw cass of cancr, by sit and sx 18 5
Tabl G Numbr of tumors considrd not to b infiltrating and mtastasizing, but 19 includd in th total cancr incidnc, by diagnosis and sx Tabl H Numbr of bnign tumors and prcancrous lsions rgistrd, but 19 not includd in th total cancr incidnc, by diagnosis and sx Tabl I Cumulativ probability of dvloping a cancr bfor a crtain ag in 21 wdn, by sit and sx Tabl J Prvalnc of cancr in wdn, by sit and sx, 1958-2002 and 1998-2002 23 Tabl K Estimats of th annual linar trnd of slctd sits, 1983-2002 and 1993-2002 25 Tabl 1 Numbr of nw cass, by sit, sx and ag at diagnosis 33 Tabl 2 Numbr of nw cass, by sit, sx and county 47 Tabl 3A Numbr of nw cass, by sit, sx, mdical rgion and th municipalitis 51 of tockholm, Malmö and Götborg Tabl 3B Numbr of nw cass found incidntally at autopsy, by sit, sx, mdical 55 rgion and th municipalitis of tockholm, Malmö and Götborg Tabl 3C Numbr of scond and multipl primaris, by sit, sx, mdical rgion 59 and th municipalitis of tockholm, Malmö and Götborg Tabl 4 Rats pr 100 000, by sit, sx and ag at diagnosis and rats ag adjustd 63 to th wdish population 2000 and th world standard population Tabl 5 Rats pr 100 000 ag standardizd to th wdish population 2000, 76 by sit, sx and county Tabl 6 Rats pr 100 000 ag standardizd to th wdish population 2000, by sit, 80 sx, mdical rgion and th municipalitis of tockholm, Malmö and Götborg Tabl 7 Rats pr 100 000 ag adjustd to th world standard population, by sit, 84 sx and yar of diagnosis 1983-2002 Tabl 8 Prcntag of cytologically or histologically vrifid cass, by sit, 88 sx and ag at diagnosis Tabl 9 Prcntag of cass found incidntally at autopsy, by sit, sx and 92 ag at diagnosis Tabl 10 Prcntag of cass found incidntally at autopsy, by sit, sx and county 96 and th municipalitis of tockholm, Malmö and Götborg APPENDICE Appndix 1 Major xcptions from th cods in th 7th WHO rvision 100 (WHO/H/CANC/24.1 for Anatomical Location) Appndix 2 Dfinitions of statistical trms 101 Appndix 3 Form usd for clinical rport 104 Appndix 4 Map of wdn 105 6
Matrial According to Rgulations by th National Board of Halth and Wlfar (OF(M) 1984:32) all physicians in hospitals and othr stablishmnts for mdical tratmnt undr public or privat administration in wdn must rport all cass of cancr ("Clinical rport", Appndix 3) to th Cancr Rgistry. Furthrmor, pathologists and cytologists sparatly rport vry cancr diagnosis on surgically rmovd tissus, biopsis, cytological spcimns, bon marrow aspirats and autopsis. Thus, th majority of cass ar notifid twic, in sparat rports. Only prsons that hav official rsidncy in wdn ar includd in th Cancr rgistr. Th rgistration of nw cancr rports and th major chck-up and corrction work is prformd by six rgional cancr rgistris covring th whol country. Ths rgistris ar associatd with th oncological cntr in ach mdical rgion of wdn (tockholm-gotland, Uppsala-Örbro, Linköping, Lund-Malmö, Götborg and Umå). Th rgionalization implis a clos contact btwn th rgistry and th rporting physician which in turn allviats th task of corrcting and chcking th matrial. Annualy th rgional rgistris snd information of nwly rgistrd cass and corrctions concrning thos prviously rportd to th National Cancr Rgistry. Th prsnt publication compriss statistics on cass of cancr diagnosd in 2002. Th following disass ar to b rportd to th National Cancr Rgistry. A B C D All dfinitly malignant noplasms (.g. carcinoma, sarcoma, malignant lymphoma, lukmia and malignant tratoma). Carcinoid tumors of digstiv and othr organs, granulosa cll tumors of th ovary, thymomas, adamantinomas and chordomas. Histologically bnign tumors of th cntral nrvous systm and mnings, transitional cll papillomas of th urinary tract, all hormonally activ tumors of th ndocrin glands (xcpt th thyroid) and th ntro-chromaffin and nurondocrin systms. Prcancrous lsions of lip, mouth, larynx, bronchus, tracha, crvix utri, skin, vulva and vagina, gastro-intstinal polyps with suspctd malignancy, "bronchial adnomas", atypical pithlial prolifrations of th brast (carcinoma in situ typ) and adnoma phyllods, prcancrous ndomtrial lsions, hydatidiform mols of placntal tissu, and ovarian cystadnomas of bordrlin typ. Disass mntiond undr A - C ar includd in th total cancr incidnc (Tabls F, G, I, J and 1-10), although a numbr of th tumors listd undr C ar considrd not to b "infiltrating and mtastasizing" (Tabl G). Th bnign tumors and prcancrous lsions mntiond undr D ar listd in Tabl H. 7
Basal cll carcinoma (basalioma) hav not bn rgistrd. If a prson has mor than on primary tumor, ach tumor is rgistrd sparatly. This also applis for tumors apparing in th sam parnchymal organ, providd th noplastic tissus and histogntic proprtis diffr among th tumors (for instanc, if on noplasm is a carcinoma and anothr a sarcoma). Each nw primary tumor in th skin, intstin and urinary tract is rgistrd. Information from dath crtificats is availabl to th Rgistry, supplying dat and caus of dath. Dath crtificats until Dcmbr 31, 2001 hav bn mrgd with th fils of th Cancr Rgistry 1958-2001. Du to th fact that th Caus of Dath Rgistry has not bn updatd to 2002, 2001 is th last yar availabl. Cancr diagnoss basd on dath crtficats ar not rgistrd. Th prsons in th Cancr Rgistry hav also bn followd up rgarding to migration through tatistics wdn. Information availabl in th Cancr Rgistry Data in cancr rports - Uniqu prsonal idntification numbr composd of 8 digits basd on cntury, yar, month and day of birth, supplmntd with th so-calld rgistration numbr (3 digits) and a chck digit - x - Domicil (county, municipality, parish) - Hospital - Hospital dpartmnt - Pathology/cytology dpartmnt - pcimn numbr, and yar whn spcimn was takn - it of tumor. Th Rgistry has vr sinc 1958 and still, mainly followd a cod basd on th 7th WHO rvision (WHO/H/CANC/24.1 for Anatomical Location). For xcptions cf. Appndix 1. For th yars 1987-1992, th ICD-9 coding systm hav bn usd and 1993-w th ICD-O-2/ ICD-10 (Intrnational Classification of Disass for Oncology. cond Edition. WHO Gnva 1990) - Tumor srial numbr - Malignancy (ys/no) - Histological typ (WHO/H/CANC/24.1 Histology ) and from 1993 according to NOMED (Intrnational Classification of Disass for Oncology. cond Edition. WHO Gnva 1990) - Basis of diagnosis: 1 Clinical diagnosis only 2 X-ray 3 Histological xamination of surgical or biopsy matrial (patho-anatomic diagnosis, "PAD") 4 Autopsy with histopathological xamination of surgical or biopsy matrial 5 Cytological diagnosis 6 Gross xamination at surgry 7 Autopsy without histopathological xamination - Dat of diagnosis (cntury, yar, month, day) 8
- Diagnosis mad incidntally at autopsy (ys/no) 2.2 Data from dath crtificats - Dat of dath (cntury, yar, month, day) - Caus of dath. Main undrlying caus, according to: ICD-7 1958-1968, ICD-8 1969-1986, ICD-9 1987-1996, ICD-10 1997-w Rporting procdurs and controls of th matrial Th rports ar rgistrd continuously at th rgional cancr rgistris. Usually a notification from th pathology/cytology lab arrivs first, followd by a clinical notification. Whnvr rports arriv sparatly, thy ar rgistrd with a flag to show that on rport is lacking. If th missing rport dos not arriv within thr to nin months, a rmindr is snt out. In 20-30 pr cnt of th cass, rports hav to b tracd according to this schm. If th missing rport dos not arriv, th rquird information can b takn from th hospital cas rcord, if availabl. If this sourc of information is also lacking, rgistration is don on th basis of th information that is availabl at hand. Th prcntag of cass with such an incomplt rgistration is lss than two pr cnt. A small numbr of cass (annually som hundrd) ar rportd too lat to b includd in th publication. Ths cass ar addd to th rgistry whnvr thy arriv. An stimation of th drop-out rat of cancrs can b don by comparing th Cancr Rgistry data with th Caus of Dath Rgistry (s nxt chaptr). Th matrial passs through th following controls: - th idntification numbr is chckd against th rgistr covring th total population of wdn - duplicats ar subjct to spcial chcking - th validity and logical contnts of th cods ar chckd whn th matrial is procssd. 9
Validity of th data Approximatly 98 pr cnt of th cass ar morphologically vrifid (Tabl 8). Th rliability of th diagnosis may vary with th hospital, dpartmnt and/or physician concrnd; this may add to a gographical variability, though th structur of th country's public halth systm is homognous. Th availability of facilitis for pathology srvic likwis varis. Th rliability of th diagnosis also varis with ag and typ of disas. Th figurs on incidnc from th Cancr Rgistry includ data on cass of cancr found incidntally at autopsy. Th contribution from this additional sourc varis with sit and typ of tumor. Variations in th incidnc of a particular typ of tumor in a crtain gographical rgion may partly b du to diffrncs in frquncy and thoroughnss of th autopsy xamination and th histologic xamination of th autopsy spcimns. Cancr of bronchus/lung, pancras, colon, livr and prostat ar oftn ovrlookd at clinical xaminations but ar found incidntally at autopsy. Tabl 3B givs th numbr of all cass found incidntally at autopsy by sit, sx and mdical rgion. Th wdish Cancr Rgistry dos not us information on cancrs basd on dath crtificats, th rason bing that th data on th dath crtificats in many instancs ar uncrtain - spcially rgarding old prsons - as shown in a sparat analysis (1). In 2001, thr wr 2 369 prsons in th Caus of Dath Rgistry with cancr statd as undrlying caus of dath which wr not on fil in th Cancr Rgistry 1958-2001. Th most common cancr sits wr - as notd prviously - bronchus/lung, pancras and prostat. Th distribution by sx, ag, and autopsy is shown in Tabl A1 and Tabl A2. Th figurs show that most of th cass ar 75 yars of ag, or oldr, and not autopsid. Du to th fact that th Caus of Dath Rgistry has not bn updatd to 2002, 2001 is th last yar availabl. REFERENCE 1. Britta Mattsson, Cancr Rgistration in wdn, acadmic thsis, Karolinska Institut, tockholm 1984. 10
Tabl A1: Main cancr sits in not autopsid cass in th Caus of Dath Rgistry 2001, but not in th Cancr Rgistry 1958-2001 Ag at dath ICD-10 it x All ags 0-49 50-74 75+ C00-C97 All sits M 1 109 10 320 779 F 1 290 10 238 1 042 C16 tomach M 23 0 6 17 F 24 0 2 22 C18-C21 Colon and rctum M 67 0 23 44 F 93 0 11 82 C22 Livr and intrahpatic bil ducts M 67 0 22 45 F 74 0 19 55 C23-C24 Gallbladdr, othr and unspcifid parts of M 47 0 10 37 biliary tract F 72 0 11 61 C25 Pancras M 138 2 54 82 F 220 0 39 181 C26 Othr and ill-dfind digstiv organs M 25 0 7 18 F 38 0 1 37 C34 Bronchus and lung M 197 1 79 117 F 150 0 53 97 C50 Brast M 0 0 0 0 F 51 5 11 35 C51-C58 Fmal gnital organs F 55 1 9 45 C61 Prostat M 152 0 10 142 C64-C68 Urinary tract M 87 0 28 59 F 79 0 13 66 C69-C72 Cntral nrvous systm M 49 2 21 26 F 62 1 23 38 C76-C80 Ill-dfind, scondary and unspcifid sits M 111 0 21 90 F 227 1 19 207 C81-C96 Lymphoid, hamatopoitic and rlatd tissu M 81 2 19 60 F 105 1 20 84 Othr sits M 65 3 20 42 F 40 1 7 32 Tabl A2: Main cancr sits in autopsid cass in th Caus of Dath Rgistry 2001, but not in th Cancr Rgistry 1958-2001 Ag at dath ICD-10 it x All ags 0-49 50-74 75+ C00-C97 All sits M 45 1 18 26 F 49 0 20 29 C16 tomach M 4 0 2 2 F 4 0 2 2 C18-C21 Colon and rctum M 2 0 1 1 F 10 0 2 8 C22 Livr and intrahpatic bil ducts M 3 0 1 2 F 5 0 2 3 C23-C24 Gallbladdr, othr and unspcifid parts of M 4 0 1 3 biliary tract F 6 0 5 1 C25 Pancras M 5 0 3 2 F 3 0 2 1 C26 Othr and ill-dfind digstiv organs M 0 0 0 0 F 0 0 0 0 C34 Bronchus and lung M 11 0 1 10 F 9 0 3 6 C50 Brast M 0 0 0 0 F 4 0 1 3 C51-C58 Fmal gnital organs F 2 0 1 1 C61 Prostat M 1 0 0 1 C64-C68 Urinary tract M 1 0 1 0 F 1 0 0 1 C69-C72 Cntral nrvous systm M 0 0 0 0 F 0 0 0 0 C76-C80 Ill-dfind, scondary and unspcifid sits M 2 0 1 1 F 2 0 0 2 C81-C96 Lymphoid, hamatopoitic and rlatd tissu M 9 1 5 3 F 2 0 2 0 Othr sits M 3 0 2 1 F 1 0 0 1
tatistical trms Ag Th ag of th patint at th dat of diagnosis. Crud incidnc rat Th total numbr of cass dividd by th corrsponding man population pr 100 000. Rats for mals and fmals ar calculatd sparatly. Ag spcific incidnc rat Numbr of cass for ach fiv yar ag-group dividd by th corrsponding man population pr 100 000. Rats for mals and fmals ar calculatd sparatly. Ag standardizd incidnc rat In Tabls E, K and 4-6, th figurs hav bn adjustd for ag distribution to th wdish population Dcmbr 31, 2000. In ordr to facilitat intrnational comparisons, th incidnc rats hav also bn adjustd to th world standard population (Tabls E, 4 and 7). In th lattr tabl th sits 204-209 (lukmia, polycythæmia vra and mylofibrosis) ar aggrgatd. Th standard populations and mor dtails on dfinitions of statistical trms ar givn in Appndix 2. Cumulativ probability of dvloping cancr In Tabl I th cumulativ probability to dvlop a cancr bfor a crtain ag has bn stimatd from th ag spcific incidnc rats in Tabl 4. Prvalnc In Tabl J th numbr of rsidnt prsons in wdn Dcmbr 31, 2002 with a diagnosd cancr wr countd as th prvalnc. Th calculations wr don for two rcruiting priods: th whol rgistry 1958-2002, and to nabl comparisons btwn yars, th last fiv yar priod 1998-2002. Trnd Th trnds ovr tim ar calculatd from th ag adjustd figurs on tumor rats in th 18 diffrnt ag groups. In Tabl K th trnd figurs for both th last 10 and 20 yars ar prsntd. Th tim sris of ag standardizd rats plottd in Figurs F1-F28 covr th priod from 1960 to 2002. Comparisons btwn trnds covring diffrnt tim priods should b mad with caution sinc diagnostic mthods may vary, and coding practics chang. Furthrmor, in th trnd priods shown in th prsnt publication, th ag structur of th population, th autopsy frquncy (rcnt figur 15 pr cnt, compard to 50 pr cnt in th svntis), and typ and forms of scrning activitis vary. 12
Th population of wdn Th lif xpctancy at birth in wdn for 2002 was 77.7 yars for mals and 82.1 for fmals. om dmographic data for th population ar givn in Tabls B - D. Tabl B: lctd population data for wdn 2002, by sx Mals Fmals Total Man population 4 417 776 4 507 182 8 924 958 Numbr of liv births 49 187 46 628 95 815 Numbr of lat fotal daths (still births) 182 170 352 Numbr of daths 45 780 49 229 95 009 Numbr of daths from cancr* 11 131 10 484 21 615 Crud dath rats** 10.4 10.9 10.6 Infant mortality rats*** 3.5 3.0 3.3 * Last avalibal data from 2001 ** Numbr of daths pr 1 000 of th man population *** Numbr of daths during th first yar of lif pr 1 000 liv births ourc: tatistics wdn and Th National Board of Halth and Wlfar Tabl C: Th man population of wdn 2002, by sx and ag Ag Mals % Fmals % Total % All ags 4 417 776 49.5 4 507 182 50.5 8 924 958 100.0 0-4 235 914 2.6 223 220 2.5 459 133 5.1 5-9 277 442 3.1 264 777 3.0 542 218 6.1 10-14 315 887 3.5 298 862 3.3 614 749 6.9 15-19 270 320 3.0 255 324 2.9 525 644 5.9 20-24 262 792 2.9 253 527 2.8 516 319 5.8 25-29 292 502 3.3 282 332 3.2 574 834 6.4 30-34 313 398 3.5 301 970 3.4 615 368 6.9 35-39 337 398 3.8 320 600 3.6 657 997 7.4 40-44 297 885 3.3 286 897 3.2 584 782 6.6 45-49 297 101 3.3 288 936 3.2 586 037 6.6 50-54 310 587 3.5 305 475 3.4 616 062 6.9 55-59 319 799 3.6 312 661 3.5 632 460 7.1 60-64 232 701 2.6 233 728 2.6 466 428 5.2 65-69 183 968 2.1 198 418 2.2 382 386 4.3 70-74 163 254 1.8 194 217 2.2 357 470 4.0 75-79 140 758 1.6 185 448 2.1 326 206 3.7 80-84 101 287 1.1 156 784 1.8 258 070 2.9 85+ 64 788 0.7 144 011 1.6 208 799 2.3 85-89 47 318 0.5 93 732 1.1 141 050 1.6 90-94 15 037 0.2 40 280 0.5 55 317 0.6 95+ 2 433 0.0 10 000 0.1 12 433 0.1 ourc: tatistics wdn 13
Tabl D: Th man population of wdn 2002, by sx and domicil Mals % Fmals % Total % wdn 4 417 776 49.5 4 507 182 50.5 8 924 958 100.0 County 01 tockholms län 903 687 10.1 940 988 10.5 1 844 675 20.7 03 Uppsala län 146 661 1.6 150 981 1.7 297 641 3.3 04 ödrmanlands län 127 822 1.4 130 291 1.5 258 113 2.9 05 Östrgötlands län 206 091 2.3 206 810 2.3 412 901 4.6 06 Jönköpings län 162 758 1.8 165 140 1.9 327 898 3.7 07 Kronobrgs län 88 598 1.0 88 183 1.0 176 780 2.0 08 Kalmar län 116 522 1.3 118 141 1.3 234 662 2.6 09 Gotlands län 28 353 0.3 29 044 0.3 57 397 0.6 10 Blking län 75 133 0.8 74 814 0.8 149 946 1.7 12 kån län 560 092 6.3 580 739 6.5 1 140 831 12.8 13 Hallands län 137 901 1.5 139 701 1.6 277 602 3.1 14 Västra Götalands län 746 903 8.4 757 641 8.5 1 504 544 16.9 17 Värmlands län 135 765 1.5 137 911 1.5 273 676 3.1 18 Örbro län 134 808 1.5 138 467 1.6 273 275 3.1 19 Västmanlands län 128 699 1.4 129 736 1.5 258 435 2.9 20 Dalarnas län 137 939 1.5 138 885 1.6 276 823 3.1 21 Gävlborgs län 138 098 1.5 139 494 1.6 277 592 3.1 22 Västrnorrlands län 121 886 1.4 122 813 1.4 244 699 2.7 23 Jämtlands län 64 258 0.7 64 009 0.7 128 267 1.4 24 Västrbottns län 127 158 1.4 127 867 1.4 255 024 2.9 25 Norrbottns län 128 651 1.4 125 532 1.4 254 183 2.8 Municipality 0180 tockholm 365 057 4.1 391 491 4.4 756 548 8.5 1280 Malmö 127 370 1.4 136 570 1.5 263 939 3.0 1480 Götborg 232 458 2.6 240 636 2.7 473 094 5.3 Mdical rgion R1 tockholm/gotland 932 039 10.4 970 032 10.9 1 902 071 21.3 R2 Uppsala/Örbro 949 791 10.6 965 763 10.8 1 915 554 21.5 R3 Linköping 485 370 5.4 490 090 5.5 975 460 10.9 R4 Lund/Malmö 782 887 8.8 804 030 9.0 1 586 917 17.8 R5 Götborg 825 738 9.3 837 048 9.4 1 662 786 18.6 R6 Umå 441 952 5.0 440 220 4.9 882 172 9.9 ourc: tatistics wdn 14
Total cancr incidnc 2002 Th incidnc is basd on a total of 46 749 cancrs rportd to th wdish Cancr Rgistry in 2002, 817 cass of thm wr found incidntally at autopsy. Th numbr of prsons with cancr diagnosd for th first tim in 2002 was 39 726 (20 491 mals and 19 235 fmals); thus. 7 023 cancrs wr diagnosd in prsons with at last on prvious cancr diagnosis. Th distribution of all rportd cancrs is givn by sx in Tabl E blow. CANCER INCIDENCE IN WEDEN 2002 Tabl E: Total numbrs and total rats pr 100 000, by sx Rats pr 100 000 x Nw cass Crud rat wdn* World** All tumors M 24 142 546.5 604.8 290.9 F 22 607 501.6 463.0 264.5 M+F 46 749 Numbr of prsons (first primaris) M 20 491 463.8 508.4 253.8 F 19 235 426.8 396.3 232.9 M+F 39 726 cond primaris M 3 651 82.6 96.4 37.0 F 3 372 74.8 66.7 31.7 M+F 7 023 Tumors found incidntally at autopsy M 485 11.0 13.0 4.9 F 332 7.4 6.4 2.5 M+F 817 *Ag adjustd to th wdish population 2000 **Ag adjustd to th World population CANCER INCIDENCE IN WEDEN 2002 Figur A: Comparison btwn diffrnt mthods of calculating incidnc rats pr 100 000, by sx 700 Pr 100 000 Mals 600 Pr 100 000 Fmals 600 500 500 400 300 200 100 0 Ag stand. wdn 2000 Ag standard World Crud rats 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 400 300 200 100 0 Ag stand. wdn 2000 Ag standard World Crud rats 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 15
Th prcntag distribution of th tn most frqunt forms of cancr is givn in Figur B blow. Th cass covr 79.1 pr cnt of all mal cancr. Th corrsponding figur for fmals is 73.2 pr cnt. CANCER INCIDENCE IN WEDEN 2002 Figur B: Th tn most frqunt spcifid cancr sits, by sx MALE FEMALE Prostat kin (mlanoma xcludd) 7,4 Tracha, bronchus, lung 7,1 Colon 7,0 Urinary organs (xcluding kidny) 6,9 Rctum and anus 4,7 Malignant mlanoma of skin 4,0 Malignant lymphoma 3,7 Othr and unspcifid sits 3,2 Nrvous systm 2,5 0 10 20 30 32,6 % Brast 29,3 Colon 8,0 Corpus utri 5,8 Tracha, bronchus, lung 5,6 kin (mlanoma xcludd) 5,3 Othr and unspcifid sits 4,4 Malignant mlanoma of skin 4,1 Rctum and anus 3,8 Ovary 3,6 Malignant lymphoma 3,3 0 10 20 30 % Th ag-spcific incidnc rats for all cancr ar shown in Figur C. Th graph illustrats that cancr mainly is a disas of th oldr ag groups. In th ag groups from 25-29 to 55-59 yars, th incidnc is highr among fmals, mostly bcaus of th dominanc of brast and gnital cancr. CANCER INCIDENCE IN WEDEN 2002 Figur C: Ag-spcific incidnc rats pr 100 000. All sits, by sx 3500 3000 2500 Pr 100 000 Mals Fmals 2000 1500 1000 500 0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Ag at diagnosis 16 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95+ In Figur D, closly rlatd cancr sits hav bn groupd and prsntd by sx. Th distribution by individual sit and sx, is shown in Tabl F.
CANCER INCIDENCE IN WEDEN 2002 Figur D: Groupd cancr sits, by sx MALE NERVOU YTEM 2.5 GENITAL ORGAN 1.5 KIN 11.4 LEUKEMIA & LYMPHOMA 7.7 PROTATE 32.6 REPIRATORY YTEM 8.0 URINARY YTEM 9.1 OTHER 5.6 DIGETIVE YTEM 21.3 FEMALE KIN 9.4 NERVOU YTEM 2.7 LEUKEMIA & LYMPHOMA 7.1 GENITAL ORGAN 12.8 REPIRATORY YTEM 5.9 URINARY YTEM 4.5 BREAT 29.3 OTHER 8.3 DIGETIVE YTEM 19.8 17
CANCER INCIDENCE IN WEDEN 2002 Tabl F: Prcntag distribution of th nw cass of cancr, by sit and sx ICD-7 it Mals % Fmals % Total % 140-209 All sits 24 142 100.0 22 607 100.0 46 749 100.0 140 Lip 106.4 60.3 166.4 141 Tongu 95.4 70.3 165.4 142 alivary glands 48.2 44.2 92.2 143 Floor of mouth 33.1 18.1 51.1 144 Mouth, othr parts and unspcifid 74.3 73.3 147.3 145 Msopharynx 88.4 33.1 121.3 146 Nasopharynx 20.1 7-27.1 147 Hypopharynx 52.2 7-59.1 148 Pharynx, parts unspcifid 2-2 - 4-150 Osophagus 261 1.1 111.5 372.8 151 tomach 589 2.4 430 1.9 1 019 2.2 152 mall intstin 128.5 86.4 214.5 153 Colon 1 683 7.0 1 800 8.0 3 483 7.5 154 Rctum and anus 1 125 4.7 860 3.8 1 985 4.2 155 Biliary passags and livr, primary 395 1.6 362 1.6 757 1.6 155.0 Livr, primary 264 1.1 111.5 375.8 156 Livr not spcifid as primary 47.2 62.3 109.2 157 Pancras 413 1.7 454 2.0 867 1.9 158 Pritonum 6-19.1 25.1 160 Nos and nasal sinuss 27.1 26.1 53.1 161 Larynx 175.7 32.1 207.4 162 Tracha, bronchus, lung and plura, primary 1 713 7.1 1 269 5.6 2 982 6.4 162.1 Bronchus and lung, primary 1 598 6.6 1 244 5.5 2 842 6.1 163 Lung, unspcifid 36.1 24.1 60.1 164 Mdiastinum 8-1 - 9-170 Brast 34.1 6 623 29.3 6 657 14.2 171 Crvix utri - - 463 2.0 463 1.0 172 Corpus utri - - 1 317 5.8 1 317 2.8 173 Chorionpithlioma of utrus - - 3-3 - 174 Utrus parts unspcifid - - 134.6 134.3 175 Ovary, tub and broad ligamnt - - 818 3.6 818 1.7 175.0 Ovary - - 783 3.5 783 1.7 176 Othr fmal gnital organs - - 182.8 182.4 177 Prostat 7 866 32.6 - - 7 866 16.8 178 Tstis 263 1.1 - - 263.6 179 Othr mal gnital organs 94.4 - - 94.2 180 Kidny 528 2.2 377 1.7 905 1.9 180.0 Rnal parnchyma 415 1.7 290 1.3 705 1.5 181 Urinary organs (xcluding kidny) 1 674 6.9 639 2.8 2 313 4.9 190 Malignant mlanoma of skin 971 4.0 930 4.1 1 901 4.1 191 kin (mlanoma xcludd) 1 796 7.4 1 202 5.3 2 998 6.4 192 Ey 72.3 54.2 126.3 193 Nrvous systm 605 2.5 621 2.7 1 226 2.6 194 Thyroid gland 93.4 227 1.0 320.7 195 Endocrin glands 193.8 451 2.0 644 1.4 196 Bon 42.2 27.1 69.1 197 Connctiv tissu, muscl 150.6 118.5 268.6 199 Othr and unspcifid sits 764 3.2 1 000 4.4 1 764 3.8 200 Malignant non-hodgkin lymphoma 754 3.1 628 2.8 1 382 3.0 201 Hodgkin disas 85.4 92.4 177.4 202 Rticulosis and rlatd forms 52.2 35.2 87.2 203 Multipl myloma, plasmocytoma 289 1.2 246 1.1 535 1.1 204 Lymphatic lukmia 315 1.3 212.9 527 1.1 205 Myloid lukmia 208.9 199.9 407.9 206 Monocytic lukmia 10-18.1 28.1 207 Othr and unspcifid lukmia 30.1 21.1 51.1 208 Polycythamia vra 58.2 59.3 117.3 209 Mylofibrosis 72.3 61.3 133.3 200-202 Malignant lymphoma 891 3.7 755 3.3 1 646 3.5 204-207 Lukmia 563 2.3 450 2.0 1 013 2.2 18
CANCER INCIDENCE IN WEDEN 2002 Tabl G: Numbr of tumors considrd not to b infiltrating and mtastasizing, but includd in th total cancr incidnc, by diagnosis and sx it / histopathologic diagnosis Mals Fmals Total Papilloma, urinary tract 5 0 5 Angiosarcoma of kaposi 16 5 21 Histologically bnign tumors of th cntral nrvous systm 315 446 761 Histologically bnign tumors of ndocrin 164 418 582 glands (xcluding thyroid adnoma) Low grad fibrosarcoma (including 14 8 22 Drmatofibro-sarcoma protubrans) CANCER INCIDENCE IN WEDEN 2002 Tabl H: Numbr of bnign tumors and prcancrous lsions rgistrd, but not includd in th total cancr incidnc, by diagnosis and sx it / histopathologic diagnosis Mals Fmals Total Prcancrous lsions of lip and mouth 23 12 35 Prcancrous lsions of larynx, tracha and bronchus 35 5 40 Prcancrous pithlial lsions of skin 1 874 2 166 4 040 Malignant mlanoma in situ of th skin 260 372 632 Prcancrous lsions of vulva and vagina - 131 131 Gastro-intstinal polyp with prcancrous chang 641 612 1 253 Prcancrous chang of brast and adnoma phyllods 5 661 666 Carcinoma in situ ("stag 0") of utrin - 3172 3 172 crvix (squamous cll typ) Hydatidiform mol - 89 89 Prcancrous ndomtrial chang - 59 59 Ovarian cystadnoma with bordrlin malignancy - 202 202 Prlukmia 136 157 293 19
Cumulativ probability of dvloping cancr Th risk of dvloping cancr varis strongly with ag and by sit. Tabl I shows th probability to dvlop a spcific cancr up to a crtain ag for slctd sits. Only sits with a lif-tim probability (up to ag 85) of at last on pr cnt ar prsntd in th tabl. 20
CANCER INCIDENCE IN WEDEN 2002 Tabl I : Cumulativ probability of dvloping a cancr bfor a crtain ag in wdn, by sit and sx ICD-7 it x < 25 < 35 < 45 < 55 < 65 < 75 < 85 104-209 All sits M 0.5 1.0 1.9 4.5 12.8 29.4 48.4 Ag F 0.5 1.2 3.0 7.7 15.7 26.4 37.6 151 tomach M 0.0 0.0 0.0 0.1 0.3 0.8 1.5 F 0.0 0.0 0.0 0.1 0.2 0.4 0.9 153 Colon M 0.0 0.0 0.1 0.2 0.7 2.1 4.6 F 0.0 0.0 0.1 0.3 0.7 1.9 3.8 154 Rctum and anus M 0.0 0.0 0.0 0.2 0.6 1.6 3.0 F 0.0 0.0 0.1 0.2 0.4 1.1 1.9 155 Biliary passags and livr, primary M 0.0 0.0 0.0 0.1 0.2 0.5 1.1 F 0.0 0.0 0.0 0.0 0.2 0.4 0.8 157 Pancras M 0.0 0.0 0.0 0.1 0.3 0.6 1.1 F 0.0 0.0 0.0 0.1 0.2 0.5 1.0 162 Tracha, bronchus, lung and plura, primary M 0.0 0.0 0.0 0.2 1.0 2.8 4.6 F 0.0 0.0 0.0 0.2 0.9 1.9 2.8 170 Brast M 0.0 0.0 0.0 0.0 0.0 0.0 0.1 F 0.0 0.1 0.8 3.1 6.4 9.6 12.5 172 Corpus utri F 0.0 0.0 0.0 0.2 0.9 1.9 2.8 175 Ovary, tub and broad ligamnt F 0.0 0.0 0.1 0.4 0.8 1.3 1.7 177 Prostat M 0.0 0.0 0.0 0.4 3.6 11.0 20.2 180 Kidny M 0.0 0.0 0.0 0.1 0.4 0.8 1.4 F 0.0 0.0 0.0 0.1 0.3 0.5 0.9 181 Urinary organs (xcl. kidny) M 0.0 0.0 0.0 0.2 0.8 2.3 4.6 F 0.0 0.0 0.0 0.1 0.2 0.7 1.3 190 Malignant mlanoma of skin M 0.0 0.1 0.2 0.4 0.9 1.5 2.3 F 0.0 0.2 0.4 0.6 1.0 1.4 1.8 191 kin (mlanoma xcludd) M 0.0 0.0 0.0 0.1 0.5 1.5 4.7 F 0.0 0.0 0.0 0.1 0.3 0.9 2.1 193 Nrvous systm M 0.1 0.2 0.3 0.5 0.7 1.1 1.3 F 0.1 0.2 0.3 0.5 0.7 1.1 1.2 195 Endocrin glands M 0.0 0.0 0.1 0.1 0.2 0.3 0.4 F 0.0 0.0 0.1 0.2 0.4 0.7 1.0 199 Unspcifid sits M 0.0 0.0 0.0 0.1 0.4 1.1 2.0 F 0.0 0.0 0.0 0.1 0.5 1.1 2.1 200 Malignant non-hodgkin lymphoma M 0.0 0.0 0.1 0.2 0.5 1.1 1.9 F 0.0 0.0 0.1 0.2 0.4 0.8 1.4 204-207 Lukmia M 0.1 0.1 0.1 0.2 0.4 0.8 1.5 F 0.1 0.1 0.2 0.2 0.4 0.6 0.9 Othr sits * M 0.2 0.5 0.7 1.2 2.1 3.7 5.8 F 0.1 0.4 0.7 1.2 1.9 3.1 4.7 * All individual sit includd in othr sit has a probability blow on pr cnt at 84 yars of ag. Not: Th probability has bn stimatd from th ag spcific rats in Tabl 4. 21
Th prvalnc of cancr in wdn Th numbr of prsons rsidnt in wdn Dcmbr 31, 2002 and diagnosd with a cancr in th priods 1958-2002 and 1998-2002 ar shown in Tabl J. For simplicity all prsons ar considrd as prvalnt cass, although som might b curd from thir disas. om individuals may hav mor than on primary diagnosis. In all sits ach prson is countd only onc. For th singl sits thy ar countd onc for ach diagnostic group. Th prvalnc of a disas is affctd by dmographic, diagnostic and tratmnt factors that all may chang ovr tim: th incidnc of th disas th ag distribution arly diagnosis lngth of survival This fact maks prvalnc tim trnd analyss complx. 22
CANCER INCIDENCE IN WEDEN 2002 Tabl J: Prvalnc of cancr in wdn as of Dcmbr 31, 2002 for cass diagnosd 1958-2002 and 1998-2002, and as a comparison th numbr of prsons diagnosd 2002, by sit and sx Prvalnc of cass Prvalnc of cass Incidnt cass diagnosd 1958-2002 diagnosd 1998-2002 diagnosd 2002 ICD-7* it Mals Fmals Total Mals Fmals Total Mals Fmals Total 140-209 All sits 135 825 193 480 329 305 69 256 71 617 140 873 20 491 19 235 39 726 140 Lip 1 491 522 2 013 420 225 645 104 59 163 141 Tongu 510 430 940 236 203 439 93 68 161 142 alivary glands 540 674 1 214 172 179 351 48 44 92 143 Floor of mouth 199 118 317 109 55 164 33 18 51 144 Mouth, othr parts and unspcifid 471 544 1 015 197 212 409 72 70 142 145 Msopharynx 504 268 772 284 134 418 87 32 119 146 Nasopharynx 214 113 327 81 36 117 20 6 26 147 Hypopharynx 136 44 180 82 24 106 52 7 59 148 Pharynx, part unspcifid 15 5 20 5 3 8 2 2 4 150 Osophagus 447 226 673 329 148 477 260 110 370 151 tomach 1 896 1 488 3 384 851 633 1 484 588 430 1 018 152 mall intstin 669 582 1 251 299 265 564 126 84 210 153 Colon 10 034 13 245 23 279 4 764 5 358 10 122 1 598 1 718 3 316 154 Rctum and anus 6 879 6 899 13 778 3 338 2 778 6 116 1 111 855 1 966 155 Biliary passags and livr, primary 505 590 1 095 333 327 660 395 361 756 156 Livr, not spcifid as primary 23 39 62 14 31 45 47 62 109 157 Pancras 309 344 653 246 274 520 412 454 866 158 Pritonum 11 47 58 9 35 44 6 19 25 160 Nos and nasal sinuss 278 211 489 106 87 193 27 26 53 161 Larynx 1 553 326 1 879 554 120 674 173 32 205 162 Tracha, bronchus, lung 2 950 2 770 5 720 1 876 1 694 3 570 1 688 1 249 2 937 163 Lung, not spcifid as primary 34 38 72 14 22 36 36 24 60 164 Mdiastinum 45 8 53 14 4 18 8 1 9 170 Brast 289 72 476 72 765 127 27 252 27 379 34 6 096 6 130 171 Crvix utri - 9 794 9 794-1 664 1 664-460 460 172 Corpus utri - 17 633 17 633-5 303 5 303-1 316 1 316 173 Chorionpithlioma of utrus - 152 152-15 15-3 3 174 Utrus, part unspcifid - 1 344 1 344-377 377-134 134 175 Ovary, tub and broad ligamnt - 8 764 8 764-2 574 2 574-816 816 176 Othr fmal gnital organs - 1 547 1 547-635 635-178 178 177 Prostat 45 497-45 497 29 375-29 375 7 853-7 853 178 Tstis 5 138-5 138 1 195-1 195 256-256 179 Othr mal gnital organs 755-755 290-290 93-93 180 Kidny 4 246 3 520 7 766 1 607 1 205 2 812 518 369 887 181 Urinary organs (xcl. kidny) 13 622 5 028 18 650 5 629 1 979 7 608 1 635 616 2 251 190 Malignant mlanoma of skin 9 956 12 937 22 893 3 601 3 829 7 430 920 892 1 812 191 kin (mlanoma xcludd) 10 123 8 038 18 161 5 640 4 087 9 727 1 347 976 2 323 192 Ey 775 809 1 584 248 230 478 71 54 125 193 Nrvous systm 5 470 7 960 13 430 1 663 2 276 3 939 596 612 1 208 194 Thyroid gland 1 294 4 529 5 823 295 840 1 135 92 221 313 195 Endocrin glands 3 344 8 233 11 577 848 1 982 2 830 191 449 640 196 Bon 659 512 1 171 155 105 260 41 27 68 197 Connctiv tissu, muscl 1 504 1 434 2 938 524 404 928 150 117 267 199 Othr and unspcifid sits 1 025 1 423 2 448 579 855 1 434 761 999 1 760 200 Malignant non-hodgkin lymphoma 4 892 4 344 9 236 2 240 1 917 4 157 748 625 1 373 201 Hodgkin disas 1 749 1 377 3 126 397 337 734 85 92 177 202 Rticulosis and rlatd forms 613 297 910 232 121 353 52 35 87 203 Multipl myloma, plasmocytoma 1 135 1 044 2 179 792 722 1 514 287 245 532 204 Lymphatic lukmia 2 528 2 025 4 553 1 230 866 2 096 314 212 526 205 Myloid lukmia 747 735 1 482 410 382 792 206 197 403 206 Monocytic lukmia 30 28 58 19 20 39 10 18 28 207 Othr and unspcifid lukmia 84 96 180 33 32 65 30 21 51 208 Polycythamia vra 593 668 1 261 241 264 505 58 59 117 209 Mylofibrosis 267 276 543 193 179 372 71 61 132 * In all sits ach prson is countd only onc. For singl sits th prsons ar countd onc for ach diagnostic group. 23
Trnds in th cancr incidnc Factors that affct trnds includ changs in coding practics, ag structur of th population at risk, and th autopsy frquncy, as wll as th introduction of scrning activitis and improvmnts in diagnostic practics. For this rason, conclusions may b difficult to draw from trnd figurs covring long tim priods. In th prsntation of th trnds, w prsnt figurs both for a 20-yar priod and th latst dcad (Tabl K). Th annual numbr of cancr cass in wdn has incrasd constantly sinc 1960. Th avrag annual incras is 2.0 pr cnt for mn and 1.8 for womn. About half of this incras is xplaind by th continuous aging of th population. This is sn in th graphs in Figur A (pag 15) whr th crud rats ar compard with ag standardizd rats. Whn th numbr of cancr cass is considrd ovr th priod 1983-2002, th avrag annual incras is 1.2 pr cnt for mn and 1.1 for womn. Th avrag annual changs in tim trnds ar calculatd according to an xponntial modl (th nd of Appndix 2) with th ag standardizd incidnc rats as point stimats. Th avrag annual incras in th ag standardizd rats for all cancr is 0.4 pr cnt for both mn and womn during th complt priod. Th figur for th priod 1993-2002 is 0.7 for mals and 0.4 for fmals. An incras in th trnd for th yars 1983-2002 is sn. g. for th following sits: Malignant mlanoma of skin. n ovr a 20-yar priod, this is on of th most rapidly incrasing malignant tumors in wdn. For mn, th avrag incras pr yar is 2.2 pr cnt and for womn slightly lss (2.0 pr cnt). Non-mlanoma skin cancr (mainly squamous carcinomas). An avrag annual incras of 3.4 pr cnt is obsrvd for mn and 3.8 for womn for th 20-yar priod. During th latst 10-yar priod studid th figurs ar 3.0 pr cnt for mn and 3.7 pr cnt for womn. Bronchus and lung, primary. Womn show a rathr strong avrag incras pr yar, 2.6 pr cnt, whil th prviously notd incrasing trnd in mals has turnd to a dcras of 1.5 pr cnt calculatd for th whol 20 yar priod. Th gap btwn th incidnc curvs for both sxs is, howvr, still considrabl. 24
CANCER INCIDENCE IN WEDEN 2002 Tabl K: Estimats of th annual linar trnd of slctd sits, 1983-2002 and 1993-2002 Annual chang in prcnt Rats ag adjustd to for trnd priod th population 2000 E of th latst pr 100.000 ICD-7 it x 20 Yars 10 Yars 1983 1993 2002 140-209 All sits M.4 *.7 * 556.9 578.2 604.8 (ag standardisd) F.4 *.4 * 429.3 445.1 463.0 140 Lip M -3.4 * -4.0 * 5.1 3.6 2.7 F 1.2 1.3 1.0.9 1.2 150 Osophagus M - 1.4 6.4 6.0 6.5 F.4.8 2.1 2.6 2.2 151 tomach M -4.2 * -4.2 * 34.1 22.2 15.2 F -4.3 * -3.2 * 17.1 11.0 8.4 153 Colon M.3.3 40.1 41.9 43.3 F -.1.2 35.8 34.8 35.5 154 Rctum M.1 -.2 26.4 28.3 28.3 F -.1 -.2 17.4 17.7 17.2 155 Biliary passags M -3.2 * -2.5 * 17.7 12.2 10.1 and livr primary F -4.7 * -5.1 * 17.3 11.6 7.2 155.0 Livr, primary M -2.4 * -1.6 9.2 7.0 6.7 F -3.6 * -5.2 * 4.7 3.7 2.2 157 Pancras M -3.7 * -4.1 * 19.1 14.8 10.1 F -2.9 * -3.8 * 14.1 12.7 9.2 161 Larynx M -1.9 * -1.2 5.7 4.0 4.3 F.6 3.8.5.7.7 162.1 Bronchus and lung M -1.5 * -1.2 * 53.1 45.0 39.2 primary F 2.6 * 2.4 * 16.4 20.8 25.7 170 Brast F 1.6 * 1.7 * 102.4 116.0 138.8 171 Crvix utri F -1.5 * -1.6 13.2 11.4 9.9 172 Corpus utri F 1.4 * 1.1 * 22.7 24.7 27.0 175 Ovary, tub and broad ligamnt F -1.8 * -2.2 * 24.8 21.2 17.2 177 Prostat M 2.2 * 3.2 * 133.1 159.6 197.5 178 Tstis M 1.9 * 2.7 3.9 4.3 5.8 180.0 Rnal parnchyma M -2.8 * -2.6 * 17.8 14.1 10.0 F -2.6 * -2.7 * 11.1 8.9 6.0 181 Urinary organs (xcluding kidny) M.5 * - 36.7 41.9 42.4 F.8 * 1.3 * 11.0 11.4 12.6 190 Malignant mlanoma of skin M 2.2 * 1.9 * 13.7 18.3 23.3 F 2.0 * 1.6 11.7 16.0 19.7 191 kin (mlanoma xcludd) M 3.4 * 3.0 * 24.8 38.0 49.2 F 3.8 * 3.7 * 10.5 16.4 22.3 193 Nrvous systm M -1.1 * -1.4 15.7 15.1 13.8 F -.6-1.2 15.0 14.9 13.4 194 Thyroid gland M -1.8 * -.8 2.5 1.9 2.2 F -1.5 * -.8 6.0 4.6 4.9 200 Malignant non-hodgkin lymphoma M.5 -.5 15.9 18.9 18.6 F 1.0 * -.2 9.7 13.0 12.8 201 Hodgkin disas M -2.3 * -2.4 * 2.8 2.3 1.9 F -.9.8 2.3 1.9 2.0 203 Multipl myloma, plasmocytoma M -1.0 * -1.2 8.3 8.1 7.1 F -.7 * -.4 6.2 5.4 4.9 204-207 Lukmia M -.4.4 16.9 14.2 13.9 F.1.6 10.1 8.8 9.3 140-209 ALL ITE M 1.2 * 1.5 * 18 778 21 427 24 142 (NUMBER OF CAE) F 1.1 *.9 * 18 294 20 729 22 607 * Implis that th trnd is considrd to b strictly incrasing or dcrasing at th 98% confidnc lvl 25
Brast cancr in womn. Th annual incras is 1.6 pr cnt for th 20 yar priod and 1.7 for th 10-yar priod. Prostat. This is th most common cancr sit in mn with an avrag annual incras of 2.2 pr cnt. For th last 10-yar priod th incras is 3.2 pr cnt. Tstis. An avrag annual incras of 1.9 pr cnt is sn for th 20 yar priod and vn highr during th last dcad (2.7 pr cnt). Urinary organs (xcluding kidny). Th incras for mn during th whol priod is 0.5 for mn and for womn 0.8 pr cnt a yar. For th last 10-yar priod, thr has bn no chang at all for mn, whil th womn has an incras (1.3 pr cnt). Malignant non-hodgkin lymphoma. Th avrag annual incras for th whol priod is 0.5 pr cnt for mn and 1.0 pr cnt for womn. Ths figurs ar partly "balancd" by a dcras in Hodgkin disas. Th calculations of th annual changs in trnds and th graphs in Figurs F8 and F9 show that th prvious trnds towards an incras in th incidnc of cancr in th biliary passags and primary livr cancr (in both mals and fmals) hav bn brokn during th 1980s and arly 1990s. This also applis for cancr of th ovary (Figur F16) and for cancrs of pancras (Figur F10), and lung (Figur F12a and 12b) in mals. A dcras in trnd is obsrvd.g. for Hodgkin disas, cancr of lip in mn, and for cancrs of Crvix utri. Th ag standardizd rat has dcrasd with 1.5 pr cnt a yar for th 20-yar priod. This is vidntly in grat masur an ffct of scrning activitis. Th incidnc sms to b lvling out at a rat of approximatly 10 pr 100 000 during th lat 1990s. tomach. Thr is a rmarkabl dcras in incidnc for both mn and womn during th whol priod (4.2 pr cnt for mn and 4.3 pr cnt for womn annually). Corrsponding figurs for th last 10-yar priod is 4.2 for mn and 3.2 for womn. Th rats in th incidnc of cancr in various sits during th priod 1960-2002 ar plottd and prsntd in Figurs F1-F28. For many sits, th numbr of cass ar fw and random variations play an important rol for th configuration of th graphs. Plas not that diffrnt scals ar usd among th figurs. Th rats ar ag standardizd according to th wdish population Dcmbr 31, 2000. 26
30000 Numbr of cass Figur E. All its. Nw cass 25000 20000 15000 10000 5000 Mals Fmals 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 700 Pr 100 000 Figur F1. All its. Ag standardizd 600 500 400 300 200 100 Mals Fmals 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 27
Figur F2: Lip (icd-7:140) Pr 100 000 7 Mals 6 Fmals 5 4 3 2 1 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis Figur F3: Osophagus (icd-7:150) Pr 100 000 8 7 6 5 Mals 4 Fmals 3 2 1 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 70 60 50 Pr 100 000 Figur F4: tomach (icd-7:151) Mals Fmals 5 4 Figur F5: mall intstin (icd-7:152) Pr 100 000 Mals Fmals 40 3 30 2 20 10 1 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 50 Pr 100 000 Figur F6: Colon (icd-7:153) 30 Figur F7: Rctum and anus (icd-7:154) Pr 100 000 40 25 30 20 15 20 10 Mals Fmals 10 5 Mals Fmals 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 28
20 Figur F8: Biliary passags and livr, primary (icd-7:155) Pr 100 000 Mals 15 Figur F9: Livr, primary (icd-7:155.0) Pr 100 000 Mals 15 Fmals 10 Fmals 10 5 5 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 25 20 Pr 100 000 Figur F10: Pancras (icd-7:157) Mals Fmals 7 6 5 Pr 100 000 Figur F11: Larynx (icd-7:161) Mals Fmals 15 4 10 3 2 5 1 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis Figur F12a: Bronchus and lung, primary (icd-7:162.1) Pr 100 000 60 50 40 30 20 10 0 Mals Fmals 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 8 7 6 5 4 3 2 1 0 Figur F12b: Bronchus and lung, primary (icd-7:162.1) Ag group 0-54 yars Pr 100 000 Mals Fmals 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 29
160 Pr 100 000 Figur F13: Brast (icd-7:170) 30 Pr 100 000 Figur F14: Crvix utri (icd-7:171) Fmals 120 20 80 40 Fmals 10 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 30 Pr 100 000 Figur F15: Corpus utri (icd-7:172) 30 Pr 100 000 Figur F16: Ovary (icd-7:175.0) Fmals 20 20 10 10 Fmals 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 250 Pr 100 000 Figur F17: Prostat (icd-7:177) 7 Pr 100 000 Figur F18: Tstis (icd-7:178) 200 6 5 150 4 100 50 0 Mals 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 3 2 1 0 Mals 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 30
25 Figur F19: Kidny, rnal parnchyma (icd-7:180.0) Pr 100 000 Mals 50 Figur F20: Urinary organs, xcl. kidny (icd-7:181) Pr 100 000 Mals 20 Fmals 40 Fmals 15 30 10 20 5 10 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 25 Figur F21: Malignant mlanoma of skin (icd-7:190) Pr 100 000 60 Figur F22: kin, xcl. mlanoma (icd-7:191) Pr 100 000 Mals 20 50 Fmals 15 10 5 Mals Fmals 40 30 20 10 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 20 15 Figur F23: Brain and nrvous systm (icd-7:193) Pr 100 000 Mals Fmals 8 7 6 Figur F24: Thyroid gland (icd-7:194) Pr 100 000 Mals Fmals 5 10 4 3 5 2 1 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 31
25 20 Figur F25: Malignant non-hodgkin lymphoma (icd-7:200) Pr 100 000 Mals Fmals 8 6 Figur F26: Hodgkin disas (icd-7:201) Pr 100 000 Mals Fmals 15 4 10 5 2 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis Figur F27: Multipl myloma plasmocytoma (icd-7:203) Pr 100 000 12 Mals 10 8 6 4 2 0 Fmals 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis Figur F28: Lukmia (icd-7:204-207) Pr 100 000 20 18 16 14 12 10 8 6 4 Mals 2 Fmals 0 1960 65 70 75 80 85 90 95 2000 Yar of diagnosis 32
CANCER INCIDENCE IN WEDEN 2002 PART 1 ( 14) Tabl 1 : Numbr of nw cass by sit, sx and ag at diagnosis ICD-7 it x All ags Ag at diagnosis 00-04 05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 140- All sits M 24142 54 40 41 63 81 149 164 241 341 518 1067 2120 2714 3301 3854 4034 3343 2017 209 F 22607 48 29 45 67 66 156 274 419 648 1122 1832 2464 2373 2514 2774 2907 2689 2180 140 Lip M 106-1 2 2 3 11 9 14 13 23 13 15 F 60 - - - 3 3 3 8 8 3 5 13 14 140.0 Uppr lip M 7-1 - - - 2-1 - - - 3 F 15 - - - - 2-3 3-3 2 2 140.1 Lowr lip M 49 - - 1 1 2 5 4 2 6 15 5 8 F 24 - - - 2-1 3 3 2 1 8 4 140.8 Multipl parts M - F - 140.9 Lip unspcifid M 50 - - 1 1 1 4 5 11 7 8 8 4 F 21 - - - 1 1 2 2 2 1 1 3 8 141 Tongu M 95 - - - - - 2 2 1 4 6 7 14 19 9 11 16 3 1 F 70 - - - - 1 1 2 2 1 3 7 4 9 9 10 5 5 11 141.0 Bas of tongu M 48 - - 2 1 4 9 12 6 4 9 1 - F 12 - - 1-4 1 1 2 2 1 - - 141.7 Othr spcifid part M 29 - - - - - 2 1 1 2 3-4 3 2 4 4 2 1 F 42 - - - - 1 1 1 2-2 1 1 7 6 6 3 3 8 141.8 Multipl parts M 1 - - - 1 - - F 4 - - - - 2 - - - 1 - - 1 141.9 Part unspcifid M 17 1 - - 2 3 1 4 1 3 2 - - F 12 1 - - 1-2 1 1 1 1 2 2 142 alivary glands M 48 - - - - 1-1 2 2 1 4 9 6 4 2 8 6 2 F 44 - - - - 1 2 2 3 - - 2 4 5 5 5 6 4 5 142.0 Parotid M 35 - - - - 1 - - 1 1 1 4 6 4 4 1 5 5 2 F 37 - - - - 1 2 2 2 - - 2 4 4 4 4 4 3 5 142.5 ublingual M 1-1 - - - - F - 142.6 ubmandibular M 4 - - - - - 2 1 - - 1 - - F 4-1 1 1 1 -
CANCER INCIDENCE IN WEDEN 2002 PART 2 ( 14) Tabl 1 : Numbr of nw cass by sit, sx and ag at diagnosis ICD-7 it x All ags Ag at diagnosis 00-04 05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 142.8 Multipl glands M - F 1-1 - - - - 142.9 Gland unspcifid M 8 1-1 - - 1 1-1 2 1 - F 2 1 - - 1 - - 143 Floor of mouth M 33 - - - 1 3 6 7 4 4 3 3 2 F 18-2 2 1 4-1 1 1 1 2 3 144 Mouth, othr parts and M 74 2-1 3 6 8 7 6 7 7 13 14 unspcifid F 73 - - - - - 1 - - 2 3 2 7 6 4 8 15 14 11 145 Msopharynx M 88-2 2 12 12 21 15 6 11 4 3 - F 33-1 2 4 9 6 3 3 3 1 1-146 Nasopharynx M 20-1 - - - 2 1 1 2 1 3 3 2-1 1 2 - F 7 - - 1 1 1 1 1 1 1 - - - 147 Hypopharynx M 52 - - - 2 4 7 8 6 14 7 4 - F 7 - - - 1 2 1 1 1 - - 1-148 Pharynx, part unspcifid M 2 1 - - 1 - - F 2-1 - - - 1 150 Osophagus M 261 - - - 1-1 - - 4 7 20 23 26 34 57 43 31 14 F 111 - - - - 3 10 10 15 23 15 15 20 150.0 Osophagus, spcifid part M 136 - - - 1-1 - - 3 4 12 13 16 21 23 24 12 6 F 56 - - - - 2 6 6 3 7 8 10 14 150.8 Multipl parts M 1 - - - - - 1 F - 150.9 Part unspcifid M 124 - - 1 3 8 9 10 13 34 19 19 8 F 55 - - - - 1 4 4 12 16 7 5 6 151 tomach M 589 1 2 6 13 23 47 55 87 91 101 84 79 F 430 - - - - 1 2 3 2 6 18 14 29 32 39 53 74 81 76 151.1 Cardia M 133 - - 2 7 6 12 16 25 20 19 13 13 F 60 2 1 1 3 2 5 3 7 11 8 7 10 151.9 Part unspcifid M 456 1 2 4 6 17 35 39 62 71 82 71 66 F 370 - - - - 1 2 1 1 5 15 12 24 29 32 42 66 74 66
CANCER INCIDENCE IN WEDEN 2002 PART 3 ( 14) Tabl 1 : Numbr of nw cass by sit, sx and ag at diagnosis ICD-7 it x All ags Ag at diagnosis 00-04 05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 152 mall intstin M 128-3 4 6 10 12 16 12 13 22 16 14 F 86-2 1 4 4 5 12 6 17 16 10 9 152.0 Duodnum M 29-1 - 2 3 4 4 4 2 3 3 3 F 21-1 - 1 2-2 - 3 7 3 2 152.7 Othr spcifid part M 26-1 2 3 3 2 5 1 1 1 4 3 F 19 - - 1 3 1 1 1 1 4 3 1 3 152.8 Multipl parts M 10 - - - - - 1 2 2 1 3 1 - F 3 1-1 - 1-152.9 Part unspcifid M 63-1 2 1 4 5 5 5 9 15 8 8 F 43-1 - - 1 4 8 5 9 6 5 4 153 Colon M 1683 - - 2 6 1 4 8 8 20 27 52 108 156 219 268 339 283 182 F 1800 - - - 4 4 7 10 10 15 39 65 122 133 166 297 342 330 256 153.0 Cocum and ascndns M 553 - - - 1-1 2 5 6 9 11 37 36 70 88 107 110 70 F 654 1 3 6 14 14 36 40 56 113 128 126 117 153.1 Transvrs and flxurs M 252 - - 1 - - 1 1 1 5 1 13 19 24 33 39 55 31 28 F 298 1 1 5 4 9 20 25 26 48 64 60 35 153.2 Dscndns M 70 1-2 - 5 5 7 4 11 15 13 7 F 73 - - - - - 1 2 - - 2 2 3 7 3 17 11 18 7 153.3 igmoid M 583 2 1 3 12 18 34 64 83 102 116 96 52 F 502 - - - - 2 1 2 3 2 13 28 48 38 49 84 91 79 62 153.4 Appndix M 31 - - 1 5 1 1 1-2 2-3 4 4 2 4 1 - F 51 - - - 4 2 3 4 2-3 4 7 2 5 2 4 6 3 153.8 Multipl parts M - F 1-1 - - - - 153.9 Part unspcifid M 194 - - - - - 1 1 1 2 3 5 10 21 25 26 42 32 25 F 221 - - - - - 2-1 2 3 8 8 21 26 33 44 41 32 154 Rctum and anus M 1125 - - - 1-2 1 8 16 24 44 97 126 170 188 191 161 96 F 860 - - - - - 3 2 8 20 25 39 62 80 111 137 141 135 97 154.0 Rctum inkl. rcto-sigmoidal junction M 1091 - - - 1-2 1 7 15 23 43 90 119 166 187 186 157 94 F 779 - - - - - 3 2 8 17 19 33 53 67 104 129 130 125 89
CANCER INCIDENCE IN WEDEN 2002 PART 4 ( 14) Tabl 1 : Numbr of nw cass by sit, sx and ag at diagnosis ICD-7 it x All ags Ag at diagnosis 00-04 05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 154.1 Anus M 33-1 1 1 1 7 7 4 1 5 4 1 F 78 - - 3 6 6 9 12 6 8 11 10 7 154.8 Multipl parts M 1 - - - - - 1 F 3 1 1 - - - 1 155 Biliary passags and M 395 - - 1 1-2 - 3 3 12 22 30 27 44 64 91 65 30 livr, primary F 362 1 - - 1 1-1 - 3 4 14 30 33 38 53 72 67 44 155.0 Livr, primary M 264 - - 1 - - 1-3 2 7 15 18 13 25 52 65 44 18 F 111 1 - - 1 1 - - - 2-5 5 11 11 16 23 23 12 155.1 Gall bladdr M 60 - - - 1 3 7 5 11 3 10 12 8 F 150 1 - - 2 5 10 13 19 25 27 29 19 155.2 Extrahpatic bil ducts M 28 - - - 2 1 3 2 7 6 3 2 2 F 28 - - 1 1 2 2 3 2 3 5 7 2 155.3 Ampulla of vatr M 16 - - - - - 1 - - - 1 1 2 3 - - 5 2 1 F 27 - - - 1 1 6 3 2 3 5 2 4 155.8 Multipl parts M 3 - - - 2-1 F 1 - - - - - 1 155.9 Unspcifid bil passags M 24 - - - 1 - - - - 1 1 2-4 1 3 6 5 - F 45 - - - - 1 6 3 4 6 12 6 7 156 Livr, not spcifid M 47-1 - - - 8 2 6 15 8 4 3 as primary F 62 - - - 1 2 4 3 7 17 6 15 7 157 Pancras M 413 - - 1 - - - - 1 5 7 30 51 51 56 74 75 47 15 F 454 - - - - 1 - - 2 7 8 27 32 40 62 65 101 70 39 158 Pritonum M 6 - - 1 - - - 1 1 2 - - 1 F 19 - - - - - 1 - - - 1-1 3 2 5 2 3 1 160 Nos and nasal sinuss M 27 - - - - 2 - - 1 2 1 2 2 2 4-4 5 2 F 26 - - - - 1 4 4 3 2 8 2 2 160.0 Nos (intrnal) and nasal M 19-1 2 1 2 1 1 3-2 4 2 cavitis F 17 - - - - 1 3 2 3 1 5-2 160.1 Eustachian tub and M 1 - - - - 1 - middl ar F -