Volume 4, Number 39; October 10, 2005
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Volume 4, Number 39; October 10, 2005 |
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58-year-old African-American male with 5 days right lower quadrant pain.
Recommended reading:
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Patient: 30 year-old Bangladeshi immigrant female referred from primary care with anemia, abdominal pain, and generalized weakness. |
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Session Handout:
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Clinical Question: 1) Which cancers are most common in young adults, and how do they typically prsent?
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Readings:
Link Directly to Fulltext Article at Publisher <2> Unique Identifier [PMID]: 15661684 Authors: Jemal A. Murray T. Ward E. Samuels A. Tiwari RC. Ghafoor A. Feuer EJ. Thun MJ. Institution: Department of Epidemiology and Research Surveillance, American Cancer Society, Atlanta, GA, USA. Title: Cancer statistics, 2005. TABLE 7 Reported Deaths for the Five Leading Cancer Sites, by Age and Sex, United States, 2002
Source: Ca: a Cancer Journal for Clinicians. 55(1):55, 2005 Jan-Feb. Abstract: Each year, the American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute and mortality data from the National Center for Health Statistics. Incidence and death rates are age-standardized to the 2000 US standard million population. A total of 1,372,910 new cancer cases and 570,280 deaths are expected in the United States in 2005. When deaths are aggregated by age, cancer has surpassed heart disease as the leading cause of death for persons younger than 85 since 1999. When adjusted to delayed reporting, cancer incidence rates stabilized in men from 1995 through 2001 but continued to increase by 0.3% per year from 1987 through 2001 in women. The death rate from all cancers combined has decreased by 1.5% per year since 1993 among men and by 0.8% per year since 1992 among women. The mortality rate has also continued to decrease from the three most common cancer sites in men (lung and bronchus, colon and rectum, and prostate) and from breast and colorectal cancers in women. Lung cancer mortality among women has leveled off after increasing for many decades. In analyses by race and ethnicity, African American men and women have 40% and 20% higher death rates from all cancers combined than White men and women, respectively. Cancer incidence and death rates are lower in other racial and ethnic groups than in Whites and African Americans for all sites combined and for the four major cancer sites. However, these groups generally have higher rates for stomach, liver, and cervical cancers than Whites. Furthermore, minority populations are more likely to be diagnosed with advanced stage disease than are Whites. Progress in reducing the burden of suffering and death from cancer can be accelerated by applying existing cancer control knowledge across all segments of the population. Publication Type: Journal Article.
Link Directly to Fulltext Article at Science Direct <5> Unique Identifier [PMID]: 12782451 Authors: Wu XC. Chen VW. Steele B. Roffers S. Klotz JB. Correa CN. Carozza SE. Institution: Department of Public Health and Preventive Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA. xwu@lsuhsc.edu Title: Cancer incidence in adolescents and young adults in the United States, 1992-1997.[see comment]. Comments Comment in: J Adolesc Health. 2003 Jun;32(6):403-4; PMID: 12782450
Source: Journal of Adolescent Health. 32(6):405-15, 2003 Jun. Abstract: PURPOSE: To examine cancer incidence patterns among adolescents and young adults in the United States. METHODS: Cancer incidence data from 26 population-based central cancer registries for 1992-1997 were used. Individual cancers were grouped into specific diagnostic groups and subgroups using an integrated classification scheme. The integrated scheme was developed for this study and was based on the most commonly used schemes in population-based epidemiologic studies: Surveillance, Epidemiology, and End Results Program's site groups, International Classification of Childhood Cancer, and International Agency for Research on Cancer's Histological Groups for Comparative Studies. Percent distributions and age-specific incidence rates per million population were computed for adolescents (aged 15-19 years) and young adults (aged 20-24 years) by gender. RESULTS: The data for 26,010 cancer cases were examined. Among 15-19-year-olds, the five most common cancers were Hodgkin's disease, leukemia, cancer in the brain and other nervous system, bone cancer, and non-Hodgkin's disease. Among 20-24-year-olds, the five most common cancers were Hodgkin's disease, testicular cancer, thyroid cancer, melanoma of the skin, and leukemia. The proportions and rates of the histologic subtypes for most of the common cancers changed with advancing age. For example, among 15-19-year-olds, acute lymphocytic leukemia accounted for approximately 60% of leukemias in males and 50% in females. Among 20-24-year-olds, however, the corresponding percentages of acute lymphocytic leukemia were 37% in males and 31% in females. For ovarian cancer, the germ cell tumor was the most common subtype (54.6% of all ovarian cancers) among 15-19-year-olds. In contrast, ovarian carcinoma was the predominant subtype (70.4%) among 20-24-year-olds. For both age groups, the incidence rates of nodular Hodgkin's disease, melanoma of the skin, and thyroid cancer were significantly greater in females than in males. CONCLUSIONS: Cancer incidence patterns among adolescents and young adults are distinctive. In these age groups, a transition from predominantly pediatric histologic subtypes to adult subtypes was observed for Hodgkin's disease, leukemia, ovarian cancer, and soft tissue sarcoma. Gender differences were found for Hodgkin's disease, melanoma of the skin, and thyroid cancer. Publication Type: Journal Article.
Link Directly to Fulltext Article at Publisher <9> Unique Identifier [PMID]: 11835231 Authors: Bleyer WA. Institution: The University of Texas M.D. Anderson Cancer Center, The University of Texas Medical School-Houston, TX 77030, USA. ableyer@mdanderson.org Title: Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. [Review] [48 refs]
Source: Medical & Pediatric Oncology. 38(1):1-10, 2002 Jan. Abstract: Cancer in adolescents and young adults has unique features in addition to the special medical, physical, psychological, and social needs of patients in this age group. The spectrum of malignant diseases is different from that in any other period in life, and it is strikingly different from the pattern in older persons. More people 15-25 years of age are diagnosed to have cancer than during the first 15 years of life. During the last 25 years, the incidence of cancer in this age range has increased faster while the increase in their cancer survival rates has been significantly lower than in younger or older patients, especially in comparison to results of the national pediatric cooperative cancer groups. Thus the 5-year outcome in 15-19 year olds with leukemias and sarcomas is not only worse than in younger patients, but also lower in this population at large than in patients of the same age treated at Children's Cancer Group institutions. In the United States, only approximately 5% of 15-25 year olds with cancer are entered onto clinical trials, in contrast to 60-65% of younger patients. Thus, cancer during adolescence and early adult life is an underestimated challenge that merits specific resources, solutions, and an international focus. Copyright 2002 Wiley-Liss, Inc. [References: 48] Publication Type: Journal Article. Review. Review, Tutorial.
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Resident Report / Department of Medicine & Grady Branch Library Emory University School of Medicine 2005 Edition Participating Faculty: Carlos Del Rio MD / Joyce Doyle MD / Lorenzo Difrancesco MD / Erich Folch MD / Alicia Hidron MD
Contact:
Karl Woodworth
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