Cancer Mortality in Romania, 1955-2004. Digestive
Sites: Esophagus, Stomach, Colon and Rectum, Pancreas, Liver, Gallbladder
and Biliary Tree
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Simona Valean1, Petru Armean2, Simona Resteman1,
Georgiana Nagy1, Adina Muresan3, Petru A.
1) Medical Clinic I, University of Medicine and Pharmacy "Iuliu
2) Faculty of Medicine and Pharmacy, University of Oradea;
3) Department of Physiology, University of Medicine and Pharmacy
"Iuliu Hatieganu" Cluj-Napoca, Romania
Aim: Until recently, gastric cancer was the most frequent
digestive neoplasia in our country. Our study presents the first
synthesis of data regarding mortality rates from digestive cancers,
for a period covering 50 years, in Romania.
Methods: Age-standardized mortality rates /100,000
population, general and/or per gender, concerning six digestive
cancers, were identified from the statistics of IARC/OMS (Lyon,
France) (years 1955-2002) and of the Ministry of Public Health
(Bucharest, Romania) (year 2004). For 2002, incidence and mortality
rates per sex from digestive cancers were available and case fatality
ratios could be calculated as an approximation of survival rates,
as well as sex ratio.
Results: Age standardized mortality rates per
sex and cancer site registered the following changes: esophageal
cancer increased from 2.03/0.62 (M/F) to 2.8/0.5; gastric cancer
registered a decrease, from 33.14/18.77 to 17.0/6.6; colorectal
cancer increased from 4.65/4.57 to 13.6/9.0; pancreatic cancer
increased from 5.50/2.92 to 8.1/4.2 and liver cancer (including
peripheric cholangiocarcinoma) increased from 1.77/0.83 to 8.8/3.9.
In our population, the case fatality ratio appeared to be better
only in colorectal cancer, 0.61 in males and 0.62 in females,
respectively. Sex ratio was highest for esophageal cancer (males/females
5.8/1) and lowest for colorectal cancer (1.5/1).
Conclusions: Our study found opposite trends
in the mortality rates from digestive cancers, with gastric cancer
rates decreasing and the other five digestive cancers increasing.
A new hierarchy of digestive cancers has been drawn up, with colorectal
cancer as the main cause of death, and gastric cancer in second
position, followed by pancreatic, liver, esophageal, and gallbladder
and biliary tree cancers.
Mortality - cancer - esophagus - stomach - colon and rectum -
pancreas - liver - gallbladder and biliary tree