Abstract TP178: Walk Score and Risk of Ischemic Stroke Among Town Residents

BACKGROUND: Regular physical activities, including light-to-moderate activities, such as walking, have well-established benefits for reducing the risk of ischemic stroke. It remains unknown whether certain area characteristics can influence the risk of stroke through promoting such activities. OBJECTIVES: We tested the hypothesis that how walkable an area is will be negatively associated with the risk of ischemic stroke in persons residing in the area. METHODS: We calculated the age- adjusted annual incidence rates of ischemic stroke among residents in each of the 63 cities in Minnesota between 2007 and 2011. The walk score, an online database, provides a numerical walkability score for any location within the United States, ranging between 0 and 100 that is computed by using exclusive algorithms. The route to amenities is sorted into nine different categories: grocery, restaurants, shopping, coffee, banks, parks, schools, books, and entertainment, which are weighed according to their prominence. RESULTS: There are 2,901,389 persons residing in 63 cities in Minnesota (average population per town is 46053). The average walk score of the 63 towns in Minnesota was 37, ranging from 14 to 69. The average median age of residents was similar in tertiles of towns based on walk score as follows: ≤25 (n=9) 36 years; 26-50(n=46) 36 years; and 51-100(n=8) 34 years. The age adjusted incidence of ischemic stroke was similar in tertiles of towns based on walk score as follows: ≤25 (n=9) 2157 per 100,000; 26-50(n=46) 1924 per 100,000; and 51-100(n=8) 2856 per 100,000 residents. The correlation between age adjusted ischemic stroke incidence and walk score was low (R2=0.32) within Minnesota. CONCLUSIONS: The ready availability of indices such as walk score makes it an attractive option but currently such indices lack the sensitivity to measure the magnitude and health benefits of light-to-moderate activities performed within a town.

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Abstract T MP66: Injury to the Head or Neck Increases Risk of Ischemic Stroke Three-fold After Trauma.

Stroke ◽

10.1161/str.45.suppl_1.tmp66 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Christine K Fox ◽

Adam L Numis ◽

Steve Sidney ◽

Heather J Fullerton

Keyword(s):

Ischemic Stroke ◽

Traumatic Injury ◽

Young Patients ◽

Risk Groups ◽

Population Based ◽

Incidence Rates ◽

Neck Injury ◽

Diagnostic Code ◽

Stroke Incidence ◽

Diagnostic Codes

Background: Over 2 million people under age 50 are seen in a U.S. emergency room monthly for non-fatal injuries. Our objective was to measure ischemic stroke incidence after traumatic injury in young patients and identify stroke risk factors. Methods: We performed a population-based study of ischemic stroke after trauma among people <50 years old in a Northern Californian integrated health care system. We electronically identified a cohort of patients with diagnostic codes for trauma (ICD-9 800-959.9) in emergency and inpatient encounters from 1997-2011, then identified ischemic stroke outcomes within 4 weeks. To determine stroke, we required an ICD-9 stroke code (433-438) plus a radiology report of brain imaging containing a keyword: stroke, infarct#, thromb#, ischemi#, lacun#, or dissect#. A neurologist reviewed the reports to exclude those inconsistent with ischemic stroke. We obtained clinical data such as injury type from electronic databases to calculate stratified incidence rates and risk ratios. Results: From 1.5 million trauma encounters, we identified 197 ischemic strokes. The 4-week stroke incidence after any traumatic injury was 0.013% (95% CI 0.011, 0.015). Patients with stroke had a mean age of 37.7 years (SD 12.2) versus 24.0 years (SD 13.8) in those without stroke (P<0.0001). Patients with injury to the head or neck were more likely to have a stroke compared to those with other types of injuries (Table). The 4-week stroke incidence after head or neck injury was 0.07% (95% CI 0.05, 0.09) among adults and 0.005% (95% CI 0.001, 0.01) among children (P<0.0001). Of the 197 stroke cases, 16% (95% CI 11, 22) had a diagnostic code for cranio-cervical dissection. Conclusions: A 4-week stroke incidence of 0.013% suggests that 260 young people have an ischemic stroke after a traumatic injury every month in the U.S. Further research is needed to identify the highest risk groups, such as those with head or neck injury, and opportunities for stroke prevention.

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Incidence, recurrence, and long-term survival of ischemic stroke subtypes: A population-based study in the Middle East

International Journal of Stroke ◽

10.1177/1747493016684843 ◽

2017 ◽

Vol 12 (8) ◽

pp. 835-843 ◽

Cited By ~ 15

Author(s):

Hamidreza Saber ◽

Amanda G Thrift ◽

Moira K Kapral ◽

Ashkan Shoamanesh ◽

Amin Amiri ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle East ◽

Incidence Study ◽

Incidence Rates ◽

Large Artery ◽

Small Artery ◽

Community Based ◽

Stroke Incidence ◽

Stroke Subtypes ◽

Artery Disease

Background Incidence, risk factors, case fatality and survival rates of ischemic stroke subtypes are unknown in the Middle East due to the lack of community-based incidence stroke studies in this region. Aim To characterize ischemic stroke subtypes in a Middle Eastern population. Methods The Mashad Stroke Incidence Study is a community-based study that prospectively ascertained all cases of stroke among the 450,229 inhabitants of Mashhad, Iran between 2006 and 2007. We identified 512 cases of first-ever ischemic stroke [264 men (mean age 65.5 ± 14.4) and 248 women (mean age 64.14 ± 14.5)]. Subtypes of ischemic stroke were classified according to the TOAST criteria. Incidence rates were age standardized to the WHO and European populations. Results The proportion of stroke subtypes was distributed as follows: 14.1% large artery disease, 15% cardioembolic, 22.5% small artery disease, 43.9% undetermined and 4.5% other. The greatest overall incidence rates were attributed to undetermined infarction (49.97/100,000) followed by small artery disease (25.54/100,000). Prevalence of hypertension, diabetes and atrial fibrillation differed among ischemic stroke subtypes. Overall, there were 268 (52.34%) deaths and 73 (14.25%) recurrent strokes at five years after incident ischemic stroke, with the greatest risk of recurrence seen in the large artery disease (35.6%) and cardioembolic (35.5%) subgroups. Survival was similar in men and women for each stroke subtype. Conclusions We observed markedly greater incidence rates of ischemic stroke subtypes than in other countries within the Mashad Stroke Incidence Study after age standardization. Our findings should be considered when planning prevention and stroke care services in this region.

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Solitary Plasmacytoma Incidence, Mortality, and Survival Trends in the United States

Blood ◽

10.1182/blood.v126.23.5629.5629 ◽

2015 ◽

Vol 126 (23) ◽

pp. 5629-5629

Author(s):

Anirudh Bikmal ◽

Lakshmi Radhakrishnan ◽

Ajay K. Nooka

Keyword(s):

Regression Analysis ◽

Black Males ◽

Survival Rates ◽

The United States ◽

Mortality Rates ◽

Incidence Rates ◽

Study Cohort ◽

Solitary Plasmacytoma ◽

Incidence And Mortality ◽

Adjusted Incidence

Abstract Background: The trends of incidence of solitary bone plasmacytoma (SBP) varied over time due to the changing definitions and the absence of clarity of the criteria. Prior studies have attempted to identify factors such as older age, gender, race as prognostic factors that influence survival of patients with SBP, but with changing paradigm of myeloma treatments, there is limited literature regarding the incidence, mortality and survival trends of SBP. Methods: We used the SEER registry from 1973-2009 to evaluate the incidence, mortality and survival trends in patients with SBP. The results were reported as crude incidence, mortality and survival rates. Two-sample t-tests, ANOVA as well regression analysis were used to examine correlation. Statistics were computed using the National Cancer Institute SEER*Stat software, version 8.2.0. and SAS software, version 9.4 (SAS Institute Inc, Cary, NC). Using the ICD-O-3 and morphologic codes of 9731/3 to identify cases, the final study cohort consisted of 2,734 cases. Trends were evaluated by the eras of diagnosis: 1973-1980, 1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2009. Age-adjusted incidence rates (IR), standard mortality rates (SMR), survival rate (SR) were expressed as new cases per 100,000 person-years, and age-adjusted to the 2000 US standard population. Results: The median age of diagnosis of SBP among blacks is 61 years (range, 21-91) compared to others: 60 years (range, 28-88) and whites: 66 years (20-97). The age adjusted incidence rates for black males is: 0.3 (95%CI 0.2, 0.3) followed by black females 0.2 (95%CI 0.1, 0.2) white males 0.2 (95%CI 0.2, 0.2) white females 0.1 (95%CI 0.1, 0.1). The trends in incidence and mortality rates are illustrated in table 1 with highest IR noted for black males during the era 2006-2009. The 5-year survival rates for both males (figure 1) and females (figure 2) seem to be trending down over the eras examined. Regression analysis suggests males and other race have increased odds of survival (HR = 0.829, p=0.0078; HR = 0.54 and p=0.0038, respectively). Conclusions: Similar to myeloma, black patients tend to be diagnosed with SBP younger and have increased incidence. The incidence rates seem to be increasing, highest among blacks males, more likely from increased awareness and diagnosis. The mortality and survival patterns are comparable to whites. Interestingly, while the 5-year survival for myeloma among all racial groups is improving this analysis shows a decreasing trend for SBP. This observation is more likely from including myeloma patients under the diagnosis of SBP over the period of study. Recently, the International Myeloma Working Group (IMWG) clarified the definition of SBP which will help in accurate diagnosis and ultimately can help in accurate representation of the survival trends. Table 1. Incidence and Mortality Rates across Study Eras (SEER-9), 1973-2009 Years White (IR) White (MR) Black (IR) Black (MR) Other (IR) Other (MR) Male 1973-1980 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.1) 1981-1985 0 0 0 (0, 0.2) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.1) 1986-1990 0.1 (0.1, 0.2) 0.1 (0, 0.1) 0.1 (0, 0.3) 0.1 (0, 0.2) 0.3 (0.1, 0.5) 0 (0, 0.2) 1991-1995 0.2 (0.1, 0.2) 0.1 (0.1, 0.2) 0.2 (0.1, 0.4) 0 (0, 0.1) 0.1 (0, 0.3) 0.1 (0, 0.2) 1996-2000 0.2 (0.2, 0.3) 0.1 (0.1, 0.1) 0.3 (0.1, 0.5) 0.2 (0.1, 0.4) 0.2 (0.1, 0.4) 0.2 (0, 0.4) 2001-2005 0.4 (0.4, 0.5) 0.2 (0.2, 0.3) 0.5 (0.3, 0.7) 0.3 (0.1, 0.6) 0.2 (0, 0.2) 0 (0, 0.2) 2006-2009 0.4 (0.4, 0.5) 0.2 (0.2, 0.3) 0.7 (0.4, 1) 0.3 (0.1, 0.5) 0.1 (0, 0.2) 0.1 (0, 0.2) Female 1973-1980 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 1981-1985 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 1986-1990 0.1 (0, 0.1) 0 (0, 0.1) 0.1 (0, 0.2) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.2) 1991-1995 0.1 (0.1, 0.1) 0 (0, 0.1) 0.2 (0.1, 0.3) 0.1 (0, 0.2) 0 (0, 0.1) 0 (0, 0.1) 1996-2000 0.1 (0.1, 0.1) 0.1 (0.1, 0.1) 0.1 (0, 0.2) 0.1 (0, 0.2) 0.1 (0.2) 0 (0, 0.1) 2001-2005 0.2 (0.2, 0.2) 0.1 (0.1, 0.2) 0.3 (0.2, 0.4) 0.1 (0, 0.2) 0.1 (0, 0.2) 0 (0, 0.1) 2006-2009 0.2 (0.2, 0.3) 0.1 (0.1, 0.2) 0.3 (0.2, 0.5) 0.2 (0.1, 0.3) 0.1 (0, 0.2) 0 (0, 0.1) Figure 1. 5-year Survival Rates in males (SEER-9), 1973-2012 Figure 1. 5-year Survival Rates in males (SEER-9), 1973-2012 Figure 2. 5-year Survival Rates in females (SEER-9), 1973-2012 Figure 2. 5-year Survival Rates in females (SEER-9), 1973-2012 Disclosures Nooka: Spectrum Pharmaceuticals: Consultancy; Onyx Pharmaceuticals: Consultancy.

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Modifiable and Non-Modifiable Risk Factors of Stroke: A Review Update

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v1i1.22944 ◽

2015 ◽

Vol 1 (1) ◽

pp. 22-26 ◽

Cited By ~ 1

Author(s):

MS Jahirul Hoque Choudhury ◽

Md Tauhidul Islam Chowdhury ◽

Abu Nayeem ◽

Waseka Akter Jahan

Keyword(s):

Black Males ◽

Incidence Rates ◽

Modifiable Risk Factors ◽

Industrialized Countries ◽

Stroke Incidence ◽

Black Females ◽

White Males ◽

Industrialized Nations ◽

Risks Factors ◽

Adjusted Incidence

Stroke is the third most common cause of death in industrialized countries. Stroke is the most important cause of morbidity and longterm disability in Europe as well as in other industrialized nations. Prevalence rate was higher among men compared with women 3.44 and 2.41 per 1000 respectively. Data from the Northern Manhattan study showed the age adjusted incidence of first ischemic stroke per 100,000 was 88 in Whites 191 in Blacks and 149 in Hispanics. Black has almost thrice the risk of first ever stroke compared with Whites. The age adjustment stroke incidence rates for first ever stroke are 167 for White males, 138 for White females, 323 for Black males and 260 for Black females. Among American-Indian age 65-74, the annual rates per 1,000 population of new and recurrent stoke are 6.1 for men and 6.6 for women. Stroke accounted for about one of every 15 deaths in the United State in 2003. About 50 percent of these deaths occurred out of hospital. On average, about every three minutes someone dies of a stroke. In this review the modifiable and non-modifiable risks factors are discussed.J. Natl Inst. Neurosci Bangladesh 2015;1(1):22-26

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Electrocardiographic ST-T Abnormities Are Associated With Stroke Risk in the REGARDS Study

Stroke ◽

10.1161/strokeaha.119.028069 ◽

2020 ◽

Vol 51 (4) ◽

pp. 1100-1106

Author(s):

Mitsuaki Sawano ◽

Ya Yuan ◽

Shun Kohsaka ◽

Taku Inohara ◽

Takeki Suzuki ◽

...

Keyword(s):

Ischemic Stroke ◽

Racial Differences ◽

Stroke Risk ◽

Proportional Hazards ◽

The United States ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Common Finding ◽

Increased Risk

Background and Purpose— In previous studies, isolated nonspecific ST-segment and T-wave abnormalities (NSSTTAs), a common finding on ECGs, were associated with greater risk for incident coronary artery disease. Their association with incident stroke remains unclear. Methods— The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study is a population-based, longitudinal study of 30 239 white and black adults enrolled from 2003 to 2007 in the United States. NSSTTAs were defined from baseline ECG using the standards of Minnesota ECG Classification (Minnesota codes 4-3, 4-4, 5-3, or 5-4). Participants with prior stroke, coronary heart disease, and major and minor ECG abnormalities other than NSSTTAs were excluded from analysis. Multivariable Cox proportional hazards regression was used to examine calculate hazard ratios of incident ischemic stroke by presence of baseline NSSTTAs. Results— Among 14 077 participants, 3111 (22.1%) had NSSTTAs at baseline. With a median of 9.6 years follow-up, 106 (3.4%) with NSSTTAs had ischemic stroke compared with 258 (2.4%) without NSSTTAs. The age-adjusted incidence rates (per 1000 person-years) of stroke were 2.93 in those with NSSTTAs and 2.19 in those without them. Adjusting for baseline age, sex, race, geographic location, and education level, isolated NSSTTAs were associated with a 32% higher risk of ischemic stroke (hazard ratio, 1.32 [95% CI, 1.05–1.67]). With additional adjustment for stroke risk factors, the risk of stroke was increased 27% (hazard ratio, 1.27 [95% CI, 1.00–1.62]) and did not differ by age, race, or sex. Conclusions— Presence of NSSTTAs in persons with an otherwise normal ECG was associated with a 27% increased risk of future ischemic stroke.

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Incidence of Stroke and Ischemic Stroke Subtypes: A Community-Based Study in Brno, Czech Republic

Cerebrovascular Diseases ◽

10.1159/000512180 ◽

2020 ◽

pp. 1-8

Author(s):

Petra Sedova ◽

Robert D. Brown ◽

Miroslav Zvolsky ◽

Silvia Belaskova ◽

Michaela Volna ◽

...

Keyword(s):

Ischemic Stroke ◽

Czech Republic ◽

Epidemiological Data ◽

Incidence Rates ◽

National Registry ◽

World Health ◽

Large Artery ◽

Stroke Incidence ◽

European Standard Population ◽

Stroke Diagnosis

Background: There are few contemporary epidemiological data on stroke for Central Europe. We performed a population-based study evaluating the incidence of stroke, stroke types, and ischemic stroke (IS) subtypes in Brno, the second biggest city in the Czech Republic (CR). Methods: Using the National Registry of Hospitalized Patients, and hospital databases, we identified all patients hospitalized with a stroke diagnosis in Brno hospitals in 2011. For Brno residents with validated stroke diagnosis, we calculated (a) the overall incidence of hospitalized stroke, (b) incidence rates for IS, subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), and (c) incidence rates for IS subtypes. We calculated the average annual age- and sex-standardized incidence (European Standard Population and World Health Organization), to compare our results with other studies. Results: The overall crude incidence of stroke in Brno was 213/100,000 population. The incidence of stroke for stroke types were as follows: SAH, 6.9; ICH, 26.4; and IS, 180 cases per 100,000 population, respectively. The WHO-standardized annual stroke incidence was 107 for all strokes and 88 for IS, 14.4 for ICH, and 5 for SAH. For IS subtypes, the WHO-standardized incidence was large artery atherosclerosis 25.8, cardioembolism 27.8, lacunar 21.6, other determined etiology 6.2, and undetermined etiology 6.5 cases per 100,000 population. Conclusions: The stroke incidence is lower than that previously reported for the CR and Eastern Europe probably reflecting socioeconomic changes in post-communistic countries in the region. These findings could contribute to stroke prevention strategies and influence health policies.

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Chronic myeloid leukemia incidence trends among Caucasians in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e17005 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e17005-e17005

Author(s):

Rakesh Mandal ◽

Binay Kumar Shah

Keyword(s):

Chronic Myeloid Leukemia ◽

Incidence Rate ◽

Myeloid Leukemia ◽

Age Groups ◽

The United States ◽

Incidence Rates ◽

Background Information ◽

Incidence Trends ◽

Caucasian Women ◽

Adjusted Incidence

e17005 Background: Information on trend of Chronic Myeloid Leukemia (CML) incidence rate is scant. This study was conducted to evaluate the time trends of CML incidence rates among Caucasians in the U.S. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) Program to extract annual age-adjusted incidence rates of CML from 1973-2008 for <60yr and >60yr age groups classified by gender. Trends of incidence rates were evaluated using the National Cancer Institute’s Joinpoint Regression Program (v 3.5.2). The maximum number of joinpoints used was 4. The annual percentage change (APC %) for the final selected joinpoint model for each cohort is shown in the table. Results: The annual age-adjusted CML incidence rates for 1973 vs. 2008 were 0.72/0.67, 5.67/4.47, 0.93/0.67, and 10.5/8.5 per 100,000 population for the 4 cohorts: women (<60yr, >60yr) and men (<60yr, >60yr), respectively. Among Caucasian women (>60yr), the incidence rate decreased significantly from 5.58/100,000 in 2001 to 4.47/100,000 in 2008 (APC= -3.08, CI -5.8 to -0.3, p = 0.004). The incidence trend from 1973-2001 was stable for this cohort (APC=0.1, CI -0.3 to 0.5). The incidence trends among women <60yr, men <60yr, and men >60yr were stable from 1973-2008. Conclusions: The annual age-adjusted incidence rates of chronic myeloid leukemia among older (>60 year) Caucasian women has declined sharply from 2001-2008. The rate change is unexplained. It may help generate hypotheses regarding risk factors for CML. [Table: see text]

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Risk-adjusted incidence rates for prostate cancer in the United States

The Prostate ◽

10.1002/pros.21419 ◽

2011 ◽

Vol 72 (2) ◽

pp. 181-185 ◽

Cited By ~ 15

Author(s):

Ray M. Merrill ◽

Arielle Sloan

Keyword(s):

Prostate Cancer ◽

United States ◽

The United States ◽

Incidence Rates ◽

Adjusted Incidence

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Time Trends in Incidence and Case Fatality of Ischemic Stroke

Stroke ◽

10.1161/strokeaha.114.008387 ◽

2015 ◽

Vol 46 (5) ◽

pp. 1173-1179 ◽

Cited By ~ 23

Author(s):

Anne Merete Vangen-Lønne ◽

Tom Wilsgaard ◽

Stein Harald Johnsen ◽

Maria Carlsson ◽

Ellisiv B. Mathiesen

Keyword(s):

Ischemic Stroke ◽

Time Trends ◽

Age Groups ◽

Case Fatality ◽

Population Based ◽

Industrialized Countries ◽

Stroke Incidence ◽

Fractional Polynomial ◽

Adjusted Incidence ◽

Age And Sex

Background and Purpose— Ischemic stroke incidence has declined in industrialized countries the last decades, with possible exception for the youngest age groups. We estimated age- and sex-specific trends in incidence and case fatality of first-ever ischemic stroke between 1977 and 2010 in a Norwegian municipality. Methods— Age-adjusted time trends in incidence from 1977 to 2010 were estimated by fractional polynomial and Poisson regression, and case fatality by logistic regression in 36 575 participants of the population-based Tromsø Study. Results— There were 1214 first-ever ischemic strokes within a total follow-up time of 611 176 person-years. The overall age- and sex-adjusted incidence decreased by 24% in 1995 to 2010. In women aged 30 to 49 years, the incidence increased significantly from 1980 to 2010. In men aged 30 to 49 years, there was a nonsignificant, rising trend from 1977 to 2010. Men aged 50 to 64 years had similar incidence in 2010 compared with 1989. From the mid-1990s to 2010, the incidence declined significantly in women aged 50 to 74 years and in men aged 65 to 74 years, but remained stable in those aged ≥75 years. Case fatality decreased significantly in men aged 30 to 84 years from 1995 to 2010, whereas there was no significant change in women. Conclusions— Age-adjusted incidence of first-ever ischemic stroke increased in young women, declined in women aged 50 to 74 years and men aged 65 to 74 years and remained stable among the oldest. Case fatality declined in men aged 30 to 84 years, but not in women.

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Contemporary incidence and mortality rates of kidney cancer in the United States

Canadian Urological Association Journal ◽

10.5489/cuaj.1760 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 247 ◽

Cited By ~ 55

Author(s):

Giorgio Gandaglia ◽

Praful Ravi ◽

Firas Abdollah ◽

Abd-El-Rahman M. Abd-El-Barr ◽

Andreas Becker ◽

...

Keyword(s):

Kidney Cancer ◽

The United States ◽

Mortality Rates ◽

Incidence Rates ◽

Short Term ◽

Annual Percent Change ◽

Cancer Specific Survival ◽

Incidence And Mortality ◽

Short Term Mortality ◽

Adjusted Incidence

Introduction: This is a timely update of incidence and mortality for renal cell carcinoma (RCC) in the United States.Methods: Relying on the Surveillance, Epidemiology, and End Results (SEER) database, we computed age-adjusted incidence, mortality rates and 5-year cancer-specific survival (CSS) for patients with histologically confirmed kidney cancer between 1975 and 2009. Long-term (1975–2009) and short-term (2000–2009) trends were examined by joinpoint analysis, and quantified using the annual percent change (APC). The reported findings were stratified according to disease stage.Results: Age-adjusted incidence rates of RCC increased by +2.76%/year between 1975 and 2009 (from 6.5 to 17.1/100 000 person years, p < 0.001), and by +2.85%/year between 2000 and 2009 (p < 0.001). For the same time points, the corresponding APC for the incidence of localized stage were +4.55%/year (from 3.0 to 12.2/100 000 person years, p < 0.001), and +4.42%/year (p < 0.001), respectively. The incidence rates of regional stage increased by +0.88%/year between 1975 and 2009 (p < 0.001), but stabilized in recent years (2000–2009: +0.56%/year, p = 0.4). Incidence rates of distant stage remained unchanged in long- and short-term trends. Overall mortality rates increased by +1.72%/year between 1975 and 2009 (from 1.2 to 5.0/100 000 person-years, P<0.001), but stabilized between 1994 and 2004 (p = 0.1). Short-term mortality rates increased in a significant fashion by +3.14%/year only for localized stage (p < 0.001).Interpretation: In contemporary years, there is a persisting upward trend in incidence and mortality of localized RCC.

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