Incidence and trends of pancreatic cancer (PC) in Girona: A population-based study from the Girona Cancer Registry (1994-2015).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 225-225
Author(s):  
Adelaida Garcia-Velasco ◽  
Carmen Carmona ◽  
Antonia Bianca ◽  
Helena Teixidor ◽  
Marc Valero ◽  
...  
Keyword(s):  
Cancer Registry ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Neuroendocrine Neoplasms ◽  
Standard Population ◽  
European Standard Population ◽  
Drastic Increase ◽  
Adjusted Incidence ◽  
Incident Cases

225 Background: PC is the third leading-cause of cancer death in Spain. In this study we aim to investigate PC’s incidence and trends during 1994-2015 in Girona. Methods: Data were extracted from the population-based Girona Cancer Registry. Incident PC cases were classified using the ICD-O-3 Third Edition. Age-adjusted incidence rates (ASRE) to the European standard population and world standard population (ASRW) were obtained. Trends were assessed using the estimated annual percentage of change (EAPC) of the ASRE13. Results: We identified 1590 PC incident cases, 45.8% females and 54.2%. Patients > 64 years old represented a 72.6% of cases. According to histology, epithelial tumors stand for a 44% of cases and neuroendocrine neoplasms represented only the 3% of all cases, being most of PC tumors’ histology non-specified. Cases detected only by death certificates (DCO) were 7.7% in males and 7.4% in females. For the whole study population, crude rate (CR) cancer incidence was 11.26 cases per 100,000 inhabitants/year (12.17 men; 10.34 women). Regarding the ASR, results show an ASRE13 of 12.99 (95% CI 12.36;13.65) and ASRW of 5.58 (95% CI 5.8;13.655.91). Age-specific rates reflected a drastic increase with age, having the population over 85 years the highest rate (74.5 cases per 100,000 inhabitants/year). We also found a significant increase in incidence of PC cases over the study period, with an EAPC of 1.41% per year, present in both men (EAPC = 1.30%) and women (EAPC = 1.37%). Conclusions: Incidence rates of PC in Girona are within the European average, and likewise they have been increasing for the last two decades. There is an increase of incidence in the elderly population reflected in age-specific rates, reason whereby we believe there are a high proportion of unspecific histologies. These results can be used as baseline for further research.

scholarly journals Incidence and Survival Trends of Pancreatic Cancer in Girona: Impact of the Change in Patient Care in the Last 25 Years

2020 ◽  
Vol 17 (24) ◽  
pp. 9538
Author(s):  
Adelaida García-Velasco ◽  
Lluís Zacarías-Pons ◽  
Helena Teixidor ◽  
Marc Valeros ◽  
Raquel Liñan ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Incidence Rates ◽  
Future Research ◽  
Kaplan Meier ◽  
Standard Population ◽  
European Standard Population ◽  
Classification Of Diseases ◽  
Incident Cases

(1) Background: We investigated the incidence and survival trends for pancreatic cancer (PC) over the last 25 years in the Girona region, Catalonia, Spain; (2) Methods: Data were extracted from the population-based Girona Cancer Registry. Incident PC cases during 1994–2015 were classified using the International Classification of Diseases for Oncology Third Edition (ICD-O-3). Incidence rates age-adjusted to the European standard population (ASRE) and world standard population (ASRW) were obtained. Trends were assessed using the estimated annual percentage of change (EAPC) of the ASRE13. Observed and relative survivals (RS) were estimated with the Kaplan–Meier and Pohar Perme methods, respectively; (3) Results: We identified 1602 PC incident cases. According to histology, 44.4% of cases were exocrine PC, 4.1% neuroendocrine, and 51.1% malignant-non-specified. The crude incidence rate (CR) for PC was 11.43 cases-per-100,000 inhabitants/year. A significant increase of incidence with age and over the study period was observed. PC overall 5-year RS was 7.05% (95% confidence interval (CI) 5.63; 8.84). Longer overall survival was observed in patients with neuroendocrine tumours (5-year RS 61.45%; 95% CI 47.47; 79.55). Trends in 5-year RS for the whole cohort rose from 3.27% (95% CI 1.69–6.35) in 1994–1998 to 13.1% (95% CI 9.98; 17.2) in 2010–2015; (4) Conclusions: Incidence rates of PC in Girona have increased in the last two decades. There is a moderate but encouraging increase in survival thorough the study period. These results can be used as baseline for future research.

scholarly journals The Rising Incidence of Gout and the Increasing Burden of Comorbidities: A Population-based Study over 20 Years

2017 ◽  
Vol 45 (4) ◽  
pp. 574-579 ◽  
Author(s):  
Mohanad M. Elfishawi ◽  
Nour Zleik ◽  
Zoran Kvrgic ◽  
Clement J. Michet ◽  
Cynthia S. Crowson ◽  
...  
Keyword(s):  
New York ◽  
Population Based ◽  
Incidence Rates ◽  
Comorbid Conditions ◽  
Population Based Study ◽  
Significant Public Health ◽  
Public Health Challenge ◽  
Rising Incidence ◽  
Adjusted Incidence ◽  
Incident Cases

Objective.To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions.Methods.The medical records were reviewed of all adults with a diagnosis of incident gout in Olmsted County, Minnesota, USA, during 2 time periods (January 1, 1989–December 31, 1992, and January 1, 2009–December 31, 2010). Incident cases had to fulfill at least 1 of 3 criteria: the American Rheumatism Association 1977 preliminary criteria for gout, the Rome criteria, or the New York criteria.Results.A total of 158 patients with new-onset gout were identified during 1989–1992 and 271 patients during 2009–2010, yielding age- and sex-adjusted incidence rates of 66.6/100,000 (95% CI 55.9–77.4) in 1989–1992 and 136.7/100,000 (95% CI 120.4–153.1) in 2009–2010. The incidence rate ratio was 2.62 (95% CI 1.80–3.83). At the time of their first gout flare, patients diagnosed with gout in 2009–2010 had higher prevalence of comorbid conditions compared with 1989–1992, including hypertension (69% vs 54%), diabetes mellitus (25% vs 6%), renal disease (28% vs 11%), hyperlipidemia (61% vs 21%), and morbid obesity (body mass index ≥ 35 kg/m2; 29% vs 10%).Conclusion.The incidence of gout has more than doubled over the recent 20 years. This increase together with the more frequent occurrence of comorbid conditions and cardiovascular risk factors represents a significant public health challenge.

New Zealand (NZ) Pacific Peoples and Maori Have a Higher Risk of Developing Multiple Myeloma Than Other New Zealanders.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4760-4760 ◽  
Author(s):  
Julia K. Phillips ◽  
Gordon L. Purdie
Keyword(s):  
Multiple Myeloma ◽  
Cancer Registry ◽  
Incidence Rates ◽  
White Americans ◽  
Pacific Population ◽  
Malignant Plasma Cell ◽  
Standard Population ◽  
Plasma Cell Neoplasms ◽  
Icd 10 ◽  
Adjusted Incidence

Abstract The incidence of multiple myeloma shows ethnic variation, myeloma age-standardized incidence being higher in African Americans at 11.3 per 100,000 than White Americans in whom the incidence is 5.1 per 100,000 (standardized to US 2000 census population)[Ries et al (2007) http://seer.cancer.gov/csr/1975_2004/]. NZ has a number of ethnic minorities, which includes Maori and Pacific peoples. New diagnoses of multiple myeloma in NZ are reported to a national cancer registry. Since 1994 this has been a legal requirement. We examined data from the cancer registry for 1996 to 2004 to establish the relative incidence of multiple myeloma in NZ ethnic groups. During this period ICD-9 (multiple myeloma and immunoproliferative neoplasms) was used for coding until 2000 when it was replaced by ICD-10 (multiple myeloma and malignant plasma cell neoplasms). Between 1996 and 2004 there were 2101 myeloma registrations. Median age was between 70 and 75yrs. M:F ratio was 1.3. Maori accounted for 160 patients (7.6%), Pacific peoples 81 (3.8%). Mean age-standardized annual incidence rates per 100,000 and 95% confidence intervals (WHO world standard population (WSP)) for the 9 year period were as follows:- All Male Female Maori 6.4 (5.4–7.6) 7.9 (6.3–9.8) 4.9 (3.8–6.3) Pacific Peoples 8.4 (6.6–10.8) 10.9 (7.8–15.2) 6.0 (4.3–8.4) Non-Maori, non-Pacific 4.4 (4.2–4.6) 5.4 (5.1–5.7) 3.4 (3.1–3.6) All ethnicities 4.6 (4.4–4.8) 5.7 (5.4–6.0) 3.6 (3.3–3.8) The population adjusted incidence of multiple myeloma was significantly higher in Pacific peoples (ratio 1.93 (95% CI 1.50–2.48)) and Maori (ratio 1.46 (95% CI 1.23–1.74)) than in the non Maori, non Pacific population. Conclusion: The overall incidence of myeloma in NZ (4.6 per 100,000, 95%CI 4.4–4.8 WSP) is higher than that reported for a UK population (3.3 per 100,000 WSP) [Phekoo et al (2004) Brit J Haem 127:299]. The incidence of myeloma in NZ Pacific peoples is especially high at 8.4 per 100,000. The incidence of myeloma in NZ Maori at 6.4 per 100,000 is intermediate between that of the NZ non Maori, non Pacific population and that of Pacific peoples.

scholarly journals Cancer incidence in the Western Amazon: population-based estimates in Rio Branco, Acre State, Brazil, 2007-2009

2012 ◽  
Vol 28 (11) ◽  
pp. 2125-2132 ◽  
Author(s):  
Juliano de Pádua Nakashima ◽  
Rosalina Jorge Koifman ◽  
Sergio Koifman
Keyword(s):  
Cancer Registry ◽  
Cancer Incidence ◽  
Population Based ◽  
Incidence Rates ◽  
Developing Regions ◽  
Colon And Rectum ◽  
The Subject ◽  
Incidence Pattern ◽  
Incident Cases ◽  
Cancer Incidence Rates

Cancer incidence rates vary widely in Brazil. The literature on the subject for the western Amazon region is scarce. This study aimed to determine cancer incidence in the population of Rio Branco, Acre State. A total of 718 new cases were recorded during the study period. Among men, the five leading cancer sites were prostate (ASR 75.1), stomach (ASR 23.0), lung (ASR 19.1), colon and rectum (ASR 9.5), and leukemia (ASR 6.9). Among women, they were breast (ASR 41.5), cervix (ASR 41.3), lung (ASR 11.8), colon and rectum (ASR 11.0), and stomach (ASR 7.7). These indicators reveal that Rio Branco has a cancer incidence pattern that overlaps with epidemiological cancer patterns observed in developed and developing regions. The results of the study point to the importance of implementing a population-based cancer registry - currently nonexistent in Rio Branco - as a factor to promote analysis of incident cases of the disease and monitoring of its evolution.

scholarly journals Incidence and Trends of the Leading Cancers with Elevated Incidence Among American Indian and Alaska Native Populations, 2012–2016

2020 ◽  
Author(s):  
Stephanie C Melkonian ◽  
Hannah K Weir ◽  
Melissa A Jim ◽  
Bailey Preikschat ◽  
Donald Haverkamp ◽  
...  
Keyword(s):  
American Indian ◽  
Cancer Incidence ◽  
Alaska Native ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Breast Cancers ◽  
Age Adjusted Rates ◽  
Incident Cases ◽  
Hispanic White

Abstract Cancer incidence varies among American Indian and Alaska Native (AI/AN) populations, as well as between AI/AN and White populations. This study examined trends for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations and estimated potentially avoidable incident cases among AI/AN populations. Incident cases diagnosed during 2012–2016 were identified from population-based cancer registries and linked with the Indian Health Service patient registration databases to improve racial classification of AI/AN populations. Age-adjusted rates (per 100,000) and trends were calculated for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations (rate ratio >1.0), by region. Trends were estimated using joinpoint regression analyses. Expected cancers were estimated by applying age-specific cancer incidence rates among non-Hispanic White populations to population estimates for AI/AN populations. Excess cancer cases among AI/AN populations were defined as observed minus expected cases. Liver, stomach, kidney, lung, colorectal and female breast cancers had higher incidence rate among AI/AN populations across most regions. Between 2012 and 2016, nearly 5,200 excess cancers were diagnosed among AI/AN populations, with the largest number of excess cancers (1,925) occurring in the Southern Plains region. Culturally informed efforts may reduce cancer disparities associated with these and other cancers among AI/AN populations.

scholarly journals POS0803 TRENDS IN THE INCIDENCE OF GIANT CELL ARTERITIS ACROSS SEVEN DECADES AND CHANGES IN DIAGNOSTIC MODALITIES: A POPULATION-BASED STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 654.1-654
Author(s):  
T. Garvey ◽  
C. S. Crowson ◽  
M. Koster ◽  
K. J. Warrington
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Population Based ◽  
Incidence Rates ◽  
Large Vessel ◽  
Vessel Imaging ◽  
Group 3 ◽  
Group 2 ◽  
Diagnostic Modalities ◽  
Incident Cases

Background:Diagnostic methods for giant cell arteritis (GCA) have evolved over recent decades, and large vessel imaging plays an increasing role in disease detection.Objectives:This study aims to estimate the incidence of GCA over the past 10 years in a population and compare it to preceding incidence estimates. It also explores trends in the diagnostic modalities used to identify GCA.Methods:A pre-existing population-based cohort of patients diagnosed with GCA between 1950 and 2009 was extended with incident cases from 2010 to 2019. The diagnosis of GCA was confirmed by review of medical records of patients with ICD9/10 codes for GCA between 1/1/2010 and 12/31/2019. Incident cases that met either one of the following sets of inclusion criteria were added to the cohort: one, American College of Rheumatology 1990 GCA classification criteria; or two, patients aged ≥50 years with elevation of erythrocyte sedimentation rate or C-reactive protein and radiographic evidence of large vessel vasculitis attributed to GCA. Incident cases were classified into one of three groups: group 1, temporal artery biopsy (TAB) positive; group 2, TAB negative or not done with positive large-vessel imaging; or group 3, clinical diagnosis of GCA.Results:The study cohort included 305 patients diagnosed with GCA from 1950 until 2019. Fifty-five incident cases were diagnosed between 2010 and 2019; 37 females (67%) and 18 males (33%). The age and sex adjusted incidence rates (95% CI) per 100,000 between 2010 and 2019 for females, males, and the total population were 13.0 (8.8, 17.3), 8.6 (4.6, 12.7), and 10.8 (8.0, 13.7), respectively. The corresponding incidence rates from 2000-2009 were 28.0 (21.0, 35.1), 10.2 (5.0, 15.5), and 20.5 (15.9, 25.1), respectively. This represents a significant decline in the incidence rates in females (p<0.001) and the total group (p<0.001) between the 2000-2009 and 2010-2019 cohorts but no change in males (p=0.64). Of the 55 patients diagnosed between 2010 and 2019, there were 37 (67%) in group 1, 10 (18%) in group 2, and 8 (15%) in group 3. In contrast, of the 250 patients diagnosed between 1950 and 2009 there were 209 (84%) in group 1, 4 (2%) in group 2, and 37 (15%) in group 3. There was a significant difference between the 1950-2009 and 2010-2019 cohorts in the composition of these groups (p<0.001).Conclusion:In this population-based cohort of patients with GCA diagnosed over a 70-year period, the incidence of GCA has declined in recent years. The total decline is driven by a decline in females but not in males. The reasons for this are unclear but should be followed over time and investigated in other population-based cohorts. There has also been a shift in the diagnostic modalities for GCA. In recent years, there are fewer TAB positive patients, and more patients diagnosed with large vessel imaging. This is the first population-based incidence cohort demonstrating a trend towards increased use of large vessel imaging for the diagnosis of GCA.References:[1]Chandran AK, et al. Incidence of Giant Cell Arteritis in Olmsted County, Minnesota, over a 60-year period 1950-2009. Scand J Rheumatol. 2015;44(3):215-218.[2]Gonzalez-Gay MA, et al. Giant cell arteritis: is the clinical spectrum of the disease changing? BMC Geriatr. 2019; Jul 29;19(1):200.[3]Rubenstein E, et al. Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systemic literature review and meta-analysis. Rheumatology (Oxford). 2020 May 1:59(5):1011-1020.Figure 1.Trends in the incidence of GCA in Olmsted County by sex (1950-2019).Acknowledgements:This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health (NIH) under Award Number R01 AG034676, and CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.Disclosure of Interests:Thomas Garvey: None declared, Cynthia S. Crowson: None declared, Matthew Koster: None declared, Kenneth J Warrington Grant/research support from: Clinical research support from Eli Lilly and Kiniksa

Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

2014 ◽  
Vol 112 (08) ◽  
pp. 255-263 ◽  
Author(s):  
Alexander T. Cohen ◽  
Luke Bamber ◽  
Stephan Rietbrock ◽  
Carlos Martinez
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Recurrence Rates ◽  
Recurrent Vte ◽  
Active Cancer

SummaryContemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2–132.9) per 100,000 person-years and 107.0 (95% CI, 105.8–108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4–10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

Incidence of Skull Fractures in Olmsted County, Minnesota

Neurosurgery ◽  
1984 ◽  
Vol 15 (3) ◽  
pp. 318-324 ◽  
Author(s):  
Evan Lloyd Nelson ◽  
Joseph L. Melton ◽  
John F. Annegers ◽  
Edward R. Laws ◽  
Kenneth P. Offord
Keyword(s):  
Rural Areas ◽  
Motor Vehicle ◽  
Skull Fracture ◽  
Age Groups ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Skull Fractures ◽  
Olmsted County ◽  
Type Motor

Abstract Between 1935 and 1974, 3598 episodes of head trauma among Olmsted County, Minnesota, residents resulted in 1097 skull fractures. Of these, 53% were simple, 16% were depressed, 12% were compound, and 19% were basilar. The age- and sex-adjusted incidence of skull fractures was 44.3 per 100,000 person-years overall, was somewhat greater in the urban than in the rural areas of Olmsted County, and was relatively stable for the final 30 years of the study. Age-specific incidence rates were highest for the very young, and simple linear fractures were the predominant type of skull fracture in this age group and among the elderly. The male:female ratio of incidence rates varied from 2.1:1 to 4.5:1 depending on fracture type. Motor vehicle accidents accounted for 38% of the skull fractures and were a particularly important cause among young males. Falls accounted for 37% of the skull fractures and were the major cause of fractures in the elderly and pediatric age groups. The results of this population-based study may be helpful in formulating recommendations for the evaluation and management of head-injured patients.

scholarly journals Incidence of atrial fibrillation in different major cancer subtypes: a Nationwide population-based 12 year follow up study

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christina Boegh Jakobsen ◽  
Morten Lamberts ◽  
Nicholas Carlson ◽  
Morten Lock-Hansen ◽  
Christian Torp-Pedersen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Cancer Subtypes ◽  
History Of ◽  
The Difference ◽  
Rate Ratios ◽  
New Onset

Abstract Background The prevalence of both atrial fibrillation (AF) and malignancies are increasing in the elderly, but incidences of new onset AF in different cancer subtypes are not well described.The objectives of this study were therefore to determine the incidence of AF in different cancer subtypes and to examine the association of cancer and future AF. Methods Using national databases, the Danish general population was followed from 2000 until 2012. Every individual aged > 18 years and with no history of cancer or AF prior to study start was included. Incidence rates of new onset AF were identified and incidence rate ratios (IRRs) of AF in cancer patients were calculated in an adjusted Poisson regression model. Results A total of 4,324,545 individuals were included in the study. Cancer was diagnosed in 316,040 patients. The median age of the cancer population was 67.0 year and 51.5% were females. Incidences of AF were increased in all subtypes of cancer. For overall cancer, the incidence was 17.4 per 1000 person years (PY) vs 3.7 per 1000 PY in the general population and the difference increased with age. The covariate adjusted IRR for AF in overall cancer was 1.46 (95% confidence interval (CI) 1.44–1.48). The strength of the association declined with time from cancer diagnosis (IRR0-90days = 3.41 (3.29–3.54), (IRR-180 days-1 year = 1.57 (CI 1.50–1.64) and (IRR2–5 years = 1.12 (CI 1.09–1.15). Conclusions In this nationwide cohort study we observed that all major cancer subtypes were associated with an increased incidence of AF. Further, cancer and AF might be independently associated.

scholarly journals Increasing Cervical Cancer Incidence in Rural Eastern Cape Province of South Africa From 1998 to 2012: A Population-Based Cancer Registry Study

2020 ◽  
pp. 1-8
Author(s):  
Nontuthuzelo I.M. Somdyala ◽  
Debbie Bradshaw ◽  
Muhammad A. Dhansay ◽  
Daniela C. Stefan
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Cancer Registry ◽  
Screening Program ◽  
Population Based ◽  
Incidence Rates ◽  
District Health ◽  
Northern Area ◽  
Southern Area ◽  
Screening Coverage

PURPOSE In this study, we aimed to investigate trends in the age-standardized and age-specific incidence rates in two distinct regions (the northern and southern areas) of South Africa covered by a population-based cancer registry. In addition, trends in coverage of the cervical cancer screening program were assessed using routine health service data. METHODS Occurrences (topography C53.0-C53.9) for the period 1998-2012 were extracted from a cancer registry database from which basic descriptive statistics and frequencies were analyzed for all variables using CanReg4. Trends over time were estimated using a direct standardization method and world standard population as a reference. Screening coverage annualized figures for women age ≥ 30 years by sub–health district were extracted from the District Health Information System. RESULTS In the northern area, annual age-standardized incidence rates per 100,000 women increased from 24.0 (95% CI, 21.1 to 27.0) in 1998-2002 to 39.0 (95% CI, 35.6 to 42.5) in 2008-2012, with a screening coverage rate of 15% by 2012. In contrast, no increase was observed in incidence in the southern area, with rates of 20.0 (95% CI, 18.5 to 21.4) in 1998-2002 and 18.8 (95% CI, 16.2 to 21.4) in 2008-2012, and the southern area had a higher screening coverage of 41% in 2012. Overall, the percentage distribution of stage at diagnosis showed that 28.5% of occurrences were diagnosed at disease stages I and II and 35%, at III and IV; 36% had with missing stage information (2003-2012). In 77% of occurrences, a histologically verified diagnosis was made, compared with only 12.3% by cytology. CONCLUSION This study has demonstrated an almost two-fold increase in the incidence rate in the northern area but little change in the southern area of the cancer registry.

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