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      Malignant brain neoplasms incidence and mortality trends in Croatia from 2001 to 2014

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          Abstract

          Aim

          To analyze the sex-specific incidence and mortality trends of brain malignancies in Croatia from 2001 to 2014.

          Methods

          Incidence and mortality rates per 100 000 population were calculated using data obtained from the Croatian National Cancer Registry and the Croatian Bureau of Statistics. Rates were age-standardized to the European Standard Population, and trends were assessed using joinpoint regression.

          Results

          In the observed period there were 6634 new brain malignancy cases (52% men) and 5379 deaths due to this diagnosis (52% men). Age-standardized incidence rates ranged from 9.2-11.5 per 100 000 in men and from 7-8.8 per 100 000 in women. Mortality rates ranged from 7.5-8.7 per 100 000 in men and from 5-6.5 in women. Incidence trends in men, mortality in men, and mortality in women were not statistically significant, while a significant trend was observed in incidence in women (annual percent change -1.5; 95% confidence interval -2.3 to -0.6). No joinpoints were observed in any of the joinpoint analyses by sex for incidence and mortality. Age-specific incidence and mortality rates in both sexes indicate a trend shift toward older age. The proportion of morphologically verified cases ranged from 40.2%-62.4% in men and from 38.6%-56.3% in women; the proportion of death-certificate-only cases ranged from 3.3%-9.4% in men and from 3.3%-17.5% in women.

          Conclusion

          Incidence and mortality of brain malignancies in Croatia are among the highest in Europe, while reporting on brain malignancies is still poor. There is a need for improved care of patients with brain malignancies and detailed and accurate data reporting.

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          Most cited references11

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          Permutation tests for joinpoint regression with applications to cancer rates.

          The identification of changes in the recent trend is an important issue in the analysis of cancer mortality and incidence data. We apply a joinpoint regression model to describe such continuous changes and use the grid-search method to fit the regression function with unknown joinpoints assuming constant variance and uncorrelated errors. We find the number of significant joinpoints by performing several permutation tests, each of which has a correct significance level asymptotically. Each p-value is found using Monte Carlo methods, and the overall asymptotic significance level is maintained through a Bonferroni correction. These tests are extended to the situation with non-constant variance to handle rates with Poisson variation and possibly autocorrelated errors. The performance of these tests are studied via simulations and the tests are applied to U.S. prostate cancer incidence and mortality rates. Copyright 2000 John Wiley & Sons, Ltd.
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            The accuracy of cancer mortality statistics based on death certificates in the United States.

            One measure of the accuracy of cancer mortality statistics is the concordance between cancer defined as the underlying cause of death from death certificates and cancer diagnoses recorded in central, population-based cancer registries. Previous studies of such concordance are outdated. To characterize the accuracy of cancer mortality statistics from the concordance between cancer cause of death and primary cancer site at diagnosis. Central cancer registry records from California, Colorado, and Idaho in the U.S. were linked with state vital statistics data and evaluated by demographic and tumor information across 79 site categories. A retrospective arm (confirmation rate per 100 deaths) compared death certificate data from 2002 to 2004 with cancer registry diagnoses from 1993 to 2004, while a prospective arm (detection rate per 100 deaths) compared cancer registry diagnoses from 1993 to 1995 with death certificate data from 1993 to 2004 by International Statistical Classification of Diseases and Related Health Problems (ICD) version used to code deaths. With n=265,863 deaths where cancer was recorded as the underlying cause based on the death certificate, the overall confirmation rate for ICD-10 was 82.8% (95% confidence interval [CI], 82.6-83.0%), the overall detection rate for ICD-10 was 81.0% (95% CI, 80.4-81.6%), and the overall detection rate for ICD-9 was 85.0% (95% CI, 84.8-85.2%). These rates varied across primary sites, where some rates were <50%, some were 95% or greater, and notable differences between confirmation and detection rates were observed. Important unique information on the quality of cancer mortality data obtained from death certificates is provided. In addition, information is provided for future studies of the concordance of primary cancer site between population-based cancer registry data and data from death certificates, particularly underlying causes of death coded in ICD-10. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries

              OBJECTIVES Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country. METHODS The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable. RESULTS The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening. CONCLUSIONS The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.
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                Author and article information

                Journal
                Croat Med J
                Croat. Med. J
                CMJ
                Croatian Medical Journal
                Croatian Medical Schools
                0353-9504
                1332-8166
                February 2019
                : 60
                : 1
                : 33-41
                Affiliations
                [1 ]Department of Neurosurgery, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine Zagreb, Croatia
                [2 ]Department of General Internal Medicine, Gastroenterology, Internistic Oncology, and Hematology, County Hospital Čakovec, Čakovec, Croatia
                [3 ]Department of Oncology, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
                [4 ]Department of Neurosurgery, Division of Surgery, General Hospital Dr. Josip Benčević, Slavonski Brod, Croatia
                [5 ]Department of Pediatric Surgery, Children`s Hospital Zagreb, Zagreb, Croatia
                [6 ]Croatian National Cancer Registry, Division for Epidemiology and Prevention of Noncommunicable Chronic Diseases, Croatian Institute of Public Health, Zagreb, Croatia
                [7 ]Department of Medical Statistics, Epidemiology, and Medical Informatics, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
                Author notes
                Correspondence to:
Mario Šekerija
Croatian Institute of Public Health
Rockefellerova 7
10000 Zagreb, Croatia
 mario.sekerija@ 123456hzjz.hr
                Article
                CroatMedJ_0033
                10.3325/cmj.2019.60.33
                6406061
                30825276
                b3d4e7a0-7723-41aa-89c4-9aad9c073074
                Copyright © 2019 by the Croatian Medical Journal. All rights reserved.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 December 2018
                : 20 February 2019
                Categories
                Public Health

                Medicine
                Medicine

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