Trends in incidence of and mortality from cancer in The Netherlands in the period 1989–1998
Introduction
Cancer registries provide background information on the site-, gender-, and age-specific incidence of cancer in a defined population. Incidence data may form a basis for setting priorities for cancer control activities. Monitoring changes in cancer occurrence and mortality can also provide essential information on changes in detection and treatment.
In The Netherlands, there are nine regional cancer registries. These registries are maintained by the Comprehensive Cancer Centres, which were established during the late 1970s and early 1980s, their primary task being improving care for cancer patients. The regional registries submit their data to the nationwide Netherlands Cancer Registry (NCR), which has been complete since 1989 and has now become the second largest cancer registry in Europe. In the years 1989 and 1990, the most common cancer sites among males were the lung, prostate and colon [1]. For females, the most common site was the breast followed by the colon and lung. Compared with other countries in Northwestern Europe and North America, high incidence rates in The Netherlands were reported for the lung and stomach among males, breast cancer among females and colorectal cancer for both sexes. In 1989 and 1990, mortality was highest for cancer of the lung, prostate, colorectal and stomach cancers in males and for breast, colon, lung and ovary cancers in females [2].
In this paper, trends in cancer incidence and mortality during the period 1989–1998 are described. Tumour sites are only reported if a clear trend is observed. Melanoma skin cancer is described extensively in another paper [3].
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Patients and methods
The NCR includes all invasive and in situ malignancies diagnosed from 1989 onwards in The Netherlands. Carcinoma in situ of the cervix and basal cell carcinomas of the skin have not been included, the latter being registered by the Eindhoven cancer registry. Notification is obtained from the pathology and haematology departments in their regions. All pathology laboratories in The Netherlands have a combined automated archive (PALGA) for the pathological diagnoses. Other sources are the
Results
The total number of patients with primary cancers in The Netherlands increased from 56 368 in 1989 to 65 771 in 1998 (17%). When adjusted to the European standard population, the rate for both sexes increased slightly from 381 per 106 person-years in 1989 to 390 in 1998. For males, the rates decreased from 449 to 442 per 106 person-years (EAPC 0.2%, P=0.53), for females an increase was observed from 313 to 337 per 106 person-years (EAPC 0.9%, P=0.001).
The results according to site are presented
Discussion
An impressive number of changes in incidence and mortality occurred during the 1990s, partly due to tobacco and alcohol habits and partly due to early detection and screening. They are summarised in Table 1, Table 2. It is unlikely that changes in completeness of the cancer registry influenced our rates, since registration activities in the nine regions started several years before 1989.
The opposite trends in lung cancer for males and females were caused by the difference in smoking habits
Acknowledgments
We thank K.K.H. Aben, M. Beelen, R.A.M. Damhuis, K. van der Kooij, N. Kuck-Koot, W.J. Louwman, M. Oostindiër, M. Schaapveld, and H. Huveneers for their contributions and G. Bieger-Smith for her English corrections.
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