International journal of cancer. Journal international du cancer
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The aim of this study was to compare trends in prognostic factors and survival from cutaneous melanoma between 1993 and 2003 in 2 populations with dramatically different underlying incidence rates [Yorkshire, UK, and New South Wales (NSW), Australia] and to look at whether the greater investment in melanoma prevention and early detection in Australia has resulted in any relative differences in survival. Patients diagnosed with invasive melanoma between 1993 and 2003 in Yorkshire (n = 4,170) and NSW (n = 30,520) were identified from cancer registry databases and prognostic information (age, sex, socioeconomic background, tumour site and Breslow thickness) was extracted. Age-standardised incidence rates, 5-year relative survival and relative excess risk of death were calculated. ⋯ Despite the increase in good prognosis of thin tumours, there was no significant change in survival over the time period in either area. After adjustment for differences in prognostic factors, the relative excess risk of death in Yorkshire compared to that in NSW reduced from 1.36 (95% CI 1.20-1.53) to 1.11 (95% CI 0.99-1.23). Differences in tumour thickness appeared to be the most important factor.
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Vitamin D receptor (VDR) activation inhibits proliferation and angiogenesis in the colorectal epithelium, and inhibits metastasis of colorectal tumors. Polymorphisms in the VDR gene alter receptor cellular levels and functioning, and may confer altered susceptibility to colorectal neoplasia. We aimed to investigate the influence of VDR polymorphisms and dietary factors impacting on vitamin D metabolism on colorectal adenoma (CRA) recurrence. ⋯ Milk accounted for 60% of dairy product intake, and on analysis of milk and nonmilk dairy products separately recurrence risk in individuals in the highest tertile of milk intake was half that of lowest tertile individuals (RR = 0.52; 95% CI: 0.38-0.72, p(trend) = 3.2 x 10(-5)), whereas nonmilk dairy products did not influence recurrence. VDR polymorphism genotypes and haplotypes did not directly alter recurrence risk, but the reduction in risk associated with high dairy product intake was confined to individuals with ApaI aA/AA genotype (p(interaction) = 0.02). These findings indicate dairy products, and in particular milk, have chemopreventive activity against CRA recurrence.