Global surveillance of cancer survival 1995-2009 : analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75 000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems. FUNDING: Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA).

Aspirin and statin use and the subsequent development of depression in men and women: Results from a longitudinal population-based study.

OBJECTIVE: Low-grade chronic inflammation is one potential mechanism underlying the well-established association between major depressive disorder (MDD) and increased cardiovascular morbidity. Both aspirin and statins have anti-inflammatory properties, which may contribute to their preventive effect on cardiovascular diseases. Previous studies on the potentially preventive effect of these drugs on depression have provided inconsistent results. The aim of the present paper was to assess the prospective association between regular aspirin or statin use and the incidence of MDD. METHOD: This prospective cohort study included 1631 subjects (43.6% women, mean age 51.7 years), randomly selected from the general population of an urban area. Subjects underwent a thorough physical evaluation as well as semi-structured interviews investigating DSM-IV mental disorders at baseline and follow-up (mean duration 5.2 years). Analyses were adjusted for a wide array of potential confounders. RESULTS: Our main finding was that regular aspirin or statin use at baseline did not reduce the incidence of MDD during follow-up, regardless of sex or age (hazard ratios, aspirin: 1.19; 95%CI, 0.68-2.08; and statins: 1.25; 95%CI, 0.73-2.14; respectively). LIMITATIONS: Our study is not a randomized clinical trial and could not adjust for all potential confounding factors, information on aspirin or statin use was collected only for the 6 months prior to the evaluations, and the sample was restricted to subjects between 35 and 66 years of age. CONCLUSION: Our data do not support a large scale preventive treatment of depression using aspirin or statins in subjects aged from 35 to 66 years from the community.

Motivational model of problem drinking for men and women /

This thesis tested a path model of the relationships of reasons for drinking and reasons for limiting drinking with consumption of alcohol and drinking problems. It was hypothesized that reasons for drinking would be composed of positively and negatively reinforcing reasons, and that reasons for limiting drinking would be composed of personal and social reasons. Problem drinking was operationalized as consisting of two factors, consumption and drinking problems, with a positive relationship between the two. It was predicted that positively and negatively reinforcing reasons for drinking would be associated with heavier consumption and, in turn, more drinking problems, through level of consumption. Negatively reinforcing reasons were also predicted to be associated with drinking problems directly, independent of level of consumption. It was hypothesized that reasons for limiting drinking would be associated with lower levels of consumption and would be related to fewer drinking problems, through level of consumption. Finally, among women, reasons for limiting drinking were expected to be associated with drinking problems directly, independent of level of consumption. The sample, was taken from the second phase of the Niagara Young Aduh Health Study, a community sample of young adult men and women. Measurement models of reasons for drinking, reasons for limiting drinking, and problem drinking were tested using Confirmatory Factor Analysis. After adequate fit of each measurement model was obtained, the complete structural model, with all hypothesized paths, was tested for goodness of fit. Cross-group equality constraints were imposed on all models to test for gender differences. The results provided evidence supporting the hypothesized structure of reasons for drinking and problem drinking. A single factor model of reasons for limiting drinking was used in the analyses because a two-factor model was inadequate. Support was obtained for the structural model. For example, the resuhs revealed independent influences of Positively Reinforcing Reasons for Drinking, Negatively Reinforcing Reasons for Drinking, and Reasons for Limiting Drinking on consumption. In addition. Negatively Reinforcing Reasons helped to account for Drinking Problems independent of the amount of alcohol consumed. Although an additional path from Reasons for Limiting Drinking to Drinking Problems was hypothesized for women, it was of marginal significance and did not improve the model's fit. As a result, no sex differences in the model were found. This may be a result of the convergence of drinking patterns for men and women. Furthermore, it is suggested that gender differences may only be found in clinical samples of problem drinkers, where the relative level of consumption for women and men is similar.

Sexual selections in the northern fall field cricket, Gryllus pennsylvanicus: a manipulation of the adult sex ratio

The operational sex ratio has long been considered an important constraint on the structure of mating systems. The effects of an experimentally manipulated sex ratio on mating behavior and selection were investigated in a polygynous species, Gryllus pennsylvanicus, where the potential exists for spatial/temporal fluctuations in sex ratio of field populations. Four different sex ratios (males: females, 5:0, 5:2, 5:5, 5:10) were investigated. Observations were conducted in late summer over two field seasons, from 2400 h , to 1000 h EST. Several male characters thought to be associated with male reproduc.tive success were studied: calling duration, searching distance, weight, fighting behavior, courtship frequency, and mating success. Variance in male mating success was used as the indicator for the opportunity for sexual selection. Total selection was estimated as the univariate regression coefficient between relative fitness and the character of interest, while direct selection was estimated as standardized partial regression coefficients generated from a multiple regression of relative fitness on each character. The opportunity for sexual selection was highest at 5:2 and lowest at 5:10. The frequency of fighting behavior was highest at 5:2 and 5:5. Fighting ability (% wins) was determined to be an important correlate of male body weight. Direct selection for increased male body weight was detected at 5:2, while total selection for body weight was seen at 5:5. Selection on male body weight was not detected at 5: 10. Calling duration decreased as sex ratio became more female-biased. Total and direct selection were detected for increased calling at 5:2, only total selection for calling was seen at 5:5, whereas direct selection against calling was detected at 5: 10. Searching distance also decreased as sex ratio became more female-biased, however no form of selection was detected for searching at any of the sex ratios. Data are discussed in terms of sexual selection on male reproductive tactics, the mating system and maintenance of genetic variation in male reproductive behavior.

Social neuroendocrinology of competition

The relationship between testosterone concentrations and aggressive behaviour in studies of people has produced very inconsistent findings. However, one consistent fmding that has emerged is that competitive and aggressive interactions potentiate testosterone release in both human and non-human species. It has been argued that socially-induced alterations in testosterone concentrations may function to influence ongoing and/or future social behaviour. Nonetheless, few studies have empirically tested this hypothesis. The current series of experiments was designed to address the extent to which competitioninduced fluctuations in testosterone concentrations were associated with ongoing and/or subsequent social behaviour. In Study 1, men (n = 38) provided saliva samples prior to, and at the conclusion of, the Point Subtraction Aggression Paradigm (PSAP). Although baseline testosterone concentrations were not related to aggressive behaviour, there was a positive correlation between change in testosterone and aggressive behaviour such that men who were most aggressive on the PSAP demonstrated the largest increase in testosterone concentrations. Furthermore, a rise in testosterone during the PSAP predicted willingness to choose a subsequent competitive task. In Study 2, men and women provided saliva samples prior to and after competing against a same-sex opponent on the Number Tracing Task (NTT). The outcome of the competition was rigged such that half of the individuals won most of the races, while the other half lost most of the races, thus experimentally creating a winner and loser in the laboratory. Following the competitive interaction, men and women played the PSAP with their same-sex partner. Results indicated that men selected the aggressive response (but not reward or protection responses), more frequently than women. For men assigned to the loss condition, an increase in testosterone concentrations in response to the NTT predicted subsequent aggressive behaviour. For men assigned to the win condition, an increase in testosterone concentrations in response to the NTT predicted subsequent aggressive behaviour, but only among those men who scored high on trait dominance. Change in testosterone and trait dominance did not predict aggressive behaviour in women. In Study 3, men provided saliva samples prior to, during, and at the end of the PSAP. They were randomly assigned to one of four experimental conditions that differed in the extent to which they were provoked and whether they received reward for behaving aggressively (i.e., stealing points). Results indicated that baseline testosterone concentrations did not correlate with aggression in any of the experimental conditions. Consistent with Study 1, there was a positive correlation between change in testosterone and aggressive behaviour among men who were provoked, but did not receive reward for aggression (i.e., reactive condition). Men who were provoked but did not receive reward for aggression enjoyed the task the most and were more likely to choose the competitive versus non-competitive task relative to men assigned to the other experimental conditions. Also, individual differences in aggressive behaviour among these men were positively correlated with the extent to which they enjoyed the task. Together, these studies indicate that testosterone dynamics within the context of competition influence subsequent competitive and aggressive behaviours in humans and that testosterone may be a marker of the intrinsically rewarding nature of costly aggressive behaviour.

Cognitive consequences of expressive suppression : effects of sex and emotional valence

The present research was designed to examine whether sex and/or emotional valence pl aya role in the cognitive consequences (e.g., memory) of expressive suppression. Seventy-two (36 male and 36 female) undergraduates were randomly assigned to either a control or expressive suppression condition, and were asked to watch silent film clips intended to elicit amusement and disgust. While watching each film, participants listened to sixteen nonemotional words. After each film, participants were asked to answer questions about wha t they had seen in the film (visual memory), to recall as many words as they could (auditory recall memory), and to select from a list any words that they had heard during the previous film clip (auditory recognition memory). With regard to the effects of expressive suppression on visual memory, results indicated a 3-way interaction between condition, sex and film emotion: Men performed more poorly than women on the visual memory test after watching both the amusing and disgusting films in the control condition, and when watching the amusing film in the expressive suppression condition. However, men in the expressive suppression condition performed better than women after watching the disgusting film. In terms of the effects of expressive suppression on auditory memory (recognition and recall), a condition x film emotion interaction indicated that there was no difference in auditory memory for the expressive suppression and control conditions when watching the amusing film, but that the expressive suppression group showed poorer auditory memory than the control group for words presented during the disgusting film. Moreover, a ma in effect of sex on auditory memory suggested that men recalled and recognized more words than women across conditions. Taken together, these findings suggest that both sex and the emotional valence of films may influence the effects of expressive suppression on memory. Results will be discussed in the context of previous literature concerning the effects of expressive suppression on cognition.