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).

Reasons for late presentation to HIV care in Switzerland.

INTRODUCTION: Late presentation to HIV care leads to increased morbidity and mortality. We explored risk factors and reasons for late HIV testing and presentation to care in the nationally representative Swiss HIV Cohort Study (SHCS). METHODS: Adult patients enrolled in the SHCS between July 2009 and June 2012 were included. An initial CD4 count <350 cells/µl or an AIDS-defining illness defined late presentation. Demographic and behavioural characteristics of late presenters (LPs) were compared with those of non-late presenters (NLPs). Information on self-reported, individual barriers to HIV testing and care were obtained during face-to-face interviews. RESULTS: Of 1366 patients included, 680 (49.8%) were LPs. Seventy-two percent of eligible patients took part in the survey. LPs were more likely to be female (p<0.001) or from sub-Saharan Africa (p<0.001) and less likely to be highly educated (p=0.002) or men who have sex with men (p<0.001). LPs were more likely to have their first HIV test following a doctor's suggestion (p=0.01), and NLPs in the context of a regular check-up (p=0.02) or after a specific risk situation (p<0.001). The main reasons for late HIV testing were "did not feel at risk" (72%), "did not feel ill" (65%) and "did not know the symptoms of HIV" (51%). Seventy-one percent of the participants were symptomatic during the year preceding HIV diagnosis and the majority consulted a physician for these symptoms. CONCLUSIONS: In Switzerland, late presentation to care is driven by late HIV testing due to low risk perception and lack of awareness about HIV. Tailored HIV testing strategies and enhanced provider-initiated testing are urgently needed.

Identification and ethnic diversity underlie support for multicultural rights : a multilevel analysis in Bulgaria

Bulgaria is historically a multicultural society, composed of the Bulgarian (ethnic) majority and a number of ethnic minorities among which Bulgarian Turks and Roma are the largest. Both minority communities are stigmatized in contemporary Bulgaria, though to different degrees and for different reasons. Ethnic minorities' rights to preserve their culture, customs, and language are a topic of contentious debate. The purpose of this study was to examine individual- and context-level antecedents of the ethnic Bulgarian majority's support for multicultural rights of ethnic minorities. Multilevel regression analyses were conducted with International Social Survey Programme ISSP 2003 data (N = 920 in 28 Bulgarian districts). At the individual-level, an ethnic conception of the nation and anti-Roma symbolic prejudice were negatively related to support for multicultural rights, whereas national identification was positively related to the support of these rights. Over and above individual-level effects, and in line with recent extensions of intergroup contact theory, thepercentage ofBulgarianTurks withindistricts was positively related to support for multicultural rights. Importantly, support for multicultural rights was particularly high in districts characterized by ethnic diversity, that is, in districts with high proportions of both Bulgarian Turks and Roma. The beneficial effects of ethnic diversity and theoretical implications of findings are discussed.

M. Tullius Cicero, Academica priora (1-13), De natura Deorum (13-46v), De fato (46v-50v), Epistolae ad familiares I-VIII, 8, 6 (51-91v). - Dares Phrygius, De excidio Troiae historia (92-97v).

Ce ms. forme un recueil de deux groupes de textes différents (Cicéron, ff. 1-91v et Darès, ff. 92-97v), mais contemporains et homogènes. Chacun possède son propre système de signatures.

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 47 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 50 et annexes / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 44 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 34 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 36 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 39 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 42 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 43 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 40 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 45 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 48 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1