Overview of The Cancer Registry of Norway

Cancer Registry of Norway Institute of Population-based Cancer Research Overview of The Cancer Registry of Norway Frøydis Langmark Director Houston, June 8th 2006 RightCancer Registry of Norway - Institute of Population-based Cancer Research 2 The Nordic Region Population: 24.7 million people The Nordic countries: Denmark (with the Faroe Islands and Greenland), Finland (with Åland), Iceland, Norway and Sweden. Denmark, Norway and Sweden are all monarchies. Iceland and Finland are republics. RightCancer Registry of Norway - Institute of Population-based Cancer Research 3 Norway Population: 4.6 million - a nearly homogenous Caucasian At the beginning of 2006 there were 387 000 persons in Norway with immigrant background, referring to 8.3% of the total population. The overall percentage of population growth caused by immigration is now 35-40%. No exact numbers are available regarding the size of the Sámi population, but estimated to 60 000 - 100 000. (Statistics Norway) Head of State: His Majesty King Harald V of Norway Head of Government: Prime Minister Jens Stoltenberg Social democratic government Official language: Norwegian (a northern Germanic branch closely related to Danish and Swedish) 20 000 individuals in Norway speak the Sámi language (Finno-Ugric branch) Mean life expectancy of 78.7 years RightCancer Registry of Norway - Institute of Population-based Cancer Research 4 Important organizational topics for discussion: • The Cancer Registry is organisationally close to the milieus concerning diagnostic investigation, all modality treatments, and cancer research ): disease and patient-centered or • fusion of a variety of registries for different diseases or • fusion of epidemiologic institutions • The concept of Comprehensive Cancer Centre in Norway RightCancer Registry of Norway - Institute of Population-based Cancer Research 5 The Cancer Registry of Norway has through the years been operating under some very favourable legal premises; •compulsory reporting of cancer cases since 1951 from diagnostic and therapeutic health personnel • in 2002 a new Cancer Registry Regulation was established (the English version can be obtained at request) RightCancer Registry of Norway - Institute of Population-based Cancer Research 6 Purpose of The Cancer Registry of Norway is to: 1. Collect and, within the scope of the Regulations, process data relating to causes of cancer and cancer studies in Norway in order to document the distribution of cancer in the country and describe changes over time, 2. Conduct, promote and provide a basis for research to develop new knowledge of the causes, diagnosis, natural course and effects of treatment of cancer in order to improve and enhance the quality of preventive measures and medical assistance that are offered or provided to combat cancer, including the follow-up of individual patients and groups of patients, RightCancer Registry of Norway - Institute of Population-based Cancer Research 7 3. Provide advice and counselling on medical assistance to combat cancer, 4. Provide advice and information to other public administrative bodies and the population at large on measures that may prevent the development of cancer. In addition to such purposes, mentioned in the first paragraph, data in The Cancer Registry may be processed for the following purposes; management, planning and quality assurance of public health services and the public health administration, for the preparation of statistics and for research. RightCancer Registry of Norway - Institute of Population-based Cancer Research 8 Section 1-7 (Data relating to cancer cases in the Cancer Registry) The Cancer Registry may without consent contain the following data relating to persons who have or have had cancer, precancerous conditions, or benign tumours in the central nervous system to the extent that these data are necessary in order to achieve the purpose of the Registry: 1. Personal data: 1.1. name and personal identity number, 1.2. address and municipality of recidence, 1.3. marital status, RightCancer Registry of Norway - Institute of Population-based Cancer Research 9 Section 2-1 (Duty of health care personnel to document and report data) Clinicians, pathologists, radiologists and other laboratory physicians who provide medical assistance in connection with cancer shall, without regard to their duty to adhere to the rules of confidentiality, report such data as are mentioned in section 1-7, first paragraph, to The Cancer Registry. RightCancer Registry of Norway - Institute of Population-based Cancer Research 10 2. Administrative data: 2.1. institution/enterprise/unit where the medical assistance is offered and provided, 2.2. the name and address of the physician responsible for treatment, and of the physician responsible for the patient, if different, 2.3. admission to a health institution, date of admission, date of discharge, and outpatient consultations, if any RightCancer Registry of Norway - Institute of Population-based Cancer Research 11 3. Medical data: 3.1. relating to the reason why the public health services were contacted, the time and evolution of symptoms, diagnosis, treatment, follow-up consultations and relapses, if any, 3.2. relating to the cancer 3.2.1. the site of origin of the cancer 3.2.2. disease category, 3.2.3. morphological diagnosis, 3.2.4. spread at the time of diagnosis, 3.2.5. metastases, 3.2.6. relapses, RightCancer Registry of Norway - Institute of Population-based Cancer Research 12 3.3. relating to the basis for diagnosis: 3.3.1. clinical findings, 3.3.2. imaging diagnostics, 3.3.3. histopathological examination, 3.3.4. cytological material, 3.3.5. other type of examination 3.4. cancer treatment received by the data subject (patient), indications and contra-indications for treatment, method of treatment, as well as any complications or side-effects, RightCancer Registry of Norway - Institute of Population-based Cancer Research 13 Section 1-10 (Data relating to cause of death) The Cancer Registry may contain personal health data relating to cause of death, autopsy, date of death, time, month and year for all the persons registered in the Registry. RightCancer Registry of Norway - Institute of Population-based Cancer Research 14 • The Main cancer database: contains data from several sources (clinicians, pathologists, administrative patient discharge registry, death registry) • Several additional clinical databases connected to the Main database are either already established or will soon be: * Radiation treatment database * Mammography screening database * Cervical screening database * Polyposis families database * Nordic Solid Tumors in children (NOPHO) database * Colorectal cancer database RightCancer Registry of Norway - Institute of Population-based Cancer Research 15 * * * * * * * * Prostate cancer database Lung cancer database Ovarian cancer database Breast cancer database Malignant melanoma database Lymphoma database Leukemia database Sarcoma database • Advantages: * 11-digit personal number * legal basis for reporting system and content * legal basis for “no informed consent required” RightCancer Registry of Norway - Institute of Population-based Cancer Research 16 Organisation Board Director Administration Research dept. Research dept. Research dept. Research on causes of cancer Screening based research Clinical research RightCancer Registry of Norway - Institute of Population-based Cancer Research 17 The research deptartment for clinical research has the following quality registries; * Childhood cancer * Breast cancer * Lung cancer * Lymphomas & leukemia * Ovarian cancer * Colorectal cancer * Prostate cancer among others RightCancer Registry of Norway - Institute of Population-based Cancer Research 18 Internal Research Structure of The Cancer Registry of Norway Three Research Departments: 1) Causal/Carcinogenic research - Head Steinar Tretli (responsibility for all exposure databases - height / weight / occupational / fertility / JANUS Biobank a.o.) (33 employees, 19 researchers) 2) Screening-based research - Head Steinar Thoresen (responsibility for all screening databases) (31 employees, 9 researchers) 3) Clinical research and descriptive reports - Head Geir Hoff (responsibility for the Main database and all clinical quality registries) (57 empl,17 researchers) RightCancer Registry of Norway - Institute of Population-based Cancer Research 19 Ongoing research areas Etiological research; Sensitive windows (fetal life) - Height and weight Fertility - Endocrine disrupters - Gene-environmental factors - Helicobacter pylori - SV40 - Radiation (ionizing, electromagnetic fields, UV) - Nickel Alcohol - Offshore - Nurses - Pulp and paper Developing countries - Simulation modelling - Janus Biobank RightCancer Registry of Norway - Institute of Population-based Cancer Research 20 Screening related research • Evaluation of the mammography programme: mortality change, biological features, health service logistics, quality of diagnostics and treatment • Vaccination against HPV infection of the cervix • Evaluation of the cervix screening programme: logistics, compliance, tests • Colorectal cancer screening: adenoma/cancer, life-style, quality of life, health economy, health services, laboratory studies RightCancer Registry of Norway - Institute of Population-based Cancer Research 21 Clinical and descriptive research • Prediction of cancer • Patient-flow in the Norwegian health system • Projects related to the different clinical registries diagnostics, treatment and outcome quality evaluation of cancer care RightCancer Registry of Norway - Institute of Population-based Cancer Research 22 Through the establishment of clinical registries in The Cancer Registry with multi-disciplinary external coworkers, we know that Norway will be able to provide good studies on diagnostics, treatment, progression of disease, side-effects and long-term effects in cancer on a population base, socalled reality-based medicine as an important resource beside evidence-based medicine with its selection problems. RightCancer Registry of Norway - Institute of Population-based Cancer Research 23 The vision and challenge from now on, is to create a platform for translational research where the flow of information and quest for hypotheses-discussion and -testing go in both directions between each corner of the triad: Population-based research Basic research Clinical trials RightCancer Registry of Norway - Institute of Population-based Cancer Research 24 After all - although etiology and outcome of cancer are complex processes, the questions asked, leading to studies of patient- or healthy populations, usually are quite simple. The originality lies mostly in the completeness and quality of data which Norway together with some other countries, can offer. But we believe that a functioning Comprehensive Cancer Centre of our country, together with strong international cancer research milieus, would be able to come up with new types of questions - based on much tighter connections between heterogeneous research milieus which only may have the cancer focus in common. RightCancer Registry of Norway - Institute of Population-based Cancer Research 25 Number of publications last two years: 2004: 73 2005: 80 Number of dissertations: 1951-1986: 1 1987-2005: 29 RightCancer Registry of Norway - Institute of Population-based Cancer Research 26 Finances in 2006: * Government budget: External research project funding: US$ 12 673 561 Merck Research Lab.: * HPV vaccine project US$ 936 518 Network of Excellence (2004-09) * Biobanks US$ The Royal Norwegian Navy: * Cancer risk US$ US$ 671 580 411 342 302 211 27 The Norwegian Cancer Society * Prostate cancer quality control RightCancer Registry of Norway - Institute of Population-based Cancer Research The Cancer Registry of Norway The Main database • Patients: 1.008.369 comprises malignant tumors, benign brain tumors and certain precursor lesions • Number of diagnoses: 1.209.347 (incl. basal cell carcinoma) • Number of invasive cancers: 772.763 • Number of notifications: 2.843.376 RightCancer Registry of Norway - Institute of Population-based Cancer Research 28 The Cancer Registry of Norway The mammography screening programme: >1.3 mill. women invited >1 mill. screened 4.264 invasive cancers detected 881 precursor lesions (DCIS) detected RightCancer Registry of Norway - Institute of Population-based Cancer Research 29 The cervical screening programme: A) Cytology Registry (1992) • Includes all smears (N= 7.140.119) • also smears outside the programme, • from all labs (also private), all age groups B) CIN Registry (1999) • A uniform report form for all follow-up/treatment of “abnormal” pap-smears (N= 21 843) • All treatments of premalignant lesions in hospitals • Preoperative work-out (cytology/histology) • Earlier treatment C) Histology Registry (2002) • All cervical histology reports, including normals (N= 80 736) RightCancer Registry of Norway - Institute of Population-based Cancer Research 30 Cervix screening programme (since 1991) CYTOLOGY 1.nov 1991 - 1.dec. 2005 No. of samples Normal Normal, benign Unsatisfactory ASC-US ASC-H LSIL HSIL SCC (squamous cell carcinoma) AGUS ACI ACC (adenocarcinoma) Other cancers Metastases Lacking morphology Total no. of reports per 30.11.05 RightCancer Registry of Norway - Institute of Population-based Cancer Research 6399196 20804 341499 168418 15236 118185 65524 2044 6034 2077 809 56 204 27 7140113 31 JANUS Biobank established in 1972 Number of usable sera today Number of persons 452.390 316.869 Number of malignant diagnoses 28.205 More than 100 published studies RightCancer Registry of Norway - Institute of Population-based Cancer Research 32 The following shows some numbers from the cancer picture of Norway (and The Nordic Region) RightCancer Registry of Norway - Institute of Population-based Cancer Research 33 Cancer in Norway 2004 Number of new cases according to site and gender Site All cancers Stomach Colon Rectum Pancreas Lung Breast Cervix Ovary Prostate Testis Mal. Melanoma Lip Leukemia Lymphoma Oral cavity M 12919 346 1128 609 292 1350 13 F 11515 221 1217 528 312 897 2754 270 478 3818 261 475 24 290 485 125 535 12 247 410 88 Cancer in Norway 2004 34 RightCancer Registry of Norway - Institute of Population-based Cancer Research Change in age-adjusted incidence rates of cancer in Norway, from 1954-58 to 2000-2004 All cancers Colorectal Stomach Prostate Testis Breast Cervix RightCancer Registry of Norway - Institute of Population-based Cancer Research        82 % 157 % - 79 % 228 % 308 % 102 % - 39 % 35 Change in age-adjusted incidence rates of cancer in Norway, from 1954-58 to 2000-2004 Lung (men) Lung (females ) Mal.melanoma Other skin cancer Lip Oral cavity       255 % 708 % 573 % 280 % - 63 % 53 % RightCancer Registry of Norway - Institute of Population-based Cancer Research 36 Cancer in Norway Lung cancer 1953-1957 2000-2004 Lung cancer Males total Females total Males < 40 years of age Females < 40 years of age RightCancer ry of NorwayNorway e Institute of Population-based Cancer Research Cancer R egist Registry of - I nsti tut - of P opulat ion-based Cancer Research Male/female ratios of inc. rates 3.7 1.7 1953 (n) 2004 ( n) 172 58 1350 897 6 7 T/gbr/foredrag/anderson021205.ppt 37 The following is an example of Nordic record linkage showing linking of the 5 Nordic cancer registries with occupational census information registries. Farmers have the lowest risk for most cancers. Waiters and unemployed have the highest risk for many frequent cancers. RightCancer Registry of Norway - Institute of Population-based Cancer Research 38 Table 30. Farmers, men (N = 436,387). Observed number (Obs) of cancers and standardised incidence ratio (SIR), 1971-91, by country and cancer site. Denmark ICD-7 140 141 143-144 145-148 150 151 153 154 155.0 155.1 157 160 161 162 162.2 170 177 178 180.0 181 190 191 193 194 197 201 200,202 203 204.3 204.0-2,4 199 140-204 Site Lip Tongue Mouth Pharynx Oesophagus Stomach Colon Rectum Liver Gallbladder Pancreas Nose Larynx Lung Pleura Breast Prostate Testis Kidney Bladder Melanoma Other skin* Brain Thyroid Connective tissue Hodgkin’s disease NHL Multiple myeloma Acute leukaemia Other leukaemia Unknown All sites** Obs 358 16 39 39 101 700 757 743 62 77 375 33 108 1501 18 19 1277 130 243 744 179 1303 394 34 52 61 318 170 175 240 93 9276 SIR 176 39 45 36 53 98 70 84 35 69 72 74 36 43 24 76 89 90 62 54 69 68 98 81 108 78 103 98 121 92 81 70 Finland Obs 617 57 42 83 234 1899 664 732 174 149 684 46 292 4757 36 13 2782 53 543 916 392 480 427 99 106 134 363 292 173 357 378 17983 SIR 150 82 62 62 84 103 75 86 53 86 82 83 68 75 51 61 97 99 74 79 100 102 89 94 89 115 92 103 99 102 97 86 Norway Obs 237 13 35 33 69 801 780 565 44 47 350 25 59 755 9 15 2474 76 289 700 244 405 268 68 46 62 314 215 107 164 341 9397 SIR 151 25 48 38 46 87 75 79 45 76 75 68 34 42 18 94 99 119 74 70 70 101 93 113 85 112 96 94 97 105 71 77 Sweden Obs 270 16 32 47 90 757 861 646 84 49 378 37 58 673 7 20 3084 45 429 652 298 510 406 74 94 85 436 285 135 245 293 11290 SIR 181 29 38 40 50 97 82 86 38 57 70 110 31 40 14 84 95 98 78 60 79 97 97 102 95 104 98 120 95 99 71 79 Total Obs 1482 102 148 202 494 4157 3062 2686 364 322 1787 141 517 7686 70 67 9617 304 1504 3012 1113 2698 1495 275 298 342 1431 962 590 1006 1105 47946 SIR 161 47 47 45 62 98 76 84 44 75 76 83 47 58 29 78 96 99 73 65 81 81 94 98 93 103 97 104 103 99 79 79 95% CI 153 39 40 39 57 95 73 81 40 67 72 70 43 56 22 169 57 56 51 68 101 78 87 49 83 79 98 52 59 36 99 98 111 76 68 86 85 99 110 104 115 102 111 112 106 84 79 60 94 88 69 63 76 78 90 87 83 93 92 98 95 93 - 74 78 - * Basal cell carcinomas are included for Denmark and excluded for Finland, Norway and Sweden ** Excludes non-melanoma skin cancer Occupa ti ona l cance rs i n th e Nord ic coun tri es, An derse n A e t al , Scan d.J o f Work, RightCancer Registry of Norway - Instituteat ion-based Cancer Research Research 39 Cancer Registry of Norway - Inst it ute of Popul of Population-based Cancer Env.& Hea lth, Vo l 25, Supp l. 2 , 19 99 Table 84. Waiters, men (N = 8,974). Observed number (Obs) of cancers and standardised incidence ratio (SIR), 1971-91, by country and cancer site. Denmark ICD-7 140 141 143-144 145-148 150 151 153 154 155.0 155.1 157 160 161 162 162.2 170 177 178 180.0 181 190 191 193 194 197 201 200,202 203 204.3 204.0-2,4 199 140-204 Site Lip Tongue Mouth Pharynx Oesophagus Stomach Colon Rectum Liver Gallbladder Pancreas Nose Larynx Lung Pleura Breast Prostate Testis Kidney Bladder Melanoma Other skin* Brain Thyroid Connective tissue Hodgkin’s disease NHL Multiple myeloma Acute leukaemia Other leukaemia Unknown All sites** Obs [4.3] 5 15 20 24 17 24 28 21 5 17 2 36 135 1 [0.5] 33 7 13 46 5 30 10 1 2 1 2 4 2 5 3 481 SIR 0 541 824 840 639 122 117 163 612 234 169 214 582 202 67 0 133 130 162 174 77 77 107 103 179 46 30 119 65 97 137 181 Finland Obs [1.2] 2 [0.3] 1 4 3 4 [2.5] 4 1 3 1 2 17 [0.3] [0.1] 15 [0.4] 3 4 [1.9] [1.3] 4 [0.5] [0.5] [0.6] 1 1 1 2 2 76 SIR 0 743 0 214 492 54 143 0 426 196 119 519 147 93 0 0 215 0 120 120 0 0 181 0 0 0 68 115 151 182 169 119 Norway Obs 4 5 5 11 11 12 24 12 5 3 9 [0.6] 5 45 [0.8] 1 37 3 11 16 9 6 5 1 [1.0] 3 3 3 3 3 7 264 SIR 167 537 392 723 490 94 157 113 364 351 137 0 181 166 0 376 123 115 177 111 109 111 84 82 0 238 53 92 167 132 103 145 Sweden Obs SIR Total Obs 5 21 25 40 45 42 69 49 41 9 40 4 47 246 3 1 123 13 33 92 23 41 28 3 3 4 13 9 7 15 22 1092 SIR 51 716 547 656 505 102 135 125 498 201 156 181 366 185 93 87 132 129 135 160 97 80 113 77 73 72 65 87 93 129 143 159 95% CI 17 443 354 469 368 74 105 92 357 92 112 49 269 163 19 - 120 - 1094 - 808 - 894 675 138 171 165 676 382 213 464 487 210 272 484 158 221 190 197 146 109 164 225 213 185 111 164 191 212 217 168 1 55 9 1112 5 412 8 463 6 10 17 9 11 [1.0] 11 1 4 49 2 [0.3] 38 3 6 26 9 5 9 1 1 [1.5] 7 1 1 5 10 271 285 113 137 101 441 0 171 208 158 235 292 0 122 178 79 196 128 90 126 81 66 0 111 34 50 160 192 153 2 111 69 93 129 62 58 75 16 15 20 35 40 37 72 - 90 149 - * Basal cell carcinomas are included for Denmark and excluded for Finland, Norway and Sweden ** Excludes non-melanoma skin cancer Occupa ti ona l cance rs i n th e Nord ic coun tri es, An derse n A e t al , Scan d.J o f Work, RightCancer Registry of Norway - Instituteat ion-based Cancer Research Research Cancer Registry of Norway - Inst it ute of Popul of Population-based Cancer Env.& Hea lth, Vo l 25, Supp l. 2 , 19 99 40 Table 96. Economically inactive persons, men (N = 422,337). Observed number (Obs) of cancers and standardised incidence ratio (SIR), 1971-91, by country and cancer site. Denmark ICD-7 140 141 143-144 145-148 150 151 153 154 155.0 155.1 157 160 161 162 162.2 170 177 178 180.0 181 190 191 193 194 197 201 200,202 203 204.3 204.0-2,4 199 140-204 Site Lip Tongue Mouth Pharynx Oesophagus Stomach Colon Rectum Liver Gallbladder Pancreas Nose Larynx Lung Pleura Breast Prostate Testis Kidney Bladder Melanoma Other skin* Brain Thyroid Connective tissue Hodgkin’s disease NHL Multiple myeloma Acute leukaemia Other leukaemia Unknown All sites** Obs 130 33 55 75 125 526 625 513 163 88 332 17 169 2365 39 9 865 71 225 773 108 928 196 23 27 30 190 100 71 180 83 8299 SIR 123 192 138 153 127 127 106 106 173 135 115 76 116 126 104 68 100 99 111 105 95 97 105 105 106 76 119 105 92 124 145 116 Finland Obs 344 59 61 144 324 1495 634 606 338 145 647 35 392 6351 48 16 2002 39 434 919 198 358 280 58 78 82 277 198 108 250 374 17355 SIR 122 138 155 165 162 111 108 103 149 123 114 104 138 142 114 106 92 112 98 116 90 107 100 91 101 106 110 107 91 103 133 119 Norway Obs 111 92 78 126 170 707 646 430 119 46 344 35 153 1549 24 13 1486 69 254 611 185 258 191 54 35 36 196 139 68 106 499 8749 SIR 111 274 174 233 181 118 101 98 189 116 117 152 147 141 79 137 96 132 105 99 83 106 104 133 95 89 98 96 94 104 162 114 Sweden Obs 251 171 258 353 464 1436 1648 1116 603 177 1005 51 420 3433 69 57 4618 157 931 1627 454 820 710 137 156 195 713 313 236 433 790 24712 SIR 114 219 219 216 179 120 109 104 185 144 129 109 162 143 97 160 98 137 119 106 81 109 114 120 106 135 112 93 110 118 133 119 Total Obs 836 355 452 698 1083 4164 3553 2665 1223 456 2328 138 1134 13698 180 95 8971 336 1844 3930 945 2364 1377 272 296 343 1376 750 483 969 1746 59115 SIR 118 207 187 197 166 117 107 103 172 132 121 110 143 139 99 130 97 123 110 107 85 103 108 113 103 114 110 98 100 113 141 118 95% CI 110 186 170 183 157 114 103 99 163 120 116 93 135 137 86 126 230 205 212 176 121 110 107 182 144 126 130 151 141 115 158 99 137 115 110 90 107 114 128 116 126 116 106 110 121 147 119 105 95 110 105 104 79 99 103 101 92 102 104 92 92 106 - 134 117 - * Basal cell carcinomas are included for Denmark and excluded for Finland, Norway and Sweden ** Excludes non-melanoma skin cancer Occupa ti ona l cance rs i n th e Nord ic coun tri es, An derse n A e t al , Scan d.J o f RightCancer Registry of Norway - Instituteat ion-based Cancer Research Research Cancer Registry of Norway - Inst it ute of Popul of Population-based Cancer Work, En v.& He alth, Vol 25 , Sup pl. 2, 1 999 41 Cancer in Norway Females Age-adjusted incidence rates - 1953-2004 170 Breast females 90 80 Rate per 100 000 70 60 50 40 30 20 10 0 1953 1958 1963 1968 1973 1978 1983 1988 1993 1998 2003 Year of diagnosis Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 42 Cancer in Norway Males Age-adjusted incidence rates - 1953-2004 177 Prostate 120 100 Rate per 100 000 80 60 40 20 0 1953 1958 1963 1968 1973 1978 1983 1988 1993 1998 2003 Year of diagnosis Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 43 Cancer in Norway Males Age-adjusted incidence rates - 1953-2004 178 Testis 12 10 Rate per 100 000 8 6 4 2 0 1953 1958 1963 1968 1973 1978 1983 1988 1993 1998 2003 Year of diagnosis Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 44 Prediction of cancer in Norway 2020 Basis for predicted Predicted 1993-1997 Observed (average no. of annual cases) 2018-2020 Expected (% increase) (average no. of annual cases) 2004 Incident cases Men Females 10 004 9 365 14 175 (42%) 12 919 12 708 (36%) 11 515 RightCancer Registry of Norway - Institute of Population-based Cancer Research 45 Cancer in Norway 5-year relative survival 1955–99, follow-up 31/12-04, males All sites Testis Lung Prostate Melanoma of skin Leukemia 0-14 years 100 80 60 % 40 20 0 1955-1959 1960-1964 1965-1969 1970-1974 1975-1979 Period of diagnosis 1980-1984 1985-1989 1990-1994 1995-1999 RightCancer Registry of Norway - Institute of Population-based Cancer Research 46 Cancer in Norway 5-year relative survival 1955–99, follow-up 31/12-04, females All sites Uterine cervix Lung Breast Melanoma of skin Leukemia 0-14 years 100 80 60 % 40 20 0 1955-1959 1960-1964 1965-1969 1970-1974 1975-1979 1980-1984 1985-1989 1990-1994 1995-1999 Period of diagnosis RightCancer Registry of Norway - Institute of Population-based Cancer Research 47 Cancer in Norway 5-year relative survival in percent by period and stage 154 Rectum, males 100% 80% 60% 40% 20% 0% 1955-59 1960-64 1965-69 1970-74 1975-79 1980-84 1985-89 1990-94 1995-99 Total Localized Regional Distant Period of diagnosis Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 48 Cancer in Norway Rectal cancer Distribution of disease stage over time, males 1400 1200 1000 800 600 400 200 0 Localized Regional Distant Numbers RightCancer Registry of Norway - Institute of Population-based Cancer Research -1 19 96 64 3 -1 19 968 69 -1 19 973 74 -1 19 97 79 8 -1 19 983 84 -1 19 98 89 8 -1 19 993 94 -1 19 998 99 -2 00 3 Period of diagnosis 19 59 49 5-year relative survival in percent according to stage (follow-up 2004) 1958-1962 (f) tot. 62.8 I 83.3 II 55.3 III 36.2 IV 13.6 (m) tot. 41.8 loc. 53.9 reg. 29.0 dist. 18.1 1995-1999 83.6 93.1 81.1 61.5 14.5 74.8 87.9 76.9 23.7 Breast Prostate Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 50 Cancer in Norway Number of deaths from cancer in Norway 2003 All cancer forms 10552 Testis Malignant melanoma Breast Colorectal Prostate 13 243 717 1608 1070 Pancreas Lung Mesothelioma 592 1916 45 Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 51 Cancer in Norway Prevalence Total number of persons alive 31.12.04 all whom have had at least one cancer diagnosis Total Lung Colorectal Pancreas Breast Prostate Testis Malignant melanoma 173 802 3 766 22 805 462 30 359 20 069 4 879 14 623 Cancer in Norway 2004 RightCancer Registry of Norway - Institute of Population-based Cancer Research 52