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|Title:||Exploring the epidemiological characteristics of cancers of unknown primary site in an Australian population: implications for research and clinical care|
|Citation:||Australian and New Zealand Journal of Public Health, 2008; 32(4):383-389|
|Publisher:||Public Health Assoc Australia Inc|
|Colin Luke, Bogda Koczwara, Christos Karapetis, Ken Pittman, Tim Price, Dusan Kotasek, Kerry Beckmann, Michael P. Brown and David Roder|
|Abstract:||Objectives: To investigate incidence, mortality and case survival trends for cancer of unknown primary site (CUP) and consider clinical implications. Method: South Australian Cancer Registry data were used to calculate age-standardised incidence and mortality rates from 1977 to 2004. Disease-specific survivals, socio-demographic, histological and secular predictors of CUP, compared with cancers of known primary site, and of CUP histological types, using multivariable logistic regression were investigated. Results: Incidence and mortality rates increased approximately 60% between 1977-80 and 1981-84. Rates peaked in 1993-96. Male to female incidence and mortality rate ratios approximated 1.3:1. Incidence and mortality rates increased with age. The odds of unspecified histological type, compared with the more common adenocarcinomas, were higher for males than females, non-metropolitan residents, low socio-economic areas, and for 1977-88 than subsequent diagnostic periods. CUP represented a higher proportion of cancers in Indigenous patients. Case survival was 7% at 10 years from diagnosis. Factors predictive of lower case survival included older age, male sex, Indigenous status, lower socio-economic status, and unspecified histology type. Conclusion: Results point to poor CUP outcomes, but with a modest improvement in survival. The study identifies socio-demographic groups at elevated risk of CUP and of worse treatment outcomes where increased research and clinical attention are required.|
|Keywords:||Humans; Neoplasms, Unknown Primary; Epidemiologic Methods; Registries; Incidence; Logistic Models; Risk Factors; Epidemiologic Studies; Pilot Projects; Public Health; Public Health Practice; Socioeconomic Factors; Adult; Aged; Aged, 80 and over; Middle Aged; South Australia; Female; Male; Practice Patterns, Physicians'|
|Rights:||© 2008 The Berkeley Electronic Press|
|Appears in Collections:||Public Health publications|
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