Explanatory Text

The explanatory text for each cancer site follows a consistent format:

  • Description of mortality trends. The contribution of the tumor to total cancer mortality is given first (see histograms in Overview of Cancer Mortality) so that the reader can appreciate how the cancer fits into the general "cancer landscape." The secular mortality trend is described during the period for which data are available (usually 1952-1995), and any peculiarities in trends for specific age ranges (35-64 years, 65 years and older) are noted. Finally the age-standardized mortality rates for males and females in both parts of Germany are indicated for the year 1990 in preparation for the comparison of mortality rates with other European countries and the world. Although German data are available up to the year 1995, 1990 is used because, at the time the atlas was written, more recent data were not available for all the other reference countries.

  • International comparison. The highest and lowest mortality rates for both sexes in 1990 are stated to give an impression of the range of European mortality that is associated with the cancer in question. The age-standardized mortality rates for the United States and Japan are also indicated for purposes of international comparison.

  • Relative 5-year survival rates. The relative 5-year survival rates are taken from the projections of the Robert Koch Institute, which were based on data from the cancer registries of the former GDR in the east and of the Saarland in the west (see section on "Material" above). These rates describe the probability of surviving for 5 years following a diagnosis of cancer, relative to the probability of survival for those of the same age in the population at large, rather than for cancer sufferers. A relative 5-year survival rate of 100% means that patients with this cancer have the same mortality after five years as the general population. A relative 5-year survival rate of 50% means that the mortality rate is twice as high as in the general population (Estève 1994).

  • Incidence data. The age-standardized incidence rates for the cancer are given based on data published in the 1989 cancer registry of the former GDR for the east (Möhner et al. 1994) and on 3-year averages for 1988-1990 obtained from the cancer registry of the Saarland for the west (Saarland Statistical Bureau 1992). Where possible, the secular trend based on the data from these publications is noted. Because there is a high degree of interest in the annual number of new cases but no precise figures due to the lack of a nationwide cancer registry in Germany, the published extrapolation of the Robert Koch Institute (Schön et al. 1995) are stated as the estimated incidence numbers.

  • Description of the cancer maps. The regional distribution of mortality shown on the maps is briefly described, and any distinctive features relating to geographic patterns or discrepancies between the 5-year periods are noted.

  • Risk factors. This portion of the text briefly reviews the information currently available on known or presumed risk factors and includes a selection of references for further reading.

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