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Cancer Surveillance

Cancer surveillanceThis research unit focuses on exploring and explaining the risks and outcomes of various cancer epidemics. How often do particular types of cancer occur? Who is at risk? What is the impact of prevention measures? Which trends in survival and mortality can be discerned, and how can we interpret them? Answering these and other related questions is the aim of our research.

Population-based approach of cancer risk and outcome

Cancer is a major cause of death in developed countries, despite continuous improvement in cancer survival over time. The research our unit conducts is based on registry data concerning prognosis, quality of care, quality of life and public health impact. In turn, the results of our studies add to the value of the data of the long-standing Eindhoven Cancer Registry, which is part of the Netherlands Cancer Registry (since 1989), and various European databases. We coordinated a large project (EUROCADET) for the European Commission investigating potential impact of lifestyle interventions on future cancer risk in Europe.

Some of our recent contributions

  • Calculating the impact of prevention measures - We calculated the impact of a variety of cancer prevention scenarios, using a new version of the Prevent model which was originally developed at our department. We found that the impact of cancer prevention measures at the population level appears to be modest and a long-term affair. Structural obstacles in public space that promote unhealthy behaviours remain present (Karim-Kos et al. Eur J Cancer 2008;44:1345-89). 
  • Explaining the rise in multiple primary tumours - In a project funded by the Dutch Cancer Society, we started to analyze the rising occurrence of multiple primary tumours, which currently involve up to 10% of all newly diagnosed patients. This is partly caused by more effective but carcinogenic therapies, and partly by shared risk factors such as UV exposure, smoking and alcohol, which cause multiple cancers, especially in older people (Koomen et al. Cancer Epidemiol Biomarkers Prev 2010;6:1453-9).
     

Ongoing projects

  • Multiple primary cancer: an exploratory study of the public health and clinical impact of multiple cancers, increasing markedly with rising survival rates, partly as a side effect of carcinogenic treatments, partly related to similar underlying etiology and/or genetics. But there is also quite some detection bias largely occurring within the first 6 to 12 months. This project funded by the Dutch Cancer Society (2008-2012) furthermore found that about 7% of all cancer survivors suffer from more than 1 cancer and that up to 10% of all new cancers is a second or third one. Specific studies are carried out with a variety of combinations including prostate, melanoma, colorectal and ovarian cancer. It will also support strategies for early detection during long term follow-up. The project was carried out with the Netherlands Cancer Registry and will result in about 15-20 papers and will be continued by special studies among older patients. (contact person: Li Fang Liu, MD, supervised by Esther de Vries PhD and Isabelle Soerjomataram MD, PhD).
     
  • Progress against cancer: this project, starting in 2007 and also funded by KWF kankerbestrijding aimed to assess progress by considering 4 trends, i.e. in incidence, survival and mortality. About 20 papers have been published after a heavily cited overview in the Eur J Cancer in 2008. Generally. Results are encouraging for most tumours. Contactperson is Henrike Karim-Kos, supervised by Esther de Vries )
     
  • Migration and cancer: the literature repeatedly shows that migrants only attain the same cancer risks as the county of destination if they migrated before age 15 and otherwise only as a second generation. In fact migratory natural experiments can almost serve as proof for the external causes . Project is carried out by Melina Arnold, MSc supervised by Jan Willem Coebergh.
     
  • Cancer of the digestive tract: a large number of studies of incidence and prognosis and of quality of care and QL of such patients has been done with the Eindhoven Cancer registry where also data on co-morbidity are available, a link with the Pharmo registry on drug use and a multitude of studies is carried  out with various clinicians across the Netherlands, Valery Lemmens PhD is the coordinator and chief supervisor. Of recent nature is a trial of the value of intensified I FOBT together with Preof dr Jan Jansen, now at Elkerliek hospital in Helmond. 
     
  • Quite a few studies are carried out of  rapidly increasing. skin cancers by Estherde Vries PhD , most often with Tamar Nijsten and others at the Department of Dermatology,. Increasingly studies are carried out of the frequency of Basalcell skin cancers  here, by far the most frequent skin cancer especially in the face, but increasingly also at the trunk in women. Reason is also the availability of new therapies whose cost effectiveness nees to be studied.
     
  • A plethora of studies is carried out through the head of the section Jan Willem Coebergh with the research staff of the Eindhoven Cancer Registry at the Comprehensive Cancer Center South, which kept the tradition alive of a truly multidisciplinary clinical network. From there is also being managed the Eurocourse project FP7 on best practices of cancer registries across the EU.