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J Epidemiol Community Health. 2007 December; 61(12): 1104.
PMCID: PMC2465666


Pre‐malignant gastric lesions in The Netherlands

Gastric cancer is the fourth most common cancer and second leading cause of cancer‐related deaths worldwide. The pre‐malignant gastric lesions, atrophic gastritis, intestinal metaplasia and dysplasia, have long been identified as principal risk factors for gastric cancer. However, a study to evaluate epidemiological time trends of pre‐malignant gastric lesions in The Netherlands found that the incidence is declining. Patients with a first diagnosis of atrophic gastritis, intestinal metaplasia or dysplasia between 1991 and 2005 were identified in the Dutch nationwide histopathology registry. The median age at diagnosis was 65.7 years. In all, 23 278 patients were newly diagnosed with atrophic gastritis, 65 937 with intestinal metaplasia and 8517 with dysplasia. The incidence of atrophic gastritis declined similarly in men and women with 8.2% per year, and dysplasia with 8.1% per year. Significantly more females were present in the atrophic gastritis group (male/female 1.0/1.2) compared with the group of patients with intestinal metaplasia (1.0/0.9) or dysplasia (1.0/0.8). The proportional number of new intestinal metaplasia cases declined, with 2.9% per year in males and 2.4% in females. These findings imply that a further decrease of at least 24% in the incidence of gastric cancer in the coming decade may be anticipated in Western countries without specific intervention. (Gut published online 14 Aug 2007; doi: 10.1136/gut.2007.127167)

Childhood cancer in Ireland

Cancer is relatively rare in childhood compared with later in life, but it is one of the more frequent causes of non‐traumatic deaths in children in Ireland. Population‐based studies of mortality and survival can indicate whether childhood malignancies are being treated successfully, and help to monitor the implementation of new treatment guidelines and contribute to understanding the epidemiology of these diseases. Incidence and survival for cancers diagnosed in children <15 years in the Republic of Ireland between 1994 and 2000 were analysed, as were longer‐term mortality trends. World age‐standardised incidence rates in Ireland averaged 142 cases per million children per year, slightly higher than the European average and slightly lower than the US average, although differences varied by diagnostic group. Observed 5‐year survival in Ireland (79% overall) was slightly higher than European and US averages, significantly higher for acute non‐lymphocytic leukaemia (67%) and (compared with the US) significantly lower for Hodgkin lymphoma (83%). Rates of childhood cancer mortality have declined markedly since the 1950s, in line with other developed countries, but it is vital to continue to quantify the childhood burden of cancer in order to estimate care needs, plan interventions and quantify use of appropriate cancer treatments. (Arch Dis Child published online 12 Jun 2007; doi: 10.1136/adc.2005.087544)

Glenys Hughes

Prevalence of overweight and obesity in The Netherlands

The prevalence of overweight and obesity in Dutch children is rising at a faster rate than ever before. In a study to assess the prevalence of overweight and obesity in children in 2003, data were obtained from the child healthcare system on 90 071 children aged 4–16 years. The findings were compared with the Third and Fourth Growth Studies carried out in 1980 and 1997, respectively. International cut‐off points for body mass index were used to determine overweight and obesity. On average 14.5% of the boys and 17.5% of the girls were overweight, a substantial increase since 1980 (boys 3.9%, girls 6.9%) and 1997 (boys 9.7%, girls 13.0%). A similar picture was seen with obesity, with 2.6% of boys and 3.3% of girls being obese compared with 1980 (boys 0.2%, girls 0.5%) and 1997 (boys 1.2%, girls 2.0%). At the age of 4, 12.3% of boys and 16.2% of girls were already overweight. There is an urgent need for preschool intervention programmes. (Arch Dis Child published online 29 Jun 2007; doi: 10.1136/adc.2006.115402)

HIV in pregnant women in west Africa

At the beginning of the HIV epidemic, the infection spread rapidly in east and central Africa but very few cases were found in west Africa. In 1986 a similar virus with lower pathogenicity, subsequently named HIV‐2, was found in two patients from Guinea‐Bissau and the neighbouring Cabo Verde. Seroepidemiological surveys showed HIV‐2 to be present in west Africa, with the highest prevalence, 8.9%, in the adult urban population of Bissau, capital of Guinea Bissau. Since then, declining prevalence rates of HIV‐2 but increasing prevalence of HIV‐1 have been reported. In the neighbouring countries of Senegal and the Gambia the prevalence of HIV‐1 and HIV‐2 has continued at a comparatively low level among pregnant women. A study of the trends of HIV prevalence from antenatal surveys in Bissau from 1987 to 2004 sought to determine whether HIV prevalence levels had changed after the country's civil war of 1998–9. A total of 20 422 women were tested at the maternity clinic, Simão Mendes National Hospital, Bissau, for HIV. The total HIV‐1 prevalence increased from 0.0% in 1987 to 4.8% in 2004, and total HIV‐2 prevalence decreased from 8.3% in 1987 to 2.5% in 2004. HIV‐1 prevalence increased from 2.5% in 1997 to 5.2% in 1999, but has stabilised in the subsequent years. There is, therefore, no evidence of a long‐term effect of the civil war in Guinea‐Bissau on HIV‐1 or HIV‐2 prevalence. (Sex Transm Infect published online 4 Jul 2007; doi:10.1136/sti.2007.025353)

Occupational rhinitis in Europe

New onset of rhinitis in adults has been associated with occupational exposure, with cleaners and medical professionals at particular risk, a study shows. A follow‐up of the European Community Respiratory Health Survey (ECRHS) was conducted on 4994 participants aged 28–57 from 27 centres who had no symptoms of rhinitis at baseline. Self‐reported nasal allergies (allergic rhinitis) and runny, blocked nose for 12 months (perennial rhinitis) were noted. Occupational exposures at any time during follow‐up were defined by job title. The cumulative incidence of allergic rhinitis was 12%, perennial rhinitis 11% and both conditions 3%. Compared with office workers, male medical professionals were at increased risk of new onset of allergic rhinitis. For perennial rhinitis odds ratios were significantly increased in cleaners. (Occup Environ Med published online 30 Jul 2007; doi:10.1136/oem.2006.031542)

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