A retrospective mortality and cancer incidence study of former nuclear weapons assemblers from the Iowa Army Ammunitions Plant was conducted. This study examined whether or not workers at the plant exhibited higher rates of mortality or cancer as a result of their work-related activities. Potential exposures included radiation, beryllium, asbestos, and solvents. Cancer incidence was determined by calculating standardized incidence ratios (SIR) and using the Iowa population as reference. SIRs were calculated on 3,889 workers from1969-2005. Overall and cause-specific mortality was determined by calculating standardized mortality ratios (SMR) and using the U.S. and Iowa populations as reference. SMRs were calculated on 5,743 workers from 1947-2005. The SIR results showed that overall cancer incidence was lower than the Iowa population. Using the Iowa population as reference, the SMR analyses for men demonstrated excesses for all cancers (SMR 1.09, 95% CI 1.02-1.17), lung cancer (SMR 1.38, 95% CI 1.24-1.54), diseases of the respiratory system (SMR 1.15, 95% CI 1.03-1.46), mesothelioma (SMR 6.20, 95 % 1.28-18.1), asbestosis (SMR 9.28, 95% CI 1.12-33.5) and COPD (SMR 1.27, 95% CI 1.10-1.46). Significantly lower SMRs were observed stomach cancer and ischemic heart disease. For women excesses were observed for all cancers (SMR 1.41, 95% CI 1.17-1.69), lung cancer (SMR 2.47, 95% CI 1.72-3.44), ischemic heart disease (SMR 1.32, 95% CI 1.09-1.58), respiratory diseases (SMR 1.59, 95% CI 1.14-2.16), and COPD (SMR 2.47, 95% CI 1.60-3.65). Using the U.S. population, men experienced lower overall mortality while women had significantly higher overall mortality. In conclusion, the SIR portion of the study showed overall lower cancer incidence for both men and women. This may be due to the Healthy Worker Effect and the limited dates of study. There are no cancer registry data before 1969 thus missing cancers with short induction periods. Workers may have also moved out of the Iowa and had a cancer diagnosis in another state. Compared to Iowa population, there was an excess of respiratory disease deaths and deaths from lung cancer in both men and women. Considering the significant respiratory exposures workers may have experienced, further study with a nested case-control design is suggested.

自從民國七十一年起惡性腫瘤（俗稱癌症）開始躍昇為國人十大死因之第一位，而且癌症死亡率有逐年攀升的趨勢。另外，根據衛生署公佈的「民國八十五年癌症登記報告」中，發現國人罹患癌症的情況不僅有集中特定癌症而且亦有逐年遞增的現象，由此可知癌症一直威脅著國人的健康。 由於政府在民國八十四年開辦全民健康保險，提供大部份國民基本的醫療保障，然而健保的給付項目以及金額仍然有限，因此壽險業者為了補足全民健保的缺口，陸續推出終身癌症保險以提供國人更完整的保障。然而國內終身癌症保險仍屬初期階段，缺乏完整的統計經驗資料，大部份採用國外再保險公司所提供的癌症經驗資料，並未參酌國內醫院所作的癌症統計；壽險業最近因損失率過高，也將終身癌症保險的給付內容重新修訂，以作為調整保費的依據，因此其終身癌症保險之保費適足性值得探討。 本研究限定在定額型個人終身癌症保險，主要探討在國人癌症發生率逐年上升情況下，如何去建立一套終身癌症保險費率釐定模型，並且參考國內醫院的癌症統計資料，在合理的精算假設下，使用S-Plus統計軟體計算出終身癌症保險之保費，進一步探討壽險業之費率適足性。 在本文實證分析中，列舉國內三家壽險公司，就其給付內容比較保費，並探討其保費適足性，發現其相同處在於國內三家壽險公司的年繳保費明顯不足，而且其年繳保費差額隨著年齡呈直線遞增。其兩者年繳保費之比率方面，本實證分析的年繳保費皆高出三家壽險公司二至四倍左右，因此在長期之下保費的不足會導致壽險公司虧損，進而可能影響到壽險公司的清償能力，此結果可提供壽險業者及監理機關參考。 / With the increasing of cancer incidence rate, the insurers provide completely and thoughtfully designed planning in order to meet the requirements of the public, supplemental to the national health insurance program enforced by the government of R.O.C. in 1995. However, many domestic insurers have faced the problem of the experience loss ratio beyond the expected. Since the whole life cancer insurance policies have been issued on the market a few years ago, the empirical data from the insurance are insufficient for the pricing. In addition, only a fewer researches have focused on the actuarial model of this type of insurance. In this paper, we will investigate the premium calculation of the whole life cancer insurance under the influence of specified factors, and outline the appropriate model construction procedures. The data we use are not only from Department of Health of the Executive Yuan but also from domestic hospital, such as National Taiwan University Hospital and Veterans General Hospital. Moreover, we make reference to medical studies and make use of rational actuarial assumptions, i.e., the trend of cancer incidence rate, cancer survival rate, cancer outpatient rate, average cancer outpatient treatment days, cancer inpatient rate, cancer surgical rates, cancer radiotherapy or chemotherapy rates, average cancer radiotherapy or chemotherapy treatment days, cancer bone marrow transplantation rates, cancer mortality rates, and other cancer rates, available to the premium calculation in empirical analysis. Finally, we examine the premiums of three whole life insurance policies to compare to our results in empirical analysis and discuss whether premiums are adequate. We hope that this paper could be beneficial to the actuaries and also provide suggestions for the government surveillance.

BACKGROUND: Organ transplantation is one of the best modalities for treating fatal organ failure. Despite the success of this procedure, an increasing incidence of cancer in this population has drawn the attention of public health officials in recent years. OBJECTIVES: The overall objective of this study is to conduct a detailed examination of adverse health outcomes among Canadian organ transplant recipients, with an emphasis on cancer incidence and mortality. METHODS: This project employed a retrospective cohort follow-up study design, whereby Canadian Organ Replacement Registry records were linked to the Canadian Mortality Database and the Canadian Cancer Registry Database. The study population consisted of more than 16,000 solid organ transplant recipients registered between January 1, 1981 and December 31, 1998. This study was designed to assess the risks of developing cancer, overall and site-specific, in transplant recipients in comparison to the general Canadian population using Standardized Incidence Ratios (SIR), Standardized Mortality Ratios (SMR), and Proportionate Mortality Ratios (PMR). In addition, Cox and logistic models were used to assess the effects of various risk factors on cancer incidence and mortality in transplant sub-populations, while cumulative incidence was used to study the patient survival pattern. Lastly, Population Attributable Risk (PAR) was used to quantify the impact of organ transplantation on cancer incidence and mortality. RESULTS: Among major causes of death, the highest PMRs are due to genitourinary diseases, followed by endocrine, nutritional and metabolic diseases, and infectious diseases. SIRs indicate that cancer incidence and mortality were relatively lower than that observed for other major causes of death, and slightly higher than that observed in the general Canadian population. Lastly, logistic regression results indicate that age, year of surgery, and smoking status were significant risk factors in mortality due to all causes, while the Cox regression model shows that age, sex and year of surgery were significant risk factors for cancer incidence. Overall, the PAR in this cohort was very minimal, indicating that the risk in mortality and cancer incidence due to organ transplantation is negligible. CONCLUSION: Life threatening diseases such as those of the genitourinary system, as well as endocrine, nutritional and metabolic diseases and infectious diseases are leading causes of death. Future research should be directed at ways of reducing incidence and subsequent mortality due to these causes.

BACKGROUND: Organ transplantation is one of the best modalities for treating fatal organ failure. Despite the success of this procedure, an increasing incidence of cancer in this population has drawn the attention of public health officials in recent years. OBJECTIVES: The overall objective of this study is to conduct a detailed examination of adverse health outcomes among Canadian organ transplant recipients, with an emphasis on cancer incidence and mortality. METHODS: This project employed a retrospective cohort follow-up study design, whereby Canadian Organ Replacement Registry records were linked to the Canadian Mortality Database and the Canadian Cancer Registry Database. The study population consisted of more than 16,000 solid organ transplant recipients registered between January 1, 1981 and December 31, 1998. This study was designed to assess the risks of developing cancer, overall and site-specific, in transplant recipients in comparison to the general Canadian population using Standardized Incidence Ratios (SIR), Standardized Mortality Ratios (SMR), and Proportionate Mortality Ratios (PMR). In addition, Cox and logistic models were used to assess the effects of various risk factors on cancer incidence and mortality in transplant sub-populations, while cumulative incidence was used to study the patient survival pattern. Lastly, Population Attributable Risk (PAR) was used to quantify the impact of organ transplantation on cancer incidence and mortality. RESULTS: Among major causes of death, the highest PMRs are due to genitourinary diseases, followed by endocrine, nutritional and metabolic diseases, and infectious diseases. SIRs indicate that cancer incidence and mortality were relatively lower than that observed for other major causes of death, and slightly higher than that observed in the general Canadian population. Lastly, logistic regression results indicate that age, year of surgery, and smoking status were significant risk factors in mortality due to all causes, while the Cox regression model shows that age, sex and year of surgery were significant risk factors for cancer incidence. Overall, the PAR in this cohort was very minimal, indicating that the risk in mortality and cancer incidence due to organ transplantation is negligible. CONCLUSION: Life threatening diseases such as those of the genitourinary system, as well as endocrine, nutritional and metabolic diseases and infectious diseases are leading causes of death. Future research should be directed at ways of reducing incidence and subsequent mortality due to these causes.

BACKGROUND: Organ transplantation is one of the best modalities for treating fatal organ failure. Despite the success of this procedure, an increasing incidence of cancer in this population has drawn the attention of public health officials in recent years. OBJECTIVES: The overall objective of this study is to conduct a detailed examination of adverse health outcomes among Canadian organ transplant recipients, with an emphasis on cancer incidence and mortality. METHODS: This project employed a retrospective cohort follow-up study design, whereby Canadian Organ Replacement Registry records were linked to the Canadian Mortality Database and the Canadian Cancer Registry Database. The study population consisted of more than 16,000 solid organ transplant recipients registered between January 1, 1981 and December 31, 1998. This study was designed to assess the risks of developing cancer, overall and site-specific, in transplant recipients in comparison to the general Canadian population using Standardized Incidence Ratios (SIR), Standardized Mortality Ratios (SMR), and Proportionate Mortality Ratios (PMR). In addition, Cox and logistic models were used to assess the effects of various risk factors on cancer incidence and mortality in transplant sub-populations, while cumulative incidence was used to study the patient survival pattern. Lastly, Population Attributable Risk (PAR) was used to quantify the impact of organ transplantation on cancer incidence and mortality. RESULTS: Among major causes of death, the highest PMRs are due to genitourinary diseases, followed by endocrine, nutritional and metabolic diseases, and infectious diseases. SIRs indicate that cancer incidence and mortality were relatively lower than that observed for other major causes of death, and slightly higher than that observed in the general Canadian population. Lastly, logistic regression results indicate that age, year of surgery, and smoking status were significant risk factors in mortality due to all causes, while the Cox regression model shows that age, sex and year of surgery were significant risk factors for cancer incidence. Overall, the PAR in this cohort was very minimal, indicating that the risk in mortality and cancer incidence due to organ transplantation is negligible. CONCLUSION: Life threatening diseases such as those of the genitourinary system, as well as endocrine, nutritional and metabolic diseases and infectious diseases are leading causes of death. Future research should be directed at ways of reducing incidence and subsequent mortality due to these causes.

BACKGROUND: Organ transplantation is one of the best modalities for treating fatal organ failure. Despite the success of this procedure, an increasing incidence of cancer in this population has drawn the attention of public health officials in recent years. OBJECTIVES: The overall objective of this study is to conduct a detailed examination of adverse health outcomes among Canadian organ transplant recipients, with an emphasis on cancer incidence and mortality. METHODS: This project employed a retrospective cohort follow-up study design, whereby Canadian Organ Replacement Registry records were linked to the Canadian Mortality Database and the Canadian Cancer Registry Database. The study population consisted of more than 16,000 solid organ transplant recipients registered between January 1, 1981 and December 31, 1998. This study was designed to assess the risks of developing cancer, overall and site-specific, in transplant recipients in comparison to the general Canadian population using Standardized Incidence Ratios (SIR), Standardized Mortality Ratios (SMR), and Proportionate Mortality Ratios (PMR). In addition, Cox and logistic models were used to assess the effects of various risk factors on cancer incidence and mortality in transplant sub-populations, while cumulative incidence was used to study the patient survival pattern. Lastly, Population Attributable Risk (PAR) was used to quantify the impact of organ transplantation on cancer incidence and mortality. RESULTS: Among major causes of death, the highest PMRs are due to genitourinary diseases, followed by endocrine, nutritional and metabolic diseases, and infectious diseases. SIRs indicate that cancer incidence and mortality were relatively lower than that observed for other major causes of death, and slightly higher than that observed in the general Canadian population. Lastly, logistic regression results indicate that age, year of surgery, and smoking status were significant risk factors in mortality due to all causes, while the Cox regression model shows that age, sex and year of surgery were significant risk factors for cancer incidence. Overall, the PAR in this cohort was very minimal, indicating that the risk in mortality and cancer incidence due to organ transplantation is negligible. CONCLUSION: Life threatening diseases such as those of the genitourinary system, as well as endocrine, nutritional and metabolic diseases and infectious diseases are leading causes of death. Future research should be directed at ways of reducing incidence and subsequent mortality due to these causes.

Introduction Lung cancer is the most common cause of cancer-related death in the United States (US). Tobacco smoking is a well-recognized cause of lung cancer. About 2% of the United States (US) population lives in Tennessee (TN). Nearly 21 % of TN adults are current smokers as per 2019 data, compared to 14% across the US. The percentage of smokers has historically been high in TN and its surroundings. This can be attributed to the area's socio-economic and cultural characteristics, along with large areas of tobacco farming in the region. This increases the risk of lung cancer in the TN population. Surveillance Epidemiology and End Results Program (SEER) is a collection of cancer registries across the US, covering about 35% of the US population (TN cancer registry is not a part of SEER). Our study compares lung cancer incidence and characteristics in the TN cancer registry with the SEER 18 registry. Materials and Methods Data were collected from the TN cancer registry and SEER separately for lung and bronchial cancer. Data was analyzed for different histological subtypes, age groups, gender, stage at diagnosis, and rural/urban residence. Stata and Microsoft Excel were used in data analysis. A Chi-square test was used to calculate the statistical significance. Results From 2008 to 2017, 58644 cases of lung cancer were reported in the Tennessee cancer registry. During the same period, 519112 cases were reported in the SEER registry. The most frequent histological subtype of lung cancer in TN and SEER was adenocarcinoma (frequency of 17,503 Vs. 182346), followed by squamous cell carcinoma and small cell carcinoma. Most cancers in TN and SEER were diagnosed at stage of distant metastasis (46% vs. 52% ), followed by regional metastasis, localized, and in situ (Image1). The frequency of lung cancer diagnosis was high among those older than 65 in TN and SEER (64% vs. 69%). Males had a higher incidence of lung cancer in both registries. Most lung cancers were reported in the urban area in both registries. Chronic obstructive pulmonary disease was the most commonly reported secondary diagnosis (3,099), followed by pleural effusion in the TN database; the comparable data were not available in SEER. Relative survival at 12 months and five years for lung cancer in TN were 46.6 % and 19.5 % (Vs. 46.4% and 19.9% in SEER) Discussion and Conclusion If both registries were perfect, then lung and bronchial cancer incidence will be 9241 and 6048 per million in ten years in TN and SEER, respectively. But after careful analysis, we conclude that such analysis will be erroneous. The proportion of different histological types, stage at diagnosis, age groups, and gender were in the same order in both groups. Although chi-square test values are significant for all the variables, we infer no conclusion considering the data's inherent bias. Further in-depth analysis of the data is required.

This work will first introduce the problems related to the colorectal cancer - its epidemiology and screening possibilities. Next the main topic is addressed - i.e. to ascertain the influence of national screening programmes for colorectal cancer on really observed data of lethality and incidence of this disease. Group of so-called APC models was selected as a useful tool for this purpose. Applying these methods on data of The National Oncological Registry of the Czech Republic for the period between 1980 till 2009 this work aims to prove expected reducing effect of area-wide screening programme on incidence and lethality related to colorectal cancer. Using the AP model and data of previous period before the screening introduction (i.e. 1980-1999) the values of incidence and lethality were predicted for the period in question (i.e. 2000-2009). Mere comparison of this predicted values with really observed data showed that real lethality and incidence was significantly lower in both sexes as compared to the model without the screening intervention. Difference between predicted and real data corroborates positive influence of colorectal cancer screening.

In this dissertation, we consider the problem of partitioning a set of k population with respect to a control population. For this problem some multistage methodologies are proposed and their properties are derived. Using the Monte Carlo simulation techniques, the small and moderate sample size performance of the proposed procedure are studied. We have also considered at statistical surveillance of various cancers in Louisiana.

As a validation study, this study addressed an under-researched area of bronchopulmonary cancer mortality and incidence. The association between altitude and bronchopulmonary cancer mortality and incidence was investigated using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research. The theoretical framework for my study was Bronfenbrenner's ecological model. This model emphasizes the relevance of social and physical environments that influence patterns of disease and injury and shape responses to these patterns of disease and injury. The age-adjusted bronchopulmonary cancer mortality and incidence rates per 100,000 people in the highest elevation and lowest elevation states were investigated. The data used in this study spans from 2006 to 2014. In this study, bivariate statistics were used to analyze the data. The relevant technique of performing an unpaired t-test was used. After performing age, gender, and race-stratified analysis, no significant difference in cancer mortality and incidence was found within the following three groups: Black or African American, Asian or Pacific Islander, and American Indian or Alaska Native. This was a new finding, as previous studies did not stratify for race. Cancer mortality and incidence were found to be lower in both the male and female groups for the highest elevation states. Cancer mortality and incidence were also found to be lower in all age categories for the highest elevation states. A positive social change impact of this study is that this research provides the groundwork for future studies to probe what in the environment is lowering the bronchopulmonary cancer mortality and incidence for the White population.