Introdução - Estudos sobre o câncer de cólon mostram que a sua incidência, no mundo, tem aumentado de maneira significativa no último século. Acredita-se que este resultado esteja relacionado, entre outros aspectos, com a industrialização, a urbanização ocorridas neste período e mudanças no estilo de vida. A morbimortalidade associada ao câncer de cólon observada em países desenvolvidos é maior do que em países em desenvolvimento e o que se tem observado é que, embora a tendência da incidência seja crescente para ambos os sexos, a mortalidade permanece estável. Objetivo - Analisar as tendências da incidência e da mortalidade de pacientes com câncer de cólon, registrados no Registro de Câncer de Base Populacional (RCBP) do Município de São Paulo. Métodos - Foram analisadas as tendências temporais da incidência no período de 1997 a 2005 e da mortalidade no período de 1980 a 2007. As análises foram feitas separadamente por sexo e faixa etária e os efeitos da idade, do período e da coorte foram estimados através do modelo de regressão de Poisson. Resultados - Houve aumento na incidência por câncer de cólon no município de São Paulo, em quase todas as faixas etárias estudadas. O aumento da mortalidade foi menor do que o aumento da incidência e parece coincidir com um efeito de coorte presente durante todo o período do estudo. Tanto na incidência quanto na mortalidade, os aumentos foram mais pronunciados entre os homens. O modelo idade-período apresentou o melhor ajuste para os coeficientes de incidência para ambos os sexos, e o modelo completo (idade-período-coorte) se mostrou com melhor ajuste para os coeficientes de mortalidade para ambos os sexos. Não foi identificada interação estatisticamente significativa do sexo para os coeficientes de incidência e de mortalidade. Conclusão: Os resultados encontrados no presente estudo mostraram um aumento da incidência e da mortalidade, em ambos os sexos, em quase todas as faixas etárias. Observamos uma tendência da estabilização nas coortes de nascimento do câncer de cólon para ambos os sexos, sugerindo que as mudanças de estilo de vida podem contribuir para a redução da mortalidade por câncer de cólon, principalmente nas coortes mais jovens. / Introduction Studies on colon cancer show that its incidence worldwide has been increasing in the last century. There is evidence suggesting that this can be partially related to the industrialisation and urbanisation which occurred in the period and life style changes. Morbi-mortality associated with colon cancer observed in industrialised countries is greater than in developing countries. Colon cancer incidence presents an increasing trend for both sexes, probably due to a wider access to available diagnostic methods, while mortality rates remain stable. Objective: To assess incidence and mortality trends in patients with colon cancer, registered in São Paulo Cancer Registry. Methods: Temporal trends between 1997 and 2005 for incidence and between 1980 and 2007 for mortality were assessed. Analyses were performed separately by sex and age group, and effects of age, period and cohort were estimated by using Poisson´s regression model. Results: For all age groups assessed, there was an increase in colon cancer incidence in the city of São Paulo. The increase in mortality rates was lower than the increase in incidence which seems to coincide with a cohort effect present during the period studied. Increases in both incidence and mortality rates, were more pronounced among men. The age-period model presented the best adjustment to incidence coefficients for both sexes and the complete age-periodcohort model showed the best adjustment to mortality coefficients for both sexes. No significant statistical interaction for sex and incidence coefficient or sex and mortality coefficient was found. Conclusion: Results found in the present study revealed an increase in incidence and mortality rates, for both sexes and all age groups. A stabilisation in birth cohorts of colon cancer for both sexes was observed, suggesting that life style changes may contribute to the reduction in colon cancer mortality, especially in younger cohorts.

Este estudo epidemiológico do Câncer da Boca refere-se aos municípios da Grande São Paulo, excluído o município de São Paulo, no período de 1969-1971. Fundamenta-se em informações colhidas no Registro de Câncer da Faculdade de Saúde Pública da Universidade de São Paulo, onde dentre 44.140 fichas de notificação de câncer, 238 referem-se a câncer bucal em residentes nesses municípios. Sendo 194 casos no sexo masculino com 43 óbitos e 44 casos no sexo feminino com 9 óbitos. Os coeficientes de incidência de câncer bucal nos sexos masculino e feminino foram respectivamente, 5.71 por 100.000 homens e 2.19 por 100.000 mulheres. Os coeficientes de mortalidade foram de 1,27 para o sexo masculino e de 0.28 para o sexo feminino. A localização anatômica mais frequente no sexo masculino foi o lábio e no sexo feminino a lingua. O tipo histológico mais frequente foi o Carcinoma Espinocelular. / This epidemiological study of cancer of the mouth was conducted in the counties of the Greater São Paulo, excluded the Capital, from 1969 to 1971. It is based on information taken from the cancer files of the São Paulo University School of Public Health, where from 44,140 index cards reporting mouth cancer, 238 refer to mouth cancer in residents of those counties. Of these, 194 ocurred in the male population resulting in 43 deaths and 44 in the female population of which 9 ended in death. The incidence rates of cancer of the mouth in the male and the female populations were respectively 5.71 per 100,000 and 2.19 per 100,000. The death rates were also respectively 1.27 and 0.28. The region most frequently affected in the male population was the lip and in the female population the tongue. The most frequent histological type was the Spinocellu1ar Carcinoma.

Introdução: Estatísticas sobre a ocorrência de casos novos de câncer são fundamentais para o planejamento e monitoramento das ações de controle da doença. No estado de São Paulo, a incidência de câncer é obtida indiretamente por meio de estimativas oficiais (para o estado como um todo e sua capital) e, de forma direta, em municípios cobertos por Registro de Câncer de Base Populacional (RCBP). Existem, atualmente, três RCBP ativos (São Paulo, Jaú e Santos), um inativo (Barretos) e um em reimplantação (Campinas). Dado o desconhecimento do panorama da incidência de câncer em áreas não cobertas por RCBP, este estudo teve como objetivo estimar a incidência de câncer, calcular taxas brutas e padronizadas por idade, específicas por sexo e localização primária do tumor para as 17 Redes Regionais de Atenção à Saúde (RRAS) de São Paulo e municípios, em 2010. Método: Utilizou-se como estimador da incidência de câncer a razão Incidência/Mortalidade (I/M), por sexo, grupo etário quinquenal dos 0 aos 80 anos e localização primária do tumor. O numerador da razão foi formado pelo número agregado de casos novos entre 2006-2010, em dois RCBP ativos (Jaú e São Paulo, respectivamente, com cobertura correspondente a 0,3 por cento e 27,3 por cento da população estadual). No denominador, o número de óbitos oficial nas respectivas áreas e período. O número estimado de casos novos resultou da multiplicação das I/M pelo número de óbitos por câncer registrados em 2010 para o conjunto de municípios formadores de cada uma das RRAS ou para cada município. O método de referência foi aquele utilizado no Globocan series, da Agência Internacional de Pesquisa contra o Câncer. O ajuste por idade das taxas de incidência ocorreu pelo método direto, tendo como padrão a população mundial. Resultados: Estimaram-se 53.476 casos novos de câncer para o sexo masculino e 55.073 casos para o feminino (excluindo-se os casos de câncer de pele não melanoma), com taxas padronizadas de 261/100.000 e 217/100.000, respectivamente. No sexo masculino, a RRAS 6 apresentou para todos os cânceres a maior taxa de incidência padronizada (285/100.000), e a RRAS 10, a menor (207/100.000). Os cânceres mais incidentes em homens foram próstata (77/100.000), cólon/reto/anus (27/100.000) e traqueia/brônquio/pulmão (16/100.000). Entre as mulheres, as taxas de incidência padronizadas por idade foram de 170/100.000 (RRAS 11) a 252/100.000 (RRAS 07); o câncer de mama foi o mais incidente (58/100.000), seguido pelos tumores de cólon/reto/anus (23/100.000) e de colo uterino (9/100.000). Conclusões: Os resultados apontaram diferentes padrões de incidência com taxas que ultrapassaram a magnitude estadual. Dados provenientes de RCBP locais podem ser usados na obtenção indireta de estimativas regionais e locais. Neste estudo, as taxas de incidência apresentadas podem estar sub ou superestimadas refletindo a qualidade, completitude e padrões observados no RCBP de maior representatividade considerado na análise. / Introduction: Statistics on the occurrence of new cases of cancer are fundamental to the planning and monitoring of control measures. In Sao Paulo state, Brazil, cancer incidence can be obtained by the official estimates for the state as a whole and the capital and in municipalities covered by Population Based Cancer Registries (PBCR). The currently panorama of PBCR in Sao Paulo includes three active registries, one retired and one in re-deployment. Given the unknown cancer incidence in areas not covered by PBCR, this study aimed to estimate cancer incidence (standardized incidence rates = SIR) according to gender, age group and tumor type for 17 Regional Networks of Health Care (RNHC) and municipalities in São Paulo state, Brazil, in 2010. Methods: We used as estimator the Incidence:Mortality ratio (I:M) adjusted for sex, five-year age group (0-80 years) and primary tumor site. The ratio numerator was composed by the aggregated number of new cases diagnosed in 2006-2010 in two active PBCR, Jau and Sao Paulo, covering 0.3 per cent and 27.3 per cent of the state population, respectively, while the denominator was the official number of cancer deaths in the same areas and period. The estimated number of incident cases resulted from the multiplication of I:M by the number of deaths registered in 2010 for the set of municipalities that compose the region or for each local area. The reference method was the one used in Globocan series of the International Agency for Research on Cancer. Results: We had estimated a total of 53,476 new cases of cancer for males and 55,073 cases for females (excluding non melanoma skin cancers) in the state of São Paulo, corresponding to standardized rates (world population) of 261/100,000 and 217/100,000, respectively. Among males, RNHC-6 presented the highest standardized incidence rate of all cancers (285/100,000) and the RNHC-10, the lowest (207/100,000). Most frequent tumor sites in men were: prostate (SIR=77/100,000), colorectum/anus (SIR=27/100,000) and trachea/bronchus/lung (SIR=16/100,000). Among women, rates for all cancers excluding non-melanoma skin varied from 170/100,000 (RNHC-11) to 252/100,000 (RNHC-7); breast cancer was the most incident cancer site (SIR=58/100,000), followed by colorectum/anus (SIR=23/100,000) and cervix (SIR=9/100,000). Conclusions: Our results showed different patterns of regional incidence with rates that often exceeded the values presented for the state. Data from local PBCR can be used to obtain regional and local estimates. However, the estimated rates may be under- or overestimated reflecting the quality, completeness and the patterns observed in the most representative registry used in the analysis.

Orientador: Carlos Roberto Silveira Correa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T18:36:53Z (GMT). No. of bitstreams: 1 Bismarck_CarlaMariaFrancoMeneghetti_M.pdf: 1189411 bytes, checksum: 246dc2dfa146956e8d5e63565d6878d1 (MD5) Previous issue date: 2008 / Resumo: Este estudo de tipo coorte foi realizado em Campinas-SP, no Bairro Jardim Santa Mônica visando identificar a incidência anual de infecção por Toxocara canis; seus fatores de risco socioeconômicos e sua associação com sinais e sintomas respiratórios e dermatológicos. A população de estudo foi constituída por setenta e duas crianças na faixa etária de 4 a 15 anos, que freqüentavam o período da manhã das instituições de ensino da região e que apresentaram sorologia negativa em um primeiro inquérito sorológico imunoenzimático (ELISA). A todas foi aplicado um questionário fechado que visava identificar variáveis socioeconômicas. Durante um ano, outro questionário também foi aplicado mensalmente a todas as crianças a qual tinha o objetivo de identificar se a criança apresentara algum sinal ou sintoma de doença respiratória ou de doença dermatológica nos trinta dias anteriores. Essas informações eram mensalmente cruzadas com as obtidas nos prontuários clínicos dessas crianças na unidade básica de saúde à qual estavam adstritas. Após seis meses, nova sorologia foi realizada em todas as crianças e três delas apresentaram sorologia positiva para infecção por Toxocara canis. Outras três saíram da coorte, por abandono, após essa segunda coleta. Após mais seis meses, nova sorologia foi realizada e, das sessenta e seis crianças analisadas duas tornaram-se soropositivas para T. canis. Ao final do estudo foi possível estimar uma taxa de incidência de 7,2% casos de infecção por T. canis para cada cem crianças/ano. Não se verificou diferença significativa na incidência de infecção com relação às variáveis analisadas no estudo. / Abstract: This cohort study type was carried out in Campinas-SP, in Jardim Santa Mônica District, and had in view the annual incidence of toxocariasis and its socioeconomic risk factors and its association to breathing and dermatological signals and symptons. The studied population was constituted by seventy two childrens, from 4 to 15 years old, who attented to the reagion teaching institution's early period and who presented negative serology in a first imunoenzimatic serological inquiry (ELISA). To all of them, it was applied a closed questionnaire, which aimed to identify socioeconomic variant. Throughout a year, another questionnaire was also monthly applied to all of them, wich aimed to identify if the child had presented any sign or symptom of breath or dermatological disease in the previous thirty days. This information was monthly crossed with the one obtained in these children's clinical reports in the health basic unit to which they were connected. After six months, new serology was accomplished in all children and three of them presented positive serology to T. canis infection. Other three ones left the cohort, by abandon, after this second assessment. After more six months, new serology was achiwed and, from sixty six children analysed, two turned out to be T. canis seropositive. At the end of the study, it was possible to estimate a rate of 7,2% cases of Toxocara canis infection for each hundred children/year. It has not been verified a substantial difference in the incidence of infection relate to the variants analysed in this study / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Orientador: João Batista de Miranda / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T22:32:06Z (GMT). No. of bitstreams: 1 Yamada_NeideSumie_M.pdf: 1286859 bytes, checksum: 13049b157f58cc99cc1277c8a5174f29 (MD5) Previous issue date: 2012 / Resumo: Introdução: As infecções são uma das complicações mais temidas nas artroplastias de quadril e joelho. A falta de um registro nacional de artroplastias e a escassez de publicações nacionais sobre o tema leva ao desconhecimento sobre os fatores de risco desta complicação na população brasileira. Objetivo: O objetivo deste trabalho é identificar a incidência e os fatores de risco para infecções relacionadas com as artroplastias de quadril (PTQ) e joelho (PTJ) em pacientes do hospital das clínicas da Unicamp. Métodos: Foi realizado um estudo tipo caso-controle, retrospectivo, das PTQs e PTJs feitas no período de 2005 a 2009, onde foi revisado os prontuários e coletados estes dados: idade, sexo, peso, altura,tipo de cirurgia, tempo de duração da cirurgia, número de doses de antibioticoterapia profilática, tempo de internação pré e pós-operatório, tempo de sondagem vesical de demora, presença de comorbidades como hipertensão e diabetes, história de etilismo e tabagismo, infecções recentes e tardias. Resultados: Foram incluídas neste estudo 173 artroplastias, sendo 109 (63%) de quadril e 64 (37%) de joelho. A incidência de infecções nas PTQs foi de 6,4% e nas PTJs foi de 20,3%. Dentre os fatores de risco para infecção, os que tiveram correlação positiva foram o maior tempo de internação pós-operatório e o maior tempo total de internação. Conclusão: A incidência de infecções em prótese total de joelho e quadril foi considerada alta, acima da estabelecida na literatura. Os únicos fatores de risco que apresentaram correlação foram o tempo de internação pós- operatória e o tempo total de internação / Abstract: Introduction: Infections are one of the most challenging drawbacks in hip and knee Arthroplasty surgery. The lack of a national databank and the shortage of national paper about this issue, cause risk factors unknown among Brazilian people. Objective: To identitify incidence and risk factors ofinfection related to hip and knee Arthroplasty surgery, in a Brazilian teaching hospital. Method: A retrospective case-control study was performed between 2005 and 2009, to evaluate medical records of patients submitted to hip or knee Arthroplasty. Data collected was the following: age, gender, weight, heitght, kind of surgery, surgery duration, antibiotic drug doses number, hospitalization length, urinary catheter length, medical conditions (such diabetes, high bloodo pressure, smoking, drinking), acute and chronic infections. Results: It was included 173 patients, of which 109 (63%) were total hip arthroplasties and 64 (37%) were total knee arthroplasties. Hip arthrplasty infection rate was 6,4%, and Knee Arthroplasty infection rate was 20,3%. Among infection risk factors, total length of hospital stay and length of post-surgical hospital stay were the that presented significant correlation. Conclusion: Infection rates after hip and knee arthroplasties were considered high. The only risk factors that presented a significant correlation were total hospital stay length and post-surgical hospital stay length / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências da Cirurgia

Abstract Using three different schizophrenic populations from Northern Finland, gender differences in some sociodemographic variables, age at onset, incidence, treatment, outcome and deinstitutionalization of schizophrenia were examined. The first study population comprises the Northern Finland 1966 Birth Cohort, which is an unselected, general population birth cohort. We followed prospectively 11017 subjects from 16 to 28 years of age by means of the Finnish Hospital Discharge Register. From this study population gender differences at the age of onset and incidence of schizophrenia were calculated. The second study population was formed of 1525 patients who had their first treatment episodes at the closed therapeutic community ward situated at the Department of Psychiatry, University of Oulu during 1977 - 1993. Gender differences were assessed in relation to age at first admission, some sociodemographic variables, degree of active participation of the patients in individual, group, and milieu therapy and institutional outcome of the patients with schizophrenia. The third study population consisted of all the 253 long-stay psychiatric inpatients treated for at least six months without a break during 1992 in the Department of Psychiatry, Oulu University Hospital. From this study population gender differences at the age of onset and in relation to some sociodemographic and clinical variables were studied. The placements after the last discharge and at the end of the follow-up and factors predicting hospitalization after the follow-up were also monitored. There were no statistically significant gender differences regarding age at onset in any of these three different study populations. The time lag between the first psychotic symptoms and the first psychiatric hospitalization was minimal. In the Northern Finland 1966 Birth Cohort study the annual incidence rate of DSM-III-R schizophrenia was relatively high, 7.9 per 10 000 in men and 4.4 in women by the age of 28. In men it was highest in the age group of the 20-24 year-olds while in women the peak occurred earlier in the age group of the 16-19 year-olds. In the Therapeutic community study there were no statistically significant gender differences in the sociodemographic variables, in the length of stay and in the number of treatment episodes in this ward in any of the diagnostic groups. Differences with regard to male and female participation in individual, group and milieu therapy and the institutional outcome were minimal, some trends, however, favoring females. In the long-stay patients study almost two-thirds of these patients were men. Very few gender differences were found in relation to sociodemographic and clinical characteristics or regarding the utilization of psychiatric hospital care. About 70% of the long-stay patients were discharged during the four year follow-up period and only 15% were able to live without continuous support. Marital status (being not married), dwelling place (living in city), absence of negative symptoms and severity of the illness were associated with hospitalization at the end of the follow-up. Gender did not predict hospitalization at the end of the follow-up period. The results of this study indicate that there are probably different subgroups of schizophrenia in which there are no gender differences regarding age at onset and in the clinical picture of the disturbance or there are regional differences in the manifestation of the illness. In Finland patients are hospitalized earlier after the onset of the first psychotic symptoms than in many other countries. According to the Northern Finland 1966 Birth Cohort study the incidence of schizophrenia is higher among young men than women and the total life-time incidence of schizophrenia may be smaller in women. The results from the Therapeutic community study suggest that therapeutic community treatment may level out the gender differences in the treatment process and outcome. The long-stay patient study showed that long-term patients are dependent on considerable support and that the most seriously ill patients are in fact in hospital. Alternative residential facilities have been a presupposition to the deinstitutionalization of the long-stay patients.

Abstract Incidence trends of laryngeal cancer in Finland were analyzed, especially in relation to survival, in a patient series of 5766 patients diagnosed in 1956–1995 and identified from the Finnish Cancer Registry. The age-adjusted incidence rate decreased from 6.5 to 3.5 per 100 000 person-years in males and remained unchanged among females. Only minor improvement occurred in survival. In a hospital-based material from Northern Finland (353 patients with laryngeal squamocellular carcinoma, LSCC, diagnosed in 1976–1995), the incidence among males decreased only for supraglottic cancer, diminishing the supraglottic to glottic incidence ratio from 1.4:1 to 0.5:1. Evaluation of diagnostic delays and their impact on survival and risk of recurrence was undertaken in a sample of 66 LSCC patients. In only 38% of the patients was malignancy suspected at the initial visit to a physician; infection was the most common misdiagnosis (41%). Half of the first consultations resulted in referral, whereas 17% of the patients were neither referred nor controlled. The median patient delay was 2 months and median professional delay 3 months. The latter exceeded 12 months in 17% of the patients. The delays were not significantly related to any other clinical parameter, nor were they interrelated. Professional delay of 12 months or more resulted in increased relative hazard of death (HR = 4.74, p = 0.05), equalling the effect of advanced stage (stage IV). One-third of the patients developed a recurrence. In univariate analysis, professional delay of 12 months or more increased the risk of local (p = 0.019) and neck (p = 0.019) recurrence. In a multivariate model, professional delay of 12 months or more indicated an adjusted relative hazard ratio (HR) of 4.6 for local recurrence (p = 0.02) and 9.5 for neck recurrence (p = 0.015). Immunohistochemical factors p53, apoptosis, angiogenesis and proliferation were included in a multivariate model evaluating prognostic factors of LSCC in addition to clinical and sociodemographic factors. Advanced stage (stages III–IV) (relative hazard ratio of death (HR) 8.9, p = 0.01), supraglottic site (HR 5.6, p = 0.02) and high apoptotic index (≥ 0.3) (HR 11.1, p = 0.05) were the best indicators of impaired prognosis. Professional delay and enhanced apoptotic rate could be helpful in selecting LSCC patients for more aggressive primary treatment.

Magister Scientiae - MSc / Oral cancer is characterised by marked geographical differences in frequency and site preference as reported by various studies. In South Africa, a few studies have been reported on the patterns and aetiology of oral cancer, and age standardised incidence rates (ASIR). Studies in several countries have shown an increase in oral cancer incidence among younger people. Title: Epidemiology of oral cancer in South Africa 1996-2002. Aim and Objective: The aim of this study was to determine the age standardised incidence rates (ASIR) of oral cancer by age, gender, race and site in South Africa for a consecutive period of seven years. Method: Pathology case records of oral cancer diagnosed over a seven-year period from 1996 to 2002 and reported to the National Cancer Registry (NCR) were analysed for age, sex, race, and date of diagnosis, basis of diagnosis, topography and tumour type. The data was tabulated and categorised using Microsoft Excel. The South African population size for each year of the study was estimated by linear extrapolation using the 1996 and 2001 census results. Age standardisation incidence rates against the world population were calculated by the standard direct method. Results: The total number of oral squamous cell carcinoma cases over the 7-year period was 9702. The majority of cases (34%) were on the tongue. The male to female ratio was 1:3. The age standardized incidence rates in this study was lower among African women; (0.640 per 100000 per year) and the highest was 13.40 new cases per 100000 per year (coloured males). Lip cancer was highest among both males and females of the white population. The cumulative rate of developing oral cancer was 1:83 and 1:32 for males and females respectively. / South Africa

Les matériaux absorbants des ondes électromagnétiques sont des éléments importants pour l'évaluation de nombreux systèmes électroniques militaires mais également civils. Ces matériaux sont utilisés, par exemple, pour la réduction des interférences électromagnétiques (EMI) dans divers composants sans fils, la réduction de la surface équivalente radar (SER) ou comme absorbants à l'intérieur des chambres de mesures. C’est cette dernière application qui est visée par les travaux de cette thèse. L’objectif de mes travaux de thèse est d’optimiser des matériaux absorbants utilisés dans les chambres anéchoïques. La géométrie et la composition du matériau absorbant sont les deux paramètres qui influencent la capacité d’absorption de l’onde électromagnétique par un matériau. Ce seront donc les deux pistes d’optimisation explorés durant cette thèse. Notre but est d’obtenir les absorbants présentant les plus faibles coefficients de réflexion et de transmission, soit une absorption élevée, ceci dans une large bande de fréquence. / The electromagnetic absorber materials are important elements for evaluating various electronic and civil systems. These materials are used, for example, for minimizing electromagnetic interferences (EMI) in different wireless components, for minimizing the radar cross section (RCS) or for usage in anechoic chambers. The latter application is the targeted work in this thesis. The objective of this work is to optimize the absorber materials used in anechoic chambers. The geometry and the material composition are the two parameters that influence the absorption of the electromagnetic wave inside the material itself. This are the two topics of optimization explored in this thesis. Our objective is to obtain material absorbers that have low reflection and transmission coefficients and high absorption in a large frequency band.

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.