title: Cancer incidence on a small island--research opportunities in general practice.
abstract: OBJECTIVE
  To test the impression of an increased cancer incidence on the island of Pellworm (in the far North of Germany) and to illustrate the feasibility of a general practice-based approach in epidemiological research.
  
  
  METHODS
  Cancer incidence on Pellworm was prospectively registered in the only general practice on the island from 1986 to 1992. Age-standardized rates and expected rates were calculated on the basis of the Saarland cancer registry, the only registry in Germany. Standardized incidence ratios and 95% confidence intervals (CI) for Poisson-distributed events were also calculated. The cancer data were summed up over a seven-year period.
  
  
  METHODS
  The only general practice on the island of Pellworm, a North Frisian marshland-island.
  
  
  METHODS
  The total practice population between 1986 and 1992 (N = 1172)
  
  
  RESULTS
  The crude annual cancer incidence rate for Pellworm was, according to the impression, unexpectedly high: 634/100 000 for men and 502/100 000 for women. After age standardization, however, this increased rate of cancer incidence was even lower than in the Saarland (ratios: 0.86 for men and 0.95 for women). Only the incidence of neoplasms of the lymphatic and haematopoietic tissue in men exceeded the limits of statistical likelihood (ratio: 3.21; 95% CI: 1.17-7.10).
  
  
  CONCLUSIONS
  The impression of an increased rate of cancer on Pellworm could not be validated. The overall incidence rate was even lower than expected. Only the rate of leukaemia/lymphoma (men) was significantly higher. Reasons for this result could not be detected by a descriptive approach. General practice is a suitable place for studies in cancer epidemiology, especially in such ideal circumstances as a clearly limited area and complete and reliable documentation.
authors.affiliation: Department of General Practice, University of Göttingen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Kurzke
authors.forename: W
authors.initials: W
authors.lastname: Himmel
authors.forename: K
authors.initials: K
authors.lastname: Wegscheider
authors.forename: H H
authors.initials: HH
authors.lastname: Abholz
authors.forename: M M
authors.initials: MM
authors.lastname: Kochen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D004812:Epidemiologic Methods; D005194:Family Practice / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007938:Leukemia / Q000453:epidemiology / Q000209:etiology; D016013:Likelihood Functions; D008223:Lymphoma / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016012:Poisson Distribution; D012042:Registries / Q000706:statistics & numerical data; D012106:Research; D012307:Risk Factors; D012934:Social Isolation