title: Regional geographic variations in kidney cancer incidence rates in European countries.
abstract: BACKGROUND
  Marked unexplained national variations in incidence rates of kidney cancer have been observed for decades in Europe.
  
  
  OBJECTIVE
  To investigate geographic variations at the regional level and identify European regions with high incidence rates of kidney cancer.
  
  
  METHODS
  Regional- and national-level incidence data were extracted from the Cancer Incidence in Five Continents databases, local cancer registry databases, and local published reports. World population age-standardised rates (ASRs) were calculated for the periods 2003-2007 and 1988-1992. Rates by period and sex were compared using map visualisation.
  
  
  RESULTS
  During 2003-2007, the highest ASR was found in the Plzen region, Czech Republic (31.4/100,000 person-years in men). Other regions of the Czech Republic had ASRs of 18.6-27.5/100,000 in men, with a tendency for higher rates in regions south of Prague. Surrounding regions, including eastern Germany and regions of Slovakia and Austria, had medium-to-high incidence rates (13.0-16.8/100,000 in men). Three other areas in Europe showed higher incidence rates in men compared with the rest of the continent: Lithuania, Estonia, Latvia, and Belarus (15.0-17.6/100,000); Iceland (13.5/100,000), and northern Italy (up to 16.0/100,000). Similar regional differences were observed among women, with rates approximately half of those observed in men in the same region. In general, these regional geographic variations remained stable over the periods 1988-1992 and 2003-2007, although higher incidence rates were detected in the Baltic countries in 2003-2007.
  
  
  CONCLUSIONS
  Several European regions show particularly high rates of kidney cancer incidence. Large variations were observed within countries covered by national health-care systems, implying that overdetection is not the major factor.
  
  
  RESULTS
  We present regional geographic variations in kidney cancer incidence rates in Europe. We highlight several regions with high incidence rates where further studies should be conducted for cancer control and prevention.
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Ariana
authors.initials: A
authors.lastname: Znaor
authors.affiliation: First Faculty of Medicine, Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic.
authors.forename: Ivana
authors.initials: I
authors.lastname: Holcatova
authors.affiliation: Regional Authority of Public Health in Banska Bystrica, Banska Bystrica, Slovakia.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Fabianova
authors.affiliation: National Institute of Public Health, Bucharest, Romania.
authors.forename: Dana
authors.initials: D
authors.lastname: Mates
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Magdalena B
authors.initials: MB
authors.lastname: Wozniak
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ferlay
authors.affiliation: International Agency for Research on Cancer, Lyon, France. Electronic address: scelog@iarc.fr.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Scelo
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data / Q000639:trends; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
keywords: Geographic variations; Incidence rate; Kidney cancer