Data collected by the Cancer Registry of the Canton of Vaud, Switzerland, were used to estimate the risk of suicide for patients diagnosed with cancer. Among 24,166 cases of invasive neoplasms other than nonmelanomatous skin cancer reported between 1976 and 1987 and followed through integrated active follow-up to the end of 1987, for a total of 57,164 person years at risk, there were 55 registered suicides vs. 21.3 expected (standardized mortality ratio, SMR = 2.6; 95% confidence interval, CI = 2.0–3.4). The ratio was slightly, but not significantly higher for males (SMR = 2.8) than for females (SMR = 2.2) and comparable across subsequent age groups. The risk of suicide was high during the 1st year after notification (SMR = 3.9) and decreased to 2.2 between 1 and 5 years and to 1.5 over 5 years. This study suggests that the risk of suicide after a diagnosis of cancer may be greater than previously estimated from cancer registry data in Finland, Sweden, and Connecticut (USA), at least in this population of Central Europe with high overall suicide rates.

The variation with latitude of incidence and mortality for cutaneous malignant melanoma (CMM) in the non-Maori population of New Zealand was assessed. For those aged 20 to 74 years, the effects of age, time period, birth-cohort, gender, and region (latitude), and some interactions between them were evaluated by log-linear regression methods. Increasing age-standardized incidence and mortality rates with increasing proximity to the equator were found for men and women. These latitude gradients were greater for males than females. The relative risk of melanoma in the most southern part of New Zealand (latitude 44 degrees S) compared with the most northern region (latitude 36 degrees S) was 0.63 (95 percent confidence interval [CI] = 0.60-0.67) for incidence and 0.76 (CI = 0.68-0.86) for mortality, both genders combined. The mean percentage change in CMM rates per degree of latitude for males was greater than those reported in other published studies. Differences between men and women in melanoma risk with latitude suggest that regional sun-behavior patterns or other risk factors may contribute to the latitude gradient observed.

Background Sperm counts have been steadily decreasing over the past five decades with regional differences in the Western world. The reasons behind these trends are complex, but numerous insights indicate that environmental and lifestyle factors are important players. Objective To evaluate semen quality and male reproductive health in Switzerland. Materials and methods A nationwide cross‐sectional study was conducted on 2523 young men coming from all regions of Switzerland, recruited during military conscription. Semen volume, sperm concentration, motility, and morphology were analyzed. Anatomy of the genital area and testicular volume was recorded. Testicular cancer incidence rates in the general population were retrieved from Swiss regional registries. Results Median sperm concentration adjusted for period of sexual abstinence was 48 million/mL. Comparing with the 5th percentile of the WHO reference values for fertile men, 17% of men had sperm concentration below 15 million/mL, 25% had less than 40% motile spermatozoa, and 43% had less than 4% normal forms. Disparities in semen quality among geographic regions, urbanization rates, and linguistic areas were limited. A larger proportion of men with poor semen quality had been exposed in utero to maternal smoking. Furthermore, testicular cancer incidence rates in the Swiss general population increased significantly between 1980 and 2014. Discussion For the first time, a systematic sampling among young men has confirmed that semen quality is affected on a national level. The median sperm concentration measured is among the lowest observed in Europe. No specific geographical differences could be identified. Further studies are needed to determine to what extent the fertility of Swiss men is compromised and to evaluate the impact of environmental and lifestyle factors. Conclusion A significant proportion of Swiss young men display suboptimal semen quality with only 38% having sperm concentration, motility, and morphology values that met WHO semen reference criteria.

A comparison of the site distribution of cutaneous malignant melanoma in New Zealand and Canada was performed. This series deals with 41,331 incident cases registered between 1968 and 1990 and is the largest to date to evaluate the influence of age and gender on the site distribution of melanoma. Site-specific, age-standardized rates per unit surface area and relative tumour density were assessed by gender and country and differences compared with statistical techniques adapted to this context. The age-standardized rates for all sites were higher in New Zealand than in Canada, the ratio being 3.2 for men and 3.8 for women. Occurrence of melanoma was denser for chronically than intermittently exposed sites in both New Zealand and Canada. The highest incidence rate per unit area was for the ears in men which was more than 5 times the rate for the entire body in each country. For each gender, melanomas were relatively commoner on the trunk and the face in Canada, and on the lower limbs in New Zealand. The variations in the site distribution were similar in each country and consistent with the effect of differential patterns of sun exposure between genders. Our results show that the levels of risk of melanoma between phenotypically comparable populations exposed to different amount of UV radiation vary in a site-specific manner, especially for intermittently exposed sites. This suggests that both environmental conditions and lifestyle factors influence the site distribution of melanoma in these two populations. Although exposure to ultraviolet radiation (UVR) has been identified as the chief environmental risk factor for skin cancer among Caucasians (IARC, 1992), the aetiology of cutaneous malignant melanoma (hereafter referred to as melanoma) is not fully understood. The site distribution of melanoma has been important in generating aetiological hypotheses about the disease. As determinants of the anatomical site distribution have not yet been elucidated, some speculation has occurred about the mode of the carcinogenic process involved (Lee and Merrill, 1970;Green, 1992).Unlike squamous cell carcinoma and, to a lesser extent, basal cell carcinoma which are strongly associated with UVR and frequently observed on heavily exposed sites such as the face and the neck, the back of the hands and the forearms (Pearl and Scott, 1986;Levi et al., 1988;Osterlind et al., 1988;Kaldor et al., 1993), melanoma has long been known to occur commonly on less sun-exposed sites, such as the trunk for men and the lower limbs for women (Lee and Yongchaiyudha, 1971;Davis, 1976;Crombie, 1981). However, when differences in surface area between anatomical parts of the body were considered, risks of the same order of magnitude have generally been reported for melanoma occurring on chronically and intermittently exposed sites, although substantial variation existed between studies (Elwood and Lee, 1975;Elwood and Gallagher, 1983;Pearl and Scott, 1986;Osterlind et al., 1988;Green et al., 1993;Franceschi et al., 1996). The occurrence of melanoma...

Results support the hypothesis that changes in lifestyle factors resulted in a pattern of carcinogenic exposures that explains both the upsurge in melanoma in the last few decades and the current levelling off in incidence.