Summary The European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS) is designed to address concerns about a possible increase in the risk of cancer in Europe following the nuclear accident in Chernobyl in 1986. This paper reports results of surveillance of childhood leukaemia in cancer registry populations from 1980 up to the end of 1991. There was a slight increase in the incidence of childhood leukaemia in Europe during this period, but the overall geographical pattern of change bears no relation to estimated exposure to radiation resulting from the accident. We conclude that at this stage of follow-up any changes in incidence consequent upon the Chernobyl accident remain undetectable against the usual background rates. Our results are consistent with current estimates of the leukaemogenic risk of radiation exposure, which, outside the immediate vicinity of the accident, was small.

Summary In Scotland over the last 31 years the incidence of gastric cancer has significantly declined by 0.6% per annum in males and 1.1% in females. In contrast, for oesophageal cancer, incidence rates have risen significantly by 3.0% and 2.0% per annum in males and females respectively. Increasing incidence of both adenocarcinomas and squamous carcinomas of the oesophagus in men and squamous and recently adenocarcinomas in women has been observed. This cannot be entirely accounted for by a growth in the proportion of histologically verified (HV) tumours over time. Scotland (1960Scotland ( -1990.Smoothed rates, in the form of 3 year moving averages. were calculated, standardised to the world population (Boyle Correspondence: PA McKinney

Consequently, an analysis of survival data from cancers of the oral cavity and pharynx in Scotland over 20 years has been undertaken to determine whether changes have occurred over this period and to which specific factor(s) they are likely to be attributable. Materials and methodsThe Central Scottish Cancer Registry based in the Information & Statistics Division of the National Health Service (NHS) in Scotland aims to record all incident cases of cancer in the Scottish population. Registrations are derived from hospital discharge records, death certificates, out-patient and pathology departments, histopathology and cytology systems and general practitioners. Follow-up of patients is achieved through the NHS central register, which notifies the registry of any person registered with cancer who has died. This system is augmented by computerised medical record linkage of cancer registrations and all death records to maximise ascertainment of deaths in cancer patients (Kendrick and Clarke, 1993). Further details of this system are described elsewhere .All cases (for both men and women) of oral cavity and pharynx cancer (International classification of diseases, version 9 (ICD-9) codes 140-9) (World Health Organization, 1977) diagnosed in the period 1968-87 were extracted from the national cancer register and tabulated by site of cancer, age (0-64, 65 and older) and period of diagnosis (1968-72, 1973-77, 1978-82 and 1983-87

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1983 -87 (Sharp et al., 1993b, largely due to the introduction of platinum-based chemotherapy (Ellis and Sikora, 1987). The complete excision of residual masses following chemotherapy is now accepted practice with more experinced surgeons in this area more likely to perform adequate resection (Ewing et al., 1987;Hendry et al., 1987;Whillis et al., 1991). It has also been suggested that results of therapy for this diease in Scotland are better in centres where a large number of patients are seen (Harding et al., 1993). In Scotland there are five oncology centres, patients with NSGCT being treated in them all. The audit was designed to assess if there was any variation in the success of therapy across the country for this usually curable cancer.This audit, and those reported in the accompanying two papers (Clarke et al., 1995;Howard et al., 1995) were part of a Scottish National Audit assessing the appropriateness and variation in manag t strategies and success of therapy for testicular NSGCIT. The (Clarke et al., 1995). New registrations not referred to oncology centres were excluded from the survival analysis as their diagnosis had not been validated.The end of the follow-up period was defined as 31 December 1992 and survival time was caculated from date of diagnosis until death, or the end of follow-up. Actuarial survival curves based on Kaplan-Mewer estimates were described and the log rank chi-square test for differences in survival rates alculated. These data are summarised by means of the 5 year survival rates with associated standard error. Deaths from causes other than the disease or its treatment, as assessed by the reviewer in this study, were censored.As numbers of patients in some health boards were small these were grouped crudely according to population density to investigate area of residence at diagnosis of cancer. A priori the following groupings were defined (1)