European Journal of Cancer Prevention最新文献

Background: Cervical (CC), ovarian (OC), and uterine (UC) cancers are major contributors to global gynecological cancer (GC) burden. This research intended to update trends in disease burden and care quality for these cancers and quantify cross-country inequalities between 1990 and 2021.

Methods: We performed a secondary analysis utilizing the Global Burden of Disease 2021 database. Disease burden and care quality were evaluated through age-standardized incidence rates (ASIR), age-standardized years lived with disability rates (ASYR), and quality-of-care index (QCI). Trends were analyzed using estimated annual percentage changes, while absolute and relative cross-country inequalities were quantified using the slope index of inequality and concentration index.

Results: From 1990 to 2021, global ASIR and ASYR for CC and OC declined, whereas UC showed an increase in both rates. Concurrently, a general uptrend in QCI was observed for all three GCs. Across the WHO regions, the European region reported the highest ASIR and ASYR for OC and UC in 2021, and the African region recorded the highest for CC. In both 1990 and 2021, countries/territories with higher socio-demographic index (SDI) experienced a higher ASYR for OC and UC, while CC primarily concentrated in lower SDI countries/territories. Significant healthcare inequalities in age-standardized QCI were observed, with higher SDI countries/territories generally exhibiting better QCI.

Conclusion: Trends in the burden and QCI for gynecological cancers demonstrated significant disparities among WHO regions and 204 countries/territories, with global inequalities persisting. Urgent action is needed to develop geographically tailored strategies for equitable access to high-quality healthcare.

Thyroid cancer incidence has increased globally, with Asia bearing a major burden because of its large population and socioeconomic diversity. This study analyzed age-standardized incidence and mortality rates in Asia in 2022 and projected trends to 2050. This ecological, population-level study analyzed thyroid cancer data from 47 Asian countries using secondary data from the GLOBOCAN 2022. Spearman's correlation examined its association with the Human Development Index, while 2050 projections were derived from demographic trends. In 2022, Asia accounted for 72.7% of global thyroid cancer cases and 61.3% of related deaths, with 596.6 thousand new cases and 29.1 thousand deaths, including 50% of incidence and 25% of mortality in younger individuals. The age-standardized incidence and mortality rates were 10.7/100 000 and 0.5/100 000, respectively. Incidence rates rose faster in younger and male individuals. A significant correlation was found between the Human Development Index and cancer rates. South Korea had the highest incidence rate (7.6 per 100 000 males; 39.5 per 100 000 females), while the United Arab Emirates had the highest mortality rate (0.9/100 000 males and 13.9/100 000 females). In contrast, China had the largest absolute numbers of new cases and deaths, with 124.9 thousand new cases and 4.3 thousand deaths in males, and 341.2 thousand new cases and 7.2 thousand deaths in females. By 2050, 747.6 thousand new cases and 58.6 thousand deaths are expected in Asia. Targeted public health strategies addressing socioeconomic disparities, gender-specific risks, and emerging environmental factors may help reduce overdiagnosis and preventable deaths.

Objective: The objective of the present study was to evaluate the factors affecting women's behaviors toward breast cancer prevention.

Methods: This research, designed as a descriptive cross-sectional study, was conducted with 400 women. Research data were collected using a descriptive personal information form and the scale to measure factors influencing women's breast cancer prevention behaviors (ASSISTS). The forms were transferred to the online platform via Google and published as an online survey. The statistical significance was identified if the P -value was below 0.05.

Results: The highest score on the ASSISTS is 165, and the lowest is 33. As women got older, it was determined that their scores in the scale's attitude ( P  = 0.013), motivation ( P  = 0.011), self-efficacy ( P  = 0.042), and self-care ( P  = 0.017) subdimensions were higher. Women with a high-income level exhibited higher levels of positive behavior than women with medium and low-income levels in the subscales of attitude ( P  = 0.026), motivation ( P  = 0.004), support systems ( P  = 0.041), and stress management ( P  = 0.044).

Conclusion: In the attitude and motivation subscales, women with pregnancy and childbirth experience showed higher levels of positive behavior in breast cancer prevention. Married women had higher ASSISTS scores than single women. Participants' breast cancer prevention behaviors were evaluated as positive. Advanced age, pregnancy, and childbirth experience are factors that affect positive behaviors in breast cancer prevention.

Objective: Cancer remains a major public health concern in China, with modifiable risk factors contributing substantially to its burden. However, comprehensive evaluations of long-term, hierarchical risk trends are limited. This study assessed cancer burden attributable to risk factors in China from 1990 to 2023 using data from the Global Burden of Disease Study 2023.

Methods: Cancer deaths, disability-adjusted life years (DALYs), age-standardized mortality rates, and age-standardized DALY rates (ASDR) attributable to level 1 (behavioral, metabolic, and environmental/occupational) and level 2 risk factors were analyzed to characterize temporal, sex-, and age-specific patterns. Comparative effect sizes between level 1 categories were quantified using prevalence ratios with 95% uncertainty intervals.

Results: From 1990 to 2023, cancer deaths attributable to risk factors increased by 74.1%, reaching 1.28 million, while age-standardized mortality rates and ASDR declined by 36.2 and 24.2%, respectively. Behavioral risks consistently imposed the greatest burden, producing 7.65 times more deaths than metabolic risks and 4.29 times more than environmental/occupational risks in 2023. Tobacco remained the leading individual risk factor, whereas high BMI - particularly in males - showed the steepest increase, and alcohol use declined among females. Tracheal, bronchus, and lung cancer had the highest risk-attributable ASDR, and multiple myeloma showed the largest rise since 1990. Cancer burden peaked at ages 70-74 years, with males experiencing substantially higher mortality and DALY rates than females.

Conclusion: Despite declining age-standardized rates, the rising absolute burden of risk factor-attributable cancers underscores the need for strengthened tobacco control, obesity prevention, and environmental health interventions.

We provided cancer mortality rate estimates for the year 2025 in six Latin American countries (Argentina, Brazil, Chile, Colombia, Cuba, and Mexico), focusing on prostate cancer. We extracted mortality data for all cancers combined and the most common sites from the WHO and population data since 1970 from the United Nations. Estimates for 2025 were computed applying a linear regression to the most recent segment identified through Poisson join-point regression. Avoided deaths number from 1991 to 2025 was estimated by applying the 1990 peak rate to population data. Mortality from all cancers is predicted to be favorable for both sexes in all countries. The lowest total cancer mortality rates are expected in Mexico (67.7/100 000 males; 61.4/100 000 females), while the highest ones in Cuba (136.6/100 000 males; 91.6/100 000 females). Prostate cancer mortality is declining in all countries, although rates remain high in Cuba (25.2/100 000 in 2025). Downward patterns are observed for all age groups in all countries, except the elderly in Cuba and Mexico. Declines in mortality are predicted for colorectal (except for males in Brazil and Cuba, and females in Chile), stomach (except Cuban males), pancreatic (except Argentinian and Cuban males), lung, bladder (except Argentinian females), breast, and ovarian (except Cuba) cancers. Uterine cancer mortality, particularly from cervical cancer, remains highin Argentina (10.2/100 000) and Cuba (10.4/100 000). Except for uterine, stomach, and prostate cancers, cancer mortality rates are still relatively low in Latin America, except Cuba. Controlling tobacco particularly in Cuba, implementing organized cervical cancer screening, and advancing cancer treatment also for prostate cancer remain crucial in all countries considered.

Little is known about maternal occupational exposure to hydrocarbons and offspring cancer risk. We aimed to estimate childhood cancer risk associated with maternal exposure to aliphatic/alicyclic, aromatic, and chlorinated hydrocarbons, and methylene chloride, trichloroethylene, 1,1,1-trichloroethane, and toluene. In this case-control study, all cancer cases ( N  = 10 442) diagnosed at less than 20 years (born 1968-2016) in Denmark were matched to 261 050 cancer-free controls (25 : 1 matching ratio). Maternal exposure during pregnancy was determined from a job-exposure matrix. We performed unconditional logistic regression to estimate cancer risks from hydrocarbon exposures, adjusting for maternal age, maternal birthplace, and the child's birthplace. For medulloblastoma, we observed strong associations with maternal occupational exposure to chlorinated hydrocarbons [adjusted odds ratio (aOR): 2.33, 95% confidence interval (CI): 1.29-4.20] including the individual solvents: trichloroethylene (aOR: 1.76, 95% CI: 1.08-2.88) and methylene chloride (aOR: 1.62, 95% CI: 0.98-2.68). The risk of medulloblastoma also increased with maternal exposure to aliphatic/alicyclic hydrocarbons (aOR: 1.78, 95% CI: 0.99-3.20), aromatic hydrocarbons (aOR: 1.64, 95% CI: 0.93-2.89), and toluene (aOR: 1.83, 95% CI: 1.04-3.22). The risk of non-Hodgkin lymphoma (NHL) increased with exposure to chlorinated hydrocarbons (aOR: 1.95, 95% CI: 1.09-3.51). The strongest association with acute lymphoblastic leukemia (ALL) was observed for aromatic hydrocarbons (aOR: 1.35, 95% CI: 1.07-1.71). We saw increased risks in medulloblastoma, NHL, and ALL in offspring of mothers occupationally exposed to solvents in pregnancy over a span of 50 years in Denmark. We encourage maternal workplace safety measures that reduce exposures in pregnancy to improve children's health.

This study evaluated the overtreatment rate (defined as a histological finding of low-grade intraepithelial lesion or negative after cervical excisional procedures) associated with the 'see-and-treat' approach in patients undergoing cervical conization for citology-detected suspected high-grade cervical lesions. The 'see-and-treat' strategy consists of colposcopy and immediate excision without prior cervical biopsy when a high-grade lesion is suspected based on colposcopic impression. Secondary objectives were to compare this cohort with patients treated after histological confirmation of high-grade lesions and to identify clinical and epidemiological factors associated with increased overtreatment risk, to better select candidates for 'see-and-treat'. We conducted a retrospective monocentric cohort study on women over 25 years of age with high-grade cytology who underwent an excisional procedure with or without a previous cervical biopsy. Overtreatment was defined as histopathology showing cervical intraepithelial neoplasia grade 1 or negative findings. Of the 892 patients included, 643 underwent the 'see-and-treat' approach. The overall overtreatment rate in this group was 13.5%, and 6% among women with both high-grade cytology and high-grade colposcopic impression (high-concordance subgroup). The factors most strongly associated with overtreatment were low-grade or negative colposcopic impression [odds ratio (OR): 7.36] and nonvisible squamocolumnar junction (OR: 3.57). Menopause (OR: 4.5, P < 0.0001) and atypical squamous cells - cannot exclude HSIL cytology (OR: 2.97, P < 0.0001) also increased the risk, whereas human papillomavirus 16/18 positivity was associated with a lower risk ( P = 0.004). In the high-concordance subgroup, none of these factors showed significant correlation with overtreatment. The 'see-and-treat' approach appears particularly advantageous in cases with high-grade concordance, offering a low overtreatment rate and allowing the detection of 2.8% of invasive cancers that might have been missed by biopsy. Moreover, it significantly reduces the interval between colposcopy and treatment (29 vs. 68 days). These findings support the selective use of 'see-and-treat' in appropriately stratified patients.

Cancer survivors face an increased risk of second primaries, but adherence to cancer screening and prevention recommendations remains limited. Post-treatment follow-up visits represent teachable moments for health promotion, including prevention of second primary cancers. We assessed practices and perceptions of second cancer screening and prevention among French hospital-based oncology health care professionals. An anonymous online survey using Likert scale was conducted. Clustering identified three prevention activity profiles (low, intermediate, high), and multinomial logistic regression explored associated factors. The median declared promotion activity of the 415 respondents was 8 for mammographic screening ([interquartile range: 5-10), 7 (2-9) for cervical cancer screening, 5 (1-7) for colorectal screening, 9 (7-10) for smoking cessation, and 7 (5-9) for alcohol control. Seventy-five percent of respondents addressed obesity management if indicated. Perceived importance and feasibility of secondary prevention activities were high [9 (7-10) and 8 (6-10)]. A high prevention activity profile was associated with greater perceived importance of secondary prevention [odds ratio (OR) per one-point Likert-scale increase = 1.1, 95% confidence interval (CI): 1.04-1.2] and its feasibility (OR = 1.1, 95% CI: 1.06-1.14); and managing head and neck cancer patients (OR = 7.64, 95% CI 1.55-37.8). Lung and sarcoma specialists were less likely to be in the high prevention activity group. Hospital-based oncology health care professionals are aware of and engaged in second primary cancer prevention, though activity levels vary. Its generalization, organization, and development could improve cancer survivors' adherence to cancer prevention recommendations, and improve health impacts.

The objective of this study is to evaluate long-term cancer incidence and mortality trends in the Italian provinces of Milan and Lodi (2007-2021), with a specific focus on the impact of the COVID-19 pandemic in 2020. Data from the Milan Cancer Registry, covering 3.5 million inhabitants, were analyzed. Cancer cases were classified using International Classification of Diseases-O-3 and mortality data with International Classification of Diseases-10 codes. The age-standardized rates were then computed. Joinpoint regression estimated trends excluding 2020 to avoid distortions, including sensitivity analyses. Quality indicators were preliminarily assessed. Overall, 335 849 cases were registered (173 058 males; 162 791 females). Incidence declined among males [annual percent change (APC) -1.9%/year, 2007-2021], driven by prostate, lung, colorectal, and bladder cancers. Female incidence showed heterogeneous patterns, stabilizing and modestly decreasing in recent years (APC -0.6%/year, 2011-2021). Mortality declined steadily in both sexes (-1.9%/year in males; -2.1%/year in females). In 2020, incidence rates dropped sharply compared with 2019 (-19% males; -13% females), reflecting diagnostic delays and competing mortality, but returned to baseline in 2021. Increases were limited to thyroid and testicular cancers, which are largely linked to differences in diagnostic intensity and exposure differences. Cancer incidence decreased among males and stabilized or slightly declined among females, while mortality continued to decrease in both sexes. The abrupt 2020 reduction reflects pandemic disruptions but has a limited long-term effect. These findings confirm the crucial role of population-based cancer registries in monitoring trends and supporting health policy.

Laryngeal cancer remains a global health concern. Using Global Cancer Observatory (GLOBOCAN) 2022 data, we conducted a cross-sectional study, calculated age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) with the Segi-Doll standard, assessed human development index (HDI) correlations, and projected burden to 2050. In 2022, there were 189.2 thousand new cases and 103.4 thousand deaths worldwide; ASIR was 1.9/100 000 and ASMR 1.0/100 000. Males had higher burden than females (ASIR 3.5 vs. 0.5; ASMR 1.9 vs. 0.2 per 100 000). Medium-HDI countries had the highest ASIR (2.5/100 000) and ASMR (1.6/100 000), while lower-HDI countries experienced higher mortality burdens. South Central Asia, Eastern Asia, and Eastern Europe reported the highest cases and deaths, while the Caribbean had the highest ASIR (4.3/100 000) and ASMR (2.2/100 000). India and China had the highest cases and deaths, whereas Cuba reported the highest ASIR (8.3/100 000) and ASMR (4.0/100 000). Incidence peaked at ages 80-84 and mortality at greater than or equal to 5; Chad showed the youngest peak age. From 1990 to 2021, ASIR and ASMR declined overall but varied by gender and age. By 2050, 49.5% countries are projected to increases, especially in Asia and Africa, highlighting the need for targeted prevention strategies. Priority regions for intervention include South Central Asia, Eastern Asia, and Eastern Europe, with older males and populations in low-HDI countries being particularly vulnerable. Targeted strategies should consider local risk factors and healthcare accessibility.