Journal of Cancer Epidemiology最新文献

Background: Despite being one of the most preventable forms of cancer, cervical cancer remains an important public health problem, especially in developing countries. However, there is limited evidence regarding awareness and practice of screening for cervical cancer among women in resource-poor settings like Nepal. This study is aimed at assessing the awareness of cervical cancer, risk perception, and practice of Pap smear tests among adult women of Dhulikhel municipality of Kavreplanchowk district in Nepal. Methodology. A community-based cross-sectional study was conducted among 422 women (aged 18-45 years) residing across the Dhulikhel municipality of Nepal. Systematic random sampling method with face-to-face interviews was conducted to collect data. A descriptive analysis was performed to assess the sociodemographic characteristics of the participants. The chi-square test was used to determine the factors associated with risk perception and participants' demographic characteristics.

Results: The mean age (±SD) of the participants was 30.7 ± 7.9 years. This study found that around 55% and 38% of women had heard about cervical cancer and Pap smear test, respectively. Of those who had heard of the Pap test, only 37.6% had ever practiced the test. Similarly, 33.2% and 12.1% knew about the correct age group and time interval to perform the Pap test, respectively. Among those who had heard about cervical cancer, nearly 57% had positive perceptions toward cervical cancer. In addition, risk perception of cervical cancer was found to be associated with participant age, family type, and marital status.

Conclusion: The women had inadequate knowledge and practice of cervical cancer and Pap smear test. This study concluded the need for a context-specific and effective health awareness program to promote preventive measures for cervical cancer and enhance the practice of Pap smear test in the community.

Aim: The Auckland Advanced Breast Cancer Review (AABC) was a review of patients diagnosed with advanced inoperable/metastatic breast cancer (ABC) within the Auckland region of New Zealand, commissioned in response to a Breast Cancer Registry report (BCFNZR) that showed poor and inequitable survival outcomes. The review was aimed at assessing equity of care and identifying healthcare delivery gaps for patients with ABC in the Auckland region.

Method: In this retrospective study, patients living within the Auckland region, diagnosed with ABC between the 1st January 2013 to the 31st December 2015 were identified from the Breast Cancer Registry. Data censorship date was 30th January 2019 to allow a minimum of 3 years of follow-up. Demographic, diagnostic, treatment, and survival data were extracted from electronic records for statistical analysis.

Results: Of the 388 patients that met inclusion criteria for this study, median overall survival (medOS) was 18.9 months in the total population, with no difference between patients with de novo metastatic disease (dnMBC -18.9 m) and recurrent metastatic disease (rMBC -18.7 m). No statistically significant differences in medOS was found amongst Maori (16.2 m), Pacific People (17.3 m), and NZ European (18.9 m) or when patients were stratified according domicile district health board. Median number of lines of systemic treatment was two, with similar treatment exposure between ethnic groups.

Conclusion: While treatment uptake and survival outcomes were generally comparable across ethnicity and district health boards, dnMBC survival outcomes were considerably poorer than expected, earmarking this subset of patients with ABC for more in-depth research.

Introduction: Adult T-cell leukaemia/lymphoma (ATLL) is a rare and aggressive malignancy of mature T-cells. Limited epidemiological studies have shown that there is substantial variation in age at diagnosis and subtype distribution between different geographical regions. This is the first epidemiological study of ATLL in South Africa.

Methods: A national epidemiological study of ATLL in South Africa was performed. All new cases of ATLL from 2009 to 2019 were identified by laboratory database search in public and private health care sectors. Demographic and diagnostic data were obtained, and the cases were subtyped according to the Shimoyama classification.

Results: There were 31 patients with ATLL over the 10-year period, with an incidence of 0.06 per 100000 population. The male to female ratio was 1 : 1 and the median age at diagnosis was 37 years. Acute ATLL was the most commonly seen subtype in South Africa.

Conclusion: In this, the first epidemiological study of ATLL in South Africa, we demonstrate that ATLL is a rare disease, that acute ATLL is the most commonly diagnosed subtype, and that ATLL is likely under diagnosed. Patients present at a considerably younger age than the reported age in other nations.

Esophageal cancer is an aggressive, often deadly disease globally that represents a significant health problem in Tanzania. The WHO reported 604,100 new esophageal cancer cases worldwide during 2020 and 544,076 deaths (Sung, 2021; World Health Organization, 2020). In Eastern Africa, 16,137 cases and 15,188 deaths were related to this disease in 2020. Esophageal cancer is associated with various etiologic risk factors, and access to the disease treatment is a major barrier to survival. This study examined associations between the prevalence of four geographically stratified, population-level, etiologic risk factors (tobacco use, unprotected water use, solid fuel source use, and poverty), as well as two access-to-care predictors (persons per hospital and distance from residence to where esophageal cancer treatment occurs). Regional- and coarser-scale zonal incidence rates were calculated for 2006 through 2016 and evaluated for geographic differences in relation to risk factors and access to care predictors using Poisson regression. Differences in the geographic distribution of esophageal cancer were observed. Distance from the region of residence to the treatment center (Ocean Road Cancer Institute) was statistically associated with the geographic pattern of esophageal cancer incidence. Further research into etiologic risk factors, dietary practices, and nutrition is needed to better understand the associations with esophageal cancer in Tanzania and other parts of Eastern Africa.

Background: Estimation of survival requires follow-up of patients from diagnosis until death ensuring complete and good quality data. Many population-based cancer registries in low- and middle-income countries have difficulties linking registry data with regional or national vital statistics, increasing the chances of cases lost to follow-up. The impact of lost to follow-up cases on survival estimates from small population-based cancer registries (<500 cases) has been understudied, and bias could be larger than in larger registries.

Methods: We simulated scenarios based on idealized real data from three population-based cancer registries to assess the impact of loss to follow-up on 1-5-year overall and net survival for stomach, colon, and thyroid cancers-cancer types with very different prognosis. Multiple scenarios with varying of lost to follow-up proportions (1-20%) and sample sizes of (100-500 cases) were carried out. We investigated the impact of excluding versus censoring lost to follow-up cases; punctual and bootstrap confidence intervals for the average bias are presented.

Results: Censoring of lost to follow-up cases lead to overestimation of the overall survival, this effect was strongest for cancers with a poor prognosis and increased with follow-up time and higher proportion of lost to follow-up cases; these effects were slightly larger for net survival than overall survival. Excluding cases lost to follow-up did not generate a bias on survival estimates on average, but in individual cases, there were under- and overestimating survival. For gastric, colon, and thyroid cancer, relative bias on 5-year cancer survival with 1% of lost to follow-up varied between 6% and 125%, 2% and 40%, and 0.1% and 1.0%, respectively.

Conclusion: Estimation of cancer survival from small population-based registries must be interpreted with caution: even small proportions of censoring, or excluding lost to follow-up cases can inflate survival, making it hard to interpret comparison across regions or countries.

Purpose: This cohort study describes the differences in kidney cancer age-adjusted incidence and mortality rates between American Indians/Alaskan Natives (AI/ANs) and Whites in Oklahoma. Additionally, rates for the U.S. are updated to establish an epidemiological comparison between Oklahoma and the rest of the country.

Materials and methods: Kidney cancer age-adjusted incidence and mortality rates for Oklahoma were gathered using the Oklahoma Central Cancer Registry since 1999. National rates were obtained from the Center for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database between 1997 and 2017. Rate ratios were used to compare incidence and mortality rates for AI/ANs and Whites within Oklahoma as well as the entire country. Joinpoint regression models were created to illustrate trends in kidney cancer incidence and mortality.

Results: The age-adjusted incidence rate of kidney cancer in Oklahoma for AI/ANs and Whites was 32.3 and 15.8 per 100,000, respectively, for an incidence rate ratio of 2.04. The national incidence rate ratio was 0.89. The age-adjusted mortality rate in Oklahoma for AI/ANs and Whites was 9.78 and 4.98 per 100,000, respectively, for a mortality rate ratio of 1.98. Oklahomans, irrespective of race, fare worse in terms of kidney cancer mortality compared to the rest of the country.

Conclusions: In Oklahoma, AI/ANs are more likely than Whites to have a kidney cancer diagnosis. AI/ANs are twice as likely to die from kidney cancer than Whites in Oklahoma. AI/AN populations in certain states may benefit from kidney cancer early screening initiatives.