Journal of Cancer Epidemiology最新文献

Introduction: Head and neck tumors (HNT) are tumors that normally occur at the head and neck region of the body. Epidermal growth factor receptor (EGFR) has been found to be highly expressed in breast and other tumors; therefore, there is the need to investigate the level of EGFR expression among patients with head and neck tumors in Ghana.

Method: The level of EGFR expression was determined in head and neck tumor and control head and neck tissues with quantitative real-time PCR and immunohistochemistry analysis.

Results: The level of EGFR expressions was high in tumor tissues than in the control tissues. There was a significant difference of p value 0.025 among the ages >40 and ≤ 40 when the high and low level of EGFR was compared in the head and neck malignant tumor. The area under the curve for the high expression of EGFR among the malignant head and neck tumors was 0.901 with a specificity of 86.4%.

Conclusion: EGFR can serve as a prognostic marker in monitoring patients with HNT as well as a molecular therapeutic target.

Introduction: Breast cancer remains the most commonly diagnosed malignancy in women. It encompasses considerable heterogeneity in pathology, patient clinical characteristics, and outcome. This study describes factors associated with overall survival (OS) of breast cancer in an updated national database.

Methods: We conducted a retrospective analysis of patients with breast cancer diagnosed between 2004 and 2016 based on the National Cancer Database. Categorical variables were summarized using frequencies/percentages, whereas continuous variables were summarized using the median/interquartile range (IQR). OS was explored using the Kaplan-Meier method.

Results: Data from n = 2,671,549 patients were analyzed. The median age at diagnosis was 61 years (range 18-90). 75% were non-Hispanic (NH) White; 11% were NH-Black; 4.7% were Hispanic-White; 0.1% were Hispanic-Black; and 3.4% were Asian. Most cases (73%) presented with ductal carcinoma histology; while 15% with lobular carcinoma. Rarer subtypes included epithelial-myoepithelial, fibroepithelial, metaplastic, and mesenchymal tumors. OS was associated with molecular subtype, histologic subtype, and AJCC clinical staging. Survival also correlated with race: a cohort including Asians and Pacific Islanders had the best survival, while Black patients had the worst. Finally, facility type also impacted outcome: patients at academic centers had the best survival, while those at community cancer programs had the worst.

Conclusion: This large database provides a recent and comprehensive overview of breast cancer over 12 years. Molecular subtype, histologic subtype, stage, race, and facility type were correlated with OS. In addition to the educational perspective of this overview, significant factors impacting the outcome identified here should be considered in future cancer research on disparities.

Over the last three decades, the incidence of thyroid cancer has increased worldwide. The reasons for this increase remain controversial. In Algeria, however, to date, information on thyroid cancer has been limited to a hospital-based case series. We analyzed data from a population-based cohort study in Oran District, Algeria, to describe demographic and clinicopathological characteristics of patients diagnosed with thyroid cancer between 1993 and 2013. Medical records and pathology reports of thyroid cancer patients who had surgery were reviewed. Changes in demographic and clinicopathological features over the 21-year period are described. During the study period, thyroid cancer was diagnosed in 1248 women (86.5%, mean age 43.7 ± 15.2 years) and 195 men (23.4%, mean age 48.1 ± 15.9 years). Most cases (83.1% for women and 69.8% for men) sought a diagnosis following a self-neck check. The most common histologic types were papillary (58.3%), follicular (29.7%), anaplastic (4.1%), and medullary (0.8%) carcinomas. The incidence of papillary carcinomas significantly increased (p < 0.001) while the incidence of other histologic types significantly decreased over time. Tumor size overall significantly decreased (p < 0.001) while the frequency of small (≤20 mm) and larger (>20 mm) carcinomas significantly increased (p < 0.05). The frequency of thyroid cancers with capsular effractions and angioinvasions also decreased over time. Thyroid cancer incidence in Algeria has increased substantially in line with international trends with changes in clinical practice being a possible contributing factor. However, the increasing papillary-to-follicular cancer ratio may be due to changes in iodine nutrition status in Algeria. Further research, including exploration of biological and molecular features of thyroid cancer, will enable a better understanding of risk factors and etiopathogenetic mechanisms.

Background: Central nervous system (CNS) tumours account for only 1-2% of cancer incidence but are a major reason for mortality and morbidity due to malignancies. Recent studies show an increase in the rate of CNS tumours worldwide, especially in developing countries. Moreover, there is significant heterogeneity in epidemiological patterns worldwide. This study is aimed at representing nationwide epidemiology of CNS tumours in Iran.

Methods: Iran National Cancer Registry 2010-2014 data were reviewed for CNS tumours. The epidemiological rates were calculated for both genders and all age groups using the 2011 census information.

Results: Out of 17345 cases, 58.5% were men and 41.5% were women. The mean age was 45.55 years ranging from less than 1 month to 100 years old. Average total age-standardized incidence rate (ASR) was 5.19 for primary tumours. The annual percent change (APC) was 14.23% during the study period. The most frequent site and histology recorded were brain, NOS and diffuse astrocytic, respectively. Geographical distribution showed about five-fold difference in ASRs between different provinces.

Conclusion: The overall ASR calculated was higher than the global rate in 2012 but lower than that of most developed countries, showing an increasing trend which may be due to either advances in diagnosing or risk factor augmentation. The mean age and incident rates were higher than those of previous reports in Iran.

Background: A high mortality has been reported during the first ninety days of cancer therapy and is more pronounced in patients with febrile neutropenia. The Bugando Medical Center oncology department offers cancer diagnosis and treatment services to the population of the Lake Zone of Tanzania with limited data on the outcome within 90 days of therapy. Here, we report the 90-day mortality and factors associated with it among cancer patients attending the oncology department of the tertiary hospital in Tanzania. Methodology. Enrolled participants underwent baseline physical examinations, and their functional status was assessed using Karnofsky score. On each clinic visit, full blood picture was taken and patients were investigated for infections. Data were entered in the Microsoft Excel, cleaned and coded and then transferred to STATA version 13 for analysis.

Results: A total of 102 participants were included in the final analysis. Their median age was 50 years (38-60). The majority of the study participants were females 76 (75%), and 82 (80.4%) had primary school education. The majority of the patients had solid cancer 96 (94.1%). A total of 12 (11.8%) patients died within 90 days of starting therapy. Low hemoglobin level at the start of cancer therapy, Karnofsky score below 80%, and using 5-fluorouracil-containing therapy were statistically significantly found to be associated with mortality within 90 days of therapy among cancer patients.

Conclusion: One tenth of cancer patients at Bugando Medical Center do not survive within 90 days of therapy; the mortality is significantly high among anemic patients, with poor performance status, on 5-fluorouracil regimen, and diagnosed with head and neck cancer, necessitating close follow-up of these patients.

Background: Pancreatic cancer is one of the deadliest forms of cancer, with incidence rates rising in many countries around the world. Geographic variation in pancreatic cancer incidence has not been studied extensively, especially in low- and middle-income countries. The aim of this study was to characterize the distribution of pancreatic cancer incidence in the central Nile Delta region of Egypt and to examine differences by urban and rural patient residence using the nation's only population-based cancer registry.

Methods: Utilizing the Gharbiah province population-based cancer registry, data were abstracted for 1,089 pancreatic cancer cases diagnosed over twelve years from 1999 to 2010. Age- and sex-specific incidence rates were calculated and compared for urban and rural areas of the eight districts of Gharbiah.

Results: Age-adjusted incidence of pancreatic cancer within Gharbiah varied considerably by urban/rural patient residence and by district. Incidence rates were 1.3 times higher in urban compared to rural areas (4.45 per 100,000 in urban areas and 3.43 per 100,000 in rural areas). The highest incidence rates were observed in urban centers of Kotour, El Santa, and Kafr El-Zayat districts (12.94, 8.32, and 7.89, respectively).

Conclusion: Incidence rates varied greatly by urban and rural areas and by district of residence in the Nile Delta region of Egypt. Future studies should examine potential environmental risk factors that may contribute to the geographic distribution of pancreatic cancer in this region.

Background: Cervical cancer is the major cause of morbidity and mortality among women worldwide with an estimated 528,000 new cases and 266,000 deaths annually. In Ethiopia, there are 7095 new cases and 4732 deaths of cervical cancer every year. But cervical cancer screening utilization remains limited. Therefore, the aim of the study was to assess cervical cancer screening utilization and associated factors among women in the Shabadino district, Southern Ethiopia.

Methods: A community-based cross-sectional study was conducted in the Shabadino district, Southern Ethiopia, using a structured questionnaire. A systematic random sampling method was used to recruit 536 study participants. The collected data were entered and analyzed using SPSS version 22.0. Bivariate and multivariate logistic regressions were used to assess factors associated with cervical cancer screening utilization at a 95% level of significance and a p value of less than 0.05.

Results: The study revealed that among 506 women, only 52 (10.3%) have been screened for cervical cancer. Women who are educated (completed primary school and above) (AOR = 1.9; 95% CI = 1.18-3.05), who have a history of the presence of sexually transmitted diseases (AOR = 2.6; 95% CI = 1.26-5.23), who have multiple sexual partners (AOR = 4.0; 95% CI = 1.86-8.66), and who knew methods of cervical cancer prevention (AOR = 4.3; 95% CI = 1.18-13.05) were significantly associated with high cervical cancer screening utilization.

Conclusion: The magnitude of cervical cancer screening utilization among women was very low. Educational status, history of multiple sexual partners, history of sexually transmitted diseases, and knowing methods of prevention were significant factors of high cervical cancer screening utilization. Recommendation. It is very crucial to implement an appropriate awareness creation method. Additionally, the STI clinic should be linked to the cervical cancer screening service to increase the knowledge of cervical cancer prevention and the utilization of cervical cancer screening.

Background: The impact of the dose intensity administered in consolidation in Latin America is unknown. This study aimed to evaluate the relative dose intensity (RDI) in consolidation and its impact in overall survival.

Methods: A retrospective study of 86 patients with AML who were diagnosed between 2010 and 2016 with a 2-year follow-up in a fourth-level Colombian hospital was carried out. Clinical characteristics were reported, Kaplan-Meier was used for estimating the overall survival, and Cox regression was used for multivariate analysis.

Results: The median overall survival (OS) was 20.83 months, and the median event-free survival (EFS) was 16.83 months. 64.3% of the patients achieved remission after the 7 + 3 chemotherapy induction treatment. Patients under 30 years of age, with white blood cell counts less than 100.000 cells/mm3 who responded to induction treatment had a better OS. Additionally, patients receiving an RDI greater than 0.75 of the planned consolidation dose had better survival. The prognostic variables with impact in the OS were the leukocyte count in peripheral blood at diagnosis, the RDI in consolidation treatment with HIDAC and the response obtained after induction.

Conclusion: This retrospective study allowed us to know the epidemiology of AML in a reference Colombian Hospital. Additionally, in our knowledge, it is the first study that reports the RDI in consolidation with HIDAC in Latin America as a prognostic factor that directly impacts the OS.

Background: Cervical cancer is a major public health problem in many developing countries. Despite the value of screening to prevent morbidity and mortality from cervical cancer, little available literature shows early detection and treatment to be limited in Ethiopia. The aim of this study was to determine the magnitude of and identify factors associated with women's intention to screen for cervical cancer using the theory of planned behavior.

Methods: A community-based cross-sectional study design supplemented with a qualitative approach was employed. Using multistage sampling, a total of 821 women were used in the study. An interviewer-administered survey questionnaire was used to collect quantitative data, whereas purposively selected 12 female health care providers were included in in-depth interviews. Descriptive statistics and simple and multiple binary logistic regression analysis were used to determine the magnitude of women's intention, identify associated factors, and explore barriers for intention to cervical cancer screening among Debre Berhan women, Ethiopia. The statistical association was determined at a P value of less than 0.05. Moreover, thematic analysis was used to search the hindrances of women's intention to screen for cervical cancer.

Results: The median age of women who participated in this study was 39 years with IQR of 35 to 42 years. Three hundred sixty-one (361, 45.3%) of women had an intention to screen for cervical cancer within three months from the date of the interview. Positive attitude towards cervical cancer screening (AOR = 6.164; 95% CI: 4.048, 9.387), positive subjective norm (AOR = 2.001; 95% CI: 1.342, 2.982), and higher perceived behavioral control (AOR = 7.105; 95% CI: 4.671, 10.807) were predictors of the women's intention to screen for cervical cancer. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure pinch the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women's intention.

Conclusion: This study showed that women's intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women's intention to screen for cervical cancer. Thus, efforts should be exerted to improve the attitude of women involving influential people, which could improve women's intention for cervical cancer screening. Moreover, behavioral change communication focusing on the constructs of the theory of planned behavior is crucial.

Objectives: This study is aimed at describing the epidemiological trends of primary CNS tumors in children and adults at the National Neurologic Institute in Saudi Arabia.

Methods: A retrospective epidemiological approach was used where data was obtained from the department of pathology registry files and pathology reports. The records of all patients registered from January 2005 to December 2014 with a diagnosis of primary CNS tumor (brain and spinal cord) were selected. Data about sex, age, tumor location, and histologic type were collected. The classification was based on the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3).

Results: Nine hundred and ninety-two (992) cases of primary CNS tumors throughout the ten years (2005 to 2014) were reviewed. There were 714 (71.97%) adults and 278 (28.02%) in the pediatric age group. Nonmalignant tumors dominated the adult population (60.08%) while malignant tumors were more frequent in the pediatric population. Gliomas constituted the most common neoplastic category in children and adults. The most common single tumor entity was meningioma (26.99%, ICD-O-3 histology codes 9530/0, 9539/1, and 9530/3). Medulloblastomas (ICD-O-3 histology codes 9470, 9471, and 9474) were the most common single tumor entity in the pediatric age group (26.62%).

Conclusions: This is an institution-based, detailed, and descriptive epidemiological study of patients with primary CNS tumors in Saudi Arabia. In contrast to other regional and international studies, the medulloblastomas in our institution are more frequent than pilocytic astrocytomas. Limitations to our study included the referral bias and histology-based methodology.