Cancer Epidemiology最新文献

Comprehensive geriatric assessment and early treatment failure in nonagenarian patients with cancer, a retrospective monocentric study

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-26 DOI: 10.1016/j.canep.2025.102830

Aglaé Guerin , Zoé ap Thomas , Céline Nagera-Lazarovici , Geoffroy Beraud-Chaulet , Mariana Iacob , Florence Canoui-Poitrine , Elena Paillaud , Capucine Baldini , Arnaud Pagès , Maxime Frélaut

Background

The incidence of cancer among patients aged over 90 is increasing, but this population is poorly described in literature. This underrepresentation complicates decision-making for cancer treatments, despite the contribution of comprehensive geriatric assessment (CGA). This study aimed to describe early failure of specific anti-cancer treatments in a population of nonagenarians treated in a Comprehensive Cancer Center after undergoing a CGA.

Methods

This retrospective, monocentric cohort study included patients aged over 90 referred to an oncogeriatric team for CGA between 2019 and 2023, regardless of cancer type or planned treatment. The primary endpoint was the early treatment failure rate within 3 months of the initiation of treatment, defined as unplanned discontinuation, progression, or death.

Results

119 patients were included, with a median age of 91 years (range: 90–99 years), 53 % were men. The most common cancers were skin (30 %), head and neck (24 %), genito-urinary (12 %), and breast cancers (11 %). Most patients were independent for activities of daily living with a median ADL score of 6/6 and IADL score of 3/4. They had an average of 1.3 severe comorbidities. Half of them suffered from undernutrition. The geriatric oncology team recommended 53.8 % treatment modifications (94.5 % de-escalation). The most common treatments received were radiotherapy (27 %), surgery (18 %), hormonal therapy (10 %) and chemotherapy (9 %). A quarter of the patients received exclusive supportive care. Among patients receiving specific treatment, early failure occurred in 22.7 % (20/88). The 6-month survival probability from initiation of treatment was 69.2 % (95 % CI: 60.3 %, 76.8 %), varying significantly by treatment intent: 93.9 % (95 % CI: 80.4 %, 98.3 %) for curative treatments, 77.4 % (95 % CI: 64.5 %, 86.6 %) for palliative treatments, and 26.8 % (95 % CI: 14.3 %, 44.6 %) for exclusive supportive care.

Conclusion

In this population of nonagenarians, who benefit from a CGA to identify and manage patient frailties, anti-cancer treatments were carried out with few early treatment failures.

{"title":"Comprehensive geriatric assessment and early treatment failure in nonagenarian patients with cancer, a retrospective monocentric study","authors":"Aglaé Guerin , Zoé ap Thomas , Céline Nagera-Lazarovici , Geoffroy Beraud-Chaulet , Mariana Iacob , Florence Canoui-Poitrine , Elena Paillaud , Capucine Baldini , Arnaud Pagès , Maxime Frélaut","doi":"10.1016/j.canep.2025.102830","DOIUrl":"10.1016/j.canep.2025.102830","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of cancer among patients aged over 90 is increasing, but this population is poorly described in literature. This underrepresentation complicates decision-making for cancer treatments, despite the contribution of comprehensive geriatric assessment (CGA). This study aimed to describe early failure of specific anti-cancer treatments in a population of nonagenarians treated in a Comprehensive Cancer Center after undergoing a CGA.</div></div><div><h3>Methods</h3><div>This retrospective, monocentric cohort study included patients aged over 90 referred to an oncogeriatric team for CGA between 2019 and 2023, regardless of cancer type or planned treatment. The primary endpoint was the early treatment failure rate within 3 months of the initiation of treatment, defined as unplanned discontinuation, progression, or death.</div></div><div><h3>Results</h3><div>119 patients were included, with a median age of 91 years (range: 90–99 years), 53 % were men. The most common cancers were skin (30 %), head and neck (24 %), genito-urinary (12 %), and breast cancers (11 %). Most patients were independent for activities of daily living with a median ADL score of 6/6 and IADL score of 3/4. They had an average of 1.3 severe comorbidities. Half of them suffered from undernutrition. The geriatric oncology team recommended 53.8 % treatment modifications (94.5 % de-escalation). The most common treatments received were radiotherapy (27 %), surgery (18 %), hormonal therapy (10 %) and chemotherapy (9 %). A quarter of the patients received exclusive supportive care. Among patients receiving specific treatment, early failure occurred in 22.7 % (20/88). The 6-month survival probability from initiation of treatment was 69.2 % (95 % CI: 60.3 %, 76.8 %), varying significantly by treatment intent: 93.9 % (95 % CI: 80.4 %, 98.3 %) for curative treatments, 77.4 % (95 % CI: 64.5 %, 86.6 %) for palliative treatments, and 26.8 % (95 % CI: 14.3 %, 44.6 %) for exclusive supportive care.</div></div><div><h3>Conclusion</h3><div>In this population of nonagenarians, who benefit from a CGA to identify and manage patient frailties, anti-cancer treatments were carried out with few early treatment failures.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102830"},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exposure to per- and poly-fluoroalkyl substances and hematological cancer: A systematic review and meta-analysis

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-25 DOI: 10.1016/j.canep.2025.102831

Michele Sassano , Sirui Zhang , Elizabeth Maria Kappil , Tongzhang Zheng , Paolo Boffetta , Monireh Sadat Seyyedsalehi

Recent literature suggests that exposure to per- and polyfluoroalkyl substances (PFAS) may be associated with increased cancer risk. However, evidence regarding their association with hematological cancers is inconclusive. Hence, we aimed to summarize findings of epidemiological studies on the issue. We conducted a systematic review by searching Pubmed and Scopus in April 2025 to identify studies on the association between PFAS and cancer types other than liver, kidney, and testis. We pooled relative risks (RRs) and 95 % confidence intervals (CIs) for the association between PFAS exposure and hematological cancers with restricted maximum likelihood method. Fourteen studies were included in the review. We found pooled RRs of 1.04 (95 % CI: 0.98, 1.10; I²=12.0 %, p_het=0.332), 1.04 (95 % CI: 0.95, 1.14; I²=0.0 %, p_het=0.523), and 1.06 (95 % CI: 0.94, 1.19; I²=42.9 %, p_het=0.105) for the association between environmental or occupational PFAS exposure and total hematological cancer, leukemia, and lymphoma, respectively. As for types of lymphoma, environmental or occupational PFAS exposure was associated with incidence of non-Hodgkin lymphoma (RR: 1.15; 95 % CI: 1.01, 1.29; I²=0.0 %, p_het=0.579), while no association with its mortality or with Hodgkin lymphoma was observed. The RR for the association between high serum levels of perfluorooctanoic acid and total hematological cancer was 1.13 (95 % CI: 0.72, 1.75; I²=64.6 %%, p_het=0.023). Our results are suggestive of an association between PFAS exposure and non-Hodgkin lymphoma. Weak associations were also observed for total hematological cancer and leukemia among male individuals. Due to potential exposure misclassification in included studies, further evidence is needed to confirm our findings.

{"title":"Exposure to per- and poly-fluoroalkyl substances and hematological cancer: A systematic review and meta-analysis","authors":"Michele Sassano , Sirui Zhang , Elizabeth Maria Kappil , Tongzhang Zheng , Paolo Boffetta , Monireh Sadat Seyyedsalehi","doi":"10.1016/j.canep.2025.102831","DOIUrl":"10.1016/j.canep.2025.102831","url":null,"abstract":"<div><div>Recent literature suggests that exposure to per- and polyfluoroalkyl substances (PFAS) may be associated with increased cancer risk. However, evidence regarding their association with hematological cancers is inconclusive. Hence, we aimed to summarize findings of epidemiological studies on the issue. We conducted a systematic review by searching Pubmed and Scopus in April 2025 to identify studies on the association between PFAS and cancer types other than liver, kidney, and testis. We pooled relative risks (RRs) and 95 % confidence intervals (CIs) for the association between PFAS exposure and hematological cancers with restricted maximum likelihood method. Fourteen studies were included in the review. We found pooled RRs of 1.04 (95 % CI: 0.98, 1.10; I<sup>2</sup>=12.0 %, <em>p</em><sub>het</sub>=0.332), 1.04 (95 % CI: 0.95, 1.14; I<sup>2</sup>=0.0 %, <em>p</em><sub>het</sub>=0.523), and 1.06 (95 % CI: 0.94, 1.19; I<sup>2</sup>=42.9 %, <em>p</em><sub>het</sub>=0.105) for the association between environmental or occupational PFAS exposure and total hematological cancer, leukemia, and lymphoma, respectively. As for types of lymphoma, environmental or occupational PFAS exposure was associated with incidence of non-Hodgkin lymphoma (RR: 1.15; 95 % CI: 1.01, 1.29; I<sup>2</sup>=0.0 %, <em>p</em><sub>het</sub>=0.579), while no association with its mortality or with Hodgkin lymphoma was observed. The RR for the association between high serum levels of perfluorooctanoic acid and total hematological cancer was 1.13 (95 % CI: 0.72, 1.75; I<sup>2</sup>=64.6 %%, <em>p</em><sub>het</sub>=0.023). Our results are suggestive of an association between PFAS exposure and non-Hodgkin lymphoma. Weak associations were also observed for total hematological cancer and leukemia among male individuals. Due to potential exposure misclassification in included studies, further evidence is needed to confirm our findings.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102831"},"PeriodicalIF":2.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiology of carcinomatosis 癌肿流行病学

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-24 DOI: 10.1016/j.canep.2025.102815

Kyle A. Mani , Jun Lu , Eric J. Lehrer , Ming Wang , Lauren E. Henke , Richard S. Hoehn , Nicholas G. Zaorsky

Background

Carcinomatosis is an advanced form of metastatic cancer, which has been thought to be an invariantly fatal disease. We characterized prognostic factors for overall survival (OS) in patients with de-novo carcinomatosis.

Methods

Patients were identified from the SEER database from 1/1/2016–12/31/2020. Kaplan–Meier method and log-rank test were used to evaluate OS and a Cox proportional hazards model was used to calculate adjusted hazard ratios (aHR) with 95 % confidence intervals (CIs).

We included patients with carcinomatosis across 30 primary sites. The most common primary tumors were colorectal, pancreas, ovary, and lung & bronchus, and stomach.

Results

Among newly diagnosed cancer patients in SEER, a total of 3131 (59.7 % female, 80.1 % White) patients with carcinomatosis were identified, corresponding to an incidence of 9.0 per 1000,000 persons. Of all patients with metastatic disease, only 0.17 % were diagnosed with carcinomatosis. Compared to patients with de novo metastatic disease without carcinomatosis (i.e., those with metastases limited to the brain, bone, liver, or lung), patients with carcinomatosis were associated with over twice the risk of mortality (aHR = 2.3, 95 % CI: 2.2–2.5). The 1-year OS for patients with carcinomatosis was 35.8 % (95 % CI: 34.0 %–37.7 %). The most common primary sites included: colorectal (14.8 %), pancreas (14.8 %), ovary (9.8 %), and lung & bronchus (8.9 %). Patients with appendiceal (1-year OS: 88.2 %, 95 % CI: 81.8 %–95.1 %) and ovarian (1-year OS: 58.7 %, 95 % CI: 53.0 %–65.0 %) carcinomatosis had markedly longer survival compared to patients with carcinomatosis from other primary sites. Patients who were at highest risk of death are more likely to be older; male; Black; have more advanced T and N categories; and/or have synchronous metastases (P < .001).

Conclusions

Carcinomatosis is associated with poorer OS compared to other forms of metastases. Patients with ovarian and appendiceal tumors have markedly longer survival.

{"title":"Epidemiology of carcinomatosis","authors":"Kyle A. Mani , Jun Lu , Eric J. Lehrer , Ming Wang , Lauren E. Henke , Richard S. Hoehn , Nicholas G. Zaorsky","doi":"10.1016/j.canep.2025.102815","DOIUrl":"10.1016/j.canep.2025.102815","url":null,"abstract":"<div><h3>Background</h3><div>Carcinomatosis is an advanced form of metastatic cancer, which has been thought to be an invariantly fatal disease. We characterized prognostic factors for overall survival (OS) in patients with de-novo carcinomatosis.</div></div><div><h3>Methods</h3><div>Patients were identified from the SEER database from 1/1/2016–12/31/2020. Kaplan–Meier method and log-rank test were used to evaluate OS and a Cox proportional hazards model was used to calculate adjusted hazard ratios (aHR) with 95 % confidence intervals (CIs).</div><div>We included patients with carcinomatosis across 30 primary sites. The most common primary tumors were colorectal, pancreas, ovary, and lung & bronchus, and stomach.</div></div><div><h3>Results</h3><div>Among newly diagnosed cancer patients in SEER, a total of 3131 (59.7 % female, 80.1 % White) patients with carcinomatosis were identified, corresponding to an incidence of 9.0 per 1000,000 persons. Of all patients with metastatic disease, only 0.17 % were diagnosed with carcinomatosis. Compared to patients with de novo metastatic disease without carcinomatosis (i.e., those with metastases limited to the brain, bone, liver, or lung), patients with carcinomatosis were associated with over twice the risk of mortality (aHR = 2.3, 95 % CI: 2.2–2.5). The 1-year OS for patients with carcinomatosis was 35.8 % (95 % CI: 34.0 %–37.7 %). The most common primary sites included: colorectal (14.8 %), pancreas (14.8 %), ovary (9.8 %), and lung & bronchus (8.9 %). Patients with appendiceal (1-year OS: 88.2 %, 95 % CI: 81.8 %–95.1 %) and ovarian (1-year OS: 58.7 %, 95 % CI: 53.0 %–65.0 %) carcinomatosis had markedly longer survival compared to patients with carcinomatosis from other primary sites. Patients who were at highest risk of death are more likely to be older; male; Black; have more advanced T and N categories; and/or have synchronous metastases (<em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>Carcinomatosis is associated with poorer OS compared to other forms of metastases. Patients with ovarian and appendiceal tumors have markedly longer survival.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102815"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Individuals from culturally and linguistically diverse backgrounds have more advanced prostate cancer at diagnosis in Victoria, Australia

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-23 DOI: 10.1016/j.canep.2025.102827

Koku Sisay Tamirat , Michael James Leach , Nathan Papa , Jeremy Millar , Eli Ristevski

Introduction

The Australian Cancer Plan prioritises individuals from culturally and linguistically diverse (CALD) backgrounds as a focus of interventions aimed at improving cancer care experiences and outcomes. We aimed to investigate differences in the National Comprehensive Cancer Network (NCCN) risk category classification at prostate cancer (PCa) diagnosis between CALD and non-CALD populations.

Methods

We included Victorian Prostate Cancer Outcomes Registry registrants with a PCa diagnosis (February 2009-August 2022) and country-of-birth data. CALD status was defined as birth in a mainly non-English-speaking country (CALD) versus Australia or a mainly English-speaking country (MESC). CALD individuals were further sub-grouped by preferred spoken language: English-speaking and non-English-speaking. We estimated the effect of CALD status on NCCN risk categories using partial proportional ordinal logistic regression.

Results

There were 25,951 individuals: 18,392 (71 %) Australian-born, 5046 (19 %) CALD and 2513 (10 %) MESC-born. Of 4872 CALD individuals with preferred-language data, 498 (10 %) preferred speaking a language other than English. Compared to Australian-born individuals, non-English-speaking CALD individuals presented with less low-risk (15 % vs 22 %) but more high-risk (32 % vs 21 %) and metastatic (18 % vs 8 %) disease. CALD individuals had significantly more advanced (regional or metastatic) disease than Australian-born individuals (adjusted odds ratio [aOR]=1.17, 95 % confidence interval [CI]=1.06–1.29). Non-English-speaking CALD individuals had significantly more advanced PCa (aOR=1.54, 95 % CI=1.23–1.94).

Conclusions

Individuals from CALD backgrounds had greater odds of presenting with high-risk or advanced PCa. Improving early detection of PCa for CALD individuals requires investigation of underlying factors to plan effective interventions.

{"title":"Individuals from culturally and linguistically diverse backgrounds have more advanced prostate cancer at diagnosis in Victoria, Australia","authors":"Koku Sisay Tamirat , Michael James Leach , Nathan Papa , Jeremy Millar , Eli Ristevski","doi":"10.1016/j.canep.2025.102827","DOIUrl":"10.1016/j.canep.2025.102827","url":null,"abstract":"<div><h3>Introduction</h3><div>The Australian Cancer Plan prioritises individuals from culturally and linguistically diverse (CALD) backgrounds as a focus of interventions aimed at improving cancer care experiences and outcomes. We aimed to investigate differences in the National Comprehensive Cancer Network (NCCN) risk category classification at prostate cancer (PCa) diagnosis between CALD and non-CALD populations.</div></div><div><h3>Methods</h3><div>We included Victorian Prostate Cancer Outcomes Registry registrants with a PCa diagnosis (February 2009-August 2022) and country-of-birth data. CALD status was defined as birth in a mainly non-English-speaking country (CALD) versus Australia or a mainly English-speaking country (MESC). CALD individuals were further sub-grouped by preferred spoken language: English-speaking and non-English-speaking. We estimated the effect of CALD status on NCCN risk categories using partial proportional ordinal logistic regression.</div></div><div><h3>Results</h3><div>There were 25,951 individuals: 18,392 (71 %) Australian-born, 5046 (19 %) CALD and 2513 (10 %) MESC-born. Of 4872 CALD individuals with preferred-language data, 498 (10 %) preferred speaking a language other than English. Compared to Australian-born individuals, non-English-speaking CALD individuals presented with less low-risk (15 % vs 22 %) but more high-risk (32 % vs 21 %) and metastatic (18 % vs 8 %) disease. CALD individuals had significantly more advanced (regional or metastatic) disease than Australian-born individuals (adjusted odds ratio [aOR]=1.17, 95 % confidence interval [CI]=1.06–1.29). Non-English-speaking CALD individuals had significantly more advanced PCa (aOR=1.54, 95 % CI=1.23–1.94).</div></div><div><h3>Conclusions</h3><div>Individuals from CALD backgrounds had greater odds of presenting with high-risk or advanced PCa. Improving early detection of PCa for CALD individuals requires investigation of underlying factors to plan effective interventions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102827"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maximal weight change during adulthood and breast cancer risk: A 14-year follow-up of the Guangzhou Biobank Cohort Study

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-23 DOI: 10.1016/j.canep.2025.102825

Xiao Yi Lin , Jiao Wang , Wei Sen Zhang , Chao Qiang Jiang , Ya Li Jin , Kar Keung Cheng , Tai Hing Lam , Lin Xu

Background

Obesity is a risk factor for breast cancer (BC) after menopause, but the association of weight fluctuation during adulthood with BC risk remains unknown.

Methods

A total of 20,056 female participants aged 50 years or older from the Guangzhou Biobank Cohort Study (2003–2008) were followed up until 2020 through linkage with the cancer registry. At baseline, maximal weight change was defined as the difference between the highest and lowest weight since age 18. Cox proportional hazards regression was used, adjusting for potential confounders.

Results

During an average follow-up of 14.2 years, 326 BC cases were identified. A maximal weight gain of 5 kg or more since age 18 was associated with a higher BC risk, compared to a weight change of less than 5 kg (adjusted hazard ratio [adHR] 1.36, 95 % confidence interval [CI] 1.02–1.81; P = 0.03). Among participants who gained 5 kg or more, each additional kilogram was associated with a 2 % higher BC risk (adHR 1.02 per 1 kg, 95 % CI 1.00–1.04; P = 0.02). Similar patterns were found in women who reached the highest weight before the age of 50 (adHR 1.06 per 1 kg, 95 % CI 1.03–1.08; P < 0.001). Additionally, a 1-kg increase in weight was associated with a 10 % (95 % CI 1.05–1.16; P < 0.001) higher risk of BC in women who weighed more than peers at age 20.

Conclusions

These findings suggest that preventing excessive weight gain in adulthood, particularly among women who reached their highest weight before 50 years of age and who were heavier than peers at age 20, may reduce BC risk. Weight management should be emphasized, both at the highest and earliest adult years, in mitigating BC risk.

{"title":"Maximal weight change during adulthood and breast cancer risk: A 14-year follow-up of the Guangzhou Biobank Cohort Study","authors":"Xiao Yi Lin , Jiao Wang , Wei Sen Zhang , Chao Qiang Jiang , Ya Li Jin , Kar Keung Cheng , Tai Hing Lam , Lin Xu","doi":"10.1016/j.canep.2025.102825","DOIUrl":"10.1016/j.canep.2025.102825","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a risk factor for breast cancer (BC) after menopause, but the association of weight fluctuation during adulthood with BC risk remains unknown.</div></div><div><h3>Methods</h3><div>A total of 20,056 female participants aged 50 years or older from the Guangzhou Biobank Cohort Study (2003–2008) were followed up until 2020 through linkage with the cancer registry. At baseline, maximal weight change was defined as the difference between the highest and lowest weight since age 18. Cox proportional hazards regression was used, adjusting for potential confounders.</div></div><div><h3>Results</h3><div>During an average follow-up of 14.2 years, 326 BC cases were identified. A maximal weight gain of 5 kg or more since age 18 was associated with a higher BC risk, compared to a weight change of less than 5 kg (adjusted hazard ratio [adHR] 1.36, 95 % confidence interval [CI] 1.02–1.81; <em>P</em> = 0.03). Among participants who gained 5 kg or more, each additional kilogram was associated with a 2 % higher BC risk (adHR 1.02 per 1 kg, 95 % CI 1.00–1.04; <em>P</em> = 0.02). Similar patterns were found in women who reached the highest weight before the age of 50 (adHR 1.06 per 1 kg, 95 % CI 1.03–1.08; <em>P</em> < 0.001). Additionally, a 1-kg increase in weight was associated with a 10 % (95 % CI 1.05–1.16; <em>P</em> < 0.001) higher risk of BC in women who weighed more than peers at age 20.</div></div><div><h3>Conclusions</h3><div>These findings suggest that preventing excessive weight gain in adulthood, particularly among women who reached their highest weight before 50 years of age and who were heavier than peers at age 20, may reduce BC risk. Weight management should be emphasized, both at the highest and earliest adult years, in mitigating BC risk.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102825"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indirect adjustment of tobacco smoking in occupational studies of lung cancer: A systematic review of the available methods and their applications

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-22 DOI: 10.1016/j.canep.2025.102820

Behzad Heibati , Jo S. Stenehjem , Elisabeta Pletea , Michelle C. Turner , Eva S. Schernhammer , Damien M. McElvenny , Tom Loney , Kurt Straif , Irina Guseva Canu

Tobacco smoking is an important risk factor and potentially a major confounding factor in occupational lung cancer studies. However, as individual information on tobacco smoking is often not available, indirect adjustment methods may be used to account for potential confounding from smoking. Therefore, we aimed at providing an overview of the available indirect adjustment methods for smoking in studies of occupational exposures and lung cancer risk. We conducted a systematic search of relevant studies that applied statistical methods for indirect adjustment of tobacco smoking and were published between 1-Jan-2000 and 2-Apr-2025 to capture developments in recent decades. Studies were retrieved from Embase, MEDLINE, and Web of Science. Fifteen studies fulfilled our inclusion criteria and were included. We grouped the studies into four methods of indirect smoking adjustment: (1) without distributions for adjusted data; (2) distributions for adjusted data; (3) negative control outcomes; (4) factor analysis models. For studies with an external comparison group, percentage change in estimates from before to after indirect adjustment ranged −36.1 %_to_+ 17.3 %, while the corresponding range for those with internal comparison was −16.2 %_to_+ 47.8 %. The choice of indirect adjustment method depends on the use of reference group (external vs. internal) and the data available. Adjustment methods 1 and 2 use partial cohort data or ancillary data from other similar workers and may be preferable over methods 3 and 4, if such data are available. Methods 3 and 4 may be well suited if such data are lacking but have stronger assumptions.

{"title":"Indirect adjustment of tobacco smoking in occupational studies of lung cancer: A systematic review of the available methods and their applications","authors":"Behzad Heibati , Jo S. Stenehjem , Elisabeta Pletea , Michelle C. Turner , Eva S. Schernhammer , Damien M. McElvenny , Tom Loney , Kurt Straif , Irina Guseva Canu","doi":"10.1016/j.canep.2025.102820","DOIUrl":"10.1016/j.canep.2025.102820","url":null,"abstract":"<div><div>Tobacco smoking is an important risk factor and potentially a major confounding factor in occupational lung cancer studies. However, as individual information on tobacco smoking is often not available, indirect adjustment methods may be used to account for potential confounding from smoking. Therefore, we aimed at providing an overview of the available indirect adjustment methods for smoking in studies of occupational exposures and lung cancer risk. We conducted a systematic search of relevant studies that applied statistical methods for indirect adjustment of tobacco smoking and were published between 1-Jan-2000 and 2-Apr-2025 to capture developments in recent decades. Studies were retrieved from Embase, MEDLINE, and Web of Science. Fifteen studies fulfilled our inclusion criteria and were included. We grouped the studies into four methods of indirect smoking adjustment: (1) without distributions for adjusted data; (2) distributions for adjusted data; (3) negative control outcomes; (4) factor analysis models. For studies with an external comparison group, percentage change in estimates from before to after indirect adjustment ranged −36.1 %_to_+ 17.3 %, while the corresponding range for those with internal comparison was −16.2 %_to_+ 47.8 %. The choice of indirect adjustment method depends on the use of reference group (external vs. internal) and the data available. Adjustment methods 1 and 2 use partial cohort data or ancillary data from other similar workers and may be preferable over methods 3 and 4, if such data are available. Methods 3 and 4 may be well suited if such data are lacking but have stronger assumptions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102820"},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical outcomes by breast cancers diagnostic modes: A comprehensive evaluation of a national breast cancer screening programme

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-22 DOI: 10.1016/j.canep.2025.102821

Quentin Rollet , Isabelle Robert , Sophie Couffignal , Fanny Lorin , Yaiza Rivero , Claudine Backes

Introduction

Breast cancer is the leading cause of diagnosis and cancer-related death among women in almost every country worldwide. To reduce and to control breast cancer mortality, Luxembourg implemented the Programme Mammographie, a population-based organised programme in 1992. We aimed to compare the clinical and screening characteristics of breast cancers diagnosed in Luxembourg’s eligible screening population by detection modes.

Methods

1618 women aged 50–71 diagnosed with a first breast cancer between 2013 and 2018 were included from Luxembourg National Cancer Registry (Registre National du Cancer, RNC). The detection mode (screen-detected, interval-detected, and diagnosis-detected) is determined by linking RNC data with 144,270 participations in the Programme Mammographie between 2011 and 2018.

Results

Screen-detected breast cancers were diagnosed at younger ages, more often found in situ, at a lower stage at diagnosis, smaller, showed less lymph node invasion, and were more frequently treated with conservative surgery than diagnosis-detected. Interval-detected cases had the lowest proportion of in situ cancers and displayed distinct molecular subtypes usually considered as more aggressive. Cancers found after the initial round of participation had worse prognosis than those found after subsequent rounds. Interval cancers diagnosed during the second year had worse prognosis than those diagnosed in the first year after participation. The best prognosis was identified in screen-detected cases whose participation was on time regarding the penultimate, and the worst in diagnosis-detected with no participation over the period.

Conclusions

Regular participation in the Programme Mammographie is associated with earlier detection and less advanced forms of breast cancer at diagnosis. However, healthier behaviors among screening participants might also contribute to these outcomes. The indicators produced supports public health policies to further increase its level of effectiveness.

{"title":"Clinical outcomes by breast cancers diagnostic modes: A comprehensive evaluation of a national breast cancer screening programme","authors":"Quentin Rollet , Isabelle Robert , Sophie Couffignal , Fanny Lorin , Yaiza Rivero , Claudine Backes","doi":"10.1016/j.canep.2025.102821","DOIUrl":"10.1016/j.canep.2025.102821","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer is the leading cause of diagnosis and cancer-related death among women in almost every country worldwide. To reduce and to control breast cancer mortality, Luxembourg implemented the <em>Programme Mammographie</em>, a population-based organised programme in 1992. We aimed to compare the clinical and screening characteristics of breast cancers diagnosed in Luxembourg’s eligible screening population by detection modes.</div></div><div><h3>Methods</h3><div>1618 women aged 50–71 diagnosed with a first breast cancer between 2013 and 2018 were included from Luxembourg National Cancer Registry (<em>Registre National du Cancer, RNC)</em>. The detection mode (screen-detected, interval-detected, and diagnosis-detected) is determined by linking RNC data with 144,270 participations in the <em>Programme Mammographie</em> between 2011 and 2018.</div></div><div><h3>Results</h3><div>Screen-detected breast cancers were diagnosed at younger ages, more often found <em>in situ</em>, at a lower stage at diagnosis, smaller, showed less lymph node invasion, and were more frequently treated with conservative surgery than diagnosis-detected. Interval-detected cases had the lowest proportion of <em>in situ</em> cancers and displayed distinct molecular subtypes usually considered as more aggressive. Cancers found after the initial round of participation had worse prognosis than those found after subsequent rounds. Interval cancers diagnosed during the second year had worse prognosis than those diagnosed in the first year after participation. The best prognosis was identified in screen-detected cases whose participation was on time regarding the penultimate, and the worst in diagnosis-detected with no participation over the period.</div></div><div><h3>Conclusions</h3><div>Regular participation in the <em>Programme Mammographie</em> is associated with earlier detection and less advanced forms of breast cancer at diagnosis. However, healthier behaviors among screening participants might also contribute to these outcomes. The indicators produced supports public health policies to further increase its level of effectiveness.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102821"},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identifying environmental factors and biological metrics associated with cancer prevalence and mortality: An environment-wide association study 确定与癌症发病率和死亡率相关的环境因素和生物指标：全环境关联研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-21 DOI: 10.1016/j.canep.2025.102828

Zongyuan Li , Cheng Yu , Jianqi Hao , Yueli Shu , Jian Zhang , Kejia Zhao , Qiang Pu , Lunxu Liu

Background

Present knowledge about determinants of oncogenesis and cancer mortality remains incomplete, inconsistent, and controversial. We aimed to conduct an environment-wide association study (EWAS) to systematically investigate and tentatively validate correlations of environmental factors and biological metrics with prevalence and mortality of cancer.

Methods

All eligible participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and randomly split into training and testing sets by survey years. Environmental and biological exposures were assessed through either physical examinations or laboratory tests. We conducted survey-weighted logistic regression and COX proportional hazards regression models to investigate the relationships of 398 factors with cancer prevalence and 380 factors with cancer mortality, respectively. To adjust for multiple comparisons, positive findings in the training set (false discovery rate [FDR] < 5 %) were tentatively validated in the testing set (P value < 0.05). Random forest models were further fitted to evaluate the importance and diagnostic value of identified factors in relation to cancer prevalence.

Results

Overall, 55,021 general participants and 5163 cancer survivors were included in the study of cancer prevalence and mortality, respectively. After adjusting potential confounders, we identified 7 environmental or biological factors (e.g. total bilirubin, testosterone, and beta-cryptoxanthin) associated with cancer prevalence in the general population, as well as 21, 8, and 6 indicators associated with all-cause (e.g. C-reactive protein), cancer-specific (e.g. blood selenium), and noncancer mortality (e.g. albumin) among individuals with cancer, respectively. EWAS-identified factors contributed to better performance of random forest models in predicting cancer prevalence.

Conclusions

Employing an EWAS approach, this study provided novel insights into potential targets for prevention and control of cancer.

{"title":"Identifying environmental factors and biological metrics associated with cancer prevalence and mortality: An environment-wide association study","authors":"Zongyuan Li , Cheng Yu , Jianqi Hao , Yueli Shu , Jian Zhang , Kejia Zhao , Qiang Pu , Lunxu Liu","doi":"10.1016/j.canep.2025.102828","DOIUrl":"10.1016/j.canep.2025.102828","url":null,"abstract":"<div><h3>Background</h3><div>Present knowledge about determinants of oncogenesis and cancer mortality remains incomplete, inconsistent, and controversial. We aimed to conduct an environment-wide association study (EWAS) to systematically investigate and tentatively validate correlations of environmental factors and biological metrics with prevalence and mortality of cancer.</div></div><div><h3>Methods</h3><div>All eligible participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and randomly split into training and testing sets by survey years. Environmental and biological exposures were assessed through either physical examinations or laboratory tests. We conducted survey-weighted logistic regression and COX proportional hazards regression models to investigate the relationships of 398 factors with cancer prevalence and 380 factors with cancer mortality, respectively. To adjust for multiple comparisons, positive findings in the training set (false discovery rate [FDR] < 5 %) were tentatively validated in the testing set (P value < 0.05). Random forest models were further fitted to evaluate the importance and diagnostic value of identified factors in relation to cancer prevalence.</div></div><div><h3>Results</h3><div>Overall, 55,021 general participants and 5163 cancer survivors were included in the study of cancer prevalence and mortality, respectively. After adjusting potential confounders, we identified 7 environmental or biological factors (e.g. total bilirubin, testosterone, and beta-cryptoxanthin) associated with cancer prevalence in the general population, as well as 21, 8, and 6 indicators associated with all-cause (e.g. C-reactive protein), cancer-specific (e.g. blood selenium), and noncancer mortality (e.g. albumin) among individuals with cancer, respectively. EWAS-identified factors contributed to better performance of random forest models in predicting cancer prevalence.</div></div><div><h3>Conclusions</h3><div>Employing an EWAS approach, this study provided novel insights into potential targets for prevention and control of cancer.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102828"},"PeriodicalIF":2.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leukemia epidemiology and burden of disease in South Africa: 2015–2019

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-21 DOI: 10.1016/j.canep.2025.102818

Rochelle Woudberg , Sarah Muriel Meiring , Edina Sinanovic

Background

Leukemia ranks as the 11th most prevalent cancer globally, contributing significantly to the cancer burden. Despite its rising impact, recent epidemiological data on leukemia in South Africa remain limited. This study investigates the incidence, mortality trends, and disease burden of leukemia in South Africa from 2015 to 2019.

Methods

Leukemia incidence data were obtained from the South African National Cancer Registry, and mortality data from Statistics South Africa for 2015–2019. Age-standardized incidence and mortality rates were calculated using mid-year population data and the Segi world standard population for standardization. The burden of disease was quantified using Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs). Rates were compared by age, sex, year, and province.

Results

There were 2 001 new cases of leukemia and 1 244 deaths reported, with an incidence rate of 4.11 per 100,000 and mortality rate of 3.01 per 100,000 population. The male-to-female ratio was 1.1:1 and the mean age was 38 years at diagnosis and 53 at death. Acute myeloid leukemia was the most common type of leukemia in South Africa. Gauteng had the highest age standardized incidence rate (4.92 per 100,000), and the Western Cape had the highest age standardized mortality rate (3.98 per 100,000). In 2019, leukemia accounted for 6 309 DALYs, with a decline in age standardized DALY (-1.04 %) and YLL (-4.7 %) rate, respectively.

Conclusion

This study provides up-to-date incidence and mortality data, expressing the burden of leukemia in South Africa. The age-standardized mortality and DALY rates showed favorable patterns over the study period. However, the incidence rates showed an increase, which may reflect the progressive aging and growth of the population. These findings highlight the need for sustained efforts to improve leukemia detection, treatment access, and healthcare quality in South Africa.

{"title":"Leukemia epidemiology and burden of disease in South Africa: 2015–2019","authors":"Rochelle Woudberg , Sarah Muriel Meiring , Edina Sinanovic","doi":"10.1016/j.canep.2025.102818","DOIUrl":"10.1016/j.canep.2025.102818","url":null,"abstract":"<div><h3>Background</h3><div>Leukemia ranks as the 11th most prevalent cancer globally, contributing significantly to the cancer burden. Despite its rising impact, recent epidemiological data on leukemia in South Africa remain limited. This study investigates the incidence, mortality trends, and disease burden of leukemia in South Africa from 2015 to 2019.</div></div><div><h3>Methods</h3><div>Leukemia incidence data were obtained from the South African National Cancer Registry, and mortality data from Statistics South Africa for 2015–2019. Age-standardized incidence and mortality rates were calculated using mid-year population data and the Segi world standard population for standardization. The burden of disease was quantified using Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs). Rates were compared by age, sex, year, and province.</div></div><div><h3>Results</h3><div>There were 2 001 new cases of leukemia and 1 244 deaths reported, with an incidence rate of 4.11 per 100,000 and mortality rate of 3.01 per 100,000 population. The male-to-female ratio was 1.1:1 and the mean age was 38 years at diagnosis and 53 at death. Acute myeloid leukemia was the most common type of leukemia in South Africa. Gauteng had the highest age standardized incidence rate (4.92 per 100,000), and the Western Cape had the highest age standardized mortality rate (3.98 per 100,000). In 2019, leukemia accounted for 6 309 DALYs, with a decline in age standardized DALY (-1.04 %) and YLL (-4.7 %) rate, respectively.</div></div><div><h3>Conclusion</h3><div>This study provides up-to-date incidence and mortality data, expressing the burden of leukemia in South Africa. The age-standardized mortality and DALY rates showed favorable patterns over the study period. However, the incidence rates showed an increase, which may reflect the progressive aging and growth of the population. These findings highlight the need for sustained efforts to improve leukemia detection, treatment access, and healthcare quality in South Africa.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102818"},"PeriodicalIF":2.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-04-18 DOI: 10.1016/j.canep.2025.102826

Shaopan Cao , Mehran Asad Ayoubi

Background

Our aim was to compare risk of synchronous and metachronous hepatobiliary second primary malignancies (SPMs) in survivors of human papillomavirus (HPV)-related [i.e., p16(+)] and HPV-unrelated [i.e., p16(-)] oropharyngeal cancer (OPC).

Methods

A retrospective study was conducted for cases with OPC diagnosis during years 2018–2021 who had known p16 status using data of USA from Surveillance, Epidemiology, and End Results (SEER) Program [Incidence - SEER Research Limited-Field Data, 22 Registries (excl IL and MA), Nov 2023 Sub (2000–2021)]. In the statistical analyses, death was considered as a competing event for the development of a hepatobiliary SPM. Bias due to unbalanced baseline characteristics was eliminated by adjustments using propensity score and inverse probability of treatment weighting (IPTW). Risk of development of a hepatobiliary SPM was assessed using propensity-score-adjusted time-varying Cox proportional hazard regression [adjusted hazard ratio (aHR) with 95 % confidence interval (95 % CI)].

Results

Overall, 25759 cases with tumor status of p16(-) (6353) and p16(+) (19406) with median (interquartile range) follow-up times of 14 (6, 26) and 20 (9, 32) months, respectively, were included. From these, 48 had a hepatobiliary SPM. Compared to HPV-related OPC, HPV-unrelated OPC had significantly elevated risk of synchronous all hepatobiliary SPMs [aHR= 2.39 (95 % CI, 1.11–5.15); P = 0.026] and synchronous hepatocellular carcinoma (HCC) SPM [aHR= 2.86 (95 % CI, 1.18–6.92); P = 0.020], but not metachronous ones. Curves of cumulative incidence of a hepatobiliary (or HCC) SPM and cumulative survival probability for those with a hepatobiliary SPM, both stratified by p16 status and adjusted by IPTW, were generated. The median survival time among patients with a hepatobiliary SPM was shorter for HPV-unrelated OPC (0.8 years) compared to HPV-related OPC (2.6 years).

Conclusion

The observed elevated risk was likely due to heavy alcohol and tobacco use and the protective role of HPV infection against HCC development in carriers of hepatitis C virus.

{"title":"HPV-unrelated oropharyngeal cancer has elevated risk of synchronous hepatobiliary second primary malignancies compared to HPV-related oropharyngeal cancer: a population-based study from SEER","authors":"Shaopan Cao , Mehran Asad Ayoubi","doi":"10.1016/j.canep.2025.102826","DOIUrl":"10.1016/j.canep.2025.102826","url":null,"abstract":"<div><h3>Background</h3><div>Our aim was to compare risk of synchronous and metachronous hepatobiliary second primary malignancies (SPMs) in survivors of human papillomavirus (HPV)-related [i.e., p16(+)] and HPV-unrelated [i.e., p16(-)] oropharyngeal cancer (OPC).</div></div><div><h3>Methods</h3><div>A retrospective study was conducted for cases with OPC diagnosis during years 2018–2021 who had known p16 status using data of USA from Surveillance, Epidemiology, and End Results (SEER) Program [Incidence - SEER Research Limited-Field Data, 22 Registries (excl IL and MA), Nov 2023 Sub (2000–2021)]. In the statistical analyses, death was considered as a competing event for the development of a hepatobiliary SPM. Bias due to unbalanced baseline characteristics was eliminated by adjustments using propensity score and inverse probability of treatment weighting (IPTW). Risk of development of a hepatobiliary SPM was assessed using propensity-score-adjusted time-varying Cox proportional hazard regression [adjusted hazard ratio (aHR) with 95 % confidence interval (95 % CI)].</div></div><div><h3>Results</h3><div>Overall, 25759 cases with tumor status of p16(-) (6353) and p16(+) (19406) with median (interquartile range) follow-up times of 14 (6, 26) and 20 (9, 32) months, respectively, were included. From these, 48 had a hepatobiliary SPM. Compared to HPV-related OPC, HPV-unrelated OPC had significantly elevated risk of synchronous all hepatobiliary SPMs [aHR= 2.39 (95 % CI, 1.11–5.15); P = 0.026] and synchronous hepatocellular carcinoma (HCC) SPM [aHR= 2.86 (95 % CI, 1.18–6.92); P = 0.020], but not metachronous ones. Curves of cumulative incidence of a hepatobiliary (or HCC) SPM and cumulative survival probability for those with a hepatobiliary SPM, both stratified by p16 status and adjusted by IPTW, were generated. The median survival time among patients with a hepatobiliary SPM was shorter for HPV-unrelated OPC (0.8 years) compared to HPV-related OPC (2.6 years).</div></div><div><h3>Conclusion</h3><div>The observed elevated risk was likely due to heavy alcohol and tobacco use and the protective role of HPV infection against HCC development in carriers of hepatitis C virus.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102826"},"PeriodicalIF":2.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0