Pub Date : 2026-02-06DOI: 10.1016/j.canep.2026.103001
Riccardo Capocaccia, Mario Fusco, Maurizio Zarcone, Santo Fruscione, Maria Teresa Pesce, Fabrizio Stracci, Walter Mazzucco, Giorgio Graziano, Sergio Mazzola, Antonietta Minichino, Alessandra Sessa, Rosario Tumino, Antonino Ziino Colanino, Giuseppa Candela, Ilaria Loperto, Francesca Vitale, Rossella Abbate, Santa Valenti Clemente, Romina Vincenzi, Daniela Piras, Antonio Porcheddu, Cinzia Gasparotti, Giovanni Maifredi, Pasquala Pinna, Ermelinda Zollo, Valerio Ciullo, Susanna Baracco, Valerio Napolioni, Sonia Manasse, Spate Eugenia, Antonella Usticano, Adele Caldarella, Annalisa Turi, Enrica Santelli, Rocco Galasso, Luciana Del Riccio, Luigi Martinelli, William Mantovani, Diego Serraino, Luigino Dal Maso, Margherita Ferrante, Enrica Migliore, Silvia Leite, Marco Villa, Claudia Casella, Antonio Giampiero Russo, Lina Negrino, Giancarlo D'orsi, Federica Manzoni, Rossella Bruni, Maurizio Castelli, Maria Gambino, Rossella Cavallo, Anna Clara Fametti, Silvia Ghisleni, Giuseppe Sampietro
As national cancer survival estimates in Italy date back to 2011, we provided updated figures using population-based cancer registries. Analyses by age and sex included 1.418.044 cancers diagnosed between 2013 and 2017 from 34 registries covering 48 million residents. The 2008-2017 period, with 20 registries covering 24 million residents, was used for trends and regional comparisons. Net survival was estimated by Pohar-Perme method with life tables by year, sex, residence and calculated using the international standard distribution. Five-year age-standardized net survival for all cancers combined was 66.7 % in females and 62.2 % in males. Females had better survival than males for most cancers, notably acute lymphatic leukaemia (+9 % points (pp)), upper respiratory/digestive (+9 pp), lung (+6 pp), CNS (+5 pp), and stomach (+4 pp). Males had a higher survival for bladder (+4 pp), kidney (+2 pp), and urinary cancers (+5 pp). Best outcomes (>75 %) were documented for prostate, testicular, breast, endometrial, thyroid, melanoma, Hodgkin lymphoma, bladder, and chronic lymphatic leukaemia. Poorest prognosis (<30 %) was for CNS, liver, lung, pancreas, and acute myeloid leukaemias. Survival was age-dependent, highest in younger and lowest in older patients, with > 40 % points gaps in some haematological cancers. From 2008-2017, net survival arose from 65.7 % to 70.7 % in men and from 69.9 % to 74.1 % in women. Improvements were seen for pancreas, lung, and acute leukaemias, mainly in women, while decreases affected bladder, cervical, chronic lymphatic leukaemia in men. Geographical disparities persisted, with higher survival in Northern-Central Italy (64.0 % for men and 68.3 % for women) than in Southern-Islands (58.1 % for men and 63.7 %, for women). Our findings confirmed a better prognosis for younger patients and females than male patients. Survival has continued to improve over time, even at a higher improving rate in the considered period than the past.
{"title":"Cancer survival in Italian patients diagnosed between 2008 and 2017.","authors":"Riccardo Capocaccia, Mario Fusco, Maurizio Zarcone, Santo Fruscione, Maria Teresa Pesce, Fabrizio Stracci, Walter Mazzucco, Giorgio Graziano, Sergio Mazzola, Antonietta Minichino, Alessandra Sessa, Rosario Tumino, Antonino Ziino Colanino, Giuseppa Candela, Ilaria Loperto, Francesca Vitale, Rossella Abbate, Santa Valenti Clemente, Romina Vincenzi, Daniela Piras, Antonio Porcheddu, Cinzia Gasparotti, Giovanni Maifredi, Pasquala Pinna, Ermelinda Zollo, Valerio Ciullo, Susanna Baracco, Valerio Napolioni, Sonia Manasse, Spate Eugenia, Antonella Usticano, Adele Caldarella, Annalisa Turi, Enrica Santelli, Rocco Galasso, Luciana Del Riccio, Luigi Martinelli, William Mantovani, Diego Serraino, Luigino Dal Maso, Margherita Ferrante, Enrica Migliore, Silvia Leite, Marco Villa, Claudia Casella, Antonio Giampiero Russo, Lina Negrino, Giancarlo D'orsi, Federica Manzoni, Rossella Bruni, Maurizio Castelli, Maria Gambino, Rossella Cavallo, Anna Clara Fametti, Silvia Ghisleni, Giuseppe Sampietro","doi":"10.1016/j.canep.2026.103001","DOIUrl":"https://doi.org/10.1016/j.canep.2026.103001","url":null,"abstract":"<p><p>As national cancer survival estimates in Italy date back to 2011, we provided updated figures using population-based cancer registries. Analyses by age and sex included 1.418.044 cancers diagnosed between 2013 and 2017 from 34 registries covering 48 million residents. The 2008-2017 period, with 20 registries covering 24 million residents, was used for trends and regional comparisons. Net survival was estimated by Pohar-Perme method with life tables by year, sex, residence and calculated using the international standard distribution. Five-year age-standardized net survival for all cancers combined was 66.7 % in females and 62.2 % in males. Females had better survival than males for most cancers, notably acute lymphatic leukaemia (+9 % points (pp)), upper respiratory/digestive (+9 pp), lung (+6 pp), CNS (+5 pp), and stomach (+4 pp). Males had a higher survival for bladder (+4 pp), kidney (+2 pp), and urinary cancers (+5 pp). Best outcomes (>75 %) were documented for prostate, testicular, breast, endometrial, thyroid, melanoma, Hodgkin lymphoma, bladder, and chronic lymphatic leukaemia. Poorest prognosis (<30 %) was for CNS, liver, lung, pancreas, and acute myeloid leukaemias. Survival was age-dependent, highest in younger and lowest in older patients, with > 40 % points gaps in some haematological cancers. From 2008-2017, net survival arose from 65.7 % to 70.7 % in men and from 69.9 % to 74.1 % in women. Improvements were seen for pancreas, lung, and acute leukaemias, mainly in women, while decreases affected bladder, cervical, chronic lymphatic leukaemia in men. Geographical disparities persisted, with higher survival in Northern-Central Italy (64.0 % for men and 68.3 % for women) than in Southern-Islands (58.1 % for men and 63.7 %, for women). Our findings confirmed a better prognosis for younger patients and females than male patients. Survival has continued to improve over time, even at a higher improving rate in the considered period than the past.</p>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"103001"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138002","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}
Pub Date : 2026-02-04DOI: 10.1016/j.canep.2026.102998
Anjali Gupta, Tomi Akinyemiju
{"title":"Corrigendum to \"Early-onset cancer incidence in the United States by race/ethnicity between 2011 and 2020\" [Cancer Epidemiol. 92 (2024) 102632].","authors":"Anjali Gupta, Tomi Akinyemiju","doi":"10.1016/j.canep.2026.102998","DOIUrl":"https://doi.org/10.1016/j.canep.2026.102998","url":null,"abstract":"","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"102998"},"PeriodicalIF":2.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127627","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}
Pub Date : 2026-02-03DOI: 10.1016/j.canep.2026.103013
Shaveena Sivapalan, Paul J Chuba, Susanna M Szpunar, Khalid Berdi, Carrie L Dul, Jeffrey S Falk, Amr Aref
Background: Black women with breast cancer in the United States experience significantly higher mortality than White women, despite similar incidence rates. Both biological and socioeconomic factors contribute to this disparity. The Area Deprivation Index (ADI), a composite measure of socioeconomic disadvantage, may provide insight into neighborhood-level influences on survival. We aimed to examine the relative influences of race, ADI, and established clinical risk factors with overall survival among women with breast cancer in Metropolitan Detroit.
Methods: We conducted a retrospective cohort study of 3350 women diagnosed with stage 0-IV breast cancer between 2005 and 2015 at Ascension (now Henry Ford) hospitals in Metropolitan Detroit. Data were extracted from the METRIQ® cancer registry. Variables included race, age, stage, receptor-defined subtype, marital status, insurance, and ADI derived from 9-digit ZIP codes. Kaplan-Meier and Cox proportional hazards models were used to evaluate associations with overall survival.
Results: The cohort was 75.5 % White, 19.6 % Black, and 4.9 % Asian/Other. Mean age at diagnosis was 61.4 years. Survival differed significantly by race, with mean survival of 105.3 months for White versus 96.1 months for Black (p < 0.001). ADI strongly predicted outcomes: women in the most deprived quartile had 26 % lower 10-year survival compared to the least deprived quartile (94.1 vs. 108.2 months, p < 0.001). Survival was also associated with age, hormone receptor positivity, tumor subtype, nodal status, and AJCC pathologic stage (p < 0.001), as well as with HER2 positivity by immunohistochemistry (p < 0.001). Mean survival for cases having luminal A, luminal B, and Her2 enriched histologies were statistically significantly longer at 102.9 ± 1.1 months (95 % CI 100.9-105.0), 103.2 ± 3.4 months (CI 95.6-109.8) and 104.5 ± 4.8 months (CI 95.1-113.9) respectively compared to TNBC at 87.9 ± 3.1 months (CI 81.8-94.0) (p < 0.001). In multivariable Cox regression adjusting for age, stage, and subtype, ADI remained a significant predictor while race dropped from the model.
Conclusions: Breast cancer survival disparities in Metropolitan Detroit are driven predominantly by socioeconomic deprivation as measured by ADI. Although Black women presented at younger ages and with more aggressive subtypes, neighborhood level disadvantage accounted for the largest impact on survival. These findings highlight the need for interventions targeting socioeconomic and environmental determinants of health to reduce racial disparities in breast cancer outcomes.
{"title":"All-cause mortality by race and socioeconomic status among women treated for breast cancer in metropolitan Detroit.","authors":"Shaveena Sivapalan, Paul J Chuba, Susanna M Szpunar, Khalid Berdi, Carrie L Dul, Jeffrey S Falk, Amr Aref","doi":"10.1016/j.canep.2026.103013","DOIUrl":"https://doi.org/10.1016/j.canep.2026.103013","url":null,"abstract":"<p><strong>Background: </strong>Black women with breast cancer in the United States experience significantly higher mortality than White women, despite similar incidence rates. Both biological and socioeconomic factors contribute to this disparity. The Area Deprivation Index (ADI), a composite measure of socioeconomic disadvantage, may provide insight into neighborhood-level influences on survival. We aimed to examine the relative influences of race, ADI, and established clinical risk factors with overall survival among women with breast cancer in Metropolitan Detroit.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 3350 women diagnosed with stage 0-IV breast cancer between 2005 and 2015 at Ascension (now Henry Ford) hospitals in Metropolitan Detroit. Data were extracted from the METRIQ® cancer registry. Variables included race, age, stage, receptor-defined subtype, marital status, insurance, and ADI derived from 9-digit ZIP codes. Kaplan-Meier and Cox proportional hazards models were used to evaluate associations with overall survival.</p><p><strong>Results: </strong>The cohort was 75.5 % White, 19.6 % Black, and 4.9 % Asian/Other. Mean age at diagnosis was 61.4 years. Survival differed significantly by race, with mean survival of 105.3 months for White versus 96.1 months for Black (p < 0.001). ADI strongly predicted outcomes: women in the most deprived quartile had 26 % lower 10-year survival compared to the least deprived quartile (94.1 vs. 108.2 months, p < 0.001). Survival was also associated with age, hormone receptor positivity, tumor subtype, nodal status, and AJCC pathologic stage (p < 0.001), as well as with HER2 positivity by immunohistochemistry (p < 0.001). Mean survival for cases having luminal A, luminal B, and Her2 enriched histologies were statistically significantly longer at 102.9 ± 1.1 months (95 % CI 100.9-105.0), 103.2 ± 3.4 months (CI 95.6-109.8) and 104.5 ± 4.8 months (CI 95.1-113.9) respectively compared to TNBC at 87.9 ± 3.1 months (CI 81.8-94.0) (p < 0.001). In multivariable Cox regression adjusting for age, stage, and subtype, ADI remained a significant predictor while race dropped from the model.</p><p><strong>Conclusions: </strong>Breast cancer survival disparities in Metropolitan Detroit are driven predominantly by socioeconomic deprivation as measured by ADI. Although Black women presented at younger ages and with more aggressive subtypes, neighborhood level disadvantage accounted for the largest impact on survival. These findings highlight the need for interventions targeting socioeconomic and environmental determinants of health to reduce racial disparities in breast cancer outcomes.</p>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"103013"},"PeriodicalIF":2.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120915","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}
Pub Date : 2026-01-31DOI: 10.1016/j.canep.2026.103011
Thao Linh Ha , Thuy Ngan Tran , Sarah Hoeck , Guido Van Hal
Background
Timely follow-up colonoscopy after a positive fecal immunochemical test (FIT) is essential for the effectiveness of colorectal cancer (CRC) screening programs (CRC-SP). However, a substantial proportion of individuals fail to complete diagnostic follow-up. This study aimed to identify individual- and municipality-level factors associated with nonadherence to follow-up colonoscopy in the Flemish CRC-SP.
Methods
Individual-level data from the Flemish Centre for Cancer Detection (CCD), including 26,539 individuals with a positive FIT result in 2019, were linked with publicly available municipality-level indicators to assess demographic, socioeconomic, and healthcare-related characteristics. The outcome was nonadherence to follow-up colonoscopy within one year after a positive FIT result. A multivariable logistic regression model was developed using a structured approach: univariable screening (p < 0.15), multicollinearity assessment, and variable selection using least absolute shrinkage and selection operator (LASSO) regression. A random intercept for province was incorporated to account for potential clustering.
Results
A total of 5021 individuals (18.9 %) did not complete a follow-up colonoscopy within one year after a positive FIT result. In the final multivariable model, older age (65–69: OR = 1.12, 95 % CI: 1.03–1.21, p = 0.006; 70–74: OR = 1.29, 95 % CI: 1.20–1.40, p < 0.001), male gender (OR = 1.14, 95 % CI: 1.07–1.22, p < 0.001), and higher proportions of individuals living alone (OR = 1.02, 95 % CI: 1.00–1.03, p = 0.009) was associated with increased odds of nonadherence. In contrast, having a global medical dossier (GMD) were associated with better adherence (OR = 0.97, 95 % CI = 0.96–0.98, p < 0.001). Variance at the provincial level was negligible.
Conclusions
This study provides evidence to support targeted implementation strategies within the Flemish CRC-SP. Strengthening primary care involvement and addressing social determinants of health may improve follow-up colonoscopy rates and enhance the equity and effectiveness of the screening program.
粪便免疫化学试验（FIT）阳性后及时随访结肠镜检查对于结直肠癌（CRC）筛查计划（CRC- sp）的有效性至关重要。然而，相当大比例的个体未能完成诊断随访。本研究旨在确定佛兰德CRC-SP患者随访结肠镜检查依从性不符合的个人和城市因素。方法弗拉芒癌症检测中心（CCD）的个人数据，包括2019年FIT结果呈阳性的26,539人，与公开的市级指标相关联，以评估人口、社会经济和医疗保健相关特征。结果是在FIT阳性结果后一年内不坚持随访结肠镜检查。采用结构化方法建立了多变量逻辑回归模型：单变量筛选（p <； 0.15），多重共线性评估，以及使用最小绝对收缩和选择算子（LASSO）回归的变量选择。一个随机截距的省份被纳入考虑潜在的聚类。结果共有5021例（18.9 %）患者在FIT阳性后一年内未完成结肠镜随访。在最后的多变量模型中,老年人(65 - 69年:= 1.12,95 % CI: 1.03 - -1.21, p = 0.006;70 - 74年:= 1.29,95 % CI: 1.20 - -1.40, p & lt; 0.001),男性性别(或= 1.14,95 % CI: 1.07 - -1.22, p & lt; 0.001),和更高比例的个人独自生活(或= 1.02,95 % CI: 1.00 - -1.03, p = 0.009)与不依从的几率增加。相比之下，拥有全球医疗档案（GMD）与更好的依从性相关（OR = 0.97, 95 % CI = 0.96-0.98, p <； 0.001）。省一级的差异可以忽略不计。结论：本研究为支持佛兰德CRC-SP有针对性的实施策略提供了证据。加强初级保健的参与和解决健康的社会决定因素可以提高结肠镜检查的随访率，提高筛查项目的公平性和有效性。
{"title":"Determinants of colonoscopy adherence after positive colorectal cancer screening: Insights from individual and municipality-level data in Flanders","authors":"Thao Linh Ha , Thuy Ngan Tran , Sarah Hoeck , Guido Van Hal","doi":"10.1016/j.canep.2026.103011","DOIUrl":"10.1016/j.canep.2026.103011","url":null,"abstract":"<div><h3>Background</h3><div>Timely follow-up colonoscopy after a positive fecal immunochemical test (FIT) is essential for the effectiveness of colorectal cancer (CRC) screening programs (CRC-SP). However, a substantial proportion of individuals fail to complete diagnostic follow-up. This study aimed to identify individual- and municipality-level factors associated with nonadherence to follow-up colonoscopy in the Flemish CRC-SP.</div></div><div><h3>Methods</h3><div>Individual-level data from the Flemish Centre for Cancer Detection (CCD), including 26,539 individuals with a positive FIT result in 2019, were linked with publicly available municipality-level indicators to assess demographic, socioeconomic, and healthcare-related characteristics. The outcome was nonadherence to follow-up colonoscopy within one year after a positive FIT result. A multivariable logistic regression model was developed using a structured approach: univariable screening (p < 0.15), multicollinearity assessment, and variable selection using least absolute shrinkage and selection operator (LASSO) regression. A random intercept for province was incorporated to account for potential clustering.</div></div><div><h3>Results</h3><div>A total of 5021 individuals (18.9 %) did not complete a follow-up colonoscopy within one year after a positive FIT result. In the final multivariable model, older age (65–69: OR = 1.12, 95 % CI: 1.03–1.21, p = 0.006; 70–74: OR = 1.29, 95 % CI: 1.20–1.40, p < 0.001), male gender (OR = 1.14, 95 % CI: 1.07–1.22, p < 0.001), and higher proportions of individuals living alone (OR = 1.02, 95 % CI: 1.00–1.03, p = 0.009) was associated with increased odds of nonadherence. In contrast, having a global medical dossier (GMD) were associated with better adherence (OR = 0.97, 95 % CI = 0.96–0.98, p < 0.001). Variance at the provincial level was negligible.</div></div><div><h3>Conclusions</h3><div>This study provides evidence to support targeted implementation strategies within the Flemish CRC-SP. Strengthening primary care involvement and addressing social determinants of health may improve follow-up colonoscopy rates and enhance the equity and effectiveness of the screening program.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103011"},"PeriodicalIF":2.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080033","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}
Pub Date : 2026-01-22DOI: 10.1016/j.canep.2026.102993
Jong Won Shin , Jae Woong Sull , Nguyen Thien Minh , Sun Ha Jee
Background
This study aimed to evaluate the associations between serum creatinine, a potential antioxidant marker, and major endogenous antioxidant biomarkers with lung cancer risk, stratified by sex, alcohol consumption, and smoking status.
Methods
We analyzed 133,596 cancer-free adults from the Korean Cancer Prevention Study II (KCPS-II) cohort. During a mean follow-up of 13.5 years, 721 incident lung cancer cases were identified. Serum levels of creatinine, total bilirubin, albumin, and uric acid were measured. Alcohol consumption and smoking status were classified as never, former, current, and ever users, with ever users including both current and former users. Individuals with both alcohol and smoking exposure were additionally analyzed as a high-risk group. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for lung cancer, stratified by alcohol and smoking status. Biomarkers were analyzed by quartiles and linear trends.
Results
A 1-SD increase in serum creatinine was inversely associated with lung cancer risk in the overall population, including current drinkers (HR: 0.85, 95 % CI: 0.73–0.98), ever drinkers (HR: 0.85, 95 % CI: 0.75–0.97), former smokers (HR: 0.77, 95 % CI: 0.62–0.96), and ever smokers (HR: 0.81, 95 % CI: 0.70–0.93). In men, similar associations were observed in current drinkers (HR: 0.83, 95 % CI: 0.72–0.97), ever drinkers (HR: 0.86, 95 % CI: 0.75–0.99), former smokers (HR: 0.77, 95 % CI: 0.62–0.96), and ever smokers (HR: 0.80, 95 % CI: 0.70–0.92). High-risk groups exposed to both smoking and alcohol showed consistent inverse associations, with current smokers who were also current drinkers (HR: 0.81, 95 % CI: 0.66–1.00), and ever smokers who were also ever drinkers (HR: 0.78, 95 % CI: 0.67–0.91). No significant association was observed in women.
Conclusions
In men, serum creatinine showed a strong inverse association with lung cancer risk under oxidative stress conditions related to smoking and alcohol consumption.
{"title":"Sex-specific associations of creatinine and antioxidant biomarkers with lung cancer risk by drinking and smoking behavior: A prospective cohort study","authors":"Jong Won Shin , Jae Woong Sull , Nguyen Thien Minh , Sun Ha Jee","doi":"10.1016/j.canep.2026.102993","DOIUrl":"10.1016/j.canep.2026.102993","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the associations between serum creatinine, a potential antioxidant marker, and major endogenous antioxidant biomarkers with lung cancer risk, stratified by sex, alcohol consumption, and smoking status.</div></div><div><h3>Methods</h3><div>We analyzed 133,596 cancer-free adults from the Korean Cancer Prevention Study II (KCPS-II) cohort. During a mean follow-up of 13.5 years, 721 incident lung cancer cases were identified. Serum levels of creatinine, total bilirubin, albumin, and uric acid were measured. Alcohol consumption and smoking status were classified as never, former, current, and ever users, with ever users including both current and former users. Individuals with both alcohol and smoking exposure were additionally analyzed as a high-risk group. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for lung cancer, stratified by alcohol and smoking status. Biomarkers were analyzed by quartiles and linear trends.</div></div><div><h3>Results</h3><div>A 1-SD increase in serum creatinine was inversely associated with lung cancer risk in the overall population, including current drinkers (HR: 0.85, 95 % CI: 0.73–0.98), ever drinkers (HR: 0.85, 95 % CI: 0.75–0.97), former smokers (HR: 0.77, 95 % CI: 0.62–0.96), and ever smokers (HR: 0.81, 95 % CI: 0.70–0.93). In men, similar associations were observed in current drinkers (HR: 0.83, 95 % CI: 0.72–0.97), ever drinkers (HR: 0.86, 95 % CI: 0.75–0.99), former smokers (HR: 0.77, 95 % CI: 0.62–0.96), and ever smokers (HR: 0.80, 95 % CI: 0.70–0.92). High-risk groups exposed to both smoking and alcohol showed consistent inverse associations, with current smokers who were also current drinkers (HR: 0.81, 95 % CI: 0.66–1.00), and ever smokers who were also ever drinkers (HR: 0.78, 95 % CI: 0.67–0.91). No significant association was observed in women.</div></div><div><h3>Conclusions</h3><div>In men, serum creatinine showed a strong inverse association with lung cancer risk under oxidative stress conditions related to smoking and alcohol consumption.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102993"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025604","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}
Pub Date : 2026-01-22DOI: 10.1016/j.canep.2026.102996
Joseph A. Dottino , Katherine E. Baumann , Katharine M. Esselen , Rebecca Costa , Stephanie Argetsinger , Dennis Ross-Degnan , Anita K. Wagner
Background
To assess population-level trends in use of poly (ADP-ribose) polymerase inhibitors (PARPis) among ovarian cancer patients in the years following initial FDA approvals.
Methods
A national, commercial and Medicare Advantage insurance claims database was used to identify patients with ovarian cancer from 2015 to 2021. Year of ovarian cancer diagnosis was categorized by initial period of PARPi approval for treatment indication (2015–2016) and expanded period of PARPi approval for treatment and maintenance indications (2017–2021). Clinical and demographic characteristics were assessed. The primary outcome was proportion of patients with PARPi dispensings. Time from first observed ovarian cancer diagnosis to first observed PARPi dispensing was calculated.
Results
Of 23,165 patients with ovarian cancer, most were 65 years or older (62.8 %) and had Medicare Advantage insurance (66.2 %). More patients diagnosed in the expanded compared to the initial approval period received PARPi (9.8 % vs. 6.6 %, p < 0.0001) and within less time from diagnosis to PARPi initiation (HR: 2.31, 95 % CI 2.06, 2.59). Age over 65 was associated with lower likelihood of PARPi receipt (OR: 0.85, 95 % CI 0.74, 0.98). In the initial approval period, patients residing in non-white zip codes were more likely to receive a PARPi (OR: 1.61, 95 % CI 1.19, 2.18) and frail patients were less likely to receive a PARPi (OR: 0.41, 95 % CI 0.22, 0.78).
Conclusion
Since 2015, PARPi use increased among ovarian cancer patients, and time from diagnosis to PARPi receipt decreased, reflecting expanded PARPi indications over time. Monitoring demographic and clinical characteristics of PARPi recipients may help assess population-level use of novel therapeutics.
本研究旨在评估FDA批准卵巢癌患者使用聚（adp -核糖）聚合酶抑制剂（PARPis）后的人群水平趋势。方法使用国家、商业和联邦医疗保险优势保险索赔数据库识别2015年至2021年的卵巢癌患者。卵巢癌诊断年份按PARPi治疗适应症批准初始期（2015-2016年）和PARPi治疗和维持适应症批准延长期（2017-2021年）进行分类。评估临床和人口学特征。主要终点是使用PARPi配药的患者比例。计算首次观察到卵巢癌诊断至首次观察到PARPi配药的时间。结果在23,165例卵巢癌患者中，大多数年龄在65岁及以上（62.8 %），并有医疗保险优势（66.2% %）。与最初的批准期相比，更多的患者在扩大的批准期接受了PARPi(9.8 % vs. 6.6 %,p <； 0.0001)，并且从诊断到PARPi启动的时间更短（HR: 2.31, 95 % CI 2.06, 2.59）。65岁以上的患者接受PARPi的可能性较低（OR: 0.85, 95 % CI 0.74, 0.98）。在最初的批准期内，居住在非白人邮政编码地区的患者更有可能接受PARPi (OR: 1.61, 95 % CI 1.19, 2.18)，体弱患者更不可能接受PARPi （OR: 0.41, 95 % CI 0.22, 0.78）。结论自2015年以来，卵巢癌患者使用PARPi的人数增加，从诊断到接受PARPi的时间缩短，反映PARPi适应证随着时间的推移而扩大。监测PARPi接受者的人口学和临床特征可能有助于评估新疗法在人群水平上的使用情况。
{"title":"Trends in use of poly (ADP-ribose) polymerase inhibitor (PARPi) in ovarian cancer","authors":"Joseph A. Dottino , Katherine E. Baumann , Katharine M. Esselen , Rebecca Costa , Stephanie Argetsinger , Dennis Ross-Degnan , Anita K. Wagner","doi":"10.1016/j.canep.2026.102996","DOIUrl":"10.1016/j.canep.2026.102996","url":null,"abstract":"<div><h3>Background</h3><div>To assess population-level trends in use of poly (ADP-ribose) polymerase inhibitors (PARPis) among ovarian cancer patients in the years following initial FDA approvals.</div></div><div><h3>Methods</h3><div>A national, commercial and Medicare Advantage insurance claims database was used to identify patients with ovarian cancer from 2015 to 2021. Year of ovarian cancer diagnosis was categorized by initial period of PARPi approval for treatment indication (2015–2016) and expanded period of PARPi approval for treatment and maintenance indications (2017–2021). Clinical and demographic characteristics were assessed. The primary outcome was proportion of patients with PARPi dispensings. Time from first observed ovarian cancer diagnosis to first observed PARPi dispensing was calculated.</div></div><div><h3>Results</h3><div>Of 23,165 patients with ovarian cancer, most were 65 years or older (62.8 %) and had Medicare Advantage insurance (66.2 %). More patients diagnosed in the expanded compared to the initial approval period received PARPi (9.8 % vs. 6.6 %, p < 0.0001) and within less time from diagnosis to PARPi initiation (HR: 2.31, 95 % CI 2.06, 2.59). Age over 65 was associated with lower likelihood of PARPi receipt (OR: 0.85, 95 % CI 0.74, 0.98). In the initial approval period, patients residing in non-white zip codes were more likely to receive a PARPi (OR: 1.61, 95 % CI 1.19, 2.18) and frail patients were less likely to receive a PARPi (OR: 0.41, 95 % CI 0.22, 0.78).</div></div><div><h3>Conclusion</h3><div>Since 2015, PARPi use increased among ovarian cancer patients, and time from diagnosis to PARPi receipt decreased, reflecting expanded PARPi indications over time. Monitoring demographic and clinical characteristics of PARPi recipients may help assess population-level use of novel therapeutics.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102996"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025000","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}
Cervical cancer remains common among Thai women, but nationwide evidence on incidence and survival is limited. This study analyzed trends over the past decade.
Methods
We conducted a nationwide, retrospective cohort study using data from the Thai national population-based cancer registry. The study included women diagnosed with cervical cancer between 2012 and 2022. Age-standardized incidence rates (ASR) were calculated using the WHO standard population. Relative survival was estimated using the Ederer II method, based on national life tables.
Results
A total of 47,220 newly diagnosed cervical cancer cases were included. The ASR ranged from 7.69 to 11.18 per 100,000 women. Incidence increased from 2012 to 2015 (slope = +0.43), then declined until 2021 (slope = –0.36), with a slight resurgence in 2022. Younger women (aged 30–39 years) exhibited a steadily increasing incidence trend. The overall 5-year relative survival rate was 75 % (95 % CI, 74–75 %), and survival rates at 1, 3, and 5 years declined progressively throughout the study period.
Conclusion
While cervical cancer incidence in Thailand declined overall from 2012 to 2022, rates increased among younger women. Relative survival also declined over time. These findings underscore the need to re-evaluate national screening strategies, particularly for younger populations, and to strengthen timely access to diagnosis and treatment.
{"title":"Incidence trends and survival of cervical cancer: A population-based study on Thai Cancer registry database","authors":"Apirak Nguanboonmak , Boonyita Pakkaranang , Marut Yanaranop , Pichaya Tantiyavarong","doi":"10.1016/j.canep.2026.102992","DOIUrl":"10.1016/j.canep.2026.102992","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains common among Thai women, but nationwide evidence on incidence and survival is limited. This study analyzed trends over the past decade.</div></div><div><h3>Methods</h3><div>We conducted a nationwide, retrospective cohort study using data from the Thai national population-based cancer registry. The study included women diagnosed with cervical cancer between 2012 and 2022. Age-standardized incidence rates (ASR) were calculated using the WHO standard population. Relative survival was estimated using the Ederer II method, based on national life tables.</div></div><div><h3>Results</h3><div>A total of 47,220 newly diagnosed cervical cancer cases were included. The ASR ranged from 7.69 to 11.18 per 100,000 women. Incidence increased from 2012 to 2015 (slope = +0.43), then declined until 2021 (slope = –0.36), with a slight resurgence in 2022. Younger women (aged 30–39 years) exhibited a steadily increasing incidence trend. The overall 5-year relative survival rate was 75 % (95 % CI, 74–75 %), and survival rates at 1, 3, and 5 years declined progressively throughout the study period.</div></div><div><h3>Conclusion</h3><div>While cervical cancer incidence in Thailand declined overall from 2012 to 2022, rates increased among younger women. Relative survival also declined over time. These findings underscore the need to re-evaluate national screening strategies, particularly for younger populations, and to strengthen timely access to diagnosis and treatment.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102992"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024977","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}
Pub Date : 2026-01-22DOI: 10.1016/j.canep.2026.102989
Ariana Znaor , Brian Rous , Gabrielle Goldman Levy , Reiko Watanabe , Robert Jakob , Eva Krpelanova , Harshima D. Wijesinghe , Pavitratha Puspanathan , Ian A. Cree , Freddie Bray , Dilani Lokuhetty
Background
The International Classification of Diseases for Oncology (ICD-O) was specifically developed for coding tumours according to their site of origin (topography), microscopic appearance or histology, behaviour and grade (morphology), and is optimal for use in cancer registries. The fourth edition of the ICD-O (ICD-O-4) aims to provide an improved structure of unique codes to existent and newly defined tumour entities and has been harmonised with the International Classification of Diseases 11th Edition (ICD-11).
Methods
Based on an International Association of Cancer Registries (IACR) survey of cancer registries, over 90 % of the respondents (250 of 276) agreed to an update of ICD-O-3.2 morphology by the addition of a fifth digit to the existing four-digit histology code. Following the 5th Edition of the WHO Classification of Tumours (WCT), a beta version of ICD-O-4 was developed and disseminated for open consultation by the International Agency on Research for Cancer (IARC) on the WCT website.
Results
Following closure of the consultation period, the ICD-O-4 codes were finalized. The main changes in comparison to ICD-O-3.2 include the addition of a 5th alphanumeric digit to the histology code, changes in the first four digits of histology codes, changes of behaviour codes (e.g. pituitary adenoma code changed from /1 to /3), a new topography code for gastroesophageal junction (C16.7), detailed codes for extrahepatic bile ducts (C24.2, C24.3) and cystic duct (C24.4), change of the code for anal skin cancer from skin to anus (C44.5 to C21.3) and an optional additional digit in the topography code.
Conclusion
ICD-O-4 is compiled in consultation with pathologists, epidemiologists, public health researchers as well as the cancer registry community. The five-digit histology codes enable a hierarchical and detailed coding of tumours, while the new topography and behaviour codes reflect the evidence base on tumour aetiology, stage and behaviour.
国际肿瘤疾病分类（ICD-O）是专门根据肿瘤的起源位置（地形）、显微外观或组织学、行为和分级（形态学）对肿瘤进行编码而开发的，最适合用于癌症登记。ICD-O第四版（ICD-O-4）旨在为现有和新定义的肿瘤实体提供一种改进的独特代码结构，并已与国际疾病分类第11版（ICD-11）协调一致。方法：根据国际癌症登记处协会（IACR）对癌症登记处的调查，超过90% %的受访者（276人中的250人）同意更新ICD-O-3.2形态学，在现有的四位组织编码基础上增加第五位。继世卫组织肿瘤分类（WCT）第五版之后，制定了ICD-O-4的测试版，并在WCT网站上发布，供国际癌症研究机构（IARC）公开磋商。在咨询期结束后，ICD-O-4规范定稿。与ICD-O-3.2相比，主要变化包括组织编码增加了第5位字母数字，组织编码的前四位数字发生了变化，行为编码发生了变化（如垂体腺瘤编码从/1变为/3），胃食管交界处的新地形图编码（C16.7），肝外胆管（C24.2, C24.3）和胆囊管（C24.4）的详细编码，将肛门皮肤癌的代码从皮肤更改为肛门（C44.5至C21.3），并在地形代码中增加一个可选的附加数字。结论icd - o -4是在与病理学家、流行病学家、公共卫生研究人员以及癌症登记界协商后编制的。五位数的组织学编码能够对肿瘤进行分层和详细的编码，而新的地形和行为编码则反映了基于肿瘤病因学，阶段和行为的证据。
{"title":"The International Classification of Diseases for Oncology, 4th Edition (ICD-O-4): An overview","authors":"Ariana Znaor , Brian Rous , Gabrielle Goldman Levy , Reiko Watanabe , Robert Jakob , Eva Krpelanova , Harshima D. Wijesinghe , Pavitratha Puspanathan , Ian A. Cree , Freddie Bray , Dilani Lokuhetty","doi":"10.1016/j.canep.2026.102989","DOIUrl":"10.1016/j.canep.2026.102989","url":null,"abstract":"<div><h3>Background</h3><div>The International Classification of Diseases for Oncology (ICD-O) was specifically developed for coding tumours according to their site of origin (topography), microscopic appearance or histology, behaviour and grade (morphology), and is optimal for use in cancer registries. The fourth edition of the ICD-O (ICD-O-4) aims to provide an improved structure of unique codes to existent and newly defined tumour entities and has been harmonised with the International Classification of Diseases 11th Edition (ICD-11).</div></div><div><h3>Methods</h3><div>Based on an International Association of Cancer Registries (IACR) survey of cancer registries, over 90 % of the respondents (250 of 276) agreed to an update of ICD-O-3.2 morphology by the addition of a fifth digit to the existing four-digit histology code. Following the 5th Edition of the WHO Classification of Tumours (WCT), a beta version of ICD-O-4 was developed and disseminated for open consultation by the International Agency on Research for Cancer (IARC) on the WCT website.</div></div><div><h3>Results</h3><div>Following closure of the consultation period, the ICD-O-4 codes were finalized. The main changes in comparison to ICD-O-3.2 include the addition of a 5th alphanumeric digit to the histology code, changes in the first four digits of histology codes, changes of behaviour codes (e.g. pituitary adenoma code changed from /1 to /3), a new topography code for gastroesophageal junction (C16.7), detailed codes for extrahepatic bile ducts (C24.2, C24.3) and cystic duct (C24.4), change of the code for anal skin cancer from skin to anus (C44.5 to C21.3) and an optional additional digit in the topography code.</div></div><div><h3>Conclusion</h3><div>ICD-O-4 is compiled in consultation with pathologists, epidemiologists, public health researchers as well as the cancer registry community. The five-digit histology codes enable a hierarchical and detailed coding of tumours, while the new topography and behaviour codes reflect the evidence base on tumour aetiology, stage and behaviour.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102989"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024998","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}
Pub Date : 2026-01-22DOI: 10.1016/j.canep.2026.102999
Paul C. Lambert , Yngvar Nilssen , Tor Åge Myklebust , Bjarte Aagnes , Bjørn Møller , Mark J. Rutherford
Quantifying cancer survival is a crucial component of cancer surveillance and control. Survival for all cancers combined is an overall summary to explore differences between population groups and over time. Net survival is the usual measure for reporting survival for all cancers combined. Differences in the cancer site distribution between groups can be adjusted for using standardization. We propose using individual weights incorporated into the Pohar Perme estimator of net survival for standardized all cancers combined survival estimates, rather than a weighted average of stratum specific estimates. This removes sparse data problems, where estimates are unobtainable for some strata. Extending to reference adjusted all-cause survival gives an alternative, interpretable measure, enabling partitioning of all-cause survival differences into those due to cancer site/age/sex distribution differences, other cause mortality differences and cancer mortality differences. We illustrate the methods using data on 749 889 individuals diagnosed with cancer in Norway 1986–2021. Using individual weights gives very similar estimates to traditional and model-based standardization and avoids using ad-hoc sparse data methods. Reference adjusted all-cause survival provides measures with simpler interpretation. For example, between 1986 and 1990 and 2016–2021 there was a 25.9 %age point improvement in 5-year all-cause survival. This improvement was partitioned into changes in the site/age/sex distribution (2.0), changes in other cause mortality rates (4.4) with the majority (19.6) due to improvements in cancer survival. Survival of all cancers combined is easily analyzed non-parametrically using individual weights. Reference adjusted all-cause survival gives a more interpretable measure improving understanding of differences over time/between groups.
{"title":"Survival of all cancer sites combined: Partitioning of temporal changes into cancer, non-cancer and case-mix","authors":"Paul C. Lambert , Yngvar Nilssen , Tor Åge Myklebust , Bjarte Aagnes , Bjørn Møller , Mark J. Rutherford","doi":"10.1016/j.canep.2026.102999","DOIUrl":"10.1016/j.canep.2026.102999","url":null,"abstract":"<div><div>Quantifying cancer survival is a crucial component of cancer surveillance and control. Survival for all cancers combined is an overall summary to explore differences between population groups and over time. Net survival is the usual measure for reporting survival for all cancers combined. Differences in the cancer site distribution between groups can be adjusted for using standardization. We propose using individual weights incorporated into the Pohar Perme estimator of net survival for standardized all cancers combined survival estimates, rather than a weighted average of stratum specific estimates. This removes sparse data problems, where estimates are unobtainable for some strata. Extending to reference adjusted all-cause survival gives an alternative, interpretable measure, enabling partitioning of all-cause survival differences into those due to cancer site/age/sex distribution differences, other cause mortality differences and cancer mortality differences. We illustrate the methods using data on 749 889 individuals diagnosed with cancer in Norway 1986–2021. Using individual weights gives very similar estimates to traditional and model-based standardization and avoids using ad-hoc sparse data methods. Reference adjusted all-cause survival provides measures with simpler interpretation. For example, between 1986 and 1990 and 2016–2021 there was a 25.9 %age point improvement in 5-year all-cause survival. This improvement was partitioned into changes in the site/age/sex distribution (2.0), changes in other cause mortality rates (4.4) with the majority (19.6) due to improvements in cancer survival. Survival of all cancers combined is easily analyzed non-parametrically using individual weights. Reference adjusted all-cause survival gives a more interpretable measure improving understanding of differences over time/between groups.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102999"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024975","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}
Pub Date : 2026-01-21DOI: 10.1016/j.canep.2026.102995
Thu Thu Win Myint , Nick McIvor , Richard Douglas , Alana Cavadino , Sandar Tin Tin , Mark Elwood
<div><h3>Background</h3><div>Cancers of the oral cavity, larynx, and hypopharynx have traditionally been associated with common risk factors such as tobacco and alcohol use. With changes in smoking and drinking patterns, the incidence of these cancers is expected to change. Although the incidence of oral cavity cancer has been reported recently, there is limited evidence available for laryngeal and hypopharyngeal cancers in New Zealand (NZ). Furthermore, while growing evidence suggests increasing incidence of tongue cancer among females and young individuals, this trend has not been investigated in NZ. This study will therefore assess the incidence rates, trends in incidence, and survival of tongue, other oral cavity, laryngeal and hypopharyngeal cancers.</div></div><div><h3>Methods</h3><div>The study included patients with a primary diagnosis of squamous cell carcinoma (SCC) oral tongue, other oral cavity, larynx and hypopharynx, which were retrieved from the National Cancer Registry from 2006 to 2022. Directly age-standardised incidence rates were calculated, using the World Health Organisation standard population. Time trends were analysed with joinpoint regression to identify annual percentage changes (APCs), and overall and relative survival rates were estimated.</div></div><div><h3>Results</h3><div>The average annual incidence rate per 100,000 population was 1.2 for oral tongue SCC, 1.0 for other oral cavity SCC, 1.1 for laryngeal SCC, and 0.3 for hypopharyngeal SCC. Males consistently showed a higher incidence rate than females for all tumours except oral tongue SCC, where the incidence rates in older-aged females were higher than that of their male counterparts. Incidence rates differed by ethnicity, with Pasifika having higher incidence rates for oral tongue and other oral cavity SCC, and Māori for laryngeal and hypopharyngeal SCC, compared to European. Over the past 17 years, trends in incidence rates of laryngeal SCC declined significantly with 5 % per year overall and across all sexes, age groups and ethnic groups, whereas those of oral tongue, other oral cavity and hypopharyngeal SCC remained stable. Both overall and relative survival rates were highest for oral tongue SCC and lowest for hypopharyngeal SCC. The 5-year relative survival rates were 73 % for oral tongue SCC, 58 % for other oral cavity SCC, 67 % for laryngeal SCC and 42 % for hypopharyngeal SCC. In addition to age effects, survival outcomes varied by ethnicity, with notable disparity observed among Māori for other oral cavity and laryngeal SCC.</div></div><div><h3>Conclusion</h3><div>This study confirms a consistent decline in laryngeal SCC incidence rates in New Zealand over the last 17 years. However, no such decline was observed for oral tongue, other oral cavity, and hypopharyngeal SCC. The findings suggest that the risk attributed by common risk factors such as smoking may vary between tumour sites and demographic groups, particularly for oral tongue SCC.</div></div
{"title":"Changing patterns in tongue, oral cavity, laryngeal and hypopharyngeal squamous cell carcinomas in New Zealand: Incidence, trends and survival from 2006 to 2022","authors":"Thu Thu Win Myint , Nick McIvor , Richard Douglas , Alana Cavadino , Sandar Tin Tin , Mark Elwood","doi":"10.1016/j.canep.2026.102995","DOIUrl":"10.1016/j.canep.2026.102995","url":null,"abstract":"<div><h3>Background</h3><div>Cancers of the oral cavity, larynx, and hypopharynx have traditionally been associated with common risk factors such as tobacco and alcohol use. With changes in smoking and drinking patterns, the incidence of these cancers is expected to change. Although the incidence of oral cavity cancer has been reported recently, there is limited evidence available for laryngeal and hypopharyngeal cancers in New Zealand (NZ). Furthermore, while growing evidence suggests increasing incidence of tongue cancer among females and young individuals, this trend has not been investigated in NZ. This study will therefore assess the incidence rates, trends in incidence, and survival of tongue, other oral cavity, laryngeal and hypopharyngeal cancers.</div></div><div><h3>Methods</h3><div>The study included patients with a primary diagnosis of squamous cell carcinoma (SCC) oral tongue, other oral cavity, larynx and hypopharynx, which were retrieved from the National Cancer Registry from 2006 to 2022. Directly age-standardised incidence rates were calculated, using the World Health Organisation standard population. Time trends were analysed with joinpoint regression to identify annual percentage changes (APCs), and overall and relative survival rates were estimated.</div></div><div><h3>Results</h3><div>The average annual incidence rate per 100,000 population was 1.2 for oral tongue SCC, 1.0 for other oral cavity SCC, 1.1 for laryngeal SCC, and 0.3 for hypopharyngeal SCC. Males consistently showed a higher incidence rate than females for all tumours except oral tongue SCC, where the incidence rates in older-aged females were higher than that of their male counterparts. Incidence rates differed by ethnicity, with Pasifika having higher incidence rates for oral tongue and other oral cavity SCC, and Māori for laryngeal and hypopharyngeal SCC, compared to European. Over the past 17 years, trends in incidence rates of laryngeal SCC declined significantly with 5 % per year overall and across all sexes, age groups and ethnic groups, whereas those of oral tongue, other oral cavity and hypopharyngeal SCC remained stable. Both overall and relative survival rates were highest for oral tongue SCC and lowest for hypopharyngeal SCC. The 5-year relative survival rates were 73 % for oral tongue SCC, 58 % for other oral cavity SCC, 67 % for laryngeal SCC and 42 % for hypopharyngeal SCC. In addition to age effects, survival outcomes varied by ethnicity, with notable disparity observed among Māori for other oral cavity and laryngeal SCC.</div></div><div><h3>Conclusion</h3><div>This study confirms a consistent decline in laryngeal SCC incidence rates in New Zealand over the last 17 years. However, no such decline was observed for oral tongue, other oral cavity, and hypopharyngeal SCC. The findings suggest that the risk attributed by common risk factors such as smoking may vary between tumour sites and demographic groups, particularly for oral tongue SCC.</div></div","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102995"},"PeriodicalIF":2.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024999","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}
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