Cancer Epidemiology最新文献

Corrigendum to “Biased effects of pre-diagnostic physical activity on breast cancer survival: Systematic review and meta-analysis” [Cancer Epidemiol. 89 (2024) 102544]

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-18 DOI: 10.1016/j.canep.2025.102773

Ziyu Wang , Frances E.M. Albers , Sabrina E. Wang , Dallas R. English , Brigid M. Lynch

引用次数: 0

Patterns of recurrence among adults diagnosed with screen-detected lung cancer 筛查出肺癌的成人复发模式

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-18 DOI: 10.1016/j.canep.2025.102777

Nikki M. Carroll , Jennifer Eisenstein , Kris F. Wain , Jared M. Freml , Robert T. Greenlee , Stacey A. Honda , Christine Neslund-Dudas , Katharine A. Rendle , Anil Vachani , Debra P. Ritzwoller

Background

With the recent shift in lung cancer staging towards early-stage disease coinciding with the introduction of lung cancer screening (LCS), little is known if LCS has affected the rate of recurrence and survival in community settings. Our objective was to evaluate variation in the detection and outcomes of recurrent lung cancer stratified by receipt of LCS.

Methods

Patients aged 55–80 years old diagnosed with stage I-IIIA non-small cell lung cancer (NSCLC) between 1/1/2014 and 12/31/2020 who completed definitive therapy and were considered disease-free were identified. Rates of recurrence were calculated in discrete 12-month intervals and by cumulative incidence. Survival was evaluated by multivariable adjusted Restricted Mean Survival Time (aRMST). Factors associated with recurrence were evaluated by Poisson models.

Results

Among 916 patients meeting study criteria, 708 (77 %) were non-screen-detected and 208 (23 %) were considered screen-detected. The proportion of recurrence between non-screen-detected (22 %) and screen-detected (17 %) was similar (P = 0.11). Recurrence rates during the first and second years after definitive therapy were 10.1 and 4.1 per 100 person-years for the non-screen-detected and 6.0 and 4.5 per 100 person-years for screen-detected, respectively. Two-year cumulative incidence of recurrence was 16.5 % (95 % CI, 13.9 %-19.4 %) for non-screen-detected patients and 13.8 % (95 % CI, 9.3 %-19.0 %) in the screen-detected group. Recurrence-free survival and survival after recurrence were similar between the two groups. Screening status was not associated with the likelihood of recurrence (RR=0.94, 95 % CI, 0.59–1.50).

Conclusion

These findings provide evidence of recurrence being a part of the intrinsic nature of disease progression despite mode of detection. Our findings emphasize the need for all patients to receive surveillance and survivorship care after treatment for early-stage NSCLC regardless of mode of detection. Further study with longer follow-up is warranted.

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引用次数: 0

Analysis of time trends of prevalence of high-risk HPV infections, high grade cervical precancer and cervical cancer disease in women from Eastern India over 20 years − Pooled analysis from three studies 20 年来印度东部妇女高危型人类乳头瘤病毒感染、高级别宫颈癌前病变和宫颈癌患病率的时间趋势分析--三项研究的汇总分析

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-18 DOI: 10.1016/j.canep.2025.102776

Sreeya Bose , Ranajit Mandal , Dipanwita Banerjee , Manisha Vernekar , Maqsood Siddiqi , Jayanta Chakrabarti , Rengaswamy Sankaranarayanan , Eric Lucas , Richard Muwonge , Partha Basu

Background

Cervical cancer remains a leading cause of cancer related morbidity and mortality among women worldwide, particularly in low-and middle- income countries (LMICs). The incidence of cervical cancer has declined in India over the last two decades despite the lack of any organised population-based screening programme or HPV vaccination. This study analyses the trends in high-risk human papilloma virus (hrHPV) prevalence and CIN 2 + detection and examines the influence of sociodemographic factors in West Bengal, India from over a span of two decades.

Methods

Data from three cervical cancer screening studies conducted in rural West Bengal were analysed between 2001 and 2021. A total of 80,988 women aged 30–60 years were screened using Hybrid Capture II© (HC II) test. Detection rates of CIN 2 + were stratified by age, education and marriage. Logistic regression models were used to identify factors influencing high risk HPV positivity and CIN 2 + prevalence.

Results

The overall high risk HPV positivity rate remained relatively stable (5 %) across the study periods with no significant difference between self-collected and provider collected samples. However, CIN 2 + detection rates declined significantly from 5.7/1000 in 2001-2003 to 2/1000 in 2018–2021 (adjusted odds ratio [OR]:0.27; 95 % confidence interval [CI]:0.12–0.46). Higher education (OR: 0.64; 95 % CI: 0.45–0.88) and delayed age at marriage (OR: 0.62; 95 %CI: 0.31–1 for age>21) were associated with lower CIN 2 + risk.

Conclusion

The findings of the study indicate that the observed decline in CIN 2 + prevalence in West Bengal can be attributed to improved education, delayed age at marriage, reduced fertility rate and women’s empowerment, which can explain the gradual reduction in cervical cancer incidence in India. However, the cervical cancer incidence in India remains above WHO elimination targets. Expedited implementation of HPV vaccination and strengthening screening programmes are necessary to sustain and accelerate progress towards elimination of cervical cancer.

{"title":"Analysis of time trends of prevalence of high-risk HPV infections, high grade cervical precancer and cervical cancer disease in women from Eastern India over 20 years − Pooled analysis from three studies","authors":"Sreeya Bose , Ranajit Mandal , Dipanwita Banerjee , Manisha Vernekar , Maqsood Siddiqi , Jayanta Chakrabarti , Rengaswamy Sankaranarayanan , Eric Lucas , Richard Muwonge , Partha Basu","doi":"10.1016/j.canep.2025.102776","DOIUrl":"10.1016/j.canep.2025.102776","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains a leading cause of cancer related morbidity and mortality among women worldwide, particularly in low-and middle- income countries (LMICs). The incidence of cervical cancer has declined in India over the last two decades despite the lack of any organised population-based screening programme or HPV vaccination. This study analyses the trends in high-risk human papilloma virus (hrHPV) prevalence and CIN 2 + detection and examines the influence of sociodemographic factors in West Bengal, India from over a span of two decades.</div></div><div><h3>Methods</h3><div>Data from three cervical cancer screening studies conducted in rural West Bengal were analysed between 2001 and 2021. A total of 80,988 women aged 30–60 years were screened using Hybrid Capture II© (HC II) test. Detection rates of CIN 2 + were stratified by age, education and marriage. Logistic regression models were used to identify factors influencing high risk HPV positivity and CIN 2 + prevalence.</div></div><div><h3>Results</h3><div>The overall high risk HPV positivity rate remained relatively stable (5 %) across the study periods with no significant difference between self-collected and provider collected samples. However, CIN 2 + detection rates declined significantly from 5.7/1000 in 2001-2003 to 2/1000 in 2018–2021 (adjusted odds ratio [OR]:0.27; 95 % confidence interval [CI]:0.12–0.46). Higher education (OR: 0.64; 95 % CI: 0.45–0.88) and delayed age at marriage (OR: 0.62; 95 %CI: 0.31–1 for age>21) were associated with lower CIN 2 + risk.</div></div><div><h3>Conclusion</h3><div>The findings of the study indicate that the observed decline in CIN 2 + prevalence in West Bengal can be attributed to improved education, delayed age at marriage, reduced fertility rate and women’s empowerment, which can explain the gradual reduction in cervical cancer incidence in India. However, the cervical cancer incidence in India remains above WHO elimination targets. Expedited implementation of HPV vaccination and strengthening screening programmes are necessary to sustain and accelerate progress towards elimination of cervical cancer.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102776"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436726","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

Healthy Eating Index (HEI-2020) score and colorectal cancer risk

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-15 DOI: 10.1016/j.canep.2025.102771

Arianna Natale , Dariush Khaleghi Hashemian , Jerry Polesel , Attilio Giacosa , Livia S.A. Augustin , Eva Negri , Federica Toffolutti , Carlo La Vecchia , Marta Rossi , Francesca Bravi

Purpose

The aim of this study is to evaluate if the alignment with the 2020–2025 Dietary Guidelines for Americans (DGA), measured by the Healthy Eating Index 2020 (HEI-2020), is associated with colorectal cancer (CRC) risk in an Italian population.

Methods

A multicentric case-control study was carried out in Italy between 1992 and 1996. Cases were 1953 patients (males 58 %, median age = 62 years) admitted to major hospitals with incident, histologically confirmed CRC. Controls were 4154 patients (males 50 %, median age = 58 years) admitted to the same hospitals for acute non-neoplastic conditions. Participants’ usual diet before study enrolment was collected using a validated food frequency questionnaire, and the alignment with DGA was assessed using the HEI-2020 score, ranging between 0 (no alignment) and 100 (complete alignment). Odds ratios (ORs) and the corresponding 95 % confidence intervals (CIs) were estimated using multiple logistic regression models including terms for selected socioeconomic, lifestyle factors, and potential confounders.

Results

The HEI-2020 score ranged from 29.4 and 97.0. Subjects in the highest tertile of scores had lower risk of CRC compared to those in the lowest tertile (OR: 0.69, 95 % CI = 0.60–0.80). Similar estimates were found for colon (OR: 0.70, 95 % CI = 0.59 – 0.83) and rectal cancer (OR: 0.69, 95 % CI = 0.56–0.85). The findings were also consistent across strata of different covariates.

Conclusions

Alignment with DGA was inversely associated with CRC risk in an Italian population.

{"title":"Healthy Eating Index (HEI-2020) score and colorectal cancer risk","authors":"Arianna Natale , Dariush Khaleghi Hashemian , Jerry Polesel , Attilio Giacosa , Livia S.A. Augustin , Eva Negri , Federica Toffolutti , Carlo La Vecchia , Marta Rossi , Francesca Bravi","doi":"10.1016/j.canep.2025.102771","DOIUrl":"10.1016/j.canep.2025.102771","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to evaluate if the alignment with the 2020–2025 Dietary Guidelines for Americans (DGA), measured by the Healthy Eating Index 2020 (HEI-2020), is associated with colorectal cancer (CRC) risk in an Italian population.</div></div><div><h3>Methods</h3><div>A multicentric case-control study was carried out in Italy between 1992 and 1996. Cases were 1953 patients (males 58 %, median age = 62 years) admitted to major hospitals with incident, histologically confirmed CRC. Controls were 4154 patients (males 50 %, median age = 58 years) admitted to the same hospitals for acute non-neoplastic conditions. Participants’ usual diet before study enrolment was collected using a validated food frequency questionnaire, and the alignment with DGA was assessed using the HEI-2020 score, ranging between 0 (no alignment) and 100 (complete alignment). Odds ratios (ORs) and the corresponding 95 % confidence intervals (CIs) were estimated using multiple logistic regression models including terms for selected socioeconomic, lifestyle factors, and potential confounders.</div></div><div><h3>Results</h3><div>The HEI-2020 score ranged from 29.4 and 97.0. Subjects in the highest tertile of scores had lower risk of CRC compared to those in the lowest tertile (OR: 0.69, 95 % CI = 0.60–0.80). Similar estimates were found for colon (OR: 0.70, 95 % CI = 0.59 – 0.83) and rectal cancer (OR: 0.69, 95 % CI = 0.56–0.85). The findings were also consistent across strata of different covariates.</div></div><div><h3>Conclusions</h3><div>Alignment with DGA was inversely associated with CRC risk in an Italian population.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102771"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spatiotemporal analysis of lung cancer mortality in Spain

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-15 DOI: 10.1016/j.canep.2025.102770

Pablo Medín , Carlos M. Leveau , Javier Riancho , Ana Santurtún

Background

Lung cancer is the leading cause of cancer-related mortality in Spain. This study aims to analyze the spatiotemporal pattern of lung cancer mortality in Spain and to discuss the role of potential risk factors.

Methods

A spatiotemporal study of lung cancer mortality was conducted in Spain. Moran’s I index and Local Indicators of Spatial Association (LISA) were utilized to identify spatial clustering. Bivariate spatial associations and multivariate regression models were applied to examine the association between lung cancer mortality, population density, mining activity, and average income per capita.

Results

A total of 81.8 % of lung cancer deaths occurred in males, though there is a rising trend in deaths among females. There are low-mortality clusters mainly concentrated in inland areas of the peninsula and in the northern half of the country, while high-mortality clusters are distributed heterogeneously and, in some regions, follow the course of the rivers. Municipal-level association analysis shows a direct relationship with population density and, among individuals aged 65 and older, with mining activity; however, it reveals an inverse relationship with average income per capita.

Conclusion

A better understanding of the spatiotemporal behavior of lung cancer mortality and its associated risk factors could be useful for primary prevention efforts and healthcare planning.

{"title":"Spatiotemporal analysis of lung cancer mortality in Spain","authors":"Pablo Medín , Carlos M. Leveau , Javier Riancho , Ana Santurtún","doi":"10.1016/j.canep.2025.102770","DOIUrl":"10.1016/j.canep.2025.102770","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is the leading cause of cancer-related mortality in Spain. This study aims to analyze the spatiotemporal pattern of lung cancer mortality in Spain and to discuss the role of potential risk factors.</div></div><div><h3>Methods</h3><div>A spatiotemporal study of lung cancer mortality was conducted in Spain. Moran’s I index and Local Indicators of Spatial Association (LISA) were utilized to identify spatial clustering. Bivariate spatial associations and multivariate regression models were applied to examine the association between lung cancer mortality, population density, mining activity, and average income per capita.</div></div><div><h3>Results</h3><div>A total of 81.8 % of lung cancer deaths occurred in males, though there is a rising trend in deaths among females. There are low-mortality clusters mainly concentrated in inland areas of the peninsula and in the northern half of the country, while high-mortality clusters are distributed heterogeneously and, in some regions, follow the course of the rivers. Municipal-level association analysis shows a direct relationship with population density and, among individuals aged 65 and older, with mining activity; however, it reveals an inverse relationship with average income per capita.</div></div><div><h3>Conclusion</h3><div>A better understanding of the spatiotemporal behavior of lung cancer mortality and its associated risk factors could be useful for primary prevention efforts and healthcare planning.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102770"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421575","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

Addressing the cervical cancer burden in the Rio Grande Valley of Texas through a multi-component program to improve screening and diagnostic follow-up: A retrospective cohort study

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-15 DOI: 10.1016/j.canep.2025.102772

Melissa Lopez Varon , Mila Pontremoli Salcedo , Bryan Fellman , Catherine Troisi , Rose Gowen , Maria Daheri , Ana Rodriguez , Paul Toscano , Laura Guerra , Monica Gasca , Blanca Cavazos , Elena Marin , Susan Fisher-Hoch , Maria E. Fernandez , Belinda Reininger , Li Ruosha , Ellen Baker , Kathleen Schmeler

Background

Cervical cancer is preventable by following guidelines for vaccination, screening, diagnosis and treatment of preinvasive cervical lesions. We implemented a multicomponent intervention to increase rates of colposcopy after abnormal screening results in three clinic systems in the Rio Grande Valley, along the Texas-Mexico border. The goal of this study was to assess the outcomes of this program including participation in colposcopy within 90 days of screening for women with abnormal screening results, and the time between screening and colposcopy appointments during the first year (Year 1/baseline) and subsequent years (Years 2 through 4) of program implementation.

Methods

We performed a retrospective cohort analysis of medical records of clinics participating in the program. We utilized multiple logistic regression and linear regression to assess the colposcopic outcomes of women with indication for colposcopy.

Results

A total of 1556 of the 14,846 (10.5 %) women who had undergone cervical cancer screening had abnormal results and met the criteria to be referred for colposcopy. There was a significant increase in the proportion of women who underwent colposcopy (within 90 days of screening) from Year 1/baseline (82.7 %) to Year 2 (90.6 %), OR= 1.65, p-value< 0.05. Similarly, the mean interval from screening to colposcopy decreased significantly from baseline (79 days) to Year 2 (49 days), to Years 3 and 4 (40 and 41 days, respectively), p < 0.001.

Conclusions

Our results suggest that multicomponent interventions can improve and sustain appropriate and timely colposcopy among women in medically underserved regions, improving cervical cancer prevention efforts in resource-limited settings.

{"title":"Addressing the cervical cancer burden in the Rio Grande Valley of Texas through a multi-component program to improve screening and diagnostic follow-up: A retrospective cohort study","authors":"Melissa Lopez Varon , Mila Pontremoli Salcedo , Bryan Fellman , Catherine Troisi , Rose Gowen , Maria Daheri , Ana Rodriguez , Paul Toscano , Laura Guerra , Monica Gasca , Blanca Cavazos , Elena Marin , Susan Fisher-Hoch , Maria E. Fernandez , Belinda Reininger , Li Ruosha , Ellen Baker , Kathleen Schmeler","doi":"10.1016/j.canep.2025.102772","DOIUrl":"10.1016/j.canep.2025.102772","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer is preventable by following guidelines for vaccination, screening, diagnosis and treatment of preinvasive cervical lesions. We implemented a multicomponent intervention to increase rates of colposcopy after abnormal screening results in three clinic systems in the Rio Grande Valley, along the Texas-Mexico border. The goal of this study was to assess the outcomes of this program including participation in colposcopy within 90 days of screening for women with abnormal screening results, and the time between screening and colposcopy appointments during the first year (Year 1/baseline) and subsequent years (Years 2 through 4) of program implementation.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort analysis of medical records of clinics participating in the program. We utilized multiple logistic regression and linear regression to assess the colposcopic outcomes of women with indication for colposcopy.</div></div><div><h3>Results</h3><div>A total of 1556 of the 14,846 (10.5 %) women who had undergone cervical cancer screening had abnormal results and met the criteria to be referred for colposcopy. There was a significant increase in the proportion of women who underwent colposcopy (within 90 days of screening) from Year 1/baseline (82.7 %) to Year 2 (90.6 %), OR= 1.65, p-value< 0.05. Similarly, the mean interval from screening to colposcopy decreased significantly from baseline (79 days) to Year 2 (49 days), to Years 3 and 4 (40 and 41 days, respectively), p < 0.001.</div></div><div><h3>Conclusions</h3><div>Our results suggest that multicomponent interventions can improve and sustain appropriate and timely colposcopy among women in medically underserved regions, improving cervical cancer prevention efforts in resource-limited settings.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102772"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421574","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

Associations of dietary fat types (MUFA, PUFA, SFA) and sources (animal, plant) with colorectal cancer risk: A comprehensive systematic review and dose-response meta-analysis of prospective cohort studies

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-13 DOI: 10.1016/j.canep.2025.102768

Mohammadmatin Mahjourian , Javad Anjom-Shoae , Mohammad Amin Mohammadi , Christine Feinle-Bisset , Omid Sadeghi

Background and objectives

While dietary fat intake has long been implicated as a risk factor for colorectal cancer, evidence from prospective cohort studies remains inconsistent. Moreover, previous meta-analyses examining the link between dietary fat intake and risk of colorectal cancer have not explored the dose-response relationships. Therefore, the current systematic review and meta-analysis was conducted to assess the dose-response associations of intakes of specific types (MUFA, PUFA and SFA) and sources (animal, plant) of dietary fat with the risk of colorectal, colon or rectal cancer.

Methods

A comprehensive literature search of relevant online databases was performed to detect eligible studies until May 2023, identifying 21 prospective cohort studies with a total sample size of 2311,737 participants. The follow-up periods ranged from 7 to 19.4 years, during which 21,125 cases of colorectal, colon or rectal cancer were recorded.

Results

Comparing extreme intake levels of total fat revealed the summary relative risk (RR) of 1.05 (95 % CI: 0.96–1.15) for colorectal cancer, 0.99 (95 % CI: 0.87–1.11) for colon cancer, and 1.09 (0.95 % CI: 0.93–1.13) for rectal cancer, indicating no significant association. Neither animal nor plant fat intake was associated with the risk of cancers. While no significant findings were also observed for MUFA or PUFA, the highest versus lowest comparison showed that a high intake of SFA was associated with a reduced risk of both colorectal 0.91 (95 % CI: 0.85–0.99) and colon cancer 0.86 (95 % CI: 0.75–0.98). However, in the non-linear dose-response analysis, the inverse association was seen within a certain range (<40 g/day).

Conclusions

These findings suggest that dietary SFA intake, less than 40 g/day, may have a protective effect against colorectal cancer. Further studies are needed to confirm our findings.

{"title":"Associations of dietary fat types (MUFA, PUFA, SFA) and sources (animal, plant) with colorectal cancer risk: A comprehensive systematic review and dose-response meta-analysis of prospective cohort studies","authors":"Mohammadmatin Mahjourian , Javad Anjom-Shoae , Mohammad Amin Mohammadi , Christine Feinle-Bisset , Omid Sadeghi","doi":"10.1016/j.canep.2025.102768","DOIUrl":"10.1016/j.canep.2025.102768","url":null,"abstract":"<div><h3>Background and objectives</h3><div>While dietary fat intake has long been implicated as a risk factor for colorectal cancer, evidence from prospective cohort studies remains inconsistent. Moreover, previous meta-analyses examining the link between dietary fat intake and risk of colorectal cancer have not explored the dose-response relationships. Therefore, the current systematic review and meta-analysis was conducted to assess the dose-response associations of intakes of specific types (MUFA, PUFA and SFA) and sources (animal, plant) of dietary fat with the risk of colorectal, colon or rectal cancer.</div></div><div><h3>Methods</h3><div>A comprehensive literature search of relevant online databases was performed to detect eligible studies until May 2023, identifying 21 prospective cohort studies with a total sample size of 2311,737 participants. The follow-up periods ranged from 7 to 19.4 years, during which 21,125 cases of colorectal, colon or rectal cancer were recorded.</div></div><div><h3>Results</h3><div>Comparing extreme intake levels of total fat revealed the summary relative risk (RR) of 1.05 (95 % CI: 0.96–1.15) for colorectal cancer, 0.99 (95 % CI: 0.87–1.11) for colon cancer, and 1.09 (0.95 % CI: 0.93–1.13) for rectal cancer, indicating no significant association. Neither animal nor plant fat intake was associated with the risk of cancers. While no significant findings were also observed for MUFA or PUFA, the highest versus lowest comparison showed that a high intake of SFA was associated with a reduced risk of both colorectal 0.91 (95 % CI: 0.85–0.99) and colon cancer 0.86 (95 % CI: 0.75–0.98). However, in the non-linear dose-response analysis, the inverse association was seen within a certain range (<40 g/day).</div></div><div><h3>Conclusions</h3><div>These findings suggest that dietary SFA intake, less than 40 g/day, may have a protective effect against colorectal cancer. Further studies are needed to confirm our findings.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102768"},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402889","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

Treatment switching between Enzalutamide and Abiraterone Acetate and time to oral opioid initiation in castration-resistant prostate cancer patients

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-12 DOI: 10.1016/j.canep.2025.102769

Ibrahim M. Asiri , Ronald C. Chen , Viraj Master , Lanyu Mi , Sarah E. James , Folakemi T. Odedina , Alan H. Bryce , Jon C. Tilburt , Irbaz B. Riaz , Syed Arsalan Ahmed Naqvi , Veronica Abraham , Steven R.H. Beach , Ewan K. Cobran

Background and aims

Enzalutamide (ENZ) and Abiraterone Acetate (AA) are both first-line treatments for castration-resistant prostate cancer (CRPC). CRPC patients may switch from ENZ to AA or from AA to ENZ, if they do not respond well to the treatment, or experience intolerable side effects. This study examine treatment switching from ENZ to AA or from AA to ENZ, while investigating death as a competing risk. Whether ENZ compared to AA was associated with a longer time to starting oral opioids was also investigated.

Methods

An active comparator new-user design was used to identify 1406 men diagnosed with CRPC who received ENZ and AA using the Surveillance, Epidemiology, and End Results-Medicare Linked Database from 2012 to 2016. Inverse probability treatment weights (IPTW)-adjusted Fine-Gray competing risk models were used to compare the switching drugs and time-to-first use of oral opioids after initiating ENZ and AA.

Results

Most patients (61 %) received AA, while 39 % received ENZ. Overall, ENZ demonstrated a significant reduction in the Sub-distribution Hazard Ratio (SHR) for switching treatment (IPTW-adjusted SHR 0.63; 95 % CI, 0.54–0.73; P < 0.001), indicating a decrease in treatment switching compared to AA. Cumulative incidence curves revealed substantial differences in switching patterns over time (Gray's test, p < 0.001). For time-to-first oral opioid use, the IPTW-adjusted SHR when comparing ENZ to AA was 0.95 (95 % CI, 0.83–1.09; P = 0.48), showing no significant difference between the two groups.

Conclusion

Patients who began their treatment with ENZ exhibited a substantially lower hazard of switching to AA when compared to those who started with AA.

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引用次数: 0

Survival rate of colorectal cancer and its relation to the individual and geographical variations in Malaysia, 2013–2018

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-11 DOI: 10.1016/j.canep.2025.102756

Siti Ramizah Ramli , Zahir Izuan Azhar , Sukumaran Raman , Siti Norbayah Yusof , Mariam Mohamad

Background

Colorectal cancer (CRC) ranks as the second most deadly cancer globally, accounting for nearly 10 % of all cancer-related deaths in 2021. Despite advancements in CRC management, significant disparities in survival rates persist, even in highly developed countries. These lower survival rates are particularly evident in socioeconomically deprived areas and regions with limited healthcare accessibility. Our objective was to assess the impact of individual and geographical variations on CRC survival outcomes.

Methods

This retrospective cohort study utilised secondary data from the National Cancer Registry. Adult CRC patients diagnosed between 1st January 2013 to 31st December 2018 (6 years), with documented cause of deaths were included. Kaplan-Meier survival analysis was conducted to determine the 5-year survival rate and median survival time, while multilevel Cox proportional hazard analysis was carried out to identify factors that contribute to the overall CRC survival.

Results

A total of 18,513 CRC patients were diagnosed between 2013 and 2018, with 10,819 deaths occurred during follow-up. The 5-year CRC survival rate was 42 % with median survival time of 36 months (95 %CI: 34.46–37.54). After adjusting for covariates in multilevel Cox proportional hazard regression analysis, the study found that older age, male gender, Malay and other ethnicities, living in Peninsular Malaysia, rectal, rectosigmoid and anal cancers, advanced disease stage, receiving other, none or delayed treatments, and living in less densely populated areas were significantly associated with a higher risk of mortality (p < 0.05).

Conclusion

This study identified several sociodemographic, clinical and population density factors that can influence CRC survivals in Malaysia. These findings provide valuable insights for policymakers to focus on high-risk populations with poor survival, in providing cancer control services and enhancing existing cancer prevention programmes to improve survival outcomes.

{"title":"Survival rate of colorectal cancer and its relation to the individual and geographical variations in Malaysia, 2013–2018","authors":"Siti Ramizah Ramli , Zahir Izuan Azhar , Sukumaran Raman , Siti Norbayah Yusof , Mariam Mohamad","doi":"10.1016/j.canep.2025.102756","DOIUrl":"10.1016/j.canep.2025.102756","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) ranks as the second most deadly cancer globally, accounting for nearly 10 % of all cancer-related deaths in 2021. Despite advancements in CRC management, significant disparities in survival rates persist, even in highly developed countries. These lower survival rates are particularly evident in socioeconomically deprived areas and regions with limited healthcare accessibility. Our objective was to assess the impact of individual and geographical variations on CRC survival outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilised secondary data from the National Cancer Registry. Adult CRC patients diagnosed between 1st January 2013 to 31st December 2018 (6 years), with documented cause of deaths were included. Kaplan-Meier survival analysis was conducted to determine the 5-year survival rate and median survival time, while multilevel Cox proportional hazard analysis was carried out to identify factors that contribute to the overall CRC survival.</div></div><div><h3>Results</h3><div>A total of 18,513 CRC patients were diagnosed between 2013 and 2018, with 10,819 deaths occurred during follow-up. The 5-year CRC survival rate was 42 % with median survival time of 36 months (95 %CI: 34.46–37.54). After adjusting for covariates in multilevel Cox proportional hazard regression analysis, the study found that older age, male gender, Malay and other ethnicities, living in Peninsular Malaysia, rectal, rectosigmoid and anal cancers, advanced disease stage, receiving other, none or delayed treatments, and living in less densely populated areas were significantly associated with a higher risk of mortality (p < 0.05).</div></div><div><h3>Conclusion</h3><div>This study identified several sociodemographic, clinical and population density factors that can influence CRC survivals in Malaysia. These findings provide valuable insights for policymakers to focus on high-risk populations with poor survival, in providing cancer control services and enhancing existing cancer prevention programmes to improve survival outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102756"},"PeriodicalIF":2.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387474","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

"High incidence of abnormal pap smears and low awareness of cervical cancer among women in Rewa, Madhya Pradesh, India: Implications for screening and education"

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-10 DOI: 10.1016/j.canep.2025.102767

Amaresh Nigudgi , Prakash Tiwari , Himanshu Singh Chandel, Priyanka Singh

Objectives

The objectives of the study were to determine the incidence of abnormal Pap smears and assess the awareness of cervical cancer and its associated socio-demographic factors among women in Rewa, Madhya Pradesh, India.

Methods

This cross-sectional study combined screening for cervical abnormalities using cytopathology archives from two government-aided tertiary care hospitals with a community-based survey. The survey included 666 women aged 21–75 years from rural and urban areas of Rewa, covering questions about socio-demographic factors, awareness of cervical cancer risk factors, symptoms, and screening tests.

Results

The cytological analysis revealed 207 abnormal Pap smears, translating to a high abnormality rate of 26.4 % ASC-US+ (207/785), including 2.5 % HSIL+ (20/785). Awareness of cervical cancer was notably low, with only 46.6 % of participants having heard of the disease. Moreover, recall awareness of key risk factors such as HPV infection, smoking, and weakened immune systems was exceptionally low, at 2.7 %, 2.4 %, and 2.0 % respectively.

Conclusions

The findings highlight a high rate of abnormal Pap smears and a critical lack of awareness about cervical cancer in Rewa. Given the low awareness levels and high rate of abnormal cytologies, particularly among older women, there is an urgent need for targeted screening and educational interventions. These efforts are essential, particularly for underprivileged women, to reduce both the incidence and mortality of cervical cancer.

{"title":"\"High incidence of abnormal pap smears and low awareness of cervical cancer among women in Rewa, Madhya Pradesh, India: Implications for screening and education\"","authors":"Amaresh Nigudgi , Prakash Tiwari , Himanshu Singh Chandel, Priyanka Singh","doi":"10.1016/j.canep.2025.102767","DOIUrl":"10.1016/j.canep.2025.102767","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives of the study were to determine the incidence of abnormal Pap smears and assess the awareness of cervical cancer and its associated socio-demographic factors among women in Rewa, Madhya Pradesh, India.</div></div><div><h3>Methods</h3><div>This cross-sectional study combined screening for cervical abnormalities using cytopathology archives from two government-aided tertiary care hospitals with a community-based survey. The survey included 666 women aged 21–75 years from rural and urban areas of Rewa, covering questions about socio-demographic factors, awareness of cervical cancer risk factors, symptoms, and screening tests.</div></div><div><h3>Results</h3><div>The cytological analysis revealed 207 abnormal Pap smears, translating to a high abnormality rate of 26.4 % ASC-US+ (207/785), including 2.5 % HSIL+ (20/785). Awareness of cervical cancer was notably low, with only 46.6 % of participants having heard of the disease. Moreover, recall awareness of key risk factors such as HPV infection, smoking, and weakened immune systems was exceptionally low, at 2.7 %, 2.4 %, and 2.0 % respectively.</div></div><div><h3>Conclusions</h3><div>The findings highlight a high rate of abnormal Pap smears and a critical lack of awareness about cervical cancer in Rewa. Given the low awareness levels and high rate of abnormal cytologies, particularly among older women, there is an urgent need for targeted screening and educational interventions. These efforts are essential, particularly for underprivileged women, to reduce both the incidence and mortality of cervical cancer.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102767"},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378965","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