Cancer Epidemiology最新文献

{"title":"Prevalence of Human Papillomavirus in Arica and Antofagasta, in the north of Chile","authors":"María Jesús Acuña ,&nbsp;Edgardo Mancilla ,&nbsp;Dania Acuña ,&nbsp;Giuliano Bernal","doi":"10.1016/j.canep.2025.102913","DOIUrl":"10.1016/j.canep.2025.102913","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer is primarily caused by the Human Papillomavirus (HPV). Despite all the advances in early detection of HPV infection, cervical cancer remains one of the most common types of cancer in women, with a high presence in Latin America. We previously reported on the prevalence of HPV in the Coquimbo region, so the objective of this study was to determine the frequency of HPV in women in the Antofagasta and Arica regions of northern Chile.</div></div><div><h3>Methods</h3><div>We analyzed 823 cervical samples from women aged 15–79 who attended gynecological checkups during 2024 to detect HPV genotypes using qPCR. Of these, 199 come from Arica and 624 from Antofagasta, in northern Chile.</div></div><div><h3>Results</h3><div>The overall HPV positivity rate was 19.20 %; 23.62 % in Arica and 17.79 % in Antofagasta. The HR-HPV positivity rates in the G1 (15–29 years) and G2 (30–79 years) age groups were 30.92 % and 16.54 %, respectively. The most prevalent genotypes of HPV infection among our entire population were HPV16, HPV 31, and HPV52. Single infection (75.95 %) was the main HPV infection pattern observed in the entire group, followed by double or multiple infection (24.05 %), which was similar in Groups 1 and 2, where the prevalence of single infection was 72.34 % and 77.48 %, respectively.</div></div><div><h3>Conclusion</h3><div>The prevalence of HPV infections in women in the Arica and Antofagasta regions appears lower than that previously reported for Coquimbo, but similar to that reported in Chile by the Ministry of Health. This reflects the great heterogeneity of HPV prevalence in our vast country. On the other hand, molecular detection of 14 HR-HPV genotypes is important because it will not only help women avoid cervical cancer, but could also inform the introduction of new vaccines targeting a broader spectrum of HR-HPV.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102913"},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004392","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}

{"title":"Cancer incidence and mortality in Italy, 2013–2017","authors":"Andrea Tittarelli ,&nbsp;Sabrina Fabiano ,&nbsp;Viviana Perotti ,&nbsp;Maurizio Zarcone ,&nbsp;Maria Teresa Pesce ,&nbsp;Alessio Gili ,&nbsp;Fabrizio Stracci ,&nbsp;Walter Mazzucco ,&nbsp;Luigino Dal Maso ,&nbsp;Emanuele Crocetti ,&nbsp;Riccardo Capocaccia ,&nbsp;Giovanna Tagliabue ,&nbsp;Paolo Contiero ,&nbsp;AIRTUM Working Group","doi":"10.1016/j.canep.2025.102905","DOIUrl":"10.1016/j.canep.2025.102905","url":null,"abstract":"<div><div>The demographic transition, together with changes in lifestyles and the exposure to other risk factors, contributed to a rising burden of chronic degenerative diseases, including cancer, in Italy. We provided updated figures on cancer incidence and mortality in Italy during the period 2013–2017, using data provided by 34 population-based cancer registries from the AIRTUM network. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) per 100,000 were estimated, stratified by sex, cancer site or type, and macroarea. The cumulative risk (number of individuals who need to be followed over a lifetime for one to develop cancer), stratified by cancer site and sex, was estimated. Overall, 1,359,053 incident cancer cases (52.8 % in men) were registered during the surveillance period. The ASR for all malignant tumours was 657.1 per 100,000 among men and 475.5 per 100,000 among women. We documented the highest ASRs for all cancer sites in both sexes (males: 685.7 per 100,000, females: 496.1 per 100,000) in the North, followed by the Center (males: 646.6 per 100,000, females: 488.1 per 100,000), and the South and Islands (males: 626.7 per 100,000, females: 435.4 per 100,000). Mortality rates are less than half that of incidence rates (SMR was 331.8 per 100,000 men and 188.8 per 100,000 women), with negligible differences among Italian areas. One man out of two and 1 women out of three may develop a cancer in their lifetime. Despite incidence and mortality figures in Italy were almost aligned with the ones documented in Europe, our findings recalled the importance for policy-makers to implement national policies and community-based prevention strategies aimed at reducing the cancer burden.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102905"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004391","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}

{"title":"Do breast cancer survivors benefit from mammography screening? A population-based study","authors":"Bayan Sardini ,&nbsp;Mette Bach Larsen ,&nbsp;Sisse Helle Njor","doi":"10.1016/j.canep.2025.102910","DOIUrl":"10.1016/j.canep.2025.102910","url":null,"abstract":"<div><h3>Background</h3><div>Mammography screening reduces breast cancer mortality by approximately 25 % in the general population and might therefore also benefit breast cancer survivors. However, its impact on mortality rates in this group remains unstudied. We aimed to estimate the effect of mammography screening on breast cancer mortality in this population.</div></div><div><h3>Methods</h3><div>We used data from invitations to the regional mammography screening program in Funen, Denmark (1993–2007), before the nationwide program's rollout in 2008. Breast cancer mortality among invited survivors (study group) was compared to survivors of similar age in counties without screening programs (control group).</div></div><div><h3>Results</h3><div>The study and control groups comprised 2109 invited breast cancer survivors and 15,417 non-invited breast cancer survivors. Of those, 406 (19 %) and 3385 (22 %) died from breast cancer within the follow-up period. The relative risk for invited versus not invited at 22 years of follow-up was 0.88 (95 %CI: 0.81–0.97). The relative risk for participants compared to a similar group in the control group of non-invited breast cancer survivors was 0.62 (95 %CI: 0.51–0.76).</div></div><div><h3>Conclusions</h3><div>Mammography screening might reduce breast cancer mortality less among breast cancer survivors than among the general population. However, this is most likely due to a lower participation rate among breast cancer survivors.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102910"},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989991","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}

{"title":"Unveiling the shifting trends and landscape of dietary-related cancer burden in China, global and different income regions: Based on GBD2021","authors":"Nanting Chen ,&nbsp;Chengmiao Li ,&nbsp;Haomin Lin ,&nbsp;Zhiji Wang ,&nbsp;Jingnan Xiong ,&nbsp;Yidan Jing ,&nbsp;Rana Jahanban-Esfahlan ,&nbsp;Guodong Liu ,&nbsp;Jianbo Dai ,&nbsp;Junchao Wang","doi":"10.1016/j.canep.2025.102911","DOIUrl":"10.1016/j.canep.2025.102911","url":null,"abstract":"<div><h3>Background</h3><div>This study assessed the burden of dietary risk-attributed cancers (DRAC) in China from 1990 to 2021, comparing trends with global patterns and across sociodemographic index (SDI) regions. We further projected future trajectories up to 2036.</div></div><div><h3>Methods</h3><div>The study assesses DRAC using age-standardized disability-adjusted life-years rates (ASDR) and age-standardized mortality rates (ASMR) based on Global Burden of Disease 2021. Temporal trends were evaluated using annual percentage change (APC) and estimated annual percentage change (EAPC). Key drivers were identified through decomposition and age-period-cohort analyses, while future trends were projected using a Bayesian age-period-cohort model.</div></div><div><h3>Results</h3><div>From 1990 to 2021, most countries exhibited negative EAPC values for overall population ASDR and ASMR, especially in China (-2.9; − 2.7). However, since approximately 2013, APC values for ASDR and ASMR among younger adults (under 55 years) in China and middle SDI regions have been positive. As for sexes, the ASDR and ASMR for DRAC were consistently higher in males than in females across China. Specifically, a diet rich in red meat and diet deficient in whole grains posed the highest dietary cancer risk for females and males respectively. Projections suggest that by 2036, China's ASDR and ASMR for DRAC may decrease to about 200 and 8, while global figures could drop to about 180 and 7 per 100,000.</div></div><div><h3>Conclusions</h3><div>Although China’s overall DRAC burden declined particularly fast on a global scale from 1990 to 2021, projections indicate it will remain above the global average by 2036. Notably, since 2013, both China and middle SDI regions have witnessed a rising burden of dietary risk-attributed cancers among young adults. Distinct burden profiles and risk factor distributions have been observed between genders. Targeted public health policies tailored to age, sex, and leading dietary risks should be formulated and implemented in the future.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102911"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931575","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}

{"title":"Risk of second primary cancers among melanoma survivors following radiotherapy: A population-based cohort study","authors":"Ashmitha Ashok Kumar,&nbsp;Alfred K. Lam,&nbsp;Vinod Gopalan","doi":"10.1016/j.canep.2025.102909","DOIUrl":"10.1016/j.canep.2025.102909","url":null,"abstract":"<div><h3>Background</h3><div>Cutaneous melanoma incidence is rising globally, and survival rates have improved significantly due to advances in early detection and treatment. As a result, the long-term health of melanoma survivors is gaining increasing clinical attention. One emerging concern is the development of second primary cancers (SPCs), which may result from shared risk factors, genetic susceptibility, or late effects of cancer treatment, including radiotherapy. While radiotherapy is used selectively in melanoma management, particularly for regional nodal or in-transit metastases, its potential to induce long-latency malignancies remains underexplored in this population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 19,640 adults diagnosed with primary cutaneous melanoma between 2010 and 2024 at a tertiary centre in Queensland, Australia. Patients with prior malignancies or incomplete follow-up were excluded. Only those who survived at least one-year post-treatment were included to minimise misclassification of metastases as SPCs. Standardised incidence ratios (SIRs) were calculated using national cancer incidence data. Directed acyclic graph (DAG)-guided Cox regression models were used to estimate hazard ratios (HRs), adjusting for age, year of diagnosis, surgery, chemotherapy, and immunotherapy. Excess absolute risks (EARs) were calculated per 10,000 person-years.</div></div><div><h3>Results</h3><div>Of the cohort, 9182 received radiotherapy and 10,458 did not. SPCs occurred in 8.3 % of irradiated patients and 5.1 % of non-irradiated patients. Radiotherapy was associated with elevated SPC risk (HR 1.13; 95 % CI, 1.02–1.25). The highest relative risks were observed for second primary melanoma (HR 3.45; 95 % CI, 2.89–4.12), soft tissue sarcoma (HR 2.87; 95 % CI, 1.10–6.34), hematologic malignancies (HR 1.42; 95 % CI, 1.08–1.88), and lung cancer (HR 1.32; 95 % CI, 1.05–1.67). Risk stratification revealed the greatest burden among males aged 45–70. EAR peaked at 5.1 per 10,000 person-years in the 10–14-year latency window. Radiotherapy accounted for 15.4 % of all SPCs and 18.1 % of radiation-associated cancers.</div></div><div><h3>Conclusions</h3><div>Radiotherapy was associated with a modest but statistically significant increase in long-term SPC risk in melanoma survivors, particularly for radiosensitive cancers. These findings support the need for long-term, risk-adapted surveillance strategies, especially among middle-aged males receiving radiotherapy. Future studies should integrate clinical, genetic, and dosimetric data to better inform individualised survivorship care.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102909"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912105","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}

{"title":"Assessing the impact of environmental tobacco smoke on five-year cancer mortality","authors":"Jiarong Liu ,&nbsp;Vidya Purushothaman ,&nbsp;Raphael E. Cuomo","doi":"10.1016/j.canep.2025.102908","DOIUrl":"10.1016/j.canep.2025.102908","url":null,"abstract":"<div><h3>Background</h3><div>Environmental tobacco smoke (ETS), also known as passive smoke, is a major public health concern due to its adverse health effects, which are comparable to those of active smoking. Although the risks of ETS for cardiovascular and respiratory outcomes are well documented, less is known about its impact on cancer prognosis. This study evaluated the association between ETS exposure and five-year all-cause mortality among patients diagnosed with breast, colorectal, lung, melanoma, or stomach cancer.</div></div><div><h3>Methods</h3><div>Clinical data were obtained from the UC San Diego Health system and the UC Health Data Warehouse. The study cohort included 17,729 adult patients with a confirmed cancer diagnosis and no recorded history of active smoking. ETS exposure and five-year mortality were identified using structured electronic health record data. Multivariable exact logistic regression and Cox proportional hazards models were used to estimate the association between ETS exposure and five-year mortality, adjusting for age, sex, cancer type, race, ethnicity, hypertension, hyperlipidemia, and type 2 diabetes.</div></div><div><h3>Results</h3><div>Among patients with documented ETS exposure, the five-year mortality rate was 86.95 %, compared to 61.69 % among those without ETS exposure. ETS exposure was independently associated with significantly increased odds of five-year mortality (OR = 7.83, 95 % CI: 3.64–5.85, p &lt; 0.001). Lung and stomach cancers were associated with higher mortality risk relative to breast cancer, whereas female sex, colon cancer, melanoma, White race, hypertension, hyperlipidemia, and type 2 diabetes were associated with reduced mortality.</div></div><div><h3>Conclusion</h3><div>ETS exposure is a significant predictor of five-year mortality among cancer patients with no history of smoking. These findings underscore the need for increased clinical attention and public health efforts to reduce involuntary exposure to tobacco smoke in vulnerable populations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102908"},"PeriodicalIF":2.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864334","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}

{"title":"Associations between neighborhood socioeconomic status, readmission, and mortality for patients with cancer: A nationwide cohort study","authors":"Devika A. Shenoy ,&nbsp;Jay B. Lusk ,&nbsp;Hannah Mahoney ,&nbsp;Beau Blass ,&nbsp;Amy G. Clark ,&nbsp;Caroline E. Sloan ,&nbsp;Bradley G. Hammill","doi":"10.1016/j.canep.2025.102907","DOIUrl":"10.1016/j.canep.2025.102907","url":null,"abstract":"<div><h3>Background</h3><div>Cancer presents a disproportionate burden, particularly among individuals from low socioeconomic status neighborhoods. Disparities in outcomes persist, influenced by limited access to healthcare services, cultural barriers, and neighborhood socioeconomic status. This nationwide study aimed to investigate the associations between neighborhood socioeconomic status and mortality/readmission among hospitalized Medicare-eligible patients with cancer.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients with cancer who were hospitalized between 2020 and 2022, using United States (U.S.) Medicare claims data. We used logistic regression models to explore the association between neighborhood socioeconomic status, measured via the corrected Duke Area Deprivation Index, and 1) 30-day mortality and 2) hospital readmission rates. Odds ratios were calculated to assess for associations in a stepwise manner after adjusting for sociodemographic characteristics, comorbidities, and regional/hospital characteristics.</div></div><div><h3>Results</h3><div>The study included 266,269 admissions. Patients from neighborhoods with a higher area deprivation index (i.e., lower socioeconomic status) exhibited higher mortality rates (adjusted odds ratio 1.06 [95 % confidence interval 1.01, 1.12]) compared to patients from lower area deprivation index neighborhoods. There were no overall differences in readmission rates for patients from high area deprivation index neighborhoods. High area deprivation index neighborhoods were associated with less teaching hospitals (30.2 % vs 39.9 %), more public hospitals (16.4 % vs 11.2 %), and less primary care providers (mean 66 vs 93.2) when compared to low area deprivation index neighborhoods.</div></div><div><h3>Conclusion</h3><div>The study revealed significant associations between neighborhood socioeconomic status and mortality in patients with cancer in the U.S. Understanding the interplay between neighborhood socioeconomic status and oncologic outcomes is crucial for developing targeted interventions to provide equitable oncology care.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102907"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864335","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}

{"title":"Algorithm development for identifying breast cancer incident cases and epidemiological updates: A cohort study based on multiple secondary sources","authors":"Andrea Faragalli ,&nbsp;Marica Iommi ,&nbsp;Donatella Sarti ,&nbsp;Chiara Peconi ,&nbsp;Marco Pompili ,&nbsp;Emilia Prospero ,&nbsp;Flavia Carle ,&nbsp;Rosaria Gesuita","doi":"10.1016/j.canep.2025.102906","DOIUrl":"10.1016/j.canep.2025.102906","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to develop and validate an algorithm for identifying incident breast cancer (BC) cases using Healthcare Utilization Databases (HUDs) and to assess BC incidence trends in the Marche Region, Italy, from 2010 to 2021.</div></div><div><h3>Methods</h3><div>This population-based longitudinal study included women aged ≥ 18 years residing in Marche. The HUDs Algorithm was developed to identify new BC cases using hospital discharge, outpatient, and beneficiary databases, and it was validated against the Cancer Registry by evaluating agreement, sensitivity, and positive predictive value (PPV). Age-standardized BC incidence rates were estimated. A Poisson regression model was used to assess trends, including comparisons between pre/post COVID-19 pandemic periods.</div></div><div><h3>Results</h3><div>Validation results showed a sensitivity of 81.2 % and PPV of 85.0 %. A total of 18,158 incident BC cases were identified, with a mean incidence rate of 224.7 per 100,000 person-years (95 % CI: 221.5–228.0). No significant increase in BC incidence was observed over time, but a marked decline occurred in 2020–2021, likely due to COVID-19-related disruptions.</div></div><div><h3>Conclusions</h3><div>HUDs can be a valuable complementary data source, providing additional information useful for timely epidemiological surveillance and supporting rapid public health responses in cases where Cancer Registry data are delayed. Further refinements and integration with other data could enhance the accuracy of the HUDs Algorithm.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102906"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864336","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}

{"title":"Impact of socioeconomic individual and ecological factors on extreme diagnosis-to-treatment interval in diffuse large B-Cell lymphoma in the French real-world cohort REALYSA","authors":"Christelle Cantrelle ,&nbsp;Aurélien Belot ,&nbsp;Alain Monnereau ,&nbsp;Fontanet Bijou ,&nbsp;Cédric Rossi ,&nbsp;Côme Bommier ,&nbsp;Hadia Khebbeb Hafirassou ,&nbsp;Ludovic Fouillet ,&nbsp;Hervé Ghesquières ,&nbsp;Loic Ysebaert ,&nbsp;Sandra Le Guyader Peyrou","doi":"10.1016/j.canep.2025.102875","DOIUrl":"10.1016/j.canep.2025.102875","url":null,"abstract":"<div><h3>Introduction</h3><div>Diffuse large B-cell lymphoma (DLBCL) is an aggressive though potentially curable lymphoid malignancy requiring timely treatment initiation. We investigated the impact of individual socioeconomic status and home area-level (ecological) factors on the diagnosis-to-treatment interval (DTI) in DLBCL patients, focusing on extreme delays in a French real-world cohort (REALYSA).</div></div><div><h3>Methods</h3><div>We analyzed patients with newly diagnosed DLBCL in the multicentric prospective cohort. DTI was defined as a duration in days between diagnosis confirmation and first-line therapy. Short and long DTIs (10th percentiles) were compared to intermediate DTI using multinomial models to identify factors associated with extreme DTIs. Socio-demographic data (including sex, education, employment, marital status, social support (SSQ6-score)…) and ecological characteristics (French deprivation index, local accessibility to general practitioners) were considered.</div></div><div><h3>Results</h3><div>Among 889 newly diagnosed DLBCL patients (median age 66 years, 49 % with aaIPI ≥1, 35 % with B-symptoms, 33 % with bulky disease), median DTI was 25 days (interquartile range: 15–39 days). The 10th- and 90th-percentile for extreme DTIs were &lt; 8 and &gt; 50 days respectively. In multivariable analysis, factors associated with short DTI included aaIPI (OR=3.03, CI95 %[1.44–6.41]), bulky disease (OR=3.06, CI95 %[1.68–5.58]), and B symptoms (OR=2.35, CI95 %[1.30–4.25]) - indicating expedited treatment for aggressive presentations. Conversely, factors associated with long DTI included older age (OR&gt;80 y = 3.31, CI95 %[1.39–7.89]), being a blue-collar worker or farmer (OR=2.36, CI95 %[1.18–4.73]), or changing type of treatment facility between biopsy and initial treatment.</div></div><div><h3>Conclusion</h3><div>In this large real-world cohort of newly diagnosed DLBCL patients, age, occupational status, and patients’ pathway were linked to very long delays to treatment. Interventions to streamline DTIs, especially for older and/or blue-collar or farmer patients, and for those changing facility of treatment, are warranted to improve quality of care.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102875"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829138","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}

{"title":"Epidemiology and risk factors of invasive pulmonary fungal disease in patients with lung cancer","authors":"Lijuan Wang ,&nbsp;Kaiyao Jiang ,&nbsp;Meiyu Qu ,&nbsp;Zhiying Hao ,&nbsp;Yan Song ,&nbsp;Ruigang Hou","doi":"10.1016/j.canep.2025.102901","DOIUrl":"10.1016/j.canep.2025.102901","url":null,"abstract":"<div><h3>Background</h3><div>Patients with lung cancer exhibit heightened susceptibility to invasive pulmonary fungal diseases (IPFD) due to malignancy-associated immunosuppression. Current data on the pathogen distribution profile of IPFD in this population remain limited. This study investigated the epidemiological distribution of fungal pathogens causing IPFD in patients with lung cancer, with the aim of guiding clinical management.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of consecutive patients with lung cancer treated at the Second Hospital of Shanxi Medical University from June 2019 to May 2024. Patients were included if they had a discharge diagnosis of IPFD, received antifungal therapy, or presented microbiological evidence of fungal infection. All patients were diagnosed according to the 2007 Revised Consensus on Pulmonary Fungal Infections. Demographic, clinical, and laboratory data were collected. Univariate and multivariate logistic regression analyses were employed to identify independent IPFD risk factors.</div></div><div><h3>Results</h3><div>Of 1274 with lung cancer, 92 had proven or probable IPFD. <em>Candida spp</em>. (57.4 %) and <em>Aspergillus spp.</em> (35.3 %) were the predominant pathogens, with sputum (77.94 %), bronchoalveolar lavage fluid (17.65 %), and tissue (4.41 %) as specimen sources. Multivariate analysis identified the following independent risk factors for IPFD with lung cancer: hypertension (OR=5.08; 95 %CI: 1.41–18.28, P = 0.013), chronic respiratory diseases (OR=3.13; 95 %CI: 1.14–8.56, P = 0.026), bone marrow suppression (OR=2.72; 95 % CI: 1.17–6.33, P = 0.020), multiple comorbidities (OR=2.68; 95 % CI: 1.02–7.09, P = 0.046), and smoking (OR=2.47; 95 %CI: 1.08–5.64, P = 0.032).</div></div><div><h3>Conclusions</h3><div><em>Candida</em> and <em>Aspergillus</em> species were the most common causative agents of IPFD in patients with lung cancer. However, the emergence of less common fungi such as Geotrichum capitatum and Rhizopus microsporus, observed with increasing frequency in this study, warrants heightented clinical vigilance. Recognizing key risk factors, including chronic respiratory diseases, male sex, hypertension, multiple comorbidities and smoking, may guide early diagnosis and targeted antifungal therapy, ultimately improving clinical outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102901"},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826661","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}