Cancer Epidemiology最新文献

We characterized trends in early onset (aged 20–49) cancer incidence by race/ethnicity and sex using the 2011–2020 Surveillance, Epidemiology, and End Results (SEER) Program dataset. We estimated age-standardized cancer incidence rates, incidence rate ratios (IRR), and annual percentage changes (APC) with 95 % confidence intervals (CI). During the time period examined, cancer incidence increased for female breast (APC: 0.64; 95 % CI: 0.10, 1.20), female colorectal (APC: 2.16; 95 % CI: 1.22, 3.10), and male colorectal (APC: 2.49; 95 % CI: 1.81, 3.19) cancer. Among racial/ethnic groups examined, Hispanic individuals had the largest increases in female all sites (APC: 1.31; 95 % CI: 0.38, 2.25), female breast (APC: 1.04; 95 % CI: 0.29, 1.81), and female (APC: 4.67; 95 % Cl: 3.07, 6.30) and male (APC: 3.53; 95 % CI: 2.58, 4.49) colorectal cancer incidence. Further research is needed to clarify the causal mechanisms driving these patterns.

Background

Patients with oral cancer usually experience disfigurement and dysfunction which are shared risk factors of suicide. The aim of the study was to comprehensively assess the characteristics of suicide and risk factors for suicide in patients with oral cancer.

Methods

Surveillance, Epidemiology, and End Results database was used to acquire information of patients with common malignant tumors including oral cancer from 1975 to 2020. The aim was to explore the incidence of suicide, and timing of suicide among patients with oral cancer. A Fine-Gray competing risks regression model was employed to analyze risk factors associated with suicide among patients with various demographic and tumor characteristics.

Results

Totally, 7685 patients with different malignant tumors committed suicide. Among them, 203 patients with oral cancer died due to suicide, presenting a suicide rate of 54.5/100,000 person-years, which was almost 3.5 times that of the US general population and 1.5 times that of the overall US patients with cancer in our study. Approximately 18 %, 40 %, and 55 % of suicides occurred in first year, first 3 years, and first 5 years after diagnosis. Being male, White race, and having a single primary tumor might be regarded as the risk factors for suicide.

Conclusion

As oral cavity is closely associated with appearance, pronunciation and ingestion, patients with oral cancer have a significant high risk of suicide. Tremendous attention needs to be paid to patients with oral cancer particularly those exhibiting characteristics associated with a high risk of suicide.

Background

Renal cell carcinoma (RCC) remains a global health concern due to its poor survival rate. This study aimed to investigate the influence of medical determinants and socioeconomic status on survival outcomes of RCC patients. We analyzed the survival data of 41,563 RCC patients recorded under the Surveillance, Epidemiology, and End Results (SEER) program from 2012 to 2020.

Methods

We employed a competing risk model, assuming lifetime of RCC patients under various risks follows Chen distribution. This model accounts for uncertainty related to survival time as well as causes of death, including missing cause of death. For model analysis, we utilized Bayesian inference and obtained the estimate of various key parameters such as cumulative incidence function (CIF) and cause-specific hazard. Additionally, we performed Bayesian hypothesis testing to assess the impact of multiple factors on the survival time of RCC patients.

Results

Our findings revealed that the survival time of RCC patients is significantly influenced by gender, income, marital status, chemotherapy, tumor size, and laterality. However, we observed no significant effect of race and origin on patient's survival time. The CIF plots indicated a number of important distinctions in incidence of causes of death corresponding to factors income, marital status, race, chemotherapy, and tumor size.

Conclusions

The study highlights the impact of various medical and socioeconomic factors on survival time of RCC patients. Moreover, it also demonstrates the utility of competing risk model for survival analysis of RCC patients under Bayesian paradigm. This model provides a robust and flexible framework to deal with missing data, which can be particularly useful in real-life situations where patients information might be incomplete.

Background

Colorectal cancer (CRC) screening services in Ireland were cancelled or postponed for periods during the COVID-19 pandemic. The aim of this study was to assess the impact of screening colonoscopy delays after a positive FIT on clinical and histopathological outcomes due to these restrictions.

Methods

Participants in the Irish National Bowel Screening Programme with a positive Immunochemical Faecal Test (FIT) during the COVID-19 pandemic (March 2020-December 2021) were included. Patients were categorised into attended for a colonoscopy <3 months and attended for colonoscopy ≥3–17 months post positive FIT. Chi-Square Test of independence was performed using WinPepi.

Results

3227 individuals had a complete index colonoscopy <3 months and 262 attended colonoscopy from ≥3 to 17 months post positive FIT. Of the clients whose colonoscopy was between ≥3–17 months from positive FIT, the median wait time was 3 months. There was no significant difference found between the two groups for CRC (5.8 % vs 5.0 %, p=0.544) or for the proportion of cancer stage I, stage II and unknown (33.7 %, 40.6 %, 25.7 %, p=0.411). There was no difference in the proportions of adenomas (57.8 % vs 58.4 %, p=0.849) and the proportion of advanced adenomas (7.7 % vs 10.7 %, p=0.077) detected between the two groups. A similar proportion of polyps were detected in individuals whose index colonoscopies were postponed <3 months from positive FIT (66.9 % vs 66 %, p=0.786).

Conclusion

A median delay of 3 months in screening colonoscopies after a positive FIT does not adversely impact clinical or histopathological outcomes. There was no significant difference in cancer staging, advanced adenomas or polyps detected between those who attended colonoscopies <3 months and ≥3–17 months post positive FIT. COVID-19 related disruptions to the normal functioning of the Irish bowel screening programme did not compromise our key objectives of advanced adenoma and cancer detection.

Background

The second-to-fourth digit ratio (2D:4D) is thought to reflect prenatal exposure to sex steroids. We investigated the relationship between 2D:4D and odds of prostate cancer.

Method

Data were collected in PROtEuS, a population-based case-control study conducted in Montréal, Canada (2005–2012), including 1931 incident prostate cancer cases aged < 76 years and 1994 population controls. In-person interviews elicited information on potential risk factors. Digit lengths were measured by interviewers applying a standard protocol. Odds ratios (OR) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders.

Results

The OR of prostate cancer for a standard deviation increase in 2D:4D was 0.91 (95 % CI: 0.85–0.98). For less and more aggressive cancers, ORs were 0.93 (95 % CI: 0.87–1.00) and 0.85 (95 % CI: 0.77–0.93), respectively. There was an interaction with ancestry (p=0.04), whereas the OR among men of African descent was 1.23 (95 % CI: 0.96–1.57, based on 128 cases).

Conclusion

Findings suggest an inverse association between 2D:4D and odds of overall prostate cancer, more pronounced for aggressive cancers. This supports the notion that high levels of testosterone in utero, estimated by a low 2D:4D ratio, are associated with a higher risk of prostate cancer. Contrastingly, a high digit ratio was associated with greater cancer odds among participants of African descent. Upon replication, 2D:4D could prove to be an easily measured marker of prostate cancer risk.

Background

Helicobacter pylori (H. pylori) infection may be associated with colorectal polyps/adenomas, but the current evidence remains controversial.

Methods

We retrospectively screened the medical records of 655 participants who underwent both colonoscopy and H. pylori test from June 15, 2020 to April 30, 2023. The number, size, location, and pathological type of colorectal polyps/adenomas were compared between H. pylori positive and negative groups. Adjusting for age, gender, smoking, drinking, hypertension, diabetes, fatty liver, body mass index, and inflammatory and metabolic indicators, multivariate logistic regression analyses were performed to evaluate the association of H. pylori infection with the number, size, location, and pathological type of colorectal polyps/adenomas, where no polyp/adenoma was used as reference.

Results

Overall, 508 participants were included, of whom 154 and 354 were divided into H. pylori positive and negative groups, respectively. H. pylori positive group had significantly higher colorectal polyps/adenomas (74.7 % vs. 65.8 %, P=0.048), low-grade adenomas (55.7 % vs. 47.6 %, P=0.026), advanced adenomas (22.6 % vs. 13.3 %, P=0.008), and colorectal polyps/adenomas with sizes of ≥6 mm (61.7 % vs. 48.5 %, P=0.002) and ≥10 mm (25.2 % vs. 14.6 %, P=0.004) than H. pylori negative group. In multivariate logistic regression analyses, H. pylori infection was independently associated with low-grade adenomas (OR=2.677, 95 %CI=1.283–5.587, P=0.009), advanced adenomas (OR=3.017, 95 %CI=1.007–9.036, P=0.049), right-side colon polyps/adenomas (OR=5.553, 95 %CI=1.679–18.360, P=0.005), and colorectal polyps/adenomas with sizes of ≥10 mm (OR=4.436, 95 %CI=1.478–13.310, P=0.008), but not number of colorectal polyps/adenomas.

Conclusion

H. pylori infection is associated with increased risk of colorectal polyps/adenomas, especially low-grade adenomas, advanced adenomas, right-side colon polyps/adenomas, and large colorectal polyps/adenomas.

Objectives

The Food Environment Index (FEI) has shown varying positive impacts on health outcomes related to diabetes, obesity, and hypertension. However, a relationship between FEI and hypertension among breast cancer (BC) survivors, particularly Black women survivors, remains underexplored. Black women who are BC survivors have a high prevalence of hypertension and increased risk of mortality compared to White women with BC. Our analysis aims to fill this gap by assessing the FEI's association with hypertension in this population.

Design

Utilizing social media recruitment strategies and BC survivor networks, 100 Black female BC survivors completed an online survey, that included sociodemographic and clinical characteristics as well as lifestyle factors. The 2023 FEI County Health Rankings was used to assess the food environment and the index ranges from 0 (worst) to 10 (best). Adjusted prevalence odds ratios (PORs) and 95 % confidence intervals (CI) were calculated for the associations between FEI, sociodemographic and clinical factors, and hypertension status.

Results

Among the 94 study participants with data on hypertension status, 54.3 % reported a diagnosis of hypertension. Residing in counties with a below-median FEI (<8.8 v. above median: ≥8.8) was significantly associated with hypertension (POR = 4.10, 95 % CI: 1.19–14.13). Age at survey (≥50 years compared to <50 years: POR= 0.29, 95 % CI: 0.10–0.87) and household income ($75,000-$99,999 compared to > $99,999/year: POR = 12.02, 95 % CI: 2.08–69.43) were also significantly associated with hypertension.

Conclusion

Our study highlights the potential impact of the food environment on hypertension among Black BC survivors living in Maryland. Our findings call attention to the need for targeted interventions to improve food accessibility and quality in underserved communities, especially for special populations such as cancer survivors.

Background

Lung cancer (LC) screening using low-dose computed tomography (CT) is recommended according to standard risk criteria or personalized risk calculators. Machine learning (ML) models that can predict disease risk are an emerging method in medicine for identifying hidden associations that are personally unique.

Materials and methods

Using the tree-based pipeline optimization tool (TPOT), we developed an ML-based model, which is an ensemble of the Random Forest and XGboost models, based on known risk factors for LC, as part of a larger trial for ML prediction using electronic medical records and chest CT. We used data from patients with LC vs. controls (1:2) of patients aged ≥ 35 years. We developed a model for all LC patients as well as for patients with and without a smoking background. We included age, gender, body mass index (BMI), smoking history, socioeconomic status (SES), history of chronic obstructive pulmonary disease (COPD)/emphysema/chronic bronchitis (CB), interstitial lung disease (ILD)/pulmonary fibrosis (PF), and family history of LC.

Results

Of the 4076 patients, 1428 (35 %) were in the LC group and 2648 (65 %) were in the control group. For the entire study population, our model achieved an accuracy of 71.2 %, with a sensitivity of 69 % and a positive predictive value (PPV) of 74 %. Higher accuracy was achieved for the two subgroups. An accuracy of 74.8 % (sensitivity 72 %, PPV 76 %) and 73.0 % (sensitivity 76 %, PPV 72 %) was achieved for the smoking and never-smoking cohorts, respectively. For the entire population and smoker cohort, COPD/emphysema/CB were the most important contributors, followed by BMI and age, while in the never-smoking cohort, BMI, age and SES were the most important contributors.

Conclusion

Known risk factors for LC could be used in ML models to modestly predict LC. Further studies are needed to confirm these results in new patients and to improve them.

Background

Synovial sarcoma (SS) is a rare soft-tissue cancer. Existing literature encompasses Surveillance, Epidemiology, and End Results (SEER) data-based research on SS explaining the incidence-prevalence in general, by subtypes, and by age at diagnosis. Therefore, this study aimed to fill in the gap of knowledge about measures of disease occurrence and burden of SS by tumor site using the SEER database.

Methods

In this cross-sectional study, primary SS patients were selected from SEER 17 Registries, Nov. 2021 (2000–2020) using ICD-O-3 codes 9040, 9041, 9042, and 9043. Patients with additional cancers were excluded. The primary tumor site was categorized into (1) head/neck, (2) internal thorax, (3) abdomen/pelvis, (4) upper extremity, and (5) lower extremity using ICD-10CM codes. Five outcomes were analyzed: age-adjusted incidence rate, 5-year limited-duration prevalence rate, incidence-based mortality, case-fatality rate, and overall survival.

Results

From 2000–2020, the overall age-adjusted incidence rate was 0.15 per 100,000; the 5-year limited duration prevalence rate was 0.56 per 100,000; and the incidence-based mortality rate was 0.06 per 100,000 people. The case-fatality and 5-year OS rates were 39.2 % and 62.9 %, respectively. Lower extremity had the highest incidence of 0.07 (estimated 1166 cases), prevalence of 0.36 (estimated 224 cases), and mortality rate of 0.025 (estimated 429 deaths) per 100,000. The other four locations had much closer rates with each other. Intrathoracic SS had the highest case-fatality rate of 71.5 % (148/207) and lowest 5-year OS of 26.0 % (95 % CI: 19.6 %, 32.9 %) than other sites.

Conclusion

Based on the measures of disease frequency, the most common primary tumor site is the lower extremity, followed by the upper extremity, abdomen/pelvis, internal thorax, and head/neck. The least favorable primary location is the internal thorax. Those with a primary location of the upper extremity have the longest overall survival, followed by the head/neck, lower extremity, abdomen/pelvis, and internal thorax.