Pub Date : 2026-02-11DOI: 10.1016/j.canep.2026.103017
Phuong Dung Nguyen , Andrew N. Page , Kate A. McBride , Matthew J. Spittal , Sithum Munasinghe
Background
Breast cancer is the most diagnosed cancer among Australian women. Recently, incidence rates have risen but mortality rates have decreased. The extent to which these changes are the result of cumulative risk factor effects (age-effects), events affecting all women at specific points in time (period effects), or changes in generational risk factors (cohort effects) is unclear. This study investigates whether observed trends in breast cancer incidence and mortality are associated with age, period, or cohort effects.
Methods
Annual Australian breast cancer incidence (1982–2020) and mortality data (1907–2022) were obtained from the Australian Institute of Health and Welfare. Age-Period-Cohort (APC) modelling with a drift in cohort function was used to estimate adjusted age, period and cohort effects.
Results
Age effects showed higher incidence and mortality rates with increasing age, peaking at 75–84 years. Cohort effects showed progressively increasing risk among women born after the 1940s, with higher incidence among younger cohorts. Incidence peaks corresponded with introduction of population-based mammography screening, and also changes in population level risk factors. Period effects (adjusting for cohort effects) were modest, demonstrating reductions in incidence over time, while mortality peaked in the 1990s before declining after 2000.
Conclusion
Increasing age-related breast cancer incidence and mortality reinforce the importance of early prevention. Incidence has shifted due to cohort and period effects with younger generations showing the highest increases in incidence, suggesting generational shifts in breast cancer risk, likely attributable to mammography screening and increased prevalence of modifiable risk factors.
{"title":"Temporal trends in breast cancer incidence and mortality in Australia: An Age-Period-Cohort analysis","authors":"Phuong Dung Nguyen , Andrew N. Page , Kate A. McBride , Matthew J. Spittal , Sithum Munasinghe","doi":"10.1016/j.canep.2026.103017","DOIUrl":"10.1016/j.canep.2026.103017","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most diagnosed cancer among Australian women. Recently, incidence rates have risen but mortality rates have decreased. The extent to which these changes are the result of cumulative risk factor effects (age-effects), events affecting all women at specific points in time (period effects), or changes in generational risk factors (cohort effects) is unclear. This study investigates whether observed trends in breast cancer incidence and mortality are associated with age, period, or cohort effects.</div></div><div><h3>Methods</h3><div>Annual Australian breast cancer incidence (1982–2020) and mortality data (1907–2022) were obtained from the Australian Institute of Health and Welfare. Age-Period-Cohort (APC) modelling with a drift in cohort function was used to estimate adjusted age, period and cohort effects.</div></div><div><h3>Results</h3><div>Age effects showed higher incidence and mortality rates with increasing age, peaking at 75–84 years. Cohort effects showed progressively increasing risk among women born after the 1940s, with higher incidence among younger cohorts. Incidence peaks corresponded with introduction of population-based mammography screening, and also changes in population level risk factors. Period effects (adjusting for cohort effects) were modest, demonstrating reductions in incidence over time, while mortality peaked in the 1990s before declining after 2000.</div></div><div><h3>Conclusion</h3><div>Increasing age-related breast cancer incidence and mortality reinforce the importance of early prevention. Incidence has shifted due to cohort and period effects with younger generations showing the highest increases in incidence, suggesting generational shifts in breast cancer risk, likely attributable to mammography screening and increased prevalence of modifiable risk factors.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103017"},"PeriodicalIF":2.3,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173874","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 : 2026-02-09DOI: 10.1016/j.canep.2026.103010
Letícia Gabriella Souza da Silva , Paulo Vitor de Souza Silva , Maria Fernanda Dantas Chaves , Nayara Priscila Dantas de Oliveira , Isabelle Ribeiro Barbosa , Gabriel De La Cruz-Ku , J. Smith Torres-Roman , Ana Margarida Condeço Melhorado , Dyego Leandro Bezerra de Souza
Introduction
Cervical cancer is one of the leading causes of cancer-related death among women in countries with lower socioeconomic levels. In Brazil, it represents the third most common type of cancer and the fourth leading cause of death, excluding non-melanoma skin cancers. Delays in initiating oncologic treatment have remained frequent even after the implementation of Law No. 12,732, which mandates treatment initiation within 60 days of diagnosis.
Objective
To analyze the spatial distribution of the proportion of cervical cancer cases that started treatment within 60 days after diagnosis and to assess its spatial correlation with contextual socioeconomic indicators and healthcare service availability in Brazil.
Methods
Ecological study included the 133 Intermediate Regions of Urban Articulation during the post-enactment period of Law No. 12,732 (2013–2019). The dependent variable—the proportion of cases initiating treatment within 60 days—was obtained from the Integrated Cancer Hospital Registry. Socioeconomic variables were extracted from the Atlas of Human Development in Brazil, while data on medical density and health service availability were obtained from the National Registry of Health Establishments and the Outpatient Information System of the Brazilian Unified Health System. Spatial clustering was evaluated using Global Moran’s I and the Local Indicator of Spatial Association. Multivariate analysis employed spatial regression models with global effects.
Results
The proportion of cervical cancer cases that initiated treatment within 60 days was 40.4 % (95 % CI: 39.9 %–40.9 %). A positive spatial correlation was observed between timely treatment and cytopathological test density (p = 0.00523), while a negative correlation was found with the population aging rate (p < 0.001).
Conclusion
Regions with lower population aging rates and greater availability of cytopathological exams were associated with higher compliance with the “60-day law.” These findings highlight the influence of socioeconomic context and healthcare service distribution on timely access to cervical cancer treatment.
{"title":"Spatial distribution of timely treatment for cervical cancer: Socioeconomic inequalities and disparities in healthcare service availability in Brazil","authors":"Letícia Gabriella Souza da Silva , Paulo Vitor de Souza Silva , Maria Fernanda Dantas Chaves , Nayara Priscila Dantas de Oliveira , Isabelle Ribeiro Barbosa , Gabriel De La Cruz-Ku , J. Smith Torres-Roman , Ana Margarida Condeço Melhorado , Dyego Leandro Bezerra de Souza","doi":"10.1016/j.canep.2026.103010","DOIUrl":"10.1016/j.canep.2026.103010","url":null,"abstract":"<div><h3>Introduction</h3><div>Cervical cancer is one of the leading causes of cancer-related death among women in countries with lower socioeconomic levels. In Brazil, it represents the third most common type of cancer and the fourth leading cause of death, excluding non-melanoma skin cancers. Delays in initiating oncologic treatment have remained frequent even after the implementation of Law No. 12,732, which mandates treatment initiation within 60 days of diagnosis.</div></div><div><h3>Objective</h3><div>To analyze the spatial distribution of the proportion of cervical cancer cases that started treatment within 60 days after diagnosis and to assess its spatial correlation with contextual socioeconomic indicators and healthcare service availability in Brazil.</div></div><div><h3>Methods</h3><div>Ecological study included the 133 Intermediate Regions of Urban Articulation during the post-enactment period of Law No. 12,732 (2013–2019). The dependent variable—the proportion of cases initiating treatment within 60 days—was obtained from the Integrated Cancer Hospital Registry. Socioeconomic variables were extracted from the Atlas of Human Development in Brazil, while data on medical density and health service availability were obtained from the National Registry of Health Establishments and the Outpatient Information System of the Brazilian Unified Health System. Spatial clustering was evaluated using Global Moran’s I and the Local Indicator of Spatial Association. Multivariate analysis employed spatial regression models with global effects.</div></div><div><h3>Results</h3><div>The proportion of cervical cancer cases that initiated treatment within 60 days was 40.4 % (95 % CI: 39.9 %–40.9 %). A positive spatial correlation was observed between timely treatment and cytopathological test density (p = 0.00523), while a negative correlation was found with the population aging rate (p < 0.001).</div></div><div><h3>Conclusion</h3><div>Regions with lower population aging rates and greater availability of cytopathological exams were associated with higher compliance with the “60-day law.” These findings highlight the influence of socioeconomic context and healthcare service distribution on timely access to cervical cancer treatment.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103010"},"PeriodicalIF":2.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159429","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 : 2026-02-09DOI: 10.1016/j.canep.2026.103014
Roya Dolatkhah , Friederike Erdmann , Liacine Bouaoun , Beth A. Mueller , Eleni Th. Petridou , Jeremy M. Schraw , Eleanor Kane , Erin L. Marcotte , Lisa M Force , John D. Dockerty , Monika Moissonnier , Ann Olsson , Eve Roman , Jacqueline Clavel , Catherine Metayer , Corrado Magnani , Ana M. Mora , Wafaa M. Rashed , Eric J Chow , Audrey Bonaventure , Joachim Schüz
Background
Causes of childhood cancer remain poorly understood. Using data from the case-control studies of the Childhood Cancer and Leukemia International Consortium (CLIC), we explored how maternal education as a key socioeconomic status (SES) indicator, varies across studies/countries and contributes to understanding of potential environmental and lifestyle risk factors.
Methods
Control group data from cancer-free children matched by diagnosis date of cases from 16 studies were included, using both interview-based and health registry sources. Maternal education, the primary SES measure used in previous analyses with pooled CLIC data, was categorized as low, medium, or high according to the International Standard Classification of Education. Multinomial logistic regression assessed associations between maternal education and perinatal/lifestyle factors, calculating crude and adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for high vs. low education.
Results
Maternal education levels varied across studies and over time, with the highest proportions of highly educated mothers in the U.S. and lowest in Costa Rica, Italy, and Egypt. Higher maternal education was generally positively associated with higher birthweight, breastfeeding, daycare attendance, and maternal prenatal alcohol consumption. Higher maternal education was generally inversely associated with lower birthweight, younger maternal age, paternal occupational pesticide exposure, maternal prenatal smoking, and having more siblings. The direction of associations for older maternal age and for caesarean delivery differed substantially across regions. Exclusion of mothers < 21 years at birth of the index child had little effect on the results.
Conclusion
This multi-country analysis supports the use of maternal education for adjustment as a proxy for SES, showing largely consistent associations with various behaviors and exposures. While the direction of associations was generally consistent, the strengths varied sometimes considerably by geographical region. These findings support the inclusion of maternal education as a covariate in analyses of childhood cancer risk when pooling CLIC studies.
{"title":"Associations of maternal education with suggested childhood cancer risk factors: Findings from the Childhood Cancer and Leukemia International Consortium (CLIC)","authors":"Roya Dolatkhah , Friederike Erdmann , Liacine Bouaoun , Beth A. Mueller , Eleni Th. Petridou , Jeremy M. Schraw , Eleanor Kane , Erin L. Marcotte , Lisa M Force , John D. Dockerty , Monika Moissonnier , Ann Olsson , Eve Roman , Jacqueline Clavel , Catherine Metayer , Corrado Magnani , Ana M. Mora , Wafaa M. Rashed , Eric J Chow , Audrey Bonaventure , Joachim Schüz","doi":"10.1016/j.canep.2026.103014","DOIUrl":"10.1016/j.canep.2026.103014","url":null,"abstract":"<div><h3>Background</h3><div>Causes of childhood cancer remain poorly understood. Using data from the case-control studies of the Childhood Cancer and Leukemia International Consortium (CLIC), we explored how maternal education as a key socioeconomic status (SES) indicator, varies across studies/countries and contributes to understanding of potential environmental and lifestyle risk factors.</div></div><div><h3>Methods</h3><div>Control group data from cancer-free children matched by diagnosis date of cases from 16 studies were included, using both interview-based and health registry sources. Maternal education, the primary SES measure used in previous analyses with pooled CLIC data, was categorized as low, medium, or high according to the International Standard Classification of Education. Multinomial logistic regression assessed associations between maternal education and perinatal/lifestyle factors, calculating crude and adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for high vs. low education.</div></div><div><h3>Results</h3><div>Maternal education levels varied across studies and over time, with the highest proportions of highly educated mothers in the U.S. and lowest in Costa Rica, Italy, and Egypt. Higher maternal education was generally positively associated with higher birthweight, breastfeeding, daycare attendance, and maternal prenatal alcohol consumption. Higher maternal education was generally inversely associated with lower birthweight, younger maternal age, paternal occupational pesticide exposure, maternal prenatal smoking, and having more siblings. The direction of associations for older maternal age and for caesarean delivery differed substantially across regions. Exclusion of mothers < 21 years at birth of the index child had little effect on the results.</div></div><div><h3>Conclusion</h3><div>This multi-country analysis supports the use of maternal education for adjustment as a proxy for SES, showing largely consistent associations with various behaviors and exposures. While the direction of associations was generally consistent, the strengths varied sometimes considerably by geographical region. These findings support the inclusion of maternal education as a covariate in analyses of childhood cancer risk when pooling CLIC studies.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103014"},"PeriodicalIF":2.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159467","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 : 2026-02-09DOI: 10.1016/j.canep.2026.102990
Sabrina Fabiano , Viviana Perotti , Paolo Contiero , Andrea Tittarelli , Maria Teresa Pesce , Stefano Guzzinati , Fabrizio Stracci , Diego Serraino , Walter Mazzucco , Luigino Dal Maso
Objectives
We forecasted the incidence of malignant tumours in Italy in 2025, using the most representative estimates of incidence rates and recent trends in cancer incidence available. A comparison with estimates for 2025 obtained using different assumptions and data sets is also presented.
Methods
34 cancer registries (81 % of the Italian population) were used to estimate incidence rate trends in 2013–2017, by cancer types, sex, and age. The stratified incidence rates were projected until 2025 by applying trends in the same strata, using a linear regression model with the calendar year as an independent variable.
Results
We estimated 362,100 new cancer cases in Italy in 2025 (182,300 in men, 179,800 in women). Prostate is the most frequent cancer site in men (31,200 cases; age-standardised incidence rates-ASR=92.3 per 100,000), followed by lung (27,100, ASR=80.9), bladder, and colon-rectum (23,000 cases each; ASR=69.0). 55,900 women were estimated to be diagnosed with breast cancer (ASR=159.0 per 100,000), 18,900 with colorectal (ASR=47.0) and 16,400 with lung cancers (ASR=41.0).
Conclusions
Our estimates were slightly lower than those based on other assumptions and/or different datasets (i.e., ECIS/GLOBOCAN ones). More effective anti-smoking campaigns are needed to halt the predicted increase in smoking-related cancers among women.
{"title":"Estimates of cancer incidence to 2025 in Italy: Numbers and rates","authors":"Sabrina Fabiano , Viviana Perotti , Paolo Contiero , Andrea Tittarelli , Maria Teresa Pesce , Stefano Guzzinati , Fabrizio Stracci , Diego Serraino , Walter Mazzucco , Luigino Dal Maso","doi":"10.1016/j.canep.2026.102990","DOIUrl":"10.1016/j.canep.2026.102990","url":null,"abstract":"<div><h3>Objectives</h3><div>We forecasted the incidence of malignant tumours in Italy in 2025, using the most representative estimates of incidence rates and recent trends in cancer incidence available. A comparison with estimates for 2025 obtained using different assumptions and data sets is also presented.</div></div><div><h3>Methods</h3><div>34 cancer registries (81 % of the Italian population) were used to estimate incidence rate trends in 2013–2017, by cancer types, sex, and age. The stratified incidence rates were projected until 2025 by applying trends in the same strata, using a linear regression model with the calendar year as an independent variable.</div></div><div><h3>Results</h3><div>We estimated 362,100 new cancer cases in Italy in 2025 (182,300 in men, 179,800 in women). Prostate is the most frequent cancer site in men (31,200 cases; age-standardised incidence rates-ASR=92.3 per 100,000), followed by lung (27,100, ASR=80.9), bladder, and colon-rectum (23,000 cases each; ASR=69.0). 55,900 women were estimated to be diagnosed with breast cancer (ASR=159.0 per 100,000), 18,900 with colorectal (ASR=47.0) and 16,400 with lung cancers (ASR=41.0).</div></div><div><h3>Conclusions</h3><div>Our estimates were slightly lower than those based on other assumptions and/or different datasets (i.e., ECIS/GLOBOCAN ones). More effective anti-smoking campaigns are needed to halt the predicted increase in smoking-related cancers among women.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102990"},"PeriodicalIF":2.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159486","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 : 2026-02-06DOI: 10.1016/j.canep.2026.103001
Riccardo Capocaccia , Mario Fusco , Maurizio Zarcone , Santo Fruscione , Maria Teresa Pesce , Fabrizio Stracci , Walter Mazzucco , AIRTUM Working Group, 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 , 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 , AIRTUM Working Group, 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 , Giuseppe Sampietro","doi":"10.1016/j.canep.2026.103001","DOIUrl":"10.1016/j.canep.2026.103001","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 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":"10.1016/j.canep.2026.102998","url":null,"abstract":"","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 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":"10.1016/j.canep.2026.103013","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 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}
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