Cancer Epidemiology最新文献

Background: There is concern about the risk of cholangiocarcinoma mortality (CCA) among U.S. veterans who deployed to the Vietnam War theater. A variety of risk factors potentially related to Vietnam deployment may be associated with an increased risk of mortality from CCA. This study assessed the risk of CCA mortality among all Vietnam War era veterans, the first study to do so.

Methods: The Vietnam Era Veterans Mortality Study is a retrospective mortality study of all 2.5 million veterans who served in Vietnam and Southeast Asia (theater) and the 7.3 million veterans who served elsewhere during the Vietnam War (non-theater). Mortality was followed from 1979 to 2019. Hazard ratios (HRs) calculated from Cox proportional hazards models, adjusted for sex and age, compared CCA mortality risk between theater and non-theater veterans overall and by branch of service. Branch specific crude rates of CCA were also compared between theater and non-theater veterans.

Results: There were 2410 and 6502 CCA deaths among all theater and non-theater veterans respectively. Overall, there was no increased CCA mortality risk among theater versus non-theater veterans after adjusting for sex and age (hazard ratio, (HR: 1.00, 95 % CI: 0.95-1.04). When stratified by branch, the crude HRs for CCA were no different between branch-theater status groups except in non-theater Marines who had lower risk. A monotonic increase in crude rates for CCA mortality was observed in both theater and non-theater over forty years of follow-up.

Conclusion: There was no increased risk of CCA mortality in theater versus non-theater U.S. Vietnam War veterans, an important and new finding. This study lacked data on environmental exposures and behavioral factors that would further inform analyses of CCA risk. Identification of Vietnam era veterans' specific risk factors for CCA would require alternate methods and data which do not exist.

Introduction: Despite efforts to improve national lung cancer screening rates, only 4 % of eligible high-risk patients pursue this opportunity annually.

Objective: The goal of this study was to better understand the system, provider, and patient-level barriers to lung cancer screening METHODS: 300 high-risk patients in the southern Nevada region who met the criteria for lung cancer screening were given a questionnaire during their outpatient visit for low dose chest CT from August 2023 through February 2024.

Results: The most common reported barriers were absence of symptoms (38 %), not wishing to know that they had cancer (30 %), and not having awareness of the eligibility for CT screening (24 %).

Conclusion: A multifactorial approach is indicated to provide education for high-risk patients to clarify the importance of early diagnosis, demonstrate accessibility and low cost for lung cancer screening, and absolve any misconceptions about lung cancer screening.

Background: The study aims to explore the burden and trends of prostate cancer (PC) in India at the state level from 1990 to 2021, using data from the Global Burden of Disease (GBD) 2021 study.

Methods: The health metrics including age-standardised incidence rates (ASIR), prevalence rates (ASPR), disability-adjusted life years (ASDR), and mortality rates (ASMR) per 100,000 for PC were analysed across Indian states and union territories. Join point regression analysis was employed to identify significant changes in these metrics over time. Projection of ASIR were done using auto-regressive integrated moving average (ARIMA) model.

Results: The age-wise distribution of PC showed increased in ASIR, ASPR, ASDR, ASMR among older age, majorly in the 75-79 years age group. From 1990-2021, the average annual percentage change (AAPC) in ASIR, ASPR, ASMR and ASDR increased by 157 %, 278 %, 76 % and 58 % respectively. Projections indicate a further rise in ASIR to 9.15 per 100,000 by 2031. The join point analysis showed the highest annual percentage change (APC) between 1992 and 1995 period in all health metrics. Despite Gujarat state showing the highest total percentage change in all health metrics when considering regional variations, Delhi and Kerala still remain the highest overall.

Conclusion: The study emphasises the growing burden of PC in India, highlighting the need for improved diagnostic practices, localized screening guidelines, and targeted public health interventions.

Background: The global population aged 80 years or older is expected to triple by 2050, leading to an increased cancer burden in the oldest population. This study describes the estimated cancer incidence and mortality in 2022 and projections for 2050 in the oldest old, analyzed globally and by world regions and World Bank income levels, for all sexes combined, as well as separately for males and females.

Methods: Using GLOBOCAN 2022 estimates, we reported the estimated number of new cancer cases (excluding non-melanoma skin cancers), deaths, and truncated age-standardized incidence (ASIR) and mortality rates (ASMR) (per 100,000 individuals aged 80 years or older). We also presented the top five cancers by cases and deaths. Additionally, we projected the number of new cancer cases and deaths for each region in 2050, assuming no change in cancer incidence and death rates.

Result: In 2022, an estimated 2.6 million new cancer cases (14 % of all cancer cases) and 2.1 million cancer deaths (22 % of all cancer deaths) occurred in the oldest old, with regional variations. Globally, lung, colorectal, and prostate cancers were the most common cancers diagnosed and leading causes of cancer death. ASIR ranged from 987 in Africa to 2044 per 100,000 in Northern America while ASMR ranged from 981 in Africa to 1769 per 100,000 in Oceania. In 2050, an estimated 7.4 million new cancer cases and 6 million cancer deaths are expected. The greatest increases are anticipated in China, India, and Africa, with increases exceeding 200 % compared to 2022 estimates.

Conclusion: The growing cancer burden among the oldest old poses significant challenges to global healthcare systems, necessitating resource-tailored adaptations. These findings call for the inclusion of the oldest old in the development and implementation of cancer control policies and a better representation in cancer research.