Cancer Epidemiology最新文献_第3页

The association of combined GSTM1, GSTT1, and GSTP1 genetic polymorphisms with lung cancer risk in male Iraqi Waterpipe Tobacco (Nargila) smokers 伊拉克水烟（Nargila）男性吸烟者的 GSTM1、GSTT1 和 GSTP1 基因多态性组合与肺癌风险的关系。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-30 DOI: 10.1016/j.canep.2024.102689

Bassam K. Kudhair , Fadak M. Abdulridha , Ghadeer M. Hussain , Inam J. Lafta , Noralhuda N. Alabid

Mutations in genes encoding proteins necessary for detoxifying oxidative stress products have been predicted to increase susceptibility to lung cancer (LC). Despite this, the association between waterpipe tobacco smoking (WP), genetic polymorphisms, and LC risk remains poorly understood. This is the first study to explore the relationship between WP tobacco smoking and these genetic factors. Previously, we investigated the association of GSTP1 SNPs (rs1695-A/G and rs1138272-C/T) with LC in Iraqi males who smoke WP. Here, we expanded our analysis to include GSTM1 (active/null) and GSTT1 (active/null) genotypes, both individually and in combination with GSTP1 SNPs. Multiplex PCR and RFLP-PCR assays were utilized to determine the genotypes of 123 cases and 129 controls. No significant association was observed between GSTM1-null or GSTT1-null genotypes and LC risk, either separately or in combination with variant genotypes of GSTP1 (rs1695 "AG+GG" and rs1138272 "CT+TT"). However, smoking WP and carrying null genotypes elevated the risk five-fold for GSTM1-null (OR 5.17, 95 % CI 2.02–13.24, P<0.001) and three-fold for GSTT1-null (OR 3.08, 95 % CI 1.55–6.13, P=0.001) compared to non-smokers carrying active genotypes. Conversely, genotype distribution analysis based on LC histological types did not indicate an increased risk of LC. Lung cancer is a complex multifactorial disease. WP smoking and GSTs genetic polymorphisms might be associated with an increased risk of developing LC. However, our data did not confirm an association between GST polymorphisms alone and the risk of LC.

据预测，编码氧化应激产物解毒所需蛋白质的基因发生突变会增加肺癌（LC）的易感性。尽管如此，人们对吸食水烟（WP）、基因多态性和肺癌风险之间的关系仍然知之甚少。这是第一项探讨吸烟水烟与这些遗传因素之间关系的研究。此前，我们调查了吸食水烟的伊拉克男性中 GSTP1 SNPs（rs1695-A/G 和 rs1138272-C/T）与 LC 的关系。在此，我们扩大了分析范围，将 GSTM1（活跃/无效）和 GSTT1（活跃/无效）基因型单独或与 GSTP1 SNPs 结合使用。利用多重 PCR 和 RFLP-PCR 检测方法确定了 123 例病例和 129 例对照的基因型。无论是单独还是与 GSTP1 的变异基因型（rs1695 "AG+GG "和 rs1138272 "CT+TT"）相结合，均未观察到 GSTM1 空基因型或 GSTT1 空基因型与 LC 风险之间存在明显关联。然而，吸烟 WP 和携带无效基因型会使 GSTM1 无效基因型的风险升高 5 倍（OR 5.17，95 % CI 2.02-13.24，P.

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引用次数: 0

Epidemiology and geographical patterns of common childhood cancers in Iran: Evidence from the National Cancer Registry 伊朗常见儿童癌症的流行病学和地理模式：来自全国癌症登记处的证据

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-28 DOI: 10.1016/j.canep.2024.102685

Goljamal Jorjani , Gholamreza Roshandel , Mohammad Reza Taherian , Nargesbeigom Mirbehbahani , Leila Moaddabshoar , Ali Ahmadi , Fereshteh Salavati , Seyed Saeed Hashemi Nazari , Mahzad Vahidi , Koorosh Etemad

Introduction

Cancer is projected to become the primary cause of death in the 21st century. Although childhood cancer is relatively rare, it remains a significant contributor to mortality among children. This study examines the geographical distribution of childhood cancer incidence in Iranian provinces using data from the National Cancer Registry between 2014 and 2018.

Materials and methods

This registry-based study analyzed data from 14,711 children under 20 diagnosed with common childhood cancers, sourced from the Iranian National Population-based Cancer Registry for the period 2014–2018. The age-standardized incidence rates (ASR) were calculated using direct standardization methods and reported per 1 million person-years. Spatial autocorrelation measures, including global and local indices such as Moran's I and Getis-Ord's G, were employed to identify high-risk and low-risk areas, assess overall spatial dependence, and pinpoint specific clusters and hotspots of incidence rates.

Results

ASR for childhood cancer in Iran was 119.56 per 1 million individuals aged 0–19 years. Boys had a higher ASR (129.98) than girls (107.68). Childhood cancer cases increased from 2765 in 2014 to 3354 in 2018, with leukemia as the most common type, followed by brain and nervous system, lymphoma, bone, and connective and soft tissue cancers. Spatial analysis identified high-risk clusters in central Iran (Isfahan, Yazd, Tehran) and low-risk clusters in the northeast (Kermanshah, West and East Azerbaijan, Kurdistan).

Conclusion

This study highlights high childhood cancer incidence in Iran, particularly among boys and in central regions, with elevated leukemia rates. These findings call for targeted prevention strategies and further research to address geographic and gender disparities and to improve care programs.

导言预计癌症将成为 21 世纪的主要死因。虽然儿童癌症相对罕见，但仍是儿童死亡的重要原因。本研究利用 2014 年至 2018 年期间全国癌症登记处的数据，研究了伊朗各省儿童癌症发病率的地理分布情况。材料和方法这项基于登记处的研究分析了 14711 名 20 岁以下确诊为常见儿童癌症的儿童的数据，这些数据来自伊朗全国人口癌症登记处 2014 年至 2018 年期间的数据。采用直接标准化方法计算年龄标准化发病率（ASR），并报告每百万人年的发病率。研究采用了空间自相关测量方法，包括全局和局部指数，如 Moran's I 和 Getis-Ord's G，以确定高风险和低风险地区，评估总体空间依赖性，并确定发病率的特定集群和热点。男孩的发病率（129.98）高于女孩（107.68）。儿童癌症病例从2014年的2765例增加到2018年的3354例，其中白血病是最常见的类型，其次是脑和神经系统癌症、淋巴瘤、骨癌以及结缔组织和软组织癌症。空间分析确定了伊朗中部（伊斯法罕、亚兹德、德黑兰）的高风险集群和东北部（克尔曼沙阿、西阿塞拜疆和东阿塞拜疆、库尔德斯坦）的低风险集群。这些发现要求制定有针对性的预防策略，并开展进一步研究，以解决地域和性别差异问题，并改进护理计划。

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引用次数: 0

Trends in head and neck cancer incidence in Ho Chi Minh City, Vietnam between 1996 and 2015 1996 年至 2015 年越南胡志明市头颈癌发病率趋势。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-18 DOI: 10.1016/j.canep.2024.102686

Fiona Deutsch , Ngoc Ha Tran , Dung X. Pham , Nguyen Dinh Hien , V. Nguyen Tuan , Dayna Sais , Nham Tran

Introduction

This study provides an analysis of head and neck cancer (HNC) cases over a 20-year period in Ho Chi Minh City, Vietnam. It aims to shed light on HNC's characteristics and trends in this highly populated urban region.

Methods

The analysis encompasses 8974 HNC cases, emphasising incidence rates, gender distribution, and the prevalence of different subtypes, including oral cavity, nasopharyngeal, oropharyngeal, and laryngeal/pharyngeal cancers. Ho Chi Minh City was chosen due to its extensive cancer reporting systems and its role as a major urban healthcare centre attracting a wide range of patients.

Results

The study reveals an increasing incidence of HNC in Ho Chi Minh City, with a notable predominance of male patients (73 %). The breakdown of HNC cases shows oral cavity cancer at 34 %, nasopharyngeal at 33 %, oropharyngeal at 12 %, and laryngeal/pharyngeal at 21 %. Compared to global averages, Vietnamese patients are diagnosed at an earlier age, with a noticeable trend of decreasing mean age of diagnosis over the study period.

Conclusion

This comprehensive study provides valuable insights into the HNC landscape in Ho Chi Minh City, revealing a slightly lower overall incidence but an earlier age of diagnosis compared to global trends. These findings suggest the need for region-specific public health initiatives and further research to clarify the epidemiological features of HNC in Vietnam.

导言：本研究对越南胡志明市 20 年间的头颈癌 (HNC) 病例进行了分析。研究旨在揭示这一人口高度密集的城市地区 HNC 的特点和趋势：分析包括 8974 例 HNC 病例，重点是发病率、性别分布和不同亚型的发病率，包括口腔癌、鼻咽癌、口咽癌和喉癌/咽癌。之所以选择胡志明市，是因为胡志明市拥有广泛的癌症报告系统，而且胡志明市是主要的城市医疗中心，吸引了众多患者：研究显示，胡志明市的 HNC 发病率呈上升趋势，男性患者明显占多数（73%）。HNC 病例的分类显示，口腔癌占 34%，鼻咽癌占 33%，口咽癌占 12%，喉/咽癌占 21%。与全球平均水平相比，越南患者确诊年龄较早，在研究期间，平均确诊年龄呈明显下降趋势：这项全面的研究为了解胡志明市的 HNC 状况提供了宝贵的信息，与全球趋势相比，胡志明市的总体发病率略低，但确诊年龄较早。这些发现表明，有必要采取针对特定地区的公共卫生措施并开展进一步研究，以明确越南 HNC 的流行病学特征。

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引用次数: 0

Head and neck cancer mortality trends in Espírito Santo, Brazil 巴西圣埃斯皮里图的头颈癌死亡率趋势。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-18 DOI: 10.1016/j.canep.2024.102687

Jéssica Graça Sant’Anna , Max Moura de Oliveira , Priscila Marinho Abreu , Willene dos Santos Machado Zorzaneli , Camila Batista Daniel , José Roberto Vasconcelos Podestá , Maria Paula Curado , Sandra Ventorin von Zeidler

Introduction

In Brazil, regional disparities in mortality rates are evident. This study analyzes the mortality trends of head and neck squamous cell carcinoma (HNSCC) from 1998 to 2017 in Espírito Santo.

Methods

Data on deaths were obtained from the Unified Health System's Department of Informatics (DATASUS), and population statistics were sourced from the Brazilian Institute of Geography and Statistics (IBGE). Annual percentage change (APC) calculations with a 95 % confidence interval were used for standardization from 1998 to 2017. The analysis considered age, geographical healthcare regions, and specific anatomical sites (C00–06; C09–10; C12–13; C32; C14). Mortality rates adjusted for age and sex were computed for spatial distribution, focusing on Espírito Santo municipalities in two periods (1998–2007 and 2008–2017).

Results

From 1998–2017, males aged 40–59 showed a rise in age-standardized mortality rate from 48.96 to 58.24/100,000. Espírito Santo experienced an increasing mortality trend in males across the health regions, whilst in females the increase was observed only in the Central region. Oral cavity, oropharynx and larynx subsites showed a mortality increase in males with APC of 1.1 %, 4.7 % and 2.6 %, respectively, while females had a rise only in oral cavity cancer deaths. Spatial analysis revealed higher mortality rates in both sexes during 2008–2017 compared to 1998–2007.

Conclusions

Our data highlighted an escalating mortality trend from 1998 to 2017 among men aged 40–80 in oral cavity, oropharynx and larynx, whereas the female population experienced a rise limited to oral cavity cancer mortality. As the only study covering this period in Espírito Santo, it serves as a valuable tool for developing strategies for HNSCC management, considering the socio-economic advancements achieved in recent years.

导言：在巴西，死亡率的地区差异非常明显。本研究分析了1998年至2017年圣埃斯皮里图州头颈部鳞状细胞癌（HNSCC）的死亡率趋势：死亡数据来自统一卫生系统信息部（DATASUS），人口统计数据来自巴西地理统计局（IBGE）。年百分比变化 (APC) 计算的置信区间为 95%，用于 1998 年至 2017 年的标准化。分析考虑了年龄、地理医疗区域和特定解剖部位（C00-06；C09-10；C12-13；C32；C14）。在两个时期（1998-2007 年和 2008-2017 年），以圣埃斯皮里图市为重点，计算了按年龄和性别调整后的空间分布死亡率：1998-2017年，40-59岁男性的年龄标准化死亡率从48.96/100,000上升至58.24/100,000。圣埃斯皮里图各卫生区的男性死亡率均呈上升趋势，而女性死亡率仅在中部地区有所上升。口腔、口咽和喉咙亚部位的男性死亡率上升，APC 分别为 1.1%、4.7% 和 2.6%，而女性仅口腔癌死亡率上升。空间分析显示，与1998-2007年相比，2008-2017年期间男女死亡率均有所上升：我们的数据显示，1998-2017年期间，40-80岁男性口腔、口咽和喉部癌症死亡率呈上升趋势，而女性的上升仅限于口腔癌死亡率。作为圣埃斯皮里图在这一时期进行的唯一一项研究，考虑到近年来取得的社会经济进步，该研究为制定HNSCC管理策略提供了宝贵的工具。

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引用次数: 0

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-17 DOI: 10.1016/j.canep.2024.102688

D.E. Renteria Ramirez , L.A. Knøfler , J. Kirkegård , C.W. Fristrup , M.T. Stender , S.D. Nielsen , A. Markussen , P.N. Larsen , D. Akdag , H.A. Al-Saffar , H.C. Pommergaard

Background

Biliary tract cancer (BTC) is a malignancy characterized by a low 5-year survival rate (<20 %). Clinical aspects such as tumor resectability, Eastern Cooperative Oncology Group performance status score (ECOG-PS), and molecular profiling are used to determine the treatment for these patients. Diagnosis and treatment are typically established by a multidisciplinary team (MDT). However, standardized practices for BTC are lacking, and there is a need to assess the impact of current MDT treatment decisions on BTC outcomes. The purpose of this study was to investigate the role of the treatment plan proposed by the first MDT conference on survival in patients with BTC, and to identify risk factors for poor survival in this population.

Method

This nationwide, multicenter, retrospective cohort study examined data from the Danish Liver Cancer Group (2013–2020) with confirmed BTC diagnoses. Multiple imputation was used to handle missing data. Survival and variable-survival rate relationships were analyzed using the Kaplan-Meier estimator, and the Cox regression model, respectively.

Results

Eligible BTC-confirmed cases: n=1923. The overall median survival was 7.7 months (95 % CI: 7.1–8.5), with a 5-year survival rate of 16.3 %. Patients over 70 years of age, with ECOG-PS 3 or 4, non-operable cases, and with unresectable tumors had lower survival rates. Surgery as the first therapeutic option showed the highest median survival (33.1 months, 95 % CI: 27.2–41.6; p < 0.0001). Multivariable analysis showed that poor ECOG-PS, palliative and neoadjuvant chemotherapy, stereotactic radiotherapy, and best supportive care significantly increased mortality risk in patients with BTC (p=0.05).

Conclusion

Among the therapeutic options prescribed by the MDT for patients with BTC, surgery offered the best survival rates, likely due to patient-related prognostic factors. High ECOG-PS was linked to an increased mortality risk regardless of age, highlighting the importance of this criterion in treatment decisions.

背景胆道癌（BTC）是一种恶性肿瘤，其特点是 5 年生存率低（20%）。临床方面，如肿瘤可切除性、东部合作肿瘤学组（Eastern Cooperative Oncology Group）表现状态评分（ECOG-PS）和分子图谱分析被用来决定这些患者的治疗方法。诊断和治疗通常由多学科团队（MDT）确定。然而，目前还缺乏针对 BTC 的标准化实践，因此有必要评估当前 MDT 治疗决策对 BTC 治疗结果的影响。这项研究的目的是调查首次多学科小组会议提出的治疗方案对 BTC 患者生存率的影响，并确定该人群生存率低的风险因素。这项全国性、多中心、回顾性队列研究检查了丹麦肝癌组（2013-2020 年）确诊为 BTC 的数据。采用多重估算法处理缺失数据。分别使用 Kaplan-Meier 估计器和 Cox 回归模型分析了生存率和变量与生存率之间的关系。总生存期中位数为 7.7 个月（95 % CI：7.1-8.5），5 年生存率为 16.3%。年龄超过 70 岁、ECOG-PS 3 或 4、无法手术以及肿瘤无法切除的患者生存率较低。手术作为第一治疗方案的中位生存期最高（33.1 个月，95 % CI：27.2-41.6；p < 0.0001）。多变量分析显示，ECOG-PS差、姑息化疗和新辅助化疗、立体定向放疗和最佳支持治疗会显著增加BTC患者的死亡风险（P=0.05）。ECOG-PS高与死亡率风险增加有关，与年龄无关，这凸显了这一标准在治疗决策中的重要性。

{"title":"Prognosis related to treatment plan in patients with biliary tract cancer: A nationwide database study","authors":"D.E. Renteria Ramirez , L.A. Knøfler , J. Kirkegård , C.W. Fristrup , M.T. Stender , S.D. Nielsen , A. Markussen , P.N. Larsen , D. Akdag , H.A. Al-Saffar , H.C. Pommergaard","doi":"10.1016/j.canep.2024.102688","DOIUrl":"10.1016/j.canep.2024.102688","url":null,"abstract":"<div><h3>Background</h3><div>Biliary tract cancer (BTC) is a malignancy characterized by a low 5-year survival rate (<20 %). Clinical aspects such as tumor resectability, Eastern Cooperative Oncology Group performance status score (ECOG-PS), and molecular profiling are used to determine the treatment for these patients. Diagnosis and treatment are typically established by a multidisciplinary team (MDT). However, standardized practices for BTC are lacking, and there is a need to assess the impact of current MDT treatment decisions on BTC outcomes. The purpose of this study was to investigate the role of the treatment plan proposed by the first MDT conference on survival in patients with BTC, and to identify risk factors for poor survival in this population.</div></div><div><h3>Method</h3><div>This nationwide, multicenter, retrospective cohort study examined data from the Danish Liver Cancer Group (2013–2020) with confirmed BTC diagnoses. Multiple imputation was used to handle missing data. Survival and variable-survival rate relationships were analyzed using the Kaplan-Meier estimator, and the Cox regression model, respectively.</div></div><div><h3>Results</h3><div>Eligible BTC-confirmed cases: n=1923. The overall median survival was 7.7 months (95 % CI: 7.1–8.5), with a 5-year survival rate of 16.3 %. Patients over 70 years of age, with ECOG-PS 3 or 4, non-operable cases, and with unresectable tumors had lower survival rates. Surgery as the first therapeutic option showed the highest median survival (33.1 months, 95 % CI: 27.2–41.6; p < 0.0001). Multivariable analysis showed that poor ECOG-PS, palliative and neoadjuvant chemotherapy, stereotactic radiotherapy, and best supportive care significantly increased mortality risk in patients with BTC (p=0.05).</div></div><div><h3>Conclusion</h3><div>Among the therapeutic options prescribed by the MDT for patients with BTC, surgery offered the best survival rates, likely due to patient-related prognostic factors. High ECOG-PS was linked to an increased mortality risk regardless of age, highlighting the importance of this criterion in treatment decisions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102688"},"PeriodicalIF":2.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cancer of the paranasal sinuses in Germany: Data on incidence and survival from a population-based cancer registry 德国的副鼻窦癌症：来自人口癌症登记处的发病率和存活率数据。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-10 DOI: 10.1016/j.canep.2024.102684

Lisa Nachtsheim , Lennart Möller , Florian Oesterling , Hiltraud Kajueter , Andreas Stang , Lena Hieggelke , Helen Abing , Jenny Shachi Sharma , Jens Peter Klussmann , Marcel Mayer , Philipp Wolber

Purpose

This study aims to provide a broad overview of the epidemiology of cancer of the paranasal sinuses (PSC) in Germany. The data include information on incidence, staging, clinicopathological features and survival from one of the largest cancer registries in Europe.

Methods

Population-based data on PSC diagnosed from January 1st, 2009 until December 31st, 2019 were retrieved from the German Centre for Cancer Registry Data (ZfKD). Age standardized incidence was calculated and relative survival estimates were computed by sex, histological subtype, age group and T-, N-, and M-Stage.

Results

In total, 3975 cases were included in this study. The age-adjusted incidence rate (ASR) for PSC was 0.3/100,000 which remained stable during the observation period. The most frequent tumor localization was the maxillary sinus (41.9 %) and the most common histological subtype was keratinizing squamous cell carcinoma (kSCC) (44.3 %). All subtypes were predominantly found in the maxillary sinus except for adenocarcinoma and neuroendocrine carcinomas (SNEC), which were most frequently located in the ethmoidal sinus. The majority of the patients with a known T stage was diagnosed in tumor stage T4 (60.8 %). The overall 5-year relative survival (RS) for all patients with PSC was 52 %. RS dropped from 93 % for T1 stage tumors to 39 % for T4 tumors. RS was 58 % for N0 and 31 % for N+ cases, 54 % for M0 and 27 % for M1 cases.

Conclusion

Age-adjusted incidence for PSC is low and has been stable for the observed 11-year period. RS decreases continuously with increasing T-, N- and M-stage.

目的：本研究旨在概述德国鼻旁窦癌（PSC）的流行病学。数据包括来自欧洲最大的癌症登记处之一的发病率、分期、临床病理特征和存活率等信息：方法：从德国癌症登记数据中心（ZfKD）检索了 2009 年 1 月 1 日至 2019 年 12 月 31 日期间确诊的 PSC 患者的人口数据。按性别、组织学亚型、年龄组以及T期、N期和M期计算了年龄标准化发病率和相对生存率：本研究共纳入 3975 例病例。PSC的年龄调整发病率（ASR）为0.3/100,000，在观察期内保持稳定。最常见的肿瘤部位是上颌窦（41.9%），最常见的组织学亚型是角化鳞状细胞癌（44.3%）。除了腺癌和神经内分泌癌（SNEC）最常见于乙状窦外，所有亚型都主要发生在上颌窦。大多数已知T分期的患者被诊断为肿瘤T4期（60.8%）。所有 PSC 患者的总体 5 年相对生存率（RS）为 52%。相对生存率从 T1 期肿瘤的 93% 降至 T4 期肿瘤的 39%。N0和N+病例的相对生存率分别为58%和31%，M0和M1病例的相对生存率分别为54%和27%：结论：经年龄调整后，PSC 的发病率较低，且在观察的 11 年间保持稳定。随着T、N和M分期的增加，RS持续下降。

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引用次数: 0

Impact of the COVID-19 pandemic on lung cancer diagnoses and mortality: A nationwide study in France COVID-19 大流行对肺癌诊断和死亡率的影响：法国全国性研究。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-10 DOI: 10.1016/j.canep.2024.102679

Jonas Poucineau , Myriam Khlat , Nathanaël Lapidus , Christos Chouaïd , Maude Espagnacq , Tristan Delory , Sophie Le Cœur

Background

During the first wave of the COVID-19 pandemic, a reduction in the number of newly diagnosed cases of lung cancer has been reported worldwide, often associated with a higher proportion of cases diagnosed at an advanced stage compared with previous years.

Methods

Using the French National Hospital Database, we investigated incident lung cancer cases and their mortality during pandemic years 2020 and 2021, compared to predictions based on pre-pandemic years 2013–2019. Mortality was assessed up to 24 months following incidence date. Expected numbers of incident cases and all-cause deaths during the pandemic were estimated using Poisson regression models and survival was analyzed using Cox regressions.

Results

The database included 397,092 incident lung cancer cases in total, 20 % of whom underwent thoracic surgery. During the first pandemic wave (March–June 2020), there were 12 % i.e., 1940 fewer incident lung cancer cases than the expected figure (16,325), while no significant difference was found thereafter. Survival at 6 and 24 months improved steadily from 2013 to 2019 and continued to improve during pandemic years 2020–2021. However, during the first wave, a slight excess mortality was observed compared with predictions based on pre-pandemic trends.

Conclusions

The lower incidence observed during the first wave with no catch-up in the following periods could be explained by deaths among yet undiagnosed patients, either from COVID-19 or as a result of barriers to accessing healthcare. The excess mortality observed for both operated and non-operated patients may be attributable to delayed diagnosis, as well as to COVID-19-related deaths.

背景：据报道，在 COVID-19 大流行的第一波期间，全球新诊断的肺癌病例数量有所减少，与前几年相比，这往往与晚期诊断病例比例较高有关：我们利用法国国家医院数据库，对 2020 年和 2021 年大流行期间的肺癌病例及其死亡率进行了调查，并与基于 2013-2019 年大流行前的预测进行了比较。死亡率在发病后 24 个月内进行评估。使用泊松回归模型估算了大流行期间的预期病例数和全因死亡数，并使用 Cox 回归分析了存活率：数据库共收录了 397,092 例肺癌病例，其中 20% 接受了胸外科手术。在第一波大流行期间（2020 年 3 月至 6 月），肺癌病例比预期数字（16,325 例）少了 12%，即 1940 例，此后则没有发现显著差异。从 2013 年到 2019 年，6 个月和 24 个月的存活率稳步提高，并在 2020-2021 年大流行期间继续提高。然而，在第一波疫情中，与根据疫情前趋势做出的预测相比，死亡率略有上升：结论：在第一波疫情中观察到的发病率较低，而在随后的疫情中没有追赶现象，这可能是由于 COVID-19 或由于获得医疗服务的障碍导致尚未确诊的患者死亡。在手术和非手术患者中观察到的超高死亡率可能归因于诊断延迟以及与 COVID-19 相关的死亡。

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引用次数: 0

Modifiable and non-modifiable risk factors of early-onset colorectal cancer: National Health Interview Survey analysis 早发结直肠癌的可改变和不可改变风险因素：全国健康访谈调查分析。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-08 DOI: 10.1016/j.canep.2024.102682

Yahan Zhang, Ange Lu, Hyeun Ah Kang

Background and aims

Although the incidence of colorectal cancer (CRC) diagnosed in individuals younger than 50 years, early-onset CRC (EO-CRC), is rapidly increasing, the risk factors for EO-CRC are still being identified. This study aimed to confirm the modifiable and non-modifiable characteristics identified as risk factors for EO-CRC.

Methods

This cross-sectional study used 2004–2018 National Health Interview Survey (NHIS) data, which provides comprehensive health information gathered from national annual household interview surveys. Demographic, clinical, and behavioral characteristics of EO-CRC patients were compared with those without. In addition, their non-age-related characteristics (gender, race/ethnicity, region, body mass index [BMI], alcohol consumption, and smoking status) were compared with individuals with average-onset CRC (AO-CRC). For both comparisons, multivariable logistic regression analyses were performed.

Results

We identified 156 patients with EO-CRC, 204,846 with non-CRC, and 1972 with AO-CRC. Comparison between the EO-CRC and the non-CRC groups showed that higher odds of having EO-CRC was associated with older age (Odds Ratio [OR]=1.11, 95 % CI=1.08–1.14, p<0.001), living in the Midwest (vs. South) (OR=1.64, 95 % CI=1.06–2.55, p=0.03), and history of alcohol consumption (vs. lifetime abstainer) (OR=2.09, 95 % CI=1.01–4.36, p=0.049). Lower odds of having EO-CRC were associated with being Hispanic (OR=0.43, 95 % CI=0.22–0.84, p=0.01) or Asian (OR=0.38, 95 % CI=0.16–0.92, p=0.03) (vs. non-Hispanic White) and having moderate or vigorous physical activities (vs. no activity) (OR=0.58, 95 % CI=0.34–0.999, p=0.0496 and OR=0.34; 95 % CI=0.21–0.55, p<0.0001, respectively). Compared with patients with AO-CRC, patients with EO-CRC were more likely to be Hispanic (vs. non-Hispanic White) (OR=2.21, 95 % CI=1.13–4.33, p=0.02).

Conclusion

This study verified several modifiable (i.e., alcohol consumption and physical activity) and non-modifiable (i.e., race/ethnicity) risk factors while also discovering a new factor (i.e., geographical region) associated with EO-CRC.

背景和目的：尽管在50岁以下的人群中确诊的结直肠癌（CRC），即早发性结直肠癌（EO-CRC）的发病率正在迅速上升，但EO-CRC的风险因素仍在不断确定之中。本研究旨在确认作为 EO-CRC 危险因素的可改变和不可改变特征：这项横断面研究使用了 2004-2018 年全国健康访谈调查（NHIS）数据，该数据提供了从全国年度家庭访谈调查中收集的全面健康信息。将 EO-CRC 患者的人口、临床和行为特征与非 EO-CRC 患者进行了比较。此外，还将他们与年龄无关的特征（性别、种族/民族、地区、体重指数[BMI]、饮酒量和吸烟状况）与平均发病型 CRC（AO-CRC）患者进行了比较。两种比较均进行了多变量逻辑回归分析：结果：我们发现了 156 例 EO-CRC 患者、204846 例非 CRC 患者和 1972 例 AO-CRC 患者。EO-CRC 组和非 EO-CRC 组之间的比较显示，年龄越大，患 EO-CRC 的几率越高（Odds Ratio [OR]=1.11, 95 % CI=1.08-1.14, pConclusion）：这项研究验证了几个可改变（即饮酒和体育锻炼）和不可改变（即种族/民族）的风险因素，同时还发现了一个与 EO-CRC 相关的新因素（即地理区域）。

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引用次数: 0

Beyond the urban-rural divide: Exploring spatial variations in breast cancer outcomes in Queensland, Australia 超越城乡差别：探索澳大利亚昆士兰州乳腺癌结果的空间差异。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-03 DOI: 10.1016/j.canep.2024.102681

Kou Kou , Jessica Cameron , Paramita Dasgupta , Aiden Price , Hao Chen , Derrick Lopez , Kerrie Mengersen , Sandi Hayes , Peter Baade

Background

Breast cancer is the most commonly diagnosed cancer among women worldwide. While previous studies have reported urban and rural differences in breast cancer outcomes, the level of heterogeneity within these broad regions is currently unknown.

Methods

Population-level data from Queensland Cancer Register including 58,679 women aged at least 20 years who were diagnosed with breast cancer in Queensland, Australia, 2000–2019 were linked to BreastScreen Queensland and Queensland Hospital Admitted Patients Data Collection to estimate five breast cancer outcomes: incidence, proportion of localised disease and screen-detected cases (via public-funded program), surgical rates, and 5-year survival. Bayesian spatial models were used to smooth outcomes across 512–517 small areas in Queensland.

Results

The incidence of breast cancer was not proportionally distributed, with urban regions having higher rates. Less than half (47 %) of women were diagnosed with localised disease, 91 % had surgery, with five-year relative survival of 92 %. There was no evidence of geographic variation in the proportion of localised disease, surgical rates, or survival over Queensland. Publicly-funded screening detected 38 % of cases, with lower proportion of screen-detected cases observed in Queensland’s urbanised south-east corner.

Conclusion

Although the disparities in health outcomes faced by Australians living in rural areas have received increased attention, this study found limited evidence for spatial variation in breast cancer outcomes along the continuum of care across Queensland. These results suggest the detection and management practices for breast cancer may provide an achievable benchmark for other cancer types in reducing the geographical disparity in cancer outcomes.

背景：乳腺癌是全球妇女中最常见的癌症。虽然之前的研究报告了城市和农村在乳腺癌结果上的差异，但目前还不清楚这些大区域内的异质性程度：方法：将 2000-2019 年期间澳大利亚昆士兰癌症登记册（包括 58,679 名年龄在 20 岁以上、被诊断患有乳腺癌的女性）中的人口级数据与昆士兰乳腺癌筛查（BreastScreen Queensland）和昆士兰医院住院病人数据收集（Queensland Hospital Admitted Patients Data Collection）联系起来，以估计五种乳腺癌结果：发病率、局部疾病和筛查发现病例（通过公共资助项目）的比例、手术率和 5 年生存率。贝叶斯空间模型用于平滑昆士兰州 512-517 个小区域的结果：结果：乳腺癌的发病率并不是按比例分布的，城市地区的发病率更高。不到一半（47%）的妇女被诊断为局部疾病，91%的妇女接受了手术，五年相对生存率为 92%。没有证据表明昆士兰州的局部疾病比例、手术率或存活率存在地域差异。公费筛查发现了 38% 的病例，昆士兰城市化的东南角地区筛查发现的病例比例较低：尽管生活在农村地区的澳大利亚人所面临的健康结果差异已受到越来越多的关注，但本研究发现，在昆士兰州，乳腺癌治疗结果的空间差异证据有限。这些结果表明，乳腺癌的检测和管理方法可为其他癌症类型提供一个可实现的基准，以减少癌症结果的地域差异。

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引用次数: 0

Trends in incidence, treatment modalities and prognosis of esophageal adenocarcinoma in the US population 美国人口中食管腺癌的发病率、治疗方式和预后趋势。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-03 DOI: 10.1016/j.canep.2024.102683

Zhuoyang Yu , Tong Chen , Haoyu Peng , Anyuan Li , Yutong Wei , Shiyu Xiao

Background

Esophageal adenocarcinoma (EAC) was the predominant subtype of esophageal cancer in the Western population. However, an updated and comprehensive analysis of epidemiologic, clinical, and prognostic characteristics of esophageal adenocarcinoma is lacking.

Materials and methods

This was a population-based cohort study using the Surveillance Epidemiology and End-Results (SEER) Database. Patients diagnosed with EAC between 1988 and 2020 were included. Incidence trends, clinical characteristics, treatment patterns, and relative survival were systematically analyzed.

Results

The overall age-standardized incidence rate of EAC significantly increased from 1.7 per 100000 persons in 1988 to 3.6 per 100000 persons in 2020. There were no significant changes in the distribution of age group, sex, and primary site of EAC over time. However, the proportion of EAC clinically staged as I or II decreased from 35.1 % to 27.9 %. Over time, palliative chemotherapy in metastatic EAC increased from 26.7 % to 41.3 %, combination therapy was still the main treatment strategy for nonmetastatic EAC. Despite the 5-year survival rate was less than 20 %, 1-year survival has experienced a moderate increase from 46.7 % to 53.7 %. Specifically, 1-year survival rate for nonmetastatic EAC undergoing surgery only experienced a significant increase from 80.2 % in 2004–2006 to 94.7 % in 2019–2020. For metastatic EAC, obvious improvement in 1-year survival rate was observed in those treated with systematic therapy (from 26.6 % in 2004–2006 to 41.2 % in 2019–2020). In the multivariable analysis, older age, male sex, lower household income, living without a partner, advanced TNM stage, and receiving no cancer treatment were significantly associated with poor survival.

Conclusion

In summary, this population-based study of EAC patients in the US showed an increase in incidence, a shift in treatment modalities for metastatic EAC, and moderately improved 1-year survival. The search for more effective surveillance and treatment strategies should be continued in the future.

背景：食管腺癌（EAC）是西方人群中食管癌的主要亚型。然而，目前还缺乏对食管腺癌的流行病学、临床和预后特征的最新全面分析：这是一项基于人群的队列研究，使用的是监测、流行病学和最终结果（SEER）数据库。研究纳入了 1988 年至 2020 年期间确诊为 EAC 的患者。研究对发病趋势、临床特征、治疗模式和相对存活率进行了系统分析：结果：EAC的总体年龄标准化发病率从1988年的每10万人1.7例显著上升至2020年的每10万人3.6例。随着时间的推移，EAC的年龄组、性别和原发部位分布没有明显变化。不过，临床分期为 I 或 II 期的 EAC 比例从 35.1% 降至 27.9%。随着时间的推移，转移性EAC的姑息化疗比例从26.7%上升到41.3%，但联合疗法仍是非转移性EAC的主要治疗策略。尽管 5 年生存率不到 20%，但 1 年生存率却从 46.7% 增加到 53.7%。具体而言，接受手术治疗的非转移性 EAC 的 1 年生存率仅从 2004-2006 年的 80.2% 显著增加到 2019-2020 年的 94.7%。对于转移性 EAC，接受系统治疗者的 1 年生存率明显提高（从 2004-2006 年的 26.6% 提高到 2019-2020 年的 41.2%）。在多变量分析中，年龄较大、性别为男性、家庭收入较低、无伴侣生活、TNM分期较晚以及未接受癌症治疗与生存率较低显著相关：总之，这项针对美国 EAC 患者的人群研究表明，EAC 的发病率有所上升，转移性 EAC 的治疗方式有所转变，1 年生存率略有提高。未来应继续寻找更有效的监测和治疗策略。

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引用次数: 0