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Understanding female breast cancer risk in the Indian population: Evidence from a systematic review and meta-analysis 了解印度人群中的女性乳腺癌风险:来自系统回顾和荟萃分析的证据。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-16 DOI: 10.1016/j.canep.2025.102979
Saravanan Vijayakumar, Thilagavathi Ramamoorthy , Abhishek David George, Anita Nath

Background

Breast cancer incidence in India is expected to rise by about 5.6 % annually, translating to an estimated increase of 0.05 million new cases per year. This systematic review and meta-analysis aim to investigate the influence of India's unique context on breast cancer risk by identifying and synthesising population-specific risk factors.

Methods

We conducted a systematic literature search across the PubMed, Scopus, and Embase databases up to December 22, 2024. Observational studies assessing breast cancer risk factors among Indian women were included, and quality was assessed using the Joanna Briggs Institute Checklist. A meta-analysis using a random-effects model estimated pooled associations between key risk factors and breast cancer.

Results

Among the 1871 articles identified, 31 studies met the inclusion criteria of which case-control studies were of moderate to high quality. The meta-analysis revealed significant positive associations with breast cancer risk for late menopause (age >50 years), delayed first pregnancy or childbirth (age >30 years), multiple abortions, higher age at marriage, increased waist-to-hip ratio (≥0.85), and family history of cancer, particularly breast cancer. Among lifestyle factors, poor sleep quality, irregular sleep patterns, sleeping in a lighted room, and elevated stress levels were also positively associated with risk in individual studies. In contrast, higher levels of physical activity showed an inverse association.

Conclusions

Reproductive timing, hormonal exposure, central obesity, and family history influence breast cancer risk primarily among Indian women. In conclusion, the review highlights the critical need for large, extensive, population-based prospective cohort studies in India to define breast cancer prevention and early detection strategies with greater precision.
背景:印度的乳腺癌发病率预计将以每年5.6% %的速度增长,这意味着每年估计会增加0.05万新病例。本系统综述和荟萃分析旨在通过识别和综合人群特异性风险因素,调查印度独特的环境对乳腺癌风险的影响。方法:我们对PubMed、Scopus和Embase数据库进行了系统的文献检索,检索截止到2024年12月22日。评估印度妇女乳腺癌风险因素的观察性研究被纳入其中,并使用乔安娜布里格斯研究所检查表对质量进行评估。一项使用随机效应模型的荟萃分析估计了关键危险因素与乳腺癌之间的综合关联。结果:在纳入的1871篇文献中,有31篇研究符合病例对照研究中至高质量的纳入标准。荟萃分析显示,绝经晚期(50岁至50岁)、首次怀孕或分娩延迟(30岁至50岁)、多次流产、结婚年龄较高、腰臀比增加(≥0.85)和癌症家族史(尤其是乳腺癌)与乳腺癌风险显著正相关。在个人研究中,生活方式因素中,睡眠质量差、睡眠模式不规律、睡在光线充足的房间里以及压力水平升高也与风险呈正相关。相比之下,高水平的体育活动则呈现出反比关系。结论:生育时间、激素暴露、中心性肥胖和家族史主要影响印度妇女患乳腺癌的风险。总之,该综述强调了在印度开展大规模、广泛、基于人群的前瞻性队列研究的迫切需要,以便更精确地确定乳腺癌预防和早期发现策略。
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引用次数: 0
Etiologic profile and prognostic patterns of hepatocellular carcinoma in a Southern European population – Madeira, Portugal: Insight into a preventable cancer 欧洲南部人群中肝细胞癌的病因学特征和预后模式——葡萄牙马德拉:洞察一种可预防的癌症
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-12 DOI: 10.1016/j.canep.2025.102976
Pedro H. Berenguer , Cláudia Fraga , Sara Müller , Patrícia Serrão , Carolina Camacho , Laurentina Silva , Nuno Ladeira , Paulo S. Pinheiro , Carolina Sales

Background

Liver cancer is the sixth most common and third deadliest cancer worldwide. In Portugal, it remains highly lethal, with 1740 new cases and 1611 deaths estimated in 2022. Hepatocellular carcinoma (HCC) is the main histological type and exhibits variation in risk factors and outcomes. Unlike many malignancies, HCC arises predominantly in chronically diseased tissues and is largely attributable to four modifiable etiologies: hepatitis B (HBV) and C viruses (HCV), alcohol-associated liver disease (ALD), and metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to characterize HCC etiology-specific incidence and prognostic patterns in the Madeira islands, Portugal.

Methods

All HCC cases diagnosed between 2010 and 2023 were identified through the Madeira Cancer Registry. Etiologies and risk factors were assigned using clinical records, serological markers, and ICD-coded discharge data. Age-standardized incidence rates (ASIRs) were computed using the world and the 2000 U.S. standard population. Survival outcomes were assessed with Kaplan-Meier curves and Cox proportional hazards models.

Results

Among 240 HCC cases, the leading etiology was ALD (50.0 %), followed by MASLD (17.1 %), HBV (16.5 %), and HCV (11.9 %). Male incidence was nearly 8-fold higher than female incidence (ASIR: 6.9 vs. 0.9 per 100,000), with ALD dominating among men and MASLD among women. No significant temporal change in HCC incidence was observed. Most patients (63.8 %) were diagnosed at advanced stages. The age-adjusted 5-year survival was 5.6 %, and median survival was 6 months. Cancer stage was the strongest prognostic factor, while HCC etiology was not independently associated with survival.

Conclusions

HCC in Madeira presents a distinct etiologic and prognostic pattern, marked by a high ALD burden among men, a MASLD burden among women, and poor survival due to late-stage diagnosis. These findings highlight the urgency of expanding liver cancer surveillance, integrating metabolic risk management, and targeting alcohol misuse through population-level interventions, especially among males and older patients.
肝癌是世界上第六大最常见和第三致命的癌症。在葡萄牙,它仍然是高度致命的,预计2022年将有1740例新病例和1611例死亡。肝细胞癌(HCC)是主要的组织学类型,其危险因素和预后存在差异。与许多恶性肿瘤不同,HCC主要发生在慢性病变组织中,主要归因于四种可改变的病因:乙型肝炎(HBV)和丙型肝炎病毒(HCV)、酒精相关肝病(ALD)和代谢功能障碍相关脂肪变性肝病(MASLD)。本研究旨在描述葡萄牙马德拉群岛HCC病因特异性发病率和预后模式。方法2010年至2023年间诊断的所有HCC病例均通过马德拉癌症登记处确定。根据临床记录、血清学标记物和icd编码的出院数据确定病因和危险因素。年龄标准化发病率(asir)计算使用世界和2000年 美国标准的人口。生存结果采用Kaplan-Meier曲线和Cox比例风险模型进行评估。结果240例HCC中,病因以ALD(50.0 %)居首,其次为MASLD(17.1 %)、HBV(16.5 %)和HCV(11.9 %)。男性发病率比女性高近8倍(ASIR: 6.9比0.9 / 100000),ALD在男性中占主导地位,而MASLD在女性中占主导地位。HCC发病率未见明显的时间变化。大多数患者(63.8% %)诊断为晚期。年龄调整后5年生存率为5.6% %,中位生存期为6个月。癌症分期是最强的预后因素,而HCC的病因与生存没有独立的相关性。结论马德拉岛的shcc具有独特的病因学和预后模式,其特点是男性ALD负担高,女性MASLD负担高,晚期诊断导致生存率低。这些发现强调了扩大肝癌监测、整合代谢风险管理以及通过人群水平干预(尤其是男性和老年患者)针对酒精滥用的紧迫性。
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引用次数: 0
Population-based trends in gastrointestinal cancer incidence and mortality in New Zealand: A 11-year analysis 新西兰胃肠癌发病率和死亡率基于人群的趋势:一项11年分析
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-04 DOI: 10.1016/j.canep.2025.102973
Lelwala Guruge Thushani Shanika , Robin Turner , Sharon Pattison , Rhiannon Braund
Gastrointestinal (GI) cancers are a major contributor to the global cancer burden. However, no previous study has examined incidence and mortality across all GI cancer sites within a population, stratified by sex, ethnicity, and socioeconomic status. This retrospective, population-based study aimed to address this gap by providing a comprehensive overview of GI cancer incidence and mortality in New Zealand (NZ) from 2009 to 2019 and examining patterns across demographic subgroups. GI cancer cases (ICD-10-AM C15–C26) were identified from the NZ Cancer Registry and linked to the Mortality Collection to assess mortality. Baseline demographics were summarised, and age-standardised incidence and GI cancer-specific mortality rates were calculated. A total of 57,707 GI cancers were diagnosed in 55,611 individuals. The mean age at diagnosis and death were 69.9 (SD: 13.4) and 73.9 (SD: 12.9), respectively. Of those diagnosed with GI cancer, 54.4 % were male. Incidence trends varied by cancer site: small intestinal cancer increased annually (3 % in males, 4 % in females), while stomach and colorectal cancer incidence declined modestly for both sexes. GI cancer mortality declined significantly across all sites (males: RR=0.92;95 %CI:0.88,0.96;p = 0.002); females: RR= 0.91;95 %CI:0.87,0.96; p = 0.002). Māori and Pacific peoples had the highest incidence and mortality rates for stomach (incidence: 13.2 and 14.2; mortality: 9.3 and 7.1 per 100,000) and liver/biliary tract cancers (incidence: 14.1 and 18.1; mortality: 12.0 and 13.9 per 100,000). A clear socioeconomic gradient was observed, with higher incidence and mortality in the most deprived areas. This study reveals clear disparities in GI cancer incidence and mortality across sex, ethnic, and socioeconomic groups in NZ. These patterns highlight the importance of tailoring cancer prevention and early detection efforts to ensure they reach the communities most affected. A stronger focus on equity is needed, not just in NZ, but also in other settings where similar gaps in cancer outcomes persist.
胃肠道(GI)癌症是全球癌症负担的主要贡献者。然而,之前没有研究对人群中所有胃肠道癌症部位的发病率和死亡率进行过调查,并按性别、种族和社会经济地位进行了分层。这项基于人群的回顾性研究旨在通过全面概述2009年至2019年新西兰(NZ)的胃肠道癌症发病率和死亡率,并检查人口亚组的模式,来解决这一差距。从新西兰癌症登记处确定GI癌症病例(ICD-10-AM C15-C26),并与死亡率收集相关联,以评估死亡率。总结基线人口统计数据,计算年龄标准化发病率和胃肠道癌症特异性死亡率。共有55,611人被诊断出57,707例胃肠道癌症。确诊和死亡时的平均年龄分别为69.9岁(SD: 13.4)和73.9岁(SD: 12.9)。在被诊断为胃肠道癌的患者中,54.4% %为男性。不同癌症部位的发病率趋势不同:小肠癌每年增加(男性为3 %,女性为4 %),而胃癌和结直肠癌的发病率在两性中均略有下降。所有地区的胃肠道癌症死亡率均显著下降(男性:RR=0.92;95 %CI:0.88,0.96;p = 0.002);女性:RR = 0.91;95 % CI: 0.87, 0.96; = 0.002页)。Māori和太平洋地区人民的胃癌发病率和死亡率最高(发病率:13.2和14.2;死亡率:每10万人9.3和7.1),以及肝脏/胆道癌症(发病率:14.1和18.1;死亡率:12.0和13.9)。观察到明显的社会经济梯度,最贫困地区的发病率和死亡率较高。这项研究揭示了新西兰不同性别、种族和社会经济群体在胃肠道癌症发病率和死亡率方面的明显差异。这些模式突出了调整癌症预防和早期发现工作的重要性,以确保它们到达受影响最严重的社区。不仅在新西兰,而且在其他癌症结果存在类似差距的国家,都需要更加注重公平。
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引用次数: 0
Burden and determinants of benign prostate hyperplasia in Africa: Systematic review and meta-analysis 非洲良性前列腺增生的负担和决定因素:系统回顾和荟萃分析。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-03 DOI: 10.1016/j.canep.2025.102972
Kedir Seid , Abel Tibebu Goshu , Sintayehu Samuel Lorato , Mitiku Desalegn , Kelemu Abebe Gelaw , Yohannes Godie Ashebir , Olyad Kuma Getahun , Gebeyehu Lakew , Mathewos Mekonnen Gemmechu , Tiruye Menshaw Tiruneh , Yibeltal Assefa Atalay , Amlaku Nigusie Yirsaw , Eyob Ketema Bogale , Natnael Atnafu Gebeyehu , Tewodros Shitemaw Tekoye , Genanew Kassie Getahun

Objective

To determine the prevalence and determinants of benign prostate hyperplasia in Africa via a meta-analysis.

Methods

This report was presented according to the Preferred Reporting Items for Systematic Review and Meta-Analyses checklist. Thirteen articles were searched via PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, Science Direct, and African Journal Online. Data were extracted via Microsoft Excel and exported to STATA 17 for analysis. The data were analyzed via the random effects model. The heterogeneity of the studies was assessed by Cochran’s Q test and I2 statistics. Publication bias was detected via funnel plots and Egger’s test.

Result

In 13 studies conducted in Africa, with a sample size of 5619 people between 2011 and 2024, the pooled prevalence of benign prostate hyperplasia was 44 % (95 % CI 31 %-57 %) in Africa. According to the subgroup analysis, the pooled prevalence was greater in studies published from 2011--2018 (56 % (95 % CI: 38--73)) than in those published from 2019--2024 (34 %). The pooled prevalence rates were also greater in those with sample sizes > 500 than in those with sample sizes < 500 (45 % vs 41 %). Family history of BPH (OR = 5.56; 95 % CI; 1.57, 9.55), difficulty in sexual activity (OR = 13.14; 95 % CI: 5.50, 20.77), use of traditional eye medication (OR = 2.27; 95 % CI: 1.68, 2.86), family history (OR = 4.93; 95 % CI: 3.13, 6.72) and inadequate sleeping time (OR = 2.90, 95 % CI = 2.25–3.55) were factors associated with benign prostate hyperplasia among adults.

Conclusions

The pooled prevalence of BPH among adults living in Africa was significant. Family history, difficulty in sexual activity and inadequate sleeping time were significantly associated with benign prostate hyperplasia. The greater burden of BPH across the country calls for efforts by health policy makers to pay attention to it.
目的:通过荟萃分析确定非洲良性前列腺增生的患病率和决定因素。方法:本报告按照系统评价和荟萃分析首选报告项目清单提交。通过PubMed/MEDLINE、EMBASE、Scopus、b谷歌Scholar、Science Direct和African Journal Online检索了13篇文章。通过Microsoft Excel提取数据,导出到STATA 17进行分析。采用随机效应模型对数据进行分析。采用Cochran’s Q检验和I2统计量评估研究的异质性。通过漏斗图和Egger检验检测发表偏倚。结果:在非洲进行的13项研究中,2011年至2024年间样本量为5619人,非洲良性前列腺增生的总患病率为44 %(95 % CI 31 %-57 %)。根据亚组分析,2011- 2018年发表的研究(56 %(95 % CI: 38- 73))的总患病率高于2019- 2024年发表的研究(34 %)。在样本量为> 500的人群中,总患病率也高于其他人群。结论:生活在非洲的成年人中,BPH的总患病率是显著的。家族史、性活动困难和睡眠不足与良性前列腺增生显著相关。BPH在全国范围内造成的更大负担要求卫生政策制定者努力予以关注。
{"title":"Burden and determinants of benign prostate hyperplasia in Africa: Systematic review and meta-analysis","authors":"Kedir Seid ,&nbsp;Abel Tibebu Goshu ,&nbsp;Sintayehu Samuel Lorato ,&nbsp;Mitiku Desalegn ,&nbsp;Kelemu Abebe Gelaw ,&nbsp;Yohannes Godie Ashebir ,&nbsp;Olyad Kuma Getahun ,&nbsp;Gebeyehu Lakew ,&nbsp;Mathewos Mekonnen Gemmechu ,&nbsp;Tiruye Menshaw Tiruneh ,&nbsp;Yibeltal Assefa Atalay ,&nbsp;Amlaku Nigusie Yirsaw ,&nbsp;Eyob Ketema Bogale ,&nbsp;Natnael Atnafu Gebeyehu ,&nbsp;Tewodros Shitemaw Tekoye ,&nbsp;Genanew Kassie Getahun","doi":"10.1016/j.canep.2025.102972","DOIUrl":"10.1016/j.canep.2025.102972","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence and determinants of benign prostate hyperplasia in Africa via a meta-analysis.</div></div><div><h3>Methods</h3><div>This report was presented according to the Preferred Reporting Items for Systematic Review and Meta-Analyses checklist. Thirteen articles were searched via PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, Science Direct, and African Journal Online. Data were extracted via Microsoft Excel and exported to STATA 17 for analysis. The data were analyzed via the random effects model. The heterogeneity of the studies was assessed by Cochran’s Q test and I<sup>2</sup> statistics. Publication bias was detected via funnel plots and Egger’s test.</div></div><div><h3>Result</h3><div>In 13 studies conducted in Africa, with a sample size of 5619 people between 2011 and 2024, the pooled prevalence of benign prostate hyperplasia was 44 % (95 % CI 31 %-57 %) in Africa. According to the subgroup analysis, the pooled prevalence was greater in studies published from 2011--2018 (56 % (95 % CI: 38--73)) than in those published from 2019--2024 (34 %). The pooled prevalence rates were also greater in those with sample sizes &gt; 500 than in those with sample sizes &lt; 500 (45 % vs 41 %). Family history of BPH (OR = 5.56; 95 % CI; 1<strong>.</strong>57, 9.55), difficulty in sexual activity (OR = 13.14; 95 % CI: 5.50, 20.77), use of traditional eye medication (OR = 2.27; 95 % CI: 1.68, 2.86), family history (OR = 4.93; 95 % CI: 3.13, 6.72) and inadequate sleeping time (OR = 2.90, 95 % CI = 2.25–3.55) were factors associated with benign prostate hyperplasia among adults.</div></div><div><h3>Conclusions</h3><div>The pooled prevalence of BPH among adults living in Africa was significant. Family history, difficulty in sexual activity and inadequate sleeping time were significantly associated with benign prostate hyperplasia. The greater burden of BPH across the country calls for efforts by health policy makers to pay attention to it.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102972"},"PeriodicalIF":2.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679753","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}
引用次数: 0
Cancer screening knowledge and health literacy among rural women Aged 30–69 30-69岁农村妇女的癌症筛查知识和健康素养。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-03 DOI: 10.1016/j.canep.2025.102971
Kübra Akalın , Ecem Çiçek Gümüş , İlknur Dolu

Background

High participation rates are essential for the success of cancer screening programs; however, sustaining consistent engagement is a persistent challenge, especially in rural populations. To investigate the health literacy and cancer screening knowledge levels of women aged 30–69 living in rural areas who are eligible for at least one type of cancer screening, and to identify factors associated with cancer-related knowledge.

Methods

We conducted a cross-sectional study of 365 rural women aged 30–69 years who attended a Central Public Health Center between February and August 2025, in a province located in the northwestern region of Türkiye. Data were collected via a structured questionnaire, the Knowledge Scale for Cancer Screening, and the Turkiye Health Literacy Scale-32, and analyzed using t-tests, ANOVA, and linear regression

Results

Overall, 81.1 % of participants reported having undergone breast cancer screening, 59.7 % cervical cancer screening, and 50.0 % colorectal cancer screening. According to the linear regression analysis, a history of cervical cancer screening (β=0.243; t(10) = 3.235; p = 0.001) and scores on the TSOY-32 subscale for disease prevention and health promotion (β=0.202; t(10) = 2.372; p = 0.018) were significant predictors of cancer screening knowledge.Conclusion: Our study identifies potential factors that may enhance knowledge of cancer screening, which in turn could contribute to increasing the uptake of cancer screening tests. The most significant indicators were high level of health literacy related to disease prevention and health promotion as well as a previous experience with cervical cancer screening. These factors should be considered in the development of targeted interventions to increase cancer screening participation among women in rural settings.
背景:高参与率对癌症筛查项目的成功至关重要;然而,保持持续的参与是一项持续的挑战,特别是在农村人口中。调查农村地区至少有资格接受一种癌症筛查的30-69岁 妇女的健康素养和癌症筛查知识水平,并确定与癌症相关知识相关的因素。方法:我们对365名年龄在30-69岁的农村妇女进行了一项横断面研究,这些妇女于2025年2月至8月在位于基耶省西北部的一个省的中央公共卫生中心就诊。通过结构化问卷、癌症筛查知识量表和Turkiye健康素养量表-32收集数据,并使用t检验、方差分析和线性回归进行分析。结果:总体而言,81.1 %的参与者报告进行了乳腺癌筛查,59.7 %的参与者报告进行了宫颈癌筛查,50.0 %的参与者报告进行了结直肠癌筛查。根据线性回归分析,宫颈癌筛查史(β=0.243; t(10) = 3.235;p = 0.001)和TSOY-32疾病预防和健康促进量表得分(β=0.202; t(10) = 2.372;P = 0.018)是癌症筛查知识的显著预测因子。结论:我们的研究确定了可能提高癌症筛查知识的潜在因素,这反过来可能有助于增加癌症筛查测试的吸收。最重要的指标是与疾病预防和促进健康有关的卫生知识水平高,以及以前有过宫颈癌筛查的经验。在制定有针对性的干预措施以增加农村地区妇女参与癌症筛查时,应考虑到这些因素。
{"title":"Cancer screening knowledge and health literacy among rural women Aged 30–69","authors":"Kübra Akalın ,&nbsp;Ecem Çiçek Gümüş ,&nbsp;İlknur Dolu","doi":"10.1016/j.canep.2025.102971","DOIUrl":"10.1016/j.canep.2025.102971","url":null,"abstract":"<div><h3>Background</h3><div>High participation rates are essential for the success of cancer screening programs; however, sustaining consistent engagement is a persistent challenge, especially in rural populations. To investigate the health literacy and cancer screening knowledge levels of women aged 30–69 living in rural areas who are eligible for at least one type of cancer screening, and to identify factors associated with cancer-related knowledge.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of 365 rural women aged 30–69 years who attended a Central Public Health Center between February and August 2025, in a province located in the northwestern region of Türkiye. Data were collected via a structured questionnaire, the Knowledge Scale for Cancer Screening, and the Turkiye Health Literacy Scale-32, and analyzed using t-tests, ANOVA, and linear regression</div></div><div><h3>Results</h3><div>Overall, 81.1 % of participants reported having undergone breast cancer screening, 59.7 % cervical cancer screening, and 50.0 % colorectal cancer screening. According to the linear regression analysis, a history of cervical cancer screening (β=0.243; t(10) = 3.235; p = 0.001) and scores on the TSOY-32 subscale for disease prevention and health promotion (β=0.202; t(10) = 2.372; p = 0.018) were significant predictors of cancer screening knowledge.<em>Conclusion</em>: Our study identifies potential factors that may enhance knowledge of cancer screening, which in turn could contribute to increasing the uptake of cancer screening tests. The most significant indicators were high level of health literacy related to disease prevention and health promotion as well as a previous experience with cervical cancer screening. These factors should be considered in the development of targeted interventions to increase cancer screening participation among women in rural settings.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102971"},"PeriodicalIF":2.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679811","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}
引用次数: 0
Chemotherapy use in ovarian cancer patients diagnosed 2012–2017 in Australia, Canada, Norway and the UK: An International Cancer Benchmarking Partnership (ICBP) population-based study 澳大利亚、加拿大、挪威和英国2012-2017年诊断为卵巢癌患者的化疗使用:一项基于人群的国际癌症基准伙伴关系(ICBP)研究
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.canep.2025.102903
Matthew E. Barclay , Sean McPhail , Shane A. Johnson , Ruth Swann , John Butler , Christian J. Finley , Andriana Barisic , Damien Bennett , Oliver Bucher , Nicola Creighton , Cheryl A. Denny , Ron A. Dewar , David W. Donnelly , Laura Downie , Norah Finn , Steven Habbous , Dyfed W. Huws , Leon May , Bjørn Møller , David S. Morrison , Georgios Lyratzopoulos

Objective

To describe use of chemotherapy in patients with ovarian cancer in national or sub-national populations of Australia, Canada, Norway and the UK.

Methods

Linked population-based data sources were used to describe use and time to chemotherapy initiation in ovarian cancer patients diagnosed in study periods during 2012–2017. Random-effects meta-analysis characterised the size of interjurisdictional variation.

Results

Among 39,879 patients, chemotherapy use ranged from 49 % (Wales) to 75 % (Manitoba). Across jurisdictions, chemotherapy use was higher in advanced disease (79 %, 95 %CI: 74 %–83 %), and lower for stages 1–2 or localised/regional disease (54 %, 95 %CI: 48 %–60 %). Within jurisdictions, chemotherapy use was similar in patients aged 15–64 and 65–74 and then decreased sharply with increasing age. There was large interjurisdictional variation in chemotherapy use in patients aged 85–99 years with advanced disease, being, for example, 23 % (95 %CI: 20 %–25 %) in England and 61 % (95 %CI: 51 %–70 %) in Ontario. However, jurisdictions with the highest chemotherapy use in recorded advanced stage, including Ontario, tended to have higher percentage of missing stage information. Overall, time from diagnosis to chemotherapy initiation was shorter in New South Wales and Victoria and longer in Scotland and Wales. In patients with advanced disease, interjurisdictional variation in time-to-treatment was limited.

Conclusions

Even within the same age groups and stage strata, use of chemotherapy varied substantially between jurisdictions during the mid-2010s. Future work should examine use of surgery in combination with chemotherapy. The reasons for the international variation in chemotherapy use and its contribution to international variation in survival should be established.
目的:描述澳大利亚、加拿大、挪威和英国国家或次国家人群中卵巢癌患者化疗的使用情况。方法:使用相关的基于人群的数据源来描述2012-2017年研究期间诊断的卵巢癌患者的化疗使用情况和开始化疗时间。随机效应荟萃分析表征了辖区间差异的大小。结果:在39,879例患者中,化疗使用率从49% %(威尔士)到75% %(马尼托巴)不等。在各个辖区,晚期疾病的化疗使用较高(79 %,95 %CI: 74 %-83 %),而1-2期或局部/区域疾病的化疗使用较低(54 %,95 %CI: 48 %-60 %)。在辖区内,15-64岁和65-74岁患者的化疗使用情况相似,然后随着年龄的增长急剧下降。在85-99岁的晚期疾病患者中,化疗的使用有很大的司法管辖区差异,例如,在英国为23 %(95 %CI: 20 %-25 %),在安大略省为61 %(95 %CI: 51 %-70 %)。然而,在有记录的晚期化疗使用最高的司法管辖区,包括安大略省,往往有更高的阶段信息缺失百分比。总的来说,新南威尔士州和维多利亚州从诊断到化疗开始的时间较短,苏格兰和威尔士较长。在疾病晚期的患者中,不同地区在治疗时间上的差异有限。结论:即使在相同的年龄组和阶段,2010年代中期不同司法管辖区的化疗使用也存在很大差异。未来的工作应探讨手术与化疗联合使用。应确定化疗使用的国际差异的原因及其对生存的国际差异的贡献。
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引用次数: 0
Survival disparities in non-small cell lung cancer: Disaggregating Asians from NHPI and identifying variability among common Asian subgroups – The largest single-center study in Hawaiʻi 非小细胞肺癌的生存差异:将亚洲人从NHPI中分离出来,并确定亚洲常见亚群之间的变异性——夏威夷最大的单中心研究。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.canep.2025.102904
Chalothorn Wannaphut , Manasawee Tanariyakul , Gene T. Yoshikawa , Brenda Y. Hernandez , Nicolas A. Villanueva , Jared D. Acoba

Background

The American Cancer Society and the National Cancer Institute emphasize the need to disaggregate data for U.S. Asian, Native Hawaiian, and Other Pacific Islander (NHPI) populations to better understand racial disparities in cancer outcomes. Asian populations are diverse, with distinct genetic, cultural, and socioeconomic backgrounds that differ from those of NHPI, influencing cancer prognosis. This study analyzes non-small cell lung cancer outcomes among Asian and NHPI populations.

Methods

This retrospective cohort study identified NSCLC patients treated at Queen's Medical Center in Honolulu, Hawaiʻi, from 2000 to 2022. Patients were categorized into six racial/ethnic groups: White, Chinese, Japanese, Filipino, Other Asians, and NHPI. Survival differences were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.

Results

The cohort comprised 4160 patients, including 977 White, 419 Chinese, 968 Japanese, 724 Filipino, 217 Other Asians, and 855 NHPI patients. NHPI had the highest proportion of individuals under 60 years old (27.5 %), the highest percentage of Medicaid/uninsured (37 %), and the lowest proportion receiving surgery (23.4 %) compared to other races (p < 0.001). Median overall survival (OS) was 20.9 (18.3–23.5) months for White patients, 22.3 (17.8–26.9) months for Chinese patients, 17.7(15.3–20.2) months for Japanese patients, 19.7(16.1–23.3) months for Filipino patients, 25.7(14.7–36.6) months for Other Asians patients and 14.7(12.0–17.3) months for NHPI patients (p < 0.001). Asian NSCLC patients had a lower risk of death compared to White patients (adjusted HR 0.89, 95 % CI 0.85–0.97, p = 0.010). In contrast, NHPI patients had a higher mortality rate compared to White patients (adjusted HR 1.15, 95 % CI 1.03–1.28, p = 0.011) in the multivariable analysis without treatment. However, both associations were no longer statistically significant after additional adjustment for treatment. Subgroup analyses of Asian patients compared to Whites patients revealed that the Chinese patients had the lowest risk of death, with this difference remaining significant even after adjusting for treatment (adjusted HR 0.82, 95 % CI 0.72–0.93, p = 0.003).

Conclusion

Our findings demonstrate the heterogeneity in NSCLC outcomes between U.S. Asians and NHPI patients as well as among individual Asian ethnic populations. Further research is needed to validate these differences and their clinical implications.
背景:美国癌症协会和国家癌症研究所强调有必要对美国亚裔、夏威夷原住民和其他太平洋岛民(NHPI)人群的数据进行分类,以更好地了解癌症结局的种族差异。亚洲人口是多样化的,具有与NHPI不同的独特遗传、文化和社会经济背景,影响癌症预后。本研究分析了亚洲和非小细胞肺癌人群的预后。方法:这项回顾性队列研究确定了2000年至2022年在夏威夷檀香山皇后医疗中心接受治疗的非小细胞肺癌患者。患者被分为六个种族/民族组:白人、中国人、日本人、菲律宾人、其他亚洲人和非裔美国人。采用Kaplan-Meier分析和Cox比例风险模型评估生存差异。结果:该队列包括4160例患者,其中白人977例,中国人419例,日本人968例,菲律宾人724例,其他亚洲人217例,NHPI患者855例。与其他种族相比,NHPI患者中60岁以下人群的比例最高(27.5% %),医疗补助/无保险人群的比例最高(37% %),接受手术的比例最低(23.4% %)(p )。结论:我们的研究结果表明,美国亚裔患者和NHPI患者以及个别亚裔人群在非小细胞肺癌结局上存在异质性。需要进一步的研究来验证这些差异及其临床意义。
{"title":"Survival disparities in non-small cell lung cancer: Disaggregating Asians from NHPI and identifying variability among common Asian subgroups – The largest single-center study in Hawaiʻi","authors":"Chalothorn Wannaphut ,&nbsp;Manasawee Tanariyakul ,&nbsp;Gene T. Yoshikawa ,&nbsp;Brenda Y. Hernandez ,&nbsp;Nicolas A. Villanueva ,&nbsp;Jared D. Acoba","doi":"10.1016/j.canep.2025.102904","DOIUrl":"10.1016/j.canep.2025.102904","url":null,"abstract":"<div><h3>Background</h3><div>The American Cancer Society and the National Cancer Institute emphasize the need to disaggregate data for U.S. Asian, Native Hawaiian, and Other Pacific Islander (NHPI) populations to better understand racial disparities in cancer outcomes. Asian populations are diverse, with distinct genetic, cultural, and socioeconomic backgrounds that differ from those of NHPI, influencing cancer prognosis. This study analyzes non-small cell lung cancer outcomes among Asian and NHPI populations.</div></div><div><h3>Methods</h3><div>This retrospective cohort study identified NSCLC patients treated at Queen's Medical Center in Honolulu, Hawaiʻi, from 2000 to 2022. Patients were categorized into six racial/ethnic groups: White, Chinese, Japanese, Filipino, Other Asians, and NHPI. Survival differences were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The cohort comprised 4160 patients, including 977 White, 419 Chinese, 968 Japanese, 724 Filipino, 217 Other Asians, and 855 NHPI patients. NHPI had the highest proportion of individuals under 60 years old (27.5 %), the highest percentage of Medicaid/uninsured (37 %), and the lowest proportion receiving surgery (23.4 %) compared to other races (p &lt; 0.001). Median overall survival (OS) was 20.9 (18.3–23.5) months for White patients, 22.3 (17.8–26.9) months for Chinese patients, 17.7(15.3–20.2) months for Japanese patients, 19.7(16.1–23.3) months for Filipino patients, 25.7(14.7–36.6) months for Other Asians patients and 14.7(12.0–17.3) months for NHPI patients (p &lt; 0.001). Asian NSCLC patients had a lower risk of death compared to White patients (adjusted HR 0.89, 95 % CI 0.85–0.97, p = 0.010). In contrast, NHPI patients had a higher mortality rate compared to White patients (adjusted HR 1.15, 95 % CI 1.03–1.28, p = 0.011) in the multivariable analysis without treatment. However, both associations were no longer statistically significant after additional adjustment for treatment. Subgroup analyses of Asian patients compared to Whites patients revealed that the Chinese patients had the lowest risk of death, with this difference remaining significant even after adjusting for treatment (adjusted HR 0.82, 95 % CI 0.72–0.93, p = 0.003).</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate the heterogeneity in NSCLC outcomes between U.S. Asians and NHPI patients as well as among individual Asian ethnic populations. Further research is needed to validate these differences and their clinical implications.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102904"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259852","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}
引用次数: 0
A clinical rule-based indicator to identify recurrence of colorectal cancer after curative resection using linked routinely collected national data 一个临床规则为基础的指标,以确定结肠直肠癌治愈性切除后复发使用链接常规收集的国家数据
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-11-21 DOI: 10.1016/j.canep.2025.102962
Orouba Almilaji , Linda Sharples , Ajay Aggarwal , David Cromwell , Kieran Horgan , Michael Braun , Robert Arnott , Julie Nossiter , Angela Kuryba , Alexandra Lewin , Thomas Cowling , Jan Van Der Meulen , Kate Walker

Background

Cancer recurrence is under-recorded in most national cancer registries. We developed and validated a clinical rule-based indicator to identify recurrence after curative major resection in patients with non-metastatic colorectal cancer (CRC), based on national routinely collected administrative hospital records and chemotherapy and radiotherapy datasets.

Methods

Recurrence was defined as the cancer becoming clinically detectable again after a period of “remission” (nine months to five years after curative major resection). 34,984 CRC patients aged 18–75 years undergoing curative major resection for non-metastatic disease diagnosed between August 2014 and September 2019 in the English Cancer Registry were identified and linked to records of outpatient visits and admissions in English administrative hospital data and to chemotherapy and radiotherapy datasets. The indicator was developed with a panel of surgical and oncological experts, based on relevant diagnosis (ICD-10), procedure (OPCS-4), and administrative codes.

Results

Of the 34,984 patients, the indicator identified 6556 (18.7 %) as having recurrence. 6173 (94.2 %) of which could be identified using administrative hospital data of admitted patients alone. Recurrence was found in a greater proportion of rectal cancer patients, and in those with more advanced T stage and N stage, and higher cancer grade. Overall and recurrence-free five-year survival from surgery was 88.7 % and 77.4 %, respectively. Two-year overall survival after recurrence was 63.9 %. 135 (82.8 %) of the 163 patients who self-reported recurrence in a national patient experience survey, and 1412 (95.2 %) of the 1483 patients with reported recurrence/progression in Cancer Registry data had recurrence defined by the developed indicator.

Conclusions

The validity of the CRC recurrence indicator was supported by observed associations with tumour characteristics, self-reported recurrence, and poor overall survival in patients with recurrence. This indicator can be used in research and service evaluation, to overcome the problem of incomplete cancer recurrence recording in most national cancer registries.
背景:在大多数国家癌症登记处,癌症复发率记录不足。基于国家常规收集的行政医院记录和化疗和放疗数据集,我们开发并验证了一种基于临床规则的指标,用于识别非转移性结直肠癌(CRC)患者治愈性大切除后的复发。方法复发定义为肿瘤在“缓解期”(治愈性大切除后9个月至5年)后再次被临床检测到。在2014年8月至2019年9月期间,在英国癌症登记处发现了34,984名年龄在18-75岁之间因非转移性疾病接受治疗性大切除的结直肠癌患者,并将其与英国行政医院数据中的门诊就诊和入院记录以及化疗和放疗数据集联系起来。该指标是由外科和肿瘤学专家小组根据相关诊断(ICD-10)、程序(OPCS-4)和行政法规制定的。结果在34,984例患者中,该指标确定6556例(18.7 %)复发。其中6173例(94.2 %)可以单独使用住院患者的医院管理数据识别。直肠癌患者复发率较高,T期和N期越晚期,肿瘤分级越高。手术后总生存率和无复发生存率分别为88.7% %和77.4% %。复发后两年总生存率为63.9 %。在一项全国患者经历调查中,163名自我报告复发的患者中有135名(82.8 %),而在癌症登记处数据中报告复发/进展的1483名患者中,1412名(95.2% %)的复发由所制定的指标定义。结论CRC复发指标的有效性与肿瘤特征、自我报告的复发以及复发患者较差的总生存期之间的相关性得到了支持。该指标可用于研究和服务评估,以克服大多数国家癌症登记处癌症复发记录不完整的问题。
{"title":"A clinical rule-based indicator to identify recurrence of colorectal cancer after curative resection using linked routinely collected national data","authors":"Orouba Almilaji ,&nbsp;Linda Sharples ,&nbsp;Ajay Aggarwal ,&nbsp;David Cromwell ,&nbsp;Kieran Horgan ,&nbsp;Michael Braun ,&nbsp;Robert Arnott ,&nbsp;Julie Nossiter ,&nbsp;Angela Kuryba ,&nbsp;Alexandra Lewin ,&nbsp;Thomas Cowling ,&nbsp;Jan Van Der Meulen ,&nbsp;Kate Walker","doi":"10.1016/j.canep.2025.102962","DOIUrl":"10.1016/j.canep.2025.102962","url":null,"abstract":"<div><h3>Background</h3><div>Cancer recurrence is under-recorded in most national cancer registries. We developed and validated a clinical rule-based indicator to identify recurrence after curative major resection in patients with non-metastatic colorectal cancer (CRC), based on national routinely collected administrative hospital records and chemotherapy and radiotherapy datasets.</div></div><div><h3>Methods</h3><div>Recurrence was defined as the cancer becoming clinically detectable again after a period of “remission” (nine months to five years after curative major resection). 34,984 CRC patients aged 18–75 years undergoing curative major resection for non-metastatic disease diagnosed between August 2014 and September 2019 in the English Cancer Registry were identified and linked to records of outpatient visits and admissions in English administrative hospital data and to chemotherapy and radiotherapy datasets. The indicator was developed with a panel of surgical and oncological experts, based on relevant diagnosis (ICD-10), procedure (OPCS-4), and administrative codes.</div></div><div><h3>Results</h3><div>Of the 34,984 patients, the indicator identified 6556 (18.7 %) as having recurrence. 6173 (94.2 %) of which could be identified using administrative hospital data of admitted patients alone. Recurrence was found in a greater proportion of rectal cancer patients, and in those with more advanced T stage and N stage, and higher cancer grade. Overall and recurrence-free five-year survival from surgery was 88.7 % and 77.4 %, respectively. Two-year overall survival after recurrence was 63.9 %. 135 (82.8 %) of the 163 patients who self-reported recurrence in a national patient experience survey, and 1412 (95.2 %) of the 1483 patients with reported recurrence/progression in Cancer Registry data had recurrence defined by the developed indicator.</div></div><div><h3>Conclusions</h3><div>The validity of the CRC recurrence indicator was supported by observed associations with tumour characteristics, self-reported recurrence, and poor overall survival in patients with recurrence. This indicator can be used in research and service evaluation, to overcome the problem of incomplete cancer recurrence recording in most national cancer registries.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102962"},"PeriodicalIF":2.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571963","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}
引用次数: 0
Angiotensin converting enzyme inhibitors and angiotensin receptor blockers and ovarian cancer survival: the Ovarian cancer Prognosis And Lifestyle (OPAL) study 血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂与卵巢癌生存:卵巢癌预后和生活方式(OPAL)研究
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-11-20 DOI: 10.1016/j.canep.2025.102961
Azam Majidi , Renhua Na , Susan J. Jordan , Tanya L. Ross , Anna DeFazio , Michael Friedlander , Peter Grant , Penelope M. Webb

Objective

There is some evidence that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) might improve cancer survival, but reliable data for ovarian cancer are scarce. We evaluated this using data from the prospective Ovarian cancer Prognosis and Lifestyle (OPAL) study.

Materials and methods

We included 954 Australian women diagnosed between 2012 and 2015 and considered pre-diagnosis and post-diagnosis medication use and ovarian cancer survival. We used Cox proportional hazard models to estimate adjusted hazard ratios (aHR) and 95 % confidence intervals (CI) for all medication users and monotherapy users (those who used a single medication). We applied inverse probability of treatment weighting to further reduce confounding and estimated restricted mean survival time at 7 years (end of study).

Results

We observed a modest association between ARB use before or after diagnosis and progression-free and ovarian cancer-specific survival. Estimates were further from the null for post-diagnosis use ARB monotherapy, and when weighted for users (pre-diagnosis use aHR=0.71, 95 %CI: 0.51–0.98; post-diagnosis use aHR=0.60, 0.36–1.01 for ovarian cancer-specific survival). If real, this would translate to a 6-month increase in mean survival for ARB monotherapy. The associations were attenuated in models weighted for all women. There was little evidence of an association with ACE inhibitors.

Conclusions

Further evaluation in larger cohorts is required to confirm these findings. If the observed associations are confirmed, ARBs may warrant consideration as a first line hypertension treatment for women with ovarian cancer.
目的有证据表明血管紧张素转换酶(ACE)抑制剂和血管紧张素受体阻滞剂(ARB)可提高卵巢癌患者的生存率,但缺乏可靠的卵巢癌治疗数据。我们使用前瞻性卵巢癌预后和生活方式(OPAL)研究的数据来评估这一点。材料和方法我们纳入了2012年至2015年间诊断的954名澳大利亚女性,并考虑了诊断前和诊断后的药物使用和卵巢癌生存。我们使用Cox比例风险模型来估计所有药物使用者和单一疗法使用者(使用单一药物的人)的调整风险比(aHR)和95% %置信区间(CI)。我们应用治疗加权逆概率来进一步减少混淆,并估计7年(研究结束)时的限制平均生存时间。结果:我们观察到在诊断前后使用ARB与无进展和卵巢癌特异性生存之间存在适度的关联。诊断后使用ARB单药治疗的估计值进一步偏离零值,当对用户进行加权时(诊断前使用aHR=0.71, 95 %CI: 0.51-0.98;诊断后使用aHR=0.60, 0.36-1.01卵巢癌特异性生存率)。如果是真的,这将转化为ARB单药治疗的平均生存期增加6个月。在对所有女性进行加权的模型中,这种关联减弱了。几乎没有证据表明与ACE抑制剂有关。结论:需要在更大的队列中进行进一步的评估来证实这些发现。如果观察到的关联得到证实,arb可能值得考虑作为卵巢癌妇女高血压的一线治疗。
{"title":"Angiotensin converting enzyme inhibitors and angiotensin receptor blockers and ovarian cancer survival: the Ovarian cancer Prognosis And Lifestyle (OPAL) study","authors":"Azam Majidi ,&nbsp;Renhua Na ,&nbsp;Susan J. Jordan ,&nbsp;Tanya L. Ross ,&nbsp;Anna DeFazio ,&nbsp;Michael Friedlander ,&nbsp;Peter Grant ,&nbsp;Penelope M. Webb","doi":"10.1016/j.canep.2025.102961","DOIUrl":"10.1016/j.canep.2025.102961","url":null,"abstract":"<div><h3>Objective</h3><div>There is some evidence that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) might improve cancer survival, but reliable data for ovarian cancer are scarce. We evaluated this using data from the prospective Ovarian cancer Prognosis and Lifestyle (OPAL) study.</div></div><div><h3>Materials and methods</h3><div>We included 954 Australian women diagnosed between 2012 and 2015 and considered pre-diagnosis and post-diagnosis medication use and ovarian cancer survival. We used Cox proportional hazard models to estimate adjusted hazard ratios (aHR) and 95 % confidence intervals (CI) for all medication users and monotherapy users (those who used a single medication). We applied inverse probability of treatment weighting to further reduce confounding and estimated restricted mean survival time at 7 years (end of study).</div></div><div><h3>Results</h3><div>We observed a modest association between ARB use before or after diagnosis and progression-free and ovarian cancer-specific survival. Estimates were further from the null for post-diagnosis use ARB monotherapy, and when weighted for users (pre-diagnosis use aHR=0.71, 95 %CI: 0.51–0.98; post-diagnosis use aHR=0.60, 0.36–1.01 for ovarian cancer-specific survival). If real, this would translate to a 6-month increase in mean survival for ARB monotherapy. The associations were attenuated in models weighted for all women. There was little evidence of an association with ACE inhibitors.</div></div><div><h3>Conclusions</h3><div>Further evaluation in larger cohorts is required to confirm these findings. If the observed associations are confirmed, ARBs may warrant consideration as a first line hypertension treatment for women with ovarian cancer.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102961"},"PeriodicalIF":2.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555338","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}
引用次数: 0
Hospital-based gallbladder cancer registry from a high-volume referral cancer centre in India: Insights into epidemiology and roadmap for enhancing cancer care 印度一家高容量转诊癌症中心的医院胆囊癌登记:对流行病学的见解和加强癌症护理的路线图。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-11-13 DOI: 10.1016/j.canep.2025.102958
Shraddha Patkar , Tanvi M. Shah , Gurudutt Varty , Abdeali Saif A. Kaderi , Vishnu Menon , D. Baskaran , Vikas Ostwal , Anant Ramaswamy , Mukta Ramadwar , Rajesh Dikshit , Mahesh Goel

Purpose

Gallbladder cancer (GBC) is a significant public health concern in India, with a high disease burden and complex challenges in delivering effective care. This registry aims to shed light on the epidemiology, and barriers to early detection and treatment, to inform future research and policy initiatives.

Methods

From January 2019 to December 2022, all consecutive patients with a presumed diagnosis of GBC, presenting to our institution were prospectively enrolled after informed consent. Each patient completed a standardized questionnaire, and clinical, radiologic and treatment data were recorded in a case record form. Management followed standard institutional protocols. Survival analysis was done using Kaplan–Meier curves.

Results

A total of 1950 patients were included, 1441 (73.9 %) of these hailed from the Gangetic belt region (northern and eastern states); an additional 209 (10.7 %) were migrants from these regions, representing 84.6 % of the cohort. Over 55 % belonged to lower socioeconomic classes. At presentation, 60 % had metastatic disease; only 318 (16.3 %) were eligible for curative-intent therapy, and 132 (6.8 %) did not complete planned treatment. Treatment dropout correlated significantly with male gender (p = 0.012) and unemployment (p = 0.014). After a median follow-up of 38.2 months, median overall survival was 58.2 months for early-stage patients versus 4.2 months for those with metastatic disease.

Conclusion

This registry is an attempt to generate evidence-based awareness about the substantial disease burden of gallbladder cancers in India and highlights the un-met need for capacity building of our health system, in order to provide, timely, accessible and cost-effective management of this disease.
目的:胆囊癌(GBC)是印度的一个重大公共卫生问题,疾病负担高,在提供有效治疗方面面临复杂挑战。该登记处旨在阐明流行病学以及早期发现和治疗的障碍,为未来的研究和政策举措提供信息。方法:2019年1月至2022年12月,所有假定诊断为GBC的连续患者在知情同意后前瞻性入组。每位患者完成一份标准化问卷,并将临床、放射学和治疗数据记录在病例记录表中。管理层遵循标准的机构协议。生存分析采用Kaplan-Meier曲线。结果:共纳入1950例患者,其中1441例(73.9 %)来自恒河带地区(北部和东部各州);另外209人(10.7 %)是来自这些地区的移民,占队列的84.6 %。超过55 %属于社会经济地位较低的阶层。发病时,60% %有转移性疾病;只有318例(16.3 %)符合治疗意图治疗的条件,132例(6.8 %)没有完成计划治疗。治疗退出与男性(p = 0.012)和失业(p = 0.014)显著相关。中位随访38.2个月后,早期患者的中位总生存期为58.2个月,而转移性疾病患者的中位总生存期为4.2个月。结论:该登记旨在提高对印度胆囊癌重大疾病负担的循证意识,并强调我国卫生系统能力建设未得到满足的需求,以便提供及时、可及和具有成本效益的胆囊癌管理。
{"title":"Hospital-based gallbladder cancer registry from a high-volume referral cancer centre in India: Insights into epidemiology and roadmap for enhancing cancer care","authors":"Shraddha Patkar ,&nbsp;Tanvi M. Shah ,&nbsp;Gurudutt Varty ,&nbsp;Abdeali Saif A. Kaderi ,&nbsp;Vishnu Menon ,&nbsp;D. Baskaran ,&nbsp;Vikas Ostwal ,&nbsp;Anant Ramaswamy ,&nbsp;Mukta Ramadwar ,&nbsp;Rajesh Dikshit ,&nbsp;Mahesh Goel","doi":"10.1016/j.canep.2025.102958","DOIUrl":"10.1016/j.canep.2025.102958","url":null,"abstract":"<div><h3>Purpose</h3><div>Gallbladder cancer (GBC) is a significant public health concern in India, with a high disease burden and complex challenges in delivering effective care. This registry aims to shed light on the epidemiology, and barriers to early detection and treatment, to inform future research and policy initiatives.</div></div><div><h3>Methods</h3><div>From January 2019 to December 2022, all consecutive patients with a presumed diagnosis of GBC, presenting to our institution were prospectively enrolled after informed consent. Each patient completed a standardized questionnaire, and clinical, radiologic and treatment data were recorded in a case record form. Management followed standard institutional protocols. Survival analysis was done using Kaplan–Meier curves.</div></div><div><h3>Results</h3><div>A total of 1950 patients were included, 1441 (73.9 %) of these hailed from the Gangetic belt region (northern and eastern states); an additional 209 (10.7 %) were migrants from these regions, representing 84.6 % of the cohort. Over 55 % belonged to lower socioeconomic classes. At presentation, 60 % had metastatic disease; only 318 (16.3 %) were eligible for curative-intent therapy, and 132 (6.8 %) did not complete planned treatment. Treatment dropout correlated significantly with male gender (p = 0.012) and unemployment (p = 0.014). After a median follow-up of 38.2 months, median overall survival was 58.2 months for early-stage patients versus 4.2 months for those with metastatic disease.</div></div><div><h3>Conclusion</h3><div>This registry is an attempt to generate evidence-based awareness about the substantial disease burden of gallbladder cancers in India and highlights the un-met need for capacity building of our health system, in order to provide, timely, accessible and cost-effective management of this disease.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102958"},"PeriodicalIF":2.3,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524878","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}
引用次数: 0
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Cancer Epidemiology
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