Cancer Epidemiology最新文献_第4页

Colorectal cancer survival in Mexico: Leveraging a national health insurance database 墨西哥的结直肠癌存活率：利用全国医疗保险数据库。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-21 DOI: 10.1016/j.canep.2024.102698

Susana Lozano-Esparza , Hugo Rodrigo Sánchez-Blas , Fidel David Huitzil-Meléndez , Mónica Isabel Meneses-Medina , Katherine Van Loon , Michael B. Potter , Alejandro Mohar , Martin Lajous

Purpose

We estimated the 5-year overall, age at diagnosis- and stage-specific colorectal cancer survival in patients treated through their coverage with Seguro Popular.

Methods

We conducted a retrospective study using a dataset that included 1418 colorectal cancer patients covered by Seguro Popular (Mexico’s public health insurance system covering 60 % of the population) between 2013 and 2016. Deaths were identified using the Epidemiologic Death Statistics Subsystem registry, with a specialized algorithm for record linkage. The Kaplan-Meier method was used to estimate overall survival curves and the proportion of patients alive at various follow-up time points. We compared survival curves across subgroups using the log-rank test.

Results

In this study the average age at diagnosis was 56 years with 31.9 % of patients diagnosed before the age of 50. Most cases (78.1 %) were diagnosed in advanced stages (i.e., III and IV), with nearly half of the cases originating in the rectum. The overall 5-year survival was 50 %, with higher survival (74 %) for patients with stage I-II and lower survival for those with stage III (58 %) and IV (33 %). While age at diagnosis was not associated with survival for early-stage colorectal cancer, younger patients with metastatic disease had a worse prognosis compared to older patients.

Conclusion

The 5-year overall colorectal cancer survival was 50 %, with variation by clinical stage. Almost 80 % of the population was diagnosed with advanced stages, underscoring the need for screening programs. Younger patients with metastatic disease exhibited a worse prognosis, highlighting the need for targeted interventions.

目的：我们估算了通过参加 Seguro Popular 保险接受治疗的结直肠癌患者的 5 年总生存率、诊断年龄和分期生存率：我们使用一个数据集开展了一项回顾性研究，该数据集包括 2013 年至 2016 年期间由 Seguro Popular（墨西哥的公共医疗保险系统，覆盖 60% 的人口）承保的 1418 名结直肠癌患者。死亡病例通过流行病学死亡统计子系统登记处进行确认，并采用专门的算法进行记录链接。我们采用卡普兰-梅耶法估算了总体生存曲线和不同随访时间点的存活患者比例。我们使用对数秩检验比较了不同亚组的生存曲线：本研究中，确诊患者的平均年龄为 56 岁，其中 31.9% 的患者在 50 岁之前确诊。大多数病例（78.1%）被诊断为晚期（即 III 期和 IV 期），近一半的病例起源于直肠。总的 5 年存活率为 50%，其中 I-II 期患者的存活率较高（74%），而 III 期（58%）和 IV 期（33%）患者的存活率较低。虽然诊断时的年龄与早期结直肠癌患者的生存率无关，但与年龄较大的患者相比，患有转移性疾病的年轻患者预后较差：结论：结直肠癌患者的 5 年总生存率为 50%，不同临床阶段的生存率有所不同。近 80% 的患者被确诊为晚期，这凸显了筛查计划的必要性。患有转移性疾病的年轻患者预后较差，这说明有必要采取有针对性的干预措施。

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引用次数: 0

Rurality and pediatric cancer survival in the United States: An analysis of SEER data from 2000 to 2021 美国乡村地区与儿童癌症存活率：对 2000 年至 2021 年 SEER 数据的分析。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-18 DOI: 10.1016/j.canep.2024.102705

Emma Hymel , Hong Li , Gary L. Cochran , Kendra L. Ratnapradipa , Krishtee Napit , Josiane Kabayundo , Don W. Coulter , Jenna Allison , Edward S. Peters , Shinobu Watanabe-Galloway

Background

Cancer is the leading cause of death by disease among children in the United States. Residing in rural areas may impact cancer outcomes as rural areas tend to have fewer available healthcare resources. Few population-based studies have investigated rural/urban disparities in pediatric cancer outcomes. The objective of this study was to examine rural/urban differences in (1) five-year relative survival and (2) cancer-specific survival among children in the United States.

Methods

The study is a population-based longitudinal study using data from the Surveillance, Epidemiology, and End Results (SEER) 17 registries database (2000–2021). We included data for individuals aged 0–19 with a first primary malignant cancer diagnosed from 2000 to 2016. Rurality was measured by Rural-Urban Continuum Codes (RUCCs). Five-year relative survival rates, Kaplan-Meier curves, and Cox regression analysis were used to determine the differences in pediatric cancer survivorship between rural and urban areas.

Results

Both five-year relative survival rates and log-rank tests of survival probabilities over time by rurality showed no statistically significant difference between individuals living in urban versus rural counties. However, after adjusting for age, sex, race/ethnicity, cancer type, median household income, and region, children diagnosed in rural counties had a 9 % higher risk of death compared to children diagnosed in urban counties (95 % CI 1.02–1.17), with the highest increased risk observed for children with retinoblastoma (aHR: 6.12, 95 % CI 2.01–18.59). A higher increased risk of death was observed for children living in the most rural counties (aHR: 1.18, 95 % CI 1.07–1.32).

Conclusion

In this study, residing in rural areas was associated with an increased risk of death from pediatric cancer, especially for children residing in rural areas not adjacent to urban areas. Our findings warrant further investigation to determine the rural/urban disparities in pediatric cancer outcomes and to develop interventions to deliver high-quality cancer care to rural children.

背景：癌症是美国儿童因病死亡的主要原因。居住在农村地区可能会影响癌症的治疗效果，因为农村地区可用的医疗资源往往较少。很少有基于人群的研究调查了儿科癌症结果的城乡差异。本研究旨在探讨美国农村/城市儿童在（1）五年相对生存率和（2）癌症特异性生存率方面的差异：本研究是一项基于人群的纵向研究，使用的数据来自监测、流行病学和最终结果（SEER）的 17 个登记数据库（2000-2021 年）。我们纳入了 2000 年至 2016 年期间首次确诊为原发性恶性肿瘤的 0-19 岁人群的数据。农村地区通过农村-城市连续编码（RUCCs）来衡量。采用五年相对生存率、Kaplan-Meier曲线和Cox回归分析来确定城乡之间儿科癌症生存率的差异：结果：五年相对存活率和农村地区存活概率的对数秩检验均显示，生活在城市和农村地区的个体之间没有显著的统计学差异。然而，在对年龄、性别、种族/民族、癌症类型、家庭收入中位数和地区进行调整后，农村地区确诊儿童的死亡风险比城市地区确诊儿童高 9%（95 % CI 1.02-1.17），其中视网膜母细胞瘤患儿的死亡风险最高（aHR：6.12，95 % CI 2.01-18.59）。居住在最偏远农村地区的儿童的死亡风险更高（aHR：1.18，95 % CI 1.07-1.32）：在这项研究中，居住在农村地区与儿童癌症死亡风险增加有关，尤其是居住在不毗邻城市地区的农村地区的儿童。我们的研究结果值得进一步调查，以确定儿科癌症结果的城乡差异，并制定干预措施，为农村儿童提供高质量的癌症治疗。

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引用次数: 0

Global burden of lung cancer in 2022 and projections to 2050: Incidence and mortality estimates from GLOBOCAN 2022 年全球肺癌负担及到 2050 年的预测：来自 GLOBOCAN 的发病率和死亡率估算。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-13 DOI: 10.1016/j.canep.2024.102693

Jialin Zhou , Ying Xu , Jianmin Liu , Lili Feng , Jinming Yu , Dawei Chen

Background

Lung cancer continues to pose a serious global public health challenge. Timely evidence on the global epidemiological profile of the disease is crucial to facilitate the implementation to lung cancer control efforts. This study provides updated global estimates for lung cancer incidence and mortality in 2022, along with projections for new cases and deaths up to 2050.

Methods

In the population-based study, we extracted data about lung cancer new cases and deaths from GLOBOCAN 2022 database across 185 countries or territories. We analyzed age-standardized rates by sex, country, region, and human development index (HDI). Projected new cases and deaths for 2050 were estimated using global demographic projections.

Results

In 2022, lung cancer stood as the most frequently diagnosed cancer and the primary cause of cancer-related deaths on a global scale with approximately 2.48 million new cases and 1.8 million deaths, respectively. The incidence and mortality rates of lung cancer exhibited disparities in sex and world regions. Furthermore, incidence and mortality rates increasing as HDI increased. If the incidence and mortality rates remain stable as in 2022, the burden of lung cancer is projected to increase to 4·62 million new cases and 3·55 million deaths by 2050.

Conclusions

Lung cancer is the predominant form of cancer and the foremost contributor to cancer-related mortality in 2022 with notable geographical, sex, and socioeconomic disparities.

背景：肺癌继续对全球公共卫生构成严重挑战。及时提供有关该疾病全球流行病学概况的证据对于促进肺癌控制工作的实施至关重要。本研究提供了 2022 年全球肺癌发病率和死亡率的最新估计值，以及到 2050 年新增病例和死亡人数的预测值：在这项基于人群的研究中，我们从 GLOBOCAN 2022 数据库中提取了 185 个国家或地区的肺癌新发病例和死亡病例数据。我们按性别、国家、地区和人类发展指数（HDI）分析了年龄标准化比率。我们还利用全球人口预测估算了 2050 年的新增病例和死亡人数：结果：2022 年，肺癌是全球最常见的癌症，也是癌症相关死亡的主要原因，新增病例和死亡人数分别约为 248 万和 180 万。肺癌的发病率和死亡率在性别和世界地区之间存在差异。此外，发病率和死亡率随着人类发展指数的增加而增加。如果发病率和死亡率与 2022 年保持稳定，预计到 2050 年，肺癌的负担将增加到 4-62 万新发病例和 3-55 万死亡病例：结论：肺癌是癌症的主要形式，也是 2022 年癌症相关死亡率的首要因素，但存在明显的地域、性别和社会经济差异。

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引用次数: 0

Temporal trends in age and stage-specific incidence of colorectal cancer in Saudi Arabia: A registry-based cohort study between 1997 and 2017 沙特阿拉伯结直肠癌年龄和分期发病率的时间趋势：1997年至2017年间基于登记簿的队列研究。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-13 DOI: 10.1016/j.canep.2024.102699

Norah Alsadhan , Mar Pujades-Rodriguez , Sultana A. Alhurishi , Farag Shuweihdi , Cathy Brennan , Robert M. West

Background

In Saudi Arabia, colorectal cancer (CRC) is the most common cancer in men and the third in women, posing a significant health burden. A comprehensive report of CRC incidence rates and trends in Saudi Arabia is lacking. This study aims to examine trends in CRC incidence among the Saudi population.

Methods

We used data from the Saudi Cancer Registry to examine CRC age-specific incidence rates (ASIR) and age-standardized incidence rates (ASR) between 1997 and 2017. Joinpoint regression analysis was used to determine the magnitude and direction of observed trends stratified by age, sex, and CRC stage at diagnosis. Trends were measured using the annual percentage change (APC) and the average annual percentage change (AAPC) in CRC incidence rates.

Results

In total, 19,463 new CRC cases were identified during the study period. Since 1997, ASR for CRC has steadily increased in men and women overall, irrespective of disease stages. The ASIR increased across all age groups and was more pronounced in older patients. Women aged 40–49 had a higher increase in incidence than men (AAPC= 5.3 % vs.4.7 %). Males aged 70–79 had an AAPC of 10.2 %, twice that of females (AAPC= 4.9 %). A consistent rise in ASIR was observed across all CRC stages and age groups in males and females. In recent years, males under 50 had a higher APC for distant CRC than females, while females aged 50–74 experienced a steeper increase in distant CRC than males.

Conclusion

We report a marked increase in the incidence of CRC over time in Saudi Arabia, affecting men and women across all age groups and disease stages at diagnosis. Our findings underscore the need to identify underlying risk factors and to develop and implement effective prevention policies and strategies, including screening programs to facilitate early detection and treatment.

背景：在沙特阿拉伯，结肠直肠癌（CRC）是男性最常见的癌症，是女性的第三大癌症，对健康造成了重大负担。沙特阿拉伯缺乏有关 CRC 发病率和趋势的全面报告。本研究旨在探讨沙特人口中 CRC 发病率的变化趋势：我们利用沙特癌症登记处的数据，研究了 1997 年至 2017 年间 CRC 年龄特异性发病率（ASIR）和年龄标准化发病率（ASR）。联结点回归分析用于确定按年龄、性别和确诊时的 CRC 分期分层的观察趋势的幅度和方向。使用 CRC 发病率的年度百分比变化（APC）和平均年度百分比变化（AAPC）来衡量趋势：研究期间共发现 19,463 例新的 CRC 病例。自 1997 年以来，无论疾病处于哪个阶段，男性和女性的 CRC 发病率总体上都在稳步上升。所有年龄组的ASIR都有所上升，老年患者的ASIR上升更为明显。40-49 岁女性的发病率增幅高于男性（AAPC= 5.3% 对 4.7%）。70-79 岁男性的 AAPC 为 10.2%，是女性的两倍（AAPC= 4.9%）。在所有儿童癌症阶段和年龄组中，男性和女性的 ASIR 均呈持续上升趋势。近年来，50 岁以下男性的远处 CRC APC 比女性高，而 50-74 岁女性的远处 CRC 比男性增加得更快：我们的报告显示，随着时间的推移，沙特阿拉伯的 CRC 发病率明显上升，男性和女性在诊断时均处于不同的年龄段和疾病阶段。我们的研究结果表明，有必要找出潜在的风险因素，并制定和实施有效的预防政策和策略，包括筛查计划，以促进早期发现和治疗。

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引用次数: 0

Cancer in the Grand Libreville, Gabon (2013–2017) 加蓬大利伯维尔地区的癌症（2013-2017 年）。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-10 DOI: 10.1016/j.canep.2024.102695

Mahine Ivanga , D. Maxwell Parkin , Angela Filankembo Kava , Christian Nziengui Tirogo , Paul Nzamba Bissielou , Alex Kabena , Corinne Engohan Aloghe , Rose Revignet , Alexis Parente , Veronique Blanquet , Edgard Brice Ngoungou , Ismael Herve Koumakpayi , Ernest Belembaogo

Background

The burden of cancer is expected to nearly double in sub-Saharan Africa over the next 20 years. In Gabon, the primary population-based cancer registry to be established is located in the Grand Libreville. This study presents cancer incidence rates covering the first 5-year period of registration in this region.

Patients and methods

1,549 cancer cases were recorded among residents of the Grand Libreville between 2013 and 2017, 955 (61.6 %) women and 594 (38.3 %) males.

Results

The age standardized incidence rates (ASR) for all sites were 73.3 per 10⁵ in females and 47.7 per 10⁵ in males, rather similar from those observed in neighbouring countries of central Africa. Breast (ASR 19.0 per 10⁵) and cervical cancers (ASR 16.3 per 10⁵) accounted for half of female cancers. Prostate (ASR 12.0 per 10⁵), liver (ASR 5.1 per 10⁵) and colorectal cancers (ASR of 5.0 per 10⁵) accounted for 41.1 % of male cancers.

Conclusion

Breast and prostate cancers ranked first in females and males, respectively, even if the incidences appear much lower in comparison with other regional cancer registries rates, implying they may be underestimated. Cancers of the digestive organs were markedly more frequent in men than women, especially for liver, colorectal (and anus) and the mouth and pharynx. The incidence rates of these latter cancers are relatively similar to those of other registries of the central African region. These results may be of importance for implementing more adapted strategies in the battle against cancer.

背景：在未来 20 年内，撒哈拉以南非洲地区的癌症负担预计将增加近一倍。在加蓬，以人口为基础的癌症登记处主要设在大利伯维尔。本研究介绍了该地区第一个5年登记期的癌症发病率。患者和方法：2013年至2017年期间，大利伯维尔居民共记录了1549例癌症病例，其中女性955例（61.6%），男性594例（38.3%）：所有部位的年龄标准化发病率（ASR）分别为：女性73.3/105，男性47.7/105，与中部非洲邻国的发病率相当接近。乳腺癌（每 105 例中有 19.0 例）和宫颈癌（每 105 例中有 16.3 例）占女性癌症的一半。前列腺癌（每 105 人中 ASR 为 12.0）、肝癌（每 105 人中 ASR 为 5.1）和结肠直肠癌（每 105 人中 ASR 为 5.0）占男性癌症的 41.1%：结论：乳腺癌和前列腺癌分别在女性和男性中占首位，尽管与其他地区癌症登记率相比，这两种癌症的发病率似乎要低得多，这意味着它们可能被低估了。消化器官癌症在男性中的发病率明显高于女性，尤其是肝癌、结肠直肠癌（和肛门癌）以及口腔癌和咽喉癌。后几种癌症的发病率与中部非洲地区其他登记处的数据较为相似。这些结果对于在抗击癌症的斗争中实施更加适应的战略可能具有重要意义。

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引用次数: 0

Hospital as a site of death of cancer patients in Italy: A registry-based analysis and time trends 医院是意大利癌症患者的死亡地点：基于登记的分析和时间趋势。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-10 DOI: 10.1016/j.canep.2024.102702

Gianmauro Numico , Roberto Ippoliti , Andrea Antonuzzo , Lorenza Palmero , Paolo Bossi

Background

Place of death is relevant both for individuals and for the society. Home is universally considered the optimal place of death while dying in hospital may be a signal of inappropriate end-of-life care. We aimed at studying the place of death of patients with cancer in Italy in a five-year period.

Patients and methods

The death-certificate database published by the Italian National Institute of Statistics (ISTAT) was analysed, searching the place of death and the main disease related to death. Data from 2015 to 2019 were used, to exclude the influence of the COVID pandemic. Cancer, “cognitive impairment and Alzheimer’s disease” (CIAD) and “cardiovascular and cerebrovascular diseases” (CCD) were the examined diseases. The place of death was categorized as “acute care hospital”, “hospice” or “other long-term care (LTC) structures” and “home”. We implemented an ordinary linear regression model to verify whether there was a statistically significant variation across the selected time (i), and whether a substitution effect among sites of death could be hypothesized (ii).

Results

Data on 769,517 deaths were retrieved. In 2019 35.39 % patients with cancer died in hospital, 39.57 % died at home and 20.06 % died in hospice or in other LTC structures. In the examined period, death at home decreased by 3.09 % (95 % C.I. −3.18 - −2.99; p<0.01); death in hospice and long-term structures increased by 2.71 % (95 % C.I. 2.66 – 2.76; p<0.01); death in hospital increased by 0.3 % (95 % C.I. 0.23 – 0.36; p<0.01). For patients with CIAD, death in hospital increased by 0.98 % (95 % C.I. 0.80 – 1.17; p<001) and for patients with CCD decreased by 1.43 % (95 % I.C. −1.47 – −1.39; p<0.01). Death at home decreased in both diseases.

Conclusions

More than one-third of cancer patients die in acute care hospitals and this percentage is slightly increasing in the analysed period. Mortality at home decreased in all the examined diseases. Dying at home is being progressively less frequent, while hospitals continue to represent a frequent place of death.

背景：死亡地点与个人和社会都息息相关。人们普遍认为家是最佳的死亡地点，而在医院死亡则可能是临终关怀不当的信号。我们旨在研究五年内意大利癌症患者的死亡地点：我们分析了意大利国家统计局（ISTAT）发布的死亡证明数据库，搜索了死亡地点和与死亡相关的主要疾病。为排除COVID大流行的影响，使用了2015年至2019年的数据。癌症、"认知障碍和阿尔茨海默病"（CIAD）和 "心血管和脑血管疾病"（CCD）是研究的疾病。死亡地点分为 "急症护理医院"、"临终关怀 "或 "其他长期护理（LTC）机构 "和 "家庭"。我们采用普通线性回归模型来验证所选时间（i）之间是否存在统计学意义上的显著差异，以及是否可以假设死亡地点之间存在替代效应（ii）：检索到 769 517 例死亡数据。2019年，35.39%的癌症患者死于医院，39.57%死于家中，20.06%死于临终关怀机构或其他长期护理机构。在调查期内，在家中死亡的比例下降了 3.09 %（95 % C.I. -3.18 - -2.99；p 结论：三分之一以上的癌症患者死于急症医院，在分析期内，这一比例略有上升。所有受检疾病的居家死亡率均有所下降。在家中死亡的情况正在逐渐减少，而医院仍然是一个常见的死亡地点。

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引用次数: 0

Prostate cancer incidence rates, trends, and treatment related to prostate-specific antigen screening recommendations in the United States 美国与前列腺特异性抗原筛查建议相关的前列腺癌发病率、趋势和治疗。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-09 DOI: 10.1016/j.canep.2024.102700

Ray M. Merrill

Background

Changes in US prostate-specific antigen (PSA) screening guidelines have impacted prostate cancer (PCa) incidence rates and trends. This study shows corresponding changes in PCa incidence rates and describes treatment patterns by tumor stage, age, and race/ethnicity.

Methods

Analyses were based on 777,152 cases diagnosed in 17 population-based tumor registries in the SEER Program of the US National Cancer Institute, 2007–2021. Rates were age adjusted and trends assessed using annual percent change and joinpoint regression.

Results

PCa age-adjusted incidence rates (per 100,000) fell from 165.8 in 2007 to 101 in 2014 (APC=-6.51, p<0.05) and then rose to 121.2 in 2021 (APC=1.87, p< 0.05). The significant fall and rise in rates appeared in ages 55–69 and ≥70, all racial/ethnic groups (except in Hispanics during 2014–2021), and in local/regional stage. PCa incidence rates by tumor stage, age, and race/ethnicity were presented and discussed. A few PCa cases were identified through autopsy or death certificate among the racial/ethnic groups (0.68 %-1.37 %). Unstaged cases identified through sources other than autopsy or death certificate significantly varied by race/ethnicity, ranging from 4.13 % for non-Hispanic (NH) Whites to 9.5 % for Hispanic (Chi-square p <.0001). In 2017–2021, surgery occurred in 33 % of cases (primarily in local/regional cases, inversely associated with age), radiation in 30 % of cases (increasing with age in local/regional stage cases and decreasing with age in distant stage cases), and chemotherapy in 2 % of cases (<1 % in local/regional stage cases and 9 %-38 % for age groups in distant stage cases). Several racial/ethnic differences in treatment exist, such as NH Blacks (vs. NH Whites) with local/regional disease were significantly less likely to receive surgery and more likely to receive radiation.

Conclusions

Understanding trends and patterns of PCa rates and treatment among patients by tumor stage, age, and race/ethnicity can guide public health planning in relation to screening and treatment.

背景：美国前列腺特异性抗原（PSA）筛查指南的变化影响了前列腺癌（PCa）的发病率和发病趋势。本研究显示了 PCa 发病率的相应变化，并按肿瘤分期、年龄和种族/人种描述了治疗模式：分析基于 2007-2021 年美国国家癌症研究所 SEER 计划中 17 个基于人群的肿瘤登记处诊断的 777,152 例病例。对发病率进行了年龄调整，并使用年度百分比变化和连接点回归对趋势进行了评估：结果：经年龄调整后的 PCa 发病率（每 10 万人）从 2007 年的 165.8 例降至 2014 年的 101 例（APC=-6.51，pConclusions）：了解按肿瘤分期、年龄和种族/民族划分的 PCa 发病率和治疗趋势与模式，可为筛查和治疗方面的公共卫生规划提供指导。

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引用次数: 0

Life years lost by childhood cancer treatment and health related late effects among childhood cancer survivors 儿童癌症治疗损失的寿命年数以及儿童癌症幸存者中与健康相关的晚期影响。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-07 DOI: 10.1016/j.canep.2024.102692

Thibaud Charrier , Nadia Haddy , Brice Fresneau , Boris Schwartz , Neige Journy , Charlotte Demoor-Goldschmidt , Ibrahima Diallo , Isabelle Aerts , François Doz , Vincent Souchard , Giao Vu-Bezin , Anne Laprie , Sarah Lemler , Véronique Letort , Carole Rubino , Kaniav Kamary , Naïla Myriam Aba , Claire Ducos , Médéa Locquet , Florent de Vathaire , Aurélien Latouche

Background

Identifying risk factors contributing the most to mortality of childhood cancer survivors is essential to guide harm reduction efforts in childhood cancer treatments, and long-term follow-up of childhood cancer survivors.

Methods

We assessed Life Years Lost from childhood cancer treatments and their health-related late effects among the French Childhood Cancer Survivors Study, a cohort of 7670 5-year childhood cancer survivors. Using a landmark strategy, we also assessed time-varying effects of risk factors, and how the multi-morbidity affects life years lost.

Results

We found subsequent malignant neoplasm (9.0 years [95 %CI: 4.3–13.7]), severe cardiac disease (8.0 years [95 %CI: 1.2–14.9]), and the use of radiotherapy (6.0 years [95 %CI: 4.7–7.3]) to be the highest contributors to Life Years Lost among childhood cancer survivors. We found no interaction impact on life years lost between health related late effects considered.

Conclusions

Those findings suggest that radiotherapy is the root cause of early mortality among childhood cancer survivors. Moreover patients experiencing a subsequent malignant neoplasm or a cardiac disease should be monitored closely after the event, as comorbidity is common and causes premature deaths.

背景：确定导致儿童癌症幸存者死亡的最主要风险因素对于指导儿童癌症治疗中的减害工作以及儿童癌症幸存者的长期随访至关重要：我们评估了 "法国儿童癌症幸存者研究"（French Childhood Cancer Survivors Study）中儿童癌症治疗损失的生命年数及其对健康的后期影响。我们还采用地标策略评估了风险因素的时变效应，以及多种疾病如何影响寿命损失：我们发现，恶性肿瘤（9.0 年 [95 %CI：4.3-13.7]）、严重心脏病（8.0 年 [95 %CI：1.2-14.9]）和放疗（6.0 年 [95 %CI：4.7-7.3]）是导致儿童癌症幸存者寿命损失最多的因素。我们发现，与健康相关的晚期效应对寿命损失年数没有交互影响：这些研究结果表明，放疗是导致儿童癌症幸存者早期死亡的根本原因。此外，由于合并症很常见并会导致过早死亡，因此应密切监测继发恶性肿瘤或心脏病的患者。

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引用次数: 0

The challenge of ovarian cancer care in the oldest old. 高龄老人卵巢癌护理面临的挑战。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-11-05 DOI: 10.1016/j.canep.2024.102697

Jérémy Barben, Angéline Galvin, Ariane Mamguem Kamga, Nicolas Bertrand, Julie Niogret, Julie Tisserand, Valérie Quipourt, Leila Bengrine-Lefevre, Tienhan Sandrine Dabakuyo-Yonli

Introduction: Ovarian cancer (OC) is the eighth most common cancer in women, with a poor prognosis, particularly in older women. The aim of this study was to describe an octogenarian population with OC and to examine the differences in net survival (NS) according to age.

Material and methods: In this retrospective observational population-based study from a gynecological cancer registry, patients aged > 18 years with an identified epithelial ovarian cancer stage IA to IVB diagnosed between 1998 and 2018 were included. Patients with non-available FIGO stage were excluded. Patients were stratified into three age groups: <70, 70-79 and ≥80 years, then by OC stage (FIGO I-II, IIIA-IIIB, IIIC-IV). Sociodemographic and cancer-related variables were compared using univariate test (Khi²). The 5-year NS was calculated using the Pohar-Perme method.

Results: Among the 721 patients included: 462 (64.1 %) were younger than 70 years, 176 (24.4 %) were aged between 70 and 79 years, and 83 (11.85 %) were aged 80 years or older. Patients ≥80 years had a trend for lower rate of serous carcinoma than the other age subgroups. As age increased, patients were less likely to undergo surgery and chemotherapy. While 73 % of women <70 years received a combination of surgery and chemotherapy, the rate was 62 % among women 70-79 years and 27 % among women ≥80 years (p<.0001). When focusing on FIGO IIIC-IV stages, the 5-year NS rate for women <70 years was 45.1 % (95 % CI 39.1-52.0). For women 70-79 years, it was 25.9 % (95 % CI 18.6-36.1), and for those ≥80 years, it was 19.5 % (95 % CI 10.0-38.0) (p<.005).

Discussion: The oldest patients had less optimal treatment and a lower NS compared to patients in their seventies or younger. Frailty should be carefully assessed to optimize care in the oldest patients with OC.

简介卵巢癌（OC）是妇女第八大常见癌症，预后较差，尤其是老年妇女。本研究旨在描述八十岁以上卵巢癌患者的情况，并研究净生存率（NS）在不同年龄段的差异：在这项基于人群的回顾性观察研究中，纳入了 1998 年至 2018 年间确诊的上皮性卵巢癌 IA 期至 IVB 期、年龄大于 18 岁的妇科癌症登记患者。未提供FIGO分期的患者被排除在外。患者分为三个年龄组：结果：在纳入的 721 名患者中：462人（64.1%）小于70岁，176人（24.4%）年龄在70-79岁之间，83人（11.85%）年龄在80岁或以上。与其他年龄亚组相比，≥80 岁患者的浆液性癌发生率呈下降趋势。随着年龄的增长，患者接受手术和化疗的可能性降低。73%的女性进行了讨论：与 70 多岁或更年轻的患者相比，高龄患者的最佳治疗效果较差，NS 也较低。应仔细评估体弱情况，以优化对高龄 OC 患者的护理。

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引用次数: 0

New South Wales data linkage study reveals a shift in HCC mortality risk: Time for broader strategies 新南威尔士州数据关联研究揭示了 HCC 死亡风险的变化：制定更广泛战略的时机已到

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-10-31 DOI: 10.1016/j.canep.2024.102690

Salim Maher , Alamgir Kabir , Jason Behary , Damian P. Conway , Anna C. Akon , Margo Barr , Amany Zekry

Background

This study aims to examine the impact of sociodemographic and clinical factors on hepatocellular carcinoma (HCC) mortality in New South Wales (NSW), Australia.

Methods

We conducted a 15-year retrospective study (2001–2015) using data linkage of health records and cancer registry databases, to identify all HCC cases and analyse HCC-related and all-cause mortality rates. Location-based socioeconomic status (SES) was determined using the Socioeconomic Indexes for Areas (SEIFA). Multivariable Cox regression analysis was used to determine the effect of key variables on mortality.

Results

5564 cases of HCC were diagnosed during the study period. A study cohort of 5454 cases was analysed after excluding cases with key missing data. More than half of the chronic liver disease cases were due to non-viral causes. During the study period, 4033 deaths occurred, of which 2862 were HCC-related. The median survival time for HCC-related deaths was 547 days, and the 5-year survival rate was 31.3 %. Higher HCC-related mortality rates were observed in SEIFA quintiles 2, 3 and 4, when compared to 5 (where SEIFA 1 is most disadvantaged, and SEIFA 5 is most advantaged). Furthermore, significantly increased HCC-related mortality was observed for those aged ≥65, male gender, Australian-born, hospitalisation due to complications of alcohol use, having metastatic HCC at diagnosis, and not receiving surgery for HCC.

Conclusions

There is higher prevalence of non-viral-related HCC than viral-related HCC in NSW, Australia, where HCC-related mortality risk is greatest among those Australian-born and lower to higher SES, when compared to highest SES. Identifying factors contributing to these emerging disparities is crucial for developing effective prevention programs and allocating research and health resources.

背景本研究旨在探讨澳大利亚新南威尔士州（NSW）的社会人口和临床因素对肝细胞癌（HCC）死亡率的影响。方法我们利用健康记录和癌症登记数据库的数据链接开展了一项为期 15 年（2001-2015 年）的回顾性研究，以确定所有 HCC 病例并分析 HCC 相关死亡率和全因死亡率。使用地区社会经济指数（SEIFA）确定了基于地点的社会经济地位（SES）。采用多变量 Cox 回归分析确定主要变量对死亡率的影响。在排除关键数据缺失的病例后，对 5454 个病例的研究队列进行了分析。半数以上的慢性肝病病例由非病毒引起。在研究期间，共有4033人死亡，其中2862人与HCC有关。HCC相关死亡病例的中位生存时间为547天，5年生存率为31.3%。与 SEIFA 五分位数 5 相比，SEIFA 五分位数 2、3 和 4 的 HCC 相关死亡率更高（SEIFA 五分位数 1 最不利，SEIFA 五分位数 5 最有利）。此外，年龄≥65 岁、男性、澳大利亚出生、因酗酒并发症住院、诊断时为转移性 HCC 以及未接受 HCC 手术治疗的人群的 HCC 相关死亡率也明显增加。结论在澳大利亚新南威尔士州，非病毒相关 HCC 的发病率高于病毒相关 HCC，与最高社会经济地位相比，澳大利亚出生和较低至较高社会经济地位人群的 HCC 相关死亡风险最大。找出导致这些新出现的差异的因素对于制定有效的预防计划以及分配研究和卫生资源至关重要。

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引用次数: 0