Cancer Epidemiology最新文献_第4页

Cholangiocarcinoma (CCA) mortality in Vietnam war era veterans 越战老兵胆管癌（CCA）死亡率。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102721

T. Bullman , WJ Culpepper , YS Cypel , F. Akhtar , SW Morley , A. Schneiderman , JC Weitlauf , E. Garges , VJ Davey

Background

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

Methods

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

Results

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

Conclusion

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

背景：在越战战场服役的美国退伍军人中存在胆管癌死亡率（CCA）的风险。各种可能与越南部署有关的风险因素可能与CCA死亡风险增加有关。这项研究评估了所有越南战争时期退伍军人的CCA死亡率风险，这是第一个这样做的研究。方法：越战时期退伍军人死亡率研究是一项回顾性死亡率研究，研究对象包括在越南和东南亚（战区）服役的所有250万退伍军人，以及在越南战争期间在其他地方（非战区）服役的730万退伍军人。从1979年到2019年跟踪了死亡率。根据Cox比例风险模型计算的风险比（hr），对性别和年龄进行了调整，比较了战区和非战区退伍军人总体和各服务部门之间的CCA死亡率风险。还比较了战区退伍军人和非战区退伍军人的分支特异性CCA粗率。结果：战区退伍军人和非战区退伍军人分别有2410例和6502例CCA死亡。总体而言，在调整性别和年龄后，战区退伍军人与非战区退伍军人的CCA死亡风险没有增加(风险比，（HR: 1.00, 95 % CI: 0.95-1.04）。当按军种分层时，除了非战区海军陆战队员的风险较低外，军种战区状态组之间CCA的粗hr没有差异。在40年的随访中，无论在战区还是非战区，CCA的粗死亡率均呈单调上升趋势。结论：战区与非战区美国越战老兵的CCA死亡风险没有增加，这是一个重要的新发现。这项研究缺乏环境暴露和行为因素的数据，这些数据将进一步为CCA风险分析提供信息。确定越南战争时期退伍军人的具体风险因素，需要替代的方法和数据不存在。

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引用次数: 0

Prevalence, incidence and trends of keratinocyte carcinoma in Denmark 2007–2021: A population-based register study 丹麦2007-2021年角化细胞癌的患病率、发病率和趋势：一项基于人群的登记研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102732

Anne Sofie Krogh Holdam , Vibeke Koudahl , Erik Frostberg , Karina Rønlund , Hans Bjarke Rahr

Introduction

The incidence of keratinocyte carcinoma (KC), i.e., basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is increasing worldwide, placing a significant burden on healthcare resources. This is especially the case for tumors requiring surgical intervention. It remains unclear whether this increase is a result of the population aging or a genuine increase in risk of skin cancer. Understanding age-adjusted incidence trends of KC is crucial for improving future management of the disease. We studied these trends in a large nationwide cohort, focusing on large, invasive, and surgically challenging tumors.

Methods

Information on all incident cases of BCC and SCC in Denmark was extracted from population-based databases in the calendar years 2007–2021. Age-adjusted incidence rates were calculated, standardized to the 2013 European Standard Population. Average annual percentage changes were estimated using Joinpoint regression models. Incidence trends for larger, more invasive tumors (tumor (T) category of ≥T2), and of those in the head and neck area, were elucidated with descriptive statistics.

Results

We found 183,338 patients with a first-time incidence of BCC and 42,233 patients with a first-time incidence of SCC in the period 2007–2021. The incidence rate, adjusted for age, increased from 252 to 338 per 100,000 for BCC and from 49 to 104 per 100,000 for SCC. For SCC, the increase was particularly pronounced in the last two years of the study period. Tumors ≥T2, and those in the head and neck area, increased markedly.

Conclusion

KC is the most common type of cancer worldwide, and the age-adjusted incidence rates of BCC and SCC increased significantly from 2007 to 2021, as did tumors with a higher T category and those located in anatomically sensitive areas. Since the primary treatment for many of these tumors is surgical, this raises concern about the strain on future healthcare resources.

导语：角化细胞癌（KC），即基底细胞癌（BCC）和鳞状细胞癌（SCC）的发病率在全球范围内不断增加，给医疗资源带来了重大负担。对于需要手术治疗的肿瘤尤其如此。目前尚不清楚这种增加是人口老龄化的结果还是皮肤癌风险的真正增加。了解年龄调整后的KC发病率趋势对改善未来的疾病管理至关重要。我们在一个全国性的大队列中研究了这些趋势，重点是大的、侵袭性的和手术挑战性的肿瘤。方法：从2007-2021年丹麦基于人口的数据库中提取所有BCC和SCC事件病例的信息。计算年龄调整后的发病率，并将其标准化为2013年欧洲标准人口。使用Joinpoint回归模型估计平均年百分比变化。对较大、侵袭性较强的肿瘤（肿瘤(T)分类≥T2）和头颈部肿瘤的发病率趋势进行描述性统计分析。结果：在2007-2021年期间，我们发现了183338例首次发病的BCC患者和42233例首次发病的SCC患者。根据年龄调整后的发病率，BCC从252 / 10万增加到338 / 10万，SCC从49 / 10万增加到104 / 10万。对于SCC，在研究期间的最后两年，这种增加尤为明显。≥T2及头颈部肿瘤明显增多。结论：KC是世界范围内最常见的癌症类型，2007年至2021年，BCC和SCC的年龄调整发病率显著增加，T分类较高的肿瘤和位于解剖敏感区域的肿瘤也是如此。由于这些肿瘤的主要治疗是手术，这引起了对未来医疗资源紧张的关注。

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引用次数: 0

Socioeconomic position, psychiatric medical treatment and risk of breast cancer recurrence and mortality: A Danish population-based cohort study 社会经济地位、精神医学治疗与乳腺癌复发和死亡风险：一项丹麦人群队列研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102733

Fanny Borne Asmussen , Cathrine F. Hjorth , Oleguer Plana-Ripoll , Aurélie Mailhac , Deirdre Cronin-Fenton

Background

Breast cancer patients with low socioeconomic position (SEP) have a higher risk of recurrence and mortality. We examined the extent to which prior psychiatric medication impacted this association.

Methods

We conducted a cohort study of premenopausal women diagnosed with breast cancer in Denmark from 2002 to 2011 (n = 5847), linking data from Denmark’s nationwide population-based health registries on breast cancer diagnosis, treatment, psychiatric medication prescriptions and SEP indicators (marital status, cohabitation, income, education and employment). We followed the women up to 10 years from breast cancer diagnosis until recurrence, death, emigration, other malignancy, or September 2017. We used Cox regression to estimate hazard ratios (HRs) and corresponding 95 % confidence intervals (95 %CI) associating each SEP indicator with recurrence and all-cause mortality. To evaluate interaction by psychiatric medication use on the association between SEP and prognosis, we 1) stratified the models according to prior use of psychiatric medication and 2) added an interaction term to the regression model.

Results

Women with short compared with intermediate education level and prior psychiatric medication had increased risk of recurrence (HR = 1.41, 95 %CI = 1.05–1.91); this was higher than seen in those without prior psychiatric medication (HR = 1.06, 95 %CI = 0.87–1.29). Patterns were similar for all-cause mortality. Likewise, unemployed women with a history of psychiatric medication use had a higher risk of all-cause mortality (HR = 1.74, 95 %CI = 1.31–2.31) compared to unemployed women without prior psychiatric medication use (HR = 1.32, 95 %CI = 1.03–1.70). In contrast, prior psychiatric medication use did not have a negative impact on breast cancer prognosis in women who were single, living alone or had low income.

Conclusion

Breast cancer patients with prior psychiatric disease who have short education or are unemployed may be particularly vulnerable to recurrence and mortality. These women may benefit from more frequent follow up examinations.

背景：低社会经济地位（SEP）的乳腺癌患者有较高的复发和死亡风险。我们检查了先前的精神药物对这种关联的影响程度。方法：我们对2002年至2011年丹麦诊断为乳腺癌的绝经前妇女进行了一项队列研究（n = 5847），将丹麦全国人口健康登记处的乳腺癌诊断、治疗、精神药物处方和SEP指标（婚姻状况、同居、收入、教育和就业）的数据联系起来。从乳腺癌诊断到复发、死亡、移民、其他恶性肿瘤或2017年9月，我们对这些女性进行了长达10年的随访。我们使用Cox回归来估计每个SEP指标与复发和全因死亡率相关的风险比（hr）和相应的95 %置信区间（95 %CI）。为了评估精神药物使用对SEP与预后相关性的交互作用，我们1)根据既往精神药物使用情况对模型进行分层，2)在回归模型中加入交互作用项。结果：与中等文化程度和既往精神药物治疗相比，低文化程度的女性复发风险增加（HR = 1.41, 95 %CI = 1.05-1.91）；这一比例高于未接受精神科药物治疗的患者（HR = 1.06, 95 %CI = 0.87-1.29）。全因死亡率的模式相似。同样，有精神药物使用史的失业妇女的全因死亡率（HR = 1.74, 95 %CI = 1.31-2.31）高于没有精神药物使用史的失业妇女（HR = 1.32, 95 %CI = 1.03-1.70）。相比之下，在单身、独居或低收入女性中，先前使用精神药物对乳腺癌预后没有负面影响。结论：乳腺癌患者既往有精神疾病且教育程度较低或无业人员易复发和死亡。这些妇女可能受益于更频繁的随访检查。

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引用次数: 0

Racial differences in carcinoma-in-situ and non-muscle-invasive bladder cancer mortality: Accounting for insurance status, black segregation, and neighborhood poverty 原位癌和非肌肉浸润性膀胱癌死亡率的种族差异：考虑保险状况、黑人隔离和社区贫困。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102728

Asal M. Johnson , Allen Johnson , Robert B. Hines , Xiang Zhu

Background

Few Bladder Cancer (BC) studies have examined the role of area-level variables. The purpose of this study was to examine racial differences in BC survival to elucidate if insurance status and contextual covariates could explain Black disadvantage in survival.

Method

Using the Fine-Gray subdistribution hazard models (sHR), five-year survival time was calculated from the date of diagnosis until the last day of follow-up or the date of death due to BC in Florida 2000–2014 (n = 32,321). Non-BC deaths were considered a competing risk. In all models, individual-level clinical and demographic variables were adjusted for and we included the exposures of interest for Carcinoma-in-Situ (CIS) and Non-Muscle-Invasive BC(NMIBC), separately.

Results

In CIS-Patients, living in neighborhoods with higher levels of segregation was associated with 50 % to 2-fold increase in sHR (medium level segregation sHR= 1.50, 95 % CI: 1.06–2.13; high level segregation sHR= 2.07, 95 % CI: 1.25–3.43). Uninsured CIS patients had more than 2-fold increased sHR compared to those with private insurance (sHR=2.34, 95 % CI: 1.05–5.24). In NMIBC patients, living in areas with level of poverty resulted in 10 % the hazard of death increased when compared to low poverty (high poverty sHR=1.11, 95 % CI: 1.01–1.21). Uninsured and Medicaid covered NMIBC patients had an increased sHR (uninsured sHR=2.05, 95 % CI: 1.62–2.59; Medicaid sHR=1.36, 95 % CI: 1.11–1.67). For both CIS and NMIBC patients, the Black/White survival gap decreased when insurance and contextual variables were included.

Conclusion

This study identified BC survival rates were different for Black and White patients in Florida and found that those observed gaps were, to some extent, linked to broader social factors. We recommend that future cancer studies examining racial disparities incorporate area-level variables to offer a more nuanced understanding of these complex disparities.

背景：很少有膀胱癌（BC）研究对地区级变量的作用进行研究。本研究旨在探讨膀胱癌患者生存率的种族差异，以阐明保险状况和环境协变量是否能解释黑人在生存率方面的劣势：方法：使用细-灰次分布危险模型（sHR），计算2000-2014年佛罗里达州（n = 32,321）从诊断之日起至随访最后一天或因BC死亡之日止的五年生存时间。非 BC 死亡被视为竞争风险。在所有模型中，我们对个人临床和人口统计学变量进行了调整，并分别纳入了原位癌（CIS）和非肌浸润性BC（NMIBC）的相关暴露：在CIS患者中，居住在隔离水平较高的社区与sHR增加50%至2倍有关（中等隔离水平sHR=1.50，95% CI：1.06-2.13；高隔离水平sHR=2.07，95% CI：1.25-3.43）。与有私人保险的 CIS 患者相比，没有保险的 CIS 患者的 sHR 增加了 2 倍多（sHR=2.34，95 % CI：1.05-5.24）。在 NMIBC 患者中，与低度贫困地区相比，生活在贫困地区的患者死亡风险增加了 10%（高度贫困 sHR=1.11, 95 % CI: 1.01-1.21）。未参保和享受医疗补助的 NMIBC 患者的 sHR 增加（未参保的 sHR=2.05，95 % CI：1.62-2.59；医疗补助的 sHR=1.36，95 % CI：1.11-1.67）。对于CIS和NMIBC患者而言，如果将保险和环境变量包括在内，黑人/白人的生存率差距会缩小：这项研究发现，佛罗里达州的黑人和白人 BC 患者的生存率存在差异，并发现这些观察到的差距在一定程度上与更广泛的社会因素有关。我们建议，未来研究种族差异的癌症研究应纳入地区层面的变量，以便更细致地了解这些复杂的差异。

{"title":"Racial differences in carcinoma-in-situ and non-muscle-invasive bladder cancer mortality: Accounting for insurance status, black segregation, and neighborhood poverty","authors":"Asal M. Johnson , Allen Johnson , Robert B. Hines , Xiang Zhu","doi":"10.1016/j.canep.2024.102728","DOIUrl":"10.1016/j.canep.2024.102728","url":null,"abstract":"<div><h3>Background</h3><div>Few Bladder Cancer (BC) studies have examined the role of area-level variables. The purpose of this study was to examine racial differences in BC survival to elucidate if insurance status and contextual covariates could explain Black disadvantage in survival.</div></div><div><h3>Method</h3><div>Using the Fine-Gray subdistribution hazard models (sHR), five-year survival time was calculated from the date of diagnosis until the last day of follow-up or the date of death due to BC in Florida 2000–2014 (n = 32,321). Non-BC deaths were considered a competing risk. In all models, individual-level clinical and demographic variables were adjusted for and we included the exposures of interest for Carcinoma-in-Situ (CIS) and Non-Muscle-Invasive BC(NMIBC), separately.</div></div><div><h3>Results</h3><div>In CIS-Patients, living in neighborhoods with higher levels of segregation was associated with 50 % to 2-fold increase in sHR (medium level segregation sHR= 1.50, 95 % CI: 1.06–2.13; high level segregation sHR= 2.07, 95 % CI: 1.25–3.43). Uninsured CIS patients had more than 2-fold increased sHR compared to those with private insurance (sHR=2.34, 95 % CI: 1.05–5.24). In NMIBC patients, living in areas with level of poverty resulted in 10 % the hazard of death increased when compared to low poverty (high poverty sHR=1.11, 95 % CI: 1.01–1.21). Uninsured and Medicaid covered NMIBC patients had an increased sHR (uninsured sHR=2.05, 95 % CI: 1.62–2.59; Medicaid sHR=1.36, 95 % CI: 1.11–1.67). For both CIS and NMIBC patients, the Black/White survival gap decreased when insurance and contextual variables were included.</div></div><div><h3>Conclusion</h3><div>This study identified BC survival rates were different for Black and White patients in Florida and found that those observed gaps were, to some extent, linked to broader social factors. We recommend that future cancer studies examining racial disparities incorporate area-level variables to offer a more nuanced understanding of these complex disparities.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102728"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824958","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

Prediction model establishment of prognosis factors for distant metastasis of hepatocellular carcinoma based on the SEER database 基于SEER数据库的肝癌远处转移预后因素预测模型的建立。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102729

Jixuan Wu , Chun Zhang , Youjia Zhang , Rui He , Qin Wang , Lei Zhang , Jing Hu , Runlan Wan

Background

Distant metastasis in hepatocellular carcinoma (HCC) is an important indicator of poor patient prognosis. Identifying patients who are at high risk of metastasis early on is essential for creating personalized treatment plans, yet currently, there is a scarcity of effective predictive tools.

Objective

To investigate the effects of different factors on distant metastasis in HCC patients and to establish a clinical prediction model for predicting distant metastasis in HCC patients.

Methods

Our study retrospectively examined 22,318 patients diagnosed with confirmed HCC from the SEER database. Prognostic factors for developing distant metastases in HCC patients were identified by univariate and multivariate logistic regression analyses. Utilizing data from a multivariate logistic regression analysis, we created a nomogram. Its predictive precision was evaluated by analyzing the calibration curve, the area under the curve (AUC) of the receiver operating characteristic curve, decision curve assessment (DCA), and Kaplan-Meier (KM) curve analysis of overall survival. Finally,the nomogram was visualized with an online calculator.

Results

We identified six independent prognostic factors: ethnicity, marital status, tumor size, survival time, surgery, and radiotherapy. The nomogram constructed from these six factors showed good calibration, discrimination, and clinical application value after calibration curve analysis, receiver operating characteristic curve analysis and DCA curve analysis. Besides, KaplanMeier survival curves also demonstrated that this nomogram had predictive accuracy.

Conclusion

In this research, a nomogram model was created to accurately predict distant metastasis risk in patients with HCC. This study provides guidance for optimizing individual therapies and making better clinical decisions.

背景：肝细胞癌（HCC）的远处转移是患者预后不良的一个重要指标。早期识别转移风险高的患者对制定个性化治疗方案至关重要，但目前有效的预测工具还很匮乏：研究不同因素对 HCC 患者远处转移的影响，并建立预测 HCC 患者远处转移的临床预测模型：我们的研究对 SEER 数据库中确诊的 22,318 例 HCC 患者进行了回顾性研究。通过单变量和多变量逻辑回归分析确定了HCC患者发生远处转移的预后因素。利用多变量逻辑回归分析的数据，我们绘制了一个提名图。通过分析校准曲线、接收者操作特征曲线下面积（AUC）、决策曲线评估（DCA）和总生存期的卡普兰-梅尔（KM）曲线分析，对其预测精度进行了评估。最后，利用在线计算器对提名图进行了可视化分析：我们发现了六个独立的预后因素：种族、婚姻状况、肿瘤大小、生存时间、手术和放疗。经过校准曲线分析、接收者操作特征曲线分析和 DCA 曲线分析，由这六个因素构建的提名图显示出良好的校准性、区分度和临床应用价值。此外，KaplanMeier 生存曲线也证明了该提名图具有预测准确性：本研究建立了一个提名图模型，可准确预测 HCC 患者的远处转移风险。这项研究为优化个体疗法和做出更好的临床决策提供了指导。

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引用次数: 0

Prevalence of cancer risk behaviors by county-level persistent poverty 县级持续贫困的癌症风险行为患病率。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102735

Jennifer L. Moss , Casey N. Pinto , Chan Shen

Background

Cancer mortality rates are substantially higher in persistent poverty US counties compared to non-persistent poverty US counties. This study aimed to assess the prevalence of cancer risk behaviors by persistent poverty.

Methods

Counties with poverty rates of ≥ 20 % between 1990 and 2017–21 were classified as ‘persistent poverty’ (n = 318), and others were classified as ‘non-persistent poverty’ (n = 2801). Multivariable linear regression models were used to analyze differences in county-level prevalence estimates of five cancer risk behaviors (current smoking, excessive alcohol consumption, obesity, physical inactivity, insufficient and sleep), controlling for demographic and socioeconomic variables.

Results

Compared to non-persistent poverty counties, persistent poverty counties had higher prevalence of smoking (24.3 % vs. 18.5 %), obesity (42.5 % vs. 36.8 %), physical inactivity (34.3 % vs. 25.8 %), and insufficient sleep (38.6 % vs. 34.0 %); however, persistent poverty counties had lower prevalence of excessive alcohol consumption (14.3 % vs. 17.2 %). Adjusted analyses confirmed significant differences in all cancer risk behaviors studied except insufficient sleep.

Conclusions

Persistent poverty counties exhibit higher prevalence of several cancer risk behaviors, which may contribute to elevated cancer mortality in these regions. Targeted public health interventions are needed to address these disparities.

背景：美国持续贫困县的癌症死亡率明显高于非持续贫困县。本研究旨在评估持续贫困对癌症风险行为的影响。方法：1990年至2017-21年间贫困率≥ 20 %的县被归类为“持续贫困”（n = 318），其他县被归类为“非持续贫困”（n = 2801）。多变量线性回归模型用于分析五种癌症风险行为（当前吸烟、过度饮酒、肥胖、缺乏运动、睡眠不足）的县级患病率估计值的差异，并控制了人口统计学和社会经济变量。结果：与非持续性贫困县相比，持续性贫困县的吸烟率（24.3% % vs. 18.5 %）、肥胖率（42.5% % vs. 36.8 %）、缺乏运动（34.3% % vs. 25.8 %）和睡眠不足（38.6 % vs. 34.0 %）较高；然而，持续贫困县的过度饮酒患病率较低（14.3% %对17.2% %）。调整后的分析证实，除睡眠不足外，所有癌症风险行为都存在显著差异。结论：持续贫困县表现出更高的癌症风险行为患病率，这可能是这些地区癌症死亡率升高的原因。需要有针对性的公共卫生干预措施来解决这些差异。

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引用次数: 0

Understanding current trends and incidence projections of prostate cancer in India: A comprehensive analysis of national and regional data from the global burden of disease study (1990 –2021) 了解印度前列腺癌的当前趋势和发病率预测：对来自全球疾病负担研究的国家和区域数据的综合分析（1990 -2021）。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102719

Vijay Kumar , Quazi Syed Zahiruddin , Diptismita Jena , Suhas Ballal , Sanjay Kumar , Mahakshit Bhat , Shilpa Sharma , M.Ravi Kumar , Sarvesh Rustagi , Abhay M. Gaidhane , Lara Jain , Sanjit Sah , Muhammed Shabil

Background

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

Methods

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

Results

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

Conclusion

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

背景：本研究旨在利用全球疾病负担（GBD） 2021研究的数据，探讨1990年至2021年印度邦一级前列腺癌（PC）的负担和趋势。方法：分析印度各邦和联邦属地PC的健康指标，包括每10万人的年龄标准化发病率（ASIR）、患病率（ASPR）、残疾调整生命年（ASDR）和死亡率（ASMR）。连接点回归分析用于确定这些指标随时间的显著变化。利用自回归综合移动平均（ARIMA）模型对ASIR进行投影。结果：PC的年龄分布在ASIR、ASPR、ASDR、ASMR年龄组中呈增加趋势，以75 ~ 79岁年龄组居多。1990-2021年，ASIR、ASPR、ASMR和ASDR的年均百分比变化（AAPC）分别增加了157 %、278 %、76 %和58 %。预测显示，到2031年，ASIR将进一步上升至9.15 / 10万。连接点分析显示，1992年至1995年期间，所有健康指标的年百分比变化（APC）最高。尽管考虑到地区差异，古吉拉特邦在所有健康指标中显示出最高的总百分比变化，但德里和喀拉拉邦的总体变化仍然最高。结论：该研究强调了印度PC负担的增加，强调了改进诊断实践、本地化筛查指南和有针对性的公共卫生干预措施的必要性。

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引用次数: 0

Liver cancer in Saudi Arabia: A registry-based nationwide descriptive epidemiological and survival analysis 沙特阿拉伯的肝癌：基于登记的全国描述性流行病学和生存分析。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102731

Nawal H. Almohammadi

Liver cancer is a major worldwide health concern characterized by increasing rates of occurrence. It ranks as the sixth most prevalent form of cancer and is the third highest contributor to cancer-related fatalities globally. This study aimed to describe the epidemiology of liver cancer in Saudi Arabia and to analyze the factors associated with it. This retrospective medical record review included all the patients diagnosed with a liver cancer from January 2014 to December 2020. The incidence data were obtained and collected from the Saudi Cancer registry. The net survival percentage was obtained in global cancer observatory website of the International Agency for Research on Cancer. There were 3066 occurrences of liver cancer among Saudi Nationals during the years 2014 and 2020. The majority of patients consisted of males, accounting for 2105 individuals, which represents 68.7 % of the total. The predominant morphologies are Hepatocellular carcinoma (2520, 82.2 %), choliangocarcinoma (267, 8.7 %), Adenocarcinoma (5.1 %), and malignant neoplasm (3.4 %). The age-standardized incidence rate for males between 2014 and 2020 varied from 4.0 per 100,000 to 4.8 per 100,000, whilst for females it ranged from 1.5 per 100,000 to 2.4 per 100,000. The age-standardized incidence rate among Saudi nationals is 4.7 cases per 100,000, while the age-standardized mortality rate is 4.6 deaths per 100,000. Liver cancer is a significant global health problem, marked by its high occurrence and typically poor survival rates. By emphasizing risk factors, it enhances the implementation practices that may help to provide appropriate care to maximize favourable outcomes.

肝癌是世界范围内一个主要的健康问题，其特点是发病率不断上升。它是全球第六大最常见的癌症形式，也是导致癌症相关死亡的第三大因素。本研究旨在描述沙特阿拉伯肝癌的流行病学，并分析与之相关的因素。这项回顾性医疗记录综述包括2014年1月至2020年12月期间诊断为肝癌的所有患者。发病率数据是从沙特癌症登记处获得和收集的。净生存率在国际癌症研究机构的全球癌症观测站网站上获得。2014年至2020年期间，沙特国民中有3066例肝癌病例。患者以男性为主，共2105例，占68.7% %。主要形态为肝细胞癌（2520例，82.2 %）、胆管癌（267例，8.7 %）、腺癌（5.1 %）和恶性肿瘤（3.4 %）。2014年至2020年期间，男性的年龄标准化发病率从每10万人4.0到4.8不等，而女性的发病率从每10万人1.5到2.4不等。沙特国民的年龄标准化发病率为每10万人4.7例，而年龄标准化死亡率为每10万人4.6例。肝癌是一个重大的全球健康问题，其特点是发病率高，存活率通常很低。通过强调风险因素，它加强了可能有助于提供适当护理以最大化有利结果的实施实践。

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引用次数: 0

Cervical cancer incidence and trends among women aged 15–29 years by county-level economic status and rurality – United States, 2007–2020 2007-2020 年美国 15-29 岁女性宫颈癌发病率及趋势（按县级经济状况和农村地区分列）。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102730

Radhika Agarwal , Jessica B. King , Sameer V. Gopalani , Virginia Senkomago

Introduction

Variations in cervical cancer incidence rates and trends have been reported by sociodemographic characteristics. However, research on economic characteristics is limited especially among younger women in the United States.

Methods

We analyzed United States Cancer Statistics data to examine age-standardized cervical cancer incidence rates among women aged 15–29 years during 2007–2020. We used an index-based county-level economic classification to rank counties in the top 25 %, middle 25 %-75 %, and bottom 25 %. We assessed differences in incidence using rate ratios and trends using annual percent changes (APCs) from joinpoint regression. Due to impact from the COVID-19 pandemic, trend analysis excluded 2020 data. Analyses were conducted during August-October 2023.

Results

During 2007–2020, incidence rates were lower in the top 25 % counties economically than the bottom 25 % or middle 25 %-75 % (1.6 vs 2.1 vs 1.9 per 100,000, respectively). Rates were higher in nonmetropolitan than metropolitan counties across economic groups. Overall, rates declined in all county-level economic strata, especially in the bottom 25 % during 2015–2019 (APC −10.6 %). Rates appeared to decrease in metropolitan counties and women of all races across economic categories. decreases were most evident in the top 25 % of non-Hispanic White women during 2016–2019 and nonmetropolitan counties during 2017–2019.

Conclusions

In women aged 15–29 years, declining rates of cervical cancer during 2007–2019 across county-level economic strata may partly reflect effects of human papillomavirus vaccination and cervical cancer screening. Further observed differences by race and rurality may help inform efforts to increase implementation of preventive measures in populations with the highest burden.

引言：宫颈癌发病率的变化和趋势已经根据社会人口特征进行了报道。然而，对经济特征的研究是有限的，尤其是在美国的年轻女性中。方法：我们分析了美国癌症统计数据，以检查2007-2020年15-29岁女性的年龄标准化宫颈癌发病率。我们使用了基于指数的县级经济分类，将前25个县分别排在 %、中间25个县 %-75 %和后25个县 %。我们使用接点回归的发病率比和使用年百分比变化（APCs）的趋势来评估发病率的差异。受2019冠状病毒病大流行影响，趋势分析排除了2020年的数据。分析在2023年8月至10月期间进行。结果：2007-2020年，经济上排名前25位 %的县的发病率低于排名后25位 %或排名中25位 %-75 %（分别为1.6 / 10万、2.1 / 1.9 / 10万）。在各个经济群体中，非大都市县的失业率高于大都市县。总体而言，2015-2019年期间，所有县级经济阶层的税率都有所下降，尤其是最低的25% % （APC -10.6 %）。在大都会县和所有种族、所有经济类别的女性中，这一比例似乎都有所下降。在2016-2019年和2017-2019年期间，非西班牙裔白人女性中排名前25% %的降幅最为明显。结论：2007-2019年，在15-29岁女性中，县级经济阶层宫颈癌发病率下降，可能部分反映了人乳头瘤病毒疫苗接种和宫颈癌筛查的效果。进一步观察到的种族和农村差异可能有助于为在负担最重的人群中加强预防措施的实施提供信息。

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引用次数: 0

The impact of type 2 diabetes on melanoma stage (TNM) at the time of diagnosis and its association with sex: A Danish nationwide study 2型糖尿病对诊断时黑色素瘤分期（TNM）的影响及其与性别的关系：一项丹麦全国性研究。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-02-01 DOI: 10.1016/j.canep.2024.102739

Jens Ejrnæs Tønder , Eeva-Liisa Røssell , Martin Sollie , Marie Louise Bønnelykke-Behrndtz , Tinne Laurberg

Background

Cancer has become the leading cause of death among individuals with type 2 diabetes (T2D) in high-income countries. T2D is suggested to directly influence cancer progression. However, the association between T2D and melanoma stage at diagnosis remains uncertain, as well as any potential sex disparities.

Objectives

To investigate the association between T2D and the melanoma TNM stage (Breslow thickness, ulceration status, lymph node metastases, and distant metastases) at the time of diagnosis and to assess whether the association is affected by sex.

Methods

A nationwide cross-sectional study was conducted, including all patients diagnosed with melanoma between 2004 and 2022 identified in the Danish Cancer Register. T2D status was ascertained using a validated register based algorithm. The association between T2D and melanoma stage was estimated using univariable and multivariable logistic regression analyses adjusted for sex, age, comorbidity, and year of diagnosis.

Results

The study included 30,315 individuals with melanoma. The multivariable analyses showed that T2D was associated with an increased adjust odds ratio (aOR) of tumour thickness > 4 mm (aOR 1.30, 95 %CI: [1.10–1.52]), the presence of ulceration (aOR: 1.25, 95 % CI: [1.09–1.43]), lymph node metastases (aOR 1.27 [1.10–1.47]), and distant metastases (aOR: 1.26 [1.01–1.56]). Furthermore, sex stratified analyses showed that T2D was associated with distant metastases in women, but not in men.

Conclusions

Individuals with T2D were more likely to be diagnosed with advanced stages of local, regional, and distant melanoma. This highlights the need for greater melanoma awareness and further research into treatment responses in individuals with T2D.

背景：癌症已成为高收入国家2型糖尿病（T2D）患者死亡的主要原因。T2D被认为直接影响癌症的进展。然而，T2D与黑色素瘤诊断阶段之间的关系以及任何潜在的性别差异仍然不确定。目的：探讨诊断时T2D与黑色素瘤TNM分期（brreslow厚度、溃疡状态、淋巴结转移和远处转移）之间的关系，并评估这种关系是否受性别影响。方法：进行了一项全国性的横断面研究，包括2004年至2022年间在丹麦癌症登记处发现的所有被诊断为黑色素瘤的患者。使用一种有效的基于寄存器的算法确定T2D状态。利用单变量和多变量logistic回归分析对性别、年龄、合并症和诊断年份进行校正，估计T2D与黑色素瘤分期之间的关系。结果：该研究包括30315名黑色素瘤患者。多变量分析显示，T2D与肿瘤厚度> 4 mm （aOR 1.30, 95 %CI:[1.10-1.52]）、溃疡（aOR: 1.25, 95 %CI:[1.09-1.43]）、淋巴结转移（aOR 1.27[1.10-1.47]）和远处转移（aOR: 1.26[1.01-1.56]）的调整优势比（aOR）增加相关。此外，性别分层分析显示，T2D与女性的远处转移有关，而与男性无关。结论：T2D患者更有可能被诊断为局部、区域和远处黑色素瘤的晚期。这突出了对黑色素瘤的认识和对T2D患者治疗反应的进一步研究的必要性。

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引用次数: 0