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Associations between insulin-like growth factor 1, IGF-binding protein 3, and colorectal cancer 胰岛素样生长因子1、igf结合蛋白3与结直肠癌的关系
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2026-02-01 Epub Date: 2026-01-08 DOI: 10.1016/j.canep.2026.102986
Thomas Lawler , Zoe L. Walts , Lauren Giurini , Mark Steinwandel , Wei Zheng , Shaneda Warren Andersen

Background

Higher serum insulin-like growth factor 1 (IGF-1) has been linked to colorectal cancer (CRC), with evidence supporting increased risk for colon but not rectal tumors. Few studies have included substantial numbers of non-Hispanic Black individuals, who have elevated population-level CRC risk. We investigated associations between IGF-1 and CRC in the Southern Community Cohort Study. We also report associations with IGF binding protein 3 (IGFBP-3), the primary IGF-1 transporter, and the IGF-1/IGFBP-3 ratio (a surrogate marker for biologically available IGF-1).

Methods

Participants with incident CRC (N = 297) were individually matched with controls (N = 604) on age, race, and sex. The majority of the cohort reports Black racial identity (75 %). Serum IGF-1 and IGFBP-3 were measured at enrollment. Logistic regression was used to estimate odds ratios (ORs) with 95 % confidence intervals (CIs) for CRC, colon and rectal cancers.

Results

For higher IGF-1 (tertile 3vs1), the OR for CRC was 1.45 (CI 0.95–2.21). Higher IGF-1 was associated with greater odds for colon cancer (OR 1.64, CI 1.01–2.64) but not rectal cancer (OR 0.93, CI 0.43–1.97). The associations with CRC and colon cancer were consistent among participants who fasted prior to serum draw (N = 356, CRC: OR 1.89, CI 0.95–3.78; colon cancer: OR 2.08, CI 0.96–4.51). No associations were observed for IGFBP-3 or the IGF-1/IGFBP-3 ratio in the full sample.

Conclusion

Higher IGF-1 was associated with increased odds for colon cancer, but not rectal cancer, among predominantly non-Hispanic Black individuals with lower socioeconomic status, consistent with findings from predominantly non-Hispanic White cohorts.
高血清胰岛素样生长因子1 (IGF-1)与结直肠癌(CRC)有关,有证据支持结肠肿瘤风险增加,而非直肠肿瘤。很少有研究包括大量非西班牙裔黑人,他们有较高的人群CRC风险。我们在南部社区队列研究中调查了IGF-1与CRC之间的关系。我们还报道了与IGF结合蛋白3 (IGFBP-3)、主要IGF-1转运蛋白和IGF-1/IGFBP-3比率(生物可用性IGF-1的替代标记物)的关联。方法将发生CRC的参与者(N = 297)与对照组(N = 604)在年龄、种族和性别上进行单独匹配。大多数队列报告黑人种族身份(75% %)。入组时测定血清IGF-1和IGFBP-3。采用Logistic回归估计CRC、结肠癌和直肠癌的比值比(ORs),置信区间为95% %。结果高IGF-1组CRC的OR为1.45 (CI 0.95 ~ 2.21)。较高的IGF-1与结肠癌(OR 1.64, CI 1.01-2.64)相关,但与直肠癌(OR 0.93, CI 0.43-1.97)无关。在血清抽血前禁食的参与者中,结直肠癌和结肠癌的相关性是一致的(N = 356,结直肠癌:OR 1.89, CI 0.95-3.78;结肠癌:OR 2.08, CI 0.96-4.51)。在整个样本中没有观察到IGFBP-3或IGF-1/IGFBP-3比值的关联。结论:在社会经济地位较低的非西班牙裔黑人中,较高的IGF-1与结肠癌的发病率增加有关,但与直肠癌无关,这与非西班牙裔白人人群的研究结果一致。
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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 : 2026-02-01 Epub 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。
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引用次数: 0
Socioeconomic inequalities in prostate cancer mortality: Response to recent commentary 前列腺癌死亡率的社会经济不平等:对最近评论的回应。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2026-02-01 Epub Date: 2025-12-20 DOI: 10.1016/j.canep.2025.102978
Mohammad Hajizadeh, Grace Johnston
This document is the authors’ response to the received comments for manuscript CANEP-D-25-00363.
本文是作者对CANEP-D-25-00363稿件评论的回复。
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引用次数: 0
Early-life tobacco exposure, genetic susceptibility and incident colorectal cancer risk in UK biobank: A prospective cohort analysis 英国生物样本库中的早期烟草暴露、遗传易感性和结直肠癌风险:一项前瞻性队列分析
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2026-02-01 Epub Date: 2026-01-03 DOI: 10.1016/j.canep.2025.102985
Yu Long , Yuting Zhu , Meiyin Lin , Qinming Li , Jun Liang , Chunyang Wang , Ruijie Zeng , Dongling Luo , Lijun Zhang , Yuyin Ma , Chongyang Duan , Yue Zhu , Hao Chen , Jianhua Liu

Background

Although tobacco exposure is an established risk factor for colorectal cancer (CRC), the specific impact of early-life exposure (from prenatal to adolescence) and its joints with genetic susceptibility remains uncertain. This population-based study aimed to investigate the joint effects of early-life tobacco exposure and polygenic risk on CRC.

Methods

Data from UK Biobank participants were analyzed to assess tobacco exposure during two periods: prenatal exposure (n = 429,847) and age of smoking initiation (n = 430,672). Using Cox proportional hazards models, the associations between early-life tobacco exposure and CRC incidence were explored. Additionally, we evaluated the mediating role of accelerated biological aging in the link between early-life tobacco exposure and CRC, and further integrated the polygenic risk score (PRS) to assess the joint effects of genetic on CRC risk.

Results

Early-life tobacco exposure exhibited age-at-initiation-dependent CRC risk associations. Smoking initiation in adolescence [hazard ratios (HR) = 1.13, 95 % confidence intervals (CI): 1.06–1.22], and adulthood (HR = 1.19, 95 % CI: 1.10–1.30) all significantly increased risk (P < 0.001), while in utero exposure and smoking initiation childhood (HR:1.06, 95 % CI: 0.94–1.19, P = 0.372) showed a suggestive but non-significant trend (HR:1.05, 95 % CI: 1.00–1.11, P = 0.066). In the joint analysis, high-PRS individuals with prenatal tobacco exposure had an elevated CRC risk compared to those with low PRS and no exposure (HR 1.28, 95 % CI: 1.16–1.42, P < 0.001). Furthermore, among high-PRS individuals, smoking initiation at any age (childhood, adolescence, or adulthood) increased CRC risk relative to never-smokers with low PRS. Mediation analysis indicated that accelerated biological aging may contribute to the association between smoking initiation at different ages and increased CRC risk.

Conclusion

Early-life tobacco exposure elevated CRC risk, especially in genetically susceptible individuals. These findings underscored the importance of early tobacco prevention and enhanced screening for high genetic-risk populations.
背景虽然烟草暴露是结直肠癌(CRC)的一个确定的危险因素,但早期生活暴露(从产前到青春期)及其关节与遗传易感性的具体影响仍不确定。这项以人群为基础的研究旨在探讨早期烟草暴露和多基因风险对结直肠癌的共同影响。方法分析来自英国生物银行参与者的数据,评估两个时期的烟草暴露情况:产前暴露(n = 429,847)和开始吸烟年龄(n = 430,672)。采用Cox比例风险模型,探讨早期吸烟与结直肠癌发病率之间的关系。此外,我们评估了加速生物衰老在早期烟草暴露与结直肠癌之间的中介作用,并进一步整合多基因风险评分(PRS)来评估遗传对结直肠癌风险的共同影响。结果早期烟草暴露表现出年龄依赖性结直肠癌风险关联。吸烟开始在青春期(危害比(人力资源)= 1.13,95 % (CI)置信区间:1.06 - -1.22),和成年(HR = 1.19, 95 % CI: 1.10 - -1.30)所有风险显著增加(P & lt; 0.001),而在子宫内暴露和吸烟开始的童年(人力资源:1.06,95 % CI: 0.94 - -1.19, P = 0.372)显示暗示但非重大的趋势(人力资源:1.05,95 % CI: 1.00 - -1.11, P = 0.066)。在联合分析中,产前烟草暴露的高PRS个体与低PRS和无烟草暴露的个体相比,CRC风险升高(HR 1.28, 95 % CI: 1.16-1.42, P <; 0.001)。此外,在高PRS个体中,任何年龄(儿童、青少年或成年)开始吸烟都比低PRS从不吸烟者增加结直肠癌风险。中介分析表明,加速的生物老化可能有助于不同年龄开始吸烟与CRC风险增加之间的关联。结论早期接触烟草会增加结直肠癌的风险,尤其是在遗传易感人群中。这些发现强调了早期预防烟草和加强对高遗传风险人群筛查的重要性。
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引用次数: 0
Ambient air pollution and laryngeal cancer: A systematic review 环境空气污染与喉癌:一项系统综述。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI: 10.1016/j.canep.2025.102981
Jasen Soopramanien , Sagar Mittal , Kinjal Jadeja , Lakshya Soni , Samiyah Saghir , Fathima Mannan
Ambient air pollution is a major global health concern, yet its association with laryngeal cancer remains poorly defined. This systematic review aimed to evaluate the relationship between long-term exposure to outdoor air pollutants and incidence of laryngeal cancer. Comprehensive searches of MEDLINE, EMBASE, CENTRAL, and SCOPUS were conducted from inception to 01/06/2024. Eligible studies included observational and ecological designs reporting quantitative associations between ambient pollutants and laryngeal cancer incidence. Study quality, risk of bias, and evidence certainty graded were appraised using the NIH tool, National Toxicology Program framework and GRADE approach respectively. A total of nine studies (4 ecological, 5 cohort) comprising over 7.4 million participants were included. Each pollutant was analysed by a maximum of 3 studies. Nitrogen dioxide (NO₂) demonstrated the most consistent association with laryngeal cancer, with hazard ratios between 1.18 and 1.24 per 10 μg/m³ increase. One large cohort reported a significant relationship between particulate matter ≤ 2.5 μm (PM₂.₅) and laryngeal cancer (HR 1.85; 95 % CI: 1.2–2.85), while findings across other pollutants, including PM₁₀, SO₂, O₃, CO, and NOₓ, were inconsistent. Although data remain limited, emerging evidence suggests that chronic exposure to ambient NO₂ and PM₂.₅ may increase laryngeal cancer risk. Future large-scale prospective cohort studies with standardized exposure metrics and robust confounding control are needed to better characterise this relationship. Natural experiments in regions undergoing major air-quality policy changes can provide valuable evidence on the impact of reducing exposure on laryngeal cancer incidence at a population level.
环境空气污染是一个主要的全球健康问题,但其与喉癌的关系仍不明确。本系统综述旨在评估长期暴露于室外空气污染物与喉癌发病率之间的关系。对MEDLINE、EMBASE、CENTRAL和SCOPUS进行了全面的检索,检索时间从成立到2024年6月1日。符合条件的研究包括观察性和生态学设计,报告了环境污染物与喉癌发病率之间的定量关联。研究质量、偏倚风险和证据确定性分级分别使用NIH工具、国家毒理学计划框架和GRADE方法进行评估。共纳入9项研究(4项生态研究,5项队列研究),参与者超过740万人。每种污染物最多进行3项研究分析。二氧化氮(NO₂)与喉癌的相关性最为一致,风险比为每10 μg/m³ 增加1.18 ~ 1.24。一个大型队列报告了颗粒物质≤ 2.5 μm (PM₂.₅)与喉癌(HR 1.85; 95 % CI: 1.2-2.85)之间的显着关系,而其他污染物的调查结果,包括PM₁₀,SO₂,O₃,CO和NOₓ,则不一致。尽管数据仍然有限,但新出现的证据表明,长期暴露于环境中的NO₂和PM₂。₅可能会增加喉癌的风险。未来的大规模前瞻性队列研究需要标准化的暴露指标和强大的混杂控制来更好地表征这种关系。在空气质量政策发生重大变化的地区进行自然实验,可以为减少接触对人群水平喉癌发病率的影响提供有价值的证据。
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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 : 2026-02-01 Epub 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 : 2026-02-01 Epub 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
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 : 2026-02-01 Epub 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":"2026-02-01","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
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 : 2026-02-01 Epub 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。
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引用次数: 0
Liver and gastric cancer incidence and mortality in Non‐Western immigrant men and women: a register-based cohort study from 2000 to 2017 非西方移民男性和女性的肝癌和胃癌发病率和死亡率:2000年至2017年的一项基于登记的队列研究
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2026-02-01 Epub Date: 2025-12-24 DOI: 10.1016/j.canep.2025.102974
Angeza Abdul Khaliq , Maarit H. Lamminmäki , Sirpa H. Heinävaara , Tytti M. Sarkeala

Introduction

Geographical variations in health reflect differences in environments, lifestyles, and healthcare access. Notably, non-Western countries exhibit higher rates of infection-related cancers such as liver and gastric cancers, compared to Western countries. This study compares sex-specific incidence and mortality of liver and gastric cancers in non-Western immigrants with those of the native Finnish population. We also assess how region of birth, age at immigration, and duration of residence influence liver and gastric cancer incidence and mortality among non-Western population.

Material and method

We analysed data from 162,844 non-Western immigrant men and 161,090 women residing in Finland from 1973 to 2017. Liver and gastric cancer diagnoses and causes of death from 2000 to 2017 were linked from national registries. We assessed cancer risks using a multivariate Poisson regression model, adjusting for age group, calendar period, and region of birth.

Results

Non-Western immigrant men had higher liver cancer incidence (Relative risk (IRR) 1.41, 95 % Confidence Interval (CI) 1.13–1.78) and mortality (MRR 1.50, CI 1.16–1.94), and higher gastric cancer incidence (IRR 1.74, CI 1.46–2.06) and mortality (MRR 1.74, CI 1.42–2.14) than native men. Among non-Western immigrant women, only gastric cancer showed increased incidence (IRR 2.21, 95 % CI 1.88–2.60) and mortality (MRR 2.22, 95 % CI 1.83–2.70). Age at immigration did not impact risk levels.Prolonged duration of residence decreased the risk of gastric cancer in non-Western women, whereas in men the risk remained elevated.

Discussion

The increased cancer risk among non-Western immigrants may stem from greater exposure to infections such as hepatitis B and C and H. pylori, prevalent in their countries of origin. Cultural adaptation and lifestyle changes, particularly in alcohol and tobacco use, also play a role.

Conclusion

Targeted healthcare measures, including early diagnosis and lifestyle interventions, are crucial for reducing cancer risks among non-Western immigrants in Finland. Addressing language and cultural barriers is essential for effective healthcare and for reducing health disparities.
导言:健康的地理差异反映了环境、生活方式和医疗保健获取的差异。值得注意的是,与西方国家相比,非西方国家的肝癌和胃癌等与感染有关的癌症发病率更高。本研究比较了非西方移民与芬兰本土人口中肝癌和胃癌的性别特异性发病率和死亡率。我们还评估了出生地区、移民年龄和居住时间对非西方人群中肝癌和胃癌发病率和死亡率的影响。材料和方法:我们分析了1973年至2017年居住在芬兰的162,844名非西方移民男性和161,090名女性的数据。从2000年到2017年,肝癌和胃癌的诊断和死亡原因与国家登记处相关联。我们使用多元泊松回归模型评估癌症风险,调整了年龄组、日历期和出生地区。结果:非西方移民男性的肝癌发病率(相对危险度(IRR) 1.41, 95 %置信区间(CI) 1.13-1.78)和死亡率(MRR 1.50, CI 1.16-1.94)高于本土男性,胃癌发病率(IRR 1.74, CI 1.46-2.06)和死亡率(MRR 1.74, CI 1.42-2.14)高于本土男性。在非西方移民妇女中,只有胃癌的发病率(IRR 2.21, 95 % CI 1.88-2.60)和死亡率(MRR 2.22, 95 % CI 1.83-2.70)增加。移民年龄对风险水平没有影响。居住时间的延长降低了非西方女性患胃癌的风险,而男性患胃癌的风险仍然升高。讨论:非西方移民癌症风险的增加可能源于更多的感染,如乙肝、丙肝和幽门螺杆菌,在他们的原籍国流行。文化适应和生活方式的改变,特别是在使用酒精和烟草方面,也发挥了作用。结论:有针对性的医疗保健措施,包括早期诊断和生活方式干预,对于降低芬兰非西方移民的癌症风险至关重要。消除语言和文化障碍对于有效的医疗保健和减少健康差距至关重要。
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引用次数: 0
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Cancer Epidemiology
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