Cancer Epidemiology最新文献

Objectives

The primary objective of this study was to examine the secular trends of cervical, ovarian, and corpus uteri neoplasm in Wales, UK, over the period from 2002 to 2021. We aimed to identify changes in the incidence and mortality rates of these cancers to inform future healthcare policies and cancer prevention programs.

Methods

We sourced incidence data from 2002 to 2019 and mortality data from 2002 to 2021 from the Welsh Cancer Intelligence and Surveillance Unit. The data were analysed using Joinpoint regression to compute the average annual percentage change (AAPC) in age-standardized incidence rates (ASIR) and mortality rates (ASMR) per 100,000 population for each type of cancer.

Results

The results showed that the ASIR for cervical cancer remained stable between 2002 and 2019 (AAPC = −0.5; 95 %CI = −1.4–0.4). However, the ASMR significantly declined from 4.88 in 2002–3.03 in 2021 (AAPC = −2.3; 95 %CI = −3.4 to −1.1). The ASIR for ovarian cancer significantly decreased from 27.39 in 2002–17.87 in 2019 (AAPC = −2.6; 95 %CI = −3.0 to −2.1), and the ASMR showed a statistically significant decreasing trend from 15.92 in 2002–11.2 in 2021 (AAPC = −1.7; 95 %CI = −2.5 to −0.9). In contrast, the ASIR for corpus uteri neoplasm significantly increased from 22.24 in 2002–30.41 in 2019 (AAPC = 2.2; 95 %CI = 1.2–3.4), and ASMR also showed a statistically significant increasing trend from 3.27 in 2002–6.42 in 2021 (AAPC = 3.8; 95 %CI = 2.3–5.3).

Conclusions

The study concludes that while the incidence and mortality rates for cervical and ovarian cancers in Wales have significantly decreased, corpus uteri neoplasm rates have increased during the study period. These findings underscore the need for continued efforts to improve early detection and treatment strategies, including national screening programs and public health initiatives, to mitigate the burden of these cancers.

Individuals with severe mental illness (SMI) have higher mortality rates from cancer than individuals without SMI. The aim of this paper is to highlight these disparities in cancer care in individuals with SMI and suggest potential solutions. We conducted a narrative review of published papers, focusing on mortality, incidence, behavioral and provider risk factors, screening, diagnosis, treatment, and palliative care among individuals with SMI and cancer. The literature does not provide a clear consensus on whether a difference in cancer incidence exists among individuals with SMI compared to the general population. However, it is evident that individuals with SMI have higher mortality from cancer. Factors such as increased cancer related risk behavior, mental health stigma, and difficulty accessing cancer care contribute to this mortality difference. The literature also indicates lower screening rates, delayed and improper diagnosis and treatment, as well as inadequate clinical trial enrollment in individuals with SMI. While the literature is inconclusive regarding disparities in palliative care, we outline key concepts to provide the best possible end of life care to this population. We also summarize strategies to address disparities at the screening, diagnostic, and treatment levels and describe general strategic approaches to improve cancer care in individuals with SMI. We highlight patient-related, physician-related, and healthcare/systems-related factors leading to disparities in cancer care in individuals with SMI. Future research must examine the effectiveness of proposed solutions to guide evidence-based practices.

Background

Due to the rarity of pancreatic neuroendocrine neoplasms, only few population-representative studies on incidence and survival have been conducted. The aim was to provide up-to-date nationwide incidence and relative survival estimates of neuroendocrine (NE) neoplasms overall, NE tumors (NETs), NE carcinomas (NECs), and mixed NE neoplasms (MiNEN).

Methods

We distinguished between pancreatic NETs (functioning versus non-functioning), NECs and mixed NE neoplasms and analyzed data from 2009 through 2021 from all German cancer registries covering a population of more than 80 million. We calculated crude and age-standardized incidence rates and 5-year relative survival estimates (RS).

Results

Overall 6474, 4217, and 243 patients with pancreatic NETs, NECs, and mixed NE neoplasms, respectively were registered. While the age-standardized incidence of NETs has increased (+16.4 % per year, 95 %CI 12.2;20.7), the incidence of NEC has fallen (about −6.4 % per year, 95 %CI −8.0; −4.8). The crude RS was 77.7 % (standard error [SE] 0.9) for non-functioning NETs, 90.3 % for functioning NETs (SE 3.9), and 18.5 % (SE 3.9) for MiNEN. Large and small cell NECs had a low RS (9.1 % and 6.9 %, respectively). RS for G1 NETs was 88.2 %, while it was only 36.6 % for G3 NETs. Localized NETs had a RS of 92.8 %, while distant metastatic NETs had a RS of 45.0 %.

Conclusions

The incidence of pancreatic NETs has increased markedly in Germany in the period 2009–2021. Subgroups of NETs (G1 grading or localized stage) have an excellent prognosis. RS of MiNEN is more similar to NECs than NETs.

Background

Non-malignant primary tumors of the spine (NMPTS) patients in rural areas face unique barriers that may limit their capacity to receive optimal care. With a lower geographical distribution of neurosurgical specialists and limited healthcare infrastructure, rural NMPTS patients may receive certain treatments at a lower frequency than metropolitan patients. NMPTS We sought to examine the association between residential urbanicity, race-ethnicity, treatment patterns, and survival outcomes for cases diagnosed with NMPTS.

Methods

Cases of NMPTS diagnosed between 2004 and 2019 were identified from the Central Brain Tumor Registry of the United States (CBTRUS), a combined dataset of CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology and End Results (SEER) data. Using multivariable logistic regression, we evaluated the association between urbanicity and treatment (including surgery and radiation), adjusted for age at diagnosis, sex, and race-ethnicity. Patient-level all-cause survival data were obtained from the NPCR Survival Analytical Database (2004–2018).

Results

A total of 38,414 cases were identified, 33,097 of whom lived in metropolitan and 5317 of whom lived in non-metropolitan regions. Nerve sheath tumors and meningiomas were the most common tumor histopathologies across both regions, with no clinically significant difference in other histopathologies (p<0.001). There were statistically significant differences between the frequency and type of surgery received by urbanicity (p<0.001). Overall all-cause survival was significantly lower for NH Blacks residing in non-metropolitan areas when compared to NH Blacks residing in metropolitan areas (p<0.0001).

Conclusion

Our data demonstrates significant differences in the incidence of NMPTS across both race-ethnicity and urbanicity. However, a wider analysis of all-cause mortality reveals disparities in health outcomes across both race-ethnicity and urbanicity for Black and Hispanic populations. To address the disparity in health outcomes, policymakers and health providers need to work with local communities in rural areas to improve access to equitable and quality healthcare.

Evidence suggests that inflammation may be associated with a higher risk of endometrial cancer, but previous reviews have typically examined a limited number of biomarkers. This study aimed to critically appraise the evidence on the effect of 13 circulating inflammatory biomarkers on endometrial cancer risk. MEDLINE and EMBASE databases were searched for prospective cohort, (nested) case-control and case-cohort studies, and Mendelian randomization (MR) studies published up to 31 March 2023. We performed a random-effects meta-analysis to estimate the pooled risk ratio and 95 % confidence interval (CI) for the association between each biomarker and endometrial cancer risk. Heterogeneity between studies was assessed using the I² statistic. Eight studies were included in the meta-analysis. Comparing groups with the highest versus lowest concentration of biomarker, adiponectin levels were inversely associated with risk of endometrial cancer (risk ratio (RR) =0.75, 95 % CI: 0.57–0.99, I2: 9 %). Higher levels of CRP (RR=1.18, 95 % CI: 1.05–1.33, I²: 2 %) and TNF-α (RR=1.58, 95 % CI: 1.13–2.21, I²: 0 %) were positively associated with risk of endometrial cancer. There was suggestive evidence for a positive association was also found for IL-6 (RR=1.29, 95 % CI: 0.88–1.88, I²: 0 %) and leptin (RR=1.50, 95 % CI: 0.83–2.71, I²: 0 %). Our findings suggest that circulating inflammatory biomarkers are likely involved in the carcinogenesis of endometrial cancer. Future studies should consider prospective or MR design and measure a wider range of inflammatory markers.

Systematic evaluation of evidence assessing the role of dietary patterns on oral and oropharyngeal (OOP) cancer risk can provide a better understanding of their relationship. This systematic review of observational studies aimed to integrate the most recent evidence on the relationship between posteriori and priori dietary patterns and risk of development of OOP cancers. Studies were retrieved from Embase, PubMed, and Web of Science, and a total of 22 publications were included in the systematic review, of which 17 were included in the meta-analysis. Summary risk was estimated for highest versus lowest intakes of most common identified food groups and risk of OOP cancers using the random effect, generic inverse variance method. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS) for Case-Control and Cohort studies. As per pooled analysis, consumption of healthy patterns may decrease the risk of OOP cancers by 43 %, and that of western patterns may increase this risk by 62 %. The pooling of data from ten studies analysing priori patterns and OOP cancers shows that the Mediterranean diet and diverse diet reduce the risk of such cancers, and a pro-inflammatory diet escalates the risk. On NOS, 11 studies were good in quality and 11 were moderate. Adopting a diet rich in fruits and vegetables and low intake of snacks and animal fats can potentially reduce the likelihood of developing OOP cancers. Encouraging Mediterranean diet, diverse diet and anti-inflammatory food components would be beneficial in the prevention and control of OOP cancers.

Background

Cancer, the second most common cause of death worldwide, is projected to cause 17 million deaths by 2045. Epidemiological studies on cancer play a vital role in understanding cancer burden impact and formulating control plans. This study aimed to analyse the changes in cancer mortality rates within Luxembourg from 1998 to 2021 by sex and age.

Methods

Data on cancer-related deaths were extracted from Luxembourg's National Registry of Death Causes (1998–2021), and the corresponding population data were analysed. Age-standardized mortality rates (ASRs) per 100,000 individuals were calculated and adjusted to the European standard population. To identify significant changes in cancer mortality over time, the Average Annual Percentage Changes (AAPC) method was used.

Results

We identified 23,750 cancer-related deaths, resulting in an ASR of 152.86 per 100,000 people per year. Lung cancer was the most common cancer-related case of death in men and in both sexes combined. In women, breast cancer was the most common cancer death. Significant decreases in the ASR over time were observed for both sexes. Sex-specific cancers, such as prostate (AAPC: −2.7) and breast (AAPC: −1.0) cancers, also exhibited significant decreasing trends in mortality. In the evaluation by life stage, stability or significant decreases were observed for women, men and both sexes, however significant increases were observed in late adulthood women in laryngeal and lung cancer (AAPC: 3.9 and 1.8, respectively). The trend patterns observed during 1998–2021 were largely consistent with those seen when excluding the COVID-19 pandemic year of 2020.

Conclusion

Our study provides a comprehensive analysis of mortality trends by cancer type in Luxembourg, contributing to the understanding of cancer epidemiology and informing healthcare policy and planning. This highlights the importance of targeted public health interventions as such early detection and screening programs and continued advancements in cancer treatment.

Background

Haematological (‘blood’) cancers are a diverse group of non-solid cancers with varying incidence, mortality and survival. While there is some evidence that Māori experience disparities in blood cancer outcomes relative to New Zealand’s majority European population, there is a need for a comprehensive overview of the current state of evidence in this context.

Methods

Blood cancer registrations were derived from the NZ Cancer Registry for the 2007–2019 period (combined blood cancers: 2653 Māori, 20,458 Europeans), and linked to Mortality records. We calculated age-sex-standardised incidence and mortality rates, and conducted cancer-specific survival analysis, for four main categories of blood cancers (leukaemia, Hodgkin lymphoma, non-Hodgkin lymphoma and myeloma) as well as for sub-types of leukaemia non-Hodgkin lymphoma.

Results

We found that Māori are more likely to be diagnosed with (incidence) and to die from (mortality) both leukaemia and myeloma, and similarly likely to be diagnosed or die from Hodgkin and non-Hodgkin lymphoma, compared to Europeans. Māori had demonstrably poorer cancer-specific survival outcomes across most blood cancer types (age-sex-adjusted hazard ratios [HRs], Māori vs European: leukaemia 1.77, 95 % CI 1.57–2.00; Hodgkin lymphoma 1.18, 95 % CI 0.65–2.16; non-Hodgkin lymphoma 1.71, 95 % CI 1.50–1.95; myeloma 1.40, 95 % CI 1.19–1.64).

Conclusion

Blood cancers are a common cancer type for Māori, and we found evidence of disparities in incidence, mortality and survival compared to Europeans. Further research is required to further pinpoint exactly where interventions should be aimed to reduce blood cancer incidence and address survival disparities for Māori.

Background

Russia has one of the highest lung cancer burdens globally, particularly in men. Mortality started to decline in the 1990s after the reduction in smoking prevalence. However, Russia’s recent experience is largely unknown. This study aims to describe recent trends in the incidence and mortality of lung cancer in Russia along with the use of computed tomography (CT).

Methods

We obtained incidence data from national cancer reports covering 1993–2021 and mortality and population data from the Russian Fertility and Mortality Database covering 1965–2021. The number of CT scanners was obtained from the OECD. Changes in age-standardized rates (Segi-Doll, per 100,000) were assessed using segmented regression and temporal effects using age-period-cohort analysis.

Results

Lung cancer rates in men have been substantially higher than in women and have declined sharply since their peak in the 1990s. The latest breakpoints in incidence in women were in 2012 (95 % CI: 2000; 2014) from stagnation with an annual change of 0.7 % (−0.2; 1.5) to 3.4 % (1.6; 5.2) increase. In men, the decrease in incidence stopped in 2013 (2011; 2014) from −1.8 % (−2.1; −1.4) to 0.3 % (−0.7; 1.3). The growing number of CT scans accompanied the recent changes in incidence rates. Incidence declined sharply in 2020 in men and women. There were no substantial changes in declining mortality trends. Period effects were visible after 2012 when incidence rates increased and deviated from mortality. After accounting for the period effect, generations born after the 1950s had lower risks.

Conclusion

Increasing lung cancer incidence rates in Russia in the late 2010s, especially in women, and the stable mortality trends could be a possible sign of diagnostic or treatment period effect. The increased use of CT should be monitored for possible benefits and harms.