Cancer Epidemiology最新文献_第6页

Hospital-based gallbladder cancer registry from a high-volume referral cancer centre in India: Insights into epidemiology and roadmap for enhancing cancer care 印度一家高容量转诊癌症中心的医院胆囊癌登记：对流行病学的见解和加强癌症护理的路线图。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-13 DOI: 10.1016/j.canep.2025.102958

Shraddha Patkar , Tanvi M. Shah , Gurudutt Varty , Abdeali Saif A. Kaderi , Vishnu Menon , D. Baskaran , Vikas Ostwal , Anant Ramaswamy , Mukta Ramadwar , Rajesh Dikshit , Mahesh Goel

Purpose

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

Methods

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

Results

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

Conclusion

This registry is an attempt to generate evidence-based awareness about the substantial disease burden of gallbladder cancers in India and highlights the un-met need for capacity building of our health system, in order to provide, timely, accessible and cost-effective management of this disease.

目的：胆囊癌（GBC）是印度的一个重大公共卫生问题，疾病负担高，在提供有效治疗方面面临复杂挑战。该登记处旨在阐明流行病学以及早期发现和治疗的障碍，为未来的研究和政策举措提供信息。方法：2019年1月至2022年12月，所有假定诊断为GBC的连续患者在知情同意后前瞻性入组。每位患者完成一份标准化问卷，并将临床、放射学和治疗数据记录在病例记录表中。管理层遵循标准的机构协议。生存分析采用Kaplan-Meier曲线。结果：共纳入1950例患者，其中1441例（73.9 %）来自恒河带地区（北部和东部各州）；另外209人（10.7 %）是来自这些地区的移民，占队列的84.6 %。超过55 %属于社会经济地位较低的阶层。发病时，60% %有转移性疾病；只有318例（16.3 %）符合治疗意图治疗的条件，132例（6.8 %）没有完成计划治疗。治疗退出与男性（p = 0.012）和失业（p = 0.014）显著相关。中位随访38.2个月后，早期患者的中位总生存期为58.2个月，而转移性疾病患者的中位总生存期为4.2个月。结论：该登记旨在提高对印度胆囊癌重大疾病负担的循证意识，并强调我国卫生系统能力建设未得到满足的需求，以便提供及时、可及和具有成本效益的胆囊癌管理。

{"title":"Hospital-based gallbladder cancer registry from a high-volume referral cancer centre in India: Insights into epidemiology and roadmap for enhancing cancer care","authors":"Shraddha Patkar , Tanvi M. Shah , Gurudutt Varty , Abdeali Saif A. Kaderi , Vishnu Menon , D. Baskaran , Vikas Ostwal , Anant Ramaswamy , Mukta Ramadwar , Rajesh Dikshit , Mahesh Goel","doi":"10.1016/j.canep.2025.102958","DOIUrl":"10.1016/j.canep.2025.102958","url":null,"abstract":"<div><h3>Purpose</h3><div>Gallbladder cancer (GBC) is a significant public health concern in India, with a high disease burden and complex challenges in delivering effective care. This registry aims to shed light on the epidemiology, and barriers to early detection and treatment, to inform future research and policy initiatives.</div></div><div><h3>Methods</h3><div>From January 2019 to December 2022, all consecutive patients with a presumed diagnosis of GBC, presenting to our institution were prospectively enrolled after informed consent. Each patient completed a standardized questionnaire, and clinical, radiologic and treatment data were recorded in a case record form. Management followed standard institutional protocols. Survival analysis was done using Kaplan–Meier curves.</div></div><div><h3>Results</h3><div>A total of 1950 patients were included, 1441 (73.9 %) of these hailed from the Gangetic belt region (northern and eastern states); an additional 209 (10.7 %) were migrants from these regions, representing 84.6 % of the cohort. Over 55 % belonged to lower socioeconomic classes. At presentation, 60 % had metastatic disease; only 318 (16.3 %) were eligible for curative-intent therapy, and 132 (6.8 %) did not complete planned treatment. Treatment dropout correlated significantly with male gender (p = 0.012) and unemployment (p = 0.014). After a median follow-up of 38.2 months, median overall survival was 58.2 months for early-stage patients versus 4.2 months for those with metastatic disease.</div></div><div><h3>Conclusion</h3><div>This registry is an attempt to generate evidence-based awareness about the substantial disease burden of gallbladder cancers in India and highlights the un-met need for capacity building of our health system, in order to provide, timely, accessible and cost-effective management of this disease.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102958"},"PeriodicalIF":2.3,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review on the risk of developing cancer and frequency of alcohol consumption behaviors in US adults 一项关于美国成年人患癌症风险和饮酒频率的系统综述

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-13 DOI: 10.1016/j.canep.2025.102956

Isabella Abraham , Gabriella Dasilva , Kayla Ernst , Alexandra Campson , Alana Starr , Christine Kamm , George Kosseifi , Morgan Decker , Sahar Kaleem , Nada Eldawy , Paige Brinzo , Tiffany Follin , Christine Ramdin , Maria Mejia , Lewis S. Nelson , Lea Sacca

Background

The frequency and quantity of alcohol consumption, even at moderate levels, influence both cancer incidence and outcomes. This systematic review examines the relationship between varying levels of alcohol consumption and the risk of developing cancer in U.S. adults. It also explores the comorbid conditions that may increase long-term cancer risk among alcohol users and identifies the social and demographic factors that place certain population groups at heightened risk.

Methods

The review followed the Arksey & O’Malley Framework and the Joanna Briggs Institute (JBI) recommendations for the extraction, analysis, and presentation of results in systematic reviews. [This framework consists of five steps: (1) identify research questions; (2) search for relevant studies; (3) select studies relevant to the research questions; (4) chart the data; and (5) collate, summarize, and report results.

Results

A total of 62 studies were retained for analysis following title, abstract, and full text screening. Race/ethnicity (n = 46/62) and age (n = 42/62) were the most frequently mentioned individual risk factors. Across the 62 studies reviewed, alcohol consumption was consistently identified as a risk factor for several types of cancer, including breast (n = 23/62), colorectal (n = 13/62), and liver (n = 10/62), among others. Other alcohol-associated comorbidities reported include obesity (n = 8/62), alcoholic liver disease (n = 5/62), and diabetes (n = 4/62).

Conclusion

Alcohol intake, particularly at higher frequency or greater quantity, was consistently associated with elevated risk for multiple cancers, most notably colorectal, breast, and liver. Dose-response relationships were a common finding, underscoring that risk is not limited to heavy or chronic use.

背景：饮酒的频率和数量，即使是中等水平，也会影响癌症的发病率和预后。这篇系统综述研究了美国成年人不同程度的饮酒与患癌症风险之间的关系。它还探讨了可能增加酒精使用者长期癌症风险的合并症，并确定了使某些人群处于高风险的社会和人口因素。方法：本综述遵循Arksey & O'Malley框架和Joanna Briggs研究所（JBI）对系统综述中结果的提取、分析和呈现的建议。[该框架包括五个步骤：(1)确定研究问题；(2)查找相关研究；(3)选择与研究问题相关的研究；(4)绘制数据图；(5)整理、总结和报告结果。结果：在标题、摘要和全文筛选后，共有62项研究被保留用于分析。种族/民族（n = 46/62）和年龄（n = 42/62）是最常被提及的个体危险因素。在回顾的62项研究中，酒精消费一直被确定为几种癌症的风险因素，包括乳腺癌（n = 23/62）、结肠直肠癌（n = 13/62）和肝癌（n = 10/62）等。其他与酒精相关的合并症包括肥胖（n = 8/62）、酒精性肝病（n = 5/62）和糖尿病（n = 4/62）。结论：酒精摄入，尤其是高频率或大量饮酒，始终与多种癌症（最明显的是结肠直肠癌、乳腺癌和肝癌）的风险升高相关。剂量-反应关系是一个共同的发现，强调风险不仅限于大量或长期使用。

{"title":"A systematic review on the risk of developing cancer and frequency of alcohol consumption behaviors in US adults","authors":"Isabella Abraham , Gabriella Dasilva , Kayla Ernst , Alexandra Campson , Alana Starr , Christine Kamm , George Kosseifi , Morgan Decker , Sahar Kaleem , Nada Eldawy , Paige Brinzo , Tiffany Follin , Christine Ramdin , Maria Mejia , Lewis S. Nelson , Lea Sacca","doi":"10.1016/j.canep.2025.102956","DOIUrl":"10.1016/j.canep.2025.102956","url":null,"abstract":"<div><h3>Background</h3><div>The frequency and quantity of alcohol consumption, even at moderate levels, influence both cancer incidence and outcomes. This systematic review examines the relationship between varying levels of alcohol consumption and the risk of developing cancer in U.S. adults. It also explores the comorbid conditions that may increase long-term cancer risk among alcohol users and identifies the social and demographic factors that place certain population groups at heightened risk.</div></div><div><h3>Methods</h3><div>The review followed the Arksey & O’Malley Framework and the Joanna Briggs Institute (JBI) recommendations for the extraction, analysis, and presentation of results in systematic reviews. [This framework consists of five steps: (1) identify research questions; (2) search for relevant studies; (3) select studies relevant to the research questions; (4) chart the data; and (5) collate, summarize, and report results.</div></div><div><h3>Results</h3><div>A total of 62 studies were retained for analysis following title, abstract, and full text screening. Race/ethnicity (n = 46/62) and age (n = 42/62) were the most frequently mentioned individual risk factors. Across the 62 studies reviewed, alcohol consumption was consistently identified as a risk factor for several types of cancer, including breast (n = 23/62), colorectal (n = 13/62), and liver (n = 10/62), among others. Other alcohol-associated comorbidities reported include obesity (n = 8/62), alcoholic liver disease (n = 5/62), and diabetes (n = 4/62).</div></div><div><h3>Conclusion</h3><div>Alcohol intake, particularly at higher frequency or greater quantity, was consistently associated with elevated risk for multiple cancers, most notably colorectal, breast, and liver. Dose-response relationships were a common finding, underscoring that risk is not limited to heavy or chronic use.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102956"},"PeriodicalIF":2.3,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524874","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

Temporal trends in AML incidence and mortality, with a focus on AML-related deaths among patients with myelodysplastic syndromes in the United States, 1999–2023 AML发病率和死亡率的时间趋势，重点关注1999-2023年美国骨髓增生异常综合征患者AML相关死亡。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-13 DOI: 10.1016/j.canep.2025.102960

Natalie A. Akoto , Albert E. Orhin , Denise Eke Chukwu , Albert Gyato , Simon Egyin , Maame Yaa Idun , Kwabena Owusu Aninkora

Background

Myelodysplastic syndromes (MDS) are bone marrow disorders that often affect older adults and can lead to acute myeloid leukemia (AML), a more aggressive cancer. While this progression is well known, national trends in AML-related deaths, specifically among patients with MDS, have not been well described.

Methods

Using CDC WONDER death certificate data from 1999 to 2023, we identified adults aged 25 years and above who died from AML with MDS listed as a contributing cause. We analyzed demographics, place of death, and trends over time. Age-adjusted mortality rates were calculated and stratified by sex, race, geography, and urbanization. We also examined national trends in AML incidence and mortality-to-incidence ratios (MIR).

Results

AML incidence was 5.8 per 100,000, rising slightly over time (AAPC + 0.5 %; 95 % CI: 0.25–0.70). Among 16,979 AML-related deaths in people with MDS, most were male (61.6 %), White (91.8 %), and aged ≥ 75 years. Nearly half died in hospitals, while < 1 % underwent autopsies. The age-adjusted mortality rate was 0.5 per 100,000 in males and 0.2 in females (p < 0.0001). Mortality declined overall (AAPC − 1.16 %; 95 % CI: − 1.75 to − 0.57), with the sharpest drop between 2021 and 2023 (APC − 17.12 %, 95 % CI: − 22.61 to − 9.20). Improvements were most notable in urban areas and among White patients.

Conclusion

AML-related mortality in MDS patients has declined over the past 25 years, likely reflecting progress in treatment and supportive care. However, disparities persist. More equitable access to advanced therapies is needed to ensure all patients benefit from recent advances.

背景：骨髓增生异常综合征（MDS）是一种经常影响老年人的骨髓疾病，可导致急性髓性白血病（AML），这是一种更具侵袭性的癌症。虽然这一进展是众所周知的，但aml相关死亡的全国趋势，特别是MDS患者的死亡趋势，尚未得到很好的描述。方法：使用1999年至2023年CDC WONDER死亡证明数据，我们确定了25岁及以上死于AML并将MDS列为促成原因的成年人。我们分析了人口统计数据、死亡地点和长期趋势。计算年龄调整死亡率，并按性别、种族、地理位置和城市化程度分层。我们还检查了AML发病率和死亡率-发病率比（MIR）的国家趋势。结果：AML发病率为5.8 / 100,000，随着时间的推移略有上升（AAPC + 0.5 %;95 % CI: 0.25-0.70）。在MDS患者的16,979例aml相关死亡中，大多数是男性（61.6 %），白人（91.8 %），年龄≥ 75岁。近一半死于医院，而结论：在过去的25年中，MDS患者aml相关死亡率有所下降，这可能反映了治疗和支持性护理的进步。然而，差距仍然存在。需要更公平地获得先进疗法，以确保所有患者都能从最近的进展中受益。

{"title":"Temporal trends in AML incidence and mortality, with a focus on AML-related deaths among patients with myelodysplastic syndromes in the United States, 1999–2023","authors":"Natalie A. Akoto , Albert E. Orhin , Denise Eke Chukwu , Albert Gyato , Simon Egyin , Maame Yaa Idun , Kwabena Owusu Aninkora","doi":"10.1016/j.canep.2025.102960","DOIUrl":"10.1016/j.canep.2025.102960","url":null,"abstract":"<div><h3>Background</h3><div>Myelodysplastic syndromes (MDS) are bone marrow disorders that often affect older adults and can lead to acute myeloid leukemia (AML), a more aggressive cancer. While this progression is well known, national trends in AML-related deaths, specifically among patients with MDS, have not been well described.</div></div><div><h3>Methods</h3><div>Using CDC WONDER death certificate data from 1999 to 2023, we identified adults aged 25 years and above who died from AML with MDS listed as a contributing cause. We analyzed demographics, place of death, and trends over time. Age-adjusted mortality rates were calculated and stratified by sex, race, geography, and urbanization. We also examined national trends in AML incidence and mortality-to-incidence ratios (MIR).</div></div><div><h3>Results</h3><div>AML incidence was 5.8 per 100,000, rising slightly over time (AAPC + 0.5 %; 95 % CI: 0.25–0.70). Among 16,979 AML-related deaths in people with MDS, most were male (61.6 %), White (91.8 %), and aged ≥ 75 years. Nearly half died in hospitals, while < 1 % underwent autopsies. The age-adjusted mortality rate was 0.5 per 100,000 in males and 0.2 in females (p < 0.0001). Mortality declined overall (AAPC − 1.16 %; 95 % CI: − 1.75 to − 0.57), with the sharpest drop between 2021 and 2023 (APC − 17.12 %, 95 % CI: − 22.61 to − 9.20). Improvements were most notable in urban areas and among White patients.</div></div><div><h3>Conclusion</h3><div>AML-related mortality in MDS patients has declined over the past 25 years, likely reflecting progress in treatment and supportive care. However, disparities persist. More equitable access to advanced therapies is needed to ensure all patients benefit from recent advances.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102960"},"PeriodicalIF":2.3,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524955","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

Nutritional intake of ω-3 fatty acid intake and clinical grade of prostate cancer 营养摄入ω-3脂肪酸摄入与前列腺癌临床分级。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-11 DOI: 10.1016/j.canep.2025.102959

Nagi B. Kumar , Saira Bahl , Daniel Lemay , Jasreman Dhillon , Michael Poch , Brandon Manley , Roger Li , Julio Pow-Sang , Alice Yu , Junmin Whiting , Michael J. Schell

Background

Recent laboratory and some human studies have shown that ω-3 fatty acids (FA) can inhibit tumor cell growth and induce a local anti-tumor inflammatory response, independently of androgen levels in prostate cancer (PCa) models. Our objective was to conduct a cohort study to evaluate if PCa patients with higher intake of ω-3 FA intake prior to diagnosis will have lower grade prostate tumors as determined by Gleason score at diagnosis compared to those men who consume relative lower quantities of ω-3 FA.

Methods

We recruited 172 newly diagnosed men with PCa at the Moffitt Cancer Center, who completed a validated epidemiological, food frequency questionnaire specifically to measure ω-3 fatty acid intake and consented to provide their medical information.

Results

Our results indicated that ω-3 FA intake had no impact on grade at diagnosis of PCa. In the multivariate model, ω-3 FA intake indicated a trend toward higher intake being associated with low Gleason grade after adjusting for age and PSA (P < o.25). A novel observation in this study is that, overall, ω-3 fatty acid intake of all men diagnosed with PCa (mean: 2.8 g /week) in this cohort was significantly lower (75 % lower) than the recommendations of the USRDA for optimal ω-3 fatty acid (11.2 g per week).

Conclusion

With our understanding of the benefits of ω-3 fatty acid intake for overall health, including its role in preventing prostate carcinogenesis, the overall significantly low dietary intake of ω-3 fatty acid in this cohort may be concerning, requiring further education. Additionally, the role of dietary ω-3 fatty acid intake in the modulation of biomarkers of PCa in general, warrants further studies.

背景：最近的实验室研究和一些人体研究表明，ω-3脂肪酸（FA）可以抑制前列腺癌（PCa）模型中的肿瘤细胞生长并诱导局部抗肿瘤炎症反应，而不依赖于雄激素水平。我们的目的是进行一项队列研究，以评估诊断前摄入较多ω-3脂肪酸的前列腺癌患者与摄入相对较少ω-3脂肪酸的前列腺癌患者相比，诊断时Gleason评分确定的前列腺肿瘤级别是否较低。方法：我们在Moffitt癌症中心招募了172名新诊断为PCa的男性，他们完成了一份有效的流行病学调查问卷，专门测量ω-3脂肪酸的摄入量，并同意提供他们的医疗信息。结果：ω-3脂肪酸摄取量对前列腺癌诊断时的分级无影响。在多变量模型中，在调整年龄和PSA后，ω-3脂肪酸摄入量显示出高摄入量与低Gleason分级相关的趋势（P ）。结论：随着我们对ω-3脂肪酸摄入对整体健康的益处的了解，包括其在预防前列腺癌中的作用，该队列中ω-3脂肪酸整体显著低的饮食摄入量可能令人担忧，需要进一步的研究。此外，膳食中ω-3脂肪酸的摄入在总体上对PCa生物标志物的调节中的作用值得进一步研究。

{"title":"Nutritional intake of ω-3 fatty acid intake and clinical grade of prostate cancer","authors":"Nagi B. Kumar , Saira Bahl , Daniel Lemay , Jasreman Dhillon , Michael Poch , Brandon Manley , Roger Li , Julio Pow-Sang , Alice Yu , Junmin Whiting , Michael J. Schell","doi":"10.1016/j.canep.2025.102959","DOIUrl":"10.1016/j.canep.2025.102959","url":null,"abstract":"<div><h3>Background</h3><div>Recent laboratory and some human studies have shown that ω-3 fatty acids (FA) can inhibit tumor cell growth and induce a local anti-tumor inflammatory response, independently of androgen levels in prostate cancer (PCa) models. Our objective was to conduct a cohort study to evaluate if PCa patients with higher intake of ω-3 FA intake prior to diagnosis will have lower grade prostate tumors as determined by Gleason score at diagnosis compared to those men who consume relative lower quantities of ω-3 FA.</div></div><div><h3>Methods</h3><div>We recruited 172 newly diagnosed men with PCa at the Moffitt Cancer Center, who completed a validated epidemiological, food frequency questionnaire specifically to measure ω-3 fatty acid intake and consented to provide their medical information.</div></div><div><h3>Results</h3><div>Our results indicated that ω-3 FA intake had no impact on grade at diagnosis of PCa. In the multivariate model, ω-3 FA intake indicated a trend toward higher intake being associated with low Gleason grade after adjusting for age and PSA (P < o.25). A novel observation in this study is that, overall, ω-3 fatty acid intake of all men diagnosed with PCa (mean: 2.8 g /week) in this cohort was significantly lower (75 % lower) than the recommendations of the USRDA for optimal ω-3 fatty acid (11.2 g per week).</div></div><div><h3>Conclusion</h3><div>With our understanding of the benefits of ω-3 fatty acid intake for overall health, including its role in preventing prostate carcinogenesis, the overall significantly low dietary intake of ω-3 fatty acid in this cohort may be concerning, requiring further education. Additionally, the role of dietary ω-3 fatty acid intake in the modulation of biomarkers of PCa in general, warrants further studies.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102959"},"PeriodicalIF":2.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508265","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

Implementation barriers to lung cancer screening: Conceptual misconceptions and the importance of seeking synergy with smoking cessation 肺癌筛查的实施障碍：概念上的误解和寻求与戒烟协同作用的重要性。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-10 DOI: 10.1016/j.canep.2025.102957

Arn Migowski

引用次数: 0

Spatiotemporal patterns in malignant brain and central nervous system cancer incidence and mortality in the United States 美国恶性脑和中枢神经系统癌发病率和死亡率的时空格局。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-05 DOI: 10.1016/j.canep.2025.102950

Grace Christensen , Evan L. Thacker, Chantel Sloan-Aagard

Introduction

Brain and nervous system cancers are the 5th most common cancer category in the United States and have a very low survival rate. Spatial analysis techniques can be employed to understand the distribution of rates and generate hypotheses about etiologies. The purpose of this study is to identify geographic patterns, time trends, and sex differences in mortality-incidence rate ratios, incidence rates, and mortality rates of brain and nervous system cancers.

Methods

Cancer data were sourced from the CDC Wonder Cancer database, including age-adjusted mortality-incidence rate ratios, age-adjusted incidence and mortality rates for all age groups and demographics in the United States. MIRR data were available from 1999 to 2018 which were split into four, five-year aggregated time windows to have adequate case numbers for time trend analyses. We further conducted joinpoint regression analysis for 1999–2022 (incidence) and 1999–2023 (mortality) by state and sex to identify changes in trends over time.

Results

Incidence-mortality rate ratios varied across the United States, with the highest ratios from 1999 to 2003, calculated to be around 0.67 for the different demographics studied. Since 2004, the mortality rates have remained consistent with some variation between states, with little improvement in the incidence-mortality rate ratio. From 2014 to 2018, females had significantly lower incidence and mortality rates compared to men. The average mortality rate for females was 3.7 per 100,000 compared to the mortality rate for males which was 5.5 per 100,000. Average incidence showed the same pattern with a rate of 5.6 per 100,000 in females compared to 7.7 per 100,000 in males. The Northeast region of the United States showed the highest incidence and lowest mortality. There were 12 states that saw a directional change in incidence, and 14 a directional change in mortality during the study window. Females were more likely to have a directional change in mortality, and males a directional change in incidence trends.

Conclusion

Further research should investigate reasons for the sex and state differences in brain cancer incidence and mortality rates and how regional factors contribute to survival.

导读：脑和神经系统癌症是美国第五大最常见的癌症类别，生存率非常低。空间分析技术可以用来了解发病率的分布，并产生关于病因的假设。本研究的目的是确定脑和神经系统癌症的死亡率-发病率比、发病率和死亡率的地理模式、时间趋势和性别差异。方法：癌症数据来源于CDC Wonder Cancer数据库，包括美国所有年龄组和人口统计数据的年龄调整死亡率-发病率比、年龄调整发病率和死亡率。1999年至2018年的MIRR数据被分成4个、5年的汇总时间窗口，以便有足够的病例数进行时间趋势分析。我们进一步按州和性别对1999-2022年（发病率）和1999-2023年（死亡率）进行了联点回归分析，以确定随时间变化的趋势。结果：美国各地的发病率-死亡率比率各不相同，1999年至2003年的比率最高，根据不同的人口统计数据计算，其比率约为0.67。自2004年以来，死亡率保持一致，各州之间存在一些差异，发病率-死亡率比几乎没有改善。从2014年到2018年，女性的发病率和死亡率明显低于男性。女性的平均死亡率为每10万人3.7人，而男性的死亡率为每10万人5.5人。平均发病率表现出同样的模式，女性为每10万人中有5.6人，而男性为每10万人中有7.7人。美国东北部地区的发病率最高，死亡率最低。在研究期间，有12个州的发病率发生了方向性变化，14个州的死亡率发生了方向性变化。女性的死亡率更有可能发生方向性变化，而男性的发病率趋势更有可能发生方向性变化。结论：应进一步研究脑癌发病率和死亡率的性别和州差异的原因，以及区域因素对生存率的影响。

{"title":"Spatiotemporal patterns in malignant brain and central nervous system cancer incidence and mortality in the United States","authors":"Grace Christensen , Evan L. Thacker, Chantel Sloan-Aagard","doi":"10.1016/j.canep.2025.102950","DOIUrl":"10.1016/j.canep.2025.102950","url":null,"abstract":"<div><h3>Introduction</h3><div>Brain and nervous system cancers are the 5th most common cancer category in the United States and have a very low survival rate. Spatial analysis techniques can be employed to understand the distribution of rates and generate hypotheses about etiologies. The purpose of this study is to identify geographic patterns, time trends, and sex differences in mortality-incidence rate ratios, incidence rates, and mortality rates of brain and nervous system cancers.</div></div><div><h3>Methods</h3><div>Cancer data were sourced from the CDC Wonder Cancer database, including age-adjusted mortality-incidence rate ratios, age-adjusted incidence and mortality rates for all age groups and demographics in the United States. MIRR data were available from 1999 to 2018 which were split into four, five-year aggregated time windows to have adequate case numbers for time trend analyses. We further conducted joinpoint regression analysis for 1999–2022 (incidence) and 1999–2023 (mortality) by state and sex to identify changes in trends over time.</div></div><div><h3>Results</h3><div>Incidence-mortality rate ratios varied across the United States, with the highest ratios from 1999 to 2003, calculated to be around 0.67 for the different demographics studied. Since 2004, the mortality rates have remained consistent with some variation between states, with little improvement in the incidence-mortality rate ratio. From 2014 to 2018, females had significantly lower incidence and mortality rates compared to men. The average mortality rate for females was 3.7 per 100,000 compared to the mortality rate for males which was 5.5 per 100,000. Average incidence showed the same pattern with a rate of 5.6 per 100,000 in females compared to 7.7 per 100,000 in males. The Northeast region of the United States showed the highest incidence and lowest mortality. There were 12 states that saw a directional change in incidence, and 14 a directional change in mortality during the study window. Females were more likely to have a directional change in mortality, and males a directional change in incidence trends.</div></div><div><h3>Conclusion</h3><div>Further research should investigate reasons for the sex and state differences in brain cancer incidence and mortality rates and how regional factors contribute to survival.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102950"},"PeriodicalIF":2.3,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460718","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

Combining Mendelian randomization and network toxicology to decipher the causal role and molecular mechanisms of environmental pollutants in breast cancer: A focus on Methyl-4-hydroxybenzoate 结合孟德尔随机化和网络毒理学来解读环境污染物在乳腺癌中的因果作用和分子机制：以4-羟基苯甲酸甲酯为重点。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-02 DOI: 10.1016/j.canep.2025.102953

Yunchang Yang, Yaofeng Wang, Yunqin Sun

Background

Methylparaben (MEP), a ubiquitous preservative, is an endocrine disruptor with established estrogenic activity. However, its potential non-estrogenic mechanisms and causal role in breast cancer (BC) remain inadequately explored.

Methods

We employed an integrative multi-omics approach. A two-sample Mendelian randomization (MR) analysis was conducted using genetic instruments for urinary MEP sulfate (n = 8285) and BC risk data from the FinnGen consortium (n = 182,927). To hypothesize underlying molecular mechanisms, we integrated network toxicology with transcriptomic profiling (TCGA), single-cell/spatial RNA-sequencing, and molecular docking. Shared genes were identified via Venn analysis, followed by protein-protein interaction (PPI) network construction, hub gene identification, and functional enrichment analysis.

Results

MR analysis provided evidence consistent with a causal relationship, suggesting that genetically predicted MEP levels are associated with an increased risk of breast cancer (IVW OR = 1.08, 95 % CI: 1.009–1.160, P = 0.027). Network toxicology identified 22 overlapping hub genes connecting MEP targets to BC pathogenesis. Enrichment analyses implicated key oncogenic pathways, including PI3K-Akt and MAPK signaling, as well as metabolic reprogramming. Single-cell and spatial transcriptomics localized predominant expression of hub genes like MYC and ERBB2 within malignant epithelial cells. Molecular docking further suggested plausible, high-affinity binding (binding energy < 0 kcal/mol) of MEP to core targets such as EGFR and JUN.

Conclusion

This study provides genetic evidence supporting a potential causal role of MEP in breast cancer. We propose a novel, estrogen receptor-independent mechanistic hypothesis wherein MEP may promote tumorigenesis by dysregulating growth factor signaling, activating key transcription factors, and inducing metabolic reprogramming. These findings highlight the need for a re-evaluation of MEP's public health impact and offer a framework for future experimental validation.

背景：对羟基苯甲酸甲酯（MEP）是一种普遍存在的防腐剂，是一种具有雌激素活性的内分泌干扰物。然而，其潜在的非雌激素机制及其在乳腺癌（BC）中的因果作用仍未得到充分探讨。方法：采用综合多组学方法。采用遗传仪器对尿MEP硫酸盐（n = 8285）和FinnGen联盟（n = 182,927）的BC风险数据进行双样本孟德尔随机化（MR）分析。为了推测潜在的分子机制，我们将网络毒理学与转录组学分析（TCGA）、单细胞/空间rna测序和分子对接结合起来。通过Venn分析鉴定共享基因，随后进行蛋白-蛋白相互作用（PPI）网络构建、枢纽基因鉴定和功能富集分析。结果：MR分析提供了与因果关系一致的证据，表明基因预测的MEP水平与乳腺癌风险增加相关（IVW OR = 1.08, 95 % CI: 1.009-1.160, P = 0.027）。网络毒理学鉴定出22个重叠的枢纽基因，将MEP靶点与BC发病机制联系起来。富集分析涉及关键的致癌途径，包括PI3K-Akt和MAPK信号，以及代谢重编程。单细胞和空间转录组学定位了MYC和ERBB2等枢纽基因在恶性上皮细胞中的主要表达。分子对接进一步提示MEP与EGFR、jun等核心靶点存在高亲和力结合（结合能< 0 kcal/mol）。结论：本研究为MEP在乳腺癌中的潜在因果作用提供了遗传学证据。我们提出了一个新的，雌激素受体不依赖的机制假设，其中MEP可能通过失调生长因子信号，激活关键转录因子和诱导代谢重编程来促进肿瘤发生。这些发现强调了重新评估MEP对公共卫生影响的必要性，并为未来的实验验证提供了一个框架。

{"title":"Combining Mendelian randomization and network toxicology to decipher the causal role and molecular mechanisms of environmental pollutants in breast cancer: A focus on Methyl-4-hydroxybenzoate","authors":"Yunchang Yang, Yaofeng Wang, Yunqin Sun","doi":"10.1016/j.canep.2025.102953","DOIUrl":"10.1016/j.canep.2025.102953","url":null,"abstract":"<div><h3>Background</h3><div>Methylparaben (MEP), a ubiquitous preservative, is an endocrine disruptor with established estrogenic activity. However, its potential non-estrogenic mechanisms and causal role in breast cancer (BC) remain inadequately explored.</div></div><div><h3>Methods</h3><div>We employed an integrative multi-omics approach. A two-sample Mendelian randomization (MR) analysis was conducted using genetic instruments for urinary MEP sulfate (n = 8285) and BC risk data from the FinnGen consortium (n = 182,927). To hypothesize underlying molecular mechanisms, we integrated network toxicology with transcriptomic profiling (TCGA), single-cell/spatial RNA-sequencing, and molecular docking. Shared genes were identified via Venn analysis, followed by protein-protein interaction (PPI) network construction, hub gene identification, and functional enrichment analysis.</div></div><div><h3>Results</h3><div>MR analysis provided evidence consistent with a causal relationship, suggesting that genetically predicted MEP levels are associated with an increased risk of breast cancer (IVW OR = 1.08, 95 % CI: 1.009–1.160, P = 0.027). Network toxicology identified 22 overlapping hub genes connecting MEP targets to BC pathogenesis. Enrichment analyses implicated key oncogenic pathways, including PI3K-Akt and MAPK signaling, as well as metabolic reprogramming. Single-cell and spatial transcriptomics localized predominant expression of hub genes like MYC and ERBB2 within malignant epithelial cells. Molecular docking further suggested plausible, high-affinity binding (binding energy < 0 kcal/mol) of MEP to core targets such as EGFR and JUN.</div></div><div><h3>Conclusion</h3><div>This study provides genetic evidence supporting a potential causal role of MEP in breast cancer. We propose a novel, estrogen receptor-independent mechanistic hypothesis wherein MEP may promote tumorigenesis by dysregulating growth factor signaling, activating key transcription factors, and inducing metabolic reprogramming. These findings highlight the need for a re-evaluation of MEP's public health impact and offer a framework for future experimental validation.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102953"},"PeriodicalIF":2.3,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440011","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

Association between blood cholesterol profile and risk of lung cancer: A meta-analysis of prospective cohort studies 血胆固醇与肺癌风险之间的关系：前瞻性队列研究的荟萃分析。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-01 DOI: 10.1016/j.canep.2025.102955

Anindita Bhattacharya , Ritabrata Mitra , Ankan Bandyopadhyay , Amitabha Sengupta , Koel Chaudhury

Research findings on the relationship between blood cholesterol levels and lung cancer (LC) risk have been inconsistent, leading to inconclusive evidence regarding a definitive association. The present meta-analysis aimed to comprehensively assess the association of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with the risk of LC, taking into consideration all relevant prospective cohort studies. Three databases (PubMed, Scopus, and Web of Science) were systematically searched from January 2005 to Dec 2024 to identify potentially relevant articles. This meta-analysis included articles reporting the hazard ratio (HR) with a 95 % confidence interval (CI) for the highest vs. lowest categories of at least one blood cholesterol component (TC, HDL-C, or LDL-C) or sufficient data to calculate the same in relation to the risk of LC. Based on the eligibility criteria, a total of 13 prospective cohort studies involving 2,718,010 individuals and 24,842 LC cases were included. The main analysis revealed a significant inverse association between HDL-C and the risk of LC (pooled HR = 0.83, 95 % CI: 0.74–0.92). No statistically significant associations were observed for TC or LDL-C in relation to LC risk. In conclusion, higher HDL-C levels appear to be significantly associated with a lower risk of LC, whereas no significant associations is evident for TC or LDL-C. Maintaining healthy HDL-C levels through a balanced diet and regular exercise may help reduce LC incidence. Nonetheless, further large-scale prospective studies with adequate adjustment for confounding and preclinical bias are warranted to ascertain the potential causality.

关于血胆固醇水平与肺癌（LC）风险之间关系的研究结果一直不一致，导致关于明确关联的证据不确凿。本荟萃分析旨在综合评估总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）与LC风险的关系，并考虑所有相关的前瞻性队列研究。从2005年1月到2024年12月，系统地检索了三个数据库（PubMed、Scopus和Web of Science），以确定潜在的相关文章。该荟萃分析纳入了报告至少一种血液胆固醇成分（TC、HDL-C或LDL-C）的最高和最低类别的风险比（HR）为95% %置信区间（CI）的文章，或足够的数据来计算与LC风险相关的风险比。根据入选标准，共纳入13项前瞻性队列研究，涉及2,718,010例个体和24,842例LC病例。主要分析显示HDL-C与LC风险呈显著负相关（合并HR = 0.83, 95 % CI: 0.74-0.92）。未观察到TC或LDL-C与LC风险有统计学意义的关联。总之，较高的HDL-C水平似乎与较低的LC风险显著相关，而对于TC或LDL-C没有明显的相关性。通过均衡饮食和定期运动保持健康的HDL-C水平可能有助于降低LC的发病率。尽管如此，有必要进一步进行大规模的前瞻性研究，充分调整混杂和临床前偏倚，以确定潜在的因果关系。

{"title":"Association between blood cholesterol profile and risk of lung cancer: A meta-analysis of prospective cohort studies","authors":"Anindita Bhattacharya , Ritabrata Mitra , Ankan Bandyopadhyay , Amitabha Sengupta , Koel Chaudhury","doi":"10.1016/j.canep.2025.102955","DOIUrl":"10.1016/j.canep.2025.102955","url":null,"abstract":"<div><div>Research findings on the relationship between blood cholesterol levels and lung cancer (LC) risk have been inconsistent, leading to inconclusive evidence regarding a definitive association. The present meta-analysis aimed to comprehensively assess the association of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with the risk of LC, taking into consideration all relevant prospective cohort studies. Three databases (PubMed, Scopus, and Web of Science) were systematically searched from January 2005 to Dec 2024 to identify potentially relevant articles. This meta-analysis included articles reporting the hazard ratio (HR) with a 95 % confidence interval (CI) for the highest vs. lowest categories of at least one blood cholesterol component (TC, HDL-C, or LDL-C) or sufficient data to calculate the same in relation to the risk of LC. Based on the eligibility criteria, a total of 13 prospective cohort studies involving 2,718,010 individuals and 24,842 LC cases were included. The main analysis revealed a significant inverse association between HDL-C and the risk of LC (pooled HR = 0.83, 95 % CI: 0.74–0.92). No statistically significant associations were observed for TC or LDL-C in relation to LC risk. In conclusion, higher HDL-C levels appear to be significantly associated with a lower risk of LC, whereas no significant associations is evident for TC or LDL-C. Maintaining healthy HDL-C levels through a balanced diet and regular exercise may help reduce LC incidence. Nonetheless, further large-scale prospective studies with adequate adjustment for confounding and preclinical bias are warranted to ascertain the potential causality.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102955"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432761","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

Association between sociodemographic and clinical factors and utilization of hematopoietic cell transplant in acute myeloid leukemia from 2004 to 2020 2004 - 2020年急性髓系白血病患者社会人口学、临床因素与造血细胞移植利用的关系

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-11-01 DOI: 10.1016/j.canep.2025.102952

Utsav Joshi , Aditya Ravindra , Bradley Loeffler , Uttam Bhetuwal , Shishir Acharya , Chengu Niu , Avantika Pyakuryal , Vijaya Raj Bhatt , Prajwal Dhakal

Introduction

This study investigates the influence of sociodemographic and clinical factors on the utilization of hematopoietic cell transplant (HCT) in patients with acute myeloid leukemia (AML) between 2004 and 2020.

Methods

Patients identified from the National Cancer Database were grouped into two cohorts (2004–2010 and 2011–2019) to assess HCT trends. An additional analysis was conducted for 2020 to characterize HCT use after the onset of the COVID-19 pandemic. Logistic regression and multivariable analysis were used to estimate the influence of patient characteristics on the odds of receiving HCT.

Results

Among 67,895 AML patients, 6968 (10.3 %) underwent HCT, with usage rising from 7.2 % in 2004–13.4 % in 2019. There was a notable increase in HCT utilization among patients > 70 years (0.4 % in 2004–2010–2.5 % in 2011–2019), Black patients (4.6–7.7 %), those with public insurance (3.2–6.2 %), and individuals with higher Charlson Comorbidity Index (CCI 1: 5.3–8.2 %; CCI 2–3: 1.9–4.8 %). Younger patients exhibited a higher likelihood of receiving HCT, with usage declining significantly with age and increasing CCI. Key factors such as race, education, income, insurance status, and AML subtype were significantly associated with HCT utilization (p < 0.01). Remarkably, HCT utilization for AML remained stable at 13.1 % in 2020 amid COVID-19 pandemic, comparable to 2019.

Conclusion

The rate of HCT utilization has continued to increase over time, with notable positive trends across various demographic groups. Despite this, substantial barriers related to sociodemographic and clinical factors hinder equitable treatment access, highlighting urgent need to address these inequities to enhance patient outcomes.

前言：本研究调查了2004 - 2020年社会人口学和临床因素对急性髓性白血病（AML）患者造血细胞移植（HCT）利用的影响。方法：从国家癌症数据库中确定的患者分为两组（2004-2010年和2011-2019年），以评估HCT趋势。对2020年进行了另一项分析，以确定COVID-19大流行发生后HCT使用的特征。使用Logistic回归和多变量分析来估计患者特征对接受HCT的几率的影响。结果：在67,895例AML患者中，6968例（10.3 %）接受了HCT，使用率从2004年的7.2 %上升到2019年的13.4 %。> 70岁患者（2004-2010-2.5 - %）、黑人患者（4.6-7.7 %）、公共保险患者（3.2-6.2 %）和Charlson合病指数较高的个体（CCI 1: 5.3-8.2 %;CCI 2-3: 1.9-4.8 %）的HCT使用率显著增加。年轻患者接受HCT的可能性更高，随着年龄的增长和CCI的增加，HCT的使用率显著下降。种族、教育程度、收入、保险状况和AML亚型等关键因素与HCT使用率显著相关（p ）结论：HCT使用率随着时间的推移持续增加，在不同人口群体中呈显著的正趋势。尽管如此，与社会人口统计学和临床因素相关的重大障碍阻碍了公平获得治疗，突出表明迫切需要解决这些不平等问题，以提高患者的治疗效果。

{"title":"Association between sociodemographic and clinical factors and utilization of hematopoietic cell transplant in acute myeloid leukemia from 2004 to 2020","authors":"Utsav Joshi , Aditya Ravindra , Bradley Loeffler , Uttam Bhetuwal , Shishir Acharya , Chengu Niu , Avantika Pyakuryal , Vijaya Raj Bhatt , Prajwal Dhakal","doi":"10.1016/j.canep.2025.102952","DOIUrl":"10.1016/j.canep.2025.102952","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigates the influence of sociodemographic and clinical factors on the utilization of hematopoietic cell transplant (HCT) in patients with acute myeloid leukemia (AML) between 2004 and 2020.</div></div><div><h3>Methods</h3><div>Patients identified from the National Cancer Database were grouped into two cohorts (2004–2010 and 2011–2019) to assess HCT trends. An additional analysis was conducted for 2020 to characterize HCT use after the onset of the COVID-19 pandemic. Logistic regression and multivariable analysis were used to estimate the influence of patient characteristics on the odds of receiving HCT.</div></div><div><h3>Results</h3><div>Among 67,895 AML patients, 6968 (10.3 %) underwent HCT, with usage rising from 7.2 % in 2004–13.4 % in 2019. There was a notable increase in HCT utilization among patients > 70 years (0.4 % in 2004–2010–2.5 % in 2011–2019), Black patients (4.6–7.7 %), those with public insurance (3.2–6.2 %), and individuals with higher Charlson Comorbidity Index (CCI 1: 5.3–8.2 %; CCI 2–3: 1.9–4.8 %). Younger patients exhibited a higher likelihood of receiving HCT, with usage declining significantly with age and increasing CCI. Key factors such as race, education, income, insurance status, and AML subtype were significantly associated with HCT utilization (p < 0.01). Remarkably, HCT utilization for AML remained stable at 13.1 % in 2020 amid COVID-19 pandemic, comparable to 2019.</div></div><div><h3>Conclusion</h3><div>The rate of HCT utilization has continued to increase over time, with notable positive trends across various demographic groups. Despite this, substantial barriers related to sociodemographic and clinical factors hinder equitable treatment access, highlighting urgent need to address these inequities to enhance patient outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102952"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A national study of lung cancer patients below 50 years: Variations in characteristics and outcomes by age 一项针对50岁以下肺癌患者的全国性研究：不同年龄的特征和结果的变化

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-10-31 DOI: 10.1016/j.canep.2025.102949

Katrine Kristensen , Anja Gouliaev , Torben Riis Rasmussen , Niels Lyhne Christensen

Background

Lung cancer predominantly affects the elderly. However, a small yet significant subgroup of patients below fifty years presents unique challenges in diagnosis and treatment. This study aims to describe the characteristics and outcomes of these young patients, emphasizing the need for improved diagnostic strategies and better prognostic outcomes.

Method

This national cohort study includes all patients diagnosed 2012–2023 recorded in the Danish Lung Cancer Registry. Patients below fifty years at diagnosis were categorized as young.

Results

Out of 57,325 patients a total of 1312 (2.3 %) were below fifty years at diagnosis. Young patients were more likely to be female (p = 0.006), diagnosed with adenocarcinoma (p < 0.001) and ten times more frequent anaplastic lymphoma kinase (ALK) mutated (p < 0.001). Young patients had fewer packyears (p < 0.001), better performance status (p < 0.001), lower Charlson Comorbidity index (p < 0.001), but were more frequently diagnosed in incurable disease stage, (68.0 % vs. 60.9 % p < 0.001). Adjusted OR of being diagnosed in a curable stage was 0.75 (95 %CI 0.66–0.85) for young patients, while adjusted OR for undergoing treatment with curative intent was 1.88 (1.58–2.23). Kaplan-Meier analysis indicated higher survival rates for young patients across all stages, but only marginally in stages IIIB-IV.

Conclusion

Young patients diagnosed with lung cancer are less likely to be diagnosed in a curable stage. The pathology and smoking habits differ significantly from patients above fifty years. While pending screening is important for the older population of smokers, it remains essential to consistently address the need for early diagnosis in the young population to prevent exacerbating existing disparities.

肺癌主要影响老年人。然而，一小群50岁以下的患者在诊断和治疗方面面临着独特的挑战。本研究旨在描述这些年轻患者的特征和结果，强调需要改进诊断策略和更好的预后结果。方法：本国家队列研究包括2012-2023年在丹麦肺癌登记处记录的所有确诊患者。诊断时年龄在50岁以下的患者被归类为年轻患者。结果57,325例患者中，1312例（2.3 %）诊断年龄在50岁以下。年轻患者多为女性（p = 0.006），诊断为腺癌（p <； 0.001），间变性淋巴瘤激酶（ALK）突变（p <； 0.001）发生率高10倍。年轻患者packyears较少(p & lt; 0.001),更好的性能状态(p & lt; 0.001),降低Charlson发病率指数(p & lt; 0.001),但更经常无法治愈的疾病诊断阶段,(68.0 %与60.9 % p & lt; 0.001)。年轻患者被诊断为可治愈期的调整OR为0.75(95 %CI 0.66-0.85)，而接受治疗目的的调整OR为1.88（1.58-2.23）。Kaplan-Meier分析显示，年轻患者在所有阶段的生存率都较高，但在iib - iv期只有轻微的生存率。结论年轻肺癌患者在可治愈期诊断的可能性较低。病理和吸烟习惯与50岁以上患者有显著差异。虽然待筛查对老年吸烟者很重要，但始终解决年轻人群早期诊断的需求仍然至关重要，以防止加剧现有的差距。

{"title":"A national study of lung cancer patients below 50 years: Variations in characteristics and outcomes by age","authors":"Katrine Kristensen , Anja Gouliaev , Torben Riis Rasmussen , Niels Lyhne Christensen","doi":"10.1016/j.canep.2025.102949","DOIUrl":"10.1016/j.canep.2025.102949","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer predominantly affects the elderly. However, a small yet significant subgroup of patients below fifty years presents unique challenges in diagnosis and treatment. This study aims to describe the characteristics and outcomes of these young patients, emphasizing the need for improved diagnostic strategies and better prognostic outcomes.</div></div><div><h3>Method</h3><div>This national cohort study includes all patients diagnosed 2012–2023 recorded in the Danish Lung Cancer Registry. Patients below fifty years at diagnosis were categorized as young.</div></div><div><h3>Results</h3><div>Out of 57,325 patients a total of 1312 (2.3 %) were below fifty years at diagnosis. Young patients were more likely to be female (p = 0.006), diagnosed with adenocarcinoma (p < 0.001) and ten times more frequent anaplastic lymphoma kinase (ALK) mutated (p < 0.001). Young patients had fewer packyears (p < 0.001), better performance status (p < 0.001), lower Charlson Comorbidity index (p < 0.001), but were more frequently diagnosed in incurable disease stage, (68.0 % vs. 60.9 % p < 0.001). Adjusted OR of being diagnosed in a curable stage was 0.75 (95 %CI 0.66–0.85) for young patients, while adjusted OR for undergoing treatment with curative intent was 1.88 (1.58–2.23). Kaplan-Meier analysis indicated higher survival rates for young patients across all stages, but only marginally in stages IIIB-IV.</div></div><div><h3>Conclusion</h3><div>Young patients diagnosed with lung cancer are less likely to be diagnosed in a curable stage. The pathology and smoking habits differ significantly from patients above fifty years. While pending screening is important for the older population of smokers, it remains essential to consistently address the need for early diagnosis in the young population to prevent exacerbating existing disparities.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102949"},"PeriodicalIF":2.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424764","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