Pub Date : 2025-09-24DOI: 10.1016/j.canep.2025.102935
Amanda Ramos da Cunha , Harriet Rumgay , Jerome Vignat , Mathieu Laversanne , Murielle Colombet , Maria Paula Curado , Gail Garvey , Sarbani Ghosh-Laskar , Brian O’Sullivan , Shama Virani , Isabelle Soerjomataram , Marion Piñeros
Laryngeal cancer shows considerable variation in global incidence, which has primarily been studied through national estimates. This study aims to analyse the global incidence of laryngeal cancer, comparing estimated and high-quality recorded data, and examine temporal trends to inform targeted prevention strategies. Estimated incidence rates for 2022 were obtained from the GLOBOCAN 2022 database for 185 countries. Recorded incidence data from population-based cancer registries (PBCRs) for the five-years period 2013–2017 were sourced from Cancer Incidence in Five Continents (CI5-XII). Temporal trends and the Estimated Annual Percent Change were assessed for 34 countries using the Global Cancer Observatory – Cancer Over Time database. The highest estimated age-standardized incidence rates (ASIRs) were observed in Cuba, Moldova, and Romania, particularly among males: 14.8, 12.2, and 10.3 per 100,000, respectively. Recorded data showed significant regional variability, with the highest ASIRs for males in Pskov, Russia (13.3 per 100,000) and the Azores, Portugal (11.8 per 100,000). Most countries exhibited a decline in laryngeal cancer rates among males, while trends among females remained largely stable. Our findings underscore the importance of PBCRs in identifying high-risk populations for developing laryngeal cancer. While national estimates are essential for understanding the global distribution of laryngeal cancer and other malignancies, they may overlook subnational variations. Expanding the coverage and quality of PBCRs is crucial for improving cancer surveillance and enhancing prevention and control efforts at national and global level.
{"title":"Global burden and international trends of laryngeal cancer incidence: A population-based study of recorded data and national estimates","authors":"Amanda Ramos da Cunha , Harriet Rumgay , Jerome Vignat , Mathieu Laversanne , Murielle Colombet , Maria Paula Curado , Gail Garvey , Sarbani Ghosh-Laskar , Brian O’Sullivan , Shama Virani , Isabelle Soerjomataram , Marion Piñeros","doi":"10.1016/j.canep.2025.102935","DOIUrl":"10.1016/j.canep.2025.102935","url":null,"abstract":"<div><div>Laryngeal cancer shows considerable variation in global incidence, which has primarily been studied through national estimates. This study aims to analyse the global incidence of laryngeal cancer, comparing estimated and high-quality recorded data, and examine temporal trends to inform targeted prevention strategies. Estimated incidence rates for 2022 were obtained from the GLOBOCAN 2022 database for 185 countries. Recorded incidence data from population-based cancer registries (PBCRs) for the five-years period 2013–2017 were sourced from Cancer Incidence in Five Continents (CI5-XII). Temporal trends and the Estimated Annual Percent Change were assessed for 34 countries using the Global Cancer Observatory – Cancer Over Time database. The highest estimated age-standardized incidence rates (ASIRs) were observed in Cuba, Moldova, and Romania, particularly among males: 14.8, 12.2, and 10.3 per 100,000, respectively. Recorded data showed significant regional variability, with the highest ASIRs for males in Pskov, Russia (13.3 per 100,000) and the Azores, Portugal (11.8 per 100,000). Most countries exhibited a decline in laryngeal cancer rates among males, while trends among females remained largely stable. Our findings underscore the importance of PBCRs in identifying high-risk populations for developing laryngeal cancer. While national estimates are essential for understanding the global distribution of laryngeal cancer and other malignancies, they may overlook subnational variations. Expanding the coverage and quality of PBCRs is crucial for improving cancer surveillance and enhancing prevention and control efforts at national and global level.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102935"},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152087","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}
Pub Date : 2025-09-23DOI: 10.1016/j.canep.2025.102934
Qian Chen , Ian Campbell , Mark Elwood , Alana Cavadino , Phyu Sin Aye , Sandar Tin Tin
Purpose
Ethnic and socioeconomic disparities exist in treatment of invasive breast cancer in New Zealand. This study investigated trends and disparities in locoregional treatment of ductal carcinoma in situ (DCIS) detected by BreastScreen Aotearoa (BSA), the national breast screening programme.
Methods
Women with programme-detected DCIS from 1999 to 2022 were identified from BSA records linked to the national cancer registry and hospital discharge records. Logistic regression identified associated factors.
Results
Of the 6087 cases identified, 39.7 % received breast-conserving surgery (BCS) with radiotherapy (RT), 31.5 % had mastectomy and 28.8 % had BCS alone. BCS with RT increased from 27.6 % in 1999 to 41.1 % in 2006, followed by a modest increase to 46.7 % in 2022, while mastectomy decreased from 33.3 % in 1999 to 25.4 % in 2022. The post-BCS RT use was less common among Pacific women. Sentinel lymph node biopsy (SLNB) increased from 6.2 % in 2004 (when it was implemented nationwide) to 26.0 % in 2007, then reached 37.1 % in 2013, before declining to 24.5 % in 2022. Pacific and Asian women who had mastectomy were more likely to have SLNB. Immediate breast reconstruction (IBR) after a mastectomy increased from 11.4 % in 1999 to 39.8 % in 2009, then underwent a modest decline to 22.7 % in 2022. Māori, older women, and those living in the deprived or rural areas were less likely to receive IBR.
Conclusion
Locoregional treatment for programme-detected DCIS has improved over time; however, ethnic and socioeconomic disparities persist, underscoring the need to improve equity of cancer care in New Zealand.
{"title":"Trends and disparities in locoregional treatment of programme-detected ductal carcinoma in situ in New Zealand women, 1999–2022","authors":"Qian Chen , Ian Campbell , Mark Elwood , Alana Cavadino , Phyu Sin Aye , Sandar Tin Tin","doi":"10.1016/j.canep.2025.102934","DOIUrl":"10.1016/j.canep.2025.102934","url":null,"abstract":"<div><h3>Purpose</h3><div>Ethnic and socioeconomic disparities exist in treatment of invasive breast cancer in New Zealand. This study investigated trends and disparities in locoregional treatment of ductal carcinoma in situ (DCIS) detected by BreastScreen Aotearoa (BSA), the national breast screening programme.</div></div><div><h3>Methods</h3><div>Women with programme-detected DCIS from 1999 to 2022 were identified from BSA records linked to the national cancer registry and hospital discharge records. Logistic regression identified associated factors.</div></div><div><h3>Results</h3><div>Of the 6087 cases identified, 39.7 % received breast-conserving surgery (BCS) with radiotherapy (RT), 31.5 % had mastectomy and 28.8 % had BCS alone. BCS with RT increased from 27.6 % in 1999 to 41.1 % in 2006, followed by a modest increase to 46.7 % in 2022, while mastectomy decreased from 33.3 % in 1999 to 25.4 % in 2022. The post-BCS RT use was less common among Pacific women. Sentinel lymph node biopsy (SLNB) increased from 6.2 % in 2004 (when it was implemented nationwide) to 26.0 % in 2007, then reached 37.1 % in 2013, before declining to 24.5 % in 2022. Pacific and Asian women who had mastectomy were more likely to have SLNB. Immediate breast reconstruction (IBR) after a mastectomy increased from 11.4 % in 1999 to 39.8 % in 2009, then underwent a modest decline to 22.7 % in 2022. Māori, older women, and those living in the deprived or rural areas were less likely to receive IBR.</div></div><div><h3>Conclusion</h3><div>Locoregional treatment for programme-detected DCIS has improved over time; however, ethnic and socioeconomic disparities persist, underscoring the need to improve equity of cancer care in New Zealand.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102934"},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120902","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}
Pub Date : 2025-09-23DOI: 10.1016/j.canep.2025.102936
Anne Sofie Krogh Holdam , Hans B. Rahr , Erik Frostberg , Karina Rønlund , Vibeke Koudahl
Background
Most keratinocyte carcinomas (KC) are localized and slow-growing. However, for some patients, KC can become locally advanced lesions and cause substantial tissue damage that require extensive surgery to manage. We wanted to explore risk factors for locally advanced disease with the overall aim to offer more timely diagnosis and treatment.
Methods
This nationwide, register-based cohort study examined the association of demographic factors, educational level, disposable income, cohabitating status, comorbidity, and region of residence with tumor (T) category for patients with a first-time diagnosis of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) from 2007 to 2021, using multivariable logistic regression analyses.
Results
We identified 166,467 BCC and 36,609 SCC patients. Male sex, old age, lower educational level and disposable income, living alone, and comorbidity were linked to higher odds of developing a ≥T2 tumor. Residence outside the Capital Region increased the risk of locally advanced BCC, while the risk of locally advanced SCC was higher in the Zealand, Central, and Northern regions.
Conclusion
There are significant associations between socioeconomic status, comorbidity, and region of residence and the risk of developing ≥T2 tumors in both BCC and SCC. Efforts to enhance early detection and treatment should focus on vulnerable individuals.
{"title":"Socioeconomic, health-related and geographical risk factors for locally advanced keratinocyte carcinoma: A nationwide population-based study in Denmark","authors":"Anne Sofie Krogh Holdam , Hans B. Rahr , Erik Frostberg , Karina Rønlund , Vibeke Koudahl","doi":"10.1016/j.canep.2025.102936","DOIUrl":"10.1016/j.canep.2025.102936","url":null,"abstract":"<div><h3>Background</h3><div>Most keratinocyte carcinomas (KC) are localized and slow-growing. However, for some patients, KC can become locally advanced lesions and cause substantial tissue damage that require extensive surgery to manage. We wanted to explore risk factors for locally advanced disease with the overall aim to offer more timely diagnosis and treatment.</div></div><div><h3>Methods</h3><div>This nationwide, register-based cohort study examined the association of demographic factors, educational level, disposable income, cohabitating status, comorbidity, and region of residence with tumor (T) category for patients with a first-time diagnosis of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) from 2007 to 2021, using multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>We identified 166,467 BCC and 36,609 SCC patients. Male sex, old age, lower educational level and disposable income, living alone, and comorbidity were linked to higher odds of developing a ≥T2 tumor. Residence outside the Capital Region increased the risk of locally advanced BCC, while the risk of locally advanced SCC was higher in the Zealand, Central, and Northern regions.</div></div><div><h3>Conclusion</h3><div>There are significant associations between socioeconomic status, comorbidity, and region of residence and the risk of developing ≥T2 tumors in both BCC and SCC. Efforts to enhance early detection and treatment should focus on vulnerable individuals.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102936"},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120903","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}
Pub Date : 2025-09-17DOI: 10.1016/j.canep.2025.102933
Grace Folino , Elizabeth Byrne , Mya Hendry , Peter Silberstein , Marco DiBlasi
Background
Vulvar Squamous Cell Carcinoma (VSCC) incidence rates and clinical outcomes are correlated with demographic factors, but no study expansively investigates demographic and prognostic factors of VSCC in relation to survival in the post-Gardasil era. This study aims to investigate underlying disparities in VSCC and correlate these factors with survival.
Methods
Patients were identified from the National Cancer Database using ICD-10 codes specific for vulvar structures, ICD-O-3 histology codes for squamous cell carcinoma and pre-malignant vulvar intraepithelial neoplasia Grade III (VIN3), and patient data from 2007 to 2021. Statistical analyses utilized IBM SPSS and GraphPad Prism to determine variable frequency with cross analysis and Chi-Squared tests, Kaplan Meier Survival Curves with Log-Rank Pairwise Comparison, and Cox Proportional Hazards Regression Models.
Results
The total patient population was 58,732 patients after inclusion criteria. The median age of diagnosis was 64.0 years old. Significant prognostic factors resulting in better survival included VIN3 histology, lower Charlson-Deyo Score, Black race, receiving care from Academic/Research Programs, private insurance, and median income greater than $63,000. Surgical procedures were significant in improving survival. Black patients are diagnosed younger than White and Other races. A histology type of VIN3 was associated with increased survival time, indicating early identification and treatment for better outcomes.
Conclusion
Key demographic and prognostic factors that influence survival were identified across the VSCC population. This study may serve as a tool in reevaluation of current gynecological screening protocols to promote early diagnosis and management for the entire VSCC patient population.
{"title":"Patient demographic and prognostic factors of vulvar squamous cell carcinoma: A National Cancer Database Study","authors":"Grace Folino , Elizabeth Byrne , Mya Hendry , Peter Silberstein , Marco DiBlasi","doi":"10.1016/j.canep.2025.102933","DOIUrl":"10.1016/j.canep.2025.102933","url":null,"abstract":"<div><h3>Background</h3><div>Vulvar Squamous Cell Carcinoma (VSCC) incidence rates and clinical outcomes are correlated with demographic factors, but no study expansively investigates demographic and prognostic factors of VSCC in relation to survival in the post-Gardasil era. This study aims to investigate underlying disparities in VSCC and correlate these factors with survival.</div></div><div><h3>Methods</h3><div>Patients were identified from the National Cancer Database using ICD-10 codes specific for vulvar structures, ICD-O-3 histology codes for squamous cell carcinoma and pre-malignant vulvar intraepithelial neoplasia Grade III (VIN3), and patient data from 2007 to 2021. Statistical analyses utilized IBM SPSS and GraphPad Prism to determine variable frequency with cross analysis and Chi-Squared tests, Kaplan Meier Survival Curves with Log-Rank Pairwise Comparison, and Cox Proportional Hazards Regression Models.</div></div><div><h3>Results</h3><div>The total patient population was 58,732 patients after inclusion criteria. The median age of diagnosis was 64.0 years old. Significant prognostic factors resulting in better survival included VIN3 histology, lower Charlson-Deyo Score, Black race, receiving care from Academic/Research Programs, private insurance, and median income greater than $63,000. Surgical procedures were significant in improving survival. Black patients are diagnosed younger than White and Other races. A histology type of VIN3 was associated with increased survival time, indicating early identification and treatment for better outcomes.</div></div><div><h3>Conclusion</h3><div>Key demographic and prognostic factors that influence survival were identified across the VSCC population. This study may serve as a tool in reevaluation of current gynecological screening protocols to promote early diagnosis and management for the entire VSCC patient population.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102933"},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088453","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}
Early-onset colorectal cancer (EO-CRC), diagnosed in individuals under 50, has seen rising incidence rates, while average-onset colorectal cancer rates decline. To understand EO-CRC burden across regions and patient characteristics, detailed incidence data are essential. With Texas's large population and unique demographics, this study examines recent trends in age-adjusted EO-CRC incidence.
Methods
This cross-sectional analysis used 2011–2019 Texas Cancer Registry (TCR) data. The incidence rate of EO-CRC was adjusted to the 2000 US standard population and was stratified by cancer type, sex, race/ethnicity, and stage at diagnosis. The number of EO-CRC cases between 2011 and 2019 was mapped to the Texas counties.
Results
In the study period, a total of 11,848 EO-CRC (7511 colon cancer [EO-CC] and 4337 rectal cancer [EO-RC]) cases were identified. Over 50 % of cases were diagnosed before the age of 45. The age-adjusted incidence rate (AAIR) of EO-CRC showed a slightly increasing trend over the study period (AAIR range: 10.4/100,000 persons [95 % CI = 9.8–11.0]- 12.7/100,000 persons [95 % CI = 12.0–13.3]). The AAIRs of EO-CRC among males were higher than that of females. Non-Hispanic (NH) White population had the highest AAIR, followed by the Black population and Hispanic population, while other races/ethnicities had the lowest AAIR of EO-CRC. The incidence rate of EO-CRC diagnosed at the regional stage was the highest and showed the steepest increasing trend. While EO-CRC case density by county reflects the population density, incidence rates were higher in rural counties.
Conclusion
The incidence of EO-CRC in Texas showed an increasing trend from 2011 to 2019, with notable disparities by sex, race/ethnicity, and cancer stage.
背景：早发性结直肠癌（EO-CRC）在50岁以下的人群中被诊断出来，发病率上升，而平均发病的结直肠癌发病率下降。为了了解不同地区的EO-CRC负担和患者特征，详细的发病率数据是必不可少的。由于德克萨斯州人口众多，人口结构独特，本研究探讨了年龄调整后的EO-CRC发病率的最新趋势。方法：采用2011-2019年德克萨斯州癌症登记处（TCR）数据进行横断面分析。EO-CRC的发病率调整为2000年美国标准人群，并按癌症类型、性别、种族/民族和诊断分期进行分层。2011年至2019年期间的EO-CRC病例数被映射到德克萨斯州各县。结果：研究期间共发现EO-CRC 11,848例（其中结肠癌[EO-CC] 7511例，直肠癌[EO-RC] 4337例）。超过50% %的病例在45岁之前被诊断出来。EO-CRC的年龄调整发病率（AAIR）在研究期间呈轻微上升趋势（AAIR范围：10.4/100,000人[95 % CI = 9.8-11.0]- 12.7/100,000人[95 % CI = 12.0-13.3]）。男性的EO-CRC指数高于女性。非西班牙裔（NH）白人的AAIR最高，黑人次之，西班牙裔次之，其他种族的AAIR最低。区域阶段诊断的EO-CRC发病率最高，且呈最急剧的上升趋势。各县的EO-CRC病例密度反映了人口密度，但农村县发病率较高。结论：2011 - 2019年，德克萨斯州EO-CRC发病率呈上升趋势，性别、种族和癌症分期差异显著。
{"title":"Description and recent trends (2011–2019) of early-onset colorectal cancer incidence in Texas","authors":"Yahan Zhang , Hyeun Ah Kang , Srinivas Joga Ivatury , Claire Sokas","doi":"10.1016/j.canep.2025.102927","DOIUrl":"10.1016/j.canep.2025.102927","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset colorectal cancer (EO-CRC), diagnosed in individuals under 50, has seen rising incidence rates, while average-onset colorectal cancer rates decline. To understand EO-CRC burden across regions and patient characteristics, detailed incidence data are essential. With Texas's large population and unique demographics, this study examines recent trends in age-adjusted EO-CRC incidence.</div></div><div><h3>Methods</h3><div>This cross-sectional analysis used 2011–2019 Texas Cancer Registry (TCR) data. The incidence rate of EO-CRC was adjusted to the 2000 US standard population and was stratified by cancer type, sex, race/ethnicity, and stage at diagnosis. The number of EO-CRC cases between 2011 and 2019 was mapped to the Texas counties.</div></div><div><h3>Results</h3><div>In the study period, a total of 11,848 EO-CRC (7511 colon cancer [EO-CC] and 4337 rectal cancer [EO-RC]) cases were identified. Over 50 % of cases were diagnosed before the age of 45. The age-adjusted incidence rate (AAIR) of EO-CRC showed a slightly increasing trend over the study period (AAIR range: 10.4/100,000 persons [95 % CI = 9.8–11.0]- 12.7/100,000 persons [95 % CI = 12.0–13.3]). The AAIRs of EO-CRC among males were higher than that of females. Non-Hispanic (NH) White population had the highest AAIR, followed by the Black population and Hispanic population, while other races/ethnicities had the lowest AAIR of EO-CRC. The incidence rate of EO-CRC diagnosed at the regional stage was the highest and showed the steepest increasing trend. While EO-CRC case density by county reflects the population density, incidence rates were higher in rural counties.</div></div><div><h3>Conclusion</h3><div>The incidence of EO-CRC in Texas showed an increasing trend from 2011 to 2019, with notable disparities by sex, race/ethnicity, and cancer stage.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102927"},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082134","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}
Pub Date : 2025-09-13DOI: 10.1016/j.canep.2025.102930
Yasir Ahmed Mohammed Elhadi , Rami H. Al-Rifai , Iffat Elbarazi , Abubaker Suliman , Sara Omer Alabass , Iman Osman Abufatima , Sagad Omer Obeid Mohamed , Mohammed Khogali , Emad Masuadi
Breast cancer is the most commonly diagnosed malignancy among women in Arab countries, where a substantial proportion present with advanced-stage disease. This systematic review and meta-analysis aimed to quantify the prevalence of stage III–IV breast cancer at diagnosis across the region. We systematically searched PubMed, Scopus, Web of Science, and the WHO Virtual Health Library on March 22, 2025, for studies reporting stage at diagnosis among women with breast cancer in Arab countries. Two reviewers independently screened and extracted data, and risk of bias was assessed using the Joanna Briggs Institute checklist. Random-effects meta-analyses were performed to estimate the pooled prevalence of advanced-stage presentation overall and by country. From 678 screened records, 26 studies from 13 countries comprising 14,176 women were included. The pooled prevalence of stage III–IV breast cancer at diagnosis was 46·0 % (95 % CI 43·0–50·0; I²=93·6 %), with marked heterogeneity across settings (range 13·0 % in Bahrain to 67·0 % in Libya and Yemen). Country-level subgroup differences were statistically significant (χ²=3271·72, df=12; p < 0·001), suggesting that national context may substantially influence diagnostic stage. Egger’s test showed evidence of small-study effects (intercept=1·23; p = 0·048). These findings highlight the enduring challenge of late breast cancer diagnosis in the Arab region. Urgent investment in early detection strategies through population-based screening, public awareness, and timely access to diagnostic services is critical to reducing mortality and improving outcomes.
乳腺癌是阿拉伯国家妇女中最常见的恶性肿瘤，其中相当大比例的妇女患有晚期疾病。本系统综述和荟萃分析旨在量化该地区诊断时III-IV期乳腺癌的患病率。我们于2025年3月22日系统地检索了PubMed、Scopus、Web of Science和WHO虚拟健康图书馆，以获取报告阿拉伯国家女性乳腺癌诊断阶段的研究。两位审稿人独立筛选和提取数据，并使用乔安娜布里格斯研究所的检查表评估偏倚风险。进行随机效应荟萃分析，以估计总体和各国晚期表现的总患病率。从678份被筛选的记录中，纳入了来自13个国家的26项研究，涉及14176名女性。诊断时III-IV期乳腺癌的总患病率为46.0 %(95% % CI 43.0 - 50.0; I²= 93.6 %)，不同情况下存在明显的异质性（巴林为13.0 %，利比亚和也门为67.0 %）。国家层面的亚组差异具有统计学意义（χ²=3271·72,df=12; p <； 0.001），表明国家背景可能对诊断阶段产生重大影响。Egger检验显示了小研究效应的证据（截距= 1.23;p = 0.048）。这些发现突出了阿拉伯地区晚期乳腺癌诊断的持久挑战。通过基于人群的筛查、提高公众意识和及时获得诊断服务，对早期发现战略进行紧急投资，对于降低死亡率和改善结果至关重要。
{"title":"Prevalence of advanced-stage breast cancer at diagnosis in Arab countries: A systematic review and meta-analysis","authors":"Yasir Ahmed Mohammed Elhadi , Rami H. Al-Rifai , Iffat Elbarazi , Abubaker Suliman , Sara Omer Alabass , Iman Osman Abufatima , Sagad Omer Obeid Mohamed , Mohammed Khogali , Emad Masuadi","doi":"10.1016/j.canep.2025.102930","DOIUrl":"10.1016/j.canep.2025.102930","url":null,"abstract":"<div><div>Breast cancer is the most commonly diagnosed malignancy among women in Arab countries, where a substantial proportion present with advanced-stage disease. This systematic review and meta-analysis aimed to quantify the prevalence of stage III–IV breast cancer at diagnosis across the region. We systematically searched PubMed, Scopus, Web of Science, and the WHO Virtual Health Library on March 22, 2025, for studies reporting stage at diagnosis among women with breast cancer in Arab countries. Two reviewers independently screened and extracted data, and risk of bias was assessed using the Joanna Briggs Institute checklist. Random-effects meta-analyses were performed to estimate the pooled prevalence of advanced-stage presentation overall and by country. From 678 screened records, 26 studies from 13 countries comprising 14,176 women were included. The pooled prevalence of stage III–IV breast cancer at diagnosis was 46·0 % (95 % CI 43·0–50·0; I²=93·6 %), with marked heterogeneity across settings (range 13·0 % in Bahrain to 67·0 % in Libya and Yemen). Country-level subgroup differences were statistically significant (χ²=3271·72, df=12; p < 0·001), suggesting that national context may substantially influence diagnostic stage. Egger’s test showed evidence of small-study effects (intercept=1·23; p = 0·048). These findings highlight the enduring challenge of late breast cancer diagnosis in the Arab region. Urgent investment in early detection strategies through population-based screening, public awareness, and timely access to diagnostic services is critical to reducing mortality and improving outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102930"},"PeriodicalIF":2.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050135","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}
Pub Date : 2025-09-13DOI: 10.1016/j.canep.2025.102932
Young-Rock Hong , Lee Revere , Kathryn M. Ross , Peihua Qiu , Mattia Prosperi , Thomas J. George , Beth A. Virnig
Background
Early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is a growing public health concern. Despite increasing national incidence among younger adults, state-specific analyses for Florida remain limited. Florida's large and demographically unique population necessitates investigation into EOCRC trends and patient characteristics.
Methods
This population-based study utilized colorectal cancer incidence data for Florida residents aged 25–49 diagnosed between 2002 and 2021, from the Florida Cancer Data System and National Program of Cancer Registries. Joinpoint regression evaluated age-adjusted incidence trends across demographic and clinical factors. Age-period-cohort analysis explored generational effects, while multivariate logistic regression identified factors associated with advanced-stage diagnosis (regional or distant).
Results
Among 16,318 EOCRC cases identified during 2002–2021, overall incidence increased significantly (AAPC=1.48 %, P < .001), driven primarily by colon cancers (AAPC=1.53 %, P < .001), while rectal cancers showed non-significant increase (AAPC=0.53 %, P = 0.185). A concerning shift toward advanced stages at diagnosis emerged (P < 0.001), with localized disease decreasing from 32.8 % to 26.2 %, while regional (34.6–41.0 %) and distant metastases (21.9–26.8 %) increased substantially. This stage migration was confirmed by significant increases in regional (AAPC=2.10 %, P < .001) and distant disease (AAPC=2.71 %, P < .001) incidence. Strong birth cohort effects, indicating increasing risk with rate ratios exceeding 2.0 for recent cohorts, were evident predominantly in non-Hispanic White individuals. Conversely, Hispanic and non-Hispanic Black patients showed no significant cohort effects but consistently presented with higher odds of advanced-stage disease compared to non-Hispanic Whites (AOR=1.13 and AOR=1.11, respectively). Uninsured (AOR=1.23) and Medicaid-covered patients (AOR=1.52) faced significantly higher odds of advanced presentation compared to privately insured individuals.
Conclusion
Florida experienced sustained EOCRC incidence increases from 2002 to 2021, accompanied by advanced-stage diagnosis increases and notable disparities. Birth cohort effects primarily drove increased risk in non-Hispanic White populations, while barriers to timely care, including insurance status, likely contributed to delayed diagnoses in minority communities, underscoring urgent needs for targeted interventions.
{"title":"Trends and characteristics of early-onset colorectal cancer in the state of Florida, 2002–2021","authors":"Young-Rock Hong , Lee Revere , Kathryn M. Ross , Peihua Qiu , Mattia Prosperi , Thomas J. George , Beth A. Virnig","doi":"10.1016/j.canep.2025.102932","DOIUrl":"10.1016/j.canep.2025.102932","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is a growing public health concern. Despite increasing national incidence among younger adults, state-specific analyses for Florida remain limited. Florida's large and demographically unique population necessitates investigation into EOCRC trends and patient characteristics.</div></div><div><h3>Methods</h3><div>This population-based study utilized colorectal cancer incidence data for Florida residents aged 25–49 diagnosed between 2002 and 2021, from the Florida Cancer Data System and National Program of Cancer Registries. Joinpoint regression evaluated age-adjusted incidence trends across demographic and clinical factors. Age-period-cohort analysis explored generational effects, while multivariate logistic regression identified factors associated with advanced-stage diagnosis (regional or distant).</div></div><div><h3>Results</h3><div>Among 16,318 EOCRC cases identified during 2002–2021, overall incidence increased significantly (AAPC=1.48 %, P < .001), driven primarily by colon cancers (AAPC=1.53 %, P < .001), while rectal cancers showed non-significant increase (AAPC=0.53 %, P = 0.185). A concerning shift toward advanced stages at diagnosis emerged (P < 0.001), with localized disease decreasing from 32.8 % to 26.2 %, while regional (34.6–41.0 %) and distant metastases (21.9–26.8 %) increased substantially. This stage migration was confirmed by significant increases in regional (AAPC=2.10 %, P < .001) and distant disease (AAPC=2.71 %, P < .001) incidence. Strong birth cohort effects, indicating increasing risk with rate ratios exceeding 2.0 for recent cohorts, were evident predominantly in non-Hispanic White individuals. Conversely, Hispanic and non-Hispanic Black patients showed no significant cohort effects but consistently presented with higher odds of advanced-stage disease compared to non-Hispanic Whites (AOR=1.13 and AOR=1.11, respectively). Uninsured (AOR=1.23) and Medicaid-covered patients (AOR=1.52) faced significantly higher odds of advanced presentation compared to privately insured individuals.</div></div><div><h3>Conclusion</h3><div>Florida experienced sustained EOCRC incidence increases from 2002 to 2021, accompanied by advanced-stage diagnosis increases and notable disparities. Birth cohort effects primarily drove increased risk in non-Hispanic White populations, while barriers to timely care, including insurance status, likely contributed to delayed diagnoses in minority communities, underscoring urgent needs for targeted interventions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102932"},"PeriodicalIF":2.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050139","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}
Pub Date : 2025-09-12DOI: 10.1016/j.canep.2025.102931
Ana Clara Cruz Santos de Santana , Ellen Sabrina Ramos Santos , Jefferson Felipe Calazans Batista , Alex Rodrigues Moura , Simone Soraia Silva Sardeiro , Brenda Evelin Barreto da Silva , Carlos Anselmo Lima
Background
Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution of prostate cancer incidence (1996–2017) and mortality (1996–2022) in Sergipe, Brazil, to support targeted cancer control strategies.
Methods
We analyzed prostate cancer data from the Aracaju Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were calculated using the World Standard Population. Joinpoint regression estimated Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess trends. The Mortality-to-Incidence Ratio (MIR) and its complement (1–MIR) were used as proxies for survival. Spatial distribution was examined using Empirical Bayesian Kriging and local empirical Bayes smoothing in QGIS and TerraView.
Results
Between 1996 and 2017, 10,133 incident prostate cancer cases were recorded. Incidence increased until 2007 (APC=11.9 %; p < 0.001), then declined (APC=–2.0 %; p = 0.027, with peaks in men aged ≥55. Mortality increased from 1996 to 2007 (APC=12.2 %; p < 0.001) and subsequently stabilised between 2007 and 2022 (APC=–0.8 %; p = 0.228), resulting in an overall AAPC of 2.4 % (p = 0.002) for the entire study period. By age group, mortality rose among men ≥ 75 years (AAPC=3.2 %; p = 0.001) but declined in those aged 15–54 (AAPC=–2.4 %; p = 0.004). The MIR remained flat over time, but estimated survival dropped substantially among men aged ≥ 75 years, from 63 % to 38 %. Spatial analysis revealed higher incidence in central/coastal municipalities, while elevated mortality clustered in southern/coastal areas.
Conclusions
Despite improvements in incidence rates, prostate cancer remains a significant burden in Sergipe, with persistent regional disparities in outcomes. Spatial and temporal analyses highlight the need for targeted public health interventions to improve early detection and access to care, especially in areas of high social vulnerability and among older men.
{"title":"Temporal trends and spatial distribution of prostate cancer incidence and mortality in a northeastern Brazilian state","authors":"Ana Clara Cruz Santos de Santana , Ellen Sabrina Ramos Santos , Jefferson Felipe Calazans Batista , Alex Rodrigues Moura , Simone Soraia Silva Sardeiro , Brenda Evelin Barreto da Silva , Carlos Anselmo Lima","doi":"10.1016/j.canep.2025.102931","DOIUrl":"10.1016/j.canep.2025.102931","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution of prostate cancer incidence (1996–2017) and mortality (1996–2022) in Sergipe, Brazil, to support targeted cancer control strategies.</div></div><div><h3>Methods</h3><div>We analyzed prostate cancer data from the Aracaju Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were calculated using the World Standard Population. Joinpoint regression estimated Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess trends. The Mortality-to-Incidence Ratio (MIR) and its complement (1–MIR) were used as proxies for survival. Spatial distribution was examined using Empirical Bayesian Kriging and local empirical Bayes smoothing in QGIS and TerraView.</div></div><div><h3>Results</h3><div>Between 1996 and 2017, 10,133 incident prostate cancer cases were recorded. Incidence increased until 2007 (APC=11.9 %; p < 0.001), then declined (APC=–2.0 %; p = 0.027, with peaks in men aged ≥55. Mortality increased from 1996 to 2007 (APC=12.2 %; p < 0.001) and subsequently stabilised between 2007 and 2022 (APC=–0.8 %; p = 0.228), resulting in an overall AAPC of 2.4 % (p = 0.002) for the entire study period. By age group, mortality rose among men ≥ 75 years (AAPC=3.2 %; p = 0.001) but declined in those aged 15–54 (AAPC=–2.4 %; p = 0.004). The MIR remained flat over time, but estimated survival dropped substantially among men aged ≥ 75 years, from 63 % to 38 %. Spatial analysis revealed higher incidence in central/coastal municipalities, while elevated mortality clustered in southern/coastal areas.</div></div><div><h3>Conclusions</h3><div>Despite improvements in incidence rates, prostate cancer remains a significant burden in Sergipe, with persistent regional disparities in outcomes. Spatial and temporal analyses highlight the need for targeted public health interventions to improve early detection and access to care, especially in areas of high social vulnerability and among older men.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102931"},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050138","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}
Pub Date : 2025-09-11DOI: 10.1016/j.canep.2025.102925
András Wéber , Freddie Bray , Mátyás Árvai , Lászlóné Hilbert , Dávid Kelemen , Péter Nagy , István Kenessey , Csaba Polgár
Objectives
Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools. The Lexis diagram provides a means to depict age, period and cohort influences on long-term cancer mortality trends.
Methods
Age-specific mortality rates for six cancer localizations were constructed based on the Deaths Register of the Hungarian Central Statistical Office and the Human Mortality Database, then smoothed (p-splines) within the cells of the Lexis diagram assuming Poisson distribution. After calculating the annual percentage change in mortality rates, the results were visualized using heat maps.
Results
Substantial reduction in mortality was observable from the mid-1990s in both sexes as a strong period effect, depicting two distinct epidemiological eras in Hungary. Since 2010, breast cancer mortality in women among ages 70–90 (those born between 1930 and 1950) has been rising. Women born between 1940 and 50 experienced two plateaus in lung cancer mortality, unlike men, emphasizing the delayed nature of the smoking epidemic.
Conclusions
The results align with cancer transition patterns observed in similarly developed countries and emphasize a critical need to expand the implementation of effective primary and secondary prevention measures. This includes sustaining organized screening and anti-smoking programs, as well as introducing lung cancer screening with low-dose CT.
{"title":"Half a century of cancer transition in Hungary: A visualization and assessment of mortality dynamics in the Lexis diagram, 1970–2020","authors":"András Wéber , Freddie Bray , Mátyás Árvai , Lászlóné Hilbert , Dávid Kelemen , Péter Nagy , István Kenessey , Csaba Polgár","doi":"10.1016/j.canep.2025.102925","DOIUrl":"10.1016/j.canep.2025.102925","url":null,"abstract":"<div><h3>Objectives</h3><div>Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools. The Lexis diagram provides a means to depict age, period and cohort influences on long-term cancer mortality trends.</div></div><div><h3>Methods</h3><div>Age-specific mortality rates for six cancer localizations were constructed based on the Deaths Register of the Hungarian Central Statistical Office and the Human Mortality Database, then smoothed (p-splines) within the cells of the Lexis diagram assuming Poisson distribution. After calculating the annual percentage change in mortality rates, the results were visualized using heat maps.</div></div><div><h3>Results</h3><div>Substantial reduction in mortality was observable from the mid-1990s in both sexes as a strong period effect, depicting two distinct epidemiological eras in Hungary. Since 2010, breast cancer mortality in women among ages 70–90 (those born between 1930 and 1950) has been rising. Women born between 1940 and 50 experienced two plateaus in lung cancer mortality, unlike men, emphasizing the delayed nature of the smoking epidemic.</div></div><div><h3>Conclusions</h3><div>The results align with cancer transition patterns observed in similarly developed countries and emphasize a critical need to expand the implementation of effective primary and secondary prevention measures. This includes sustaining organized screening and anti-smoking programs, as well as introducing lung cancer screening with low-dose CT.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102925"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050136","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}
Pub Date : 2025-09-11DOI: 10.1016/j.canep.2025.102929
Kuan-Fu Liao, Shih-Wei Lai
{"title":"Aspirin use associated with a decreased risk of gastric cancer","authors":"Kuan-Fu Liao, Shih-Wei Lai","doi":"10.1016/j.canep.2025.102929","DOIUrl":"10.1016/j.canep.2025.102929","url":null,"abstract":"","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102929"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050137","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}
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