Cancer Epidemiology最新文献

{"title":"Global trends, future projections, and epidemiological associations of Mesothelioma: A comprehensive analysis from 1980 to 2050.","authors":"Shanjie Luan, Yanqing Wang","doi":"10.1016/j.canep.2025.102900","DOIUrl":"10.1016/j.canep.2025.102900","url":null,"abstract":"<p><strong>Background: </strong>Malignant mesothelioma is a rare but aggressive cancer primarily caused by occupational asbestos exposure. This study aims to comprehensively assess global mesothelioma incidence and mortality trends, examine their associations with the Human Development Index (HDI), project future burden through 2050, and investigate epidemiological correlations with other malignancies.</p><p><strong>Methods: </strong>We extracted mesothelioma incidence and mortality data from GBD 2021 and GLOBOCAN 2022, covering 204 and 185 countries from 1980 to 2022, respectively. Temporal trends were analyzed using estimated annual percentage change (EAPC), while age-period-cohort (APC) modeling was applied in six high-HDI countries to assess generational burden shifts. Future projections were generated using age-stratified machine-learning models trained on historical data and validated against multiple forecasting methods. Additionally, mesothelioma's epidemiological associations with 27 other cancers were analyzed using linear and logistic regression.</p><p><strong>Results: </strong>Between 1990 and 2021, global mesothelioma incidence and mortality showed a modest decline (ASIR EAPC: -0.2 [95 % UI: -0.32 to -0.08]; ASDR EAPC: -0.23 [95 % UI: -0.3 to -0.16]). Males exhibited a significantly higher burden than females, with the UK and Australia reporting the highest incidence and mortality rates. A clear threshold effect of HDI was observed, with mesothelioma rates remaining stable below HDI 0.8 but rising sharply beyond this level. Additionally, mesothelioma demonstrated strong positive correlations with tracheobronchial lung cancer, ovarian cancer, and Hodgkin lymphoma, suggesting potential shared environmental and occupational risk factors.</p><p><strong>Conclusions: </strong>Our findings provide the most up-to-date epidemiological insights into mesothelioma, highlighting its stable long-term burden, gender disparities, and socioeconomic influences.</p>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"102900"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812741","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}

{"title":"Response to ‘reverse causality’ comment","authors":"Shan Zhang ,&nbsp;Hongwei Wang ,&nbsp;Jingjing Ji,&nbsp;Ruiyu Chai,&nbsp;Shiyi Song,&nbsp;Jikang Shi,&nbsp;Siyu Liu","doi":"10.1016/j.canep.2025.102928","DOIUrl":"10.1016/j.canep.2025.102928","url":null,"abstract":"<div><div>This document is the authors' response to the received comments for manuscript CANEP-D-25–00912.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102928"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202221","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}

{"title":"10 Years of breast cancer treatment trends in Fars Province, report of Shiraz Breast Cancer Registry","authors":"Majid Akrami ,&nbsp;Amirhesam Moosazadeh ,&nbsp;Mehrdad Taghva ,&nbsp;Nastaran Tavakolian ,&nbsp;Marzieh Karami Rad ,&nbsp;Zahra Keumarsi ,&nbsp;Masoumeh Ghoddusi Johari ,&nbsp;Vahid Zangouri","doi":"10.1016/j.canep.2025.102937","DOIUrl":"10.1016/j.canep.2025.102937","url":null,"abstract":"<div><h3>Background</h3><div>Despite global recommendations favoring breast-conserving surgery (BCS) with radiotherapy for early-stage breast cancer, there is limited long-term evidence on surgical trends and survival outcomes in low- and middle-income countries such as Iran. Understanding these patterns is crucial to improving treatment equity and patient outcomes. This study aimed to evaluate two-decade trends in surgical approach selection for breast cancer and to compare survival outcomes between BCS and mastectomy in Fars province, Iran.</div></div><div><h3>Methods</h3><div>Data from 10,091 women diagnosed with breast cancer between 2000 and 2022 were extracted from the Shiraz Breast Cancer Registry. Patients were categorized into four groups based on type of surgery (BCS or mastectomy) and receipt of radiotherapy. Logistic regression was used to identify factors influencing treatment selection. Survival and recurrence were analyzed using Kaplan-Meier and factors affecting survival were evaluated using the Cox regression model.</div></div><div><h3>Results</h3><div>Between 2000 and 2022, the proportion of patients undergoing BCS plus radiotherapy increased from 30.5 % to 73.8 %, surpassing mastectomy. The BCS plus radiotherapy group showed the most favorable outcomes, with the lowest breast cancer-specific mortality (6.2 %), recurrence rate (10.2 %), and the highest 10-year BCSS (96.01 %). These associations remained significant after multivariable adjustment.</div></div><div><h3>Conclusion</h3><div>This study reveals a significant shift toward BCS plus radiotherapy in southern Iran over the past two decades. BCS with radiotherapy is associated with superior survival outcomes compared to mastectomy. However, access barriers continue to prevent many women from receiving the optimal surgical approach, indicating the need for policy and health system interventions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102937"},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158487","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}

{"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 ,&nbsp;Harriet Rumgay ,&nbsp;Jerome Vignat ,&nbsp;Mathieu Laversanne ,&nbsp;Murielle Colombet ,&nbsp;Maria Paula Curado ,&nbsp;Gail Garvey ,&nbsp;Sarbani Ghosh-Laskar ,&nbsp;Brian O’Sullivan ,&nbsp;Shama Virani ,&nbsp;Isabelle Soerjomataram ,&nbsp;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}

{"title":"Trends and disparities in locoregional treatment of programme-detected ductal carcinoma in situ in New Zealand women, 1999–2022","authors":"Qian Chen ,&nbsp;Ian Campbell ,&nbsp;Mark Elwood ,&nbsp;Alana Cavadino ,&nbsp;Phyu Sin Aye ,&nbsp;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}

{"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 ,&nbsp;Hans B. Rahr ,&nbsp;Erik Frostberg ,&nbsp;Karina Rønlund ,&nbsp;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}

{"title":"Patient demographic and prognostic factors of vulvar squamous cell carcinoma: A National Cancer Database Study","authors":"Grace Folino ,&nbsp;Elizabeth Byrne ,&nbsp;Mya Hendry ,&nbsp;Peter Silberstein ,&nbsp;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}

{"title":"Description and recent trends (2011–2019) of early-onset colorectal cancer incidence in Texas","authors":"Yahan Zhang ,&nbsp;Hyeun Ah Kang ,&nbsp;Srinivas Joga Ivatury ,&nbsp;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}

{"title":"Prevalence of advanced-stage breast cancer at diagnosis in Arab countries: A systematic review and meta-analysis","authors":"Yasir Ahmed Mohammed Elhadi ,&nbsp;Rami H. Al-Rifai ,&nbsp;Iffat Elbarazi ,&nbsp;Abubaker Suliman ,&nbsp;Sara Omer Alabass ,&nbsp;Iman Osman Abufatima ,&nbsp;Sagad Omer Obeid Mohamed ,&nbsp;Mohammed Khogali ,&nbsp;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 &lt; 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}

{"title":"Trends and characteristics of early-onset colorectal cancer in the state of Florida, 2002–2021","authors":"Young-Rock Hong ,&nbsp;Lee Revere ,&nbsp;Kathryn M. Ross ,&nbsp;Peihua Qiu ,&nbsp;Mattia Prosperi ,&nbsp;Thomas J. George ,&nbsp;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 &lt; .001), driven primarily by colon cancers (AAPC=1.53 %, P &lt; .001), while rectal cancers showed non-significant increase (AAPC=0.53 %, P = 0.185). A concerning shift toward advanced stages at diagnosis emerged (P &lt; 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 &lt; .001) and distant disease (AAPC=2.71 %, P &lt; .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}