Cancer Epidemiology最新文献

Background

Cervical cancer disproportionately affects First Nations women in Canada but there is limited information on their participation in organized cervical cancer screening programs.

Methods

This co-led retrospective cohort study linked population-based Alberta Cervical Cancer Screening Program point of care data with First Nations identifiers. This Screening Program database includes cervical cancer screening history, screen test results, colposcopy procedure findings, and pathology results for all women in Alberta. First Nations identifiers were obtained from Alberta Health who steward these data on their behalf. Data were available from 2012 to 2018 for women 25 – 69 years of age who were age eligible to participate in cervical cancer screening. Screening participation and retention rates, and screening outcomes were compared between First Nations and non- First Nations women using descriptive statistics with trends estimated using joinpoint models.

Results

Age standardized screening participation and retention rates of First Nations women were lower than those for the non-First Nations women, with an average difference of 13.9 % lower for participation rates (95 % confidence interval = 12.9–14.8 %; P <.0001) and 7.2 % for retention rates (95 % confidence interval = 2.2 % to 12.72; P = 0.013). First Nations women consistently had higher percentages of high risk (high-grade squamous intraepithelial lesion, atypical glandular cells, atypical squamous cells where HSIL cannot be excluded, Carcinoma in situ) abnormal cytology tests than non-First Nations women.

Conclusion

Identifying where inequities were found in cervical cancer screening participation and retention in this study is the first step to reduce the disproportionate burden of cervical cancer for First Nations women in Canada.

Breast cancer (BC) is the most common neoplasm, and its global burden has become one of the most important factors jeopardizing the health of the world population, especially women. The aim of this study was to analyze mortality trends and the spatial distribution of BC in women in the capital and state of Sergipe, aiming to contribute to the implementation and improvement of strategies for the prevention and health promotion of women with BC. Trends were calculated using the Joinpoint Regression Program 5.0.2. Spatial analyses were performed using the empirical Bayesian model, thematic maps were created using QGIS 3.10.7 and Moran's I indices were calculated using TerraView 4.2.2. Between 1996 and 2022, 1384 and 3128 BC deaths were recorded in the capital and state of Sergipe, respectively. The mortality trend increased in the age groups of 45–75+ for the state of Sergipe, while in the capital, we observed stability in all age groups. The highest AAPC was 4.6213, with a 95 % confidence interval (2.16; 7.14). Univariate global Moran's I analysis indicated spatial autocorrelation during the study period. A direct relationship was found between mortality rates and the more economically developed regions.

Background

The Patient-Reported Outcomes Measurement Information System (PROMIS) Preference Score (PROPr) is estimated from descriptive health assessments within the PROMIS framework. The underlying item response theory (IRT) allows researchers to measure PROMIS health domains with any subset of items that are calibrated to this domain. Consequently, this should also be true for the PROPr. We aimed to test this assumption using both an empirical and a simulation approach.

Methods

Empirically, we estimated 3 PROMIS Pain inference (PI) scores from 3 different item subsets in a sample of n=199 cancer patients: 4 PROMIS-29 items (estimate: θ₄), the 2 original PROPr items (θ₂), and 10 different items (θ₁₀). We calculated mean differences and agreement between θ₄, and θ₂ and θ₁₀, respectively, and between their resulting PROPr₄, PROPr₂, PROPr₁₀, using intraclass correlation coefficients (ICC) and Bland-Altman (B-A) plots with 95 %-Limits of Agreement (LoA). For the simulation, we used the IRT-model to calculate all item responses of the entire 7 PROPr domain item banks from the empirically observed PROMIS-29+cognition θ. From these simulated item banks, we chose the 2 original PROPr items per domain to calculate PROPr_sim and compared it to PROPr₄ again using ICC and B-A plots.

Results

θ₄ vs θ₁₀ showed smaller bias (-0.012, 95 %-LoA −0.88;0.85) than θ₄ vs θ₂ (0.025, 95 %-LoA −0.95;1.00. ICC>0.85 (p<0.001) in both θ-comparisons. PROPr₄ vs PROPr₁₀ showed lower bias (0.0012, 95 %-LoA −0.039;0.042) than PROPr₄ vs PROPr₂ (-0.0029, 95 %-LoA −0.049;0.044). ICC>0.98 (p<0.0001) on both PROPr-comparisons. Mean PROPr_sim was larger than mean PROPr₄ (0.0228, 95 %-LoA −0.1103; 0.1558) and ICC was 0.95 (95 %CI 0.93; 0.97).

Conclusion

Different item subsets can be used to estimate the PROMIS PI for calculation of the PROPr. Reduction to 2 items per domain rather than 4 does not significantly change the PROPr estimate on average. Agreements differ across the spectrum and in individual comparisons.

Objectives

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

Methods

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

Results

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

Conclusions

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

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

Background

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

Methods

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

Results

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

Conclusions

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

Background

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

Methods

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

Results

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

Conclusion

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

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

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

Background

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

Methods

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

Results

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

Conclusion

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