Cancer Epidemiology最新文献_第7页

Epidemiological trends of lymphoma in Sri Lanka: A national cancer registry study (2005–2021) 斯里兰卡淋巴瘤的流行病学趋势：一项国家癌症登记研究（2005-2021）

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.canep.2025.102951

Bhawani Yasassri Alvitigala, Lallindra Viranjan Gooneratne, Chandu de Silva

Background

Globally, lymphoma incidence has been steadily rising, with notable regional and gender-based variations. Understanding these trends in developing countries like Sri Lanka is essential to address cancer control strategies.

Methodology

Cancer incidence and mortality data from the National Cancer Control Program (NCCP) registries (2005–2021) were analyzed. Temporal trends in age-standardized rates (ASR) were assessed using Joinpoint Regression to estimate annual percent change (APC) and average APC (AAPC).

Results

A total of new 15,577 lymphoma cases were reported with male predominance (60 %, n = 9346) and non-Hodgkin lymphoma (NHL) being the predominant subtype (79 %, n = 9561). The overall incidence increased significantly over 16 years (AAPC: 4.1 %; p < 0.05), with a 1.4-fold rise in both sexes and a marked rise among 0–19-year-olds, exclusively post-2019 (p < 0.05). NHL incidence was highest in individuals aged ≥ 60 years, with a 2-fold rise in both gender (APC: 3.2; 95 % CI: 0.4 – 6.1; p < 0.05) during 2011–2021. Hodgkin lymphoma (HL) showed a significant 3-fold increase in females, while trends in males fluctuated, with a significant average AAPC in both sexes from 2011 to 2021 (p < 0.05). Despite the non-significant rise in female incidence across most age groups, males in 40–59 and > 60 years age groups showed a decline. A significant rise in NHL-related deaths among males (p < 0.05) was noted, with a non-significant increase in females.

Conclusions

Our findings indicate an apparent rising burden of lymphoma in Sri Lanka, particularly among males and the elderly. However, this observed increase may be partly attributable to improvements in cancer diagnostics and NCCP reporting over time. Additionally, evolving WHO classifications and their gradual adoption may also have influenced the observed trends.

背景：在全球范围内，淋巴瘤发病率稳步上升，且存在显著的区域和性别差异。了解斯里兰卡等发展中国家的这些趋势对于制定癌症控制战略至关重要。方法：分析2005-2021年国家癌症控制规划（NCCP）登记处的癌症发病率和死亡率数据。采用关节点回归评估年龄标准化率（ASR）的时间趋势，以估计年变化百分比（APC）和平均APC （AAPC）。结果：共报告新发淋巴瘤15577例，男性占多数（60 %,n = 9346），非霍奇金淋巴瘤（NHL）为优势亚型（79 %,n = 9561）。总发病率在16岁时显著增加（AAPC: 4.1 %;p  ），60岁年龄组呈下降趋势。结论：我们的研究结果表明，斯里兰卡的淋巴瘤负担明显增加，特别是在男性和老年人中。然而，观察到的这一增长可能部分归因于癌症诊断和NCCP报告的改进。此外，世卫组织分类的演变及其逐步采用也可能影响到观察到的趋势。

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引用次数: 0

Prognostic factors of Mucoepidermoid Carcinoma within the head and neck: A NCDB analysis 头颈部黏液表皮样癌的预后因素：NCDB分析。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.canep.2025.102945

Sebastian Respicio , Daniel Ryan , Christopher Bine , Stone Zhang , Peter Silberstein , Marco DiBlasi

Objectives

To characterize the prognostic profile of head and neck Mucoepidermoid Carcinoma (MEC) and correlate findings with survival and surgical likelihood.

Methods

This retrospective cohort study queried the National Cancer Database from 2004 to 2021 for all head and neck structures with histologically confirmed MEC. Using SPSS and GraphPad Prism, statistical analyses were conducted via Kaplan Meier Survival with Log-Rank Pairwise Comparisons, Cox Proportional Hazards Regressions, and Binomial and Multinomial Logistic Regressions.

Results

A total of 17,713 patients were included. Significant findings include worsened overall survival (OS) and hazard ratios (HR) in relation to male sex, white race, non-Hispanic ethnicity, non-Private Insurances, non-Academic/Research treatment facilities, and not undergoing surgery. MEC in the Gum & Other Mouth and in the Lip had better OS and HR while MEC of the Nose, Nasal Cavity, & Middle Ear, MEC of the Tongue, and MEC of the Pharynx had worsened OS and HR in comparison to Salivary Gland MEC. Gum & Other Mouth MEC patients had significantly increased likelihood for Local Tumor Excision and Partial Organ Removal surgeries. Tongue MEC had significantly increased likelihood for Partial Organ Removal. Nose, Nasal Cavity, & Middle Ear MEC and Pharynx MEC had significantly decreased likelihoods for Local Tumor Excision or Total/Radical Organ Removal Surgeries.

Conclusion

By identifying key determinants of survival and surgical likelihood, this work provides valuable clinical insight into patient management and outcomes for a clinically significant malignancy. Additionally, this study comments on the role of accessible surgical care and social determinants of health regarding MEC.

目的：探讨头颈部黏液表皮样癌（MEC）的预后特征，并将其与生存和手术可能性联系起来。方法：这项回顾性队列研究查询了2004年至2021年国家癌症数据库中所有组织学证实的MEC头颈部结构。使用SPSS和GraphPad Prism进行Kaplan Meier生存分析，采用Log-Rank两两比较、Cox比例风险回归、二项和多项Logistic回归进行统计分析。结果：共纳入17713例患者。重要的发现包括与男性、白人、非西班牙裔、非私人保险、非学术/研究治疗设施和未接受手术相关的总生存率（OS）和风险比（HR）恶化。与唾液腺MEC相比，牙龈及其他口腔和唇部MEC的OS和HR较好，而鼻、鼻腔和中耳MEC、舌部MEC和咽部MEC的OS和HR较差。牙龈和其他口腔MEC患者进行局部肿瘤切除和部分器官切除手术的可能性显著增加。舌MEC明显增加部分器官切除的可能性。鼻、鼻腔、中耳MEC和咽MEC进行局部肿瘤切除或全/根治性器官切除手术的可能性显著降低。结论：通过确定生存和手术可能性的关键决定因素，这项工作为临床显著恶性肿瘤的患者管理和结果提供了有价值的临床见解。此外，本研究还评论了外科护理的可及性和MEC健康的社会决定因素的作用。

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引用次数: 0

A cross-sectional assessment of US cancer diagnoses during the COVID-19 pandemic COVID-19大流行期间美国癌症诊断的横断面评估

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.canep.2025.102944

Todd Burus , Uriel Kim , Johnie Rose , Siran M. Koroukian , Krystle A. Lang Kuhs

Background

Disruptions to cancer diagnoses were widely reported in the US during the early COVID-19 pandemic. Whether any cases remained unaccounted-for by the end of the pandemic has not been fully assessed.

Methods

We collected data on invasive cancer diagnoses occurring among individuals aged 20–89 years between January 2020 and December 2022 from the Surveillance, Epidemiology, and End Results database. Expected cancer case counts and incidence rates with 95 % credibility intervals (95 %CrIs) were estimated for 2020–2022 from pre-pandemic trends (2005–2019) using Bayesian Age-Period-Cohort models. We compared observed rates with expected rates, and estimated unaccounted-for cases. Additional site-, stage-, and subgroup-specific analyses were performed.

Results

Among 2260,704 cancer cases diagnosed in 2020–2022, the observed incidence rate was 595.5 per 100,000 persons (95 %CI, 594.7–596.2), which was 6.7 % lower than the expected rate of 638.1 (95 %CrI, 620.1–656.1) and corresponded to 160,475 fewer-than-expected cases (95 %CrI, 99,777–221,174). Annual observed rates were significantly lower than expected in 2020 (565.8 vs. 630.7), with recovery in 2021 and 2022, though not enough to overcome the existing case deficit. Incidence rates for persons aged ≥ 65 years, nonmetropolitan residents, and non-Hispanic White individuals, as well as site-specific rates for lung and kidney cancers and non-Hodgkin lymphoma, remained below expected levels beyond 2020. Early-stage colorectal cancer diagnoses were 14.2 % lower than expected over the period.

Conclusion

While annual cancer incidence rates returned to expected levels by the end of the COVID-19 pandemic, substantial numbers of unaccounted-for cases remained, raising concerns for future increases in cancer morbidity and mortality.

背景：在COVID-19早期大流行期间，美国广泛报道了癌症诊断中断。尚未充分评估到大流行结束时是否仍有病例下落不明。方法：我们从监测、流行病学和最终结果数据库中收集了2020年1月至2022年12月期间20-89岁人群中浸润性癌症诊断的数据。根据大流行前趋势（2005-2019年），使用贝叶斯年龄-时期-队列模型估计了2020-2022年的预期癌症病例数和发病率，可信区间为95% %（95% %CrIs）。我们比较了观察到的发病率和预期的发病率，并估计了未解释的病例。进行了额外的部位、阶段和亚组特异性分析。结果：在2020-2022年确诊的2260704例癌症患者中，观察到的发病率为595.5 / 10万人（95 %CI, 594.7 ~ 596.2），比预期的638.1（95 %CrI, 620.1 ~ 656.1）低6.7 %，比预期少160475例（95 %CrI, 99777 ~ 221174）。2020年的年度观察率明显低于预期（565.8比630.7），2021年和2022年将有所复苏，但不足以克服现有的病例赤字。年龄≥ 65岁、非都市居民和非西班牙裔白人的发病率，以及肺癌、肾癌和非霍奇金淋巴瘤的部位特异性发病率，在2020年后仍低于预期水平。早期结直肠癌的诊断率为14.2% %，低于预期。结论：虽然到2019冠状病毒病大流行结束时，年癌症发病率已恢复到预期水平，但仍有大量不明病例存在，这引起了人们对未来癌症发病率和死亡率上升的担忧。

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引用次数: 0

Malignancies of the small intestine: incidence and trends in a nationwide registry 小肠恶性肿瘤：发病率和趋势在全国登记。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.canep.2025.102943

Pascale J.M. Schafrat , Felice N. van Erning , Koos Zwinderman , Evelien Dekker , Arantza Farina Sarasqueta , Judith de Vos-Geelen , Stefan A.W. Bouwense , Ruben S.A. Goedegebuure , Louis Vermeulen , Ignace H.J.T. de Hingh , Dirkje W. Sommeijer

Background

Malignancies of the small intestine are rare and understudied. Improved knowledge about trends in incidence and distribution of specific subtypes might guide clinicians and researchers to further improve diagnostic and treatment strategies and ultimately improve prognosis.

Methods

This nationwide retrospective cohort study from the Netherlands Cancer Registry included all patients diagnosed with a malignancy of the small intestine in the Netherlands between 2000 and 2022. Malignancies were divided into seven subgroups: adenocarcinomas, neuroendocrine neoplasms (NENs), lymphomas, gastrointestinal stromal tumors (GISTs), other sarcomas, metastases, and “other”. Age-standardized incidence rates, overall- and relative survival were reported.

Results

A total of 11.194 patients with a malignancy of the small intestine were included. Age-standardized incidence rates (per 100.000 person-years) more than doubled between 2000 and 2020 (1.88–3.94, p < 0.001), with the largest increase in NENs (0.53–1.57, p < 0.001), followed by adenocarcinomas (0.78–1.22, p = 0.004). The most prevalent malignancy in the small intestine shifted from adenocarcinomas to NENs from 2017 onwards. NENs were mostly located in the ileum and adenocarcinomas were most frequently diagnosed in the duodenum. Survival varied significantly between subgroups. Survival of patients with lymphomas and GISTs improved over time, in contrast with patients with adenocarcinomas and NENs.

Conclusion

The incidence of malignancies of the small intestine in the Netherlands has more than doubled over the past two decades, mostly due to an increase in NENs and adenocarcinomas. Survival outcomes for these malignancies did not improve, highlighting the urgent need to further study these rare cancer subtypes in the small intestine.

背景：小肠恶性肿瘤是罕见且研究不足的。提高对特定亚型的发病率和分布趋势的了解可能会指导临床医生和研究人员进一步改进诊断和治疗策略，并最终改善预后。方法：这项来自荷兰癌症登记处的全国性回顾性队列研究纳入了2000年至2022年间荷兰所有被诊断为小肠恶性肿瘤的患者。恶性肿瘤分为7个亚组：腺癌、神经内分泌肿瘤（NENs）、淋巴瘤、胃肠道间质瘤（gist）、其他肉瘤、转移瘤和“其他”。报告了年龄标准化发病率、总生存率和相对生存率。结果：共纳入小肠恶性肿瘤患者11.194例。年龄标准化发病率（每10万人年）在2000年至2020年间增加了一倍多（1.88-3.94,p ）。结论：荷兰小肠恶性肿瘤的发病率在过去20年中增加了一倍多，主要是由于NENs和腺癌的增加。这些恶性肿瘤的生存结果没有改善，强调了进一步研究这些小肠罕见癌症亚型的迫切需要。

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引用次数: 0

Prevalence of advanced-stage breast cancer at diagnosis in Arab countries: A systematic review and meta-analysis 阿拉伯国家晚期乳腺癌的患病率：一项系统回顾和荟萃分析

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-09-13 DOI: 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。

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引用次数: 0

Incidence rates and trends of paediatric cancer in Italy, 2008–2017 2008-2017年意大利儿童癌症发病率和趋势

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-10-24 DOI: 10.1016/j.canep.2025.102947

Enrica Santelli , Gemma Gatta , Fabio Savoia , Sabrina Fabiano , Francesco Cuccaro , Viviana Perotti , Andrea Tittarelli , Tiziana Scuderi , Rosalba Amodio , Walter Mazzucco , Fabrizio Stracci , Ilaria Cozzi , AIRTUM Working Group

Background

Paediatric cancers are rare, yet, Italy has previously shown some of the highest incidence rates in Europe as a leading cause of death in children and adolescents. This study updates data from Italy for 2008–2017, analyses trends from 1998, and compares findings with other European regions.

Methods

A population-based approach was used, leveraging data from the Italian Association of Cancer Registries (AIRTUM). Thirty-one cancer registries covering 77 % of the Italian paediatric population contributed data on tumour type, age, sex, residence, and diagnosis date. Cancers were classified using the International Classification of Childhood Cancer, Third Edition (ICCC-3). Age-specific (IR) and age-standardized incidence rates (ASR) were computed, while trends were analysed with Joinpoint regression to estimate annual (APC) and average annual percentage change (AAPC).

Results

From 2008–2017, 17,322 malignant paediatric cancer cases were reported in Italy. The age-standardized incidence rate (ASR) was 166.8 per million for ages 0–14 and 294.3 per million for adolescents 15–19. Over the study period, incidence rates were generally stable, but a significant increase was observed for bone tumours in children and thyroid and melanoma in adolescents. Central Italy showed higher incidence rates compared to other Italian regions. Italy still shows one of the highest incidence rates in Europe.

Conclusion

While the study confirms overall stable incidence trends in Italy, it also highlights an increase in specific cancers such as melanoma and thyroid tumours in adolescents. Central Italy exhibited higher incidence rates, potentially due to environmental and/or diagnostic factors. Continuous monitoring and further research are needed to clarify regional variations and evaluate the impact of early diagnosis and environmental exposures.

儿童癌症是罕见的，然而，意大利以前的发病率是欧洲最高的，是儿童和青少年死亡的主要原因。这项研究更新了意大利2008-2017年的数据，分析了1998年以来的趋势，并将研究结果与其他欧洲地区进行了比较。方法采用基于人群的方法，利用意大利癌症登记协会（AIRTUM）的数据。31个癌症登记处提供了肿瘤类型、年龄、性别、居住地和诊断日期的数据，覆盖了77% 意大利儿科人口。使用国际儿童癌症分类第三版（ICCC-3）对癌症进行分类。计算年龄特异性发病率（IR）和年龄标准化发病率（ASR），并使用Joinpoint回归分析趋势，以估计年（APC）和平均年百分比变化（AAPC）。结果2008-2017年，意大利共报告小儿恶性肿瘤17322例。年龄标准化发病率（ASR） 0-14岁为166.8 /百万人，15-19岁青少年为294.3 /百万人。在研究期间，发病率总体稳定，但观察到儿童骨肿瘤和青少年甲状腺和黑色素瘤的发病率显著增加。与意大利其他地区相比，意大利中部的发病率更高。意大利仍然是欧洲发病率最高的国家之一。结论：虽然该研究证实了意大利总体稳定的发病率趋势，但它也强调了青少年中黑色素瘤和甲状腺肿瘤等特定癌症的增加。意大利中部的发病率较高，可能是由于环境和/或诊断因素。需要持续监测和进一步研究，以澄清区域差异，并评估早期诊断和环境暴露的影响。

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引用次数: 0

Use of population-based cancer registries for cancer surveillance and control in Latin America 在拉丁美洲使用基于人群的癌症登记进行癌症监测和控制

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-09-10 DOI: 10.1016/j.canep.2025.102914

Esperanza Peña-Torres , Esther de Vries , Marianna de Camargo Cancela , Marion Piñeros-Petersen

Background

Population-based cancer registries (PBCRs) are essential for guiding cancer control strategies. In Latin America (LATAM), progress has been made in expanding the number of PBCRs, but their effective use in cancer control remains limited. This study assessed the current utilization of PBCR data, identified barriers and facilitators, and explored opportunities to strengthen their role in cancer control across the region.

Methods

A cross-sectional electronic survey was conducted among 81 PBCRs in LATAM between November 2023 and February 2024. Forty-three PBCRs (53.1 %) responded. The survey included questions on registry operations, data availability and dissemination, research participation, and involvement in cancer control. Open-ended responses were analyzed thematically.

Results

Most registries were subnational (93 %) and hosted by local health authorities. Staffing was limited (≤5 staff in 65 %), and population coverage varied. Although 90.7 % accessed mortality data and personal identifiers, only 70 % collected staging data for screen-detectable cancers, and staging was reported in under 40 % of cases. While 84.1 % shared data for research and 68.1 % participated in research, only 39.5 % were involved in prevention studies. Data publication was often delayed, with only 44.2 % having incidence data beyond 2018. Fewer than half had published data in the past five years, and engagement with decision-makers or use in screening and palliative care programs was rare. Common barriers included limited data sources, staff shortages, fragmented medical records, and low stakeholder awareness of PBCR functions.

Conclusions

Despite expanded numbers of PBCR in LATAM, their usage and integration into cancer control remains limited. Strengthening institutional support, improving data quality and recollection, as well as enhancing collaboration with health authorities and researchers are critical for maximizing the impact of PBCRs in cancer control across the region.

基于人群的癌症登记（PBCRs）对于指导癌症控制策略至关重要。在拉丁美洲（LATAM），在扩大pbcr数量方面取得了进展，但它们在癌症控制中的有效使用仍然有限。本研究评估了PBCR数据的当前利用情况，确定了障碍和促进因素，并探索了在整个地区加强PBCR数据在癌症控制中的作用的机会。方法于2023年11月至2024年2月对拉丁美洲81例pbcr进行了横断面电子调查。43个pbcr（53.1 %）做出了回应。调查的问题包括登记操作、数据可用性和传播、研究参与以及参与癌症控制。对开放式回答进行主题分析。结果大多数注册中心为次国家级（93 %），由地方卫生主管部门主办。人员配备有限（65% %≤5名人员），人口覆盖率各不相同。虽然90.7% %的人访问了死亡率数据和个人标识符，但只有70% %的人收集了筛查可检测癌症的分期数据，并且在不到40% %的病例中报告了分期。84.1 %的人共享研究数据，68.1 %的人参与研究，只有39.5 %的人参与预防研究。数据发布经常被推迟，只有44.2% %拥有2018年以后的发病率数据。在过去的五年里，只有不到一半的人发表过数据，与决策者接触或在筛查和姑息治疗项目中使用的情况很少。常见的障碍包括数据源有限、工作人员短缺、医疗记录碎片化以及利益相关者对PBCR职能的认识较低。结论：尽管PBCR在拉美地区的数量有所增加，但其在癌症控制中的应用和整合仍然有限。加强机构支持、改进数据质量和回忆，以及加强与卫生当局和研究人员的合作，对于最大限度地发挥多溴链抗体在整个区域癌症控制中的作用至关重要。

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引用次数: 0

Long-term environmental background radiation is associated with urinary tract cancer incidence: A population-based study from Finland 长期环境本底辐射与尿路癌发病率相关：芬兰一项基于人群的研究

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-09-10 DOI: 10.1016/j.canep.2025.102912

Peng Li , Mikko Myrskylä , Pekka Martikainen

Background

The long-term carcinogenic effects of natural radioactive elements in the environmental background on urinary tract cancer (UTC) have not been fully investigated in the general population.

Methods

The entire Finnish population was linked to long-term municipality-level data on concentrations of uranium and radon in water and radon in indoor air by residential location annually between 1987 and 2016, and UTC incidence was tracked until 2021 based on multiple registries. The first principal component (PC1) of the three radiation exposures was used as a proxy for radiation exposure, and was assessed using the Cox proportional hazards model for its association with UTC risk. Age-standardized incidence rates (ASR) and population attributable fractions (PAF) of radiation exposure were estimated. Spatial association between regional radiation exposure and UTC risk was assessed.

Results

Among a total of 2,816,495 residents with 30-year exposure data, 6718 primary UTC cases were diagnosed during 2017–2021. UTC risk increased significantly with each standard deviation (SD) increase in PC1 (hazard ratio [HR] = 1.05, 95 %CI 1.02–1.07). Dose-response relationship was observed when exposure was modelled via natural cubic splines. Increasing UTC incidence was observed across exposure quintiles (lowest quintile: ASR = 47, 95 % CI 45–50; highest quintile: ASR = 53, 95 %CI 50–55). About 5.1 % (PAF, 95 %CI 0.5 %–9.7 %) of UTC incidence was attributable to radiation exposure. Stronger association (HR=1.06, 95 %CI 1.03–1.09, per 1-SD increase) and attributable fraction (PAF = 9.0 %, 95 %CI 3.2 %–14.8 %) were observed among men than among women. Regional UTC risk was significantly associated with regional radiation exposure adjusted for the spatial lag effect in the total population (β = 0.08, p < 0.01), men (β = 0.07, p < 0.01) and women (β = 0.1, p = 0.02).

Conclusion

Association between long-term environmental radiation exposure and UTC risk was observed in the Finnish population. Dose-response patterns were observed, especially among men. UTC risks attributable to radiation exposure and geographical patterns warrant further investigations.

环境背景中天然放射性元素对尿路癌（UTC）的长期致癌作用尚未在普通人群中得到充分研究。方法在1987年至2016年期间，所有芬兰人口每年都与按居住地点划分的市级水和室内空气中铀和氡浓度的长期数据相关联，并基于多个登记跟踪UTC发病率至2021年。使用三种辐射暴露的第一主成分（PC1）作为辐射暴露的代表，并使用Cox比例风险模型评估其与UTC风险的关联。估计辐射暴露的年龄标准化发病率（ASR）和人口归因分数（PAF）。评估了区域辐射暴露与UTC风险之间的空间关联。结果在共有2,816,495名具有30年暴露数据的居民中，2017-2021年期间诊断出6718例原发性UTC病例。随着PC1每增加一个标准差（SD）， UTC风险显著增加（风险比[HR] = 1.05, 95 %CI 1.02-1.07）。通过自然三次样条模拟暴露时，观察到剂量-反应关系。暴露五分位数中观察到UTC发病率增加（最低五分位数：ASR = 47, 95 %CI 45-50；最高五分位数：ASR = 53, 95 %CI 50-55）。约5.1 % （PAF, 95 %CI, 0.5 % -9.7 %）的UTC发病率可归因于辐射暴露。男性比女性有更强的相关性（HR=1.06, 95 %CI 1.03-1.09，每增加1-SD）和归因分数（PAF = 9.0 %,95 %CI 3.2 % -14.8 %）。区域UTC风险与总人口（β = 0.08, p <； 0.01）、男性（β = 0.07, p <； 0.01）和女性（β = 0.1, p = 0.02）的区域辐射暴露显著相关。结论：在芬兰人群中观察到长期环境辐射暴露与UTC风险之间的关联。观察到剂量-反应模式，特别是在男性中。可归因于辐射暴露和地理模式的UTC风险值得进一步调查。

{"title":"Long-term environmental background radiation is associated with urinary tract cancer incidence: A population-based study from Finland","authors":"Peng Li , Mikko Myrskylä , Pekka Martikainen","doi":"10.1016/j.canep.2025.102912","DOIUrl":"10.1016/j.canep.2025.102912","url":null,"abstract":"<div><h3>Background</h3><div>The long-term carcinogenic effects of natural radioactive elements in the environmental background on urinary tract cancer (UTC) have not been fully investigated in the general population.</div></div><div><h3>Methods</h3><div>The entire Finnish population was linked to long-term municipality-level data on concentrations of uranium and radon in water and radon in indoor air by residential location annually between 1987 and 2016, and UTC incidence was tracked until 2021 based on multiple registries. The first principal component (PC1) of the three radiation exposures was used as a proxy for radiation exposure, and was assessed using the Cox proportional hazards model for its association with UTC risk. Age-standardized incidence rates (ASR) and population attributable fractions (PAF) of radiation exposure were estimated. Spatial association between regional radiation exposure and UTC risk was assessed.</div></div><div><h3>Results</h3><div>Among a total of 2,816,495 residents with 30-year exposure data, 6718 primary UTC cases were diagnosed during 2017–2021. UTC risk increased significantly with each standard deviation (SD) increase in PC1 (hazard ratio [HR] = 1.05, 95 %CI 1.02–1.07). Dose-response relationship was observed when exposure was modelled via natural cubic splines. Increasing UTC incidence was observed across exposure quintiles (lowest quintile: ASR = 47, 95 % CI 45–50; highest quintile: ASR = 53, 95 %CI 50–55). About 5.1 % (PAF, 95 %CI 0.5 %–9.7 %) of UTC incidence was attributable to radiation exposure. Stronger association (HR=1.06, 95 %CI 1.03–1.09, per 1-SD increase) and attributable fraction (PAF = 9.0 %, 95 %CI 3.2 %–14.8 %) were observed among men than among women. Regional UTC risk was significantly associated with regional radiation exposure adjusted for the spatial lag effect in the total population (<em>β</em> = 0.08, <em>p</em> < 0.01), men (<em>β</em> = 0.07, <em>p</em> < 0<em>.</em>01) and women (<em>β</em> = 0.1, <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Association between long-term environmental radiation exposure and UTC risk was observed in the Finnish population. Dose-response patterns were observed, especially among men. UTC risks attributable to radiation exposure and geographical patterns warrant further investigations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102912"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027125","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

Epidemiology of early-onset breast cancer in Golestan, North of Iran, 2004–2019: Disparities across residential place and ethnic region 2004-2019年伊朗北部戈列斯坦早发性乳腺癌流行病学：不同居住地和民族地区的差异

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-09-09 DOI: 10.1016/j.canep.2025.102922

Atefeh Gouglani , Somayeh Livani , Nastaran Haghshenas , Moosarreza Shabihi , SeyedAhmad Hosseini , Hamideh Sadeghzadeh , Fatemeh Ghasemi-Kebria , Saeed Golfiroozi , Gholamreza Roshandel

Introduction

Early-onset breast cancer (EOBC), diagnosed in women under 45 years, is a significant health issue worldwide. Understanding the epidemiology of EOBC is crucial for developing effective prevention and detection programs. We aimed to examine EOBC incidence and temporal trends in Golestan, North of Iran, from 2004 to 2019, across ethnic regions (Turkmens vs. non-Turkmens) and place of residence (urban vs. rural).

Methods

Data on the incidence of EOBC were obtained from the Golestan Population-based Cancer Registry (GPCR). Age-standardized incidence rate (ASR) was calculated and reported per 100,000 person-years. Temporal trends in the incidence of EOBC were investigated by calculating estimated annual percent changes (EAPC).

Results

Overall, 1809 new cases of EOBC were registered by GPCR during 2004–2019, with an ASR of 14.02 per 100,000, and higher rates in urban (ASR = 16.63) compared to rural areas (10.94). The non-Turkmens region (16.50) had significantly higher incidence rates of EOBC than the Turkmens region (10.53). Our findings suggested a significant increasing trend in the incidence of EOBC in Golestan (EAPC = 3.00; 95 %CI: 0.07–6.00). Notably, rural areas experienced a steeper rise (EAPC = 4.82) compared to urban areas (EAPC = 1.88), which was statistically significant in both Turkmens and non-Turkmens regions.

Conclusion

EOBC rates in Golestan were above the global average, with higher rates in urban and non-Turkmens populations. Our findings also suggested significant increasing trends in the incidence of EOBC, with greater changes in rural residents. These findings highlight the need for targeted interventions and early detection strategies in the region.

早发性乳腺癌（EOBC）在45岁以下妇女中被诊断出来，是世界范围内的一个重大健康问题。了解EOBC的流行病学对于制定有效的预防和检测方案至关重要。我们的目的是研究2004年至2019年伊朗北部Golestan的EOBC发病率和时间趋势，跨越民族地区（土库曼人与非土库曼人）和居住地（城市与农村）。方法EOBC发病率数据来自Golestan基于人群的癌症登记处（GPCR）。计算并报告每10万人年的年龄标准化发病率（ASR）。通过计算估计年百分比变化（EAPC）来研究EOBC发病率的时间趋势。结果2004-2019年，GPCR共登记了1809例EOBC新发病例，ASR为14.02 / 10万，城市ASR为16.63 / 10万，高于农村（10.94 / 10万）。非土库曼地区的EOBC发病率（16.50）明显高于土库曼地区（10.53）。我们的研究结果表明，EOBC在Golestan的发病率有显著增加的趋势（EAPC = 3.00; 95 %CI: 0.07-6.00）。值得注意的是，与城市地区（EAPC = 1.88）相比，农村地区的EAPC上升幅度更大（EAPC = 4.82），这在土库曼和非土库曼地区都具有统计学意义。结论土库曼斯坦eobc患病率高于全球平均水平，城市和非土库曼人群eobc患病率较高。我们的研究结果还表明，EOBC的发病率有显著增加的趋势，其中农村居民的变化更大。这些发现突出表明，该地区需要有针对性的干预措施和早期发现战略。

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引用次数: 0

Socioeconomic, health-related and geographical risk factors for locally advanced keratinocyte carcinoma: A nationwide population-based study in Denmark 当地晚期角化细胞癌的社会经济、健康相关和地理危险因素：丹麦一项基于全国人群的研究

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-12-01 Epub Date: 2025-09-23 DOI: 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.

大多数角化细胞癌（KC）是局部和缓慢生长的。然而，对于一些患者，KC可能成为局部晚期病变，并导致大量组织损伤，需要广泛的手术治疗。我们希望探索局部晚期疾病的危险因素，以提供更及时的诊断和治疗。方法：本研究采用多变量logistic回归分析，对2007年至2021年首次诊断为基底细胞癌（BCC）或鳞状细胞癌（SCC）的患者进行人口统计学因素、教育水平、可支配收入、同居状况、共病和居住地区与肿瘤(T)类别的关系进行研究。结果共发现166,467例BCC和36,609例SCC患者。男性、老年、低教育水平和可支配收入、独居和合并症与发生≥T2肿瘤的较高几率相关。首都地区以外的居住地增加了本地晚期BCC的风险，而在新西兰、中部和北部地区，本地晚期SCC的风险更高。结论社会经济地位、合并症、居住地区与BCC和SCC发生≥T2肿瘤的风险有显著相关性。加强早期发现和治疗的努力应侧重于弱势群体。

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引用次数: 0