Cancer Epidemiology最新文献_第8页

The impact of delayed screening colonoscopies during the COVID-19 pandemic on clinical outcomes COVID-19 大流行期间延迟结肠镜筛查对临床结果的影响。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-31 DOI: 10.1016/j.canep.2024.102629

Róisín McCarthy , Thérèse Mooney , Patricia Fitzpatrick , Rachel A. Kennedy , Hilary Coffey , Mary Sheedy , Padraic MacMathúna

Background

Colorectal cancer (CRC) screening services in Ireland were cancelled or postponed for periods during the COVID-19 pandemic. The aim of this study was to assess the impact of screening colonoscopy delays after a positive FIT on clinical and histopathological outcomes due to these restrictions.

Methods

Participants in the Irish National Bowel Screening Programme with a positive Immunochemical Faecal Test (FIT) during the COVID-19 pandemic (March 2020-December 2021) were included. Patients were categorised into attended for a colonoscopy <3 months and attended for colonoscopy ≥3–17 months post positive FIT. Chi-Square Test of independence was performed using WinPepi.

Results

3227 individuals had a complete index colonoscopy <3 months and 262 attended colonoscopy from ≥3 to 17 months post positive FIT. Of the clients whose colonoscopy was between ≥3–17 months from positive FIT, the median wait time was 3 months. There was no significant difference found between the two groups for CRC (5.8 % vs 5.0 %, p=0.544) or for the proportion of cancer stage I, stage II and unknown (33.7 %, 40.6 %, 25.7 %, p=0.411). There was no difference in the proportions of adenomas (57.8 % vs 58.4 %, p=0.849) and the proportion of advanced adenomas (7.7 % vs 10.7 %, p=0.077) detected between the two groups. A similar proportion of polyps were detected in individuals whose index colonoscopies were postponed <3 months from positive FIT (66.9 % vs 66 %, p=0.786).

Conclusion

A median delay of 3 months in screening colonoscopies after a positive FIT does not adversely impact clinical or histopathological outcomes. There was no significant difference in cancer staging, advanced adenomas or polyps detected between those who attended colonoscopies <3 months and ≥3–17 months post positive FIT. COVID-19 related disruptions to the normal functioning of the Irish bowel screening programme did not compromise our key objectives of advanced adenoma and cancer detection.

背景：在 COVID-19 大流行期间，爱尔兰的结直肠癌 (CRC) 筛查服务被取消或推迟了一段时间。本研究旨在评估因这些限制而导致 FIT 阳性后结肠镜筛查延迟对临床和组织病理学结果的影响：方法：纳入在 COVID-19 大流行期间（2020 年 3 月至 2021 年 12 月）粪便免疫化学检验（FIT）呈阳性的爱尔兰国家肠道筛查计划参与者。结果：3227 人进行了完整的结肠镜检查：3227 人接受了完整的结肠镜检查结论：结肠镜检查的中位延迟时间为 3 个月：FIT 阳性后中位延迟 3 个月进行结肠镜筛查不会对临床或组织病理学结果产生不利影响。接受结肠镜检查的患者在癌症分期、晚期腺瘤或息肉检出率方面没有明显差异

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引用次数: 0

Cancer incidence in ELSA-Brasil: Making the case for population based cancer registries in Brazil ELSA-Brasil 的癌症发病率：为巴西基于人口的癌症登记提供依据。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-30 DOI: 10.1016/j.canep.2024.102638

Gil Patrus Pena

引用次数: 0

2D:4D digit ratio as a potential marker for prostate cancer risk 作为前列腺癌风险潜在标志物的 2D:4D 数字比率。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-30 DOI: 10.1016/j.canep.2024.102635

Leslie Kouam , Belinda Nicolau , Marie-Claude Rousseau , Hugues Richard , Philippe Corsenac , Marie-Elise Parent

Background

The second-to-fourth digit ratio (2D:4D) is thought to reflect prenatal exposure to sex steroids. We investigated the relationship between 2D:4D and odds of prostate cancer.

Method

Data were collected in PROtEuS, a population-based case-control study conducted in Montréal, Canada (2005–2012), including 1931 incident prostate cancer cases aged < 76 years and 1994 population controls. In-person interviews elicited information on potential risk factors. Digit lengths were measured by interviewers applying a standard protocol. Odds ratios (OR) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders.

Results

The OR of prostate cancer for a standard deviation increase in 2D:4D was 0.91 (95 % CI: 0.85–0.98). For less and more aggressive cancers, ORs were 0.93 (95 % CI: 0.87–1.00) and 0.85 (95 % CI: 0.77–0.93), respectively. There was an interaction with ancestry (p=0.04), whereas the OR among men of African descent was 1.23 (95 % CI: 0.96–1.57, based on 128 cases).

Conclusion

Findings suggest an inverse association between 2D:4D and odds of overall prostate cancer, more pronounced for aggressive cancers. This supports the notion that high levels of testosterone in utero, estimated by a low 2D:4D ratio, are associated with a higher risk of prostate cancer. Contrastingly, a high digit ratio was associated with greater cancer odds among participants of African descent. Upon replication, 2D:4D could prove to be an easily measured marker of prostate cancer risk.

背景：第二位数字与第四位数字之比（2D:4D）被认为反映了产前接触性类固醇的情况。我们研究了 2D:4D 与前列腺癌几率之间的关系：PROtEuS是一项基于人口的病例对照研究（2005-2012年），研究对象包括1931名年龄小于76岁的前列腺癌病例和1994名对照人群。通过面谈了解了潜在风险因素的相关信息。访谈者按照标准协议测量了数字长度。采用无条件逻辑回归法估算了比值比 (OR) 和 95 % 置信区间 (CI)，并对潜在的混杂因素进行了调整：2D:4D 标准差每增加一个标准差，前列腺癌的发病率为 0.91（95 % 置信区间：0.85-0.98）。对于侵袭性较低和侵袭性较高的癌症，OR 分别为 0.93（95 % CI：0.87-1.00）和 0.85（95 % CI：0.77-0.93）。非洲裔男性的OR值为1.23（95 % CI：0.96-1.57，基于128个病例）：研究结果表明，2D:4D 与前列腺癌的发病率呈反比关系，在侵袭性癌症中更为明显。这支持了子宫内睾酮水平高（根据低 2D:4D 比值估算）与前列腺癌风险高相关的观点。与此形成鲜明对比的是，在非洲裔参与者中，高位数比率与更高的癌症几率有关。经复制后，2D:4D 可被证明是一种易于测量的前列腺癌风险标志物。

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引用次数: 0

Association of Helicobacter pylori infection with colorectal polyps/adenomas: A single-center cross-sectional study 幽门螺杆菌感染与大肠息肉/腺瘤的关系：单中心横断面研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-29 DOI: 10.1016/j.canep.2024.102626

Lan Chen , Rongrong Cao , Jie Han , Honglu Yu , Yingchao Li , Xiaomin Wang , Jiang Chen , Xingshun Qi

Background

Helicobacter pylori (H. pylori) infection may be associated with colorectal polyps/adenomas, but the current evidence remains controversial.

Methods

We retrospectively screened the medical records of 655 participants who underwent both colonoscopy and H. pylori test from June 15, 2020 to April 30, 2023. The number, size, location, and pathological type of colorectal polyps/adenomas were compared between H. pylori positive and negative groups. Adjusting for age, gender, smoking, drinking, hypertension, diabetes, fatty liver, body mass index, and inflammatory and metabolic indicators, multivariate logistic regression analyses were performed to evaluate the association of H. pylori infection with the number, size, location, and pathological type of colorectal polyps/adenomas, where no polyp/adenoma was used as reference.

Results

Overall, 508 participants were included, of whom 154 and 354 were divided into H. pylori positive and negative groups, respectively. H. pylori positive group had significantly higher colorectal polyps/adenomas (74.7 % vs. 65.8 %, P=0.048), low-grade adenomas (55.7 % vs. 47.6 %, P=0.026), advanced adenomas (22.6 % vs. 13.3 %, P=0.008), and colorectal polyps/adenomas with sizes of ≥6 mm (61.7 % vs. 48.5 %, P=0.002) and ≥10 mm (25.2 % vs. 14.6 %, P=0.004) than H. pylori negative group. In multivariate logistic regression analyses, H. pylori infection was independently associated with low-grade adenomas (OR=2.677, 95 %CI=1.283–5.587, P=0.009), advanced adenomas (OR=3.017, 95 %CI=1.007–9.036, P=0.049), right-side colon polyps/adenomas (OR=5.553, 95 %CI=1.679–18.360, P=0.005), and colorectal polyps/adenomas with sizes of ≥10 mm (OR=4.436, 95 %CI=1.478–13.310, P=0.008), but not number of colorectal polyps/adenomas.

Conclusion

H. pylori infection is associated with increased risk of colorectal polyps/adenomas, especially low-grade adenomas, advanced adenomas, right-side colon polyps/adenomas, and large colorectal polyps/adenomas.

背景：幽门螺杆菌（H：幽门螺杆菌（H. pylori）感染可能与结直肠息肉/腺瘤有关，但目前的证据仍存在争议：我们回顾性地筛选了 2020 年 6 月 15 日至 2023 年 4 月 30 日期间接受结肠镜检查和幽门螺杆菌检测的 655 名参与者的医疗记录。比较了幽门螺杆菌阳性组和阴性组大肠息肉/腺瘤的数量、大小、位置和病理类型。在对年龄、性别、吸烟、饮酒、高血压、糖尿病、脂肪肝、体重指数以及炎症和代谢指标进行调整后，进行了多变量逻辑回归分析，以评估幽门螺杆菌感染与结直肠息肉/腺瘤的数量、大小、位置和病理类型之间的关系，并以无息肉/腺瘤作为参考：共纳入 508 名参与者，其中幽门螺杆菌阳性组和阴性组分别为 154 人和 354 人。幽门螺杆菌阳性组的结直肠息肉/腺瘤（74.7% vs. 65.8%，P=0.048）、低级别腺瘤（55.7% vs. 47.6%，P=0.026）、晚期腺瘤（22.6% vs. 13.3%，P=0.048）明显高于阴性组。与幽门螺杆菌阴性组相比，低分级腺瘤（55.7% vs. 47.6%，P=0.026）、晚期腺瘤（22.6% vs. 13.3%，P=0.008）和结直肠息肉/腺瘤的大小≥6 毫米（61.7% vs. 48.5%，P=0.002）和≥10 毫米（25.2% vs. 14.6%，P=0.004）的发病率更高。在多变量逻辑回归分析中，幽门螺杆菌感染与低级别腺瘤（OR=2.677，95 %CI=1.283-5.587，P=0.009）、晚期腺瘤（OR=3.017，95 %CI=1.007-9.036，P=0.049）、右侧结肠息肉/腺瘤（OR=5.553，95 %CI=1.679-18.360，P=0.005）和大小≥10 mm的结直肠息肉/腺瘤（OR=4.436，95 %CI=1.478-13.310，P=0.008），但与结直肠息肉/腺瘤的数量无关：结论：幽门螺杆菌感染与大肠息肉/腺瘤风险增加有关，尤其是低级别腺瘤、晚期腺瘤、右侧结肠息肉/腺瘤和大肠息肉/腺瘤。

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引用次数: 0

The food environment and hypertension: A cross-sectional analysis in Black breast cancer survivors in Maryland 食物环境与高血压：马里兰州黑人乳腺癌幸存者的横断面分析。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-26 DOI: 10.1016/j.canep.2024.102634

Yanxin Tu , Katherine L. Ho , Kate E. Dibble , Kala Visvanathan , Avonne E. Connor

Objectives

The Food Environment Index (FEI) has shown varying positive impacts on health outcomes related to diabetes, obesity, and hypertension. However, a relationship between FEI and hypertension among breast cancer (BC) survivors, particularly Black women survivors, remains underexplored. Black women who are BC survivors have a high prevalence of hypertension and increased risk of mortality compared to White women with BC. Our analysis aims to fill this gap by assessing the FEI's association with hypertension in this population.

Design

Utilizing social media recruitment strategies and BC survivor networks, 100 Black female BC survivors completed an online survey, that included sociodemographic and clinical characteristics as well as lifestyle factors. The 2023 FEI County Health Rankings was used to assess the food environment and the index ranges from 0 (worst) to 10 (best). Adjusted prevalence odds ratios (PORs) and 95 % confidence intervals (CI) were calculated for the associations between FEI, sociodemographic and clinical factors, and hypertension status.

Results

Among the 94 study participants with data on hypertension status, 54.3 % reported a diagnosis of hypertension. Residing in counties with a below-median FEI (<8.8 v. above median: ≥8.8) was significantly associated with hypertension (POR = 4.10, 95 % CI: 1.19–14.13). Age at survey (≥50 years compared to <50 years: POR= 0.29, 95 % CI: 0.10–0.87) and household income ($75,000-$99,999 compared to > $99,999/year: POR = 12.02, 95 % CI: 2.08–69.43) were also significantly associated with hypertension.

Conclusion

Our study highlights the potential impact of the food environment on hypertension among Black BC survivors living in Maryland. Our findings call attention to the need for targeted interventions to improve food accessibility and quality in underserved communities, especially for special populations such as cancer survivors.

目的：食物环境指数（FEI）对糖尿病、肥胖症和高血压相关的健康结果有不同程度的积极影响。然而，FEI 与乳腺癌（BC）幸存者（尤其是黑人女性幸存者）高血压之间的关系仍未得到充分探讨。与患有乳腺癌的白人女性相比，作为乳腺癌幸存者的黑人女性高血压发病率高，死亡风险也更高。我们的分析旨在通过评估 FEI 与该人群高血压的关系来填补这一空白：设计：利用社交媒体招募策略和BC幸存者网络，100名BC黑人女性幸存者完成了一项在线调查，调查内容包括社会人口学特征、临床特征以及生活方式因素。2023年FEI县健康排名用于评估食品环境，指数从0（最差）到10（最佳）不等。针对 FEI、社会人口学和临床因素与高血压状况之间的关系，计算了调整后的患病几率比（POR）和 95 % 的置信区间（CI）：在 94 名有高血压状况数据的研究参与者中，54.3% 的人被诊断患有高血压。居住在 FEI 低于中位数（99,999 美元/年：POR = 12.02，95 % CI：2.08-69.43）的县也与高血压密切相关：我们的研究凸显了饮食环境对马里兰州黑人 BC 幸存者高血压的潜在影响。我们的研究结果提醒人们注意有必要采取有针对性的干预措施，以改善服务不足社区的食品可及性和质量，尤其是针对癌症幸存者等特殊人群。

{"title":"The food environment and hypertension: A cross-sectional analysis in Black breast cancer survivors in Maryland","authors":"Yanxin Tu , Katherine L. Ho , Kate E. Dibble , Kala Visvanathan , Avonne E. Connor","doi":"10.1016/j.canep.2024.102634","DOIUrl":"10.1016/j.canep.2024.102634","url":null,"abstract":"<div><h3>Objectives</h3><p>The Food Environment Index (FEI) has shown varying positive impacts on health outcomes related to diabetes, obesity, and hypertension. However, a relationship between FEI and hypertension among breast cancer (BC) survivors, particularly Black women survivors, remains underexplored. Black women who are BC survivors have a high prevalence of hypertension and increased risk of mortality compared to White women with BC. Our analysis aims to fill this gap by assessing the FEI's association with hypertension in this population.</p></div><div><h3>Design</h3><p>Utilizing social media recruitment strategies and BC survivor networks, 100 Black female BC survivors completed an online survey, that included sociodemographic and clinical characteristics as well as lifestyle factors. The 2023 FEI County Health Rankings was used to assess the food environment and the index ranges from 0 (worst) to 10 (best). Adjusted prevalence odds ratios (PORs) and 95 % confidence intervals (CI) were calculated for the associations between FEI, sociodemographic and clinical factors, and hypertension status.</p></div><div><h3>Results</h3><p>Among the 94 study participants with data on hypertension status, 54.3 % reported a diagnosis of hypertension. Residing in counties with a below-median FEI (<8.8 v. above median: ≥8.8) was significantly associated with hypertension (POR = 4.10, 95 % CI: 1.19–14.13). Age at survey (≥50 years compared to <50 years: POR= 0.29, 95 % CI: 0.10–0.87) and household income ($75,000-$99,999 compared to > $99,999/year: POR = 12.02, 95 % CI: 2.08–69.43) were also significantly associated with hypertension.</p></div><div><h3>Conclusion</h3><p>Our study highlights the potential impact of the food environment on hypertension among Black BC survivors living in Maryland. Our findings call attention to the need for targeted interventions to improve food accessibility and quality in underserved communities, especially for special populations such as cancer survivors.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"92 ","pages":"Article 102634"},"PeriodicalIF":2.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790117","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

Machine learning computational model to predict lung cancer using electronic medical records 利用电子病历预测肺癌的机器学习计算模型。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-24 DOI: 10.1016/j.canep.2024.102631

Matanel Levi , Teddy Lazebnik , Shiri Kushnir , Noga Yosef , Dekel Shlomi

Background

Lung cancer (LC) screening using low-dose computed tomography (CT) is recommended according to standard risk criteria or personalized risk calculators. Machine learning (ML) models that can predict disease risk are an emerging method in medicine for identifying hidden associations that are personally unique.

Materials and methods

Using the tree-based pipeline optimization tool (TPOT), we developed an ML-based model, which is an ensemble of the Random Forest and XGboost models, based on known risk factors for LC, as part of a larger trial for ML prediction using electronic medical records and chest CT. We used data from patients with LC vs. controls (1:2) of patients aged ≥ 35 years. We developed a model for all LC patients as well as for patients with and without a smoking background. We included age, gender, body mass index (BMI), smoking history, socioeconomic status (SES), history of chronic obstructive pulmonary disease (COPD)/emphysema/chronic bronchitis (CB), interstitial lung disease (ILD)/pulmonary fibrosis (PF), and family history of LC.

Results

Of the 4076 patients, 1428 (35 %) were in the LC group and 2648 (65 %) were in the control group. For the entire study population, our model achieved an accuracy of 71.2 %, with a sensitivity of 69 % and a positive predictive value (PPV) of 74 %. Higher accuracy was achieved for the two subgroups. An accuracy of 74.8 % (sensitivity 72 %, PPV 76 %) and 73.0 % (sensitivity 76 %, PPV 72 %) was achieved for the smoking and never-smoking cohorts, respectively. For the entire population and smoker cohort, COPD/emphysema/CB were the most important contributors, followed by BMI and age, while in the never-smoking cohort, BMI, age and SES were the most important contributors.

Conclusion

Known risk factors for LC could be used in ML models to modestly predict LC. Further studies are needed to confirm these results in new patients and to improve them.

背景：根据标准风险标准或个性化风险计算器推荐使用低剂量计算机断层扫描（CT）进行肺癌（LC）筛查。能够预测疾病风险的机器学习（ML）模型是医学界一种新兴的方法，可用于识别个人独特的隐性关联：我们使用基于树的管道优化工具（TPOT）开发了一个基于 ML 的模型，该模型是随机森林模型和 XGboost 模型的集合，以 LC 的已知风险因素为基础，是使用电子病历和胸部 CT 进行 ML 预测的大型试验的一部分。我们使用的数据来自年龄≥ 35 岁的 LC 患者与对照组患者（1:2）。我们为所有 LC 患者以及有吸烟背景和无吸烟背景的患者建立了一个模型。我们将年龄、性别、体重指数（BMI）、吸烟史、社会经济地位（SES）、慢性阻塞性肺病（COPD）/肺气肿/慢性支气管炎（CB）病史、间质性肺病（ILD）/肺纤维化（PF）病史以及 LC 家族史纳入了模型：在 4076 名患者中，1428 人（35%）属于 LC 组，2648 人（65%）属于对照组。在整个研究人群中，我们的模型准确率为 71.2%，灵敏度为 69%，阳性预测值 (PPV) 为 74%。两个亚组的准确率更高。吸烟人群和从不吸烟人群的准确率分别为 74.8%（灵敏度 72%，PPV 76%）和 73.0%（灵敏度 76%，PPV 72%）。在整个人群和吸烟人群中，慢性阻塞性肺病/肺气肿/慢性阻塞性肺病是最重要的诱因，其次是体重指数和年龄，而在从不吸烟人群中，体重指数、年龄和社会经济地位是最重要的诱因：结论：已知的 LC 风险因素可用于 ML 模型，以适度预测 LC。结论：已知的 LC 风险因素可用于 ML 模型以适度预测 LC。

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引用次数: 0

Epidemiological trends of synovial sarcoma by primary tumor sites in the US from 2000 to 2020 2000 年至 2020 年美国按原发肿瘤部位划分的滑膜肉瘤流行病学趋势。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-23 DOI: 10.1016/j.canep.2024.102627

Riddhi R. Patel , George L. Delclos , Stacia M. DeSantis , Michael B. Cannell , Philip J. Lupo , Patrick P. Lin , Dejka M. Araujo

Background

Synovial sarcoma (SS) is a rare soft-tissue cancer. Existing literature encompasses Surveillance, Epidemiology, and End Results (SEER) data-based research on SS explaining the incidence-prevalence in general, by subtypes, and by age at diagnosis. Therefore, this study aimed to fill in the gap of knowledge about measures of disease occurrence and burden of SS by tumor site using the SEER database.

Methods

In this cross-sectional study, primary SS patients were selected from SEER 17 Registries, Nov. 2021 (2000–2020) using ICD-O-3 codes 9040, 9041, 9042, and 9043. Patients with additional cancers were excluded. The primary tumor site was categorized into (1) head/neck, (2) internal thorax, (3) abdomen/pelvis, (4) upper extremity, and (5) lower extremity using ICD-10CM codes. Five outcomes were analyzed: age-adjusted incidence rate, 5-year limited-duration prevalence rate, incidence-based mortality, case-fatality rate, and overall survival.

Results

From 2000–2020, the overall age-adjusted incidence rate was 0.15 per 100,000; the 5-year limited duration prevalence rate was 0.56 per 100,000; and the incidence-based mortality rate was 0.06 per 100,000 people. The case-fatality and 5-year OS rates were 39.2 % and 62.9 %, respectively. Lower extremity had the highest incidence of 0.07 (estimated 1166 cases), prevalence of 0.36 (estimated 224 cases), and mortality rate of 0.025 (estimated 429 deaths) per 100,000. The other four locations had much closer rates with each other. Intrathoracic SS had the highest case-fatality rate of 71.5 % (148/207) and lowest 5-year OS of 26.0 % (95 % CI: 19.6 %, 32.9 %) than other sites.

Conclusion

Based on the measures of disease frequency, the most common primary tumor site is the lower extremity, followed by the upper extremity, abdomen/pelvis, internal thorax, and head/neck. The least favorable primary location is the internal thorax. Those with a primary location of the upper extremity have the longest overall survival, followed by the head/neck, lower extremity, abdomen/pelvis, and internal thorax.

背景：滑膜肉瘤（SS）是一种罕见的软组织癌症：滑膜肉瘤（SS）是一种罕见的软组织癌症。现有文献包括基于监测、流行病学和最终结果（SEER）数据的 SS 研究，这些研究解释了 SS 的总体发病率、亚型和诊断年龄。因此，本研究旨在利用 SEER 数据库填补有关按肿瘤部位划分的 SS 疾病发生率和负担测量方法的知识空白：在这项横断面研究中，使用 ICD-O-3 编码 9040、9041、9042 和 9043 从 SEER 17 Registries（2000-2020 年）中选取了原发性 SS 患者。排除了患有其他癌症的患者。使用 ICD-10CM 编码将原发肿瘤部位分为 (1) 头颈部、(2) 内胸部、(3) 腹部/骨盆、(4) 上肢和 (5) 下肢。分析了五项结果：年龄调整后发病率、5 年限期发病率、发病死亡率、病死率和总生存率：从 2000 年到 2020 年，经年龄调整后的总发病率为每 10 万人 0.15 例；5 年限期发病率为每 10 万人 0.56 例；基于发病率的死亡率为每 10 万人 0.06 例。病死率和5年OS率分别为39.2%和62.9%。下肢的发病率最高，为每 10 万人 0.07 例（估计有 1166 例），患病率为每 10 万人 0.36 例（估计有 224 例），死亡率为每 10 万人 0.025 例（估计有 429 例死亡）。其他四个地点的发病率更为接近。与其他部位相比，胸腔内 SS 的病死率最高，为 71.5 %（148/207），5 年 OS 最低，为 26.0 %（95 % CI：19.6 %，32.9 %）：根据发病频率的衡量标准，最常见的原发肿瘤部位是下肢，其次是上肢、腹部/骨盆、胸腔内部和头颈部。最不利的原发部位是胸腔内部。原发部位在上肢的患者总生存期最长，其次是头颈部、下肢、腹部/骨盆和胸腔内部。

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引用次数: 0

The association between height and risk of lung cancer subtypes in men and women in the Netherlands Cohort Study 荷兰队列研究中男性和女性身高与肺癌亚型风险之间的关系

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-17 DOI: 10.1016/j.canep.2024.102613

Huyen Le , Colinda C.J.M. Simons , Piet A. van den Brandt

Objectives

Previous studies found no or weak positive associations between height and lung cancer (LC) risk, with differences between sexes. Few studies stratified the association by smoking status and LC subtype. This prospective study investigated the association between height and risks of overall LC and LC subtypes (i.e., adenocarcinoma, squamous cell carcinoma, small cell carcinoma, large cell carcinoma) in Dutch men and women, with comprehensive adjustment for smoking, and stratified by smoking status.

Materials and methods

Data originate from 120,852 Dutch participants aged 55–69 in 1986 in the Netherlands Cohort Study. Self-reported height and potential confounders were collected at baseline. After 20.3 years of follow-up, 3318 LC cases (2765 men; 553 women) and 4314 subcohort members were included in the multivariable Cox regression analysis.

Results

There were no significant associations between height and risks of overall LC and LC subtypes in men and women, except for an increased adenocarcinoma risk in taller women (HR_{quartile4 vs quartile1}=1.62, 95% CI: 1.02–2.55, P_trend=0.031). This positive association was borderline statistically significant in female current smokers only when stratifying on smoking status. No interaction by smoking status was shown in women for any LC risk. In men, smoking modified the association between height and risks of overall LC, large cell and squamous cell carcinoma, with the p-values for interaction of 0.037, 0.007 and 0.050, respectively.

Conclusion

Positive associations between height and LC subtypes were predominantly seen in smokers. Further studies should focus on LC subtypes and stratify the association by smoking status.

目的以往的研究发现，身高与肺癌（LC）风险之间没有或仅有微弱的正相关关系，且男女之间存在差异。很少有研究根据吸烟状况和肺癌亚型对两者之间的关系进行分层。这项前瞻性研究调查了荷兰男性和女性身高与总体肺癌和肺癌亚型（即腺癌、鳞状细胞癌、小细胞癌、大细胞癌）风险之间的关系，对吸烟进行了全面调整，并按吸烟状况进行了分层。基线时收集了自我报告的身高和潜在的混杂因素。结果除了身高较高的女性患腺癌的风险增加外（HRquartile4 vs quartile1=1.62，95% CI：1.02-2.55，Ptrend=0.031），男性和女性的身高与总体 LC 和 LC 亚型的风险之间没有显著关联。只有在对吸烟状况进行分层时，这种正相关才会在当前吸烟的女性中具有边缘统计学意义。在女性中，任何低密度脂蛋白血症风险与吸烟状况都没有交互作用。在男性中，吸烟改变了身高与总体 LC、大细胞癌和鳞状细胞癌风险之间的关系，交互作用的 p 值分别为 0.037、0.007 和 0.050。进一步的研究应关注 LC 亚型，并根据吸烟状况对两者之间的关系进行分层。

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引用次数: 0

Evaluation of urban–rural difference in breast cancer mortality among Chinese women during 1987–2021: A hierarchical age-period-cohort analysis 1987-2021年间中国女性乳腺癌死亡率的城乡差异评估：分层年龄-时期-队列分析

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-16 DOI: 10.1016/j.canep.2024.102622

Chunhui Li, Zeyu Zhang

Background

Breast cancer mortality varies in urban and rural areas in China. Studies have reported urban–rural difference across time period, however, the evaluation on urban–rural differences in age and birth cohort effects is limited. Our aim was to quantitatively assess urban–rural disparities in age, period and cohort effects in breast cancer mortality in China.

Methods

We collected age-specific breast cancer mortality rates for urban and rural females aged 20–84 years from 1987 to 2021. Hierarchical age-period-cohort (HAPC) models were used to evaluate the effect of area (urban, rural) on breast cancer mortality and investigate urban–rural differences in age, time period and birth cohort effects.

Results

We found a significant area (urban, rural) effect on breast cancer mortality in that rural females had a lower mortality risk than urban females [−0.25 (95 % confidence interval (CI): −0.32, −0.17)]. Age trajectories of mortality based on the HAPC model showed nonlinear trends with adjustment for area variable. The urban–rural difference in age effect appeared to be divergent with age, and urban women had higher mortality risk in the senior age group. The urban–rural difference in birth cohort effect indicated a reversal around the birth cohort group of 1962–1966, after which rural females had a higher mortality risk than urban females.

Conclusion

The area (urban, rural) could affect breast cancer mortality among women, and the effect of urban–rural difference varies with age and birth cohort. To promote the health of urban and rural females, the gap between urban and rural areas should be shorten.

背景中国城乡乳腺癌死亡率存在差异。有研究报道了不同时期的城乡差异，但对年龄和出生队列效应的城乡差异评估却很有限。我们的目的是定量评估中国乳腺癌死亡率在年龄、时期和队列效应方面的城乡差异。结果我们发现地区（城市、农村）对乳腺癌死亡率有显著影响，农村女性的死亡风险低于城市女性[-0.25（95%置信区间（CI）：-0.32，-0.17）]。根据 HAPC 模型得出的死亡率年龄轨迹显示，在对地区变量进行调整后，死亡率呈非线性趋势。年龄效应的城乡差异似乎随着年龄的增长而变化，城市妇女在高年龄组的死亡风险更高。结论地区（城市、农村）会影响妇女的乳腺癌死亡率，城乡差异的影响随年龄和出生队列而变化。为促进城乡女性的健康，应缩小城乡差距。

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引用次数: 0

Demographic, clinical, and social characteristics of anal cancer among patients stratified by age (<50 and ≥50 years) in Alabama between 2012 and 2018 2012 年至 2018 年阿拉巴马州按年龄分层（<50 岁和≥50 岁）的肛门癌患者的人口、临床和社会特征

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2024-07-16 DOI: 10.1016/j.canep.2024.102612

Anna Junkins , Daniel I. Chu , Greer A. Burkholder , Howard W. Wiener , Justin George , Mirjam-Colette Kempf , Sadeep Shrestha

Background

Anal cancer is increasing globally, with a high number of new cases occurring in highly developed countries, including the U.S. The incidence of anal cancer is higher among people living with HIV (PLHIV), and the U.S. South continues to see higher HIV incidence rates and lagging HPV vaccination rates. We aimed to identify factors associated with early onset anal cancer in Alabama which may help explain cancer disparities in the South.

Methods

Using a cross-sectional study design, we examined demographic, clinical, and social characteristics among anal cancer patients stratified by diagnosis age (<50 and ≥50 years) in the Alabama cancer registry between 2012 and 2018. We used Wilcoxon rank sums and Pearson chi-square tests to assess associations between age at diagnosis, demographic (i.e., sex, race, marital status), clinical (i.e., BMI, HIV infection, site, stage, and histological type), and social (i.e. social vulnerability) characteristics, and multivariable logistic regression to estimate the odds of early onset cancer.

Results

Among 519 patients with anal cancer in Alabama, 92 (17.7 %) were diagnosed at <50 years. The majority of patients were female (66.5 %) and White (83.4 %). Male sex, Black race, and HIV infection were associated with younger age at diagnosis. Black patients had a 4-fold increased odds of early onset anal cancer compared to White patients (AOR=4.39, CI=1.54–12.49). Black patients disproportionately lived in areas with higher social vulnerability. About 42 % of patients in areas with the highest social vulnerability were diagnosed with stage 3 or 4 cancer. About 8 % of cases were among people aged 35–44 years, which is close to double the proportion of anal cancer cases in this age group in the U.S. (4.7 %).

Conclusions

Patients who are Black, male, and PLHIV may be at higher risk of early onset anal cancer compared to other populations in the South.

背景肛门癌在全球范围内呈上升趋势，包括美国在内的高度发达国家新发病例较多。肛门癌在艾滋病病毒感染者（PLHIV）中的发病率较高，而美国南部的艾滋病病毒感染者发病率仍然较高，HPV 疫苗接种率滞后。我们旨在确定与阿拉巴马州早发肛门癌相关的因素，这可能有助于解释南方的癌症差异。方法我们采用横断面研究设计，考察了 2012 年至 2018 年间阿拉巴马州癌症登记处按诊断年龄分层（<50 岁和≥50 岁）的肛门癌患者的人口、临床和社会特征。我们使用 Wilcoxon 秩和检验和皮尔逊卡方检验来评估诊断年龄、人口统计学特征（即性别、种族、婚姻状况）、临床特征（即、结果在阿拉巴马州的 519 名肛门癌患者中，92 人（17.7%）在 50 岁时确诊。大多数患者为女性（66.5%）和白人（83.4%）。男性、黑人和艾滋病毒感染与确诊年龄较小有关。与白人患者相比，黑人患者罹患早发肛门癌的几率增加了 4 倍（AOR=4.39，CI=1.54-12.49）。黑人患者大多生活在社会脆弱性较高的地区。在社会弱势程度最高的地区，约有 42% 的患者被诊断为 3 期或 4 期癌症。大约 8% 的病例发生在 35-44 岁的人群中，接近美国该年龄段肛门癌病例比例（4.7%）的两倍。

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引用次数: 0