Cancer Epidemiology最新文献_第8页

Calcium intake and gastric cancer risk: A systematic review and dose–response meta-analysis of observational studies 钙摄入与胃癌风险：观察性研究的系统回顾和剂量反应荟萃分析

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-10-03 DOI: 10.1016/j.canep.2025.102939

Alex Richard Costa Silva , Marcela de Araújo Fagundes , Valdete Regina Guandalini , Maria Paula Curado

Calcium has been proposed as a protective factor against certain types of cancer, but findings related to gastric cancer (GC) are inconsistent. This meta-analysis aimed to assess the association between calcium intake and the risk of GC. A comprehensive search was conducted in PubMed, Scopus, EMBASE, LILACS, and Web of Science for cohort and case-control studies published up to August 19, 2024. The quality of the studies was assessed using the Newcastle–Ottawa Scale. Publication bias was tested using Egger’s and Begg’s tests. Relative risks (RRs) and 95 % confidence intervals (CIs) were pooled through a random-effects model. Given the substantial heterogeneity and potential variation in intake levels across populations, a dose-response analysis was conducted to explore potential trends across the full range of calcium consumption. Thirteen studies involving 1,610,992 participants met the inclusion criteria. A non-significant inverse association was observed between total calcium intake and GC risk when comparing the highest vs lowest intake categories (RR: 0.85; 95 % CI: 0.70–1.05). While this categorical comparison was not statistically significant, the dose-response analysis revealed a significant linear protective effect, with a 10 % reduction in risk per 300 mg/day increase in dietary calcium intake (RR: 0.90; 95 % CI: 0.82–0.99). To account for potential variations across intake levels, a non-linear model was also applied, indicating a clearer risk reduction above 400 mg/day (p for non-linearity < 0.001). Overall, this dose-response meta-analysis suggests that higher dietary calcium intake may have a protective effect against GC, reinforcing the importance of considering calcium in dietary strategies for GC prevention, although more studies are needed to confirm these findings.

钙被认为是预防某些类型癌症的保护因素，但与胃癌（GC）相关的研究结果不一致。本荟萃分析旨在评估钙摄入量与胃癌风险之间的关系。综合检索PubMed、Scopus、EMBASE、LILACS和Web of Science，检索截止到2024年8月19日发表的队列和病例对照研究。研究的质量采用纽卡斯尔-渥太华量表进行评估。发表偏倚采用Egger’s和Begg’s检验。通过随机效应模型汇总相对风险（rr）和95% %置信区间（ci）。考虑到不同人群钙摄入水平的巨大异质性和潜在差异，我们进行了一项剂量反应分析，以探索全范围钙摄入的潜在趋势。13项研究涉及1,610,992名受试者符合纳入标准。当比较最高和最低钙摄入量类别时，观察到总钙摄入量与GC风险之间无显著负相关（RR: 0.85; 95 % CI: 0.70-1.05）。虽然这一分类比较没有统计学意义，但剂量-反应分析显示了显著的线性保护作用，每增加300 毫克/天的膳食钙摄入量，风险降低10 % （RR: 0.90; 95 % CI: 0.82-0.99）。为了解释摄入水平之间的潜在差异，还应用了非线性模型，表明400 mg/天以上的风险降低更明显（非线性<； 0.001）。总的来说，这项剂量-反应荟萃分析表明，较高的膳食钙摄入量可能对胃癌有保护作用，这加强了在饮食策略中考虑钙对胃癌预防的重要性，尽管需要更多的研究来证实这些发现。

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引用次数: 0

Validity of using general and cancer-specific health administrative data to identify treatment exposures in adolescents and young adults with cancer: A population-based study using the IMPACT cohort. 使用一般和癌症特异性健康管理数据来确定青少年和年轻癌症患者接受治疗的有效性：一项使用IMPACT队列的基于人群的研究

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-10-01 Epub Date: 2025-08-09 DOI: 10.1016/j.canep.2025.102902

Louise Guolla, Cindy Lau, Kelvin K W Chan, Paul C Nathan, Sumit Gupta

Introduction: Cancer treatment details (i.e., radiation site, chemotherapy dose) are required to conduct rigorous health services research but are difficult to obtain from administrative data. We conducted a validation study to ascertain the optimal algorithm for defining cancer treatment details in cancer-specific and general health administrative data using available chart-abstracted data from adolescent and young adult (AYA) cancer patients.

Methods: Health administrative data and cancer treatment data reported by visit in Ontario, Canada were compared separately and in a combined algorithm to a reference-standard chart-abstracted database of AYA cancer patients diagnosed in 2005-2012 (n = 1173). We tested algorithms for three tiers of treatment details: any chemotherapy/radiotherapy provided; type of chemotherapy/site of radiation; dose of chemotherapy/radiation. For each algorithm, we calculated sensitivity, specificity, positive predictive value, negative predictive value with 95 % confidence intervals (95 %CI) and simple kappa statistics, overall and according to cancer type, diagnosis period, and locus of care.

Results: General health administrative data had high sensitivity and specificity (> 80 %) for detection of any chemotherapy (n = 942) or radiation exposure (n = 412) and was not improved by using cancer-specific data. In 475 patients (40.5 %) with chemotherapy treatment records, sensitivity (22.4-59.6 %) and specificity (95.8-99.1 %) varied by chemotherapy type/class. Factors associated with missing records include locus of care (9.5 % in pediatric vs. 81.7 % in adult cancer centres), year of diagnosis, and type of cancer. There was moderate to strong correlation (r = 0.50-0.79) between dosing for the most common anthracyclines, combined alkylators, cisplatin, and bleomycin. For radiation treatment data (n = 406, 98.5 %), sensitivity and specificity for radiation site ranged from 73.4 % to 91.2 % and 96.6 % to 99.7 %, respectively, with strong dosing correlation (r = 0.63-0.95, by site).

Conclusions: Both general and cancer-specific health administrative data have value in determining receipt of chemotherapy and/or radiation and can be used reliably to create cohorts of exposed cancer patients. More granular information regarding dose and type of chemotherapy and dose and site of radiation therapy is highly specific but limited by variable sensitivity. Care should be taken when using the data to estimate prevalence, compare treated/untreated groups or when full capture of an exposed population is otherwise required as underestimations of the true effect may occur.

导言：癌症治疗细节（即放疗地点、化疗剂量）需要进行严格的卫生服务研究，但很难从行政数据中获得。我们进行了一项验证研究，以确定在癌症特异性和一般健康管理数据中定义癌症治疗细节的最佳算法，使用来自青少年和年轻成人（AYA）癌症患者的可用图表抽象数据。方法：将加拿大安大略省2005-2012年诊断为AYA癌症患者的卫生管理数据和就诊报告的癌症治疗数据分别与参考-标准图表-抽象数据库（n = 1173）进行联合算法比较。我们测试了三层治疗细节的算法：提供的任何化疗/放疗；化疗类型/放疗部位；化疗/放疗剂量。对于每种算法，我们计算敏感性、特异性、阳性预测值、阴性预测值，其95% %置信区间（95% %CI）和简单kappa统计，总体上并根据癌症类型、诊断期和护理地点进行统计。结果：一般健康管理数据对任何化疗（n = 942）或放射暴露（n = 412）的检测具有较高的敏感性和特异性（> 80 %），而使用癌症特异性数据没有提高。在475例有化疗记录的患者（40.5 %）中，敏感性（22.4-59.6 %）和特异性（95.8-99.1 %）因化疗类型/类别而异。与缺失记录相关的因素包括治疗地点（儿童为9.5% %，成人癌症中心为81.7 %）、诊断年份和癌症类型。最常见的蒽环类药物、联合烷基化剂、顺铂和博来霉素的剂量之间存在中度至强相关性（r = 0.50-0.79）。放射治疗数据(98.5 n = 406年  %),敏感性和特异性辐射站点范围从73.4 % 91.2 %和96.6 % 99.7 %,分别拥有强大剂量相关性(r = 0.63 - -0.95,通过网站)。结论：一般和癌症特异性的健康管理数据在确定接受化疗和/或放疗方面都有价值，并且可以可靠地用于创建暴露的癌症患者队列。关于化疗的剂量和类型以及放射治疗的剂量和部位的更细粒度的信息是高度特异性的，但受可变敏感性的限制。在使用数据估计流行率、比较治疗/未治疗组时，或在需要对暴露人群进行全面调查时，应小心谨慎，否则可能会低估真实效果。

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引用次数: 0

Global trends, future projections, and epidemiological associations of Mesothelioma: A comprehensive analysis from 1980 to 2050. 间皮瘤的全球趋势、未来预测和流行病学关联：1980年至2050年的综合分析。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-10-01 Epub Date: 2025-08-08 DOI: 10.1016/j.canep.2025.102900

Shanjie Luan, Yanqing Wang

Background: 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.

Methods: 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.

Results: 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.

Conclusions: Our findings provide the most up-to-date epidemiological insights into mesothelioma, highlighting its stable long-term burden, gender disparities, and socioeconomic influences.

背景：恶性间皮瘤是一种罕见但侵袭性的癌症，主要由职业性接触石棉引起。本研究旨在全面评估全球间皮瘤发病率和死亡率趋势，检查其与人类发展指数（HDI）的关系，预测到2050年的未来负担，并调查与其他恶性肿瘤的流行病学相关性。方法：我们从GBD 2021和GLOBOCAN 2022中提取间皮瘤发病率和死亡率数据，分别涵盖1980年至2022年的204个和185个国家。使用估计年百分比变化（EAPC）分析时间趋势，同时在六个高hdi国家应用年龄-时期-队列（APC）模型来评估代际负担转移。未来的预测是使用历史数据训练的年龄分层机器学习模型生成的，并针对多种预测方法进行验证。此外，使用线性和逻辑回归分析了间皮瘤与其他27种癌症的流行病学关联。结果：1990年至2021年间，全球间皮瘤发病率和死亡率略有下降(ASIR EAPC: -0.2[95 % UI: -0.32至-0.08]；ASDR EAPC: -0.23[95 % UI: -0.3至-0.16])。男性的负担明显高于女性，英国和澳大利亚报告的发病率和死亡率最高。观察到明显的HDI阈值效应，间皮瘤发病率在HDI 0.8以下保持稳定，但在此水平以上急剧上升。此外，间皮瘤与气管支气管肺癌、卵巢癌和霍奇金淋巴瘤有很强的正相关，提示可能存在共同的环境和职业危险因素。结论：我们的研究结果为间皮瘤提供了最新的流行病学见解，强调了其稳定的长期负担、性别差异和社会经济影响。

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引用次数: 0

Response to ‘reverse causality’ comment 对“反向因果关系”评论的回应。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-09-29 DOI: 10.1016/j.canep.2025.102928

Shan Zhang , Hongwei Wang , Jingjing Ji, Ruiyu Chai, Shiyi Song, Jikang Shi, Siyu Liu

This document is the authors' response to the received comments for manuscript CANEP-D-25–00912.

本文是作者对CANEP-D-25-00912稿件评论的回复。

引用次数: 0

10 Years of breast cancer treatment trends in Fars Province, report of Shiraz Breast Cancer Registry 法尔斯省10年乳腺癌治疗趋势，设拉子乳腺癌登记处报告

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-09-27 DOI: 10.1016/j.canep.2025.102937

Majid Akrami , Amirhesam Moosazadeh , Mehrdad Taghva , Nastaran Tavakolian , Marzieh Karami Rad , Zahra Keumarsi , Masoumeh Ghoddusi Johari , Vahid Zangouri

Background

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.

Methods

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.

Results

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.

Conclusion

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.

尽管全球推荐早期乳腺癌保乳手术（BCS）加放疗，但在伊朗等中低收入国家，关于手术趋势和生存结果的长期证据有限。了解这些模式对于改善治疗公平性和患者预后至关重要。本研究旨在评估伊朗法尔斯省乳腺癌手术入路选择的20年趋势，并比较BCS和乳房切除术的生存结果。方法从设拉子乳腺癌登记处提取2000年至2022年间诊断为乳腺癌的10091名妇女的数据。根据手术类型（BCS或乳房切除术）和放射治疗的接受情况将患者分为四组。采用Logistic回归分析确定影响治疗方案选择的因素。采用Kaplan-Meier分析生存率和复发率，采用Cox回归模型评价影响生存率的因素。结果2000年至2022年间，接受BCS +放疗的患者比例从30.5% %增加到73.8 %，超过了乳房切除术。BCS +放疗组预后最佳，乳腺癌特异性死亡率最低（6.2 %），复发率最低（10.2 %），10年BCS最高（96.01 %）。这些关联在多变量调整后仍然显著。结论：这项研究揭示了过去20年来伊朗南部向BCS加放疗的重大转变。与乳房切除术相比，BCS联合放疗具有更好的生存结果。然而，获得手术的障碍仍然使许多妇女无法获得最佳手术方法，这表明需要政策和卫生系统干预措施。

{"title":"10 Years of breast cancer treatment trends in Fars Province, report of Shiraz Breast Cancer Registry","authors":"Majid Akrami , Amirhesam Moosazadeh , Mehrdad Taghva , Nastaran Tavakolian , Marzieh Karami Rad , Zahra Keumarsi , Masoumeh Ghoddusi Johari , 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}

引用次数: 0

Global burden and international trends of laryngeal cancer incidence: A population-based study of recorded data and national estimates 喉癌发病率的全球负担和国际趋势：记录数据和国家估计的基于人群的研究。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-09-24 DOI: 10.1016/j.canep.2025.102935

Amanda Ramos da Cunha , Harriet Rumgay , Jerome Vignat , Mathieu Laversanne , Murielle Colombet , Maria Paula Curado , Gail Garvey , Sarbani Ghosh-Laskar , Brian O’Sullivan , Shama Virani , Isabelle Soerjomataram , Marion Piñeros

Laryngeal cancer shows considerable variation in global incidence, which has primarily been studied through national estimates. This study aims to analyse the global incidence of laryngeal cancer, comparing estimated and high-quality recorded data, and examine temporal trends to inform targeted prevention strategies. Estimated incidence rates for 2022 were obtained from the GLOBOCAN 2022 database for 185 countries. Recorded incidence data from population-based cancer registries (PBCRs) for the five-years period 2013–2017 were sourced from Cancer Incidence in Five Continents (CI5-XII). Temporal trends and the Estimated Annual Percent Change were assessed for 34 countries using the Global Cancer Observatory – Cancer Over Time database. The highest estimated age-standardized incidence rates (ASIRs) were observed in Cuba, Moldova, and Romania, particularly among males: 14.8, 12.2, and 10.3 per 100,000, respectively. Recorded data showed significant regional variability, with the highest ASIRs for males in Pskov, Russia (13.3 per 100,000) and the Azores, Portugal (11.8 per 100,000). Most countries exhibited a decline in laryngeal cancer rates among males, while trends among females remained largely stable. Our findings underscore the importance of PBCRs in identifying high-risk populations for developing laryngeal cancer. While national estimates are essential for understanding the global distribution of laryngeal cancer and other malignancies, they may overlook subnational variations. Expanding the coverage and quality of PBCRs is crucial for improving cancer surveillance and enhancing prevention and control efforts at national and global level.

喉癌在全球发病率中表现出相当大的差异，这主要是通过国家估计来研究的。本研究旨在分析喉癌的全球发病率，比较估计和高质量的记录数据，并研究时间趋势，为有针对性的预防策略提供信息。2022年的估计发病率来自185个国家的GLOBOCAN 2022数据库。2013-2017年五年期间基于人群的癌症登记处（pbcr）记录的发病率数据来自五大洲癌症发病率（CI5-XII）。使用全球癌症观察站-癌症随时间变化数据库评估了34个国家的时间趋势和估计的年度百分比变化。古巴、摩尔多瓦和罗马尼亚的估计年龄标准化发病率（asir）最高，尤其是男性：分别为14.8、12.2和10.3 / 10万。记录的数据显示了显著的区域差异，俄罗斯普斯科夫（13.3 / 10万）和葡萄牙亚速尔群岛（11.8 / 10万）的男性asir最高。大多数国家的男性喉癌发病率下降，而女性的趋势基本保持稳定。我们的研究结果强调了pbcr在识别喉癌高危人群中的重要性。虽然国家估计对于了解喉癌和其他恶性肿瘤的全球分布至关重要，但它们可能忽略了国家以下地区的差异。扩大pbcr的覆盖范围和质量对于在国家和全球层面改善癌症监测和加强预防和控制工作至关重要。

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引用次数: 0

Trends and disparities in locoregional treatment of programme-detected ductal carcinoma in situ in New Zealand women, 1999–2022 1999-2022年新西兰妇女原位导管癌局部区域治疗的趋势和差异

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-09-23 DOI: 10.1016/j.canep.2025.102934

Qian Chen , Ian Campbell , Mark Elwood , Alana Cavadino , Phyu Sin Aye , Sandar Tin Tin

Purpose

Ethnic and socioeconomic disparities exist in treatment of invasive breast cancer in New Zealand. This study investigated trends and disparities in locoregional treatment of ductal carcinoma in situ (DCIS) detected by BreastScreen Aotearoa (BSA), the national breast screening programme.

Methods

Women with programme-detected DCIS from 1999 to 2022 were identified from BSA records linked to the national cancer registry and hospital discharge records. Logistic regression identified associated factors.

Results

Of the 6087 cases identified, 39.7 % received breast-conserving surgery (BCS) with radiotherapy (RT), 31.5 % had mastectomy and 28.8 % had BCS alone. BCS with RT increased from 27.6 % in 1999 to 41.1 % in 2006, followed by a modest increase to 46.7 % in 2022, while mastectomy decreased from 33.3 % in 1999 to 25.4 % in 2022. The post-BCS RT use was less common among Pacific women. Sentinel lymph node biopsy (SLNB) increased from 6.2 % in 2004 (when it was implemented nationwide) to 26.0 % in 2007, then reached 37.1 % in 2013, before declining to 24.5 % in 2022. Pacific and Asian women who had mastectomy were more likely to have SLNB. Immediate breast reconstruction (IBR) after a mastectomy increased from 11.4 % in 1999 to 39.8 % in 2009, then underwent a modest decline to 22.7 % in 2022. Māori, older women, and those living in the deprived or rural areas were less likely to receive IBR.

Conclusion

Locoregional treatment for programme-detected DCIS has improved over time; however, ethnic and socioeconomic disparities persist, underscoring the need to improve equity of cancer care in New Zealand.

目的新西兰浸润性乳腺癌的治疗存在种族和社会经济差异。本研究调查了国家乳腺筛查项目乳腺筛查（breast screen Aotearoa， BSA）检测到的导管原位癌（DCIS）局部治疗的趋势和差异。方法从与国家癌症登记处和医院出院记录相关的BSA记录中确定1999年至2022年规划检测到DCIS的女性。逻辑回归确定了相关因素。结果在6087例病例中，39.7% %行保乳手术（BCS）加放疗（RT）， 31.5% %行乳房切除术，28.8% %单独行保乳手术。BCS与RT从1999年的27.6% %增加到2006年的41.1% %，随后适度增加到2022年的46.7% %，而乳房切除术从1999年的33.3% %下降到2022年的25.4% %。在太平洋地区妇女中，bcs后RT的使用不太常见。前哨淋巴结活检（SLNB）从2004年的6.2 %（当时在全国实施）增加到2007年的26.0% %，然后在2013年达到37.1% %，然后在2022年下降到24.5% %。切除乳房的太平洋和亚洲女性患SLNB的可能性更大。乳房切除术后立即乳房重建（IBR）从1999年的11.4% %增加到2009年的39.8% %，然后在2022年经历了温和的下降到22.7% %。Māori、老年妇女以及生活在贫困地区或农村地区的妇女接受IBR的可能性较小。结论随着时间的推移，局部区域治疗方案检测DCIS有所改善；然而，种族和社会经济差异仍然存在，强调需要提高新西兰癌症治疗的公平性。

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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 : 2025-09-23 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

Patient demographic and prognostic factors of vulvar squamous cell carcinoma: A National Cancer Database Study 外阴鳞状细胞癌的患者人口统计学和预后因素：一项国家癌症数据库研究。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-09-17 DOI: 10.1016/j.canep.2025.102933

Grace Folino , Elizabeth Byrne , Mya Hendry , Peter Silberstein , Marco DiBlasi

Background

Vulvar Squamous Cell Carcinoma (VSCC) incidence rates and clinical outcomes are correlated with demographic factors, but no study expansively investigates demographic and prognostic factors of VSCC in relation to survival in the post-Gardasil era. This study aims to investigate underlying disparities in VSCC and correlate these factors with survival.

Methods

Patients were identified from the National Cancer Database using ICD-10 codes specific for vulvar structures, ICD-O-3 histology codes for squamous cell carcinoma and pre-malignant vulvar intraepithelial neoplasia Grade III (VIN3), and patient data from 2007 to 2021. Statistical analyses utilized IBM SPSS and GraphPad Prism to determine variable frequency with cross analysis and Chi-Squared tests, Kaplan Meier Survival Curves with Log-Rank Pairwise Comparison, and Cox Proportional Hazards Regression Models.

Results

The total patient population was 58,732 patients after inclusion criteria. The median age of diagnosis was 64.0 years old. Significant prognostic factors resulting in better survival included VIN3 histology, lower Charlson-Deyo Score, Black race, receiving care from Academic/Research Programs, private insurance, and median income greater than $63,000. Surgical procedures were significant in improving survival. Black patients are diagnosed younger than White and Other races. A histology type of VIN3 was associated with increased survival time, indicating early identification and treatment for better outcomes.

Conclusion

Key demographic and prognostic factors that influence survival were identified across the VSCC population. This study may serve as a tool in reevaluation of current gynecological screening protocols to promote early diagnosis and management for the entire VSCC patient population.

背景：外阴鳞状细胞癌（VSCC）的发病率和临床结果与人口统计学因素相关，但没有研究广泛调查后加德西时代VSCC的人口统计学和预后因素与生存的关系。本研究旨在探讨VSCC的潜在差异，并将这些因素与生存率联系起来。方法：使用2007年至2021年的患者数据，从国家癌症数据库中使用外阴结构特异性的ICD-10代码，鳞状细胞癌和恶性前外阴上皮内瘤变III级（VIN3）的ICD-O-3组织学代码和患者数据对患者进行识别。统计分析采用IBM SPSS和GraphPad Prism交叉分析和卡方检验确定变量频率，Kaplan Meier生存曲线采用Log-Rank两两比较，Cox比例风险回归模型。结果：符合纳入标准的患者总人数为58,732例。中位诊断年龄为64.0岁。导致生存率提高的重要预后因素包括VIN3组织学、较低的Charlson-Deyo评分、黑人种族、接受学术/研究项目的护理、私人保险和收入中位数大于63,000美元。外科手术对提高生存率有显著意义。黑人患者比白人和其他种族的患者更年轻。组织学类型VIN3与生存时间增加相关，表明早期识别和治疗可获得更好的结果。结论：确定了影响VSCC人群生存的关键人口统计学和预后因素。本研究可作为重新评估当前妇科筛查方案的工具，以促进整个VSCC患者群体的早期诊断和管理。

{"title":"Patient demographic and prognostic factors of vulvar squamous cell carcinoma: A National Cancer Database Study","authors":"Grace Folino , Elizabeth Byrne , Mya Hendry , Peter Silberstein , Marco DiBlasi","doi":"10.1016/j.canep.2025.102933","DOIUrl":"10.1016/j.canep.2025.102933","url":null,"abstract":"<div><h3>Background</h3><div>Vulvar Squamous Cell Carcinoma (VSCC) incidence rates and clinical outcomes are correlated with demographic factors, but no study expansively investigates demographic and prognostic factors of VSCC in relation to survival in the post-Gardasil era. This study aims to investigate underlying disparities in VSCC and correlate these factors with survival.</div></div><div><h3>Methods</h3><div>Patients were identified from the National Cancer Database using ICD-10 codes specific for vulvar structures, ICD-O-3 histology codes for squamous cell carcinoma and pre-malignant vulvar intraepithelial neoplasia Grade III (VIN3), and patient data from 2007 to 2021. Statistical analyses utilized IBM SPSS and GraphPad Prism to determine variable frequency with cross analysis and Chi-Squared tests, Kaplan Meier Survival Curves with Log-Rank Pairwise Comparison, and Cox Proportional Hazards Regression Models.</div></div><div><h3>Results</h3><div>The total patient population was 58,732 patients after inclusion criteria. The median age of diagnosis was 64.0 years old. Significant prognostic factors resulting in better survival included VIN3 histology, lower Charlson-Deyo Score, Black race, receiving care from Academic/Research Programs, private insurance, and median income greater than $63,000. Surgical procedures were significant in improving survival. Black patients are diagnosed younger than White and Other races. A histology type of VIN3 was associated with increased survival time, indicating early identification and treatment for better outcomes.</div></div><div><h3>Conclusion</h3><div>Key demographic and prognostic factors that influence survival were identified across the VSCC population. This study may serve as a tool in reevaluation of current gynecological screening protocols to promote early diagnosis and management for the entire VSCC patient population.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102933"},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Description and recent trends (2011–2019) of early-onset colorectal cancer incidence in Texas 德克萨斯州早发性结直肠癌发病率描述及近期趋势（2011-2019）

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-09-16 DOI: 10.1016/j.canep.2025.102927

Yahan Zhang , Hyeun Ah Kang , Srinivas Joga Ivatury , Claire Sokas

Background

Early-onset colorectal cancer (EO-CRC), diagnosed in individuals under 50, has seen rising incidence rates, while average-onset colorectal cancer rates decline. To understand EO-CRC burden across regions and patient characteristics, detailed incidence data are essential. With Texas's large population and unique demographics, this study examines recent trends in age-adjusted EO-CRC incidence.

Methods

This cross-sectional analysis used 2011–2019 Texas Cancer Registry (TCR) data. The incidence rate of EO-CRC was adjusted to the 2000 US standard population and was stratified by cancer type, sex, race/ethnicity, and stage at diagnosis. The number of EO-CRC cases between 2011 and 2019 was mapped to the Texas counties.

Results

In the study period, a total of 11,848 EO-CRC (7511 colon cancer [EO-CC] and 4337 rectal cancer [EO-RC]) cases were identified. Over 50 % of cases were diagnosed before the age of 45. The age-adjusted incidence rate (AAIR) of EO-CRC showed a slightly increasing trend over the study period (AAIR range: 10.4/100,000 persons [95 % CI = 9.8–11.0]- 12.7/100,000 persons [95 % CI = 12.0–13.3]). The AAIRs of EO-CRC among males were higher than that of females. Non-Hispanic (NH) White population had the highest AAIR, followed by the Black population and Hispanic population, while other races/ethnicities had the lowest AAIR of EO-CRC. The incidence rate of EO-CRC diagnosed at the regional stage was the highest and showed the steepest increasing trend. While EO-CRC case density by county reflects the population density, incidence rates were higher in rural counties.

Conclusion

The incidence of EO-CRC in Texas showed an increasing trend from 2011 to 2019, with notable disparities by sex, race/ethnicity, and cancer stage.

背景：早发性结直肠癌（EO-CRC）在50岁以下的人群中被诊断出来，发病率上升，而平均发病的结直肠癌发病率下降。为了了解不同地区的EO-CRC负担和患者特征，详细的发病率数据是必不可少的。由于德克萨斯州人口众多，人口结构独特，本研究探讨了年龄调整后的EO-CRC发病率的最新趋势。方法：采用2011-2019年德克萨斯州癌症登记处（TCR）数据进行横断面分析。EO-CRC的发病率调整为2000年美国标准人群，并按癌症类型、性别、种族/民族和诊断分期进行分层。2011年至2019年期间的EO-CRC病例数被映射到德克萨斯州各县。结果：研究期间共发现EO-CRC 11,848例（其中结肠癌[EO-CC] 7511例，直肠癌[EO-RC] 4337例）。超过50% %的病例在45岁之前被诊断出来。EO-CRC的年龄调整发病率（AAIR）在研究期间呈轻微上升趋势（AAIR范围：10.4/100,000人[95 % CI = 9.8-11.0]- 12.7/100,000人[95 % CI = 12.0-13.3]）。男性的EO-CRC指数高于女性。非西班牙裔（NH）白人的AAIR最高，黑人次之，西班牙裔次之，其他种族的AAIR最低。区域阶段诊断的EO-CRC发病率最高，且呈最急剧的上升趋势。各县的EO-CRC病例密度反映了人口密度，但农村县发病率较高。结论：2011 - 2019年，德克萨斯州EO-CRC发病率呈上升趋势，性别、种族和癌症分期差异显著。

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引用次数: 0