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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 Pub 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
Trends and characteristics of early-onset colorectal cancer in the state of Florida, 2002–2021 2002-2021年佛罗里达州早发性结直肠癌的趋势和特征
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-09-13 DOI: 10.1016/j.canep.2025.102932
Young-Rock Hong , Lee Revere , Kathryn M. Ross , Peihua Qiu , Mattia Prosperi , Thomas J. George , Beth A. Virnig

Background

Early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is a growing public health concern. Despite increasing national incidence among younger adults, state-specific analyses for Florida remain limited. Florida's large and demographically unique population necessitates investigation into EOCRC trends and patient characteristics.

Methods

This population-based study utilized colorectal cancer incidence data for Florida residents aged 25–49 diagnosed between 2002 and 2021, from the Florida Cancer Data System and National Program of Cancer Registries. Joinpoint regression evaluated age-adjusted incidence trends across demographic and clinical factors. Age-period-cohort analysis explored generational effects, while multivariate logistic regression identified factors associated with advanced-stage diagnosis (regional or distant).

Results

Among 16,318 EOCRC cases identified during 2002–2021, overall incidence increased significantly (AAPC=1.48 %, P < .001), driven primarily by colon cancers (AAPC=1.53 %, P < .001), while rectal cancers showed non-significant increase (AAPC=0.53 %, P = 0.185). A concerning shift toward advanced stages at diagnosis emerged (P < 0.001), with localized disease decreasing from 32.8 % to 26.2 %, while regional (34.6–41.0 %) and distant metastases (21.9–26.8 %) increased substantially. This stage migration was confirmed by significant increases in regional (AAPC=2.10 %, P < .001) and distant disease (AAPC=2.71 %, P < .001) incidence. Strong birth cohort effects, indicating increasing risk with rate ratios exceeding 2.0 for recent cohorts, were evident predominantly in non-Hispanic White individuals. Conversely, Hispanic and non-Hispanic Black patients showed no significant cohort effects but consistently presented with higher odds of advanced-stage disease compared to non-Hispanic Whites (AOR=1.13 and AOR=1.11, respectively). Uninsured (AOR=1.23) and Medicaid-covered patients (AOR=1.52) faced significantly higher odds of advanced presentation compared to privately insured individuals.

Conclusion

Florida experienced sustained EOCRC incidence increases from 2002 to 2021, accompanied by advanced-stage diagnosis increases and notable disparities. Birth cohort effects primarily drove increased risk in non-Hispanic White populations, while barriers to timely care, including insurance status, likely contributed to delayed diagnoses in minority communities, underscoring urgent needs for targeted interventions.
早发性结直肠癌(EOCRC),定义为50岁之前的诊断,是一个日益受到关注的公共卫生问题。尽管全国年轻人的发病率在上升,但对佛罗里达州具体州的分析仍然有限。佛罗里达州人口众多,人口结构独特,因此有必要对EOCRC趋势和患者特征进行调查。这项基于人群的研究利用了2002年至2021年间诊断为25-49岁的佛罗里达州居民的结直肠癌发病率数据,这些数据来自佛罗里达州癌症数据系统和国家癌症登记项目。结合点回归评估了人口统计学和临床因素中年龄调整后的发病率趋势。年龄-时期-队列分析探讨了代际效应,而多变量逻辑回归确定了与晚期诊断(区域性或远距离)相关的因素。结果2002-2021年发现的16318例EOCRC病例中,总发病率显著增加(AAPC=1.48 %,P <; )。001),主要由结肠癌驱动(AAPC=1.53 %,P <; )。直肠癌无显著升高(AAPC=0.53 %,P = 0.185)。诊断时出现了令人担忧的晚期转移(P <; 0.001),局部疾病从32.8% %下降到26.2% %,而局部(34.6-41.0 %)和远处转移(21.9-26.8 %)显著增加。区域(AAPC=2.10 %,P <; )显著增加证实了这一阶段迁移。001)和远处病变(AAPC=2.71 %,P <; )。001)发生率。强烈的出生队列效应,表明近期队列中发病率比超过2.0的风险增加,在非西班牙裔白人中尤为明显。相反,西班牙裔和非西班牙裔黑人患者没有明显的队列效应,但与非西班牙裔白人相比,他们始终表现出更高的晚期疾病几率(AOR分别为1.13和1.11)。没有保险的患者(AOR=1.23)和有医疗补助的患者(AOR=1.52)与有私人保险的个体相比,有明显更高的晚期表现的几率。结论2002 - 2021年,佛罗里达州EOCRC发病率持续上升,伴晚期诊断率上升,且差异显著。出生队列效应主要导致非西班牙裔白人人群的风险增加,而及时护理的障碍,包括保险状况,可能导致少数民族社区的诊断延迟,强调迫切需要有针对性的干预措施。
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引用次数: 0
Temporal trends and spatial distribution of prostate cancer incidence and mortality in a northeastern Brazilian state 巴西东北部一个州前列腺癌发病率和死亡率的时间趋势和空间分布
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-09-12 DOI: 10.1016/j.canep.2025.102931
Ana Clara Cruz Santos de Santana , Ellen Sabrina Ramos Santos , Jefferson Felipe Calazans Batista , Alex Rodrigues Moura , Simone Soraia Silva Sardeiro , Brenda Evelin Barreto da Silva , Carlos Anselmo Lima

Background

Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution of prostate cancer incidence (1996–2017) and mortality (1996–2022) in Sergipe, Brazil, to support targeted cancer control strategies.

Methods

We analyzed prostate cancer data from the Aracaju Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were calculated using the World Standard Population. Joinpoint regression estimated Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess trends. The Mortality-to-Incidence Ratio (MIR) and its complement (1–MIR) were used as proxies for survival. Spatial distribution was examined using Empirical Bayesian Kriging and local empirical Bayes smoothing in QGIS and TerraView.

Results

Between 1996 and 2017, 10,133 incident prostate cancer cases were recorded. Incidence increased until 2007 (APC=11.9 %; p < 0.001), then declined (APC=–2.0 %; p = 0.027, with peaks in men aged ≥55. Mortality increased from 1996 to 2007 (APC=12.2 %; p < 0.001) and subsequently stabilised between 2007 and 2022 (APC=–0.8 %; p = 0.228), resulting in an overall AAPC of 2.4 % (p = 0.002) for the entire study period. By age group, mortality rose among men ≥ 75 years (AAPC=3.2 %; p = 0.001) but declined in those aged 15–54 (AAPC=–2.4 %; p = 0.004). The MIR remained flat over time, but estimated survival dropped substantially among men aged ≥ 75 years, from 63 % to 38 %. Spatial analysis revealed higher incidence in central/coastal municipalities, while elevated mortality clustered in southern/coastal areas.

Conclusions

Despite improvements in incidence rates, prostate cancer remains a significant burden in Sergipe, with persistent regional disparities in outcomes. Spatial and temporal analyses highlight the need for targeted public health interventions to improve early detection and access to care, especially in areas of high social vulnerability and among older men.
背景:前列腺癌的发病率和死亡率表现出区域差异,通常与医疗保健和疾病管理的差异有关。本研究旨在分析巴西Sergipe市前列腺癌发病率(1996-2017年)和死亡率(1996-2022年)的时间趋势和空间分布,为有针对性的癌症控制策略提供支持。方法我们分析来自阿拉卡朱癌症登记处和死亡率信息系统的前列腺癌数据。使用世界标准人口计算年龄标准化发病率和死亡率。联合点回归估计年变化百分比(APC)和平均年变化百分比(AAPC)来评估趋势。使用死亡率-发病率比(MIR)及其补体(1-MIR)作为生存指标。利用经验贝叶斯Kriging和局部经验贝叶斯平滑对QGIS和TerraView中的空间分布进行了检验。结果1996年至2017年,共记录了10133例前列腺癌病例。发病率上升至2007年(APC=11.9 %;p <; 0.001),然后下降(APC= -2.0 %;p = 0.027,年龄≥55岁的男性发病率最高。死亡率从1996增加到2007 (APC % = 12.2;p & lt; 0.001),随后企稳在2007年和2022年之间(APC % = -0.8;p = 0.228),导致整体AAPC 2.4 % (p = 0.002)为整个研究期间。按年龄组划分,≥ 75岁男性死亡率上升(AAPC=3.2 %;p = 0.001),15-54岁男性死亡率下降(AAPC= -2.4 %;p = 0.004)。随着时间的推移,MIR保持平稳,但≥ 75岁男性的估计生存率大幅下降,从63% %降至38% %。空间分析显示,中部/沿海城市发病率较高,而死亡率升高集中在南部/沿海地区。结论:尽管发病率有所改善,但前列腺癌仍然是Sergipe地区的一个重大负担,并且在结果上存在持续的地区差异。空间和时间分析突出表明,需要有针对性的公共卫生干预措施,以改善早期发现和获得护理的机会,特别是在社会脆弱性高的地区和老年男子中。
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引用次数: 0
Half a century of cancer transition in Hungary: A visualization and assessment of mortality dynamics in the Lexis diagram, 1970–2020 匈牙利癌症转变的半个世纪:1970-2020年Lexis图中死亡率动态的可视化和评估
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-09-11 DOI: 10.1016/j.canep.2025.102925
András Wéber , Freddie Bray , Mátyás Árvai , Lászlóné Hilbert , Dávid Kelemen , Péter Nagy , István Kenessey , Csaba Polgár

Objectives

Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools. The Lexis diagram provides a means to depict age, period and cohort influences on long-term cancer mortality trends.

Methods

Age-specific mortality rates for six cancer localizations were constructed based on the Deaths Register of the Hungarian Central Statistical Office and the Human Mortality Database, then smoothed (p-splines) within the cells of the Lexis diagram assuming Poisson distribution. After calculating the annual percentage change in mortality rates, the results were visualized using heat maps.

Results

Substantial reduction in mortality was observable from the mid-1990s in both sexes as a strong period effect, depicting two distinct epidemiological eras in Hungary. Since 2010, breast cancer mortality in women among ages 70–90 (those born between 1930 and 1950) has been rising. Women born between 1940 and 50 experienced two plateaus in lung cancer mortality, unlike men, emphasizing the delayed nature of the smoking epidemic.

Conclusions

The results align with cancer transition patterns observed in similarly developed countries and emphasize a critical need to expand the implementation of effective primary and secondary prevention measures. This includes sustaining organized screening and anti-smoking programs, as well as introducing lung cancer screening with low-dose CT.
匈牙利是欧洲癌症死亡率负担最高的国家之一,因此非常需要使用适当的监测工具来监测人口死亡率的变化。Lexis图表提供了一种方法来描述年龄、时期和队列对长期癌症死亡率趋势的影响。方法基于匈牙利中央统计局的死亡登记表和人类死亡率数据库,构建6个癌症地区的年龄特异性死亡率,然后在假定泊松分布的Lexis图单元格内平滑(p样条)。在计算了死亡率的年百分比变化后,使用热图将结果可视化。结果从20世纪90年代中期开始,在两性中都观察到死亡率的大幅下降,这是一种强烈的时期效应,描绘了匈牙利两个不同的流行病学时期。自2010年以来,70-90岁女性(1930年至1950年之间出生的女性)的乳腺癌死亡率一直在上升。与男性不同,1940年至1950年之间出生的女性在肺癌死亡率方面经历了两次平稳期,这突显了吸烟流行的迟发性。结论:研究结果与在类似发达国家观察到的癌症转移模式一致,强调了扩大有效一级和二级预防措施实施的迫切需要。这包括维持有组织的筛查和反吸烟项目,以及引入低剂量CT肺癌筛查。
{"title":"Half a century of cancer transition in Hungary: A visualization and assessment of mortality dynamics in the Lexis diagram, 1970–2020","authors":"András Wéber ,&nbsp;Freddie Bray ,&nbsp;Mátyás Árvai ,&nbsp;Lászlóné Hilbert ,&nbsp;Dávid Kelemen ,&nbsp;Péter Nagy ,&nbsp;István Kenessey ,&nbsp;Csaba Polgár","doi":"10.1016/j.canep.2025.102925","DOIUrl":"10.1016/j.canep.2025.102925","url":null,"abstract":"<div><h3>Objectives</h3><div>Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools. The Lexis diagram provides a means to depict age, period and cohort influences on long-term cancer mortality trends.</div></div><div><h3>Methods</h3><div>Age-specific mortality rates for six cancer localizations were constructed based on the Deaths Register of the Hungarian Central Statistical Office and the Human Mortality Database, then smoothed (p-splines) within the cells of the Lexis diagram assuming Poisson distribution. After calculating the annual percentage change in mortality rates, the results were visualized using heat maps.</div></div><div><h3>Results</h3><div>Substantial reduction in mortality was observable from the mid-1990s in both sexes as a strong period effect, depicting two distinct epidemiological eras in Hungary. Since 2010, breast cancer mortality in women among ages 70–90 (those born between 1930 and 1950) has been rising. Women born between 1940 and 50 experienced two plateaus in lung cancer mortality, unlike men, emphasizing the delayed nature of the smoking epidemic.</div></div><div><h3>Conclusions</h3><div>The results align with cancer transition patterns observed in similarly developed countries and emphasize a critical need to expand the implementation of effective primary and secondary prevention measures. This includes sustaining organized screening and anti-smoking programs, as well as introducing lung cancer screening with low-dose CT.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102925"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050136","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
Aspirin use associated with a decreased risk of gastric cancer 阿司匹林的使用与胃癌风险降低有关
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-09-11 DOI: 10.1016/j.canep.2025.102929
Kuan-Fu Liao, Shih-Wei Lai
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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 Pub 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。
{"title":"Use of population-based cancer registries for cancer surveillance and control in Latin America","authors":"Esperanza Peña-Torres ,&nbsp;Esther de Vries ,&nbsp;Marianna de Camargo Cancela ,&nbsp;Marion Piñeros-Petersen","doi":"10.1016/j.canep.2025.102914","DOIUrl":"10.1016/j.canep.2025.102914","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102914"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027126","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
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 Pub 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。
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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 Pub 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。
{"title":"Epidemiology of early-onset breast cancer in Golestan, North of Iran, 2004–2019: Disparities across residential place and ethnic region","authors":"Atefeh Gouglani ,&nbsp;Somayeh Livani ,&nbsp;Nastaran Haghshenas ,&nbsp;Moosarreza Shabihi ,&nbsp;SeyedAhmad Hosseini ,&nbsp;Hamideh Sadeghzadeh ,&nbsp;Fatemeh Ghasemi-Kebria ,&nbsp;Saeed Golfiroozi ,&nbsp;Gholamreza Roshandel","doi":"10.1016/j.canep.2025.102922","DOIUrl":"10.1016/j.canep.2025.102922","url":null,"abstract":"<div><h3>Introduction</h3><div>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).</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102922"},"PeriodicalIF":2.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020144","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
Prevalence of Human Papillomavirus in Arica and Antofagasta, in the north of Chile 人乳头瘤病毒在非洲和智利北部安托法加斯塔的流行情况
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-09-06 DOI: 10.1016/j.canep.2025.102913
María Jesús Acuña , Edgardo Mancilla , Dania Acuña , Giuliano Bernal

Background

Cervical cancer is primarily caused by the Human Papillomavirus (HPV). Despite all the advances in early detection of HPV infection, cervical cancer remains one of the most common types of cancer in women, with a high presence in Latin America. We previously reported on the prevalence of HPV in the Coquimbo region, so the objective of this study was to determine the frequency of HPV in women in the Antofagasta and Arica regions of northern Chile.

Methods

We analyzed 823 cervical samples from women aged 15–79 who attended gynecological checkups during 2024 to detect HPV genotypes using qPCR. Of these, 199 come from Arica and 624 from Antofagasta, in northern Chile.

Results

The overall HPV positivity rate was 19.20 %; 23.62 % in Arica and 17.79 % in Antofagasta. The HR-HPV positivity rates in the G1 (15–29 years) and G2 (30–79 years) age groups were 30.92 % and 16.54 %, respectively. The most prevalent genotypes of HPV infection among our entire population were HPV16, HPV 31, and HPV52. Single infection (75.95 %) was the main HPV infection pattern observed in the entire group, followed by double or multiple infection (24.05 %), which was similar in Groups 1 and 2, where the prevalence of single infection was 72.34 % and 77.48 %, respectively.

Conclusion

The prevalence of HPV infections in women in the Arica and Antofagasta regions appears lower than that previously reported for Coquimbo, but similar to that reported in Chile by the Ministry of Health. This reflects the great heterogeneity of HPV prevalence in our vast country. On the other hand, molecular detection of 14 HR-HPV genotypes is important because it will not only help women avoid cervical cancer, but could also inform the introduction of new vaccines targeting a broader spectrum of HR-HPV.
宫颈癌主要由人乳头瘤病毒(HPV)引起。尽管在HPV感染的早期检测方面取得了所有进展,但宫颈癌仍然是妇女中最常见的癌症类型之一,在拉丁美洲发病率很高。我们之前曾报道过科金博地区HPV的流行情况,因此本研究的目的是确定智利北部安托法加斯塔和非洲地区女性HPV的发病率。方法采用qPCR方法对2024年妇科检查的823例15 ~ 79岁女性宫颈样本进行HPV基因型检测。其中,199人来自非洲,624人来自智利北部的安托法加斯塔。结果总HPV阳性率为19.20 %;23.62 %在非洲和17.79%在安托法加斯塔。G1(15 ~ 29岁)和G2(30 ~ 79岁)年龄组HR-HPV阳性率分别为30.92 %和16.54 %。在我们的整个人群中,最流行的HPV感染基因型是HPV16、hpv31和HPV52。全组HPV感染以单次感染为主(75.95 %),其次为双次或多次感染(24.05 %),1组和2组差异无统计学意义,单次感染患病率分别为72.34 %和77.48 %。结论非洲和安托法加斯塔地区妇女的HPV感染流行率似乎低于以前报告的科金博,但与卫生部报告的智利相似。这反映了我们这个幅员辽阔的国家中HPV患病率的巨大异质性。另一方面,14种HR-HPV基因型的分子检测很重要,因为它不仅可以帮助妇女避免宫颈癌,而且还可以为引入针对更广泛的HR-HPV的新疫苗提供信息。
{"title":"Prevalence of Human Papillomavirus in Arica and Antofagasta, in the north of Chile","authors":"María Jesús Acuña ,&nbsp;Edgardo Mancilla ,&nbsp;Dania Acuña ,&nbsp;Giuliano Bernal","doi":"10.1016/j.canep.2025.102913","DOIUrl":"10.1016/j.canep.2025.102913","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer is primarily caused by the Human Papillomavirus (HPV). Despite all the advances in early detection of HPV infection, cervical cancer remains one of the most common types of cancer in women, with a high presence in Latin America. We previously reported on the prevalence of HPV in the Coquimbo region, so the objective of this study was to determine the frequency of HPV in women in the Antofagasta and Arica regions of northern Chile.</div></div><div><h3>Methods</h3><div>We analyzed 823 cervical samples from women aged 15–79 who attended gynecological checkups during 2024 to detect HPV genotypes using qPCR. Of these, 199 come from Arica and 624 from Antofagasta, in northern Chile.</div></div><div><h3>Results</h3><div>The overall HPV positivity rate was 19.20 %; 23.62 % in Arica and 17.79 % in Antofagasta. The HR-HPV positivity rates in the G1 (15–29 years) and G2 (30–79 years) age groups were 30.92 % and 16.54 %, respectively. The most prevalent genotypes of HPV infection among our entire population were HPV16, HPV 31, and HPV52. Single infection (75.95 %) was the main HPV infection pattern observed in the entire group, followed by double or multiple infection (24.05 %), which was similar in Groups 1 and 2, where the prevalence of single infection was 72.34 % and 77.48 %, respectively.</div></div><div><h3>Conclusion</h3><div>The prevalence of HPV infections in women in the Arica and Antofagasta regions appears lower than that previously reported for Coquimbo, but similar to that reported in Chile by the Ministry of Health. This reflects the great heterogeneity of HPV prevalence in our vast country. On the other hand, molecular detection of 14 HR-HPV genotypes is important because it will not only help women avoid cervical cancer, but could also inform the introduction of new vaccines targeting a broader spectrum of HR-HPV.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102913"},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004392","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
Cancer incidence and mortality in Italy, 2013–2017 2013-2017年意大利癌症发病率和死亡率
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2025-09-05 DOI: 10.1016/j.canep.2025.102905
Andrea Tittarelli , Sabrina Fabiano , Viviana Perotti , Maurizio Zarcone , Maria Teresa Pesce , Alessio Gili , Fabrizio Stracci , Walter Mazzucco , Luigino Dal Maso , Emanuele Crocetti , Riccardo Capocaccia , Giovanna Tagliabue , Paolo Contiero , AIRTUM Working Group
The demographic transition, together with changes in lifestyles and the exposure to other risk factors, contributed to a rising burden of chronic degenerative diseases, including cancer, in Italy. We provided updated figures on cancer incidence and mortality in Italy during the period 2013–2017, using data provided by 34 population-based cancer registries from the AIRTUM network. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) per 100,000 were estimated, stratified by sex, cancer site or type, and macroarea. The cumulative risk (number of individuals who need to be followed over a lifetime for one to develop cancer), stratified by cancer site and sex, was estimated. Overall, 1,359,053 incident cancer cases (52.8 % in men) were registered during the surveillance period. The ASR for all malignant tumours was 657.1 per 100,000 among men and 475.5 per 100,000 among women. We documented the highest ASRs for all cancer sites in both sexes (males: 685.7 per 100,000, females: 496.1 per 100,000) in the North, followed by the Center (males: 646.6 per 100,000, females: 488.1 per 100,000), and the South and Islands (males: 626.7 per 100,000, females: 435.4 per 100,000). Mortality rates are less than half that of incidence rates (SMR was 331.8 per 100,000 men and 188.8 per 100,000 women), with negligible differences among Italian areas. One man out of two and 1 women out of three may develop a cancer in their lifetime. Despite incidence and mortality figures in Italy were almost aligned with the ones documented in Europe, our findings recalled the importance for policy-makers to implement national policies and community-based prevention strategies aimed at reducing the cancer burden.
人口结构的转变,加上生活方式的改变和其他风险因素的影响,导致意大利慢性退行性疾病(包括癌症)的负担不断增加。我们使用来自AIRTUM网络的34个基于人群的癌症登记处提供的数据,提供了2013-2017年期间意大利癌症发病率和死亡率的最新数据。每10万人的年龄标准化发病率(ASRs)和年龄标准化死亡率(ASMRs)按性别、癌症部位或类型和宏观区域分层进行了估计。按癌症部位和性别进行分层的累积风险(一个人一生中需要跟踪的患癌症的个体数量)进行了估计。总体而言,在监测期间登记了1,359,053例癌症病例(男性为52.8% %)。所有恶性肿瘤的ASR在男性中为657.1 / 100,000,在女性中为475.5 / 100,000。我们记录了北部所有癌症部位的最高asr(男性:685.7 / 10万,女性:496.1 / 10万),其次是中心(男性:646.6 / 10万,女性:488.1 / 10万),以及南部和岛屿(男性:626.7 / 10万,女性:435.4 / 10万)。死亡率不到发病率的一半(男性死亡率为每10万人331.8人,女性死亡率为每10万人188.8人),意大利各地区之间的差异可以忽略不计。每两个男人中就有一个,每三个女人中就有一个可能在他们的一生中患上癌症。尽管意大利的发病率和死亡率数据与欧洲记录的数据几乎一致,但我们的研究结果提醒了政策制定者实施旨在减轻癌症负担的国家政策和社区预防战略的重要性。
{"title":"Cancer incidence and mortality in Italy, 2013–2017","authors":"Andrea Tittarelli ,&nbsp;Sabrina Fabiano ,&nbsp;Viviana Perotti ,&nbsp;Maurizio Zarcone ,&nbsp;Maria Teresa Pesce ,&nbsp;Alessio Gili ,&nbsp;Fabrizio Stracci ,&nbsp;Walter Mazzucco ,&nbsp;Luigino Dal Maso ,&nbsp;Emanuele Crocetti ,&nbsp;Riccardo Capocaccia ,&nbsp;Giovanna Tagliabue ,&nbsp;Paolo Contiero ,&nbsp;AIRTUM Working Group","doi":"10.1016/j.canep.2025.102905","DOIUrl":"10.1016/j.canep.2025.102905","url":null,"abstract":"<div><div>The demographic transition, together with changes in lifestyles and the exposure to other risk factors, contributed to a rising burden of chronic degenerative diseases, including cancer, in Italy. We provided updated figures on cancer incidence and mortality in Italy during the period 2013–2017, using data provided by 34 population-based cancer registries from the AIRTUM network. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) per 100,000 were estimated, stratified by sex, cancer site or type, and macroarea. The cumulative risk (number of individuals who need to be followed over a lifetime for one to develop cancer), stratified by cancer site and sex, was estimated. Overall, 1,359,053 incident cancer cases (52.8 % in men) were registered during the surveillance period. The ASR for all malignant tumours was 657.1 per 100,000 among men and 475.5 per 100,000 among women. We documented the highest ASRs for all cancer sites in both sexes (males: 685.7 per 100,000, females: 496.1 per 100,000) in the North, followed by the Center (males: 646.6 per 100,000, females: 488.1 per 100,000), and the South and Islands (males: 626.7 per 100,000, females: 435.4 per 100,000). Mortality rates are less than half that of incidence rates (SMR was 331.8 per 100,000 men and 188.8 per 100,000 women), with negligible differences among Italian areas. One man out of two and 1 women out of three may develop a cancer in their lifetime. Despite incidence and mortality figures in Italy were almost aligned with the ones documented in Europe, our findings recalled the importance for policy-makers to implement national policies and community-based prevention strategies aimed at reducing the cancer burden.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102905"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004391","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
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Cancer Epidemiology
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