Cancer Epidemiology最新文献_第9页

Cancer incidence, mortality, and survival estimates in Italy: Methodological approaches 意大利的癌症发病率、死亡率和生存估计：方法学方法

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-24 DOI: 10.1016/j.canep.2025.102891

Maria Teresa Pesce , Paolo Contiero , Carlotta Buzzoni , Sabrina Fabiano , Alessio Gili , Andrea Tittarelli , Viviana Perotti , Riccardo Capocaccia , Fabrizio Stracci , Walter Mazzucco , Maurizio Zarcone , AIRTUM Working Group

Italy, home to one of the world’s oldest populations, has traditionally shown geographic differences in cancer incidence, with rates decreasing from north to south. The cancer registries that have been accredited by the Italian Cancer Registry Network (AIRTUM), during the last 20 years altogether cover the 90 % of the Italian population, aiming to improve data quality, standardize procedures, and promote research. This study presents the methodological approaches used for data collection, quality control, and analysis to describe current patterns of cancer incidence, mortality, and survival across Italy's three macro-areas (North, Central, South). Estimates of incidence rates and case numbers for 2025 were also produced. Data from 34 accredited cancer registries were analyzed, comprising over 4.6 million cases from 1981 to 2020, with a detailed focus on the 2008–2017 period, which includes over 3 million cases. Cancer incidence and mortality data were collected according to ICD-O-3 and ICD-10 classifications and processed for statistical analysis using tools such as SEERPrep, SEERStat, and the Joinpoint Regression Program. Age-standardized rates were calculated, and incidence and mortality trends from 2013 to 2017 were modeled. Five-year cumulative net survival was estimated using the Pohar-Perme method to adjust for competing risks. Survival trends were analyzed by geographic areas and cancer sites, revealing regional disparities in cancer outcomes.

意大利是世界上人口老龄化最严重的国家之一，其癌症发病率历来存在地域差异，从北向南呈下降趋势。在过去的20年里，由意大利癌症登记网络（AIRTUM）认证的癌症登记处总共覆盖了90% %的意大利人口，旨在提高数据质量，标准化程序，促进研究。本研究提出了用于数据收集、质量控制和分析的方法学方法，以描述意大利三个宏观地区（北部、中部、南部）的癌症发病率、死亡率和生存率的当前模式。还对2025年的发病率和病例数进行了估计。分析了来自34个认可的癌症登记处的数据，包括1981年至2020年的460多万例病例，并详细关注了2008年至2017年期间的300多万例病例。根据ICD-O-3和ICD-10分类收集癌症发病率和死亡率数据，并使用SEERPrep、SEERStat和Joinpoint Regression Program等工具进行统计分析。计算年龄标准化率，并对2013年至2017年的发病率和死亡率趋势进行建模。使用Pohar-Perme方法估计5年累积净生存率，以调整竞争风险。生存趋势按地理区域和癌症部位进行了分析，揭示了癌症结局的地区差异。

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引用次数: 0

Commentary: The significance of dose-response relationships in elucidating benzene’s neurocarcinogenicity 评论：剂量-反应关系在阐明苯的神经致癌性中的意义。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-19 DOI: 10.1016/j.canep.2025.102893

Monireh Sadat Seyyedsalehi, Paolo Boffetta

引用次数: 0

Further dose-response association exploration could enhance the causal inference between benzene exposure and risk of nervous system cancers 进一步的剂量-反应关联探索可以加强苯暴露与神经系统癌症风险之间的因果推理。

IF 2.3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-18 DOI: 10.1016/j.canep.2025.102892

Yachen Liang, Jingya Chen, Tianyou Chen, Xiao Li, Junjie Fang, Lefu Wu

Occupational benzene exposure is a known carcinogen; however, the dose-response relationship with cancers of the nervous system, particularly glioma, requires clarification. Based on the systematic review by Mangiaterra et al., this paper conducted a secondary analysis of the results and utilized original supplementary data to assess risk ratios (RRs) for high, medium, and low benzene exposure levels. This aimed to evaluate both linear and non-linear dose-response relationships. We observed a significantly increased risk for nervous system cancers only at high exposure levels. Risks associated with moderate and low exposure levels showed no significant increase. Both dose-response curves indicated no clear upward trend with increasing exposure. Limitations include the frequent lack of confounder adjustment in source estimates, potential publication bias, and limited original data, all of which impact the heterogeneity and accuracy of the findings. While high-concentration benzene exposure may pose a risk for nervous system cancers and potentially exhibit dose-dependency, these limitations constrain the robustness of the dose-response assessment. Future research should validate this association using high-quality, multi-level exposure data with adequate confounder adjustment. Such studies are crucial to provide a scientific basis for occupational health protection measures.

职业性接触苯是一种已知的致癌物；然而，剂量-反应关系与神经系统癌症，特别是胶质瘤，需要澄清。基于Mangiaterra等人的系统综述，本文对结果进行了二次分析，并利用原始补充数据评估高、中、低苯暴露水平的风险比（rr）。目的是评估线性和非线性剂量-反应关系。我们观察到，只有在高暴露水平下，患神经系统癌症的风险才会显著增加。与中等和低暴露水平相关的风险没有显著增加。两种剂量-反应曲线均未显示出随暴露量增加而明显上升的趋势。局限性包括来源估计中经常缺乏混杂因素调整、潜在的发表偏倚和有限的原始数据，所有这些都会影响研究结果的异质性和准确性。虽然高浓度苯暴露可能造成神经系统癌症的风险，并可能表现出剂量依赖性，但这些局限性限制了剂量-反应评估的稳健性。未来的研究应该使用高质量、多层次的暴露数据来验证这种关联，并进行适当的混杂校正。这些研究对制定职业健康防护措施具有重要的科学依据。

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引用次数: 0

The role of sleep traits in prostate, endometrial, and epithelial ovarian cancers: An observational and Mendelian randomisation study 睡眠特征在前列腺癌、子宫内膜癌和上皮性卵巢癌中的作用：一项观察性孟德尔随机研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-17 DOI: 10.1016/j.canep.2025.102877

Christos V. Chalitsios , Eirini Pagkalidou , Christos K. Papagiannopoulos , Georgios Markozannes , Emmanouil Bouras , Eleanor L. Watts , The Practical Consortium , Rebecca C. Richmond , Konstantinos K. Tsilidis

Background

Sleep traits may influence cancer risk; however, their associations with prostate (PCa), endometrial (ECa), and epithelial ovarian (EOCa) cancer remain unclear.

Methods

We conducted an observational analysis using the UK Biobank cohort and a two-sample Mendelian randomisation (MR) analysis to investigate the association between six sleep traits-duration, chronotype, insomnia, daytime napping, daytime sleepiness, and snoring-with PCa, ECa, and EOCa risk. Cox proportional hazards models were used for the observational analysis, while the inverse variance-weighted (IVW) method was applied in MR, with multiple sensitivity analyses. A Bonferroni correction was applied to account for multiple testing.

Results

Among 8608 PCa, 1079 ECa, and 680 EOCa incident diagnoses (median follow-up: 6.9 years), snoring was associated with reduced EOCa risk (HR=0.78, 95 %CI: 0.62–0.98), while daytime sleepiness was associated with increased EOCa risk (HR=1.23, 95 %CI: 1.03–1.47). However, these associations were not confirmed in MR. MR suggested higher odds of PCa (OR_IVW=1.05, 95 %CI: 1.01–1.11) and aggressive PCa (OR_IVW=1.10, 95 %CI: 1.02–1.19) for evening compared to morning chronotype. None of the findings survived multiple testing correction.

Conclusion

Sleep traits were not associated with PCa, ECa, or EOCa risk; however, an evening chronotype may increase PCa risk. Further research is needed to verify this association and investigate potential underlying mechanisms.

睡眠特征可能影响癌症风险；然而，它们与前列腺癌（PCa）、子宫内膜癌（ECa）和卵巢上皮癌（EOCa）的关系尚不清楚。方法采用英国生物银行队列和双样本孟德尔随机化（MR）分析进行观察性分析，研究持续时间、睡眠类型、失眠、白天午睡、白天嗜睡和打鼾等六种睡眠特征与PCa、ECa和EOCa风险之间的关系。观察分析采用Cox比例风险模型，MR分析采用逆方差加权（IVW）法，进行多敏感性分析。采用Bonferroni校正来解释多重检验。结果在8608例PCa、1079例ECa和680例EOCa事件诊断（中位随访时间：6.9年）中，打鼾与EOCa风险降低相关（HR=0.78, 95 %CI: 0.62-0.98），而白天嗜睡与EOCa风险增加相关（HR=1.23, 95 %CI: 1.03-1.47）。然而，这些关联并没有在MR中得到证实。MR表明，与早晨的时间型相比，晚上的PCa （ORIVW=1.05, 95 %CI: 1.01-1.11）和侵袭性PCa （ORIVW=1.10, 95 %CI: 1.02-1.19）的几率更高。这些发现都没有经过多次测试修正。结论：睡眠特征与PCa、ECa或EOCa风险无关；然而，晚上的睡眠类型可能会增加前列腺癌的风险。需要进一步的研究来验证这种关联并调查潜在的潜在机制。

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引用次数: 0

Evaluating sex-specific prediction models for colorectal cancer risk using a genome-wide polygenic risk score and lifestyle factors in a Japanese population 使用全基因组多基因风险评分和日本人群生活方式因素评估结直肠癌风险的性别特异性预测模型

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-16 DOI: 10.1016/j.canep.2025.102878

Shiori Nakano , Taiki Yamaji , Tsuyoshi Hachiya , Aya Kuchiba , Atsushi Shimizu , Norie Sawada , Manami Inoue , Shoichiro Tsugane , Motoki Iwasaki , for the Japan Public Health Center-based Prospective Study Group

Background

The predictive performance of a colorectal cancer (CRC) risk prediction model incorporating genome-wide polygenic risk scores (PRSs) and lifestyle factors remains unclear in Asian populations. This study aimed to develop and evaluate the Asian-specific models using a Japanese population-based prospective study.

Methods

We derived 31 genome-wide PRSs using a genome-wide association study of CRC from the Biobank Japan and selected the best-performing PRS with the highest C-index in development case-cohort, including 200 incident cases. In evaluation case-cohort, including 693 incident cases, we assessed the discrimination accuracy (C-index, integrated discrimination improvement (IDI), and net reclassification improvement (NRI)) of lifestyle, PRS, and combined models using 5-fold cross-validation methods and estimated 10-year absolute risk.

Results

Of the 31 derived PRSs, the PRS aggregating 104,677 variant risks performed best in the development case-cohort. The men and women in the highest quintiles of the PRS had an approximately three-fold and two-fold higher risk of CRC, respectively, than those in the lowest in the evaluation case-cohort. Meanwhile, the association of lifestyle factors with CRC risk was observed only in men. Incorporating the PRS into a lifestyle model improved the C-index from 0.64 to 0.66 for men and from 0.61 to 0.63 for women. The IDI and NRI values supported this improvement. The 10-year absolute risk was 3.3 % and 1.6 % for high-risk men and women, respectively, and 0.5 % for both low-risk men and women.

Conclusions

This study suggests that the CRC risk prediction model utilizing genome-wide PRS for Asians is valuable; however, further improvement is needed before clinical implementation.

结合全基因组多基因风险评分（prs）和生活方式因素的结直肠癌（CRC）风险预测模型在亚洲人群中的预测性能尚不清楚。本研究旨在通过一项基于日本人群的前瞻性研究，开发和评估亚洲特定模型。方法利用来自日本Biobank的CRC全基因组关联研究，我们获得了31个全基因组PRS，并在发展病例队列中选择了c指数最高的最佳PRS，包括200例事件病例。在评估病例队列中，包括693例事件病例，我们使用5倍交叉验证方法评估了生活方式、PRS和组合模型的识别准确性（c指数、综合识别改善（IDI）和净重新分类改善（NRI）），并估计了10年绝对风险。在31个衍生的PRS中，汇总了104,677个变异风险的PRS在发展病例队列中表现最好。在评估病例队列中，PRS最高五分之一的男性和女性患CRC的风险分别比最低五分之一的男性和女性高约3倍和2倍。同时，生活方式因素与结直肠癌风险的关联仅在男性中观察到。将PRS纳入生活方式模型后，男性的c指数从0.64提高到0.66，女性从0.61提高到0.63 。IDI和NRI值支持了这一改善。高风险男性和女性的10年绝对风险分别为3.3 %和1.6 %，低风险男性和女性的10年绝对风险分别为0.5 %。结论基于全基因组PRS的亚洲人结直肠癌风险预测模型是有价值的；然而，在临床应用之前，还需要进一步的改进。

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引用次数: 0

The association of type 2 diabetes and its complications with the risk of colorectal cancer 2型糖尿病及其并发症与结直肠癌风险的关系

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-16 DOI: 10.1016/j.canep.2025.102879

Eetu Mäkinen , Sanna Heikkinen , Janne Pitkäniemi , Karri Seppä

Background

The prevalence of type 2 diabetes (T2D) has increased worldwide during the 21st century. T2D and colorectal cancers (CRC) share risk factors such as obesity. This study aims to estimate the association between T2D and the incidence of primary CRC, and furthermore the association of diabetic complications with the risk of CRC.

Methods

We linked exposure data on T2D by severity (presence or absence of complications), overweight and obesity and alcohol related disorders from Care Register for Health Care and CRC cases from the Finnish Cancer Registry to a random sample of 2.5 million Finnish individuals of all ages that were followed from 2000 to 2017. To account for the cumulative burden of exposures, we employed a multi-state model where transition rates to CRC were modeled with Poisson regression, adjusted for age, calendar period, sex, overweight and obesity and alcohol related disorders.

Results

The cohort included 171,789 people diagnosed with T2D, with a median age of 67.6 at diagnosis. From the 23 533 CRCs diagnosed in the entire cohort, 2430 were in people with diabetes. Individuals diagnosed with T2D were at a higher risk of CRC (Hazard ratio 1.26, 95 % confidence interval 1.20–1.32). Persons with diabetic complications had a higher risk of CRC than those without complications after 10 years since the initial T2D diagnosis (1.21, 1.02–1.45, p = 0.033). Men with diabetic nephropathy had a significantly higher risk of CRC (1.51, 1.23–1.86) than men with diabetes without nephropathy.

Conclusion

Our research shows that people with uncomplicated T2D are at an increased risk of CRC in the first 10 years after T2D diagnosis. The risk of CRC among individuals with complicated T2D remains elevated also in longer term follow-up.

21世纪，2型糖尿病（T2D）的患病率在全球范围内呈上升趋势。T2D和结直肠癌（CRC）有共同的危险因素，如肥胖。本研究旨在评估T2D与原发性CRC发病率的关系，以及糖尿病并发症与CRC风险的关系。方法：我们将来自卫生保健护理登记处的T2D严重程度（是否存在并发症）、超重、肥胖和酒精相关疾病的暴露数据以及来自芬兰癌症登记处的CRC病例与2000年至2017年随访的250万各年龄段芬兰人的随机样本联系起来。为了解释暴露的累积负担，我们采用了一个多状态模型，其中向CRC的过渡率用泊松回归建模，并根据年龄、自然期、性别、超重、肥胖和酒精相关疾病进行调整。结果该队列包括171,789名诊断为T2D的患者，诊断时的中位年龄为67.6岁。在整个队列中诊断的23533例crc中，2430例为糖尿病患者。诊断为T2D的个体患CRC的风险较高（风险比1.26,95 %置信区间1.20-1.32）。糖尿病合并症患者在T2D初始诊断后10年发生CRC的风险高于无合并症患者（1.21,1.02-1.45,p = 0.033）。患有糖尿病肾病的男性发生结直肠癌的风险明显高于没有肾病的糖尿病男性（1.51,1.23-1.86）。结论：我们的研究表明，非复杂性T2D患者在T2D诊断后的前10年内发生CRC的风险增加。在长期随访中，合并T2D的患者发生结直肠癌的风险也升高。

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引用次数: 0

Geographic access to colonoscopy, neighborhood social vulnerability, and associations with late-stage colorectal cancers in Maryland: 2010–2021 马里兰州结肠镜检查的地理可及性、社区社会脆弱性与晚期结直肠癌的关系：2010-2021

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-16 DOI: 10.1016/j.canep.2025.102880

Samuel Roubin , Broderick Yoerg , Michael R. Desjardins

Background

Early detection of colorectal cancer (CRC) significantly improves survival. However, geographic inaccessibility of colonoscopies may prevent timely and effective screenings. The relationship between spatial access to colonoscopy providers, social determinants of health, and stage at CRC diagnosis remains understudied. We evaluated how place-based factors and individual characteristics are related to CRC diagnosis stage.

Methods

This cross-sectional, population-based study includes all CRC patients aged 50–84 at diagnosis between 2010 and 2021 from the Maryland Department of Health’s Cancer Registry (n = 21,599). We measured the spatial (geographic) accessibility to colonoscopy providers across Maryland at the census tract level using the Enhanced Two-Step Floating Catchment Area (E2SFCA) method. Multilevel logistic regression models were used to examine associations between late-stage CRC diagnosis and spatial accessibility, four census tract-level social vulnerability themes, rurality, and individual-level covariates.

Results

Among colorectal cancer cases with known stage (n = 19,239), 63.2 % (n = 12,151) were diagnosed at late-stage. Increasing socioeconomic vulnerability quartiles were associated with greater odds of late-stage diagnosis (Q4 vs Q1: OR, 1.17; 95 % CI, 1.04–1.32), while rural residence was associated with lower odds (OR, 0.69; 95 % CI, 0.59–0.80). Geographic access to colonoscopy providers was not significantly associated with late-stage diagnosis.

Conclusion

Findings suggest that non-spatial accessibility factors and place-based social determinants of health are more important than geographic access alone in influencing risk of late-stage colorectal cancer diagnosis. Public health interventions in Maryland should aim to target communities of high social vulnerability, particularly those with low socioeconomic status. Although our analysis is limited to Maryland, the results are broadly consistent with similar studies across U.S. settings and may be relevant in other states. Future studies should examine the barriers to CRC screening and diagnosis beyond geographic access.

背景：结直肠癌（CRC）的早期检测可显著提高生存率。然而，由于地理位置上的不便，结肠镜检查可能会妨碍及时有效的筛查。结肠镜检查提供者的空间可及性、健康的社会决定因素和结直肠癌诊断阶段之间的关系仍未得到充分研究。我们评估了基于地点的因素和个体特征与CRC诊断阶段的关系。方法：这项基于人群的横断面研究包括2010年至2021年间马里兰州卫生部癌症登记处（n = 21,599）诊断时年龄为50-84岁的所有结直肠癌患者。我们使用增强的两步浮动集水区（E2SFCA）方法在人口普查区水平上测量了马里兰州结肠镜检查提供者的空间（地理）可达性。采用多水平逻辑回归模型检验晚期结直肠癌诊断与空间可达性、四个人口普查区水平的社会脆弱性主题、乡村性和个人水平协变量之间的关系。结果在已知分期的结直肠癌病例中（n = 19,239例），63.2 % （n = 12,151例）为晚期诊断。增加的社会经济脆弱性四分位数与更高的晚期诊断几率相关(Q4 vs Q1: OR, 1.17；95 % CI, 1.04-1.32)，而农村居住与较低的几率相关(OR, 0.69；95 % ci, 0.59-0.80)。结肠镜检查提供者的地理位置与晚期诊断无显著相关性。结论非空间可达性因素和基于地方的健康社会决定因素在影响晚期结直肠癌诊断风险方面比地理可达性因素更重要。马里兰州的公共卫生干预措施应以社会脆弱性高的社区为目标，特别是社会经济地位低的社区。虽然我们的分析仅限于马里兰州，但结果与美国各地的类似研究大体一致，可能与其他州相关。未来的研究应该检查结直肠癌筛查和诊断的障碍，而不是地理上的障碍。

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引用次数: 0

Pharyngeal squamous cell carcinoma and risk of later esophageal squamous cell carcinoma – A nationwide population-based matched case-control study 咽鳞状细胞癌和后期食管鳞状细胞癌的风险-一项全国性的基于人群的匹配病例对照研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-15 DOI: 10.1016/j.canep.2025.102876

Peter Elbe , Isabella Ekheden , Miroslav Vujasinovic , John Maret-Ouda , Elin Marsk , Marcus Thuresson , Weimin Ye , Jonas F. Ludvigsson

Background

Pharyngeal squamous cell carcinoma has been linked to later squamous cell carcinoma of the esophagus, but it is unclear if risks are similar to that of Barrett’s esophagus and would justify routine gastroscopy surveillance.

Method

Data on pharyngeal and esophageal cancers in 1980–2016 were retrieved through histopathology reports from Sweden’s 28 pathology departments and linked to national population-based healthcare registers. We calculated hazard ratios (HRs) for esophageal cancer and death in patients with pharyngeal carcinoma compared to a matched general population, and in a secondary analysis also compared to siblings of patients.

Results

We identified 1055 adults with pharyngeal cancer without prior or concomitant cancer. 78 % were men and median age at diagnosis of pharyngeal cancer was 64 years. During a median follow-up of 2.5 years four (0.4 %) patients developed esophageal squamous cell carcinoma, equal to 1 in 263 patients (HR = 14.3; 95 % CI = 1.6–132.3). In a competing risk analysis, the risk estimate for ESCC dropped and did not attain statistical significance (subdistribution HR=1.9 (95 % CI=0.7–5.2)). Some 855 patients (81 %) died during follow-up, representing a 7.7-fold increased risk of death among patients with pharyngeal cancer (Cox regression: HR=7.7; 95 % CI = 6.8–8.6).

Conclusion

The yearly risk of developing esophageal squamous cell carcinoma was 0.07 %. This is lower than in Barrett’s esophagus and argues against long-term endoscopic surveillance among patients with pharyngeal cancer.

Level of Evidence

3

咽部鳞状细胞癌与后来的食管鳞状细胞癌有关，但尚不清楚其风险是否与Barrett食管相似，是否有必要进行常规胃镜检查。方法通过瑞典28个病理科室的组织病理学报告检索1980-2016年咽癌和食管癌的数据，并与全国人口卫生保健登记册相关联。我们计算了咽癌患者与匹配的一般人群相比食管癌和死亡的风险比（hr），并在二次分析中与患者的兄弟姐妹进行了比较。结果我们确定了1055例没有既往或合并癌症的咽喉癌成人患者。78 %为男性，诊断咽喉癌时的中位年龄为64岁。在中位随访2.5年期间，4例（0.4 %）患者发生食管鳞状细胞癌，相当于263例患者中有1例(HR = 14.3；95 % ci = 1.6-132.3)。在竞争风险分析中，ESCC的风险估估值下降，没有达到统计学意义（亚分布HR=1.9(95 % CI= 0.7-5.2)）。随访期间约有855名患者（81% %）死亡，咽癌患者的死亡风险增加了7.7倍(Cox回归：HR=7.7；95 % ci = 6.8-8.6)。结论食管癌的年发病风险为0.07 %。这比巴雷特食管低，因此反对在咽癌患者中进行长期内窥镜检查。证据水平

{"title":"Pharyngeal squamous cell carcinoma and risk of later esophageal squamous cell carcinoma – A nationwide population-based matched case-control study","authors":"Peter Elbe , Isabella Ekheden , Miroslav Vujasinovic , John Maret-Ouda , Elin Marsk , Marcus Thuresson , Weimin Ye , Jonas F. Ludvigsson","doi":"10.1016/j.canep.2025.102876","DOIUrl":"10.1016/j.canep.2025.102876","url":null,"abstract":"<div><h3>Background</h3><div>Pharyngeal squamous cell carcinoma has been linked to later squamous cell carcinoma of the esophagus, but it is unclear if risks are similar to that of Barrett’s esophagus and would justify routine gastroscopy surveillance.</div></div><div><h3>Method</h3><div>Data on pharyngeal and esophageal cancers in 1980–2016 were retrieved through histopathology reports from Sweden’s 28 pathology departments and linked to national population-based healthcare registers. We calculated hazard ratios (HRs) for esophageal cancer and death in patients with pharyngeal carcinoma compared to a matched general population, and in a secondary analysis also compared to siblings of patients.</div></div><div><h3>Results</h3><div>We identified 1055 adults with pharyngeal cancer without prior or concomitant cancer. 78 % were men and median age at diagnosis of pharyngeal cancer was 64 years. During a median follow-up of 2.5 years four (0.4 %) patients developed esophageal squamous cell carcinoma, equal to 1 in 263 patients (HR = 14.3; 95 % CI = 1.6–132.3). In a competing risk analysis, the risk estimate for ESCC dropped and did not attain statistical significance (subdistribution HR=1.9 (95 % CI=0.7–5.2)). Some 855 patients (81 %) died during follow-up, representing a 7.7-fold increased risk of death among patients with pharyngeal cancer (Cox regression: HR=7.7; 95 % CI = 6.8–8.6).</div></div><div><h3>Conclusion</h3><div>The yearly risk of developing esophageal squamous cell carcinoma was 0.07 %. This is lower than in Barrett’s esophagus and argues against long-term endoscopic surveillance among patients with pharyngeal cancer.</div></div><div><h3>Level of Evidence</h3><div>3</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"98 ","pages":"Article 102876"},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632574","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

Acute leukaemia: Patient factors associated with unplanned diagnostic pathways and the impact on survival – A nationwide register-based cohort study in Denmark 急性白血病：与计划外诊断途径相关的患者因素及其对生存的影响——丹麦一项全国性的基于登记的队列研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-10 DOI: 10.1016/j.canep.2025.102874

Line Flytkjær Virgilsen , Peter Vedsted , Henry Jensen , Henrik Frederiksen , Tarec Christoffer El-Galaly , Anne Stidsholt Roug , Linda Aagaard Rasmussen

Background

Acute leukaemia (AL) is an aggressive haematological cancer. This study investigated patient factors in unplanned diagnostic pathways and the association with the prognosis and mortality of patients.

Methods

This nationwide register-based study included all patients diagnosed with AL in Denmark in 2014–2018. Diagnostic pathways were divided into elective pathways and unplanned pathways (acute admission within up to 30 days before diagnosis and no planned admissions).

Results

We included 1495 patients with AL. Diagnostic pathway did not differ by sociodemographic characteristics. Patients with a WHO performance score of 2–4 had a 64 % probability of being diagnosed in an unplanned pathway (95 % confidence interval (CI) 59–69 %) versus 47 % (95 % CI 44–50 %) in patients with a WHO performance score of 0–1. High comorbidity level was associated with higher probability of unplanned pathways. Patients in unplanned pathways had lower one-year survival than patients in elective pathways (adjusted all-cause mortality hazard ratio: 1.44 (95 % CI 1.29–1.62). This survival difference disappeared in landmark analyses with three-month delayed entry.

Conclusions

Patients with impaired performance score and high comorbidity level more often experienced an unplanned diagnostic pathway. Unplanned pathway was associated with lower survival and death within 3 months after the diagnosis.

背景：急性白血病（AL）是一种侵袭性血液学癌症。本研究探讨了非计划诊断途径中的患者因素及其与患者预后和死亡率的关系。方法：这项基于全国登记的研究纳入了2014-2018年丹麦所有诊断为AL的患者。诊断途径分为选择性途径和非计划途径（诊断前30天内急性入院和无计划入院）。结果我们纳入了1495例AL患者，诊断途径没有因社会人口学特征而异。世卫组织绩效评分为2-4的患者在计划外途径中被诊断的概率为64% %(95 %可信区间（CI） 59-69 %)，而世卫组织绩效评分为0-1的患者为47 %（95 % CI 44-50 %）。高合并症水平与计划外途径的可能性较高相关。非计划路径患者的一年生存率低于选择路径患者(调整后全因死亡率风险比：1.44（95 % CI 1.29-1.62）。这种生存差异在延迟3个月进入的里程碑分析中消失。结论成绩评分低、合并症发生率高的患者更易出现计划外诊断途径。非计划途径与诊断后3个月内较低的生存率和死亡率相关。

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引用次数: 0

Examining the impact of the COVID-19 pandemic on invasive breast cancer incidence in Ireland: A population-based study 检查COVID-19大流行对爱尔兰浸润性乳腺癌发病率的影响：一项基于人群的研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology

Pub Date : 2025-07-07 DOI: 10.1016/j.canep.2025.102864

Jessica O’Driscoll , Paula A. Tierney , Joe McDevitt , Aline Brennan , Maria Theresa Redaniel , Mengyang Zhang , Kathleen Bennett , Deirdre Murray , Maeve Mullooly

Background

This study aimed to investigate the COVID-19 impact on invasive breast cancer incidence and one-year survival in Ireland.

Methods

Anonymised aggregate population data from the National Cancer Registry Ireland were used to examine incidence between 2014 and 2020 and differences in the distribution of clinical characteristics using chi-squared tests. Negative binomial regression examined the association between incidence and year of diagnosis. One-year survival was examined by year of diagnosis using Cox proportional hazards regression modelling.

Results

For 2020, the age-standardised incidence rate (ASR, per 100,000 females) was 131.9, compared to 163.9 for 2019. In 2020, the incidence rate significantly declined (IRR = 0.41, 95 % CI = 0.22, 0.75) relative to 2019. Fewer cases presented through organised screening (-62.3 %), while similar or increased numbers presented with symptoms (0.1 %) and via other methods (9.0 %) respectively in 2020, compared to 2019. Significant differences were observed in case distribution by ER status (p = 0.02) and stage (p < 0.01) between 2019 and 2020. One-year survival was similar for cases diagnosed during 2014–2019 and in 2020 (HR = 1.07, 95 % CI = 0.89, 1.27).

Conclusions

These findings demonstrate reductions in invasive breast cancer incidence and no difference in one-year survival following the pandemic onset. Additional studies to determine the longer-term COVID-19 impact are needed.

本研究旨在调查COVID-19对爱尔兰浸润性乳腺癌发病率和一年生存率的影响。方法使用来自爱尔兰国家癌症登记处的匿名汇总人口数据，使用卡方检验检查2014年至2020年之间的发病率和临床特征分布的差异。负二项回归检验了发病率与诊断年份之间的关系。采用Cox比例风险回归模型，按诊断年份检查一年生存率。结果2020年，年龄标准化发病率（ASR，每10万名女性）为131.9，而2019年为163.9。与2019年相比，2020年的发病率明显下降（IRR = 0.41, 95 % CI = 0.22, 0.75）。与2019年相比，2020年通过有组织筛查出现的病例较少（-62.3 %），而通过其他方法出现症状的人数（0.1 %）和其他方法出现症状的人数（9.0 %）相似或增加。2019年和2020年之间，ER状态（p = 0.02）和分期（p <； 0.01）的病例分布存在显著差异。2014-2019年和2020年确诊病例的一年生存率相似（HR = 1.07, 95 % CI = 0.89, 1.27）。结论：这些发现表明，大流行爆发后浸润性乳腺癌发病率降低，一年生存率无差异。需要进一步研究以确定COVID-19的长期影响。

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