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Is there an association between mastitis and breast cancer? a retrospective cohort study from Germany. 德国的一项回顾性队列研究:乳腺炎与乳腺癌之间是否存在关联?
IF 4.6 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-29 DOI: 10.1007/s10552-024-01909-w
Vedanth D Krishnan, Karel Kostev, Matthias Kalder

Purpose: The aim of the study was to explore the association between mastitis and subsequent breast cancer.

Methods: This retrospective cohort study included women aged ≥ 18 years with an initial mastitis diagnosis from 315 office-based gynecologists in Germany between January 2005 and December 2021. Women without mastitis were matched to women with mastitis using propensity score matching based on age, index year, average yearly consultation frequency during the follow-up period, and coexisting diseases such as obesity, benign mammary dysplasia, hypertrophy of the breast, unspecified lump of breast, and other disorders of the breast. The 10-year cumulative incidence of breast cancer for the mastitis-cohort and non-mastitis-cohort was studied with Kaplan-Meier curves using the log-rank test. The association between mastitis and breast cancer was studied separately for four age groups with univariable Cox regression analyses.

Results: In the follow-up period of 7 months to 10 years after the index date, 2.9% of mastitis patients and 2.4% of matched non-mastitis patients were diagnosed with breast cancer. A Cox regression analysis revealed a significant association between mastitis and subsequent breast cancer (HR: 1.37; 95% CI: 1.11-1.70). According to the age-stratified analyses, a strong and significant association was only observed in the age group > 50 years (HR: 1.73; 95% 1.25-2.40).

Conclusion: The findings of our retrospective cohort study support an association between mastitis and subsequent breast cancer diagnoses in women aged > 50 years. The pathophysiological basis and possibility of confounders however requires further investigation.

目的:该研究旨在探讨乳腺炎与后续乳腺癌之间的关系:这项回顾性队列研究纳入了 2005 年 1 月至 2021 年 12 月期间德国 315 名妇科医生诊室中初次诊断为乳腺炎的 18 岁以上女性。根据年龄、指数年、随访期间的年均就诊频率以及并存疾病(如肥胖、良性乳腺发育不良、乳腺肥大、乳腺不明肿块和其他乳腺疾病),采用倾向得分匹配法将未患乳腺炎的女性与患乳腺炎的女性进行配对。采用对数秩检验法,以 Kaplan-Meier 曲线研究了乳腺炎队列和非乳腺炎队列的 10 年乳腺癌累积发病率。通过单变量考克斯回归分析,分别研究了四个年龄组的乳腺炎与乳腺癌之间的关系:结果:在发病日期后 7 个月至 10 年的随访期间,2.9% 的乳腺炎患者和 2.4% 的非乳腺炎患者被确诊为乳腺癌。Cox 回归分析显示,乳腺炎与随后的乳腺癌之间存在显著关联(HR:1.37;95% CI:1.11-1.70)。根据年龄分层分析,只有年龄大于 50 岁的人群才与乳腺炎有显著联系(HR:1.73;95% 1.25-2.40):我们的回顾性队列研究结果支持乳腺炎与年龄大于 50 岁的妇女随后被诊断为乳腺癌之间存在关联。然而,病理生理学基础和混杂因素的可能性还需要进一步研究。
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引用次数: 0
Indigenous access to clinical services along the lung cancer treatment pathway: a review of current evidence. 土著居民在肺癌治疗过程中获得临床服务的途径:现有证据综述。
IF 4.6 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-16 DOI: 10.1007/s10552-024-01904-1
Virginia Signal, Moira Smith, Shaun Costello, Anna Davies, Paul Dawkins, Christopher G C A Jackson, Jonathan Koea, Jesse Whitehead, Jason Gurney

Background: Lung cancer is a deadly cancer. Early diagnosis and access to timely treatment are essential to maximizing the likelihood of survival. Indigenous peoples experience enduring disparities in lung cancer survival, and disparities in access to and through lung cancer services is one of the important drivers of these disparities. In this manuscript, we aimed to examine the current evidence on disparities in Indigenous access to services along the lung cancer treatment pathway.

Methods: A narrative literature review was conducted for all manuscripts and reports published up until July 20, 2022, using Medline, Scopus, Embase, and Web of Science. Following the identification of eligible literature, full-text versions were scanned for relevance for inclusion in this review, and relevant information was extracted. After scanning 1,459 documents for inclusion, our final review included 36 manuscripts and reports that included information on lung cancer service access for Indigenous peoples relative to non-Indigenous peoples. These documents included data from Aotearoa New Zealand, Australia, Canada, and the USA (including Hawai'i).

Results: Our review found evidence of disparities in access to, and the journey through, lung cancer care for Indigenous peoples. Disparities were most obvious in access to early detection and surgery, with inconsistent evidence regarding other components of the pathway.

Conclusion: These observations are made amid relatively scant data in a global sense, highlighting the need for improved data collection and monitoring of cancer care and outcomes for Indigenous peoples worldwide. Access to early detection and guideline-concordant treatment are essential to addressing enduring disparities in cancer survival experienced by Indigenous peoples globally.

背景:肺癌是一种致命的癌症:肺癌是一种致命的癌症。早期诊断和及时治疗对于最大限度地提高生存率至关重要。原住民在肺癌存活率方面长期存在差异,而获得和通过肺癌服务方面的差异是造成这些差异的重要原因之一。在这篇手稿中,我们旨在研究当前有关原住民在肺癌治疗过程中获得服务方面存在差异的证据:我们使用 Medline、Scopus、Embase 和 Web of Science 对截至 2022 年 7 月 20 日发表的所有手稿和报告进行了叙述性文献综述。在确定符合条件的文献后,对全文进行扫描,以确定是否适合纳入本综述,并提取相关信息。在对 1,459 篇文献进行扫描后,我们的最终综述包括了 36 篇手稿和报告,其中包含了土著居民相对于非土著居民获得肺癌服务的信息。这些文件包括来自新西兰奥特亚罗瓦、澳大利亚、加拿大和美国(包括夏威夷)的数据:我们的研究发现,有证据表明土著居民在获得肺癌治疗的机会和治疗过程中存在差异。在获得早期检测和手术治疗方面的差距最为明显,而在治疗过程的其他方面则存在不一致的证据:这些观察结果是在全球范围内数据相对匮乏的情况下得出的,凸显了改善数据收集和监测全球原住民癌症治疗及结果的必要性。要解决全球原住民在癌症存活率方面长期存在的差距,就必须获得早期检测和与指南相一致的治疗。
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引用次数: 0
Prostate-specific antigen testing patterns and prostate cancer stage at diagnosis in older Ohio cancer patients. 俄亥俄州老年癌症患者诊断时的前列腺特异性抗原检测模式和前列腺癌分期。
IF 4.6 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-03 DOI: 10.1007/s10552-024-01908-x
Sajan N Patel, Long Vu, Holly E Hartman, Weichuan Dong, Siran M Koroukian, Johnie Rose

Background: Prostate cancer (PCa) screening recommendations do not support prostate-specific antigen (PSA) screening for older men. Such screening often occurs, however. It is, therefore, important to understand how frequently and among which subgroups screening occurs, and the extent of distant stage PCa diagnoses among screened older men.

Methods: Using the 2014-2016 linked Ohio Cancer Incidence Surveillance System (OCISS) and Medicare administrative database, we identified men 68 and older diagnosed with PCa and categorized their PSA testing in the three years preceding diagnosis as screening or diagnostic. We conducted multivariable logistic regression analysis to identify correlates of screening PSA and to determine whether screening PSA is independently associated with distant stage disease.

Results: Our study population included 3034 patients (median age: 73 years). 62.1% of PCa patients underwent at least one screening-based PSA in the three years preceding diagnosis. Older age (75-84 years: aOR [95% CI]: 0.84 [0.71, 0.99], ≥ 85: aOR: 0.27 [0.19, 0.38]), and frailty (aOR: 0.51 [0.37, 0.71]) were associated with lower screening. Screening was associated with decreased odds of distant stage disease (aOR: 0.55 [0.42, 0.71]). However, older age (75-84 years: aOR: 2.43 [1.82, 3.25], ≥ 85: aOR: 10.57 [7.05, 15.85]), frailty (aOR: 5.00 [2.78, 9.31]), and being separated or divorced (aOR: 1.64 [1.01, 2.60]) were associated with increased distant stage PCa.

Conclusion: PSA screening in older men is common, though providers appear to curtail PSA screening as age and frailty increase. Screened older men are diagnosed at earlier stages, but the harms of screening cannot be assessed.

背景:前列腺癌(PCa)筛查建议不支持对老年男性进行前列腺特异性抗原(PSA)筛查。然而,这种筛查经常进行。因此,了解筛查的频率、筛查的亚群体以及接受筛查的老年男性中远期 PCa 诊断的程度非常重要:利用 2014-2016 年俄亥俄州癌症发病监测系统 (OCISS) 和医疗保险管理数据库,我们确定了确诊为 PCa 的 68 岁及以上男性,并将他们在确诊前三年的 PSA 检测分为筛查型和诊断型。我们进行了多变量逻辑回归分析,以确定筛查 PSA 的相关性,并确定筛查 PSA 是否与远期疾病独立相关:我们的研究对象包括 3034 名患者(中位年龄:73 岁)。62.1%的 PCa 患者在确诊前三年内至少接受了一次 PSA 筛查。高龄(75-84 岁:aOR [95% CI]:0.84 [0.71, 0.99];≥ 85 岁:aOR:0.27 [0.19, 0.38])和体弱(aOR:0.51 [0.37, 0.71])与筛查率较低有关。筛查与远期疾病几率的降低有关(aOR:0.55 [0.42, 0.71])。然而,年龄较大(75-84 岁:aOR:2.43 [1.82, 3.25];≥ 85 岁:aOR:10.57 [7.05, 15.85])、体弱(aOR:5.00 [2.78, 9.31])、分居或离婚(aOR:1.64 [1.01, 2.60])与远期 PCa 增高有关:结论:PSA筛查在老年男性中很常见,但随着年龄和体弱程度的增加,医疗服务提供者似乎会减少PSA筛查。接受筛查的老年男性可在较早阶段得到诊断,但筛查的危害尚无法评估。
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引用次数: 0
Sleep and cancer mortality in the Cancer Prevention Study-II. 癌症预防研究-II》中的睡眠与癌症死亡率。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s10552-024-01910-3
Sidney M Donzella, Emily Deubler, Alpa V Patel, Amanda I Phipps, Charlie Zhong

Purpose: Sleep is a multi-dimensional human function that is associated with cancer outcomes. Previous work on sleep and cancer mortality have not investigated how this relationship varies by sex and cancer site. We investigated the association of sleep duration and perceived insomnia with site-specific and overall cancer mortality among participants in the Cancer Prevention Study-II.

Methods: Sleep was collected at baseline in 1982 among 1.2 million cancer-free US adults. Cancer-specific mortality was determined through 2018. We used multivariable Cox proportional hazard models to calculate hazard ratios and 95% confidence intervals for overall and site-specific cancer mortality, stratified by sex.

Results: Among 983,105 participants (56% female) followed for a median of 27.9 person-years, there were 146,911 primary cancer deaths. Results from the adjusted model showed short (6 h/night) and long (8 h/night and 9-14 h/night) sleep duration, compared to 7 h/night, were associated with a modest 2%, 2%, and 5% higher risk of overall cancer mortality, respectively, and there was a significant non-linear trend (p-trend < 0.01). This non-linear trend was statistically significant among male (p-trend < 0.001) but not female (p-trend 0.71) participants. For male participants, short and long sleep were associated with higher risk of lung cancer mortality and long sleep was associated with higher risk of colorectal cancer mortality. Perceived insomnia was associated with a 3-7% lower risk of overall cancer mortality.

Conclusion: Sleep is important to consider in relation to sex- and site-specific cancer mortality. Future research should investigate other components of sleep in relation to cancer mortality.

目的:睡眠是一项多维度的人体功能,与癌症的预后有关。以往有关睡眠和癌症死亡率的研究并未调查这种关系如何因性别和癌症部位而异。我们在癌症预防研究-II 的参与者中调查了睡眠时间和感知失眠与特定部位和总体癌症死亡率的关系:方法:1982 年,我们对 120 万未罹患癌症的美国成年人进行了睡眠基线收集。癌症特异性死亡率的测定一直持续到 2018 年。我们使用多变量 Cox 比例危险模型计算了按性别分层的总体和部位特异性癌症死亡率的危险比和 95% 置信区间:983105名参与者(56%为女性)的随访时间中位数为27.9人年,其中146911人死于原发性癌症。调整后的模型结果显示,与7小时/晚相比,睡眠时间短(6小时/晚)和长(8小时/晚和9-14小时/晚)分别与癌症总死亡率略高2%、2%和5%的风险有关,且存在显著的非线性趋势(P-趋势 结论:睡眠与癌症的关系非常重要:睡眠与特定性别和特定部位的癌症死亡率有重要关系。未来的研究应调查与癌症死亡率相关的其他睡眠因素。
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引用次数: 0
Body mass index and the prevalence of high-risk colorectal adenomas in a population undergoing screening colonoscopy in Alberta, Canada. 加拿大艾伯塔省接受结肠镜筛查人群的体重指数和高危结肠直肠腺瘤发病率。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-30 DOI: 10.1007/s10552-024-01914-z
John M Hutchinson, Joshua Chow, Eliya Farah, Matthew T Warkentin, Yibing Ruan, Robert J Hilsden, Darren R Brenner

Purpose: There is limited evidence regarding body mass index (BMI) as an early marker of high-risk adenoma (HRA) at the time of screening colonoscopy. Because high-risk adenomas (HRA) can develop into colorectal cancer (CRC), BMI could serve as an important clinical predictor of future risk of CRC.

Methods: We examined data from 1831 adults undergoing screening colonoscopy at the Forzani & MacPhail Colon Cancer Screening Center in Alberta, Canada. We fit multivariable logistic regression models to examine the association between BMI and HRA. Non-linear relationships for BMI on HRA were also evaluated using restricted cubic splines.

Results: The mean BMI in patients with HRA was 28.2 kg/m2 compared to 27.4 kg/m2 in patients without adenomas (t test: p = 0.003). In the adjusted models, those with a BMI over 30 kg/m2 had 1.45 (95% CI 1.05-2.00) times the odds of HRA detected during colonoscopy compared to those with a BMI below 25 kg/m2. Examining BMI as continuous, the odds of HRA were 1.20 (95% CI 1.04-1.37) times higher for every 5 kg/m2 increase in BMI.

Conclusion: The findings of this study suggest that excess body mass is associated with higher risk of HRA among a screening population and may be useful an early marker of future disease.

目的:关于在进行结肠镜筛查时将体重指数(BMI)作为高危腺瘤(HRA)的早期标志物的证据有限。由于高危腺瘤(HRA)可发展为结直肠癌(CRC),因此体重指数可作为未来患 CRC 风险的重要临床预测指标:我们研究了在加拿大阿尔伯塔省 Forzani & MacPhail 结肠癌筛查中心接受结肠镜筛查的 1831 名成人的数据。我们建立了多变量逻辑回归模型来研究体重指数与 HRA 之间的关系。我们还使用限制性三次样条对 BMI 与 HRA 的非线性关系进行了评估:HRA 患者的平均体重指数为 28.2 kg/m2,而无腺瘤患者的平均体重指数为 27.4 kg/m2(t 检验:P = 0.003)。在调整模型中,与 BMI 低于 25 kg/m2 的患者相比,BMI 超过 30 kg/m2 的患者在结肠镜检查中发现 HRA 的几率是后者的 1.45 倍(95% CI 1.05-2.00)。如果将 BMI 作为连续指标进行研究,BMI 每增加 5 kg/m2 ,HRA 的几率就增加 1.20 倍(95% CI 1.04-1.37):本研究结果表明,在筛查人群中,体重超标与较高的 HRA 风险有关,可能是未来疾病的早期标记。
{"title":"Body mass index and the prevalence of high-risk colorectal adenomas in a population undergoing screening colonoscopy in Alberta, Canada.","authors":"John M Hutchinson, Joshua Chow, Eliya Farah, Matthew T Warkentin, Yibing Ruan, Robert J Hilsden, Darren R Brenner","doi":"10.1007/s10552-024-01914-z","DOIUrl":"10.1007/s10552-024-01914-z","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited evidence regarding body mass index (BMI) as an early marker of high-risk adenoma (HRA) at the time of screening colonoscopy. Because high-risk adenomas (HRA) can develop into colorectal cancer (CRC), BMI could serve as an important clinical predictor of future risk of CRC.</p><p><strong>Methods: </strong>We examined data from 1831 adults undergoing screening colonoscopy at the Forzani & MacPhail Colon Cancer Screening Center in Alberta, Canada. We fit multivariable logistic regression models to examine the association between BMI and HRA. Non-linear relationships for BMI on HRA were also evaluated using restricted cubic splines.</p><p><strong>Results: </strong>The mean BMI in patients with HRA was 28.2 kg/m<sup>2</sup> compared to 27.4 kg/m<sup>2</sup> in patients without adenomas (t test: p = 0.003). In the adjusted models, those with a BMI over 30 kg/m<sup>2</sup> had 1.45 (95% CI 1.05-2.00) times the odds of HRA detected during colonoscopy compared to those with a BMI below 25 kg/m<sup>2</sup>. Examining BMI as continuous, the odds of HRA were 1.20 (95% CI 1.04-1.37) times higher for every 5 kg/m<sup>2</sup> increase in BMI.</p><p><strong>Conclusion: </strong>The findings of this study suggest that excess body mass is associated with higher risk of HRA among a screening population and may be useful an early marker of future disease.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"1525-1529"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Trends in pancreatic cancer mortality in the United States 1999-2020: a CDC database population-based study. 1999-2020 年美国胰腺癌死亡率趋势:疾病预防控制中心数据库人口研究。
IF 4.6 4区 医学 Q3 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-19 DOI: 10.1007/s10552-024-01906-z
Alexander J Didier, Swamroop Nandwani, Alan M Fahoury, Daniel J Craig, Dean Watkins, Andrew Campbell, Caleb T Spencer, Macelyn Batten, Divya Vijendra, Jeffrey M Sutton

Introduction: Pancreatic cancer is a significant public health concern and a leading cause of cancer-related deaths worldwide. This study aimed to investigate pancreatic cancer mortality trends and disparities in the United States (US) from 1999 to 2020.

Methods: Data were obtained from the Centers for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research database. Mortality rates were age-adjusted and standardized to the year 2000 US population. Joinpoint regression was used to analyze temporal trends in age-adjusted mortality rates (AAMRs) by sociodemographic and geographic variables.

Results: Between 1999 and 2020, pancreatic cancer led to a total of 810,628 deaths in the US, an average mortality of nearly 39,000 deaths per year. The AAMR slightly increased from 10.6 in 1999 to 11.1 in 2020, with an associated annual percent change (APC) of 0.2. Mortality rates were highest among individuals aged 65 and older. Black individuals experienced the highest overall pancreatic cancer-related AAMR at 13.8. Despite this, Black individuals experienced a decreasing mortality trend over time (APC -0.2) while White individuals experienced an increasing trend in mortality (APC 0.4). Additionally, individuals residing in rural areas experienced steeper rates of mortality increase than those living in urban areas (APC 0.6 for rural vs -0.2 for urban). White individuals in urban and rural populations experienced an increase in mortality, while Black individuals in urban environments experienced a decrease in mortality, and Black individuals in rural environments experienced stable mortality trends.

Conclusions: Mortality from pancreatic cancer continues to increase in the US, with racial and regional disparities identified in minorities and rural-dwelling individuals. These disparate findings highlight the importance of ongoing efforts to understand and address pancreatic cancer treatment and outcomes disparities in the US, and future studies should further investigate the underlying etiologies of these disparities and potential for novel therapies to reduce the mortality.

导言:胰腺癌是一个重大的公共卫生问题,也是全球癌症相关死亡的主要原因。本研究旨在调查 1999 年至 2020 年美国的胰腺癌死亡率趋势和差异:数据来自美国疾病控制中心(CDC)的流行病学研究广泛在线数据数据库。死亡率经过年龄调整,并以 2000 年美国人口为标准。连接点回归用于分析按社会人口和地理变量划分的年龄调整死亡率(AAMRs)的时间趋势:结果:1999 年至 2020 年间,美国共有 810,628 人死于胰腺癌,平均每年死亡近 39,000 人。美国胰腺癌死亡率从 1999 年的 10.6 略微上升至 2020 年的 11.1,相关的年百分比变化 (APC) 为 0.2。65 岁及以上人群的死亡率最高。黑人与胰腺癌相关的总体死亡率最高,为 13.8。尽管如此,随着时间的推移,黑人的死亡率呈下降趋势(APC -0.2),而白人的死亡率呈上升趋势(APC 0.4)。此外,居住在农村地区的人比居住在城市地区的人的死亡率上升幅度更大(农村地区的 APC 为 0.6,而城市地区的 APC 为-0.2)。城市和农村人口中的白人死亡率上升,而城市环境中的黑人死亡率下降,农村环境中的黑人死亡率趋势稳定:结论:在美国,胰腺癌的死亡率持续上升,在少数民族和农村居民中发现了种族和地区差异。这些不同的研究结果凸显了美国持续努力了解和解决胰腺癌治疗和结果差异的重要性,未来的研究应进一步调查这些差异的潜在病因以及降低死亡率的新型疗法的潜力。
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引用次数: 0
Analysis of Lung Cancer Incidence in Non-Hispanic Black and White Americans using a Multistage Carcinogenesis Model. 使用多阶段致癌模型分析非西班牙裔美国黑人和白人的肺癌发病率。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-19 DOI: 10.1007/s10552-024-01936-7
Sarah Skolnick, Pianpian Cao, Jihyoun Jeon, S Lani Park, Daniel O Stram, Loïc Le Marchand, Rafael Meza

Purpose: There are complex and paradoxical patterns in lung cancer incidence by race/ethnicity and gender; compared to non-Hispanic White (NHW) males, non-Hispanic Black (NHB) males smoke fewer cigarettes per day and less frequently but have higher lung cancer rates. Similarly, NHB females are less likely to smoke but have comparable lung cancer rates to NHW females. We use a multistage carcinogenesis model to study the impact of smoking on lung cancer incidence in NHB and NHW individuals in the Multiethnic Cohort Study (MEC).

Methods: The effects of smoking on the rates of lung tumor initiation, promotion, and malignant conversion, and the incidence of lung cancer in NHB versus NHW adults in the MEC were analyzed using the Two-Stage Clonal Expansion (TSCE) model. Maximum likelihood methods were used to estimate model parameters and assess differences by race/ethnicity, gender, and smoking history.

Results: Smoking increased promotion and malignant conversion but did not affect tumor initiation. Non-smoking-related initiation, promotion, and malignant conversion and smoking-related promotion and malignant conversion differed by race/ethnicity and gender. Non-smoking-related initiation and malignant conversion were higher in NHB than NHW individuals, whereas promotion was lower in NHB individuals.

Conclusion: Findings suggest that while smoking plays an important role in lung cancer risk, background risk not dependent on smoking also plays a significant and under-recognized role in explaining race/ethnicity differences. Ultimately, the resulting TSCE model will inform race/ethnicity-specific lung cancer natural history models to assess the impact of preventive interventions on US lung cancer outcomes and disparities by race/ethnicity.

目的:不同种族/人种和性别的肺癌发病率存在复杂而矛盾的模式;与非西班牙裔白人(NHW)男性相比,非西班牙裔黑人(NHB)男性每天吸烟的数量和频率较低,但肺癌发病率较高。同样,非西班牙裔黑人女性吸烟的可能性较小,但肺癌发病率与非西班牙裔白人女性相当。我们使用多阶段致癌模型来研究多种族队列研究(MEC)中吸烟对 NHB 和 NHW 人肺癌发病率的影响:方法:使用两阶段克隆扩增(TSCE)模型分析了吸烟对肺癌发生率、促进率和恶性转化率的影响,以及多种族队列研究中NHB和NHW成人的肺癌发病率。采用最大似然法估计模型参数,并评估种族/人种、性别和吸烟史的差异:结果:吸烟会增加肿瘤的促发和恶性转化,但不会影响肿瘤的发生。非吸烟相关的肿瘤发生、促进和恶性转化以及吸烟相关的促进和恶性转化因种族/人种和性别而异。非吸烟相关的诱发和恶性转化在非吸烟者中高于非吸烟者,而吸烟相关的诱发和恶性转化在非吸烟者中低于非吸烟者:研究结果表明,虽然吸烟在肺癌风险中起着重要作用,但与吸烟无关的背景风险在解释种族/族裔差异方面也起着重要作用,但这一作用未得到充分认识。最终,TSCE 模型将为特定种族/族裔的肺癌自然史模型提供信息,以评估预防性干预措施对美国肺癌结果的影响以及不同种族/族裔之间的差异。
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引用次数: 0
Cervical cancer screening rates in females living with HIV at three healthcare settings in the United States, 2010-2019. 2010-2019 年美国三种医疗机构中感染艾滋病毒女性的宫颈癌筛查率。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-13 DOI: 10.1007/s10552-024-01937-6
Leigh Sheridan, Gaia Pocobelli, Melissa Anderson, Christopher I Li, Gina R Kruse, Jasmin A Tiro, Aruna Kamineni

Purpose: Females living with human immunodeficiency virus (FLWHIV) are at increased risk of cervical cancer and U.S. guidelines, first published in 2009 and updated since then, recommend more frequent screening in this population. We examined screening rates among FLWHIV in the U.S. during 2010-2019.

Methods: This cohort study included 18-89-year-old FLWHIV during 2010-2019 at three U.S. healthcare settings. Sociodemographics, comorbidities, and cervical cancer screening tests were ascertained from administrative and clinical databases. We reported cervical cancer screening rates overall and by modality. Generalized estimating equations with Poisson distribution were used to estimate screening rate ratios (SRRs) and 95% confidence intervals (CIs) for the associations between screening rates and calendar year, age, race and ethnicity, and comorbidity.

Results: Among 3,556 FLWHIV, a total of 7,704 cervical cancer screening tests were received over 18,605 person-years during 2010-2019 (screening rate = 41.4 per 100 person-years). Relatively lower screening rates were associated with later calendar years (SRR = 0.71 [95% CI 0.68-0.75] for 2017-2019 versus 2010-2013), older age (SRR = 0.82 [95% CI 0.74-0.89] for 50-65-year-olds versus 18-29-year-olds), non-Hispanic white race versus non-Hispanic Black race (SRR = 0.89 [95% CI 0.81-0.98]) and greater comorbidity burden (SRR = 0.89 [95% CI 0.82-0.98] for ≥ 9 versus 0-6 comorbidity score).

Conclusion: The decrease in cervical cancer screening rates during 2010-2019 in this large cohort of FLWHIV may be explained at least partly by guideline changes during the study period recommending longer screening intervals. Our findings of relatively lower screening rates in FLWHIV who were non-Hispanic white, older, and with greater comorbidity burden should be confirmed in other U.S.

Settings:

目的感染人类免疫缺陷病毒(FLWHIV)的女性罹患宫颈癌的风险更高,2009 年首次发布并在此后更新的美国指南建议对这一人群进行更频繁的筛查。我们研究了 2010-2019 年期间美国 FLWHIV 的筛查率:这项队列研究纳入了 2010-2019 年间在美国三家医疗机构就诊的 18-89 岁 FLWHIV 患者。社会人口统计学、合并症和宫颈癌筛查测试均来自行政和临床数据库。我们报告了宫颈癌筛查率的总体情况和不同方式的筛查率。我们使用泊松分布的广义估计方程来估计筛查率比(SRRs)以及筛查率与日历年、年龄、种族和民族以及合并症之间关系的 95% 置信区间(CIs):2010-2019年期间,在3556名FLWHIV中,共有18605人年接受了7704次宫颈癌筛查(筛查率=41.4/100人年)。筛查率相对较低与日历年较晚(2017-2019 年与 2010-2013 年相比,SRR = 0.71 [95% CI 0.68-0.75])、年龄较大(50-65 岁的 SRR = 0.82 [95% CI 0.74-0.89])、非西班牙裔白人种族与非西班牙裔黑人种族(SRR = 0.89 [95% CI 0.81-0.98])和更大的合并症负担(合并症评分≥9分与0-6分的SRR = 0.89 [95% CI 0.82-0.98]):这一庞大的 FLWHIV 群体的宫颈癌筛查率在 2010-2019 年期间有所下降,其原因至少有一部分是由于研究期间指南的变化,建议延长筛查间隔时间。我们的研究结果表明,在非西班牙裔白人、年龄较大、合并症较多的 FLWHIV 中,筛查率相对较低,这一结果应在美国其他地区得到证实:
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引用次数: 0
Prognosis impact and clinical findings in renal cancer patients: comparative analysis between public and private health coverage in a cross-sectional and multicenter context. 肾癌患者的预后影响和临床发现:在横断面和多中心背景下对公共和私人医疗保险的比较分析。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1007/s10552-024-01891-3
Eduardo Barrera-Juarez, Antonio Nassim Halun-Trevino, Manuel Ruelas-Martinez, Andres Madero-Frech, Victor Camacho-Trejo, Miguel Estrada-Bujanos, David Bojorquez, Jhonatan Uribe-Montoya, Francisco Rodriguez-Covarrubias, Cynthia Villarreal-Garza

Purpose: Research on disparities in prognosis and clinical characteristics between public and private healthcare sectors in developing countries remains limited. The study aimed to determine whether patients with public health coverage (1) have a greater mean tumor size at diagnosis compared to those with private health coverage; (2) exhibit differences in clinical staging and TNM classification between groups; and (3) show variations in demographic, clinical characteristics, histopathological findings, and surgical approaches among cohorts.

Methods: A cross-sectional, multicenter study was conducted on 629 patients from both private and public healthcare sectors, all histologically confirmed and surgically treated for Renal Cell Carcinoma (RCC), between 2011 and 2021 in high-volume hospitals in Monterrey, Mexico. To compare variables between groups, we employed independent samples t-tests, Mann Whitney U nonparametric test, along with Pearson's chi-square test complemented by post hoc analyses.

Results: Mean tumor size in the public group was 1.9 cm greater than in the private group (7.39 vs. 5.51 cm, p < 0.001). Patients in the public sector more frequently presented with larger tumors, a higher prevalence of risk factors (excluding BMI and hypertension), advanced disease (OR 2.12, 95% CI 1.43-3.16, p < 0.001), presence of symptoms, elevated TNM, lymphovascular invasion and a lower prevalence of minimally invasive surgery. A male-to-female ratio of 2.6:1 was noted in the private coverage group.

Conclusions: This study highlights a notable association between public health coverage and a higher prevalence of advanced RCC, with tumors in private coverage patients being smaller yet larger than commonly reported. There is a crucial need to develop new health policies for early detection of renal cancer in developing countries.

目的关于发展中国家公立和私立医疗机构之间预后和临床特征差异的研究仍然有限。本研究旨在确定公共医疗保险患者是否(1)与私人医疗保险患者相比,诊断时肿瘤的平均大小更大;(2)组间临床分期和 TNM 分类是否存在差异;以及(3)组间人口统计学、临床特征、组织病理学结果和手术方法是否存在差异:这项横断面多中心研究的对象是 2011 年至 2021 年期间在墨西哥蒙特雷大医院接受过组织学确诊和手术治疗的 629 名私立和公立医疗机构的肾细胞癌(RCC)患者。为了比较组间变量,我们采用了独立样本t检验、曼-惠特尼U非参数检验以及皮尔逊卡方检验,并辅以事后分析:结果:公立组肿瘤的平均大小比私立组大 1.9 厘米(7.39 厘米对 5.51 厘米,P 结论:公立组肿瘤的平均大小比私立组大 1.9 厘米(7.39 厘米对 5.51 厘米,P 结论):这项研究强调了公共医疗保险与晚期 RCC 患病率较高之间的显著关联,私人医疗保险患者的肿瘤比通常报告的要小,但也比通常报告的要大。发展中国家亟需制定新的医疗政策,以便及早发现肾癌。
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引用次数: 0
Racial/ethnic differences in risk factors for non-cardia gastric cancer: an analysis of the Multiethnic Cohort (MEC) Study. 非心源性胃癌风险因素的种族/民族差异:多民族队列(MEC)研究分析。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-07 DOI: 10.1007/s10552-024-01934-9
Alexandra Adams, Atish Gandhi, Patricia Friedmann, Srawani Sarkar, Brijesh Rana, Meira Epplein, Lynne Wilkens, Brian Z Huang, Haejin In

Purpose: Gastric cancer (GC) incidence rates show notable differences by racial/ethnic groups in the US. We sought to determine whether stratification by race/ethnicity would reveal unique risk factors for development of non-cardia gastric cancer (NCGC) for US population.

Methods: Analysis included 1,112 incident cases of NCGC and 190,883 controls from the Multiethnic Cohort Study, a prospective US cohort study that recruited individuals living in Hawaii and California, aged 45-75 years from 5 races/ethnicities. Descriptive analysis and Cox regression models examined the association of risk factors for GC and calculate hazard ratios for each race/ethnicity, adjusting for sociodemographic and dietary variables.

Results: Increasing age and male sex were risk factors for NCGC for most race/ethnicities. Higher risk was associated with: GC family history for Latino and Japanese American individuals [HRs range from 1.75 to 1.98]; foreign-born for Japanese American individuals [HR: 1.52, 95% CI 1.11-2.09]; lower education for African American, Japanese American, and Native Hawaiian individuals [HRs range from 1.30 to 1.74]; daily alcohol consumption for African American individuals[HR: 1.56, 95% CI 1.04-2.35]; current smoking for Latino and Japanese American individuals [HRs range from 1.89 to 1.94]; sodium consumption in the highest quartile for White individuals [HR: 2.55, 95% CI 1.23-5.26] compared to the lowest quartile; fruit consumption in the 2nd, 3rd, and 4th highest quartile for Native Hawaiian individuals [HRs range from 2.19 to 2.60] compared to the lowest quartile; diabetes for African American individuals [HR: 1.79, 95% CI 1.21-2.64]; and gastric/duodenal ulcers for Native Hawaiian individuals [HR: 1.82, 95% CI 1.04-3.18].

Conclusion: Analyses by racial/ethnic group revealed differing risk factors for NCGC. Increased knowledge of the varying pathways to GC can support personalized GC prevention strategies and risk stratification tools for early detection.

目的:在美国,不同种族/族裔群体的胃癌(GC)发病率存在明显差异。我们试图确定按种族/民族分层是否会揭示美国人口患非心源性胃癌(NCGC)的独特风险因素:多种族队列研究是一项前瞻性美国队列研究,招募了居住在夏威夷和加利福尼亚州、年龄在 45-75 岁之间、来自 5 个种族/族裔的人。描述性分析和 Cox 回归模型检验了 GC 风险因素的关联性,并计算了每个种族/族裔的危险比,同时调整了社会人口学和饮食变量:在大多数种族/人种中,年龄和男性性别的增加是NCGC的风险因素。高风险与以下因素有关拉美裔和日裔美国人的 GC 家族史[HRs 从 1.75 到 1.98 不等];日裔美国人在国外出生[HR:1.52,95% CI 1.11-2.09];非裔美国人、日裔美国人和夏威夷原住民受教育程度较低[HRs 从 1.30 到 1.74 不等];非裔美国人每天饮酒[HR:1.56,95% CI 1.04-2.35];拉美裔和日裔美国人目前吸烟[HRs 从 1.89 到 1.94 不等];钠盐摄入量较高[HRs 从 1.89 到 1.94 不等]。89至1.94];与最低四分位数相比,白人的钠消耗量处于最高四分位数[HR:2.55,95% CI 1.23-5.26];与夏威夷原住民相比,夏威夷原住民的水果消耗量处于最高的第二、第三和第四四分位数[HR:2.19至2.60]。与最低四分位数相比,非裔美国人的糖尿病[HR:1.79,95% CI 1.21-2.64];夏威夷原住民的胃/十二指肠溃疡[HR:1.82,95% CI 1.04-3.18]:按种族/族裔群体进行的分析显示,NCGC的风险因素各不相同。增加对导致 GC 的不同途径的了解有助于制定个性化的 GC 预防策略和早期检测的风险分层工具。
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引用次数: 0
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Cancer Causes & Control
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