首页 > 最新文献

Cancer Epidemiology Biomarkers & Prevention最新文献

英文 中文
Prostate Cancer Diagnosis Rates among Insured Men with and without HIV in South Africa: A Cohort Study. 南非感染和未感染艾滋病毒的投保男性的前列腺癌诊断率:一项队列研究。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0137
Yann Ruffieux, Nathalie V Fernández Villalobos, Christiane Didden, Andreas D Haas, Chido Chinogurei, Morna Cornell, Matthias Egger, Gary Maartens, Naomi Folb, Eliane Rohner

Background: Several studies have found lower prostate cancer diagnosis rates among men with human immunodeficiency virus (HIV; MWH) than men without HIV but reasons for this finding remain unclear.

Methods: We used claims data from a South African private medical insurance scheme (July 2017- July 2020) to assess prostate cancer diagnosis rates among men aged ≥ 18 years with and without HIV. Using flexible parametric survival models, we estimated hazard ratios (HR) for the association between HIV and incident prostate cancer diagnoses. We accounted for potential confounding by age, population group, and sexually transmitted infections (confounder-adjusted model) and additionally for potential mediation by prostatitis diagnoses, prostate-specific antigen testing, and prostate biopsies (fully adjusted model).

Results: We included 288,194 men, of whom 20,074 (7%) were living with HIV. Prostate cancer was diagnosed in 1,614 men without HIV (median age at diagnosis: 67 years) and in 82 MWH (median age at diagnosis: 60 years). In the unadjusted analysis, prostate cancer diagnosis rates were 35% lower among MWH than men without HIV [HR, 0.65; 95% confidence interval (CI), 0.52-0.82]. However, this association was no longer evident in the confounder-adjusted model (HR, 1.03; 95% CI, 0.82-1.30) or in the fully adjusted model (HR, 1.14; 95% CI, 0.91-1.44).

Conclusions: When accounting for potential confounders and mediators, our analysis found no evidence of lower prostate cancer diagnosis rates among MWH than men without HIV in South Africa.

Impact: Our results do not support the hypothesis that HIV decreases the risk of prostate cancer.

背景:多项研究发现,感染艾滋病毒的男性(MWH)前列腺癌诊断率低于未感染艾滋病毒的男性:一些研究发现,感染 HIV 的男性(MWH)的前列腺癌诊断率低于未感染 HIV 的男性,但这一发现的原因仍不清楚:我们利用南非私人医疗保险计划(07/2017-07/2020)的理赔数据,评估了年龄≥18 岁的男性艾滋病病毒感染者和非艾滋病病毒感染者的前列腺癌诊断率。利用灵活的参数生存模型,我们估算出了 HIV 与前列腺癌诊断率之间的危险比 (HR)。我们考虑了年龄、人群和性传播感染(混杂因素调整模型)的潜在混杂因素,还考虑了前列腺炎诊断、前列腺特异性抗原(PSA)检测和前列腺活检(完全调整模型)的潜在中介因素:我们纳入了 288 194 名男性,其中 20 074 人(7%)感染了艾滋病毒。有 1 614 名未感染 HIV 的男性(确诊年龄中位数为 67 岁)和 82 名 MWH(确诊年龄中位数为 60 岁)确诊为前列腺癌。在未经调整的分析中,MWH 的前列腺癌诊断率比未感染 HIV 的男性低 35%(HR 0.65,95% 置信区间 [CI]0.52-0-82)。然而,在混杂因素调整模型(HR 1.03,95% CI 0.82-1.30)或完全调整模型(HR 1.14,95% CI 0.91-1.44)中,这种关联不再明显:当考虑到潜在的混杂因素和中介因素时,我们的分析没有发现南非感染艾滋病毒的男性前列腺癌诊断率低于未感染艾滋病毒的男性的证据:影响:我们的研究结果并不支持艾滋病会降低前列腺癌风险的假设。
{"title":"Prostate Cancer Diagnosis Rates among Insured Men with and without HIV in South Africa: A Cohort Study.","authors":"Yann Ruffieux, Nathalie V Fernández Villalobos, Christiane Didden, Andreas D Haas, Chido Chinogurei, Morna Cornell, Matthias Egger, Gary Maartens, Naomi Folb, Eliane Rohner","doi":"10.1158/1055-9965.EPI-24-0137","DOIUrl":"10.1158/1055-9965.EPI-24-0137","url":null,"abstract":"<p><strong>Background: </strong>Several studies have found lower prostate cancer diagnosis rates among men with human immunodeficiency virus (HIV; MWH) than men without HIV but reasons for this finding remain unclear.</p><p><strong>Methods: </strong>We used claims data from a South African private medical insurance scheme (July 2017- July 2020) to assess prostate cancer diagnosis rates among men aged ≥ 18 years with and without HIV. Using flexible parametric survival models, we estimated hazard ratios (HR) for the association between HIV and incident prostate cancer diagnoses. We accounted for potential confounding by age, population group, and sexually transmitted infections (confounder-adjusted model) and additionally for potential mediation by prostatitis diagnoses, prostate-specific antigen testing, and prostate biopsies (fully adjusted model).</p><p><strong>Results: </strong>We included 288,194 men, of whom 20,074 (7%) were living with HIV. Prostate cancer was diagnosed in 1,614 men without HIV (median age at diagnosis: 67 years) and in 82 MWH (median age at diagnosis: 60 years). In the unadjusted analysis, prostate cancer diagnosis rates were 35% lower among MWH than men without HIV [HR, 0.65; 95% confidence interval (CI), 0.52-0.82]. However, this association was no longer evident in the confounder-adjusted model (HR, 1.03; 95% CI, 0.82-1.30) or in the fully adjusted model (HR, 1.14; 95% CI, 0.91-1.44).</p><p><strong>Conclusions: </strong>When accounting for potential confounders and mediators, our analysis found no evidence of lower prostate cancer diagnosis rates among MWH than men without HIV in South Africa.</p><p><strong>Impact: </strong>Our results do not support the hypothesis that HIV decreases the risk of prostate cancer.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kidney Cancer Incidence among Non-Hispanic American Indian and Alaska Native Populations in the United States, 1999 to 2020. 1999-2020 年美国非西班牙裔美国印第安人和阿拉斯加原住民的肾癌发病率。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0179
Stephanie C Melkonian, Melissa A Jim, Donald Haverkamp, Madeleine Lee, Amanda E Janitz, Janis E Campbell

Background: Non-Hispanic American Indian and Alaska Native (NH-AI/AN) people exhibit a disproportionate incidence of kidney cancer. Nationally aggregated data do not allow for a comprehensive description of regional disparities in kidney cancer incidence among NH-AI/AN communities. This study examined kidney cancer incidence rates and trends among NH-AI/AN compared with non-Hispanic White (NHW) populations by geographic region.

Methods: Using the United States Cancer Statistics American Indian and Alaska Native (AI/AN) Incidence Analytic Database, age-adjusted incidence rates (per 100,000) of kidney cancers for NH-AI/AN and NHW people for the years 2011 to 2020 combined using surveillance, epidemiology, and end Results (SEER)∗stat software. Analyses were restricted to non-Hispanic individuals living in purchased/referred care delivery area (PRCDA) counties. Average annual percent changes (AAPCs) and trends (1999-2019) were estimated using Joinpoint regression analyses.

Results: Rates of kidney cancer incidence were higher among NH-AI/AN compared with NHW persons in the United States overall and in five of six regions. Kidney cancer incidence rates also varied by region, sex, age, and stage of diagnosis. Between 1999 and 2019, trends in kidney cancer rates significantly increased among NH-AI/AN males (AAPC = 2.7%) and females (AAPC = 2.4%). The largest increases were observed for NH-AI/AN males and females aged less than 50 years and those diagnosed with localized-stage disease.

Conclusions: Study findings highlight growing disparities in kidney cancer incidence rates between NH-AI/AN and NHW populations.

Impact: Differences in geographic region, sex, and stage highlight the opportunities to decrease the prevalence of kidney cancer risk factors and improve access to preventive care.

背景非西班牙裔美国印第安人和阿拉斯加原住民(NH-AI/AN)的肾癌发病率过高。全国性的汇总数据无法全面描述 NH-AI/AN 社区肾癌发病率的地区差异。本研究按地理区域描述了与非西班牙裔白人(NHW)相比,NH-AI/AN 的肾癌发病率及其趋势。方法 我们利用美国癌症统计美国印第安人和阿拉斯加原住民(AI/AN)发病分析数据库,使用 SEER*stat 软件计算了 2011-2020 年 NH-AI/AN 和 NHW 人群中经年龄调整的肾癌发病率(每 10 万人)。分析仅限于居住在购买/转诊医疗服务地区(PRCDA)县的非西班牙裔人群。使用 Joinpoint 回归分析估算了年均百分比变化 (AAPC) 和趋势(1999-2019 年)。结果 在美国整体以及 6 个地区中的 5 个地区,与 NHW 相比,NH-AI/AN 的肾癌发病率更高。肾癌发病率也因地区、性别、年龄和诊断阶段而异。从 1999 年到 2019 年,美国新罕布什尔州男性(AAPC = 2.7%)和女性(AAPC = 2.4%)的肾癌发病率呈显著上升趋势。据观察,50 岁以下的新罕布什尔-美国印第安人/加拿大男性和女性以及被诊断为局部阶段性疾病的患者的发病率增幅最大。结论 研究结果表明,在 NH-AI/AN 和 NHW 人口中,肾癌发病率的差距越来越大。影响:地理区域、性别和分期的差异凸显了降低肾癌风险因素流行率和改善预防保健的机会。
{"title":"Kidney Cancer Incidence among Non-Hispanic American Indian and Alaska Native Populations in the United States, 1999 to 2020.","authors":"Stephanie C Melkonian, Melissa A Jim, Donald Haverkamp, Madeleine Lee, Amanda E Janitz, Janis E Campbell","doi":"10.1158/1055-9965.EPI-24-0179","DOIUrl":"10.1158/1055-9965.EPI-24-0179","url":null,"abstract":"<p><strong>Background: </strong>Non-Hispanic American Indian and Alaska Native (NH-AI/AN) people exhibit a disproportionate incidence of kidney cancer. Nationally aggregated data do not allow for a comprehensive description of regional disparities in kidney cancer incidence among NH-AI/AN communities. This study examined kidney cancer incidence rates and trends among NH-AI/AN compared with non-Hispanic White (NHW) populations by geographic region.</p><p><strong>Methods: </strong>Using the United States Cancer Statistics American Indian and Alaska Native (AI/AN) Incidence Analytic Database, age-adjusted incidence rates (per 100,000) of kidney cancers for NH-AI/AN and NHW people for the years 2011 to 2020 combined using surveillance, epidemiology, and end Results (SEER)∗stat software. Analyses were restricted to non-Hispanic individuals living in purchased/referred care delivery area (PRCDA) counties. Average annual percent changes (AAPCs) and trends (1999-2019) were estimated using Joinpoint regression analyses.</p><p><strong>Results: </strong>Rates of kidney cancer incidence were higher among NH-AI/AN compared with NHW persons in the United States overall and in five of six regions. Kidney cancer incidence rates also varied by region, sex, age, and stage of diagnosis. Between 1999 and 2019, trends in kidney cancer rates significantly increased among NH-AI/AN males (AAPC = 2.7%) and females (AAPC = 2.4%). The largest increases were observed for NH-AI/AN males and females aged less than 50 years and those diagnosed with localized-stage disease.</p><p><strong>Conclusions: </strong>Study findings highlight growing disparities in kidney cancer incidence rates between NH-AI/AN and NHW populations.</p><p><strong>Impact: </strong>Differences in geographic region, sex, and stage highlight the opportunities to decrease the prevalence of kidney cancer risk factors and improve access to preventive care.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HPV Extended Genotyping to Triage Abnormal Cervical Cancer Screens-Balancing the Harms and Benefits of an Additional Triage Test before Direct Colposcopy Referral. 用于宫颈癌筛查异常分流的 HPV 扩展基因分型--平衡直接阴道镜检查转诊前额外分流检测的危害与益处。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0655
Anna Gottschlich, Laurie W Smith, Lily Proctor, Gina S Ogilvie

The Netherlands' cervical cancer screening program transitioned to primary human papillomavirus (HPV) screening in 2017. After the introduction of HPV-based screening, the country saw increases in colposcopy referral rates and detections of low-grade lesions. In July 2022, genotyping was introduced, and those with borderline or mild dyskaryotic (BMD) cytologic abnormalities were only referred to colposcopy if positive for HPV type 16 or 18, and repeat screening otherwise. In this article, various strategies using extended genotyping (HPV16/18/31/33/45/52/58) as a triage test after an abnormal screen were explored using data from HPV-positive participants with normal or BMD cytology in the Population-Based Screening Study Amsterdam (POBASCAM) trial. The authors assessed positive and negative predictive values and colposcopy referral rates for each strategy using extended genotyping to triage women to either direct referral to colposcopy or repeat screening. Direct referral did not meet positive and negative predictive value thresholds for efficiency for any strategies. However, the authors note that direct referral may nonetheless be useful among those with BMD due to minimal increases in colposcopy referrals and concerns of loss to follow-up at repeat screening. These findings demonstrate the potential utility of extended genotyping as a triage test in primary HPV screening programs. The results should be considered alongside the fact that referral to repeat screening may result in loss of engagement of women who need treatment to prevent invasive cancer. See related article by Kroon et al., p. 1037.

荷兰的宫颈癌筛查计划于 2017 年过渡到人类乳头瘤病毒(HPV)初筛。在引入基于 HPV 的筛查后,该国的阴道镜转诊率和低级别病变的检出率均有所上升。2022 年 7 月,引入了基因分型,细胞学边缘或轻度异常(BMD)者只有在 HPV 16 型或 18 型阳性的情况下才转诊至阴道镜检查,否则重复筛查。本文利用阿姆斯特丹人口筛查研究(POBASCAM)试验中细胞学正常或 BMD 的 HPV 阳性参与者的数据,探讨了将扩展基因分型(HPV16/18/31/33/45/52/58)作为筛查异常后分流检测的各种策略。作者评估了每种策略的阳性和阴性预测值以及阴道镜检查转诊率,这些策略使用扩展基因分型将妇女分流为直接转诊至阴道镜检查或重复筛查。任何策略的直接转诊都没有达到阳性和阴性预测值的效率阈值。不过,作者指出,由于阴道镜检查转诊率的增加极少,以及对重复筛查中随访损失的担忧,直接转诊可能对有 BMD 的妇女有用。这些研究结果表明,在HPV初筛项目中,扩展基因分型作为一种分流检验具有潜在的实用性。在考虑这些结果的同时,还应考虑到转诊至重复筛查可能会导致需要治疗以预防浸润性癌症的妇女失去参与的机会。请参阅 Kroon 等人的相关文章,第 1037 页。
{"title":"HPV Extended Genotyping to Triage Abnormal Cervical Cancer Screens-Balancing the Harms and Benefits of an Additional Triage Test before Direct Colposcopy Referral.","authors":"Anna Gottschlich, Laurie W Smith, Lily Proctor, Gina S Ogilvie","doi":"10.1158/1055-9965.EPI-24-0655","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-0655","url":null,"abstract":"<p><p>The Netherlands' cervical cancer screening program transitioned to primary human papillomavirus (HPV) screening in 2017. After the introduction of HPV-based screening, the country saw increases in colposcopy referral rates and detections of low-grade lesions. In July 2022, genotyping was introduced, and those with borderline or mild dyskaryotic (BMD) cytologic abnormalities were only referred to colposcopy if positive for HPV type 16 or 18, and repeat screening otherwise. In this article, various strategies using extended genotyping (HPV16/18/31/33/45/52/58) as a triage test after an abnormal screen were explored using data from HPV-positive participants with normal or BMD cytology in the Population-Based Screening Study Amsterdam (POBASCAM) trial. The authors assessed positive and negative predictive values and colposcopy referral rates for each strategy using extended genotyping to triage women to either direct referral to colposcopy or repeat screening. Direct referral did not meet positive and negative predictive value thresholds for efficiency for any strategies. However, the authors note that direct referral may nonetheless be useful among those with BMD due to minimal increases in colposcopy referrals and concerns of loss to follow-up at repeat screening. These findings demonstrate the potential utility of extended genotyping as a triage test in primary HPV screening programs. The results should be considered alongside the fact that referral to repeat screening may result in loss of engagement of women who need treatment to prevent invasive cancer. See related article by Kroon et al., p. 1037.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859125","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 Epidermal Growth Factor Receptor and Programmed Death Ligand 1 Testing in a Population-Based Lung Cancer Surgical Resection Cohort from 2018 to 2022. 2018-2022年基于人群的肺癌手术切除队列中表皮生长因子受体和程序性死亡配体1检测的流行率。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-23-1401
Matthew P Smeltzer, Olawale A Akinbobola, Meredith A Ray, Carrie Fehnel, Andrea Saulsberry, Kourtney R Dortch, Kelly Pimenta, Anberitha T Matthews, Raymond U Osarogiagbon

Background: Biomarker-directed therapy requires biomarker testing. We assessed the patterns of epidermal growth factor receptor (EGFR) and programmed death ligand 1 (PDL1) testing in a non-small cell lung cancer (NSCLC) resection cohort. We hypothesized that testing would increase but be unevenly distributed across patient-, provider- and institution-level demographics.

Methods: We examined the population-based Mid-South Quality of Surgical Resection (MS-QSR) cohort of NSCLC resections. We evaluated the proportions receiving EGFR and PDL1 testing before and after approval of biomarker-directed adjuvant therapy (2018-2020 vs. 2021-2022). We used association tests and logistic regression to compare factors.

Results: From 2018 to 2022, 1,687 patients had NSCLC resection across 12 MS-QSR institutions: 1,045 (62%) from 2018 to 2020 and 642 (38%) from 2021 to 2022. From 2018 to 2020, 11% had EGFR testing versus 38% in 2021 to 2022 (56% in those meeting ADAURA trial inclusion criteria, P < 0.0001). From 2018 to 2020, 8% had PDL1 testing versus 20% in 2021 to 2022 (P < 0.0001). EGFR testing did not significantly differ by age (P = 0.07), sex (P = 0.99), race (P = 0.33), or smoking history (P = 0.28); PDL1 testing did not differ significantly by age (P = 0.47), sex (P = 0.41), race (P = 0.51), or health insurance (P = 0.07). Testing was significantly less likely in nonteaching and non-Commission on Cancer-accredited hospitals and after resection by cardiothoracic or general surgeons (vs. general thoracic surgeons; all P < 0.05).

Conclusions: EGFR and PDL1 testing increased after approval of biomarker-directed adjuvant therapies. However, testing rates were still suboptimal and differed by institutional- and provider-level factors.

Impact: The association of institutional, pathologist, and surgeon characteristics with differences in testing demonstrate the need for more standardization in testing processes.

背景:生物标志物导向疗法需要生物标志物检测。我们评估了非小细胞肺癌(NSCLC)切除队列中表皮生长因子受体(EGFR)和程序性死亡配体 1(PDL1)的检测模式。我们假设检测会增加,但在患者、提供者和机构层面的人口统计学中分布不均:我们研究了基于人群的中南部手术切除质量(MS-QSR)NSCLC 切除队列。我们评估了在生物标记物导向辅助治疗批准前后(2018-2020 年与 2021-2022 年)接受 EGFR 和 PDL1 检测的比例。我们使用关联检验和逻辑回归来比较各种因素:2018-2022年,12家MS-QSR机构的1687名患者接受了NSCLC切除术:1045例(62%)来自2018-2020年;642例(38%)来自2021-2022年。2018-2020年,11%的患者进行了表皮生长因子受体检测,而2021-2022年,38%的患者进行了表皮生长因子受体检测(符合ADAURA试验纳入标准的患者中,56%进行了表皮生长因子受体检测,p结论:生物标记物导向辅助疗法获批后,表皮生长因子受体(EGFR)和PDL1检测率有所上升。然而,检测率仍未达到最佳水平,且因机构和提供者层面的因素而异:影响:机构、病理学家和外科医生的特征与检测差异的关联表明,检测流程需要更加标准化。
{"title":"Prevalence of Epidermal Growth Factor Receptor and Programmed Death Ligand 1 Testing in a Population-Based Lung Cancer Surgical Resection Cohort from 2018 to 2022.","authors":"Matthew P Smeltzer, Olawale A Akinbobola, Meredith A Ray, Carrie Fehnel, Andrea Saulsberry, Kourtney R Dortch, Kelly Pimenta, Anberitha T Matthews, Raymond U Osarogiagbon","doi":"10.1158/1055-9965.EPI-23-1401","DOIUrl":"10.1158/1055-9965.EPI-23-1401","url":null,"abstract":"<p><strong>Background: </strong>Biomarker-directed therapy requires biomarker testing. We assessed the patterns of epidermal growth factor receptor (EGFR) and programmed death ligand 1 (PDL1) testing in a non-small cell lung cancer (NSCLC) resection cohort. We hypothesized that testing would increase but be unevenly distributed across patient-, provider- and institution-level demographics.</p><p><strong>Methods: </strong>We examined the population-based Mid-South Quality of Surgical Resection (MS-QSR) cohort of NSCLC resections. We evaluated the proportions receiving EGFR and PDL1 testing before and after approval of biomarker-directed adjuvant therapy (2018-2020 vs. 2021-2022). We used association tests and logistic regression to compare factors.</p><p><strong>Results: </strong>From 2018 to 2022, 1,687 patients had NSCLC resection across 12 MS-QSR institutions: 1,045 (62%) from 2018 to 2020 and 642 (38%) from 2021 to 2022. From 2018 to 2020, 11% had EGFR testing versus 38% in 2021 to 2022 (56% in those meeting ADAURA trial inclusion criteria, P < 0.0001). From 2018 to 2020, 8% had PDL1 testing versus 20% in 2021 to 2022 (P < 0.0001). EGFR testing did not significantly differ by age (P = 0.07), sex (P = 0.99), race (P = 0.33), or smoking history (P = 0.28); PDL1 testing did not differ significantly by age (P = 0.47), sex (P = 0.41), race (P = 0.51), or health insurance (P = 0.07). Testing was significantly less likely in nonteaching and non-Commission on Cancer-accredited hospitals and after resection by cardiothoracic or general surgeons (vs. general thoracic surgeons; all P < 0.05).</p><p><strong>Conclusions: </strong>EGFR and PDL1 testing increased after approval of biomarker-directed adjuvant therapies. However, testing rates were still suboptimal and differed by institutional- and provider-level factors.</p><p><strong>Impact: </strong>The association of institutional, pathologist, and surgeon characteristics with differences in testing demonstrate the need for more standardization in testing processes.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330424","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
Mammographic Texture versus Conventional Cumulus Measure of Density in Breast Cancer Risk Prediction: A Literature Review. 乳房 X 线照相术纹理与传统积云密度测量在乳腺癌风险预测中的应用:文献综述。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-23-1365
Zhoufeng Ye, Tuong L Nguyen, Gillian S Dite, Robert J MacInnis, John L Hopper, Shuai Li

Mammographic textures show promise as breast cancer risk predictors, distinct from mammographic density. Yet, there is a lack of comprehensive evidence to determine the relative strengths as risk predictor of textures and density and the reliability of texture-based measures. We searched the PubMed database for research published up to November 2023, which assessed breast cancer risk associations [odds ratios (OR)] with texture-based measures and percent mammographic density (PMD), and their discrimination [area under the receiver operating characteristics curve (AUC)], using same datasets. Of 11 publications, for textures, six found stronger associations (P < 0.05) with 11% to 508% increases on the log scale by study, and four found weaker associations (P < 0.05) with 14% to 100% decreases, compared with PMD. Risk associations remained significant when fitting textures and PMD together. Eleven of 17 publications found greater AUCs for textures than PMD (P < 0.05); increases were 0.04 to 0.25 by study. Discrimination from PMD and these textures jointly was significantly higher than from PMD alone (P < 0.05). Therefore, different textures could capture distinct breast cancer risk information, partially independent of mammographic density, suggesting their joint role in breast cancer risk prediction. Some textures could outperform mammographic density for predicting breast cancer risk. However, obtaining reliable texture-based measures necessitates addressing various issues. Collaboration of researchers from diverse fields could be beneficial for advancing this complex field.

乳腺X线照片的纹理与乳腺X线照片的密度不同,有望成为乳腺癌风险预测指标。然而,目前还缺乏全面的证据来确定纹理与密度之间哪个风险预测指标更强,以及基于纹理的测量方法的可靠性。我们在PubMed数据库中搜索了截至2023年11月发表的研究论文,这些论文使用相同的数据集评估了基于纹理的测量方法和乳腺X线照相术密度百分比(PMD)与乳腺癌风险的相关性(几率比[OR])以及它们的区分度(接收器操作特征曲线下面积[AUC])。在 11 篇出版物中,有 6 篇发现纹理与乳腺癌的相关性更强(P<0.05)。
{"title":"Mammographic Texture versus Conventional Cumulus Measure of Density in Breast Cancer Risk Prediction: A Literature Review.","authors":"Zhoufeng Ye, Tuong L Nguyen, Gillian S Dite, Robert J MacInnis, John L Hopper, Shuai Li","doi":"10.1158/1055-9965.EPI-23-1365","DOIUrl":"10.1158/1055-9965.EPI-23-1365","url":null,"abstract":"<p><p>Mammographic textures show promise as breast cancer risk predictors, distinct from mammographic density. Yet, there is a lack of comprehensive evidence to determine the relative strengths as risk predictor of textures and density and the reliability of texture-based measures. We searched the PubMed database for research published up to November 2023, which assessed breast cancer risk associations [odds ratios (OR)] with texture-based measures and percent mammographic density (PMD), and their discrimination [area under the receiver operating characteristics curve (AUC)], using same datasets. Of 11 publications, for textures, six found stronger associations (P < 0.05) with 11% to 508% increases on the log scale by study, and four found weaker associations (P < 0.05) with 14% to 100% decreases, compared with PMD. Risk associations remained significant when fitting textures and PMD together. Eleven of 17 publications found greater AUCs for textures than PMD (P < 0.05); increases were 0.04 to 0.25 by study. Discrimination from PMD and these textures jointly was significantly higher than from PMD alone (P < 0.05). Therefore, different textures could capture distinct breast cancer risk information, partially independent of mammographic density, suggesting their joint role in breast cancer risk prediction. Some textures could outperform mammographic density for predicting breast cancer risk. However, obtaining reliable texture-based measures necessitates addressing various issues. Collaboration of researchers from diverse fields could be beneficial for advancing this complex field.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086882","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
Racialized Economic Segregation and Treatment and Outcomes of Small Cell Lung Cancer. 种族化经济隔离与小细胞肺癌的治疗和预后。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0237
Bayu B Bekele, Min Lian, Pratibha Shrestha, Oumarou Nabi, Benjamin Kozower, Maria Q Baggstrom, Ying Liu

Background: Little is known about the role of residential segregation in the treatment and outcomes of small cell lung cancer (SCLC), a highly recalcitrant disease, among non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients.

Methods: We used the Surveillance, Epidemiology, and End Results database to identify men and women diagnosed with SCLC from January 2007 to December 2015 (n = 38,393). An Index of Concentration at the Extremes was computed to measure county-level racialized economic segregation and categorized into Quartile 1 (most privileged: highest concentration of high-income NHW residents) through Quartile 4 (least privileged: highest concentration of low-income NHB residents). Multilevel logistic regression was used to estimate the ORs for extensive-stage diagnosis and nonadherence to guideline-recommended treatment. HRs for lung cancer-specific and overall mortalities were computed using multilevel Cox regression.

Results: Patients in the least privileged counties had higher risks of nonadherence to guideline-recommended treatment [OR = 1.23; 95% confidence interval (CI): 1.08-1.40; Ptrend < 0.01], lung cancer-specific mortality (HR = 1.08; 95% CI: 1.04-1.12; Ptrend < 0.01), and all-cause mortality (HR = 1.13; 95% CI: 1.09-1.17; Ptrend < 0.0001) compared with patients in the most privileged counties. Adjustment for treatment did not significantly reduce the association with mortality. These associations were comparable between NHB and NHW patients. Segregation was not significantly associated with extensive-stage diagnosis.

Conclusions: The results suggest that living in the neighborhoods with higher proportions of low-income households and Black residents had adverse impacts on stage-appropriate treatment of and survival from SCLC.

Impact: This highlights the need for improving the access to quality lung cancer care in the less privileged neighborhoods.

背景:在非西班牙裔白人和非西班牙裔黑人小细胞肺癌患者中,种族经济隔离与全因死亡率之间的总体关系和种族特异性关系:非西班牙裔白人和非西班牙裔黑人小细胞肺癌患者的种族化经济隔离与全因死亡率之间的总体关联和种族特异性关联:我们使用 "监测、流行病学和最终结果 "数据库来识别 2007 年 1 月至 2015 年 12 月期间确诊为小细胞肺癌的男性和女性患者(n=38,393)。我们计算了 "极端集中指数"(ICE),以衡量县级种族经济隔离情况,并将其分为四分位1(最优越:高收入非华裔居民最集中)至四分位4(最不优越:低收入非华裔居民最集中)。多层次逻辑回归用于估算广泛分期诊断和不坚持指南推荐治疗的几率比(ORs)。使用多层次考克斯回归法计算了肺癌特异性死亡率和总死亡率的危险比(HRs):结果:生活条件最差的县的患者不遵从指南推荐治疗的风险更高(OR=1.23,95% CI 1.08-1.40;Ptrend):结果表明,生活在低收入家庭和黑人居民比例较高的社区对SCLC的阶段性适当治疗和存活率有不利影响:影响:这凸显了在条件较差的社区改善优质肺癌治疗的必要性。
{"title":"Racialized Economic Segregation and Treatment and Outcomes of Small Cell Lung Cancer.","authors":"Bayu B Bekele, Min Lian, Pratibha Shrestha, Oumarou Nabi, Benjamin Kozower, Maria Q Baggstrom, Ying Liu","doi":"10.1158/1055-9965.EPI-24-0237","DOIUrl":"10.1158/1055-9965.EPI-24-0237","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the role of residential segregation in the treatment and outcomes of small cell lung cancer (SCLC), a highly recalcitrant disease, among non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients.</p><p><strong>Methods: </strong>We used the Surveillance, Epidemiology, and End Results database to identify men and women diagnosed with SCLC from January 2007 to December 2015 (n = 38,393). An Index of Concentration at the Extremes was computed to measure county-level racialized economic segregation and categorized into Quartile 1 (most privileged: highest concentration of high-income NHW residents) through Quartile 4 (least privileged: highest concentration of low-income NHB residents). Multilevel logistic regression was used to estimate the ORs for extensive-stage diagnosis and nonadherence to guideline-recommended treatment. HRs for lung cancer-specific and overall mortalities were computed using multilevel Cox regression.</p><p><strong>Results: </strong>Patients in the least privileged counties had higher risks of nonadherence to guideline-recommended treatment [OR = 1.23; 95% confidence interval (CI): 1.08-1.40; Ptrend < 0.01], lung cancer-specific mortality (HR = 1.08; 95% CI: 1.04-1.12; Ptrend < 0.01), and all-cause mortality (HR = 1.13; 95% CI: 1.09-1.17; Ptrend < 0.0001) compared with patients in the most privileged counties. Adjustment for treatment did not significantly reduce the association with mortality. These associations were comparable between NHB and NHW patients. Segregation was not significantly associated with extensive-stage diagnosis.</p><p><strong>Conclusions: </strong>The results suggest that living in the neighborhoods with higher proportions of low-income households and Black residents had adverse impacts on stage-appropriate treatment of and survival from SCLC.</p><p><strong>Impact: </strong>This highlights the need for improving the access to quality lung cancer care in the less privileged neighborhoods.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adverse Childhood Experiences, Resilience, and Cardiovascular Disease in Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study. 童年癌症成年幸存者的不良童年经历、复原力和心血管疾病:儿童癌症幸存者研究报告》。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0249
Lindsay F Schwartz, Kayla L Stratton, Wendy M Leisenring, Stefania M Rodriguez, Shani Alston, Aaron McDonald, Chris Vukadinovich, Dayton Rinehardt, Kevin C Oeffinger, Eric J Chow, Kevin R Krull, Tara M Brinkman, Paul C Nathan, Marcia M Tan, Julie S McCrae, Tiffany Burkhardt, Kirsten K Ness, Gregory T Armstrong, Tara O Henderson

Background: The impact of adverse childhood experiences (ACE, e.g., abuse, neglect, and/or household dysfunction experienced before the age of 18) and resilience on risk for cardiovascular disease (CVD) has not previously been investigated in adult survivors of childhood cancer.

Methods: We conducted a nested case-control study among long-term, adult-aged survivors of childhood cancer from the Childhood Cancer Survivor Study. Self-report questionnaires ascertained ACEs and resilience, and scores were compared between cases with serious/life-threatening CVD and controls without CVD matched on demographic and cardiotoxic treatment factors.

Results: Among 95 cases and 261 controls, the mean ACE score was 1.4 for both groups; 53.4% of survivors endorsed ≥1 ACE. No association was observed between ACEs or resilience and CVD in adjusted models.

Conclusions: ACEs and resilience do not appear to contribute to CVD risk for adult survivors of childhood cancer with cardiotoxic treatment exposures.

Impact: Although not associated with CVD in this population, ACEs are associated with serious health issues in other populations. Therefore, future studies could investigate the effects of ACEs on other health outcomes affecting childhood cancer survivors.

背景:儿童癌症成年幸存者的童年不良经历(ACEs:如18岁前经历的虐待、忽视和/或家庭功能失调)和复原力对心血管疾病(CVD)风险的影响尚未得到研究:我们在儿童癌症幸存者研究(CCSS)的长期成年儿童癌症幸存者中开展了一项巢式病例对照研究。通过自我报告问卷调查确定了ACE和复原力,并在患有严重/危及生命的心血管疾病的病例与未患有心血管疾病的对照组之间比较了得分,对照组的人口统计学和心脏毒性治疗因素与病例相匹配:在 95 例病例和 261 例对照组中,两组的平均 ACE 得分为 1.4;53.4% 的幸存者认可的 ACE ≥1。在调整模型中,ACE或复原力与心血管疾病之间没有关联:ACE和抗逆力似乎不会对接受过心脏毒性治疗的儿童癌症成年幸存者的心血管疾病风险产生影响:影响:虽然在这一人群中,ACE 与心血管疾病无关,但在其他人群中,ACE 与严重的健康问题有关。因此,未来的研究可以调查ACE对影响儿童癌症幸存者的其他健康结果的影响。
{"title":"Adverse Childhood Experiences, Resilience, and Cardiovascular Disease in Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study.","authors":"Lindsay F Schwartz, Kayla L Stratton, Wendy M Leisenring, Stefania M Rodriguez, Shani Alston, Aaron McDonald, Chris Vukadinovich, Dayton Rinehardt, Kevin C Oeffinger, Eric J Chow, Kevin R Krull, Tara M Brinkman, Paul C Nathan, Marcia M Tan, Julie S McCrae, Tiffany Burkhardt, Kirsten K Ness, Gregory T Armstrong, Tara O Henderson","doi":"10.1158/1055-9965.EPI-24-0249","DOIUrl":"10.1158/1055-9965.EPI-24-0249","url":null,"abstract":"<p><strong>Background: </strong>The impact of adverse childhood experiences (ACE, e.g., abuse, neglect, and/or household dysfunction experienced before the age of 18) and resilience on risk for cardiovascular disease (CVD) has not previously been investigated in adult survivors of childhood cancer.</p><p><strong>Methods: </strong>We conducted a nested case-control study among long-term, adult-aged survivors of childhood cancer from the Childhood Cancer Survivor Study. Self-report questionnaires ascertained ACEs and resilience, and scores were compared between cases with serious/life-threatening CVD and controls without CVD matched on demographic and cardiotoxic treatment factors.</p><p><strong>Results: </strong>Among 95 cases and 261 controls, the mean ACE score was 1.4 for both groups; 53.4% of survivors endorsed ≥1 ACE. No association was observed between ACEs or resilience and CVD in adjusted models.</p><p><strong>Conclusions: </strong>ACEs and resilience do not appear to contribute to CVD risk for adult survivors of childhood cancer with cardiotoxic treatment exposures.</p><p><strong>Impact: </strong>Although not associated with CVD in this population, ACEs are associated with serious health issues in other populations. Therefore, future studies could investigate the effects of ACEs on other health outcomes affecting childhood cancer survivors.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rural-Urban Cancer Incidence and Trends in the United States, 2000 to 2019. 2000-2019 年美国城乡癌症发病率及趋势》。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0072
Jason Semprini, Khyathi Gadag, Gawain Williams, Aniyah Muldrow, Whitney E Zahnd

Background: Despite consistent improvements in cancer prevention and care, rural and urban disparities in cancer incidence persist in the United States. Our objective was to further examine rural-urban differences in cancer incidence and trends.

Methods: We used the North American Association of Central Cancer Registries dataset to investigate rural-urban differences in 5-year age-adjusted cancer incidence (2015-2019) and trends (2000-2019), also examining differences by region, sex, race/ethnicity, and tumor site. Age-adjusted rates were calculated using SEER∗Stat 8.4.1, and trend analysis was done using Joinpoint, reporting annual percent changes (APC).

Results: We observed higher all cancer combined 5-year incidence rates in rural areas (457.6 per 100,000) compared with urban areas (447.9), with the largest rural-urban difference in the South (464.4 vs. 449.3). Rural populations also exhibited higher rates of tobacco-associated, human papillomavirus-associated, and colorectal cancers, including early-onset cancers. Tobacco-associated cancer incidence trends widened between rural and urban from 2000 to 2019, with significant, but varying, decreases in urban areas throughout the study period, whereas significant rural decreases only occurred between 2016 and 2019 (APC = -0.96). Human papillomavirus-associated cancer rates increased in both populations until recently with urban rates plateauing whereas rural rates continued to increase (e.g., APC = 1.56, 2002-2019).

Conclusions: Rural populations had higher overall cancer incidence rates and higher rates of cancers with preventive opportunities compared with urban populations. Improvements in these rates were typically slower in rural populations.

Impact: Our findings underscore the complex nature of rural-urban disparities, emphasizing the need for targeted interventions and policies to reduce disparities and achieve equitable health outcomes.

背景尽管美国在癌症预防和治疗方面不断取得进步,但城乡癌症发病率的差异依然存在。我们的目的是进一步研究癌症发病率的城乡差异和趋势。方法 我们使用北美中央癌症登记协会(NAACCR)数据集调查了5年年龄调整后癌症发病率(2015-2019年)的城乡差异和趋势(2000-2019年),同时还研究了地区、性别、种族/民族和肿瘤部位的差异。使用 SEER*Stat 8.4.1 计算年龄调整率,使用 Joinpoint 进行趋势分析,报告年度百分比变化 (APC)。结果 我们观察到,农村地区所有癌症的 5 年综合发病率(每 10 万人 457.6 例)高于城市地区(447.9 例),其中南部地区的城乡差异最大(464.4 例 vs 449.3 例)。农村人口的烟草相关癌症、人乳头瘤病毒相关癌症和结直肠癌(包括早发癌症)发病率也较高。从 2000 年到 2019 年,农村和城市的烟草相关癌症发病率趋势有所扩大,在整个研究期间,城市地区的烟草相关癌症发病率显著下降,但降幅不一,而农村地区的烟草相关癌症发病率仅在 2016 年到 2019 年期间出现显著下降(APC=-0.96)。直到最近,两种人群的 HPV 相关癌症发病率都有所上升,城市地区的发病率趋于平稳,而农村地区的发病率则持续上升(例如,APC=1.56,2002-2019 年)。结论 与城市相比,农村人口的总体癌症发病率更高,有预防机会的癌症发病率也更高。这些比率的改善在农村人口中通常较慢。影响 我们的研究结果凸显了城乡差异的复杂性,强调需要采取有针对性的干预措施和政策来减少差异,实现公平的健康结果。
{"title":"Rural-Urban Cancer Incidence and Trends in the United States, 2000 to 2019.","authors":"Jason Semprini, Khyathi Gadag, Gawain Williams, Aniyah Muldrow, Whitney E Zahnd","doi":"10.1158/1055-9965.EPI-24-0072","DOIUrl":"10.1158/1055-9965.EPI-24-0072","url":null,"abstract":"<p><strong>Background: </strong>Despite consistent improvements in cancer prevention and care, rural and urban disparities in cancer incidence persist in the United States. Our objective was to further examine rural-urban differences in cancer incidence and trends.</p><p><strong>Methods: </strong>We used the North American Association of Central Cancer Registries dataset to investigate rural-urban differences in 5-year age-adjusted cancer incidence (2015-2019) and trends (2000-2019), also examining differences by region, sex, race/ethnicity, and tumor site. Age-adjusted rates were calculated using SEER∗Stat 8.4.1, and trend analysis was done using Joinpoint, reporting annual percent changes (APC).</p><p><strong>Results: </strong>We observed higher all cancer combined 5-year incidence rates in rural areas (457.6 per 100,000) compared with urban areas (447.9), with the largest rural-urban difference in the South (464.4 vs. 449.3). Rural populations also exhibited higher rates of tobacco-associated, human papillomavirus-associated, and colorectal cancers, including early-onset cancers. Tobacco-associated cancer incidence trends widened between rural and urban from 2000 to 2019, with significant, but varying, decreases in urban areas throughout the study period, whereas significant rural decreases only occurred between 2016 and 2019 (APC = -0.96). Human papillomavirus-associated cancer rates increased in both populations until recently with urban rates plateauing whereas rural rates continued to increase (e.g., APC = 1.56, 2002-2019).</p><p><strong>Conclusions: </strong>Rural populations had higher overall cancer incidence rates and higher rates of cancers with preventive opportunities compared with urban populations. Improvements in these rates were typically slower in rural populations.</p><p><strong>Impact: </strong>Our findings underscore the complex nature of rural-urban disparities, emphasizing the need for targeted interventions and policies to reduce disparities and achieve equitable health outcomes.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154588","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
Disparities and Determinants of Testing for Early Detection of Cervical Cancer among Nepalese Women: Evidence from a Population-Based Survey. 尼泊尔妇女接受宫颈癌早期检测的差距和决定因素:基于人口的调查证据。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1158/1055-9965.EPI-24-0037
Md Shafiur Rahman, Md Mahfuzur Rahman, Kiran Acharya, Rei Haruyama, Richa Shah, Tomohiro Matsuda, Manami Inoue, Sarah K Abe

Background: Cervical cancer presents a considerable challenge in South Asia, notably in Nepal, where screening remains limited. Past research in Nepal lacked national representation and a thorough exploration of factors influencing cervical cancer screening, such as educational and socioeconomic disparities. This study aims to measure these gaps and identify associated factors in testing for early detection of cervical cancer among Nepalese women.

Methods: Data from the 2019 Nepal Noncommunicable Disease Risk Factors survey (World Health Organization STEPwise approach to noncommunicable risk factor surveillance), involving 2,332 women aged 30 to 69 years, were used. Respondents were asked if they had undergone cervical cancer testing through visual inspection with acetic acid, Pap smear, or human papillomavirus test ever or in the past 5 years. The slope index of inequality (SII) and relative concentration index were used to measure socioeconomic and education-based disparities in cervical cancer test uptake.

Results: Only 7.1% [95% confidence interval (CI): 5.1-9.9] Nepalese women had ever undergone cervical cancer testing, whereas 5.1% (95% CI: 3.4-7.5) tested within the last 5 years. The ever uptake of cervical cancer testing was 5.1 percentage points higher (SII: 5.1, 95% CI: -0.1 to 10.2) among women from the richest compared with the poorest households. Education-based disparities were particularly pronounced, with a 13.9 percentage point difference between highly educated urban residents and their uneducated counterparts (SII: 13.9, 95% CI: 5.8-21.9).

Conclusions: Less than one in ten women in Nepal had a cervical cancer testing, primarily favoring higher educated and wealthier individuals.

Impact: Targeted early detection and cervical cancer screening interventions are necessary to address these disparities and improve access and uptake.

背景:宫颈癌(CC)是南亚地区面临的一项巨大挑战,尤其是在筛查仍然有限的尼泊尔。过去在尼泊尔开展的研究缺乏全国代表性,也没有深入探讨影响宫颈癌筛查的因素,如教育和社会经济差异。本研究旨在衡量这些差距,并确定尼泊尔妇女早期检测 CC 的相关因素:研究使用了2019年尼泊尔非传染性疾病风险因素调查(世卫组织-STEPwise非传染性风险因素监测方法)的数据,涉及2332名30-69岁的女性。受访者被问及是否曾经或在过去五年中通过 VIA、巴氏涂片或 HPV 检测进行过 CC 检测。采用不平等斜率指数(SII)和相对集中指数(RCI)来衡量接受 CC 检测的社会经济和教育程度差异:结果:只有 7.1%(95% CI:5.1-9.9)的尼泊尔妇女曾经接受过 CC 检测,5.1%(95% CI:3.4-7.5)的妇女在过去五年中接受过检测。与最贫困家庭的妇女相比,最富有家庭的妇女接受过 CC 检测的比例高出 5.1 个百分点(SII:5.1,95% CI:-0.1 至 10.2)。受教育程度的差异尤为明显,受过高等教育的城市居民与未受过教育的城市居民之间相差 13.9 个百分点(SII:13.9,95% CI:5.8 至 21.9):结论:尼泊尔每十名妇女中只有不到一人接受过CC检测,主要集中在高学历和富裕人群中:影响:有必要采取有针对性的早期检测和CC筛查干预措施,以解决这些差异并提高可及性和接受率。
{"title":"Disparities and Determinants of Testing for Early Detection of Cervical Cancer among Nepalese Women: Evidence from a Population-Based Survey.","authors":"Md Shafiur Rahman, Md Mahfuzur Rahman, Kiran Acharya, Rei Haruyama, Richa Shah, Tomohiro Matsuda, Manami Inoue, Sarah K Abe","doi":"10.1158/1055-9965.EPI-24-0037","DOIUrl":"10.1158/1055-9965.EPI-24-0037","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer presents a considerable challenge in South Asia, notably in Nepal, where screening remains limited. Past research in Nepal lacked national representation and a thorough exploration of factors influencing cervical cancer screening, such as educational and socioeconomic disparities. This study aims to measure these gaps and identify associated factors in testing for early detection of cervical cancer among Nepalese women.</p><p><strong>Methods: </strong>Data from the 2019 Nepal Noncommunicable Disease Risk Factors survey (World Health Organization STEPwise approach to noncommunicable risk factor surveillance), involving 2,332 women aged 30 to 69 years, were used. Respondents were asked if they had undergone cervical cancer testing through visual inspection with acetic acid, Pap smear, or human papillomavirus test ever or in the past 5 years. The slope index of inequality (SII) and relative concentration index were used to measure socioeconomic and education-based disparities in cervical cancer test uptake.</p><p><strong>Results: </strong>Only 7.1% [95% confidence interval (CI): 5.1-9.9] Nepalese women had ever undergone cervical cancer testing, whereas 5.1% (95% CI: 3.4-7.5) tested within the last 5 years. The ever uptake of cervical cancer testing was 5.1 percentage points higher (SII: 5.1, 95% CI: -0.1 to 10.2) among women from the richest compared with the poorest households. Education-based disparities were particularly pronounced, with a 13.9 percentage point difference between highly educated urban residents and their uneducated counterparts (SII: 13.9, 95% CI: 5.8-21.9).</p><p><strong>Conclusions: </strong>Less than one in ten women in Nepal had a cervical cancer testing, primarily favoring higher educated and wealthier individuals.</p><p><strong>Impact: </strong>Targeted early detection and cervical cancer screening interventions are necessary to address these disparities and improve access and uptake.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183828","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
Cervical cancer screening utilization among kidney transplant recipients, 2001-2018. 2001-2018年肾移植受者宫颈癌筛查利用率。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-07-11 DOI: 10.1158/1055-9965.EPI-24-0225
Christine D Hsu, Xiaoying Yu, Fangjian Guo, Victor Adekanmbi, Yong-Fang Kuo, Jordan Westra, Abbey B Berenson

Background: Kidney transplant recipients (KTRs) have elevated risks of cervical pre-cancers and cancers, and guidelines recommend more frequent cervical cancer screening exams. However, little is known about current trends in cervical cancer screening in this unique population. We described patterns in the uptake of cervical cancer screening exams among female KTRs and identified factors associated with screening utilization.

Methods: This retrospective cohort study included female KTRs between 20-65 years old, with Texas Medicare fee-for-service coverage, who received a transplant between January 1, 2001, and December 31, 2017. We determined the cumulative incidence of receiving cervical cancer screening post-transplant using ICD-9, ICD-10, and CPT codes and assessed factors associated with screening utilization, using the Fine and Gray model to account for competing events. Subdistribution hazards models were used to assess factors associated with screening uptake.

Results: Among 2,653 KTRs meeting the inclusion and exclusion criteria, the 1-, 2-, and 3-year cumulative incidences of initiating a cervical cancer screening exam post-transplant were 31.7% (95% confidence interval (CI), 30.0-33.6%), 48.0% (95% CI, 46.2-49.9%), and 58.5% (95% CI, 56.7-60.3%), respectively. KTRs who were 55-64 years old (vs. <45 years old) and those with a higher Charlson Comorbidity Score post-transplant were less likely to receive cervical cancer screening post-transplant.

Conclusions: Cervical cancer screening uptake is low in the years immediately following a kidney transplant.

Impact: Our findings highlight a need for interventions to improve cervical cancer screening utilization among KTRs.

背景:肾移植受者(KTRs)罹患宫颈癌前病变和癌症的风险较高,因此指南建议更频繁地进行宫颈癌筛查。然而,人们对这一特殊人群目前的宫颈癌筛查趋势知之甚少。我们描述了女性 KTR 接受宫颈癌筛查的模式,并确定了与筛查利用率相关的因素:这项回顾性队列研究纳入了年龄在 20-65 岁之间、享受德克萨斯州医疗保险付费服务的女性 KTR,她们在 2001 年 1 月 1 日至 2017 年 12 月 31 日期间接受了移植手术。我们使用 ICD-9、ICD-10 和 CPT 编码确定了移植后接受宫颈癌筛查的累积发病率,并使用 Fine and Gray 模型评估了与筛查利用率相关的因素,以考虑竞争事件。使用子分布危险模型评估与筛查接受率相关的因素:在符合纳入和排除标准的 2,653 名 KTR 中,移植后 1 年、2 年和 3 年的宫颈癌筛查累积发生率分别为 31.7%(95% 置信区间 (CI),30.0-33.6%)、48.0%(95% CI,46.2-49.9%)和 58.5%(95% CI,56.7-60.3%)。年龄在 55-64 岁之间的 KTR(与年龄在 55-64 岁之间的 KTR 相比)的宫颈癌筛查率分别为 48.0%(95% CI,46.2-49.9%)、58.5%(95% CI,56.7-60.3在肾移植后的几年中,宫颈癌筛查的接受率很低:我们的研究结果突出表明,有必要采取干预措施提高 KTR 接受宫颈癌筛查的比例。
{"title":"Cervical cancer screening utilization among kidney transplant recipients, 2001-2018.","authors":"Christine D Hsu, Xiaoying Yu, Fangjian Guo, Victor Adekanmbi, Yong-Fang Kuo, Jordan Westra, Abbey B Berenson","doi":"10.1158/1055-9965.EPI-24-0225","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-0225","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant recipients (KTRs) have elevated risks of cervical pre-cancers and cancers, and guidelines recommend more frequent cervical cancer screening exams. However, little is known about current trends in cervical cancer screening in this unique population. We described patterns in the uptake of cervical cancer screening exams among female KTRs and identified factors associated with screening utilization.</p><p><strong>Methods: </strong>This retrospective cohort study included female KTRs between 20-65 years old, with Texas Medicare fee-for-service coverage, who received a transplant between January 1, 2001, and December 31, 2017. We determined the cumulative incidence of receiving cervical cancer screening post-transplant using ICD-9, ICD-10, and CPT codes and assessed factors associated with screening utilization, using the Fine and Gray model to account for competing events. Subdistribution hazards models were used to assess factors associated with screening uptake.</p><p><strong>Results: </strong>Among 2,653 KTRs meeting the inclusion and exclusion criteria, the 1-, 2-, and 3-year cumulative incidences of initiating a cervical cancer screening exam post-transplant were 31.7% (95% confidence interval (CI), 30.0-33.6%), 48.0% (95% CI, 46.2-49.9%), and 58.5% (95% CI, 56.7-60.3%), respectively. KTRs who were 55-64 years old (vs. <45 years old) and those with a higher Charlson Comorbidity Score post-transplant were less likely to receive cervical cancer screening post-transplant.</p><p><strong>Conclusions: </strong>Cervical cancer screening uptake is low in the years immediately following a kidney transplant.</p><p><strong>Impact: </strong>Our findings highlight a need for interventions to improve cervical cancer screening utilization among KTRs.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579024","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
期刊
Cancer Epidemiology Biomarkers & Prevention
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1