Pub Date : 2024-10-07DOI: 10.1158/1055-9965.EPI-24-0834
Nicole C Loroña, Caroline Himbert, Jennifer Ose, Stacey A Cohen, Ildiko Strehli, Cornelia M Ulrich, Sofia Cobos, Esther Jean-Baptiste, Amanda M Bloomer, Jane C Figueiredo, Biljana Gigic, Sheetal Hardikar, Meghana Karchi, Matthew Mutch, Anita R Peoples, Martin Schneider, David Shibata, Erin M Siegel, Adetunji T Toriola, Elizabeth H Wood, Christopher I Li
Background: Findings from studies investigating the impacts of alcohol use and smoking on colorectal cancer (CRC) outcomes are inconclusive. This study aimed to investigate associations between alcohol use and smoking status at the time of diagnosis on recurrence and overall mortality among patients with CRC.
Methods: The present study included 2,216 stage I-IV patients with CRC from the longitudinal multi-center ColoCare study, with available data on recurrence and CRC-specific mortality. Cox proportional hazards models adjusted for age, sex, race, ethnicity, stage, tumor site, treatment, comorbidities, body mass index, and study site were fit, with imputations for missing data.
Results: We observed 235 recurrences and 308 CRC-specific deaths over an average of 3 years of follow-up. After adjusting for confounders, current alcohol consumption and ever smoking, relative to not current consumption and never smoking, respectively, were not statistically significantly associated with CRC recurrence (Alcohol - HR: 0.95. 95% CI: 0.71-1.29; Ever smoking - HR: 0.98, 95% CI: 0.75-1.29) or CRC-specific mortality (Alcohol - HR: 0.95. 95% CI: 0.74-1.22; Ever smoking - HR: 0.98, 95% CI: 0.77-1.24).
Conclusions: No associations were observed between alcohol and smoking at diagnosis and clinical outcomes in this well-annotated longitudinal cohort.
Impact: Our cohort study reports no significant associations; however, limiting alcohol use and avoiding smoking are health behaviors recommended for CRC survivors for prevention of other cancers and chronic conditions.
{"title":"Alcohol consumption and smoking history at time of diagnosis, and risk of colorectal cancer recurrence and mortality: Results from the ColoCare Study.","authors":"Nicole C Loroña, Caroline Himbert, Jennifer Ose, Stacey A Cohen, Ildiko Strehli, Cornelia M Ulrich, Sofia Cobos, Esther Jean-Baptiste, Amanda M Bloomer, Jane C Figueiredo, Biljana Gigic, Sheetal Hardikar, Meghana Karchi, Matthew Mutch, Anita R Peoples, Martin Schneider, David Shibata, Erin M Siegel, Adetunji T Toriola, Elizabeth H Wood, Christopher I Li","doi":"10.1158/1055-9965.EPI-24-0834","DOIUrl":"10.1158/1055-9965.EPI-24-0834","url":null,"abstract":"<p><strong>Background: </strong>Findings from studies investigating the impacts of alcohol use and smoking on colorectal cancer (CRC) outcomes are inconclusive. This study aimed to investigate associations between alcohol use and smoking status at the time of diagnosis on recurrence and overall mortality among patients with CRC.</p><p><strong>Methods: </strong>The present study included 2,216 stage I-IV patients with CRC from the longitudinal multi-center ColoCare study, with available data on recurrence and CRC-specific mortality. Cox proportional hazards models adjusted for age, sex, race, ethnicity, stage, tumor site, treatment, comorbidities, body mass index, and study site were fit, with imputations for missing data.</p><p><strong>Results: </strong>We observed 235 recurrences and 308 CRC-specific deaths over an average of 3 years of follow-up. After adjusting for confounders, current alcohol consumption and ever smoking, relative to not current consumption and never smoking, respectively, were not statistically significantly associated with CRC recurrence (Alcohol - HR: 0.95. 95% CI: 0.71-1.29; Ever smoking - HR: 0.98, 95% CI: 0.75-1.29) or CRC-specific mortality (Alcohol - HR: 0.95. 95% CI: 0.74-1.22; Ever smoking - HR: 0.98, 95% CI: 0.77-1.24).</p><p><strong>Conclusions: </strong>No associations were observed between alcohol and smoking at diagnosis and clinical outcomes in this well-annotated longitudinal cohort.</p><p><strong>Impact: </strong>Our cohort study reports no significant associations; however, limiting alcohol use and avoiding smoking are health behaviors recommended for CRC survivors for prevention of other cancers and chronic conditions.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380091","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}
Pub Date : 2024-10-07DOI: 10.1158/1055-9965.EPI-24-0833
Anne-Michelle Noone, Angela B Mariotto, Yoon Duk Hong, Lindsey Enewold
Background: Almost half of Medicare beneficiaries diagnosed with cancer from 1992-2005 had at least one comorbid condition. Conditions impact a range of domains from clinical decision making to quality of life which are important to consider when conducting cancer research. We introduce a new SEER-Medicare resource to facilitate using claims data for cancer patients.
Methods: We use the SEER-Medicare resource to estimate prevalence of comorbidities, 5-year survival rate by cancer site, stage, age and comorbidity severity, and prevalence of surgery by comorbidity for breast, prostate, colorectal and lung cancer.
Results: Overall, the most prevalent comorbidities in the year prior to cancer diagnosis were diabetes (27%), COPD (22%), peripheral vascular disease (14%), and congestive heart failure (12%). Comorbidity severity had a greater impact on the probability of dying from non-cancer causes than from dying from cancer. Severity of comorbidity and age consistently increased the probability of non-cancer death. The percentage of persons receiving surgery tended to be lower among those with severe comorbidity.
Conclusions: This study demonstrates the utility of new SEER*stat databases that contain Medicare beneficiaries and claims-based measures of comorbidity. Our results demonstrate that comorbidity is common among older persons diagnosed with cancer and the impact of comorbidity on the probability of dying from cancer varies by cancer site, stage at diagnosis and age.
Impact: Comorbidity is common among persons with cancer and impacts survival. Future research on the impact of comorbidity among cancer survivors is facilitated by new databases.
{"title":"Assessing 1 year Comorbidity Prevalence and Its Survival Implications in Medicare Beneficiaries Diagnosed with Cancer: Insights from a new SEER-Medicare Resource.","authors":"Anne-Michelle Noone, Angela B Mariotto, Yoon Duk Hong, Lindsey Enewold","doi":"10.1158/1055-9965.EPI-24-0833","DOIUrl":"10.1158/1055-9965.EPI-24-0833","url":null,"abstract":"<p><strong>Background: </strong>Almost half of Medicare beneficiaries diagnosed with cancer from 1992-2005 had at least one comorbid condition. Conditions impact a range of domains from clinical decision making to quality of life which are important to consider when conducting cancer research. We introduce a new SEER-Medicare resource to facilitate using claims data for cancer patients.</p><p><strong>Methods: </strong>We use the SEER-Medicare resource to estimate prevalence of comorbidities, 5-year survival rate by cancer site, stage, age and comorbidity severity, and prevalence of surgery by comorbidity for breast, prostate, colorectal and lung cancer.</p><p><strong>Results: </strong>Overall, the most prevalent comorbidities in the year prior to cancer diagnosis were diabetes (27%), COPD (22%), peripheral vascular disease (14%), and congestive heart failure (12%). Comorbidity severity had a greater impact on the probability of dying from non-cancer causes than from dying from cancer. Severity of comorbidity and age consistently increased the probability of non-cancer death. The percentage of persons receiving surgery tended to be lower among those with severe comorbidity.</p><p><strong>Conclusions: </strong>This study demonstrates the utility of new SEER*stat databases that contain Medicare beneficiaries and claims-based measures of comorbidity. Our results demonstrate that comorbidity is common among older persons diagnosed with cancer and the impact of comorbidity on the probability of dying from cancer varies by cancer site, stage at diagnosis and age.</p><p><strong>Impact: </strong>Comorbidity is common among persons with cancer and impacts survival. Future research on the impact of comorbidity among cancer survivors is facilitated by new databases.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380092","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}
Pub Date : 2024-10-04DOI: 10.1158/1055-9965.EPI-24-0765
Sarah L Bennis, Elliot G Arsoniadis, Christopher W Wheldon
Background: Despite the risk of anal cancer in sexual and gender minority populations (SGM), anal cancer screening remains infrequent and inconsistent in these populations. The objective of this analysis was to identify factors associated with anal cancer screenings among sexual and gender minority populations (SGM) using the Andersen's Behavioral Model of Health Services Use.
Methods: Secondary analyses of two cross-sectional surveys from the 2020 (N=1125) and 2022 (N=630) "Pennsylvania LGBTQ Health Needs Assessment." Multiple logistic regression analyses were used to identify correlates of anal cytology screening.
Results: Average age was 37.7 (SD=13.3) and 39.7 (SD=13.6) in 2020 and 2022, respectively. Approximately 16-18% reported living with HIV. A minority of respondents reported past year screening (14.0% 2020 and 13.6% 2022). Enabling and need-based factors consistently associated with screening included STI treatment, living with HIV, PrEP use, and multiple sex partners. Robust factors associated with ever being screened were age and living with HIV.
Conclusions: Anal cytology screening is being done in Pennsylvania at a small but not insignificant rate. In accordance with existing guidelines, SGM living with HIV were most likely to be screened, but still at a low rate. Predictive factors associated with screening in this study can inform future interventions to implement guideline-specific anal cancer prevention.
Impact: Factors that reflect consistent connection to healthcare are associated with increased rates of screening via anal cytology testing, indicating there are opportunities to implement anal cancer screening as part of a larger, more comprehensive SGM-focused care pathway.
背景:尽管性少数群体和性别少数群体(SGM)有罹患肛门癌的风险,但在这些人群中,肛门癌筛查仍然很少且不一致。本分析的目的是利用安德森健康服务使用行为模型(Andersen's Behavioral Model of Health Services Use)确定与性少数群体和性别少数群体(SGM)肛门癌筛查相关的因素:对来自 2020 年(N=1125)和 2022 年(N=630)"宾夕法尼亚州 LGBTQ 健康需求评估 "的两项横截面调查进行二次分析。多重逻辑回归分析用于确定肛门细胞学筛查的相关因素:2020 年和 2022 年的平均年龄分别为 37.7 岁(SD=13.3)和 39.7 岁(SD=13.6)。约 16-18% 的受访者称自己感染了 HIV。少数受访者报告了过去一年的筛查情况(2020 年为 14.0%,2022 年为 13.6%)。与筛查始终相关的有利因素和基于需求的因素包括性传播感染治疗、艾滋病毒感染者、使用 PrEP 和多个性伴侣。与曾经接受筛查有关的可靠因素包括年龄和感染艾滋病毒:宾夕法尼亚州正在进行肛门细胞学筛查,筛查率虽小,但并不低。根据现有指南,感染 HIV 的 SGM 最有可能接受筛查,但筛查率仍然很低。本研究中与筛查相关的预测因素可为未来实施针对肛门癌预防指南的干预措施提供参考:通过肛门细胞学检测进行筛查的比例增加与反映与医疗保健的持续联系的因素有关,这表明有机会将肛门癌筛查作为更广泛、更全面的以SGM为重点的护理途径的一部分来实施。
{"title":"Utilization of anal cytology screening among sexual and gender minority populations in Pennsylvania.","authors":"Sarah L Bennis, Elliot G Arsoniadis, Christopher W Wheldon","doi":"10.1158/1055-9965.EPI-24-0765","DOIUrl":"10.1158/1055-9965.EPI-24-0765","url":null,"abstract":"<p><strong>Background: </strong>Despite the risk of anal cancer in sexual and gender minority populations (SGM), anal cancer screening remains infrequent and inconsistent in these populations. The objective of this analysis was to identify factors associated with anal cancer screenings among sexual and gender minority populations (SGM) using the Andersen's Behavioral Model of Health Services Use.</p><p><strong>Methods: </strong>Secondary analyses of two cross-sectional surveys from the 2020 (N=1125) and 2022 (N=630) \"Pennsylvania LGBTQ Health Needs Assessment.\" Multiple logistic regression analyses were used to identify correlates of anal cytology screening.</p><p><strong>Results: </strong>Average age was 37.7 (SD=13.3) and 39.7 (SD=13.6) in 2020 and 2022, respectively. Approximately 16-18% reported living with HIV. A minority of respondents reported past year screening (14.0% 2020 and 13.6% 2022). Enabling and need-based factors consistently associated with screening included STI treatment, living with HIV, PrEP use, and multiple sex partners. Robust factors associated with ever being screened were age and living with HIV.</p><p><strong>Conclusions: </strong>Anal cytology screening is being done in Pennsylvania at a small but not insignificant rate. In accordance with existing guidelines, SGM living with HIV were most likely to be screened, but still at a low rate. Predictive factors associated with screening in this study can inform future interventions to implement guideline-specific anal cancer prevention.</p><p><strong>Impact: </strong>Factors that reflect consistent connection to healthcare are associated with increased rates of screening via anal cytology testing, indicating there are opportunities to implement anal cancer screening as part of a larger, more comprehensive SGM-focused care pathway.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371044","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}
Pub Date : 2024-10-03DOI: 10.1158/1055-9965.EPI-24-0576
Payton Elizabeth Clark, Kekoa Taparra, Jacob Allen Miller
Background: In the United States (US), Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) disproportionately impacts Asian Americans (AA) and Native Hawaiians and other Pacific Islanders (NHPI) who have no access to screening. EBV-based screening trials in Asia have detected most cases at early stages. We sought to identify a US target population for NPC screening and hypothesized that once-lifetime screening could be cost-effective.
Methods: We obtained NPC incidence data from the SEER Asian and Pacific Islander datasets. We estimated the number needed to screen, mortality reduction, and resource utilization using a validated model and performance data from trials. Six evaluated strategies incorporated serology, nasopharyngeal swab PCR, and endoscopy or MRI.
Results: Intermediate-incidence and high-incidence populations accounted for 10.7% of US person-years yet 42.7% of cases. Anti-BNLF2b screening with selective endoscopy was the preferred strategy. In high-incidence populations, the median NNS to detect one case was 1,992, with a median of 7.12 NPC deaths averted per 100,000 screened. Screening met the willingness-to-pay threshold in all five high-incidence populations (median ICER/GDP 0.82) and among men in intermediate-incidence populations.
Conclusions: Nearly half of NPC in the US arises among the 10% with AA or NHPI ethnicity. A suitable target population for US screening trials would be men and women age 35-65 of Chinese, Sāmoan, or Southeast Asian ethnicity, or men age 35-60 of Guamanian/Chamorro, Filipino, or Native Hawaiian ethnicity. Once-lifetime anti-BNLF2b screening could be cost-effective.
Impact: These data may aid the design of US screening trials. Targeted NPC screening might mitigate health disparities.
{"title":"Identification of High-Incidence Populations in the United States for anti-Epstein Barr Virus Serologic Screening for Nasopharyngeal Carcinoma.","authors":"Payton Elizabeth Clark, Kekoa Taparra, Jacob Allen Miller","doi":"10.1158/1055-9965.EPI-24-0576","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-0576","url":null,"abstract":"<p><strong>Background: </strong>In the United States (US), Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) disproportionately impacts Asian Americans (AA) and Native Hawaiians and other Pacific Islanders (NHPI) who have no access to screening. EBV-based screening trials in Asia have detected most cases at early stages. We sought to identify a US target population for NPC screening and hypothesized that once-lifetime screening could be cost-effective.</p><p><strong>Methods: </strong>We obtained NPC incidence data from the SEER Asian and Pacific Islander datasets. We estimated the number needed to screen, mortality reduction, and resource utilization using a validated model and performance data from trials. Six evaluated strategies incorporated serology, nasopharyngeal swab PCR, and endoscopy or MRI.</p><p><strong>Results: </strong>Intermediate-incidence and high-incidence populations accounted for 10.7% of US person-years yet 42.7% of cases. Anti-BNLF2b screening with selective endoscopy was the preferred strategy. In high-incidence populations, the median NNS to detect one case was 1,992, with a median of 7.12 NPC deaths averted per 100,000 screened. Screening met the willingness-to-pay threshold in all five high-incidence populations (median ICER/GDP 0.82) and among men in intermediate-incidence populations.</p><p><strong>Conclusions: </strong>Nearly half of NPC in the US arises among the 10% with AA or NHPI ethnicity. A suitable target population for US screening trials would be men and women age 35-65 of Chinese, Sāmoan, or Southeast Asian ethnicity, or men age 35-60 of Guamanian/Chamorro, Filipino, or Native Hawaiian ethnicity. Once-lifetime anti-BNLF2b screening could be cost-effective.</p><p><strong>Impact: </strong>These data may aid the design of US screening trials. Targeted NPC screening might mitigate health disparities.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364512","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}
Pub Date : 2024-10-03DOI: 10.1158/1055-9965.EPI-24-0926
Emma Hazelwood, Catalina Lopez Manzano, Emma E Vincent, Demetrius Albanes, D Timothy Bishop, Loïc Le Marchand, Cornelia M Ulrich, Ulrike Peters, Gwen Murphy, N Jewel Samadder, Laura Anderson, Marc J Gunter, Neil Murphy, Bethany Van Guelpen, Nikos Papadimitriou
Background: Epidemiological and laboratory-based studies have provided conflicting evidence for a role of ghrelin in colorectal cancer (CRC) development. We conducted two-sample Mendelian randomization (MR) analyses to evaluate evidence for an association of circulating ghrelin and CRC risk overall and by sex, cancer subsite and age at diagnosis.
Methods: Genetic instruments proxying plasma total ghrelin levels were obtained from a recent genome-wide association study of 54,219 participants. Summary data for CRC risk were obtained from a recent meta-analysis of several genetic consortia (up to 73,673 cases and 86,854 controls). A two-sample MR approach and several sensitivity analyses were applied.
Results: We found no evidence for an association of genetically-predicted plasma total ghrelin levels and CRC risk (0.95, 95% confidence interval: 0.81-1.12; R2 of ghrelin genetic instruments: 4.6%), with similarly null results observed when stratified by sex, anatomical subsite, and for early-onset CRC.
Conclusions: Our study suggests that plasma ghrelin levels are unlikely to have a causal relationship with overall, early-onset, and sex- and cancer subsite-stratified CRC risk.
Impact: This large-scale analysis adds to the growing body of evidence that plasma total ghrelin levels are not associated with CRC risk.
{"title":"Plasma ghrelin and risks of sex-specific, site-specific, and early-onset colorectal cancer: A Mendelian randomization analysis.","authors":"Emma Hazelwood, Catalina Lopez Manzano, Emma E Vincent, Demetrius Albanes, D Timothy Bishop, Loïc Le Marchand, Cornelia M Ulrich, Ulrike Peters, Gwen Murphy, N Jewel Samadder, Laura Anderson, Marc J Gunter, Neil Murphy, Bethany Van Guelpen, Nikos Papadimitriou","doi":"10.1158/1055-9965.EPI-24-0926","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-0926","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological and laboratory-based studies have provided conflicting evidence for a role of ghrelin in colorectal cancer (CRC) development. We conducted two-sample Mendelian randomization (MR) analyses to evaluate evidence for an association of circulating ghrelin and CRC risk overall and by sex, cancer subsite and age at diagnosis.</p><p><strong>Methods: </strong>Genetic instruments proxying plasma total ghrelin levels were obtained from a recent genome-wide association study of 54,219 participants. Summary data for CRC risk were obtained from a recent meta-analysis of several genetic consortia (up to 73,673 cases and 86,854 controls). A two-sample MR approach and several sensitivity analyses were applied.</p><p><strong>Results: </strong>We found no evidence for an association of genetically-predicted plasma total ghrelin levels and CRC risk (0.95, 95% confidence interval: 0.81-1.12; R2 of ghrelin genetic instruments: 4.6%), with similarly null results observed when stratified by sex, anatomical subsite, and for early-onset CRC.</p><p><strong>Conclusions: </strong>Our study suggests that plasma ghrelin levels are unlikely to have a causal relationship with overall, early-onset, and sex- and cancer subsite-stratified CRC risk.</p><p><strong>Impact: </strong>This large-scale analysis adds to the growing body of evidence that plasma total ghrelin levels are not associated with CRC risk.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364513","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}
Pub Date : 2024-10-03DOI: 10.1158/1055-9965.EPI-24-0792
Yuelin He, Paulo S Pinheiro, Osika Tripathi, Helen Nguyen, Malathi Srinivasan, Latha P Palaniappan, Caroline A Thompson
Background: The Hispanic population is the second largest racial/ethnic group in the US, consisting of multiple distinct ethnicities. Ethnicity-specific variations in cancer mortality may be attributed to countries of birth, so we aimed to understand differences in cancer mortality among disaggregated Hispanics by nativity (native- or foreign- born vs. US-born) over 15 years.
Methods: 228,197 Hispanic decedents (Mexican, Puerto Rican [PR], Cuban, and Central or South American) with cancer-related deaths from US death certificates (2003-2017) were analyzed. Seven cancers that contribute significantly to Hispanic male (lung and bronchus, colon and rectum, liver, prostate, and pancreas cancers) and female (lung and bronchus, liver, pancreas, colon and rectum, female breast, and ovary cancers) mortality were selected for analysis. 5-year age-adjusted mortality rates [AAMR (95% CI); per 100,000] and standardized mortality ratios [SMR (95% CI)] using foreign-born as the reference group were calculated. Joinpoint regression analysis was used to model cancer-related mortality trends.
Results: Puerto Rico-born PRs, Cuba-born Cubans, and US-born Mexicans had some of the highest cancer death rates among all the Hispanic groups. In general, foreign-born Hispanics had higher cancer mortality rates than US-born, except Mexicans. Overall, US-born and non-US-born (i.e. native- or foreign- born) Hispanic groups experienced decreasing rates of cancer deaths over the years.
Conclusions: We noted vast heterogeneity in mortality rates by nativity across Hispanic groups, a fast-growing diverse US population.
Impact: Understanding disaggregated patterns and trends in cancer burden can motivate deeper discussion around community health resources, which may improve the health of Hispanics across the US.
{"title":"Cancer Mortality among Hispanic groups in the US, by birthplace (2003-2017).","authors":"Yuelin He, Paulo S Pinheiro, Osika Tripathi, Helen Nguyen, Malathi Srinivasan, Latha P Palaniappan, Caroline A Thompson","doi":"10.1158/1055-9965.EPI-24-0792","DOIUrl":"10.1158/1055-9965.EPI-24-0792","url":null,"abstract":"<p><strong>Background: </strong>The Hispanic population is the second largest racial/ethnic group in the US, consisting of multiple distinct ethnicities. Ethnicity-specific variations in cancer mortality may be attributed to countries of birth, so we aimed to understand differences in cancer mortality among disaggregated Hispanics by nativity (native- or foreign- born vs. US-born) over 15 years.</p><p><strong>Methods: </strong>228,197 Hispanic decedents (Mexican, Puerto Rican [PR], Cuban, and Central or South American) with cancer-related deaths from US death certificates (2003-2017) were analyzed. Seven cancers that contribute significantly to Hispanic male (lung and bronchus, colon and rectum, liver, prostate, and pancreas cancers) and female (lung and bronchus, liver, pancreas, colon and rectum, female breast, and ovary cancers) mortality were selected for analysis. 5-year age-adjusted mortality rates [AAMR (95% CI); per 100,000] and standardized mortality ratios [SMR (95% CI)] using foreign-born as the reference group were calculated. Joinpoint regression analysis was used to model cancer-related mortality trends.</p><p><strong>Results: </strong>Puerto Rico-born PRs, Cuba-born Cubans, and US-born Mexicans had some of the highest cancer death rates among all the Hispanic groups. In general, foreign-born Hispanics had higher cancer mortality rates than US-born, except Mexicans. Overall, US-born and non-US-born (i.e. native- or foreign- born) Hispanic groups experienced decreasing rates of cancer deaths over the years.</p><p><strong>Conclusions: </strong>We noted vast heterogeneity in mortality rates by nativity across Hispanic groups, a fast-growing diverse US population.</p><p><strong>Impact: </strong>Understanding disaggregated patterns and trends in cancer burden can motivate deeper discussion around community health resources, which may improve the health of Hispanics across the US.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364511","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}
Pub Date : 2024-10-03DOI: 10.1158/1055-9965.EPI-24-1001
Daiana Denis Sarmiento, Natalia Tumas, Sofia Aynelen Pereyra, Graciela Fabiana Scruzzi, Sonia Alejandra Pou
Background: Mammography is crucial for early breast cancer detection. In Latin America, Argentina faces a significant breast cancer burden, with varying mammography rates. The social factors influencing mammography practices remain unclear. This study aimed to identify the proximal and distal social determinants of this practice among Argentinean women using a multilevel approach.
Methods: This nationwide cross-sectional study included 4,924 women aged 50-70 participating in the 2018 National Risk Factor Survey of Argentina. Two-level logistic models were used to estimate measures of association (ORs) between timely mammography practice (within the last 2 years) and selected covariates (sociodemographics, proximal environment, and distal-level variables). The intraclass correlation coefficient (ICC) and proportional change in variance (PCV) were calculated.
Results: 62.8% of women underwent timely mammography. Age (OR=0.96; 95%CI 0.94-0.97), health insurance (OR=2.22; 95%CI 1.87-2.63), education (OR=2.1; 95%CI 1.74-2.64), and income (OR=1.56; 95%CI 1.23-1.97) were associated with mammography practice. Women in non-marital (OR=0.61; 95%CI 0.52-0.72) or larger households (OR=0.61; 95%CI 0.51-0.63) were less likely to have timely mammograph; living in a larger city was positively associated (OR=1.28; 95%CI 1.12-1.46). Women in provinces with higher physician density (OR=1.06; 95%CI 1.01-1.11) and lower maternal mortality ratio (OR=0.9; 95%CI 0.87-0.96) had higher chances of timely mammography. The ICC and PCV suggested that the explored healthcare indicators largely explained the macro-contextual effect.
Conclusions: Multilevel factors influenced mammography practices in Argentina. The results highlight disparities linked to sociodemographic characteristics and healthcare resources.
Impact: Efforts to address social inequalities in breast cancer screening must consider multilevel determinants, including in healthcare settings.
背景介绍乳房 X 射线照相术对早期乳腺癌检测至关重要。在拉丁美洲,阿根廷面临着严重的乳腺癌负担,但乳房 X 射线照相术的普及率却参差不齐。影响乳房 X 射线照相做法的社会因素仍不清楚。本研究采用多层次方法,旨在确定阿根廷妇女进行乳房 X 射线照相术的近端和远端社会决定因素:这项全国性横断面研究纳入了参加2018年阿根廷全国风险因素调查的4924名50-70岁女性。研究采用两级逻辑模型来估算及时进行乳腺放射摄影(过去两年内)与选定协变量(社会人口学、近端环境和远端变量)之间的关联度(ORs)。计算了类内相关系数(ICC)和方差比例变化(PCV):结果:62.8%的妇女及时进行了乳腺 X 射线检查。年龄(OR=0.96;95%CI 0.94-0.97)、医疗保险(OR=2.22;95%CI 1.87-2.63)、教育程度(OR=2.1;95%CI 1.74-2.64)和收入(OR=1.56;95%CI 1.23-1.97)与乳腺 X 射线照相实践相关。非婚家庭(OR=0.61;95%CI 0.52-0.72)或人口较多的家庭(OR=0.61;95%CI 0.51-0.63)的妇女不太可能及时进行乳腺X光检查;居住在较大城市的妇女则与此呈正相关(OR=1.28;95%CI 1.12-1.46)。在医生密度较高(OR=1.06;95%CI 1.01-1.11)和孕产妇死亡率较低(OR=0.9;95%CI 0.87-0.96)的省份,妇女及时接受乳腺放射摄影的几率较高。ICC和PCV表明,所探讨的医疗指标在很大程度上解释了宏观背景的影响:结论:多层次因素影响了阿根廷的乳腺放射摄影实践。结果凸显了与社会人口特征和医疗资源相关的差异:影响:要解决乳腺癌筛查中的社会不平等问题,就必须考虑多层次的决定因素,包括在医疗保健环境中。
{"title":"Social determinants of breast cancer screening: a multilevel analysis of proximal and distal factors related to the practice of mammography.","authors":"Daiana Denis Sarmiento, Natalia Tumas, Sofia Aynelen Pereyra, Graciela Fabiana Scruzzi, Sonia Alejandra Pou","doi":"10.1158/1055-9965.EPI-24-1001","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-1001","url":null,"abstract":"<p><strong>Background: </strong>Mammography is crucial for early breast cancer detection. In Latin America, Argentina faces a significant breast cancer burden, with varying mammography rates. The social factors influencing mammography practices remain unclear. This study aimed to identify the proximal and distal social determinants of this practice among Argentinean women using a multilevel approach.</p><p><strong>Methods: </strong>This nationwide cross-sectional study included 4,924 women aged 50-70 participating in the 2018 National Risk Factor Survey of Argentina. Two-level logistic models were used to estimate measures of association (ORs) between timely mammography practice (within the last 2 years) and selected covariates (sociodemographics, proximal environment, and distal-level variables). The intraclass correlation coefficient (ICC) and proportional change in variance (PCV) were calculated.</p><p><strong>Results: </strong>62.8% of women underwent timely mammography. Age (OR=0.96; 95%CI 0.94-0.97), health insurance (OR=2.22; 95%CI 1.87-2.63), education (OR=2.1; 95%CI 1.74-2.64), and income (OR=1.56; 95%CI 1.23-1.97) were associated with mammography practice. Women in non-marital (OR=0.61; 95%CI 0.52-0.72) or larger households (OR=0.61; 95%CI 0.51-0.63) were less likely to have timely mammograph; living in a larger city was positively associated (OR=1.28; 95%CI 1.12-1.46). Women in provinces with higher physician density (OR=1.06; 95%CI 1.01-1.11) and lower maternal mortality ratio (OR=0.9; 95%CI 0.87-0.96) had higher chances of timely mammography. The ICC and PCV suggested that the explored healthcare indicators largely explained the macro-contextual effect.</p><p><strong>Conclusions: </strong>Multilevel factors influenced mammography practices in Argentina. The results highlight disparities linked to sociodemographic characteristics and healthcare resources.</p><p><strong>Impact: </strong>Efforts to address social inequalities in breast cancer screening must consider multilevel determinants, including in healthcare settings.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364514","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}
Pub Date : 2024-10-02DOI: 10.1158/1055-9965.EPI-24-0199
Kelly Offermans, Josien C A Jenniskens, Colinda C J M Simons, Iryna Samarska, Gregorio E Fazzi, Kim M Smits, Leo J Schouten, Matty P Weijenberg, Heike I Grabsch, Piet A van den Brandt
Background: Long-term energy balance-related factors (i.e., lifestyle and physiologic factors that influence the equilibrium between energy intake and energy expenditure over an extended period) such as body mass index (BMI) are linked to colorectal cancer risk, but their impact on colorectal cancer survival is unclear. We explored associations between these long-term energy balance-related factors and survival and examined potential differences across metabolic Warburg-subtypes.
Methods: Associations between long-term energy balance-related factors and survival in the total series of patients with colorectal cancer (n = 2,347) obtained from the prospective Netherlands Cohort Study, as well as according to Warburg-subtype (Warburg-low: n = 652, Warburg-moderate: n = 802, Warburg-high: n = 797), were investigated using Cox regression analysis.
Results: Among the long-term energy balance-related factors studied, only increasing prediagnostic BMI was associated with a borderline significant poorer overall survival in patients with colorectal cancer [HR5kg/m2, 1.07; 95% confidence interval (CI), 0.99-1.15]. Stratified analyses showed that prediagnostic weight gain (HR5kg, 1.04; 95% CI, 0.99-1.09) and potentially increased height (HR5cm, 1.04; 95% CI, 0.98-1.11) were associated with poor overall survival only in patients with Warburg-high colorectal cancer. Increasing prediagnostic BMI was associated with poor survival only in patients with Warburg-moderate colorectal cancer (colorectal cancer-specific: HR5kg/m2, 1.12; 95% CI, 0.96-1.32; overall: HR5kg/m2, 1.20; 95% CI, 1.05-1.36). No consistent patterns were observed across energy restriction proxies.
Conclusions: Maintaining a healthy prediagnostic BMI may be beneficial for colorectal cancer survival. Moreover, associations between prediagnostic BMI, weight change, early-life energy restriction, height, and colorectal cancer survival differed according to Warburg-subtypes.
Impact: Understanding the biologic pathways involved in associations between energy balance-related factors and colorectal cancer survival could help refine prevention strategies in the future.
{"title":"Association between Long-term Energy Balance-Related Factors and Survival in Colorectal Cancer Overall and by Metabolic Warburg-Subtypes.","authors":"Kelly Offermans, Josien C A Jenniskens, Colinda C J M Simons, Iryna Samarska, Gregorio E Fazzi, Kim M Smits, Leo J Schouten, Matty P Weijenberg, Heike I Grabsch, Piet A van den Brandt","doi":"10.1158/1055-9965.EPI-24-0199","DOIUrl":"10.1158/1055-9965.EPI-24-0199","url":null,"abstract":"<p><strong>Background: </strong>Long-term energy balance-related factors (i.e., lifestyle and physiologic factors that influence the equilibrium between energy intake and energy expenditure over an extended period) such as body mass index (BMI) are linked to colorectal cancer risk, but their impact on colorectal cancer survival is unclear. We explored associations between these long-term energy balance-related factors and survival and examined potential differences across metabolic Warburg-subtypes.</p><p><strong>Methods: </strong>Associations between long-term energy balance-related factors and survival in the total series of patients with colorectal cancer (n = 2,347) obtained from the prospective Netherlands Cohort Study, as well as according to Warburg-subtype (Warburg-low: n = 652, Warburg-moderate: n = 802, Warburg-high: n = 797), were investigated using Cox regression analysis.</p><p><strong>Results: </strong>Among the long-term energy balance-related factors studied, only increasing prediagnostic BMI was associated with a borderline significant poorer overall survival in patients with colorectal cancer [HR5kg/m2, 1.07; 95% confidence interval (CI), 0.99-1.15]. Stratified analyses showed that prediagnostic weight gain (HR5kg, 1.04; 95% CI, 0.99-1.09) and potentially increased height (HR5cm, 1.04; 95% CI, 0.98-1.11) were associated with poor overall survival only in patients with Warburg-high colorectal cancer. Increasing prediagnostic BMI was associated with poor survival only in patients with Warburg-moderate colorectal cancer (colorectal cancer-specific: HR5kg/m2, 1.12; 95% CI, 0.96-1.32; overall: HR5kg/m2, 1.20; 95% CI, 1.05-1.36). No consistent patterns were observed across energy restriction proxies.</p><p><strong>Conclusions: </strong>Maintaining a healthy prediagnostic BMI may be beneficial for colorectal cancer survival. Moreover, associations between prediagnostic BMI, weight change, early-life energy restriction, height, and colorectal cancer survival differed according to Warburg-subtypes.</p><p><strong>Impact: </strong>Understanding the biologic pathways involved in associations between energy balance-related factors and colorectal cancer survival could help refine prevention strategies in the future.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1356-1367"},"PeriodicalIF":3.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632700","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}
Pub Date : 2024-10-02DOI: 10.1158/1055-9965.EPI-24-0496
Austin Hammermeister Suger, Tabitha A Harrison, Barbara Henning, Constance Turman, Peter Kraft, Sara Lindström
Background: Contribution of dominance effects to cancer heritability is unknown. We leveraged existing genome-wide association data for seven cancers to estimate the contribution of dominance effects to the heritability of individual cancer types.
Methods: We estimated the proportion of phenotypic variation caused by dominance genetic effects using genome-wide association data for seven cancers (breast, colorectal, lung, melanoma, nonmelanoma skin, ovarian, and prostate) in a total of 166,772 cases and 284,824 controls.
Results: We observed no evidence of a meaningful contribution of dominance effects to cancer heritability. By contrast, additive effects ranged between 0.11 and 0.34.
Conclusions: In line with studies of other human traits, the dominance effects of common genetic variants play a minimal role in cancer etiology.
Impact: These results support the assumption of an additive inheritance model when conducting cancer association studies with common genetic variants.
{"title":"Nonadditive Effects of Common Genetic Variants Have a Negligent Contribution to Cancer Heritability.","authors":"Austin Hammermeister Suger, Tabitha A Harrison, Barbara Henning, Constance Turman, Peter Kraft, Sara Lindström","doi":"10.1158/1055-9965.EPI-24-0496","DOIUrl":"10.1158/1055-9965.EPI-24-0496","url":null,"abstract":"<p><strong>Background: </strong>Contribution of dominance effects to cancer heritability is unknown. We leveraged existing genome-wide association data for seven cancers to estimate the contribution of dominance effects to the heritability of individual cancer types.</p><p><strong>Methods: </strong>We estimated the proportion of phenotypic variation caused by dominance genetic effects using genome-wide association data for seven cancers (breast, colorectal, lung, melanoma, nonmelanoma skin, ovarian, and prostate) in a total of 166,772 cases and 284,824 controls.</p><p><strong>Results: </strong>We observed no evidence of a meaningful contribution of dominance effects to cancer heritability. By contrast, additive effects ranged between 0.11 and 0.34.</p><p><strong>Conclusions: </strong>In line with studies of other human traits, the dominance effects of common genetic variants play a minimal role in cancer etiology.</p><p><strong>Impact: </strong>These results support the assumption of an additive inheritance model when conducting cancer association studies with common genetic variants.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1383-1388"},"PeriodicalIF":3.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632701","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}
Pub Date : 2024-10-02DOI: 10.1158/1055-9965.EPI-24-0647
Janine V Abe, Justin Legaspi, Cherie Guillermo, David Bogumil, Veronica Wendy Setiawan, Loïc Le Marchand, Brenda Y Hernandez, Lynne R Wilkens, Gertraud Maskarinec
Background: Filipino Americans constitute 12% and 4% of the respective populations of Hawaii and California, with a large proportion of immigrants experiencing increasing cancer rates. This study investigated the incidence of colorectal, breast, and prostate cancers by generational status in the Multiethnic Cohort.
Methods: We analyzed 10,495 Filipino Multiethnic Cohort first-, second-, and third-generation participants, in which 26.8% were of mixed race and ethnicity. Linkage to statewide cancer registries identified 375 breast, 249 colorectal, and 436 prostate cancer incident cases. Cox models were used to calculate HRs and 95% confidence intervals (CI) for the association between generational status and cancer incidence. Models were adjusted for age at cohort entry and cancer-specific covariates that were chosen based on stepwise regression.
Results: Compared with the first generation, colorectal cancer showed a significantly higher incidence in the second and third generations with respective HRs of 1.43 (95% CI, 1.04, 1.98) and 1.76 (95% CI, 1.29, 2.38). This association was attenuated after adjustment for relevant covariates. Breast cancer incidence was elevated in the third versus first generation (HR = 1.29; 95% CI, 1.01, 1.63) even in the fully adjusted model, whereas little difference was observed for prostate cancer.
Conclusions: In this prospective study, we found differences in incidence by generational status, specifically colorectal cancer among men and female breast cancer.
Impact: Understanding behavioral changes due to acculturation is warranted to mitigate cancer risks in migrant populations.
{"title":"Breast, Colorectal, and Prostate Cancer Incidence among Filipino Americans by Generational Status in the Multiethnic Cohort Study.","authors":"Janine V Abe, Justin Legaspi, Cherie Guillermo, David Bogumil, Veronica Wendy Setiawan, Loïc Le Marchand, Brenda Y Hernandez, Lynne R Wilkens, Gertraud Maskarinec","doi":"10.1158/1055-9965.EPI-24-0647","DOIUrl":"10.1158/1055-9965.EPI-24-0647","url":null,"abstract":"<p><strong>Background: </strong>Filipino Americans constitute 12% and 4% of the respective populations of Hawaii and California, with a large proportion of immigrants experiencing increasing cancer rates. This study investigated the incidence of colorectal, breast, and prostate cancers by generational status in the Multiethnic Cohort.</p><p><strong>Methods: </strong>We analyzed 10,495 Filipino Multiethnic Cohort first-, second-, and third-generation participants, in which 26.8% were of mixed race and ethnicity. Linkage to statewide cancer registries identified 375 breast, 249 colorectal, and 436 prostate cancer incident cases. Cox models were used to calculate HRs and 95% confidence intervals (CI) for the association between generational status and cancer incidence. Models were adjusted for age at cohort entry and cancer-specific covariates that were chosen based on stepwise regression.</p><p><strong>Results: </strong>Compared with the first generation, colorectal cancer showed a significantly higher incidence in the second and third generations with respective HRs of 1.43 (95% CI, 1.04, 1.98) and 1.76 (95% CI, 1.29, 2.38). This association was attenuated after adjustment for relevant covariates. Breast cancer incidence was elevated in the third versus first generation (HR = 1.29; 95% CI, 1.01, 1.63) even in the fully adjusted model, whereas little difference was observed for prostate cancer.</p><p><strong>Conclusions: </strong>In this prospective study, we found differences in incidence by generational status, specifically colorectal cancer among men and female breast cancer.</p><p><strong>Impact: </strong>Understanding behavioral changes due to acculturation is warranted to mitigate cancer risks in migrant populations.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1311-1317"},"PeriodicalIF":3.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916165","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}