Cancer Epidemiology最新文献

{"title":"Examining concordance with the guidelines of the national comprehensive cancer network for the treatment of endometrial cancer in Puerto Rico","authors":"Yisel Pagán-Santana ,&nbsp;Maira Castañeda-Avila ,&nbsp;Ruth Ríos-Motta ,&nbsp;Luis Santos-Reyes ,&nbsp;Karen J. Ortiz-Ortiz","doi":"10.1016/j.canep.2024.102664","DOIUrl":"10.1016/j.canep.2024.102664","url":null,"abstract":"<div><h3>Background</h3><p>Endometrial cancer poses a significant health concern in Puerto Rico, where it ranks as the primary gynecological malignancy among women. This study evaluates concordance with the National Comprehensive Cancer Network (NCCN) guidelines for endometrial cancer first treatment in Puerto Rican women and its association with 5-year overall survival.</p></div><div><h3>Methods</h3><p>Data on patients with endometrial cancer diagnosed between 2009 and 2015 was obtained from the Puerto Rico Central Cancer Registry, which is linked to the Puerto Rico Health Insurance Linkage database (n = 2114). The association between receiving guideline-concordant first treatment and clinical, socioeconomic, and health system factors was evaluated using logistic regression. The 5-year overall survival was calculated using the Kaplan-Meier method. Cox proportional hazard regression models were used to estimate hazard ratios and 95 % confidence intervals (CIs) for associations between guideline-concordant first treatment and overall survival.</p></div><div><h3>Results</h3><p>In our cohort, 53.9 % of patients received guideline-concordant first treatment. Receiving care at a Commission on Cancer-accredited center, being evaluated by a gynecologist-oncologist, and possessing private insurance enhanced the likelihood of receiving guideline-concordant first treatment. In the Cox regression models, receiving guideline-concordant first treatment was associated with a lower mortality risk (HR: 0.72, 95 % CI: 0.59–0.89).</p></div><div><h3>Conclusion</h3><p>Guideline-concordant first treatment is a strong predictor of improved survival rates in endometrial cancer. Given that guidelines based on scientific evidence have been demonstrated to enhance patient outcomes, we must understand and promote the factors contributing to their adoption.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102664"},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877782124001437/pdfft?md5=deae112d0a660451373178400ea6a6e4&pid=1-s2.0-S1877782124001437-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241589","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}

{"title":"Colorectal cancer in older adults after the USPSTF’s 2008 updated screening recommendation","authors":"Jason Semprini","doi":"10.1016/j.canep.2024.102677","DOIUrl":"10.1016/j.canep.2024.102677","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal cancer (CRC) screenings can improve detection and prevent precancerous polyps from becoming malignant tumors. In 2008, the United States Preventive Services Task Force (USPSTF) updated their policy and no longer recommended that adults over age 75 screen for CRC. We evaluated how this policy update impacted screening behaviors and CRC outcomes in older adults.</p></div><div><h3>Methods</h3><p>We obtained data from the Behavioral Risk Factor Surveillance System to analyze blood stool and colonoscopy screening, the Surveillance, Epidemiological, End Results program to analyze CRC staging and survival, the National Association of Centralized Cancer Registries to analyze CRC incidence, and the National Center for Health Statistics to analyze mortality. With a difference-in-differences design, we compared the changes in outcome trends of the exposed group (age 75+), before and after 2008, with the changes in trends of a similar unexposed group (age 65–74).</p></div><div><h3>Results</h3><p>There was no association between the 2008 update and blood stool tests in older adults. We did, however, find that the update was associated with a 3.0 %-point decline in the probability of older adults completing a colonoscopy within the past two years (C.I. = −4.0, −2.0). Among older adults diagnosed with CRC, the update was associated with a 1.5 %-point increase in the probability of presenting at an advanced stage (C.I. = 1.1, 1.9). Finally, the update was also associated with lower CRC incidence (Est. = −13.9 cases/100,000 population; C.I. = −22.6, −5.1) and mortality rates (Est. = −5.6 deaths/100,000 population; C.I. = −10.1, −1.1). We observed the largest associations between the policy and CRC outcomes in adults age 85+.</p></div><div><h3>Discussion</h3><p>The USPSTF’s 2008 recommendation was associated with reduced colonoscopies, especially in adults over age 85. Whether this recommendation, or the 2021 updated guidance, optimizes population health by reducing the burden of CRC screening in older adults remains unknown.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102677"},"PeriodicalIF":2.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241838","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}

{"title":"Trajectories in mammographic breast screening participation in middle-age overweight and obese women: A retrospective cohort study using linked data","authors":"K.A. McBride ,&nbsp;S. Munasinghe ,&nbsp;S. Sperandei ,&nbsp;A.N. Page","doi":"10.1016/j.canep.2024.102675","DOIUrl":"10.1016/j.canep.2024.102675","url":null,"abstract":"<div><h3>Objectives</h3><p>Despite the established benefits and availability of mammographic breast screening, participation rates remain suboptimal. Women with higher BMIs may not screen regularly, despite being at increased risk of postmenopausal breast cancer and worse outcomes. This study investigated the association between prospective changes in BMI and longitudinal adherence to mammographic screening among women with overweight or obesity.</p></div><div><h3>Methods</h3><p>Retrospective cohort study of women (N = 2822) participating in the Australian Longitudinal Study on Women's Health with an average follow-up of 20 years, with screening participation enumerated via BreastScreen NSW, Australia clinical records over the period 1996–2016. Association between BMI and subsequent adherence to screening was investigated in a series of marginal structural models, incorporating a time variant/invariant socio-demographic, clinical, and health behaviour confounders. Models were also stratified by a proxy measure of socio-economic status (education).</p></div><div><h3>Results</h3><p>Participants with overweight/obesity were less adherent to mammography screening, compared to healthy/underweight participants (OR=1.29, 95 % CI=1.07, 1.55). The association between overweight/obesity and non-adherence was higher among those who ever had private health insurance (OR=1.30, 95 % CI=1.05, 1.61) compared to those who never had private health insurance and among those with lower educational background (OR=1.38, 95 % CI=1.08, 1.75) compared to those with higher educational background.</p></div><div><h3>Conclusions</h3><p>Long-term impacts on screening participation exist among women with higher BMI, who are less likely to participate in routinely organised breast screening. Women with a higher BMI should be a focus of efforts to improve breast screening participation, particularly given their increased risk of breast cancer and association of higher BMI with worse breast cancer outcomes among older women.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102675"},"PeriodicalIF":2.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877782124001541/pdfft?md5=f8b1091f2cc80cf82887740fab46530d&pid=1-s2.0-S1877782124001541-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241588","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}

{"title":"Cervical cancer screening outcomes among First Nations and non‐First Nations women in Alberta, Canada","authors":"Huiming Yang ,&nbsp;Angeline Letendre ,&nbsp;Melissa Shea-Budgell ,&nbsp;Lea Bill ,&nbsp;Bonnie A. Healy ,&nbsp;Brittany Shewchuk ,&nbsp;Gregg Nelson ,&nbsp;James Newsome ,&nbsp;Bonnie Chiang ,&nbsp;Chinmoy Roy Rahul ,&nbsp;Karen A. Kopciuk","doi":"10.1016/j.canep.2024.102672","DOIUrl":"10.1016/j.canep.2024.102672","url":null,"abstract":"<div><h3>Background</h3><p>Cervical cancer disproportionately affects First Nations women in Canada but there is limited information on their participation in organized cervical cancer screening programs.</p></div><div><h3>Methods</h3><p>This co-led retrospective cohort study linked population-based Alberta Cervical Cancer Screening Program point of care data with First Nations identifiers. This Screening Program database includes cervical cancer screening history, screen test results, colposcopy procedure findings, and pathology results for all women in Alberta. First Nations identifiers were obtained from Alberta Health who steward these data on their behalf. Data were available from 2012 to 2018 for women 25 – 69 years of age who were age eligible to participate in cervical cancer screening. Screening participation and retention rates, and screening outcomes were compared between First Nations and non- First Nations women using descriptive statistics with trends estimated using joinpoint models.</p></div><div><h3>Results</h3><p>Age standardized screening participation and retention rates of First Nations women were lower than those for the non-First Nations women, with an average difference of 13.9 % lower for participation rates (95 % confidence interval = 12.9–14.8 %; <em>P</em> &lt;.0001) and 7.2 % for retention rates (95 % confidence interval = 2.2 % to 12.72; <em>P</em> = 0.013). First Nations women consistently had higher percentages of high risk (high-grade squamous intraepithelial lesion, atypical glandular cells, atypical squamous cells where HSIL cannot be excluded, Carcinoma in situ) abnormal cytology tests than non-First Nations women.</p></div><div><h3>Conclusion</h3><p>Identifying where inequities were found in cervical cancer screening participation and retention in this study is the first step to reduce the disproportionate burden of cervical cancer for First Nations women in Canada.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102672"},"PeriodicalIF":2.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877782124001516/pdfft?md5=33a2075b4e95ac46f9ca3c49f73949e8&pid=1-s2.0-S1877782124001516-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230336","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}

{"title":"Spatial and temporal analysis of breast cancer mortality in a state in northeastern Brazil","authors":"Adriane Dórea Marques ,&nbsp;Alex Rodrigues Moura ,&nbsp;Brenda Evelin Barreto da Silva ,&nbsp;Taiana Resende Silva ,&nbsp;Caio Nemuel Nascimento Santos ,&nbsp;Lucas Nascimento Severo ,&nbsp;Angela Maria da Silva ,&nbsp;Carlos Anselmo Lima","doi":"10.1016/j.canep.2024.102661","DOIUrl":"10.1016/j.canep.2024.102661","url":null,"abstract":"<div><p>Breast cancer (BC) is the most common neoplasm, and its global burden has become one of the most important factors jeopardizing the health of the world population, especially women. The aim of this study was to analyze mortality trends and the spatial distribution of BC in women in the capital and state of Sergipe, aiming to contribute to the implementation and improvement of strategies for the prevention and health promotion of women with BC. Trends were calculated using the Joinpoint Regression Program 5.0.2. Spatial analyses were performed using the empirical Bayesian model, thematic maps were created using QGIS 3.10.7 and Moran's I indices were calculated using TerraView 4.2.2. Between 1996 and 2022, 1384 and 3128 BC deaths were recorded in the capital and state of Sergipe, respectively. The mortality trend increased in the age groups of 45–75+ for the state of Sergipe, while in the capital, we observed stability in all age groups. The highest AAPC was 4.6213, with a 95 % confidence interval (2.16; 7.14). Univariate global Moran's I analysis indicated spatial autocorrelation during the study period. A direct relationship was found between mortality rates and the more economically developed regions.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102661"},"PeriodicalIF":2.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171875","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}

{"title":"The PROPr can be measured using different PROMIS domain item sets","authors":"Christoph Paul Klapproth ,&nbsp;Felix Fischer ,&nbsp;Annika Doehmen ,&nbsp;Milan Kock ,&nbsp;Jens Rohde ,&nbsp;Kathrin Rieger ,&nbsp;Ullrich Keilholz ,&nbsp;Matthias Rose ,&nbsp;Alexander Obbarius","doi":"10.1016/j.canep.2024.102658","DOIUrl":"10.1016/j.canep.2024.102658","url":null,"abstract":"<div><h3>Background</h3><p>The Patient-Reported Outcomes Measurement Information System (PROMIS) Preference Score (PROPr) is estimated from descriptive health assessments within the PROMIS framework. The underlying item response theory (IRT) allows researchers to measure PROMIS health domains with any subset of items that are calibrated to this domain. Consequently, this should also be true for the PROPr. We aimed to test this assumption using both an empirical and a simulation approach.</p></div><div><h3>Methods</h3><p>Empirically, we estimated 3 PROMIS Pain inference (PI) scores from 3 different item subsets in a sample of n=199 cancer patients: 4 PROMIS-29 items (estimate: θ₄), the 2 original PROPr items (θ₂), and 10 different items (θ₁₀). We calculated mean differences and agreement between θ₄, and θ₂ and θ₁₀, respectively, and between their resulting PROPr₄, PROPr₂, PROPr₁₀, using intraclass correlation coefficients (ICC) and Bland-Altman (B-A) plots with 95 %-Limits of Agreement (LoA). For the simulation, we used the IRT-model to calculate all item responses of the entire 7 PROPr domain item banks from the empirically observed PROMIS-29+cognition θ. From these simulated item banks, we chose the 2 original PROPr items per domain to calculate PROPr_sim and compared it to PROPr₄ again using ICC and B-A plots.</p></div><div><h3>Results</h3><p>θ₄ vs θ₁₀ showed smaller bias (-0.012, 95 %-LoA −0.88;0.85) than θ₄ vs θ₂ (0.025, 95 %-LoA −0.95;1.00. ICC&gt;0.85 (p&lt;0.001) in both θ-comparisons. PROPr₄ vs PROPr₁₀ showed lower bias (0.0012, 95 %-LoA −0.039;0.042) than PROPr₄ vs PROPr₂ (-0.0029, 95 %-LoA −0.049;0.044). ICC&gt;0.98 (p&lt;0.0001) on both PROPr-comparisons. Mean PROPr_sim was larger than mean PROPr₄ (0.0228, 95 %-LoA −0.1103; 0.1558) and ICC was 0.95 (95 %CI 0.93; 0.97).</p></div><div><h3>Conclusion</h3><p>Different item subsets can be used to estimate the PROMIS PI for calculation of the PROPr. Reduction to 2 items per domain rather than 4 does not significantly change the PROPr estimate on average. Agreements differ across the spectrum and in individual comparisons.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102658"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877782124001371/pdfft?md5=ce62914936b18250df9ea55f5e9b1419&pid=1-s2.0-S1877782124001371-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164552","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}

{"title":"Trends in the incidence and mortality of cervical, ovarian, and corpus uteri cancers in Wales, UK: A joinpoint regression analysis from 2002 to 2021","authors":"Sindhu Sekar ,&nbsp;Srividhya Budithi,&nbsp;Sujeewa Fernando","doi":"10.1016/j.canep.2024.102660","DOIUrl":"10.1016/j.canep.2024.102660","url":null,"abstract":"<div><h3>Objectives</h3><p>The primary objective of this study was to examine the secular trends of cervical, ovarian, and corpus uteri neoplasm in Wales, UK, over the period from 2002 to 2021. We aimed to identify changes in the incidence and mortality rates of these cancers to inform future healthcare policies and cancer prevention programs.</p></div><div><h3>Methods</h3><p>We sourced incidence data from 2002 to 2019 and mortality data from 2002 to 2021 from the Welsh Cancer Intelligence and Surveillance Unit. The data were analysed using Joinpoint regression to compute the average annual percentage change (AAPC) in age-standardized incidence rates (ASIR) and mortality rates (ASMR) per 100,000 population for each type of cancer.</p></div><div><h3>Results</h3><p>The results showed that the ASIR for cervical cancer remained stable between 2002 and 2019 (AAPC = −0.5; 95 %CI = −1.4–0.4). However, the ASMR significantly declined from 4.88 in 2002–3.03 in 2021 (AAPC = −2.3; 95 %CI = −3.4 to −1.1). The ASIR for ovarian cancer significantly decreased from 27.39 in 2002–17.87 in 2019 (AAPC = −2.6; 95 %CI = −3.0 to −2.1), and the ASMR showed a statistically significant decreasing trend from 15.92 in 2002–11.2 in 2021 (AAPC = −1.7; 95 %CI = −2.5 to −0.9). In contrast, the ASIR for corpus uteri neoplasm significantly increased from 22.24 in 2002–30.41 in 2019 (AAPC = 2.2; 95 %CI = 1.2–3.4), and ASMR also showed a statistically significant increasing trend from 3.27 in 2002–6.42 in 2021 (AAPC = 3.8; 95 %CI = 2.3–5.3).</p></div><div><h3>Conclusions</h3><p>The study concludes that while the incidence and mortality rates for cervical and ovarian cancers in Wales have significantly decreased, corpus uteri neoplasm rates have increased during the study period. These findings underscore the need for continued efforts to improve early detection and treatment strategies, including national screening programs and public health initiatives, to mitigate the burden of these cancers.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102660"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164553","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}

{"title":"Disparities in cancer care in individuals with severe mental illness: A narrative review","authors":"John F. Murphy ,&nbsp;Laura B. Amin ,&nbsp;Suheda T. Celikkaleli ,&nbsp;Hannah E. Brown ,&nbsp;Umit Tapan","doi":"10.1016/j.canep.2024.102663","DOIUrl":"10.1016/j.canep.2024.102663","url":null,"abstract":"<div><p>Individuals with severe mental illness (SMI) have higher mortality rates from cancer than individuals without SMI. The aim of this paper is to highlight these disparities in cancer care in individuals with SMI and suggest potential solutions. We conducted a narrative review of published papers, focusing on mortality, incidence, behavioral and provider risk factors, screening, diagnosis, treatment, and palliative care among individuals with SMI and cancer. The literature does not provide a clear consensus on whether a difference in cancer incidence exists among individuals with SMI compared to the general population. However, it is evident that individuals with SMI have higher mortality from cancer. Factors such as increased cancer related risk behavior, mental health stigma, and difficulty accessing cancer care contribute to this mortality difference. The literature also indicates lower screening rates, delayed and improper diagnosis and treatment, as well as inadequate clinical trial enrollment in individuals with SMI. While the literature is inconclusive regarding disparities in palliative care, we outline key concepts to provide the best possible end of life care to this population. We also summarize strategies to address disparities at the screening, diagnostic, and treatment levels and describe general strategic approaches to improve cancer care in individuals with SMI. We highlight patient-related, physician-related, and healthcare/systems-related factors leading to disparities in cancer care in individuals with SMI. Future research must examine the effectiveness of proposed solutions to guide evidence-based practices.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102663"},"PeriodicalIF":2.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164551","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}

{"title":"Incidence and survival of patients with malignant pancreatic neuroendocrine neoplasms in Germany, 2009–2021","authors":"Andreas Stang ,&nbsp;Ina Wellmann ,&nbsp;Bernd Holleczek ,&nbsp;Soo-Zin Kim-Wanner ,&nbsp;Jacqueline Müller-Nordhorn ,&nbsp;Eunice Sirri ,&nbsp;Ian Wittenberg ,&nbsp;Jens T. Siveke ,&nbsp;Hiltraud Kajüter ,&nbsp;German Network of Cancer Registries","doi":"10.1016/j.canep.2024.102659","DOIUrl":"10.1016/j.canep.2024.102659","url":null,"abstract":"<div><h3>Background</h3><p>Due to the rarity of pancreatic neuroendocrine neoplasms, only few population-representative studies on incidence and survival have been conducted. The aim was to provide up-to-date nationwide incidence and relative survival estimates of neuroendocrine (NE) neoplasms overall, NE tumors (NETs), NE carcinomas (NECs), and mixed NE neoplasms (MiNEN).</p></div><div><h3>Methods</h3><p>We distinguished between pancreatic NETs (functioning versus non-functioning), NECs and mixed NE neoplasms and analyzed data from 2009 through 2021 from all German cancer registries covering a population of more than 80 million. We calculated crude and age-standardized incidence rates and 5-year relative survival estimates (RS).</p></div><div><h3>Results</h3><p>Overall 6474, 4217, and 243 patients with pancreatic NETs, NECs, and mixed NE neoplasms, respectively were registered. While the age-standardized incidence of NETs has increased (+16.4 % per year, 95 %CI 12.2;20.7), the incidence of NEC has fallen (about −6.4 % per year, 95 %CI −8.0; −4.8). The crude RS was 77.7 % (standard error [SE] 0.9) for non-functioning NETs, 90.3 % for functioning NETs (SE 3.9), and 18.5 % (SE 3.9) for MiNEN. Large and small cell NECs had a low RS (9.1 % and 6.9 %, respectively). RS for G1 NETs was 88.2 %, while it was only 36.6 % for G3 NETs. Localized NETs had a RS of 92.8 %, while distant metastatic NETs had a RS of 45.0 %.</p></div><div><h3>Conclusions</h3><p>The incidence of pancreatic NETs has increased markedly in Germany in the period 2009–2021. Subgroups of NETs (G1 grading or localized stage) have an excellent prognosis. RS of MiNEN is more similar to NECs than NETs.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102659"},"PeriodicalIF":2.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877782124001383/pdfft?md5=fd64223311a6b0400a9d31e9d6f3d071&pid=1-s2.0-S1877782124001383-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147020","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}

{"title":"The intersection of race, ethnicity, and urbanicity on treatment paradigms and clinical outcomes for non-malignant primary tumors of the spine","authors":"Brandon Bishop ,&nbsp;Harrison Hockenberry ,&nbsp;Jacob Sperber ,&nbsp;Edwin Owolo ,&nbsp;Cesar Baeta ,&nbsp;Mackenzie Price ,&nbsp;Corey Neff ,&nbsp;Carol Kruchko ,&nbsp;Jill S. Barnholtz-Sloan ,&nbsp;Antionette J. Charles ,&nbsp;Camryn Sciubba ,&nbsp;Quinn T. Ostrom ,&nbsp;Eli Johnson ,&nbsp;C. Rory Goodwin","doi":"10.1016/j.canep.2024.102657","DOIUrl":"10.1016/j.canep.2024.102657","url":null,"abstract":"<div><h3>Background</h3><p>Non-malignant primary tumors of the spine (NMPTS) patients in rural areas face unique barriers that may limit their capacity to receive optimal care. With a lower geographical distribution of neurosurgical specialists and limited healthcare infrastructure, rural NMPTS patients may receive certain treatments at a lower frequency than metropolitan patients. NMPTS We sought to examine the association between residential urbanicity, race-ethnicity, treatment patterns, and survival outcomes for cases diagnosed with NMPTS.</p></div><div><h3>Methods</h3><p>Cases of NMPTS diagnosed between 2004 and 2019 were identified from the Central Brain Tumor Registry of the United States (CBTRUS), a combined dataset of CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology and End Results (SEER) data. Using multivariable logistic regression, we evaluated the association between urbanicity and treatment (including surgery and radiation), adjusted for age at diagnosis, sex, and race-ethnicity. Patient-level all-cause survival data were obtained from the NPCR Survival Analytical Database (2004–2018).</p></div><div><h3>Results</h3><p>A total of 38,414 cases were identified, 33,097 of whom lived in metropolitan and 5317 of whom lived in non-metropolitan regions. Nerve sheath tumors and meningiomas were the most common tumor histopathologies across both regions, with no clinically significant difference in other histopathologies (p&lt;0.001). There were statistically significant differences between the frequency and type of surgery received by urbanicity (p&lt;0.001). Overall all-cause survival was significantly lower for NH Blacks residing in non-metropolitan areas when compared to NH Blacks residing in metropolitan areas (p&lt;0.0001).</p></div><div><h3>Conclusion</h3><p>Our data demonstrates significant differences in the incidence of NMPTS across both race-ethnicity and urbanicity. However, a wider analysis of all-cause mortality reveals disparities in health outcomes across both race-ethnicity and urbanicity for Black and Hispanic populations. To address the disparity in health outcomes, policymakers and health providers need to work with local communities in rural areas to improve access to equitable and quality healthcare.</p></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"93 ","pages":"Article 102657"},"PeriodicalIF":2.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147021","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}