Cancer Epidemiology最新文献

{"title":"Early-life tobacco exposure, genetic susceptibility and incident colorectal cancer risk in UK biobank: A prospective cohort analysis","authors":"Yu Long ,&nbsp;Yuting Zhu ,&nbsp;Meiyin Lin ,&nbsp;Qinming Li ,&nbsp;Jun Liang ,&nbsp;Chunyang Wang ,&nbsp;Ruijie Zeng ,&nbsp;Dongling Luo ,&nbsp;Lijun Zhang ,&nbsp;Yuyin Ma ,&nbsp;Chongyang Duan ,&nbsp;Yue Zhu ,&nbsp;Hao Chen ,&nbsp;Jianhua Liu","doi":"10.1016/j.canep.2025.102985","DOIUrl":"10.1016/j.canep.2025.102985","url":null,"abstract":"<div><h3>Background</h3><div>Although tobacco exposure is an established risk factor for colorectal cancer (CRC), the specific impact of early-life exposure (from prenatal to adolescence) and its joints with genetic susceptibility remains uncertain. This population-based study aimed to investigate the joint effects of early-life tobacco exposure and polygenic risk on CRC.</div></div><div><h3>Methods</h3><div>Data from UK Biobank participants were analyzed to assess tobacco exposure during two periods: prenatal exposure (n = 429,847) and age of smoking initiation (n = 430,672). Using Cox proportional hazards models, the associations between early-life tobacco exposure and CRC incidence were explored. Additionally, we evaluated the mediating role of accelerated biological aging in the link between early-life tobacco exposure and CRC, and further integrated the polygenic risk score (PRS) to assess the joint effects of genetic on CRC risk.</div></div><div><h3>Results</h3><div>Early-life tobacco exposure exhibited age-at-initiation-dependent CRC risk associations. Smoking initiation in adolescence [hazard ratios (HR) = 1.13, 95 % confidence intervals (CI): 1.06–1.22], and adulthood (HR = 1.19, 95 % CI: 1.10–1.30) all significantly increased risk (<em>P</em> &lt; 0.001), while in utero exposure and smoking initiation childhood (HR:1.06, 95 % CI: 0.94–1.19, <em>P</em> = 0.372) showed a suggestive but non-significant trend (HR:1.05, 95 % CI: 1.00–1.11, <em>P</em> = 0.066). In the joint analysis, high-PRS individuals with prenatal tobacco exposure had an elevated CRC risk compared to those with low PRS and no exposure (HR 1.28, 95 % CI: 1.16–1.42, P &lt; 0.001). Furthermore, among high-PRS individuals, smoking initiation at any age (childhood, adolescence, or adulthood) increased CRC risk relative to never-smokers with low PRS. Mediation analysis indicated that accelerated biological aging may contribute to the association between smoking initiation at different ages and increased CRC risk.</div></div><div><h3>Conclusion</h3><div>Early-life tobacco exposure elevated CRC risk, especially in genetically susceptible individuals. These findings underscored the importance of early tobacco prevention and enhanced screening for high genetic-risk populations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102985"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883748","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":"Ambient air pollution and laryngeal cancer: A systematic review","authors":"Jasen Soopramanien ,&nbsp;Sagar Mittal ,&nbsp;Kinjal Jadeja ,&nbsp;Lakshya Soni ,&nbsp;Samiyah Saghir ,&nbsp;Fathima Mannan","doi":"10.1016/j.canep.2025.102981","DOIUrl":"10.1016/j.canep.2025.102981","url":null,"abstract":"<div><div>Ambient air pollution is a major global health concern, yet its association with laryngeal cancer remains poorly defined. This systematic review aimed to evaluate the relationship between long-term exposure to outdoor air pollutants and incidence of laryngeal cancer. Comprehensive searches of MEDLINE, EMBASE, CENTRAL, and SCOPUS were conducted from inception to 01/06/2024. Eligible studies included observational and ecological designs reporting quantitative associations between ambient pollutants and laryngeal cancer incidence. Study quality, risk of bias, and evidence certainty graded were appraised using the NIH tool, National Toxicology Program framework and GRADE approach respectively. A total of nine studies (4 ecological, 5 cohort) comprising over 7.4 million participants were included. Each pollutant was analysed by a maximum of 3 studies. Nitrogen dioxide (NO₂) demonstrated the most consistent association with laryngeal cancer, with hazard ratios between 1.18 and 1.24 per 10 μg/m³ increase. One large cohort reported a significant relationship between particulate matter ≤ 2.5 μm (PM₂.₅) and laryngeal cancer (HR 1.85; 95 % CI: 1.2–2.85), while findings across other pollutants, including PM₁₀, SO₂, O₃, CO, and NOₓ, were inconsistent. Although data remain limited, emerging evidence suggests that chronic exposure to ambient NO₂ and PM₂.₅ may increase laryngeal cancer risk. Future large-scale prospective cohort studies with standardized exposure metrics and robust confounding control are needed to better characterise this relationship. Natural experiments in regions undergoing major air-quality policy changes can provide valuable evidence on the impact of reducing exposure on laryngeal cancer incidence at a population level.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102981"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829164","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":"Etiologic profile and prognostic patterns of hepatocellular carcinoma in a Southern European population – Madeira, Portugal: Insight into a preventable cancer","authors":"Pedro H. Berenguer ,&nbsp;Cláudia Fraga ,&nbsp;Sara Müller ,&nbsp;Patrícia Serrão ,&nbsp;Carolina Camacho ,&nbsp;Laurentina Silva ,&nbsp;Nuno Ladeira ,&nbsp;Paulo S. Pinheiro ,&nbsp;Carolina Sales","doi":"10.1016/j.canep.2025.102976","DOIUrl":"10.1016/j.canep.2025.102976","url":null,"abstract":"<div><h3>Background</h3><div>Liver cancer is the sixth most common and third deadliest cancer worldwide. In Portugal, it remains highly lethal, with 1740 new cases and 1611 deaths estimated in 2022. Hepatocellular carcinoma (HCC) is the main histological type and exhibits variation in risk factors and outcomes. Unlike many malignancies, HCC arises predominantly in chronically diseased tissues and is largely attributable to four modifiable etiologies: hepatitis B (HBV) and C viruses (HCV), alcohol-associated liver disease (ALD), and metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to characterize HCC etiology-specific incidence and prognostic patterns in the Madeira islands, Portugal.</div></div><div><h3>Methods</h3><div>All HCC cases diagnosed between 2010 and 2023 were identified through the Madeira Cancer Registry. Etiologies and risk factors were assigned using clinical records, serological markers, and ICD-coded discharge data. Age-standardized incidence rates (ASIRs) were computed using the world and the 2000 U.S. standard population. Survival outcomes were assessed with Kaplan-Meier curves and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Among 240 HCC cases, the leading etiology was ALD (50.0 %), followed by MASLD (17.1 %), HBV (16.5 %), and HCV (11.9 %). Male incidence was nearly 8-fold higher than female incidence (ASIR: 6.9 vs. 0.9 per 100,000), with ALD dominating among men and MASLD among women. No significant temporal change in HCC incidence was observed. Most patients (63.8 %) were diagnosed at advanced stages. The age-adjusted 5-year survival was 5.6 %, and median survival was 6 months. Cancer stage was the strongest prognostic factor, while HCC etiology was not independently associated with survival.</div></div><div><h3>Conclusions</h3><div>HCC in Madeira presents a distinct etiologic and prognostic pattern, marked by a high ALD burden among men, a MASLD burden among women, and poor survival due to late-stage diagnosis. These findings highlight the urgency of expanding liver cancer surveillance, integrating metabolic risk management, and targeting alcohol misuse through population-level interventions, especially among males and older patients.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102976"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737022","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":"Population-based trends in gastrointestinal cancer incidence and mortality in New Zealand: A 11-year analysis","authors":"Lelwala Guruge Thushani Shanika ,&nbsp;Robin Turner ,&nbsp;Sharon Pattison ,&nbsp;Rhiannon Braund","doi":"10.1016/j.canep.2025.102973","DOIUrl":"10.1016/j.canep.2025.102973","url":null,"abstract":"<div><div>Gastrointestinal (GI) cancers are a major contributor to the global cancer burden. However, no previous study has examined incidence and mortality across all GI cancer sites within a population, stratified by sex, ethnicity, and socioeconomic status. This retrospective, population-based study aimed to address this gap by providing a comprehensive overview of GI cancer incidence and mortality in New Zealand (NZ) from 2009 to 2019 and examining patterns across demographic subgroups. GI cancer cases (ICD-10-AM C15–C26) were identified from the NZ Cancer Registry and linked to the Mortality Collection to assess mortality. Baseline demographics were summarised, and age-standardised incidence and GI cancer-specific mortality rates were calculated. A total of 57,707 GI cancers were diagnosed in 55,611 individuals. The mean age at diagnosis and death were 69.9 (SD: 13.4) and 73.9 (SD: 12.9), respectively. Of those diagnosed with GI cancer, 54.4 % were male. Incidence trends varied by cancer site: small intestinal cancer increased annually (3 % in males, 4 % in females), while stomach and colorectal cancer incidence declined modestly for both sexes. GI cancer mortality declined significantly across all sites (males: RR=0.92;95 %CI:0.88,0.96;p = 0.002); females: RR= 0.91;95 %CI:0.87,0.96; p = 0.002). Māori and Pacific peoples had the highest incidence and mortality rates for stomach (incidence: 13.2 and 14.2; mortality: 9.3 and 7.1 per 100,000) and liver/biliary tract cancers (incidence: 14.1 and 18.1; mortality: 12.0 and 13.9 per 100,000). A clear socioeconomic gradient was observed, with higher incidence and mortality in the most deprived areas. This study reveals clear disparities in GI cancer incidence and mortality across sex, ethnic, and socioeconomic groups in NZ. These patterns highlight the importance of tailoring cancer prevention and early detection efforts to ensure they reach the communities most affected. A stronger focus on equity is needed, not just in NZ, but also in other settings where similar gaps in cancer outcomes persist.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102973"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684973","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":"A clinical rule-based indicator to identify recurrence of colorectal cancer after curative resection using linked routinely collected national data","authors":"Orouba Almilaji ,&nbsp;Linda Sharples ,&nbsp;Ajay Aggarwal ,&nbsp;David Cromwell ,&nbsp;Kieran Horgan ,&nbsp;Michael Braun ,&nbsp;Robert Arnott ,&nbsp;Julie Nossiter ,&nbsp;Angela Kuryba ,&nbsp;Alexandra Lewin ,&nbsp;Thomas Cowling ,&nbsp;Jan Van Der Meulen ,&nbsp;Kate Walker","doi":"10.1016/j.canep.2025.102962","DOIUrl":"10.1016/j.canep.2025.102962","url":null,"abstract":"<div><h3>Background</h3><div>Cancer recurrence is under-recorded in most national cancer registries. We developed and validated a clinical rule-based indicator to identify recurrence after curative major resection in patients with non-metastatic colorectal cancer (CRC), based on national routinely collected administrative hospital records and chemotherapy and radiotherapy datasets.</div></div><div><h3>Methods</h3><div>Recurrence was defined as the cancer becoming clinically detectable again after a period of “remission” (nine months to five years after curative major resection). 34,984 CRC patients aged 18–75 years undergoing curative major resection for non-metastatic disease diagnosed between August 2014 and September 2019 in the English Cancer Registry were identified and linked to records of outpatient visits and admissions in English administrative hospital data and to chemotherapy and radiotherapy datasets. The indicator was developed with a panel of surgical and oncological experts, based on relevant diagnosis (ICD-10), procedure (OPCS-4), and administrative codes.</div></div><div><h3>Results</h3><div>Of the 34,984 patients, the indicator identified 6556 (18.7 %) as having recurrence. 6173 (94.2 %) of which could be identified using administrative hospital data of admitted patients alone. Recurrence was found in a greater proportion of rectal cancer patients, and in those with more advanced T stage and N stage, and higher cancer grade. Overall and recurrence-free five-year survival from surgery was 88.7 % and 77.4 %, respectively. Two-year overall survival after recurrence was 63.9 %. 135 (82.8 %) of the 163 patients who self-reported recurrence in a national patient experience survey, and 1412 (95.2 %) of the 1483 patients with reported recurrence/progression in Cancer Registry data had recurrence defined by the developed indicator.</div></div><div><h3>Conclusions</h3><div>The validity of the CRC recurrence indicator was supported by observed associations with tumour characteristics, self-reported recurrence, and poor overall survival in patients with recurrence. This indicator can be used in research and service evaluation, to overcome the problem of incomplete cancer recurrence recording in most national cancer registries.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102962"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571963","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":"Cancer screening knowledge and health literacy among rural women Aged 30–69","authors":"Kübra Akalın ,&nbsp;Ecem Çiçek Gümüş ,&nbsp;İlknur Dolu","doi":"10.1016/j.canep.2025.102971","DOIUrl":"10.1016/j.canep.2025.102971","url":null,"abstract":"<div><h3>Background</h3><div>High participation rates are essential for the success of cancer screening programs; however, sustaining consistent engagement is a persistent challenge, especially in rural populations. To investigate the health literacy and cancer screening knowledge levels of women aged 30–69 living in rural areas who are eligible for at least one type of cancer screening, and to identify factors associated with cancer-related knowledge.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of 365 rural women aged 30–69 years who attended a Central Public Health Center between February and August 2025, in a province located in the northwestern region of Türkiye. Data were collected via a structured questionnaire, the Knowledge Scale for Cancer Screening, and the Turkiye Health Literacy Scale-32, and analyzed using t-tests, ANOVA, and linear regression</div></div><div><h3>Results</h3><div>Overall, 81.1 % of participants reported having undergone breast cancer screening, 59.7 % cervical cancer screening, and 50.0 % colorectal cancer screening. According to the linear regression analysis, a history of cervical cancer screening (β=0.243; t(10) = 3.235; p = 0.001) and scores on the TSOY-32 subscale for disease prevention and health promotion (β=0.202; t(10) = 2.372; p = 0.018) were significant predictors of cancer screening knowledge.<em>Conclusion</em>: Our study identifies potential factors that may enhance knowledge of cancer screening, which in turn could contribute to increasing the uptake of cancer screening tests. The most significant indicators were high level of health literacy related to disease prevention and health promotion as well as a previous experience with cervical cancer screening. These factors should be considered in the development of targeted interventions to increase cancer screening participation among women in rural settings.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102971"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679811","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":"Liver and gastric cancer incidence and mortality in Non‐Western immigrant men and women: a register-based cohort study from 2000 to 2017","authors":"Angeza Abdul Khaliq ,&nbsp;Maarit H. Lamminmäki ,&nbsp;Sirpa H. Heinävaara ,&nbsp;Tytti M. Sarkeala","doi":"10.1016/j.canep.2025.102974","DOIUrl":"10.1016/j.canep.2025.102974","url":null,"abstract":"<div><h3>Introduction</h3><div>Geographical variations in health reflect differences in environments, lifestyles, and healthcare access. Notably, non-Western countries exhibit higher rates of infection-related cancers such as liver and gastric cancers, compared to Western countries. This study compares sex-specific incidence and mortality of liver and gastric cancers in non-Western immigrants with those of the native Finnish population. We also assess how region of birth, age at immigration, and duration of residence influence liver and gastric cancer incidence and mortality among non-Western population.</div></div><div><h3>Material and method</h3><div>We analysed data from 162,844 non-Western immigrant men and 161,090 women residing in Finland from 1973 to 2017. Liver and gastric cancer diagnoses and causes of death from 2000 to 2017 were linked from national registries. We assessed cancer risks using a multivariate Poisson regression model, adjusting for age group, calendar period, and region of birth.</div></div><div><h3>Results</h3><div>Non-Western immigrant men had higher liver cancer incidence (Relative risk (IRR) 1.41, 95 % Confidence Interval (CI) 1.13–1.78) and mortality (MRR 1.50, CI 1.16–1.94), and higher gastric cancer incidence (IRR 1.74, CI 1.46–2.06) and mortality (MRR 1.74, CI 1.42–2.14) than native men. Among non-Western immigrant women, only gastric cancer showed increased incidence (IRR 2.21, 95 % CI 1.88–2.60) and mortality (MRR 2.22, 95 % CI 1.83–2.70). Age at immigration did not impact risk levels.Prolonged duration of residence decreased the risk of gastric cancer in non-Western women, whereas in men the risk remained elevated.</div></div><div><h3>Discussion</h3><div>The increased cancer risk among non-Western immigrants may stem from greater exposure to infections such as hepatitis B and C and H. pylori, prevalent in their countries of origin. Cultural adaptation and lifestyle changes, particularly in alcohol and tobacco use, also play a role.</div></div><div><h3>Conclusion</h3><div>Targeted healthcare measures, including early diagnosis and lifestyle interventions, are crucial for reducing cancer risks among non-Western immigrants in Finland. Addressing language and cultural barriers is essential for effective healthcare and for reducing health disparities.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102974"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835371","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":"Prostate cancer screening: Cancer mortality and opportunistic screening","authors":"Takeshi Takahashi","doi":"10.1016/j.canep.2025.102977","DOIUrl":"10.1016/j.canep.2025.102977","url":null,"abstract":"","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102977"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776608","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":"Factors associated with long COVID among cancer survivors: A population-based analysis","authors":"Stuart J. Case ,&nbsp;Lindsay Sabik ,&nbsp;Haley Grant","doi":"10.1016/j.canep.2025.102984","DOIUrl":"10.1016/j.canep.2025.102984","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer survivors endure unique immune system suppression as a result of their cancer treatment, potentially making them susceptible to long COVID in ways that differ from the general population. The purpose of this study is to assess what factors are associated with long COVID among cancer survivors.</div></div><div><h3>Methods</h3><div>Observational, cross-sectional data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed. The main outcome of interest was the prevalence of long COVID among cancer survivors who had tested positive for COVID-19. Bivariate analyses were conducted comparing those who did and did not have long COVID, and logistic regression models were used to determine the sociodemographic variables and individual health factors associated with long COVID among cancer survivors.</div></div><div><h3>Results</h3><div>In this sample, 15.2 % of cancer survivors who had tested positive for COVID-19 indicated they had long COVID. Cancer survivors who were male, older, received flu and COVID-19 vaccinations, and did not have diabetes or asthma had significantly lower odds of having long COVID.</div></div><div><h3>Conclusion</h3><div>This study provides insight into what sociodemographic and health-related factors are associated with the presence of long COVID, including age, sex, vaccination status, and comorbid conditions. Future longitudinal studies are warranted to establish causal patterns.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102984"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883747","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":"Impact of gastrointestinal bleeding on hospital outcomes in hematologic malignancies: A nationwide cross-sectional study","authors":"Pragya Jain ,&nbsp;Iqra Qazi ,&nbsp;Jacob Thompson ,&nbsp;Nency Ganatra ,&nbsp;Shivam Patel ,&nbsp;Junaid Anwar","doi":"10.1016/j.canep.2025.102975","DOIUrl":"10.1016/j.canep.2025.102975","url":null,"abstract":"<div><div>Gastrointestinal (GI) bleeding is a frequent cause of hospitalizations and is linked to greater inpatient morbidity, especially among cancer patients. Despite being a recognized complication in patients with hematologic malignancies (HMs), its impact on hospitalization outcomes and healthcare utilization in HM patients is poorly defined. To evaluate the association between GI bleeding and key hospital outcomes, including mortality, length of stay (LOS), and hospitalization costs among adults admitted with HMs, this retrospective cross-sectional study was conducted using the Nationwide Inpatient Sample (NIS) from 2018 to 2022. Multivariable models were fitted using survey-weighted logistic regression for mortality and Poisson regression with a log link for LOS and charges, adjusting for demographic and clinical covariates to calculate adjusted odds ratios (aORs) and adjusted incidence rate ratios (aIRRs), with corresponding 95 % confidence intervals (CIs). Among an estimated 2.9 million weighted hospitalizations with HMs, approximately 13 % were complicated by GI bleeding, which were characterized by higher mortality, longer LOS, and greater healthcare costs. In adjusted models, GI bleeding was associated with higher odds of in-hospital death (aOR: 1.22, 95 % CI: 1.18–1.26) as well as increased LOS (aIRR: 1.36, 95 % CI: 1.34–1.38) and higher hospitalization costs (aIRR: 1.40, 95 % CI: 1.37–1.43). This study's findings indicate that GI bleeding in patients with HMs is an independent predictor of adverse outcomes, including increased mortality and resource utilization. These findings highlight the need for early recognition, risk stratification, and proactive management strategies to mitigate the clinical and economic burden of bleeding in this high-risk population.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"100 ","pages":"Article 102975"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783846","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}