Cancer Epidemiology最新文献

{"title":"Prevalence of advanced-stage breast cancer at diagnosis in Arab countries: A systematic review and meta-analysis","authors":"Yasir Ahmed Mohammed Elhadi ,&nbsp;Rami H. Al-Rifai ,&nbsp;Iffat Elbarazi ,&nbsp;Abubaker Suliman ,&nbsp;Sara Omer Alabass ,&nbsp;Iman Osman Abufatima ,&nbsp;Sagad Omer Obeid Mohamed ,&nbsp;Mohammed Khogali ,&nbsp;Emad Masuadi","doi":"10.1016/j.canep.2025.102930","DOIUrl":"10.1016/j.canep.2025.102930","url":null,"abstract":"<div><div>Breast cancer is the most commonly diagnosed malignancy among women in Arab countries, where a substantial proportion present with advanced-stage disease. This systematic review and meta-analysis aimed to quantify the prevalence of stage III–IV breast cancer at diagnosis across the region. We systematically searched PubMed, Scopus, Web of Science, and the WHO Virtual Health Library on March 22, 2025, for studies reporting stage at diagnosis among women with breast cancer in Arab countries. Two reviewers independently screened and extracted data, and risk of bias was assessed using the Joanna Briggs Institute checklist. Random-effects meta-analyses were performed to estimate the pooled prevalence of advanced-stage presentation overall and by country. From 678 screened records, 26 studies from 13 countries comprising 14,176 women were included. The pooled prevalence of stage III–IV breast cancer at diagnosis was 46·0 % (95 % CI 43·0–50·0; I²=93·6 %), with marked heterogeneity across settings (range 13·0 % in Bahrain to 67·0 % in Libya and Yemen). Country-level subgroup differences were statistically significant (χ²=3271·72, df=12; p &lt; 0·001), suggesting that national context may substantially influence diagnostic stage. Egger’s test showed evidence of small-study effects (intercept=1·23; p = 0·048). These findings highlight the enduring challenge of late breast cancer diagnosis in the Arab region. Urgent investment in early detection strategies through population-based screening, public awareness, and timely access to diagnostic services is critical to reducing mortality and improving outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102930"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050135","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 rates and trends of paediatric cancer in Italy, 2008–2017","authors":"Enrica Santelli ,&nbsp;Gemma Gatta ,&nbsp;Fabio Savoia ,&nbsp;Sabrina Fabiano ,&nbsp;Francesco Cuccaro ,&nbsp;Viviana Perotti ,&nbsp;Andrea Tittarelli ,&nbsp;Tiziana Scuderi ,&nbsp;Rosalba Amodio ,&nbsp;Walter Mazzucco ,&nbsp;Fabrizio Stracci ,&nbsp;Ilaria Cozzi ,&nbsp;AIRTUM Working Group","doi":"10.1016/j.canep.2025.102947","DOIUrl":"10.1016/j.canep.2025.102947","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric cancers are rare, yet, Italy has previously shown some of the highest incidence rates in Europe as a leading cause of death in children and adolescents. This study updates data from Italy for 2008–2017, analyses trends from 1998, and compares findings with other European regions.</div></div><div><h3>Methods</h3><div>A population-based approach was used, leveraging data from the Italian Association of Cancer Registries (AIRTUM). Thirty-one cancer registries covering 77 % of the Italian paediatric population contributed data on tumour type, age, sex, residence, and diagnosis date. Cancers were classified using the International Classification of Childhood Cancer, Third Edition (ICCC-3). Age-specific (IR) and age-standardized incidence rates (ASR) were computed, while trends were analysed with Joinpoint regression to estimate annual (APC) and average annual percentage change (AAPC).</div></div><div><h3>Results</h3><div>From 2008–2017, 17,322 malignant paediatric cancer cases were reported in Italy. The age-standardized incidence rate (ASR) was 166.8 per million for ages 0–14 and 294.3 per million for adolescents 15–19. Over the study period, incidence rates were generally stable, but a significant increase was observed for bone tumours in children and thyroid and melanoma in adolescents. Central Italy showed higher incidence rates compared to other Italian regions. Italy still shows one of the highest incidence rates in Europe.</div></div><div><h3>Conclusion</h3><div>While the study confirms overall stable incidence trends in Italy, it also highlights an increase in specific cancers such as melanoma and thyroid tumours in adolescents. Central Italy exhibited higher incidence rates, potentially due to environmental and/or diagnostic factors. Continuous monitoring and further research are needed to clarify regional variations and evaluate the impact of early diagnosis and environmental exposures.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102947"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362391","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":"Malignancies of the small intestine: incidence and trends in a nationwide registry","authors":"Pascale J.M. Schafrat ,&nbsp;Felice N. van Erning ,&nbsp;Koos Zwinderman ,&nbsp;Evelien Dekker ,&nbsp;Arantza Farina Sarasqueta ,&nbsp;Judith de Vos-Geelen ,&nbsp;Stefan A.W. Bouwense ,&nbsp;Ruben S.A. Goedegebuure ,&nbsp;Louis Vermeulen ,&nbsp;Ignace H.J.T. de Hingh ,&nbsp;Dirkje W. Sommeijer","doi":"10.1016/j.canep.2025.102943","DOIUrl":"10.1016/j.canep.2025.102943","url":null,"abstract":"<div><h3>Background</h3><div>Malignancies of the small intestine are rare and understudied. Improved knowledge about trends in incidence and distribution of specific subtypes might guide clinicians and researchers to further improve diagnostic and treatment strategies and ultimately improve prognosis.</div></div><div><h3>Methods</h3><div>This nationwide retrospective cohort study from the Netherlands Cancer Registry included all patients diagnosed with a malignancy of the small intestine in the Netherlands between 2000 and 2022. Malignancies were divided into seven subgroups: adenocarcinomas, neuroendocrine neoplasms (NENs), lymphomas, gastrointestinal stromal tumors (GISTs), other sarcomas, metastases, and “other”. Age-standardized incidence rates, overall- and relative survival were reported.</div></div><div><h3>Results</h3><div>A total of 11.194 patients with a malignancy of the small intestine were included. Age-standardized incidence rates (per 100.000 person-years) more than doubled between 2000 and 2020 (1.88–3.94, <em>p &lt; 0.001</em>), with the largest increase in NENs (0.53–1.57, <em>p &lt; 0.001</em>), followed by adenocarcinomas (0.78–1.22, <em>p</em> = 0.004). The most prevalent malignancy in the small intestine shifted from adenocarcinomas to NENs from 2017 onwards. NENs were mostly located in the ileum and adenocarcinomas were most frequently diagnosed in the duodenum. Survival varied significantly between subgroups. Survival of patients with lymphomas and GISTs improved over time, in contrast with patients with adenocarcinomas and NENs.</div></div><div><h3>Conclusion</h3><div>The incidence of malignancies of the small intestine in the Netherlands has more than doubled over the past two decades, mostly due to an increase in NENs and adenocarcinomas. Survival outcomes for these malignancies did not improve, highlighting the urgent need to further study these rare cancer subtypes in the small intestine.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102943"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314397","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":"Use of population-based cancer registries for cancer surveillance and control in Latin America","authors":"Esperanza Peña-Torres ,&nbsp;Esther de Vries ,&nbsp;Marianna de Camargo Cancela ,&nbsp;Marion Piñeros-Petersen","doi":"10.1016/j.canep.2025.102914","DOIUrl":"10.1016/j.canep.2025.102914","url":null,"abstract":"<div><h3>Background</h3><div>Population-based cancer registries (PBCRs) are essential for guiding cancer control strategies. In Latin America (LATAM), progress has been made in expanding the number of PBCRs, but their effective use in cancer control remains limited. This study assessed the current utilization of PBCR data, identified barriers and facilitators, and explored opportunities to strengthen their role in cancer control across the region.</div></div><div><h3>Methods</h3><div>A cross-sectional electronic survey was conducted among 81 PBCRs in LATAM between November 2023 and February 2024. Forty-three PBCRs (53.1 %) responded. The survey included questions on registry operations, data availability and dissemination, research participation, and involvement in cancer control. Open-ended responses were analyzed thematically.</div></div><div><h3>Results</h3><div>Most registries were subnational (93 %) and hosted by local health authorities. Staffing was limited (≤5 staff in 65 %), and population coverage varied. Although 90.7 % accessed mortality data and personal identifiers, only 70 % collected staging data for screen-detectable cancers, and staging was reported in under 40 % of cases. While 84.1 % shared data for research and 68.1 % participated in research, only 39.5 % were involved in prevention studies. Data publication was often delayed, with only 44.2 % having incidence data beyond 2018. Fewer than half had published data in the past five years, and engagement with decision-makers or use in screening and palliative care programs was rare. Common barriers included limited data sources, staff shortages, fragmented medical records, and low stakeholder awareness of PBCR functions.</div></div><div><h3>Conclusions</h3><div>Despite expanded numbers of PBCR in LATAM, their usage and integration into cancer control remains limited. Strengthening institutional support, improving data quality and recollection, as well as enhancing collaboration with health authorities and researchers are critical for maximizing the impact of PBCRs in cancer control across the region.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102914"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027126","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":"Long-term environmental background radiation is associated with urinary tract cancer incidence: A population-based study from Finland","authors":"Peng Li ,&nbsp;Mikko Myrskylä ,&nbsp;Pekka Martikainen","doi":"10.1016/j.canep.2025.102912","DOIUrl":"10.1016/j.canep.2025.102912","url":null,"abstract":"<div><h3>Background</h3><div>The long-term carcinogenic effects of natural radioactive elements in the environmental background on urinary tract cancer (UTC) have not been fully investigated in the general population.</div></div><div><h3>Methods</h3><div>The entire Finnish population was linked to long-term municipality-level data on concentrations of uranium and radon in water and radon in indoor air by residential location annually between 1987 and 2016, and UTC incidence was tracked until 2021 based on multiple registries. The first principal component (PC1) of the three radiation exposures was used as a proxy for radiation exposure, and was assessed using the Cox proportional hazards model for its association with UTC risk. Age-standardized incidence rates (ASR) and population attributable fractions (PAF) of radiation exposure were estimated. Spatial association between regional radiation exposure and UTC risk was assessed.</div></div><div><h3>Results</h3><div>Among a total of 2,816,495 residents with 30-year exposure data, 6718 primary UTC cases were diagnosed during 2017–2021. UTC risk increased significantly with each standard deviation (SD) increase in PC1 (hazard ratio [HR] = 1.05, 95 %CI 1.02–1.07). Dose-response relationship was observed when exposure was modelled via natural cubic splines. Increasing UTC incidence was observed across exposure quintiles (lowest quintile: ASR = 47, 95 % CI 45–50; highest quintile: ASR = 53, 95 %CI 50–55). About 5.1 % (PAF, 95 %CI 0.5 %–9.7 %) of UTC incidence was attributable to radiation exposure. Stronger association (HR=1.06, 95 %CI 1.03–1.09, per 1-SD increase) and attributable fraction (PAF = 9.0 %, 95 %CI 3.2 %–14.8 %) were observed among men than among women. Regional UTC risk was significantly associated with regional radiation exposure adjusted for the spatial lag effect in the total population (<em>β</em> = 0.08, <em>p</em> &lt; 0.01), men (<em>β</em> = 0.07, <em>p</em> &lt; 0<em>.</em>01) and women (<em>β</em> = 0.1, <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Association between long-term environmental radiation exposure and UTC risk was observed in the Finnish population. Dose-response patterns were observed, especially among men. UTC risks attributable to radiation exposure and geographical patterns warrant further investigations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102912"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027125","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":"Epidemiology of early-onset breast cancer in Golestan, North of Iran, 2004–2019: Disparities across residential place and ethnic region","authors":"Atefeh Gouglani ,&nbsp;Somayeh Livani ,&nbsp;Nastaran Haghshenas ,&nbsp;Moosarreza Shabihi ,&nbsp;SeyedAhmad Hosseini ,&nbsp;Hamideh Sadeghzadeh ,&nbsp;Fatemeh Ghasemi-Kebria ,&nbsp;Saeed Golfiroozi ,&nbsp;Gholamreza Roshandel","doi":"10.1016/j.canep.2025.102922","DOIUrl":"10.1016/j.canep.2025.102922","url":null,"abstract":"<div><h3>Introduction</h3><div>Early-onset breast cancer (EOBC), diagnosed in women under 45 years, is a significant health issue worldwide. Understanding the epidemiology of EOBC is crucial for developing effective prevention and detection programs. We aimed to examine EOBC incidence and temporal trends in Golestan, North of Iran, from 2004 to 2019, across ethnic regions (Turkmens vs. non-Turkmens) and place of residence (urban vs. rural).</div></div><div><h3>Methods</h3><div>Data on the incidence of EOBC were obtained from the Golestan Population-based Cancer Registry (GPCR). Age-standardized incidence rate (ASR) was calculated and reported per 100,000 person-years. Temporal trends in the incidence of EOBC were investigated by calculating estimated annual percent changes (EAPC).</div></div><div><h3>Results</h3><div>Overall, 1809 new cases of EOBC were registered by GPCR during 2004–2019, with an ASR of 14.02 per 100,000, and higher rates in urban (ASR = 16.63) compared to rural areas (10.94). The non-Turkmens region (16.50) had significantly higher incidence rates of EOBC than the Turkmens region (10.53). Our findings suggested a significant increasing trend in the incidence of EOBC in Golestan (EAPC = 3.00; 95 %CI: 0.07–6.00). Notably, rural areas experienced a steeper rise (EAPC = 4.82) compared to urban areas (EAPC = 1.88), which was statistically significant in both Turkmens and non-Turkmens regions.</div></div><div><h3>Conclusion</h3><div>EOBC rates in Golestan were above the global average, with higher rates in urban and non-Turkmens populations. Our findings also suggested significant increasing trends in the incidence of EOBC, with greater changes in rural residents. These findings highlight the need for targeted interventions and early detection strategies in the region.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102922"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020144","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":"Socioeconomic, health-related and geographical risk factors for locally advanced keratinocyte carcinoma: A nationwide population-based study in Denmark","authors":"Anne Sofie Krogh Holdam ,&nbsp;Hans B. Rahr ,&nbsp;Erik Frostberg ,&nbsp;Karina Rønlund ,&nbsp;Vibeke Koudahl","doi":"10.1016/j.canep.2025.102936","DOIUrl":"10.1016/j.canep.2025.102936","url":null,"abstract":"<div><h3>Background</h3><div>Most keratinocyte carcinomas (KC) are localized and slow-growing. However, for some patients, KC can become locally advanced lesions and cause substantial tissue damage that require extensive surgery to manage. We wanted to explore risk factors for locally advanced disease with the overall aim to offer more timely diagnosis and treatment.</div></div><div><h3>Methods</h3><div>This nationwide, register-based cohort study examined the association of demographic factors, educational level, disposable income, cohabitating status, comorbidity, and region of residence with tumor (T) category for patients with a first-time diagnosis of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) from 2007 to 2021, using multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>We identified 166,467 BCC and 36,609 SCC patients. Male sex, old age, lower educational level and disposable income, living alone, and comorbidity were linked to higher odds of developing a ≥T2 tumor. Residence outside the Capital Region increased the risk of locally advanced BCC, while the risk of locally advanced SCC was higher in the Zealand, Central, and Northern regions.</div></div><div><h3>Conclusion</h3><div>There are significant associations between socioeconomic status, comorbidity, and region of residence and the risk of developing ≥T2 tumors in both BCC and SCC. Efforts to enhance early detection and treatment should focus on vulnerable individuals.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102936"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120903","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 national study of lung cancer patients below 50 years: Variations in characteristics and outcomes by age","authors":"Katrine Kristensen ,&nbsp;Anja Gouliaev ,&nbsp;Torben Riis Rasmussen ,&nbsp;Niels Lyhne Christensen","doi":"10.1016/j.canep.2025.102949","DOIUrl":"10.1016/j.canep.2025.102949","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer predominantly affects the elderly. However, a small yet significant subgroup of patients below fifty years presents unique challenges in diagnosis and treatment. This study aims to describe the characteristics and outcomes of these young patients, emphasizing the need for improved diagnostic strategies and better prognostic outcomes.</div></div><div><h3>Method</h3><div>This national cohort study includes all patients diagnosed 2012–2023 recorded in the Danish Lung Cancer Registry. Patients below fifty years at diagnosis were categorized as young.</div></div><div><h3>Results</h3><div>Out of 57,325 patients a total of 1312 (2.3 %) were below fifty years at diagnosis. Young patients were more likely to be female (p = 0.006), diagnosed with adenocarcinoma (p &lt; 0.001) and ten times more frequent anaplastic lymphoma kinase (ALK) mutated (p &lt; 0.001). Young patients had fewer packyears (p &lt; 0.001), better performance status (p &lt; 0.001), lower Charlson Comorbidity index (p &lt; 0.001), but were more frequently diagnosed in incurable disease stage, (68.0 % vs. 60.9 % p &lt; 0.001). Adjusted OR of being diagnosed in a curable stage was 0.75 (95 %CI 0.66–0.85) for young patients, while adjusted OR for undergoing treatment with curative intent was 1.88 (1.58–2.23). Kaplan-Meier analysis indicated higher survival rates for young patients across all stages, but only marginally in stages IIIB-IV.</div></div><div><h3>Conclusion</h3><div>Young patients diagnosed with lung cancer are less likely to be diagnosed in a curable stage. The pathology and smoking habits differ significantly from patients above fifty years. While pending screening is important for the older population of smokers, it remains essential to consistently address the need for early diagnosis in the young population to prevent exacerbating existing disparities.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102949"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424764","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":"Trends and characteristics of early-onset colorectal cancer in the state of Florida, 2002–2021","authors":"Young-Rock Hong ,&nbsp;Lee Revere ,&nbsp;Kathryn M. Ross ,&nbsp;Peihua Qiu ,&nbsp;Mattia Prosperi ,&nbsp;Thomas J. George ,&nbsp;Beth A. Virnig","doi":"10.1016/j.canep.2025.102932","DOIUrl":"10.1016/j.canep.2025.102932","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is a growing public health concern. Despite increasing national incidence among younger adults, state-specific analyses for Florida remain limited. Florida's large and demographically unique population necessitates investigation into EOCRC trends and patient characteristics.</div></div><div><h3>Methods</h3><div>This population-based study utilized colorectal cancer incidence data for Florida residents aged 25–49 diagnosed between 2002 and 2021, from the Florida Cancer Data System and National Program of Cancer Registries. Joinpoint regression evaluated age-adjusted incidence trends across demographic and clinical factors. Age-period-cohort analysis explored generational effects, while multivariate logistic regression identified factors associated with advanced-stage diagnosis (regional or distant).</div></div><div><h3>Results</h3><div>Among 16,318 EOCRC cases identified during 2002–2021, overall incidence increased significantly (AAPC=1.48 %, P &lt; .001), driven primarily by colon cancers (AAPC=1.53 %, P &lt; .001), while rectal cancers showed non-significant increase (AAPC=0.53 %, P = 0.185). A concerning shift toward advanced stages at diagnosis emerged (P &lt; 0.001), with localized disease decreasing from 32.8 % to 26.2 %, while regional (34.6–41.0 %) and distant metastases (21.9–26.8 %) increased substantially. This stage migration was confirmed by significant increases in regional (AAPC=2.10 %, P &lt; .001) and distant disease (AAPC=2.71 %, P &lt; .001) incidence. Strong birth cohort effects, indicating increasing risk with rate ratios exceeding 2.0 for recent cohorts, were evident predominantly in non-Hispanic White individuals. Conversely, Hispanic and non-Hispanic Black patients showed no significant cohort effects but consistently presented with higher odds of advanced-stage disease compared to non-Hispanic Whites (AOR=1.13 and AOR=1.11, respectively). Uninsured (AOR=1.23) and Medicaid-covered patients (AOR=1.52) faced significantly higher odds of advanced presentation compared to privately insured individuals.</div></div><div><h3>Conclusion</h3><div>Florida experienced sustained EOCRC incidence increases from 2002 to 2021, accompanied by advanced-stage diagnosis increases and notable disparities. Birth cohort effects primarily drove increased risk in non-Hispanic White populations, while barriers to timely care, including insurance status, likely contributed to delayed diagnoses in minority communities, underscoring urgent needs for targeted interventions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102932"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050139","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":"Hospital-based gallbladder cancer registry from a high-volume referral cancer centre in India: Insights into epidemiology and roadmap for enhancing cancer care","authors":"Shraddha Patkar ,&nbsp;Tanvi M. Shah ,&nbsp;Gurudutt Varty ,&nbsp;Abdeali Saif A. Kaderi ,&nbsp;Vishnu Menon ,&nbsp;D. Baskaran ,&nbsp;Vikas Ostwal ,&nbsp;Anant Ramaswamy ,&nbsp;Mukta Ramadwar ,&nbsp;Rajesh Dikshit ,&nbsp;Mahesh Goel","doi":"10.1016/j.canep.2025.102958","DOIUrl":"10.1016/j.canep.2025.102958","url":null,"abstract":"<div><h3>Purpose</h3><div>Gallbladder cancer (GBC) is a significant public health concern in India, with a high disease burden and complex challenges in delivering effective care. This registry aims to shed light on the epidemiology, and barriers to early detection and treatment, to inform future research and policy initiatives.</div></div><div><h3>Methods</h3><div>From January 2019 to December 2022, all consecutive patients with a presumed diagnosis of GBC, presenting to our institution were prospectively enrolled after informed consent. Each patient completed a standardized questionnaire, and clinical, radiologic and treatment data were recorded in a case record form. Management followed standard institutional protocols. Survival analysis was done using Kaplan–Meier curves.</div></div><div><h3>Results</h3><div>A total of 1950 patients were included, 1441 (73.9 %) of these hailed from the Gangetic belt region (northern and eastern states); an additional 209 (10.7 %) were migrants from these regions, representing 84.6 % of the cohort. Over 55 % belonged to lower socioeconomic classes. At presentation, 60 % had metastatic disease; only 318 (16.3 %) were eligible for curative-intent therapy, and 132 (6.8 %) did not complete planned treatment. Treatment dropout correlated significantly with male gender (p = 0.012) and unemployment (p = 0.014). After a median follow-up of 38.2 months, median overall survival was 58.2 months for early-stage patients versus 4.2 months for those with metastatic disease.</div></div><div><h3>Conclusion</h3><div>This registry is an attempt to generate evidence-based awareness about the substantial disease burden of gallbladder cancers in India and highlights the un-met need for capacity building of our health system, in order to provide, timely, accessible and cost-effective management of this disease.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102958"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524878","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}