Cancer Epidemiology最新文献

{"title":"Effectiveness of cervical cancer screening with cytology and human papillomavirus co-testing: A 12-year retrospective study in Oyama district, Japan","authors":"Hiroyuki Fujiwara ,&nbsp;Yuji Takei ,&nbsp;Yasushi Saga ,&nbsp;Seung Chik Jwa ,&nbsp;Akiyo Taneichi ,&nbsp;Takahiro Koyanagi ,&nbsp;Yoshifumi Takahashi ,&nbsp;Suzuyo Takahashi ,&nbsp;Kohei Tamura ,&nbsp;Miki Shinohara ,&nbsp;Mitsuaki Suzuki","doi":"10.1016/j.canep.2025.102762","DOIUrl":"10.1016/j.canep.2025.102762","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the effectiveness of cervical cancer screening with cytology and human papillomavirus (HPV) co-testing in Japan.</div></div><div><h3>Methods</h3><div>The study was conducted in Oyama district, Japan, where cytology and HPV co-testing has been implemented since 2012. Data for 2012–2020 were retrospectively analyzed; results were compared with those of cytology-alone screening conducted from 2009 to 2011. Screening outcomes, including referral rate and cervical intraepithelial neoplasia (CIN)2, CIN3/adenocarcinoma in situ, and invasive carcinoma detection rates, were assessed.</div></div><div><h3>Results</h3><div>Co-testing and cytology-alone screening were performed in 62,155 and 34,040 individuals, respectively; the corresponding referral rates were 4.1 % and 1.9 %. Co-testing resulted in significantly higher referral rates but decreasing trends over time (4.6 %, 4.0 %, and 3.8 % in 2012–2014, 2015–2017, and 2018–2020, respectively). The CIN2 detection rate, which was 0.2 % during the era of cytology alone, significantly increased to 0.49 % during 2012–2014 after the introduction of co-testing and remained higher at 0.31 % during 2015–2017 and 0.37 % during 2018–2020. In contrast, the CIN3 + detection rate increased from 0.13 % during the era of cytology alone to 0.19 % during 2012–2014 but significantly decreased to 0.14 % and 0.06 % during 2015–2017 and 2018–2020, respectively.</div></div><div><h3>Conclusion</h3><div>Our long-term data and comparison with historical controls indicate that co-testing resulted in a higher CIN2 detection rate, potentially reducing CIN3 + community incidence. Although referral rate initially increased with co-testing, a decreasing trend was noted over time.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102762"},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143165396","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 in cancer mortality in the elderly and oldest old in South America","authors":"Esther de Vries ,&nbsp;Andres Gallego ,&nbsp;Fabian Gil","doi":"10.1016/j.canep.2025.102761","DOIUrl":"10.1016/j.canep.2025.102761","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about trends in cancer among the older segments of the population, even less for South America.</div></div><div><h3>Objective</h3><div>To describe time trends in mortality of the most frequent causes of cancer death among the population aged 70 and over.</div></div><div><h3>Methods</h3><div>Using the World Health Organization´s Cancer Mortality Database, we studied trends in mortality from lung, colorectal, stomach, liver, prostate, breast, and cervical cancer from 1985 onwards. Joinpoint analyses allow discerning changes in average annual percent change (i.e., slope AAPC) of these trends over time.</div></div><div><h3>Results</h3><div>The region has a 2–3-fold variation in absolute age-specific cancer mortality rates, with the lowest rates in Argentina and Paraguay and the highest in Chile, Uruguay, and Venezuela. In most countries except for Brazil and Paraguay (both sexes), Peru (females and males 80 +), and Venezuela (males), overall cancer mortality rates were declining in the studied age range, with some fluctuations during the period. The most common causes by sex vary throughout the continent and by age group, but overall, increasing trends were observed for colorectal and breast cancer. In all countries, time trends show reductions in mortality from stomach cancer (AAPC up to –4.77 %) and in some countries (Argentina, Chile, Colombia, and Ecuador AAPC between –0.04 % and –4.37 %) for cervical cancer. In the other countries, cervical cancer mortality remained stable. Lung cancer declined in all countries in males (AAPC between –0.39 % and –2.24 %) except Brazil, Paraguay and the eldest males in Venezuela but among females, increases were observed in most countries (AAPC between +0.47 % and +4.05 %).</div></div><div><h3>Conclusions</h3><div>Cancer-specific mortality rates vary considerably between countries in South America and the high cancer mortality rates in the oldest segments of the population. Effective primary prevention strategies, vaccination implementation, early detection, effective treatment programs, and better access to healthcare overall can positively impact the trends.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102761"},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191514","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 nationwide Dietary Intake after Diagnosis and Colorectal Cancer Outcomes (PLCRC-PROTECT) cohort: Study design, clinical characteristics and baseline health behaviors","authors":"Jeroen W.G. Derksen ,&nbsp;Karel C. Smit ,&nbsp;Irene W.F. Hoeven ,&nbsp;Femke P.C. Sijtsma ,&nbsp;Miriam Koopman ,&nbsp;Anne M. May","doi":"10.1016/j.canep.2024.102724","DOIUrl":"10.1016/j.canep.2024.102724","url":null,"abstract":"<div><h3>Purpose</h3><div>The nationwide Dietary Intake After Diagnosis and Colorectal Cancer Outcomes (PROTECT) study is a prospective cohort study investigating how lifestyle-related factors including dietary intake and physical activity are associated with health-related quality of life (HRQoL), recurrence, and survival after a colorectal cancer (CRC) diagnosis.</div></div><div><h3>Methods</h3><div>Patients participating in the Prospective Dutch Colorectal Cancer (PLCRC) cohort with newly diagnosed stage I to IV colorectal cancer were recruited for PROTECT shortly after diagnosis, between 2015 and 2022. While patient-reported quality of life, physical activity, and sedentary behavior, as well as body composition data are available from PLCRC, patient-reported measurements in PROTECT included anthropometrics, dietary intake, dietary supplement use, and taste and smell alterations. Clinical data was obtained from the Netherlands Cancer Registry.</div></div><div><h3>Results</h3><div>Patients returned baseline questionnaires after a median of 43 days (IQR: 28–59) after diagnosis. At diagnosis, the 974 participants’ median age was 65 years (IQR: 58, 72), 59 % were male, 59 % had overweight/obesity, and 28 % stage I, 25 % stage II, 40 % stage III, and 6 % stage IV disease. Dietary supplements more frequently used were multivitamins (35 %), vitamin D (30 %), vitamin C (15 %), and magnesium (14 %). Around diagnosis, changes in taste ability were reported by 6 % of patients, while 2 % experienced changes in smell, and 16 % reported experiencing a dry mouthfeel. In total, 24 % adhered to ESPEN dietary guideline of ≥ 25 kCal/kg/day plus ≥ 1 gram protein/kg/day, while 45 % adhered to international physical activity guidelines.</div></div><div><h3>Conclusion</h3><div>PROTECT is a unique nationwide cohort of CRC patients with a wealth of lifestyle-related data obtained through patient-reported measurements, of which baseline assessments were presented. PROTECT participants will be followed until deceased or lost to follow-up to collect all clinical outcome data. PROTECT will inform clinical and public health guidelines on physical activity and dietary patterns for improving CRC outcomes and survivorship.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102724"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815073","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":"Global, regional and national burden of lung cancer attributable to occupational carcinogens, 1990–2019: A study of trends, inequalities and predictions based on GBD 2019","authors":"Zongjie Wang ,&nbsp;Junmin Zhu ,&nbsp;Yafei Wu ,&nbsp;Chongtao Wei ,&nbsp;Ya Fang","doi":"10.1016/j.canep.2024.102737","DOIUrl":"10.1016/j.canep.2024.102737","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer, a leading cause of cancer-related mortality, is significantly influenced by occupational carcinogens. This study aimed to assess and predict global, regional and national trends of lung cancer burden attributable to occupational carcinogens.</div></div><div><h3>Methods</h3><div>Data on the lung cancer burden attributable to nine occupational carcinogens were obtained from the Global Burden of Disease Study 2019. Regions were categorized by the Socio-Demographic Index (SDI). Descriptive statistics, Joinpoint regression, and Age-Period-Cohort (APC) models were employed to analyze trends in mortality and Disability-Adjusted Life Years (DALYs). Using the Slope Index of Inequality and Concentration Index, health inequalities were quantified. The ARIMA-LSTM model was developed to predict the burden from 2020 to 2030.</div></div><div><h3>Results</h3><div>From 1990–2019, lung cancer deaths and DALYs due to occupational carcinogens increased. Global age-standardized mortality (ASMR) and DALY (ASDR) rates declined, while middle and lower SDI regions increased. Joinpoint regression and APC analysis revealed that the local drift, period, and cohort effects exhibited increasingly unfavorable trends in lower SDI regions, while they were decreasing trends in higher SDI regions. Conversely, age effects increased similarly across all SDI regions. Health inequalities worsened over time. The ARIMA-LSTM model demonstrated global ASMR and ASDR would decrease, while low-middle and low SDI regions were expected to experience substantial increases from 2020 to 2030.</div></div><div><h3>Conclusion</h3><div>Health inequality of lung cancer burden attributable to occupational carcinogens remained a critical concern, underscoring the urgent need for targeted occupational health policies for low and low-middle SDI regions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102737"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883738","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":"Geospatial patterns by cancer stage across Australia for three common cancers","authors":"Susanna M. Cramb ,&nbsp;Jessica Cameron ,&nbsp;Paramita Dasgupta ,&nbsp;Peter D. Baade","doi":"10.1016/j.canep.2024.102738","DOIUrl":"10.1016/j.canep.2024.102738","url":null,"abstract":"<div><h3>Background</h3><div>Monitoring cancer stage is vital to interpret cancer incidence and survival patterns, yet there are currently no cancer stage estimates by small areas across Australia, despite demonstrated large disparities in cancer incidence and survival. While cancer stage data is not routinely collected in Australia, a pilot project collected stage information nationwide in 2011.</div></div><div><h3>Methods</h3><div>Data on all primary invasive melanoma, female breast and prostate cancers (stages 1–4) diagnosed during 2011 in Australia were categorised into early and intermediate/advanced stage at diagnosis. Bayesian spatial models were used to estimate standardised incidence rates (SIRs) and proportions of cancer stage across 2148 statistical areas level 2. The correlation between early and more advanced cancer rates was explored using exceedance probabilities.</div></div><div><h3>Results</h3><div>Both melanoma and prostate cancer had mainly early stage diagnoses. There was large variation in rates across the nation, and also substantial correlation between SIRs of early and more advanced stage for melanoma and prostate cancer. In contrast, breast cancer had a higher proportion of advanced cancers diagnosed, less pronounced variation in rates and limited correlation between early and more advanced stage SIRs. The proportion of cases diagnosed as early stage varied across Australia by type of cancer.</div></div><div><h3>Conclusion</h3><div>This study uncovered important spatial patterns in the diagnosis of cancer by stage across the country, which varied by cancer type and location. There is an urgent need to have contemporary information about stage at diagnosis routinely included in population-based cancer registries across the country.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102738"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900933","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":"Barriers to lung cancer screening","authors":"Sameer Rehman ,&nbsp;Mike Lim ,&nbsp;Ranjit Sidhu ,&nbsp;Phil Ramis ,&nbsp;Eric Rohren","doi":"10.1016/j.canep.2024.102722","DOIUrl":"10.1016/j.canep.2024.102722","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite efforts to improve national lung cancer screening rates, only 4 % of eligible high-risk patients pursue this opportunity annually.</div></div><div><h3>Objective</h3><div>The goal of this study was to better understand the system, provider, and patient-level barriers to lung cancer screening</div></div><div><h3>Methods</h3><div>300 high-risk patients in the southern Nevada region who met the criteria for lung cancer screening were given a questionnaire during their outpatient visit for low dose chest CT from August 2023 through February 2024.</div></div><div><h3>Results</h3><div>The most common reported barriers were absence of symptoms (38 %), not wishing to know that they had cancer (30 %), and not having awareness of the eligibility for CT screening (24 %). CONCLUSION: A multifactorial approach is indicated to provide education for high-risk patients to clarify the importance of early diagnosis, demonstrate accessibility and low cost for lung cancer screening, and absolve any misconceptions about lung cancer screening.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102722"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796634","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":"Cholangiocarcinoma (CCA) mortality in Vietnam war era veterans","authors":"T. Bullman ,&nbsp;WJ Culpepper ,&nbsp;YS Cypel ,&nbsp;F. Akhtar ,&nbsp;SW Morley ,&nbsp;A. Schneiderman ,&nbsp;JC Weitlauf ,&nbsp;E. Garges ,&nbsp;VJ Davey","doi":"10.1016/j.canep.2024.102721","DOIUrl":"10.1016/j.canep.2024.102721","url":null,"abstract":"<div><h3>Background</h3><div>There is concern about the risk of cholangiocarcinoma mortality (CCA) among U.S. veterans who deployed to the Vietnam War theater. A variety of risk factors potentially related to Vietnam deployment may be associated with an increased risk of mortality from CCA. This study assessed the risk of CCA mortality among all Vietnam War era veterans, the first study to do so.</div></div><div><h3>Methods</h3><div>The Vietnam Era Veterans Mortality Study is a retrospective mortality study of all 2.5 million veterans who served in Vietnam and Southeast Asia (theater) and the 7.3 million veterans who served elsewhere during the Vietnam War (non-theater). Mortality was followed from 1979 to 2019. Hazard ratios (HRs) calculated from Cox proportional hazards models, adjusted for sex and age, compared CCA mortality risk between theater and non-theater veterans overall and by branch of service. Branch specific crude rates of CCA were also compared between theater and non-theater veterans.</div></div><div><h3>Results</h3><div>There were 2410 and 6502 CCA deaths among all theater and non-theater veterans respectively. Overall, there was no increased CCA mortality risk among theater versus non-theater veterans after adjusting for sex and age (hazard ratio, (HR: 1.00, 95 % CI: 0.95–1.04). When stratified by branch, the crude HRs for CCA were no different between branch-theater status groups except in non-theater Marines who had lower risk. A monotonic increase in crude rates for CCA mortality was observed in both theater and non-theater over forty years of follow-up.</div></div><div><h3>Conclusion</h3><div>There was no increased risk of CCA mortality in theater versus non-theater U.S. Vietnam War veterans, an important and new finding. This study lacked data on environmental exposures and behavioral factors that would further inform analyses of CCA risk. Identification of Vietnam era veterans’ specific risk factors for CCA would require alternate methods and data which do not exist.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102721"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807368","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":"Prevalence, incidence and trends of keratinocyte carcinoma in Denmark 2007–2021: A population-based register study","authors":"Anne Sofie Krogh Holdam ,&nbsp;Vibeke Koudahl ,&nbsp;Erik Frostberg ,&nbsp;Karina Rønlund ,&nbsp;Hans Bjarke Rahr","doi":"10.1016/j.canep.2024.102732","DOIUrl":"10.1016/j.canep.2024.102732","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of keratinocyte carcinoma (KC), i.e., basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is increasing worldwide, placing a significant burden on healthcare resources. This is especially the case for tumors requiring surgical intervention. It remains unclear whether this increase is a result of the population aging or a genuine increase in risk of skin cancer. Understanding age-adjusted incidence trends of KC is crucial for improving future management of the disease. We studied these trends in a large nationwide cohort, focusing on large, invasive, and surgically challenging tumors.</div></div><div><h3>Methods</h3><div>Information on all incident cases of BCC and SCC in Denmark was extracted from population-based databases in the calendar years 2007–2021. Age-adjusted incidence rates were calculated, standardized to the 2013 European Standard Population. Average annual percentage changes were estimated using Joinpoint regression models. Incidence trends for larger, more invasive tumors (tumor (T) category of ≥T2), and of those in the head and neck area, were elucidated with descriptive statistics.</div></div><div><h3>Results</h3><div>We found 183,338 patients with a first-time incidence of BCC and 42,233 patients with a first-time incidence of SCC in the period 2007–2021. The incidence rate, adjusted for age, increased from 252 to 338 per 100,000 for BCC and from 49 to 104 per 100,000 for SCC. For SCC, the increase was particularly pronounced in the last two years of the study period. Tumors ≥T2, and those in the head and neck area, increased markedly.</div></div><div><h3>Conclusion</h3><div>KC is the most common type of cancer worldwide, and the age-adjusted incidence rates of BCC and SCC increased significantly from 2007 to 2021, as did tumors with a higher T category and those located in anatomically sensitive areas. Since the primary treatment for many of these tumors is surgical, this raises concern about the strain on future healthcare resources.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102732"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873551","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":"Socioeconomic position, psychiatric medical treatment and risk of breast cancer recurrence and mortality: A Danish population-based cohort study","authors":"Fanny Borne Asmussen ,&nbsp;Cathrine F. Hjorth ,&nbsp;Oleguer Plana-Ripoll ,&nbsp;Aurélie Mailhac ,&nbsp;Deirdre Cronin-Fenton","doi":"10.1016/j.canep.2024.102733","DOIUrl":"10.1016/j.canep.2024.102733","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer patients with low socioeconomic position (SEP) have a higher risk of recurrence and mortality. We examined the extent to which prior psychiatric medication impacted this association.</div></div><div><h3>Methods</h3><div>We conducted a cohort study of premenopausal women diagnosed with breast cancer in Denmark from 2002 to 2011 (n = 5847), linking data from Denmark’s nationwide population-based health registries on breast cancer diagnosis, treatment, psychiatric medication prescriptions and SEP indicators (marital status, cohabitation, income, education and employment). We followed the women up to 10 years from breast cancer diagnosis until recurrence, death, emigration, other malignancy, or September 2017. We used Cox regression to estimate hazard ratios (HRs) and corresponding 95 % confidence intervals (95 %CI) associating each SEP indicator with recurrence and all-cause mortality. To evaluate interaction by psychiatric medication use on the association between SEP and prognosis, we 1) stratified the models according to prior use of psychiatric medication and 2) added an interaction term to the regression model.</div></div><div><h3>Results</h3><div>Women with short compared with intermediate education level and prior psychiatric medication had increased risk of recurrence (HR = 1.41, 95 %CI = 1.05–1.91); this was higher than seen in those without prior psychiatric medication (HR = 1.06, 95 %CI = 0.87–1.29). Patterns were similar for all-cause mortality. Likewise, unemployed women with a history of psychiatric medication use had a higher risk of all-cause mortality (HR = 1.74, 95 %CI = 1.31–2.31) compared to unemployed women without prior psychiatric medication use (HR = 1.32, 95 %CI = 1.03–1.70). In contrast, prior psychiatric medication use did not have a negative impact on breast cancer prognosis in women who were single, living alone or had low income.</div></div><div><h3>Conclusion</h3><div>Breast cancer patients with prior psychiatric disease who have short education or are unemployed may be particularly vulnerable to recurrence and mortality. These women may benefit from more frequent follow up examinations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102733"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878682","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":"Racial differences in carcinoma-in-situ and non-muscle-invasive bladder cancer mortality: Accounting for insurance status, black segregation, and neighborhood poverty","authors":"Asal M. Johnson ,&nbsp;Allen Johnson ,&nbsp;Robert B. Hines ,&nbsp;Xiang Zhu","doi":"10.1016/j.canep.2024.102728","DOIUrl":"10.1016/j.canep.2024.102728","url":null,"abstract":"<div><h3>Background</h3><div>Few Bladder Cancer (BC) studies have examined the role of area-level variables. The purpose of this study was to examine racial differences in BC survival to elucidate if insurance status and contextual covariates could explain Black disadvantage in survival.</div></div><div><h3>Method</h3><div>Using the Fine-Gray subdistribution hazard models (sHR), five-year survival time was calculated from the date of diagnosis until the last day of follow-up or the date of death due to BC in Florida 2000–2014 (n = 32,321). Non-BC deaths were considered a competing risk. In all models, individual-level clinical and demographic variables were adjusted for and we included the exposures of interest for Carcinoma-in-Situ (CIS) and Non-Muscle-Invasive BC(NMIBC), separately.</div></div><div><h3>Results</h3><div>In CIS-Patients, living in neighborhoods with higher levels of segregation was associated with 50 % to 2-fold increase in sHR (medium level segregation sHR= 1.50, 95 % CI: 1.06–2.13; high level segregation sHR= 2.07, 95 % CI: 1.25–3.43). Uninsured CIS patients had more than 2-fold increased sHR compared to those with private insurance (sHR=2.34, 95 % CI: 1.05–5.24). In NMIBC patients, living in areas with level of poverty resulted in 10 % the hazard of death increased when compared to low poverty (high poverty sHR=1.11, 95 % CI: 1.01–1.21). Uninsured and Medicaid covered NMIBC patients had an increased sHR (uninsured sHR=2.05, 95 % CI: 1.62–2.59; Medicaid sHR=1.36, 95 % CI: 1.11–1.67). For both CIS and NMIBC patients, the Black/White survival gap decreased when insurance and contextual variables were included.</div></div><div><h3>Conclusion</h3><div>This study identified BC survival rates were different for Black and White patients in Florida and found that those observed gaps were, to some extent, linked to broader social factors. We recommend that future cancer studies examining racial disparities incorporate area-level variables to offer a more nuanced understanding of these complex disparities.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"94 ","pages":"Article 102728"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824958","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}