Cancer Epidemiology最新文献

{"title":"Association between sociodemographic and clinical factors and utilization of hematopoietic cell transplant in acute myeloid leukemia from 2004 to 2020","authors":"Utsav Joshi ,&nbsp;Aditya Ravindra ,&nbsp;Bradley Loeffler ,&nbsp;Uttam Bhetuwal ,&nbsp;Shishir Acharya ,&nbsp;Chengu Niu ,&nbsp;Avantika Pyakuryal ,&nbsp;Vijaya Raj Bhatt ,&nbsp;Prajwal Dhakal","doi":"10.1016/j.canep.2025.102952","DOIUrl":"10.1016/j.canep.2025.102952","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigates the influence of sociodemographic and clinical factors on the utilization of hematopoietic cell transplant (HCT) in patients with acute myeloid leukemia (AML) between 2004 and 2020.</div></div><div><h3>Methods</h3><div>Patients identified from the National Cancer Database were grouped into two cohorts (2004–2010 and 2011–2019) to assess HCT trends. An additional analysis was conducted for 2020 to characterize HCT use after the onset of the COVID-19 pandemic. Logistic regression and multivariable analysis were used to estimate the influence of patient characteristics on the odds of receiving HCT.</div></div><div><h3>Results</h3><div>Among 67,895 AML patients, 6968 (10.3 %) underwent HCT, with usage rising from 7.2 % in 2004–13.4 % in 2019. There was a notable increase in HCT utilization among patients &gt; 70 years (0.4 % in 2004–2010–2.5 % in 2011–2019), Black patients (4.6–7.7 %), those with public insurance (3.2–6.2 %), and individuals with higher Charlson Comorbidity Index (CCI 1: 5.3–8.2 %; CCI 2–3: 1.9–4.8 %). Younger patients exhibited a higher likelihood of receiving HCT, with usage declining significantly with age and increasing CCI. Key factors such as race, education, income, insurance status, and AML subtype were significantly associated with HCT utilization (p &lt; 0.01). Remarkably, HCT utilization for AML remained stable at 13.1 % in 2020 amid COVID-19 pandemic, comparable to 2019.</div></div><div><h3>Conclusion</h3><div>The rate of HCT utilization has continued to increase over time, with notable positive trends across various demographic groups. Despite this, substantial barriers related to sociodemographic and clinical factors hinder equitable treatment access, highlighting urgent need to address these inequities to enhance patient outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102952"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432717","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":"Occupational heat exposure and stomach cancer risk in a pooled analysis of two Spanish case-control studies in the stomach cancer pooling project – StoP consortium","authors":"Alice Hinchliffe ,&nbsp;Miquel Vallbona-Vistós ,&nbsp;Juan Alguacil ,&nbsp;Manolis Kogevinas ,&nbsp;Sanni Uuksulainen ,&nbsp;Nuria Aragonés ,&nbsp;Adonina Tardón ,&nbsp;Jesus Vioque ,&nbsp;Mary H. Ward ,&nbsp;Charles S. Rabkin ,&nbsp;M. Constanza Camargo ,&nbsp;Claudio Pelucchi ,&nbsp;Carlo La Vecchia ,&nbsp;Paolo Boffetta ,&nbsp;Michelle C. Turner","doi":"10.1016/j.canep.2025.102938","DOIUrl":"10.1016/j.canep.2025.102938","url":null,"abstract":"<div><h3>Background</h3><div>Occupational heat stress occurs frequently and is increasing with climate change. Studies of occupational heat exposure and stomach cancer risk are limited. We used data from the international Stomach cancer Pooling (StoP) Project to investigate the relationship between occupational heat exposure and stomach cancer risk in a pooled analysis of two Spanish case-control studies, including 566 stomach cancer cases and 2984 controls.</div></div><div><h3>Methods</h3><div>The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to participant occupations. We evaluated three exposure indices: ever vs. never exposed, cumulative exposure and duration (years). We calculated odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) using unconditional logistic regression models including terms for potential confounders.</div></div><div><h3>Results</h3><div>Overall, 60.6 % of cases and 42.7 % of controls were ever occupationally exposed to heat. Occupational heat exposure was associated with a moderately elevated risk of stomach cancer (OR 1.31; 95 % CI 1.05, 1.63) when comparing ever vs. never exposed individuals in both studies combined. Elevated ORs were also observed across categories of cumulative exposure and duration (p-trend = 0.01 and 0.03, respectively). Findings were robust to additional covariate adjustment and in analysis of never smokers. There was no clear evidence for interaction according to exposure status to other suspected occupational stomach carcinogens.</div></div><div><h3>Conclusion</h3><div>Findings from this study provide some evidence for a positive association between occupational heat exposure and stomach cancer risk. Further research is needed to advance occupational heat assessment tools for epidemiological research as well as studies in more geographically diverse populations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102938"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246065","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":"Combining Mendelian randomization and network toxicology to decipher the causal role and molecular mechanisms of environmental pollutants in breast cancer: A focus on Methyl-4-hydroxybenzoate","authors":"Yunchang Yang,&nbsp;Yaofeng Wang,&nbsp;Yunqin Sun","doi":"10.1016/j.canep.2025.102953","DOIUrl":"10.1016/j.canep.2025.102953","url":null,"abstract":"<div><h3>Background</h3><div>Methylparaben (MEP), a ubiquitous preservative, is an endocrine disruptor with established estrogenic activity. However, its potential non-estrogenic mechanisms and causal role in breast cancer (BC) remain inadequately explored.</div></div><div><h3>Methods</h3><div>We employed an integrative multi-omics approach. A two-sample Mendelian randomization (MR) analysis was conducted using genetic instruments for urinary MEP sulfate (n = 8285) and BC risk data from the FinnGen consortium (n = 182,927). To hypothesize underlying molecular mechanisms, we integrated network toxicology with transcriptomic profiling (TCGA), single-cell/spatial RNA-sequencing, and molecular docking. Shared genes were identified via Venn analysis, followed by protein-protein interaction (PPI) network construction, hub gene identification, and functional enrichment analysis.</div></div><div><h3>Results</h3><div>MR analysis provided evidence consistent with a causal relationship, suggesting that genetically predicted MEP levels are associated with an increased risk of breast cancer (IVW OR = 1.08, 95 % CI: 1.009–1.160, P = 0.027). Network toxicology identified 22 overlapping hub genes connecting MEP targets to BC pathogenesis. Enrichment analyses implicated key oncogenic pathways, including PI3K-Akt and MAPK signaling, as well as metabolic reprogramming. Single-cell and spatial transcriptomics localized predominant expression of hub genes like MYC and ERBB2 within malignant epithelial cells. Molecular docking further suggested plausible, high-affinity binding (binding energy &lt; 0 kcal/mol) of MEP to core targets such as EGFR and JUN.</div></div><div><h3>Conclusion</h3><div>This study provides genetic evidence supporting a potential causal role of MEP in breast cancer. We propose a novel, estrogen receptor-independent mechanistic hypothesis wherein MEP may promote tumorigenesis by dysregulating growth factor signaling, activating key transcription factors, and inducing metabolic reprogramming. These findings highlight the need for a re-evaluation of MEP's public health impact and offer a framework for future experimental validation.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102953"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440011","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":"Spatiotemporal patterns in malignant brain and central nervous system cancer incidence and mortality in the United States","authors":"Grace Christensen ,&nbsp;Evan L. Thacker,&nbsp;Chantel Sloan-Aagard","doi":"10.1016/j.canep.2025.102950","DOIUrl":"10.1016/j.canep.2025.102950","url":null,"abstract":"<div><h3>Introduction</h3><div>Brain and nervous system cancers are the 5th most common cancer category in the United States and have a very low survival rate. Spatial analysis techniques can be employed to understand the distribution of rates and generate hypotheses about etiologies. The purpose of this study is to identify geographic patterns, time trends, and sex differences in mortality-incidence rate ratios, incidence rates, and mortality rates of brain and nervous system cancers.</div></div><div><h3>Methods</h3><div>Cancer data were sourced from the CDC Wonder Cancer database, including age-adjusted mortality-incidence rate ratios, age-adjusted incidence and mortality rates for all age groups and demographics in the United States. MIRR data were available from 1999 to 2018 which were split into four, five-year aggregated time windows to have adequate case numbers for time trend analyses. We further conducted joinpoint regression analysis for 1999–2022 (incidence) and 1999–2023 (mortality) by state and sex to identify changes in trends over time.</div></div><div><h3>Results</h3><div>Incidence-mortality rate ratios varied across the United States, with the highest ratios from 1999 to 2003, calculated to be around 0.67 for the different demographics studied. Since 2004, the mortality rates have remained consistent with some variation between states, with little improvement in the incidence-mortality rate ratio. From 2014 to 2018, females had significantly lower incidence and mortality rates compared to men. The average mortality rate for females was 3.7 per 100,000 compared to the mortality rate for males which was 5.5 per 100,000. Average incidence showed the same pattern with a rate of 5.6 per 100,000 in females compared to 7.7 per 100,000 in males. The Northeast region of the United States showed the highest incidence and lowest mortality. There were 12 states that saw a directional change in incidence, and 14 a directional change in mortality during the study window. Females were more likely to have a directional change in mortality, and males a directional change in incidence trends.</div></div><div><h3>Conclusion</h3><div>Further research should investigate reasons for the sex and state differences in brain cancer incidence and mortality rates and how regional factors contribute to survival.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102950"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460718","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":"Survival disparities in non-small cell lung cancer: Disaggregating Asians from NHPI and identifying variability among common Asian subgroups – The largest single-center study in Hawaiʻi","authors":"Chalothorn Wannaphut ,&nbsp;Manasawee Tanariyakul ,&nbsp;Gene T. Yoshikawa ,&nbsp;Brenda Y. Hernandez ,&nbsp;Nicolas A. Villanueva ,&nbsp;Jared D. Acoba","doi":"10.1016/j.canep.2025.102904","DOIUrl":"10.1016/j.canep.2025.102904","url":null,"abstract":"<div><h3>Background</h3><div>The American Cancer Society and the National Cancer Institute emphasize the need to disaggregate data for U.S. Asian, Native Hawaiian, and Other Pacific Islander (NHPI) populations to better understand racial disparities in cancer outcomes. Asian populations are diverse, with distinct genetic, cultural, and socioeconomic backgrounds that differ from those of NHPI, influencing cancer prognosis. This study analyzes non-small cell lung cancer outcomes among Asian and NHPI populations.</div></div><div><h3>Methods</h3><div>This retrospective cohort study identified NSCLC patients treated at Queen's Medical Center in Honolulu, Hawaiʻi, from 2000 to 2022. Patients were categorized into six racial/ethnic groups: White, Chinese, Japanese, Filipino, Other Asians, and NHPI. Survival differences were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The cohort comprised 4160 patients, including 977 White, 419 Chinese, 968 Japanese, 724 Filipino, 217 Other Asians, and 855 NHPI patients. NHPI had the highest proportion of individuals under 60 years old (27.5 %), the highest percentage of Medicaid/uninsured (37 %), and the lowest proportion receiving surgery (23.4 %) compared to other races (p &lt; 0.001). Median overall survival (OS) was 20.9 (18.3–23.5) months for White patients, 22.3 (17.8–26.9) months for Chinese patients, 17.7(15.3–20.2) months for Japanese patients, 19.7(16.1–23.3) months for Filipino patients, 25.7(14.7–36.6) months for Other Asians patients and 14.7(12.0–17.3) months for NHPI patients (p &lt; 0.001). Asian NSCLC patients had a lower risk of death compared to White patients (adjusted HR 0.89, 95 % CI 0.85–0.97, p = 0.010). In contrast, NHPI patients had a higher mortality rate compared to White patients (adjusted HR 1.15, 95 % CI 1.03–1.28, p = 0.011) in the multivariable analysis without treatment. However, both associations were no longer statistically significant after additional adjustment for treatment. Subgroup analyses of Asian patients compared to Whites patients revealed that the Chinese patients had the lowest risk of death, with this difference remaining significant even after adjusting for treatment (adjusted HR 0.82, 95 % CI 0.72–0.93, p = 0.003).</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate the heterogeneity in NSCLC outcomes between U.S. Asians and NHPI patients as well as among individual Asian ethnic populations. Further research is needed to validate these differences and their clinical implications.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102904"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259852","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":"Temporal trends and spatial distribution of prostate cancer incidence and mortality in a northeastern Brazilian state","authors":"Ana Clara Cruz Santos de Santana ,&nbsp;Ellen Sabrina Ramos Santos ,&nbsp;Jefferson Felipe Calazans Batista ,&nbsp;Alex Rodrigues Moura ,&nbsp;Simone Soraia Silva Sardeiro ,&nbsp;Brenda Evelin Barreto da Silva ,&nbsp;Carlos Anselmo Lima","doi":"10.1016/j.canep.2025.102931","DOIUrl":"10.1016/j.canep.2025.102931","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution of prostate cancer incidence (1996–2017) and mortality (1996–2022) in Sergipe, Brazil, to support targeted cancer control strategies.</div></div><div><h3>Methods</h3><div>We analyzed prostate cancer data from the Aracaju Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were calculated using the World Standard Population. Joinpoint regression estimated Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess trends. The Mortality-to-Incidence Ratio (MIR) and its complement (1–MIR) were used as proxies for survival. Spatial distribution was examined using Empirical Bayesian Kriging and local empirical Bayes smoothing in QGIS and TerraView.</div></div><div><h3>Results</h3><div>Between 1996 and 2017, 10,133 incident prostate cancer cases were recorded. Incidence increased until 2007 (APC=11.9 %; p &lt; 0.001), then declined (APC=–2.0 %; p = 0.027, with peaks in men aged ≥55. Mortality increased from 1996 to 2007 (APC=12.2 %; p &lt; 0.001) and subsequently stabilised between 2007 and 2022 (APC=–0.8 %; p = 0.228), resulting in an overall AAPC of 2.4 % (p = 0.002) for the entire study period. By age group, mortality rose among men ≥ 75 years (AAPC=3.2 %; p = 0.001) but declined in those aged 15–54 (AAPC=–2.4 %; p = 0.004). The MIR remained flat over time, but estimated survival dropped substantially among men aged ≥ 75 years, from 63 % to 38 %. Spatial analysis revealed higher incidence in central/coastal municipalities, while elevated mortality clustered in southern/coastal areas.</div></div><div><h3>Conclusions</h3><div>Despite improvements in incidence rates, prostate cancer remains a significant burden in Sergipe, with persistent regional disparities in outcomes. Spatial and temporal analyses highlight the need for targeted public health interventions to improve early detection and access to care, especially in areas of high social vulnerability and among older men.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102931"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050138","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":"Do breast cancer survivors benefit from mammography screening? A population-based study","authors":"Bayan Sardini ,&nbsp;Mette Bach Larsen ,&nbsp;Sisse Helle Njor","doi":"10.1016/j.canep.2025.102910","DOIUrl":"10.1016/j.canep.2025.102910","url":null,"abstract":"<div><h3>Background</h3><div>Mammography screening reduces breast cancer mortality by approximately 25 % in the general population and might therefore also benefit breast cancer survivors. However, its impact on mortality rates in this group remains unstudied. We aimed to estimate the effect of mammography screening on breast cancer mortality in this population.</div></div><div><h3>Methods</h3><div>We used data from invitations to the regional mammography screening program in Funen, Denmark (1993–2007), before the nationwide program's rollout in 2008. Breast cancer mortality among invited survivors (study group) was compared to survivors of similar age in counties without screening programs (control group).</div></div><div><h3>Results</h3><div>The study and control groups comprised 2109 invited breast cancer survivors and 15,417 non-invited breast cancer survivors. Of those, 406 (19 %) and 3385 (22 %) died from breast cancer within the follow-up period. The relative risk for invited versus not invited at 22 years of follow-up was 0.88 (95 %CI: 0.81–0.97). The relative risk for participants compared to a similar group in the control group of non-invited breast cancer survivors was 0.62 (95 %CI: 0.51–0.76).</div></div><div><h3>Conclusions</h3><div>Mammography screening might reduce breast cancer mortality less among breast cancer survivors than among the general population. However, this is most likely due to a lower participation rate among breast cancer survivors.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102910"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989991","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":"Chemotherapy use in ovarian cancer patients diagnosed 2012–2017 in Australia, Canada, Norway and the UK: An International Cancer Benchmarking Partnership (ICBP) population-based study","authors":"Matthew E. Barclay ,&nbsp;Sean McPhail ,&nbsp;Shane A. Johnson ,&nbsp;Ruth Swann ,&nbsp;John Butler ,&nbsp;Christian J. Finley ,&nbsp;Andriana Barisic ,&nbsp;Damien Bennett ,&nbsp;Oliver Bucher ,&nbsp;Nicola Creighton ,&nbsp;Cheryl A. Denny ,&nbsp;Ron A. Dewar ,&nbsp;David W. Donnelly ,&nbsp;Laura Downie ,&nbsp;Norah Finn ,&nbsp;Steven Habbous ,&nbsp;Dyfed W. Huws ,&nbsp;Leon May ,&nbsp;Bjørn Møller ,&nbsp;David S. Morrison ,&nbsp;Georgios Lyratzopoulos","doi":"10.1016/j.canep.2025.102903","DOIUrl":"10.1016/j.canep.2025.102903","url":null,"abstract":"<div><h3>Objective</h3><div>To describe use of chemotherapy in patients with ovarian cancer in national or sub-national populations of Australia, Canada, Norway and the UK.</div></div><div><h3>Methods</h3><div>Linked population-based data sources were used to describe use and time to chemotherapy initiation in ovarian cancer patients diagnosed in study periods during 2012–2017. Random-effects meta-analysis characterised the size of interjurisdictional variation.</div></div><div><h3>Results</h3><div>Among 39,879 patients, chemotherapy use ranged from 49 % (Wales) to 75 % (Manitoba). Across jurisdictions, chemotherapy use was higher in advanced disease (79 %, 95 %CI: 74 %–83 %), and lower for stages 1–2 or localised/regional disease (54 %, 95 %CI: 48 %–60 %). Within jurisdictions, chemotherapy use was similar in patients aged 15–64 and 65–74 and then decreased sharply with increasing age. There was large interjurisdictional variation in chemotherapy use in patients aged 85–99 years with advanced disease, being, for example, 23 % (95 %CI: 20 %–25 %) in England and 61 % (95 %CI: 51 %–70 %) in Ontario. However, jurisdictions with the highest chemotherapy use in recorded advanced stage, including Ontario, tended to have higher percentage of missing stage information. Overall, time from diagnosis to chemotherapy initiation was shorter in New South Wales and Victoria and longer in Scotland and Wales. In patients with advanced disease, interjurisdictional variation in time-to-treatment was limited.</div></div><div><h3>Conclusions</h3><div>Even within the same age groups and stage strata, use of chemotherapy varied substantially between jurisdictions during the mid-2010s. Future work should examine use of surgery in combination with chemotherapy. The reasons for the international variation in chemotherapy use and its contribution to international variation in survival should be established.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102903"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056585","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":"Approaches to handle missing follow-up time: A comparative analysis of contralateral breast cancer incidence","authors":"Sarah R. Haile ,&nbsp;Miriam Wanner ,&nbsp;Dimitri Korol ,&nbsp;Sabine Rohrmann","doi":"10.1016/j.canep.2025.102942","DOIUrl":"10.1016/j.canep.2025.102942","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to compare various common approaches for handling missing vital status or follow-up time. As a case study for application of these methods, we estimated incidence of metachronous contralateral breast cancer (CBC).</div></div><div><h3>Methods</h3><div>For 1980–2016, incidence of metachronous CBC with follow-up through 2024 was estimated using Poisson regression with overdispersion, by age at incidence, year of incidence, histology and follow-up period. Missing follow-up time was ignored in the naive approach, simulated once using the average hazard derived from published Swiss cancer registry data, or multiply imputed using 3 different imputation models.</div></div><div><h3>Results</h3><div>24,612 women aged 20–84 had unilateral breast cancer between 1980 and 2016 in the Swiss cantons of Zurich and Zug. Of those, 5 % (n = 1264) were lost to follow-up. Over 291,463 person-years, 1145 contralateral breast malignancies were diagnosed, corresponding to 393 per 100,000 person-years (95 % CI 353–438). Incidence rates have been decreasing over time to 238 (171−333) for the incidence period 2010–2016. The same overall pattern was observed regardless of how we handled missing follow-up times. However, using a single imputation generally produced lower incidence rates compared to the naive approach, with multiple imputation giving higher estimates. The most complex multiple imputation model gave incidence estimates that were very similar to those from the naive approach.</div></div><div><h3>Conclusion</h3><div>Different methods to handle missing follow-up times yielded similar results: that CBC incidence has declined in recent decades. Multiple imputation is likely an appropriate method to handle missing follow-up data, enabling researchers to include all eligible individuals in the analysis.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102942"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310125","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":"Bridging data gaps: Methodological advances in extracting and analyzing genetic information from unstructured clinical records in hereditary cancer","authors":"Danny Styvens Cardona ,&nbsp;Juan Pablo Valencia-Arango ,&nbsp;Juan Pablo Gallo ,&nbsp;Catalina Andrea Bustamante ,&nbsp;Richard Orlando Salazar ,&nbsp;Carlos Andrés Carmona ,&nbsp;Melisa Naranjo Vanegas ,&nbsp;Carolina Jaramillo Jaramillo ,&nbsp;Juliana Espinosa Moncada ,&nbsp;Harvy Mauricio Velasco ,&nbsp;Natalia Gallego Lopera","doi":"10.1016/j.canep.2025.102940","DOIUrl":"10.1016/j.canep.2025.102940","url":null,"abstract":"<div><h3>Introduction</h3><div>The global impact of cancer, driven by both acquired and hereditary mutations, underscores the necessity for extensive research efforts. Despite the increasing volume of genetic data, significant gaps remain in data science research, particularly in Latinos and admixed populations. This study utilizes advanced data science techniques to integrate genetic and clinical data, aiming to improve the understanding of hereditary cancer in Colombia and demonstrating the transformative potential of data-driven approaches in cancer research.</div></div><div><h3>Methods</h3><div>This observational study analyzed healthcare databases from four regions and 11 cities in Colombia. Genetic data were extracted from PDF reports within SURA Colombia's Electronic Health Records (a Latin American health insurance provider) for individuals referred for hereditary cancer testing between October 2019 and November 2021. Variants in 30 genes, aligned with NCCN guidelines, were examined using Next-Generation Sequencing (NGS). Data extraction was automated using Python and R, followed by integration and analysis of genetic, clinical, and sociodemographic data using advanced data science tools hosted on Azure infrastructure. These tools enabled predictive modeling and cross-referencing to explore correlations between genetic variants and clinical outcomes.</div></div><div><h3>Results</h3><div>The study included 1377 patients, with a predominance of women (92.81 %) and 63 % from the northwestern region of Colombia. The largest age group (40.37 %) was between 31 and 44 years, and 95.35 % had a personal cancer history, primarily breast cancer (75.86 %). Hereditary cancer testing revealed 145 positive results and 587 uncertain outcomes. Data science-driven analysis identified higher positivity rates in patients aged 31–44 and over 50, particularly in the northeast and central regions. Among positive results, 42.6 % included variants of uncertain significance, with 95.9 % of these patients having a personal cancer history.</div></div><div><h3>Conclusion</h3><div>This study highlights the significant role of data science in analyzing hereditary cancer data. Advanced computational techniques can aid in genetic variant reclassification, uncover patterns in underrepresented populations, and inform personalized interventions for hereditary cancer management in Latin America.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"99 ","pages":"Article 102940"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267981","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}