Gender-specific trends in cigarette smoking and lung cancer incidence: A two-stage age-stratified Bayesian joinpoint model

BackgroundPrevious studies have explored population-level smoking trends and the incidence of lung cancer, but none has jointly modeled them. This study modeled the relationship between smoking rate and incidence of lung cancer, by gender, in the U.S. adult population and estimated the lag time between changes in smoking trend and changes in incidence trends.MethodsThe annual total numbers of smokers, by gender, were obtained from the database of the National Health Interview Survey (NHIS) program of the Centers for Disease Control and Prevention (CDC) for the years 1976 through 2018. The population-level incidence data for lung and bronchus cancers, by gender and five-year age group, were obtained for the same years from the Surveillance, Epidemiology, and End Results (SEER) program database of the National Cancer Institute. A Bayesian joinpoint statistical model, assuming Poisson errors, was developed to explore the relationship between smoking and lung cancer incidence in the time trend.ResultsThe model estimates and predicts the rate of change of incidence in the time trend, adjusting for expected smoking rate in the population, age, and gender. It shows that smoking trend is a strong predictor of incidence trend and predicts that rates will be roughly equal for males and females in the year 2023, then the incidence rate for females will exceed that of males. In addition, the model estimates the lag time between smoking and incidence to be 8.079 years.ConclusionsBecause there is a three-year delay in reporting smoking related data and a four-year delay for incidence data, this model provides valuable predictions of smoking rate and associated lung cancer incidence before the data are available. By recognizing differing trends by gender, the model will inform gender specific aspects of public health policy related to tobacco use and its impact on lung cancer incidence.     

Initial medical attention on patients with early-stage non-small cell lung cancer

Background

Detection of early stage non-small cell lung cancer (NSCLC) is commonly believed to be incidental. Understanding the reasons that caused initial detection of these patients is important for early diagnosis. However, these reasons are not well studied.

Methods

We retrospectively reviewed medical records of patients diagnosed with stage I or II NSCLC between 2000 and 2009 at UT MD Anderson Cancer Center. Information on suggestive LC-symptoms or other reasons that caused detection were extracted from patients'' medical records. We applied univariate and multivariate analyses to evaluate the association of suggestive LC-symptoms with tumor size and patient survival.

Results

Of the 1396 early stage LC patients, 733 (52.5%) presented with suggestive LC-symptoms as chief complaint. 347 (24.9%) and 287 (20.6%) were diagnosed because of regular check-ups and evaluations for other diseases, respectively. The proportion of suggestive LC-symptom-caused detection had a linear relationship with the tumor size (correlation 0.96; with p<.0001). After age, gender, race, smoking status, therapy, and stage adjustment, the symptom-caused detection showed no significant difference in overall and LC-specific survival when compared with the other (non-symptom-caused) detection.

Conclusion

Symptoms suggestive of LC are the number one reason that led to detection in early NSCLC. They were also associated with tumor size at diagnosis, suggesting early stage LC patients are developing symptoms. Presence of symptoms in early stages did not compromise survival. A symptom-based alerting system or guidelines may be worth of further study to benefit NSCLC high risk individuals.     

Free Testosterone Drives Cancer Aggressiveness: Evidence from US Population Studies

Cancer incidence and mortality are higher in males than in females, suggesting that some gender-related factors are behind such a difference. To analyze this phenomenon the most recent Surveillance, Epidemiology and End Results (SEER) database served to access cancer survival data for the US population. Patients with gender-specific cancer and with limited information were excluded and this fact limited the sample size to 1,194,490 patients. NHANES III provided the distribution of physiologic variables in US population (n = 29,314). Cox model and Kaplan-Meier method were used to test the impact of gender on survival across age, and to calculate the gender-specific hazard ratio of dying from cancer five years following diagnosis. The distribution of the hazard ratio across age was then compared with the distribution of 65 physiological variables assessed in NHANES III. Spearman and Kolmogorov-Smirnov test assessed the homology. Cancer survival was lower in males than in females in the age range 17 to 61 years. The risk of death from cancer in males was about 30% higher than that of females of the same age. This effect was present only in sarcomas and epithelial solid tumors with distant disease and the effect was more prominent in African-Americans than Caucasians. When compared to the variables assessed in the NHANES III study, the hazard ratio almost exactly matched the distribution of free testosterone in males; none of the other analyzed variables exhibited a similar homology. Our findings suggest that male sex hormones give rise to cancer aggressiveness in patients younger than 61 years.     

非小细胞肺癌并发下呼吸道感染患者病原微生物分布及其与病情进展的相关性

目的探究非小细胞肺癌(NSCLC)合并下呼吸道感染患者病原菌分布及与病情进展相关性。方法选取2015年6月至2018年8月延安大学附属医院肿瘤内科收治的NSCLC患者126例。采集NSCLC患者痰液进行细菌培养及鉴定。观察不同种属病原菌在NSCLC并发下呼吸道感染患者中的分布情况。结果 NSCLC并发下呼吸道感染患者中革兰阴性菌检出率为61.18%,革兰阳性菌检出率为24.71%,真菌检出率为14.12%。革兰阴性菌中大肠埃希菌检出率为40.38%,肺炎克雷伯菌检出率为32.69%,铜绿假单胞菌检出率为13.46%,鲍曼不动杆菌检出率为7.69%,其他细菌检出率为5.77%。革兰阳性菌中溶血葡萄球菌检出率为42.86%,金黄色葡萄球菌检出率为38.10%,肺炎链球菌检出率为9.52%,粪肠球菌检出率为9.52%。真菌中白假丝酵母检出率为58.33%,热带假丝酵母检出率为25.00%,光滑假丝酵母检出率为16.67%。年龄≥60岁、吸烟、TNM分期III^IV期、营养不良、住院时间≥14 d的NSCLC合并下呼吸道感染患者病原菌检出率均高于年龄<60岁、不吸烟、I^II期、营养良好、住院时间<14 d的患者(均P<0.05)。结论革兰阴性菌更易感染NSCLC合并下呼吸道感染患者。患者TNM分期、年龄等病情进展因素与病原菌感染率具有相关性。     

Combination of Circulating Tumor Cells with Serum Carcinoembryonic Antigen Enhances Clinical Prediction of Non-Small Cell Lung Cancer

Circulating tumor cells (CTCs) have emerged as a potential biomarker in the diagnosis, prognosis, treatment, and surveillance of lung cancer. However, CTC detection is not only costly, but its sensitivity is also low, thus limiting its usage and the collection of robust data regarding the significance of CTCs in lung cancer. We aimed to seek clinical variables that enhance the prediction of CTCs in patients with non-small cell lung cancer (NSCLC). Clinical samples and pathological data were collected from 169 NSCLC patients. CTCs were detected by CellSearch and tumor markers were detected using the Luminex xMAP assay. Univariate analyses revealed that histology, tumor stage, tumor size, invasiveness, tumor grade and carcinoembryonic antigen (CEA) were associated with the presence of CTCs. However, the level of CTCs was not associated with the degree of nodal involvement (N) or tumor prognostic markers Ki-67, CA125, CA199, Cyfra21-1, and SCCA. Using logistic regression analysis, we found that the combination of CTCs with tumor marker CEA has a better disease prediction. Advanced stage NSCLC patients with elevated CEA had higher numbers of CTCs. These data suggest a useful prediction model by combining CTCs with serum CEA in NSCLC patients.     

A growth rate distribution model for the age dependence of human cancer incidence: a proposed role for promotion in cancer of the lung and breast

A biological model is proposed to account for the steep rise of human cancer incidence with age. The model casts in mathematical terms the assumptions that each clone destined to give rise to a detectable tumor displays a characteristic net growth rate and that the assembly of such clones displays a distribution of growth rates. Incidence is introduced as the rate of appearance of clones whose size permits detection. While the cancer formation process may involve a series of stages, we assume that the overall kinetics of tumor detection reflect one stage of development whose duration spans the major portion of the latent period between initial cell alteration and final detection. We further assume that the net growth rates of tumor-forming clones increase in the presence of promotors and resume their original growth rates when the promoting substance is removed. Assuming that cigarette smoke has promoting activity, we show how the model could account for the abrupt impact of cessation of smoking on subsequent lung cancer incidence. If we assume that clones destined to be detected as breast cancers experience promotional activity during the period of a woman's fertility, the model predicts that as a consequence of the slowing down of the clones a discontinuous decline in incidence would follow menopause. Since women experience menopause over a range of ages, we show how aggregating the contributions from these menopausal ages results in an overall age dependence of incidence with no discontinuities and with the observed change in the incidence rate for breast cancer near the age range of menopause.     

Malignancy associated changes in epithelial cells of buccal mucosa: a potential cancer detection test

OBJECTIVE: To analyze the presence of malignancy associated changes (MACs) in normal buccal mucosa cells of lung and breast cancer patients and their relationship to tumor subtype, stage and size. STUDY DESIGN: Buccal mucosa smears of 107 lung cancer and 100 breast cancer patients and corresponding healthy subjects were collected, stained by the DNA-specific Feulgen-thionin method and scanned using an automated high-resolution cytometer. Nuclear texture features of a minimum of 500 nuclei per slide were calculated, and statistical classifiers using Gaussian models of class-probability distribution were designed, trained and tested in 3 parts: (1) ability to separate cancer patient samples from controls, (2) cross-validation of classifiers for different cancer types, and (3) correlation of MAC expression with tumor subtype, stage and size. RESULTS: Lung and breast cancer induce MACs in normal buccal mucosa cells. The classifiers based on the selected nuclear features correctly recognized >80% of lung and breast cancer cases. The results indicate that MAC detection is not dependent on the tumor subtype, stage or size. CONCLUSION: The presence of MACs in buccal mucosa cells offers the potential for developing a new noninvasive cancer screening test.     

Relationship between mitochondrial DNA mutations and clinical characteristics in human lung cancer

Mitochondrial DNA (mtDNA) is known for its high frequencies of polymorphisms and mutations, some of which are related to various diseases, including cancers. However, roles of mutations and polymorphisms in some diseases are among heated debate, especially for cancer. To investigate the possible role of mtDNA mutations in lung cancer, we sequenced complete mtDNA of lung cancer tissues, corresponding normal (i.e., non-cancerous) lung tissues, and peripheral blood samples from 55 lung cancer patients and examined the relationship between mtDNA mutations or polymorphisms and clinical parameters. We identified 56 mutations in 33 (60%) of the 55 patients, including 48 point mutations, four single-nucleotide insertions, and four single-nucleotide deletions. Nineteen of these mutations resulted in amino acid substitution. These missense mtDNA mutations were distributed in 9 of 13 mitochondrial DNA coding genes. Three hundred eighty eight polymorphisms were identified among the 55 patients. Seventy-three polymorphisms resulted in amino acid substitution. There was no association of incidence of specific mtDNA mutation or polymorphism with patients' gender, age at diagnosis, smoking history, tumor type or tumor stage (P>0.05). This study revealed a variety of mtDNA mutations and mtDNA polymorphisms in human lung cancer, some of which might be involved in human lung carcinogenesis.     

PD-1、PD-L1的表达与肺癌临床病理特征及预后的相关性分析

目的:分析程序性死亡因子-1(PD-1)、程序性死亡1-配体(PD-L1)的表达与肺癌临床病理特征及预后的相关性。方法:回顾性分析我院2015年3月～2016年6月收治的73例肺癌患者的临床资料,取距离切除肿瘤边缘3cm内的非癌组织作为癌旁组织。比较两组PD-1、PD-L1的表达,分析其和肺癌患者临床病理特征和预后的关系,采用COX比例回归分析肺癌患者预后的影响因素。结果:肺癌组织PD-1、PD-L1阳性表达率均显著高于癌旁组织(P0.05)。不同性别、年龄、病理类型、吸烟情况、EGFR表达、肿瘤大小肺癌患者PD-1、PD-L1的阳性表达率比较差异无统计学意义(P0.05);低分化程度、临床分期Ⅲ及Ⅳ期、有淋巴结转移肺癌患者PD-1、PD-L1阳性表达率分别高于中分化程度、临床分期Ⅲ期、无淋巴结转移患者,差异有统计学意义(P0.05)。PD-1、PD-L1阳性表达及阴性表达组无疾病进展生存期比较均有统计学差异(P0.05)。COX比例风险回归模型显示分化程度、临床分期、淋巴结转移、PD-1、PD-L1的表达是影响肺癌患者预后的危险因素(P0.05)。结论:肺癌组织PD-1、PD-L1呈高表达,可能参与肺癌的发生发展,有助于病情严重程度的评价和预后预测。     

循环肿瘤细胞在肺癌诊断中的应用及临床意义

为了探讨循环肿瘤细胞(circulating tumor cells,CTCs)在肺癌诊断中的应用及临床意义,本研究收集了我院2014年10月至2017年12月收治并确诊的肺癌患者87例、健康体检者40名以及肺部良性疾病患者50例作为研究对象,采用人循环肿瘤细胞试剂盒测定外周血CTC水平,两组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis检验,利用ROC曲线评价CTC在肺癌诊断上的灵敏度以及特异度。实验发现肺癌患者CTC水平(M=12.67 Unints/3 mL)显著高于肺部良性病患者(M=4.76 Unints/3 mL)和健康者(M=4.48 Unints/3 mL),差异存在统计学意义(p<0.001)。在不同性别、不同年龄段以及不同病理类型之间肺癌患者的CTC水平比较差异无统计学意义(p>0.05)。Ⅲ+Ⅳ期肺癌患者CTC水平显著高于Ⅰ+Ⅱ期患者,差异存在统计学意义(p<0.001)。有远处转移的肺癌患者CTC水平显著高于无远处转移的肺癌患者,差异存在统计学意义(p<0.001)。ROC曲线下面积为0.878(95%CI 0.820~0.936),临界值为6.34 Unints/3 mL,对应的灵敏度为0.77,特异度为0.989。本研究初步认为,CTC检测对肺癌诊断具有较高的灵敏度以及特异度,可能存在重要的临床应用价值。     

Down-regulation of microRNA-200b is a potential prognostic marker of lung cancer in southern-central Chinese population

MicroRNAs (miRNAs) may regulate diverse biological processes and play an important role in cancer. And MiRNAs have been proposed as a useful tool for lung cancer diagnosis and therapeutics in cancer. The purpose of the present study was to investigate the association among the expression level of mature miR-200b-5p in peripheral blood and the risk of lung cancer and clinic pathological characteristics. This case-control study included 24 patients with lung cancer and 12 healthy controls. MiR-200b expression was deleted using real-time PCR. and the miR-200b expression of normal controls was significantly higher than that in lung cancer patients (1732.13?pg/mL vs 881.67?pg/mL, P?<?0.05), no difference with age, sex, tissue type and clinical stage of lung cancer patients (P?>?0.05). Furthermore, miR-200b expression level fluctuated with tumor progression in lung cancer, and there was highly significant for clinical stage II compared with the clinical stage III (P?<?0.05). In addition, the down-regulation of miR-200b showed a highly discriminative receiver operating characteristic (ROC) curve profile, clearly distinguishing cancer patients from cancer-free subjects with an area under the ROC curve (AUROC) of 0.87. The detection of miR-200b expression yielded 83.30% sensitivity and 100.00% specificity in the diagnosis of lung cancer. Therefore, these findings suggested that miR-200b may be used as a marker for the detection and diagnosis of lung cancer in peripheral blood.     

食管癌三维适形放疗前后肺功能、生活质量的变化及放射性肺炎的影响因素分析

目的:探讨食管癌三维适形放疗前后肺功能、生活质量的变化及放射性肺炎的影响因素。方法:收集2017年11月~2019年11月在我院进行三维适形放疗的食管癌患者102例,对患者放疗前后的肺功能进行检测对比,并采用生活质量评价简表(QLQ-C30)对患者放疗前后的生活质量进行评估对比。统计患者放疗后放射性肺炎的发生率,根据患者放疗后是否发生放射性肺炎将患者分为放射性肺炎组和非放射性肺炎组,对两组患者的临床资料进行对比分析,采用单因素和多因素Logistic回归分析影响食管癌三维适形放疗后放射性肺炎发生的影响因素。结果:放疗前后患者肺活量(VC)占预计值的百分比、用力肺活量(FVC)占预计值的百分比、第一秒用力呼气容积(FEV1)占预计值的百分比、最大通气量(MVV)占预计值的百分比对比无统计学差异(P>0.05),放疗后患者一氧化碳弥散量(DLCO)占预计值的百分比低于放疗前(P<0.05)。放疗后患者的QLQ-C30各项评分均低于放疗前(P<0.05)。102例患者中放疗后出现放射性肺炎33例,发生率为32.35%。经单因素分析显示,两组患者在性别、体质量指数(BMI)、吸烟史、饮酒史、肿瘤大小、病理类型、肿瘤位置、合并化疗方面比较差异无统计学意义(P>0.05),而在年龄、合并肺基础疾病、全肺接受20Gy的体积(V20)、全肺照射平均剂量(MLD)方面比较差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,年龄≥60岁、合并肺基础疾病、V20≥30%、MLD≥1200cGy是食管癌三维适形放疗后出现放射性肺炎的危险因素(OR=1.309、1.193、1.416、1.309,P<0.05)。结论:食管癌三维适形放疗会对患者的肺部弥散功能、生活质量产生负面影响。部分患者放疗后会出现放射性肺炎,其主要受年龄、肺基础疾病、V20、MLD的影响。     

The clinical burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model

OBJECTIVES: The incidence of prostate cancer is increasing, as is the number of diagnostic and therapeutic interventions to manage this disease. We developed a Markov state-transition model--the Montreal Prostate Cancer Model--for improved forecasting of the health care requirements and outcomes associated with prostate cancer. We then validated the model by comparing its forecasted outcomes with published observations for various cohorts of men. METHODS: We combined aggregate data on the age-specific incidence of prostate cancer, the distribution of diagnosed tumours according to patient age, clinical stage and tumour grade, initial treatment, treatment complications, and progression rates to metastatic disease and death. Five treatments were considered: prostatectomy, radiation therapy, hormonal therapies, combination therapies and watchful waiting. The resulting model was used to calculate age-, stage-, grade- and treatment-specific clinical outcomes such as expected age at prostate cancer diagnosis and death, and metastasis-free, disease-specific and overall survival. RESULTS: We compared the model''s forecasts with available cohort data from the Surveillance, Epidemiology and End Results (SEER) Program, based on over 59,000 cases of localized prostate cancer. Among the SEER cases, the 10-year disease-specific survival rates following prostatectomy for tumour grades 1, 2 and 3 were 98%, 91% and 76% respectively, as compared with the model''s estimates of 96%, 92% and 84%. We also compared the model''s forecasts with the grade-specific survival among patients from the Connecticut Tumor Registry (CTR). The 10-year disease-specific survival among the CTR cases for grades 1, 2 and 3 were 91%, 76% and 54%, as compared with the model''s estimates of 91%, 73% and 37%. INTERPRETATION: The Montreal Prostate Cancer Model can be used to support health policy decision-making for the management of prostate cancer. The model can also be used to forecast clinical outcomes for individual men who have prostate cancer or are at risk of the disease.     

Survival disparities among racial/ethnic groups of women with ovarian cancer: An update on data from the Surveillance,Epidemiology and End Results (SEER) registry

ObjectiveUpdate information on racial disparities in ovarian cancer survival from the Surveillance, Epidemiology, and End Results (SEER) Program.MethodsData on women with epithelial ovarian cancer from the SEER Program between 1995–2015 were collected including; patient ID, age at diagnosis, year of diagnosis, surgery, chemotherapy, radiation, insurance status, region of registry, tumor grade, tumor histology, tumor summary stage, survival months, race/ethnicity, and vital status. Multivariable analyses were performed to examine overall survival, differences in survival by age at diagnosis, by year of diagnosis, risk of not receiving surgery, and risk of 12-month death across racial/ethnic groups.ResultsNon-Hispanic black women (n = 4261) had an increased risk of overall mortality (HR = 1.28, CI: 1.23–1.33) when compared to non-Hispanic white women (n = 47,475), which appears more pronounced among women diagnosed under age 50. Hispanic women (n = 7052) had no difference in survival when compared to non-Hispanic white women (HR = 1.03, CI: 0.99–1.07). Non-Hispanic Asian/PI women (n = 5008) exhibited slightly reduced risk (HR = 0.95, CI: 0.91–0.99) when compared to non-Hispanic white women. Risk of not receiving surgical intervention remains high among non-Hispanic black women and Hispanic women, when compared to non-Hispanic white women. Non-Hispanic black women, non-Hispanic Asian/PI women, and Hispanic women were all at significantly greater risk of dying within the first 12 months of cancer diagnosis when compared to non-Hispanic white women.ConclusionDisparities in survival remain across various racial/ethnic groups, when compared to non-Hispanic white women with ovarian cancer. These disparities should continue to be examined in an effort to decrease such gaps.     

Sputum analysis: Non‐invasive early lung cancer detection

Lung cancer is the leading cause of cancer‐related deaths over the world, characterized by a very high mortality rate. Molecular technique development tries to focus on early detection of cancers by studying molecular alterations that characterize cancer cells. Worldwide lung cancer research has focused on an ever‐increasing number of molecular elements of carcinogenesis at genetic, epigenetic and protein levels. The non‐invasiveness is the characteristic that all clinical trials on cancer detection should have. Abnormal chest imaging and/or non‐specific symptoms are initial signals of lung cancer that appear in an advanced stage of disease. This fact represents the cause of the low 5‐year survival rate: over 90% of patients dying within 5 years of diagnosis. Since smokers have higher quantity of sputum containing exfoliated cells from the bronchial tree, and the sputum represents the most easily accessible biological fluid and its collection is non‐invasive, analysis of this sample represents a good area of research in early lung cancer diagnosis. Continued cigarette smoking is the cause of chronic obstructive pulmonary disease (COPD), with an estimated attributable risk factor exceeding 80% in smoking affected individuals. Lung cancer is found in 40–70% of patients with COPD, particularly in severe disease, and it is a common cause of death in these patients. A large prospective trial of almost half a million non‐smokers showed as lung cancer is also common in patients with COPD who have never smoked. This review describes issues related to early lung cancer screening using non‐invasive methods. J. Cell. Physiol. © 2012 Wiley Periodicals, Inc.     

Regional Differences in Thyroid Cancer Presentation and Survival: a Seer Study

ObjectiveThe incidence of thyroid cancer has been steadily increasing. Several studies have identified gender and racial/ethnic differences in the incidence and prognosis of thyroid cancer. In this study, we sought to determine if the stage of presentation and survival rate of patients with thyroid cancer in the United States is affected by geographic region.MethodsUsing the Surveillance, Epidemiology, and End Results (SEER) database, we identified 100,404 patients diagnosed with thyroid cancer from 1973 through 2009. We assessed historical stage of diagnosis and cancer-free survival rate according to geographic region. To compare stages of diagnosis, we used multinomial logistic regression. To compare survival rates, we used Cox proportional hazards regression. Models were adjusted for age, year of diagnosis, cancer type, registry site, race/ethnicity, and stage.ResultsOf 100,404 patients, 52,902 (52.7%) were from the West, 17,915 (17.8%) from the East, 15,302 (15.2%) from the South, and 14,285 (14.2%) from the Midwest. Overall, most patients presented with localized disease. Those from the West had a higher risk of presenting with regional and distant metastases. When we double-stratified by cancer subtype and racial group, we found no significant associations between geographic region and cancer-free survival rate.ConclusionThe presentation stage and survival rate of patients with thyroid cancer differs by geographic region, but not within separate racial/ethnic groups. (Endocr Pract. 2013;19:998-1006)     

Computational modeling of pancreatic cancer reveals kinetics of metastasis suggesting optimum treatment strategies

Pancreatic cancer is a leading cause of cancer-related death, largely due to metastatic dissemination. We investigated pancreatic cancer progression by utilizing a mathematical framework of metastasis formation together with comprehensive data of 228 patients, 101 of whom had autopsies. We found that pancreatic cancer growth is initially exponential. After estimating the rates of pancreatic cancer growth and dissemination, we determined that patients likely harbor metastases at diagnosis and predicted the number and size distribution of metastases as well as patient survival. These findings were validated in an independent database. Finally, we analyzed the effects of different treatment modalities, finding that therapies that efficiently reduce the growth rate of cells earlier in the course of treatment appear to be superior to upfront tumor resection. These predictions can be validated in the clinic. Our interdisciplinary approach provides insights into the dynamics of pancreatic cancer metastasis and identifies optimum therapeutic interventions.     

The natural history of lung cancer in a periodically screened population

A mathematical model of the progression kinetics of lung cancer in a periodically screened population is proposed and data collected by the Memorial Sloan-Kettering Cancer Center in New York are used for parameter estimation. It is assumed that the development of adenocarcinoma of lung is a stochastic process with two stages, early and advanced, characterized by mean times, detection probabilities, and cure probabilities. Confidence regions of these parameters are estimated using a number of novel techniques. It is found, surprisingly, that the mean duration of the early stage is at least 4 years, the detectability less than .2, and the curability less than .5. These estimates imply that annual radiographic screening from age 45 to 80 might decrease mortality from adenocarcinoma of lung by something less than 20%.     

The association of VEGF rs833061 and rs2010963 polymorphisms with susceptibility to colorectal cancer in an Iranian population

Vascular endothelial growth factor (VEGF) is one of the most important regulators of angiogenesis. Several single nucleotide polymorphisms (SNPs) are associated with the VEGF overexpression and tumor progression in several cancers. This study aimed to determine the association of VEGF rs833061 and rs2010963 polymorphism and their haplotypes with susceptibility to colorectal cancer (CRC) in the Iranian population. A total of 284 colorectal cancer patients (37.3% women, 62.7% men) were enrolled in this study. Healthy controls without evidence of cancer history or family cancer predispositions were frequency-matched to the cases by sex and age (± 5 years). Genotyping was performed by the Sequenom mass ARRAY method and the genotype distribution and risk estimate were analyzed by SPSS software. The correlation between the genotypes and clinicopathological parameters (Dukes stage, phenotype, location, differentiation, and tumor size) among colorectal cancer patients were investigated. We found a significant relationship, between rs833061T/C genotype and their TG haplotype with the age of diagnosis < 60; (p = 0.012, p = 0.014) and rs2010963G/C genotype with female gender and TG haplotype with third and fourth tumor stage and tumor location (p = 0.04and p = 0.047). This study showed that rs833061T/C genotype and TG haplotype increase the susceptibility to colon cancer in the Iranian population. This susceptibility has a significant relationship with the age of diagnosis and different stages of the tumor.