Young adult cancer incidence trends in Taiwan and the U.S. from 2002 to 2016

BackgroundPrevious studies have not examined young adult cancer incidence trends in Taiwan, or comprehensively compared these trends at two nations with different population genetics, environmental exposures, and health care. Therefore, we compared the incidence rates and trends of the most common young adult cancers diagnosed at 20–39 years of age in Taiwan and the U.S.MethodsIncidence rates from 2002 to 2016 were calculated from the Taiwan National Health Insurance Research Datasets and the U.S. Surveillance, Epidemiology, and End Results Program. For trend assessment, average annual percent change (AAPC) values were calculated from 15 years of data using Joinpoint Regression Program. We also obtained sex or age of diagnosis stratified estimates.ResultsThe age-standardized overall young adult cancer incidence rate significantly increased from 2002 to 2016 in both Taiwan (AAPC=1.1%, 95% CI: 0.8–1.5%) and the U.S. (AAPC=1.8%, 95% CI: 1.1–2.4%). Cancers with significantly decreasing trends in Taiwan included cancers of the nasopharynx, liver, and tongue, which were not among the most common young adult cancers in the U.S. Cancers with significantly increasing trends in both Taiwan and the U.S. included colorectal, thyroid, and female breast cancers. Lymphoma, ovarian cancer, and lung and bronchus cancer had significantly increasing trends in Taiwan but not in the U.S. Although cervical cancer had significantly decreasing trends in both nations among those 30–39 years of age, its trend was significantly increasing in Taiwan but decreasing in the U.S. among those 20–29 years of age.ConclusionThe types of common young adult cancers as well as their incidence rates and trends differed in Taiwan and the U.S. Future studies should further understand the etiological factors driving these trends.     

Demographic,social and lifestyle risk factors for cancer registry-notified cancer of unknown primary site (CUP)

BackgroundLittle is known about the risk factors for cancer of unknown primary site (CUP). We examined the demographic, social and lifestyle risk factors for CUP in a prospective cohort of 266,724 people aged 45 years and over in New South Wales, Australia.MethodsBaseline questionnaire data were linked to cancer registration, hospitalisation, emergency department admission, and mortality data. We compared individuals with incident cancer registry-notified CUP (n = 327) to two sets of controls randomly selected (3:1) using incidence density sampling with replacement: (i) incident cancer registry-notified metastatic cancer of known primary site (n = 977) and (ii) general cohort population (n = 981). We used conditional logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsIn a fully adjusted model incorporating self-rated overall health and comorbidity, people diagnosed with CUP were more likely to be older (OR 1.05, 95% CI 1.04–1.07 per year) and more likely to have low educational attainment (OR 1.77, 95% CI 1.24–2.53) than those diagnosed with metastatic cancer of known primary. Similarly, compared to general cohort population controls, people diagnosed with CUP were older (OR 1.10, 95% CI 1.08–1.12 per year), of low educational attainment (OR 1.69, 95% CI 1.08–2.64), and current (OR 3.42, 95% CI 1.81–6.47) or former (OR 1.95, 95% CI 1.33–2.86) smokers.ConclusionThe consistent association with educational attainment suggests low health literacy may play a role in CUP diagnosis. These findings highlight the need to develop strategies to achieve earlier identification of diagnostically challenging malignancies in people with low health literacy.     

All Military Adolescents Are Not the Same: Sexuality and Substance Use among Adolescents in the U.S. Military Healthcare System

Data examining sexuality and substance use among active duty and military-dependent youth is limited; however, these psychosocial factors have military implications. Adolescents and young adults aged 12–23 were recruited from an active-duty trainee clinic (n = 225) and a military pediatric clinic (n = 223). Active duty participants were more likely to be older, male, White, previous tobacco users, and report a history of sexual activity and less contraception use at their most recent intercourse, compared to the dependent group. Over 10% of all participants indicated attraction to members of the same gender or both genders. In logistic regression analysis, non-White participants were less likely to use contraception compared to White participants. Adolescents and young adults seen in military clinics frequently engage in high-risk behavior. Clinicians who care for military youth should assess their patient’s psychosocial history. Further study of this population is warranted to identify factors that may influence risk and resilience.     

Cancer in Guam and Hawaii: A comparison of two U.S. Island populations

BackgroundCancer disparities within and across populations provide insight into the influence of lifestyle, environment, and genetic factors on cancer risk.MethodsGuam cancer incidence and mortality were compared to that of Hawaii using data from their respective population-based, central cancer registries.ResultsIn 2009–2013, overall cancer incidence was substantially lower in Guam than in Hawaii for both sexes while overall cancer mortality was higher for Guam males. Cervical cancer incidence and prostate cancer mortality were higher in Guam. Both incidence and mortality were higher among Guam men for cancers of the lung & bronchus, liver & intrahepatic bile duct, and nasopharynx; Chamorro men were disproportionately affected by these cancers. Filipinos and Whites in Guam had lower overall cancer incidence compared to Filipinos and Whites in Hawaii. Although breast cancer incidence was significantly lower in Guam compared to Hawaii, women in Guam presented at younger ages and with rarer disease histologies such as inflammatory carcinoma were more prevalent. Guam patients were also diagnosed at younger ages for cancers of bladder, pancreas, colon & rectum, liver & intrahepatic bile duct, lung & bronchus, stomach, non-Hodgkin lymphoma, and leukemia.ConclusionSmoking, infectious agents, and betel nut chewing appear to be important contributors to the burden of cancer in Guam. Earlier onset of cancer in Guam suggests earlier age of exposure to key risk factors and/or a more aggressive pathogenesis. Contrasting cancer patterns within Guam and between Guam and Hawaii underscore the potential influence of genes, lifestyle, and environmental factors on cancer development and progression.     

Disparities in survival improvement for U.S. childhood and adolescent cancer between 1995 and 2019: An analysis of population-based data

BackgroundAlthough treatment advances have increased childhood and adolescent cancer survival, whether patient subgroups have benefited equally from these improvements is unclear.MethodsData on 42,865 malignant primary cancers diagnosed between 1995 and 2019 in individuals ≤ 19 years were obtained from 12 Surveillance, Epidemiology, and End Results registries. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for cancer-specific mortality by age group (0–14 and 15–19 years), sex, and race/ethnicity were estimated using flexible parametric models with a restricted cubic spline function in each of the periods: 2000–2004, 2005–2009, 2010–2014 and 2015–2019, versus 1995–1999. Interactions between diagnosis period and age group (children 0–14 and adolescents 15–19 years at diagnosis), sex, and race/ethnicity were assessed using likelihood ratio tests. Five-year cancer-specific survival rates for each diagnosis period were further predicted.ResultsCompared with the 1995–1999 cohort, the risk of dying from all cancers combined decreased in subgroups defined by age, sex and race/ethnicity with HRs ranging from 0.50 to 0.68 for the 2015–2019 comparison. HRs were more variable by cancer subtype. There were no statistically significant interactions by age group (P_interaction=0.05) or sex (P_interaction=0.71). Despite non-significant differences in cancer-specific survival improvement across different races and ethnicities (P_interaction=0.33) over the study period, minorities consistently experienced inferior survival compared with non-Hispanic Whites.ConclusionsThe substantial improvements in cancer-specific survival for childhood and adolescent cancer did not differ significantly by different age, sex, and race/ethnicity groups. However, persistent gaps in survival between minorities and non-Hispanic Whites are noteworthy.     

The Old West in the Middle East: U.S. Military Metaphors in Real and Imagined Indian Country

ABSTRACT  In this article, I examine the role of the Indian Country heritage metaphor in U.S. military activities in the Middle East from a critical anthropological perspective. Research has revealed the proliferation of such discourse among soldiers, military strategists, reporters, and World Wide Web users to refer to hostile, unsecured, and dangerous territory in Iraq and Afghanistan. The salience of this symbol in 21st-century U.S. armed conflicts attests to its staying power in national narratives of colonialism at home and abroad. Summoning the Indian wars of the 19th century in the U.S. West as malleable symbolic parallels to the current war in Iraq serves to offer combat lessons in guerilla warfare while reinscribing epic stories of U.S. military imperialism and renarrating uncritically the struggles and conflicts of Native Americans, past and present, through the lens of contemporary perspectives on terrorism.     

Health and wealth: The late-20th century obesity epidemic in the U.S.

Obesity is a rapidly growing public health issue. This paper investigates obesity's relationship to individuals' wealth by analyzing data from a large U.S. longitudinal socio-economic survey. The results show a large negative association between BMI and White female's net worth, a smaller negative association for Black women and White males and no relationship for Black males. Weight changes and dieting also appear associated with wealth changes. Individuals who lose small amounts of weight experience little change in net worth, but those who lose large amounts of weight have a dramatically improved financial position, with Whites showing larger changes than Blacks.     

The high and heterogeneous burden of breast cancer in Hawaii: A unique multiethnic U.S. Population

BackgroundWhile breast cancer incidence and mortality rates differ across racial/ethnic populations in the U.S., little is known about Asian and Pacific Island subpopulations. Hawaii is one of the most racially/ethnically diverse states in the U.S. Overall, Hawaii ranks 5^th highest for breast cancer incidence in the nation (2010–2014) and rates have increased in recent years despite a stable national trend. In contrast, for breast cancer mortality, Hawaii has the 3^rd lowest rate in the nation, with rates demonstrating a steady decline for nearly 3 decades.MethodsWe examined incidence and mortality trends from 1984–2013 across the five major racial/ethnic populations of Hawaii (Native Hawaiian, White, Japanese, Chinese, and Filipino) using Hawaii’s Surveillance, Epidemiology, and End Results (SEER) registry data.ResultsWith the exception of Chinese, all groups experienced increasing incidence over the thirty year period. While Japanese experienced the most pronounced recent increase, with incidence now exceeding that of Whites, their mortality rates have remained low for decades. Native Hawaiians have consistently had the highest incidence and mortality rates in the state. The incidence rates of hormone receptor (HR)-positive breast cancer were higher among Japanese and Native Hawaiians as compared to Whites. Relative to Whites, Native Hawaiians also had a higher incidence rate of the HER2-positive subtype and, Japanese, of the triple-negative (HR-/HER2-) subtype of breast cancer.ConclusionsStudies such as this underscore the importance of considering the heterogeneity in breast cancer rates and subtypes across the different racial/ethnic populations.     

Intrahepatic Cholestasis of Pregnancy (ICP) in U.S. Latinas and Chileans: Clinical features,Ancestry Analysis,and Admixture Mapping

In the Americas, women with Indigenous American ancestry are at increased risk of intrahepatic cholestasis of pregnancy (ICP), relative to women of other ethnicities. We hypothesized that ancestry-related genetic factors contribute to this increased risk. We collected clinical and laboratory data, and performed biochemical assays on samples from U.S. Latinas and Chilean women, with and without ICP. The study sample included 198 women with ICP (90 from California, U.S., and 108 from Chile) and 174 pregnant control women (69 from California, U.S., and 105 from Chile). SNP genotyping was performed using Affymetrix arrays. We compared overall genetic ancestry between cases and controls, and used a genome-wide admixture mapping approach to screen for ICP susceptibility loci. We identified commonalities and differences in features of ICP between the 2 countries and determined that cases had a greater proportion of Indigenous American ancestry than did controls (p = 0.034). We performed admixture mapping, taking country of origin into account, and identified one locus for which Native American ancestry was associated with increased risk of ICP at a genome-wide level of significance (P = 3.1 x 10^-5, P_corrected = 0.035). This locus has an odds ratio of 4.48 (95% CI: 2.21-9.06) for 2 versus zero Indigenous American chromosomes. This locus lies on chromosome 2, with a 10 Mb 95% confidence interval which does not contain any previously identified hereditary ‘cholestasis genes.’ Our results indicate that genetic factors contribute to the risk of developing ICP in the Americas, and support the utility of clinical and genetic studies of ethnically mixed populations for increasing our understanding of ICP.     

High income men have high value as long-term mates in the U.S.: personal income and the probability of marriage,divorce, and childbearing in the U.S.

Using data from the first Census data set that includes complete measures of male biological fertility for a large-scale probability sample of the U.S. population (the 2014 wave of the Study of Income and Program Participation-N = 55,281), this study shows that high income men are more likely to marry, are less likely to divorce, if divorced are more likely to remarry, and are less likely to be childless than low income men. Men who remarry marry relatively younger women than other men, on average, although this does not vary by personal income. For men who divorce who have children, high income is not associated with an increased probability of having children with new partners. Income is not associated with the probability of marriage for women and is positively associated with the probability of divorce. High income women are less likely to remarry after divorce and more likely to be childless than low income women. For women who divorce who have children, high income is associated with a lower chance of having children with new partners, although the relationship is curvilinear. These results are behavioral evidence that women are more likely than men to prioritize earning capabilities in a long-term mate and suggest that high income men have high value as long-term mates in the U.S.     

Vertical profiles of primary productivity,biomass and physico-chemical properties in meromictic Big Soda Lake,Nevada, U.S.A.

The contribution of bacteria to total primary production was estimated in Big Soda Lake and related to vertical profiles of biomass and various physical and chemical properties. The purple sulfur bacteriaThiocapsa sp. was responsible for 25% of the total primary production. Bacteriochlorophyll (BChl) distribution and DCMU sensitivity experiments confirmed this bacterial activity. High concentrations of photosynthetically inactive phytoplankton were detected in anaerobic-low redox water and were attributed to an early season algal bloom that had settled into a zone of maximal viscosity. Nutrient enrichment bioassay experiments indicated that iron was the most important nutrient controlling early season algal growth.     

Problems of epidemiology and prophylaxis of alveococcosis (multilocular echinococcosis): a general review--with particular reference to the U.S.S.R

Lukashenko N. P., 1971. Problems of epidemiology and prophylaxis of alveococcosis (multilocular echinococcosis): a general review—with particular reference to the U.S.S.R. International Journal for Parasitology, 1: 125–134. Alveococcus multilocularis is an extremely dangerous, often fatal, parasite of man. The main endemic areas are southern G.F.R., Austria, Switzerland, northern U.S.A., Canada and Japan. The circulation of Alveococcus depends on complex biocenotic relationships between certain carnivores and numerous microtine rodents. Their roles vary widely according to terrain, reproduction, season, epizootics, animals of prey and interspecific rivalry. The infection rate of definitive hosts each year depends on the prevailing numbers of intermediate hosts in the corresponding biotope, and vice versa. The significance of the fox, polar fox, dog fox, wolf and spotted cat as definitive hosts is considered. Twenty-nine species of rodents have been recorded as intermediate hosts but the roles of insectivores appear insignificant, while those of birds and wild ungulates have yet to be studied. Domestic ungulates probably do not take part in the life-cycle of A. multilocularis. Domestic cats and dogs may be involved accidentally. The role of synanthropic rodents has not yet been fully elucidated but house mice show a high degree of infectivity. Human infection is influenced by ecological factors, living conditions, occupation and level of hygiene practised: dangerous sources of infection are team dogs, unboiled drinking water from melted ice, the skins of fur animals and possibly insects. Secondary sources are other contaminated waters, dust, wild berries and possibly vegetables. Data on the incidence of alveococcosis according to sex is contradictory; the differences between the infection rates of men and women in different regions almost certainly depend on their several modes of life and occupations. The majority of diseased persons are between 19 and 40 years old; infection probably takes place during childhood and is fatal before old age. Prophylactic measures differ markedly from those for (unilocular) echinococcosis, and must be directed towards eliminating the possibility of infecting definitive hosts and towards increased hygiene education.     

Age-related differences in colon and rectal cancer survival by stage,histology, and tumour site: An analysis of United States SEER-18 data

Age-related differences in colon and rectal cancer survival have been observed, even after accounting for differences in background mortality. To determine how stage, tumour site, and histology contribute to these differences, we extracted age-specific one-year relative survival ratio (RS) stratified by these factors. We used colon and rectal cancer cases diagnosed between 2012 and 2016 from 18 United States Surveillance Epidemiology and End Results cancer registries. For colon cancer, 1-year RS ranged from 87.8 % [95 % Confidence Interval: 87.5–88.2] in the 50–64-year-olds to 62.3 % [61.3–63.3] in 85–99-year-olds and for rectal cancer ranged from 92.3 % [91.8–92.7] to 65.0 % [62.3–67.5]. With respect to stage, absolute differences in RS between 50-64-year-olds and 75–84-year-olds increased with increasing stage (from 6 [5–7] %-points in localised disease to 27 [25–29] %-points in distant disease) and were the highest for cancers of unknown stage (> 28 %-points). Age-related differences in survival were smallest for persons with tumours in the right-sided colon (8 [7–9] %-points) and largest for tumours of the colon without tumour site further specified (25 [21–29] %-points). With respect to histology, differences ranged from 7.4 % to 10.6 %-points for cancers with one of the three primary histologies (adenocarcinoma, mucinous adenocarcinoma, signet ring cell carcinoma) and were several-fold higher (42 %-points) for those with unknown/other histology (< 6 % of cases). Because age-related differences in survival were observed for all histologies and tumour sites, RS differences are unlikely to be driven by differences in the distribution of these factors by age. Differences in stage distribution by age are likely to contribute toward age-related differences in survival. Within stage groups, age differences in survival could be explained by frailty and/or therapy. Future studies incorporating data on treatment and geriatric conditions including frailty and comorbidity would support further understanding of the age gap in colon and rectal cancer survival.     

Association between Smoking and Latent Tuberculosis in the U.S. Population: An Analysis of the National Health and Nutrition Examination Survey

Background

Evidence of an association between cigarette smoking and latent tuberculosis infection (LTBI) is based on studies in special populations and/or from high prevalence settings. We sought to evaluate the association between LTBI and smoking in a low prevalence TB setting using population-based data from the National Health and Nutrition Examination Survey (NHANES).

Methods

In 1999–2000, NHANES assessed LTBI (defined as a tuberculin skin test measurement ≥10 mm) in participants, and those ≥20 years of age were queried regarding their tobacco use and serum cotinine was measured. We evaluated the association of LTBI with self-reported smoking history and smoking intensity in multivariable logistic regression models that adjusted for known confounders (gender, age, birthplace, race/ethnicity, poverty, education, history of BCG vaccination, and history of household exposure to tuberculosis disease).

Results

Estimated LTBI prevalence was 5.3% among those ≥20 years of age. The LTBI prevalence among never smokers, current smokers, and former smokers was 4.1%, 6.6%, and 6.2%, respectively. In a multivariable model, current smoking was associated with LTBI (OR 1.8; 95% CI, 1.1–2.9). The association between smoking and LTBI was strongest for Mexican-American and black individuals. In multivariate analysis stratified by race/ethnicity, cigarette packs per day among Mexican-American smokers and cotinine levels among black smokers, were significantly associated with LTBI.

Conclusions

In the large, representative, population-based NHANES sample, smoking was independently associated with significantly increased risks of LTBI. In certain populations, a greater risk of LTBI corresponded with increased smoking exposure.     

Gospel of Wealth, Gospel of Work: Counterhegemony in the U.S. Working Class

ABSTRACT  In this article, we marshal qualitative and quantitative evidence for a distinctive U.S. working-class perspective that criticizes and dissents from the society's consumerist orthodoxy. On the basis of ethnographic and archival research in white central New York and eastern Pennsylvania, Doukas suggested that the frugal, work-centered ideology of historical U.S. working classes—the "gospel of work"—persisted as counterhegemonic in today's "gospel of wealth" consumerism. Durrenberger quantitatively tested for "gospel of work" orientations and found confirmation among predominantly white central Pennsylvanian labor unionists. We argue that the combination of methods warrants a more confident generalization and that the "wage of whiteness" needs to be assessed in regional and historic context. We conclude that "gospel of work" values are widely held despite a century-long corporate-sponsored campaign to promote consumerism and caution against assuming consumerist hegemony in the United States.     

Direct and indirect effects of hypoxia on benthos in Corpus Christi Bay, Texas, U.S.A.

Hypoxia (low oxygen conditions) has been found in the southeastern region of Corpus Christi Bay, Texas, U.S.A. every summer since 1988. The objectives of the current study were to determine direct and indirect effects of hypoxia on macrofauna. Direct physiological effects of hypoxia include reduction of benthic abundance, biomass, diversity, species richness and species evenness because of physiological intolerance. Indirect ecological effects of hypoxia include predation of emerging benthic fauna from the sediment. Macrofaunal community characteristics were compared vertically within sediments in caged and uncaged sediment samples in hypoxic and normoxic areas. Cage effects were determined with partial cages, which had reduced flow and no predator exclusion. Dissolved oxygen concentrations during the experiment was monitored in water column profiles and continuous measurement of bottom water in the hypoxic and normoxic areas. Hypoxia in Corpus Christi Bay in 1999 occurred as transient events, many of which were of short duration (less than 1 h) and moderate intensity (around 2 mg l^− 1). The macrobenthic community characteristics (i.e., abundance, biomass, species richness, diversity, and evenness) were directly affected by hypoxia as indicated by depressed levels and few deeper-dwelling organisms in the hypoxic area. Community structure was also different between the hypoxic and normoxic areas because of loss of species (presumably due to intolerance to low oxygen) in the hypoxic areas. Benthic invertebrates were found primarily in the surface in the hypoxic area, but there was no significant indication of indirect effects, i.e., increased predation pressure in the hypoxic area. The increased exposure to predation risk may be mitigated by predator avoidance of hypoxic areas. In conclusion, hypoxia in Corpus Christi Bay has negative direct effects on benthic organisms, but no indirect effects, such as increased predation pressure. The most significant finding is the interaction between hypoxia and vertical distributions of infauna, which drive hypoxia intolerant organisms to the surface and out of sediments.