Cancer incidence in the Western Australian mining industry (1996–2013)

BackgroundMiners are frequently exposed to established and potential carcinogens. We aimed to assess cancer incidence in miners relative to the general population and identify high-risk subgroups.MethodsIncident cancers in Western Australian miners (n = 153,922; 86% male) during 1996–2013 were identified. Indirectly standardised incidence ratios (SIRs) were calculated and mixed-effects Poisson models were used to calculate Incidence Rate Ratios (IRRs) to identify high-risk within-cohort subgroups.ResultsCompared with the general population, the overall cancer incidence in miners (n = 4194 cases) was lower for both females (SIR:0.83, 95%CI:0.74–0.92) and males (SIR:0.96, 95%CI:0.93–0.99). Overall, cancer incidence did not differ by employment duration or employment commencement time. Ever-underground work was associated with lung cancer (IRR:1.81, 95%CI:1.11–2.93). Relative to multi-ore miners, IRRs for specific cancers were significantly different when exclusively mining: iron (prostate:0.73, 95%CI:0.56–0.94); gold (lung:1.77, 95%CI:1.04–3.01 and colorectum:1.70, 95%CI:1.16–2.51); and other metals (urinary tract:1.85, 95%CI:1.03–3.31 and leukaemia:0.36, 95%CI:0.14–0.96).ConclusionWorking underground emerged as a significant determinant of lung cancer risk in our contemporary mining cohort. Increased risks of lung, prostate, colorectal and urinary tract cancers and leukaemia were identified in miners of specific ores. These findings underline the importance of continued surveillance of the health and exposures of this relatively young cohort of miners.     

Cancer risks in children with congenital malformations in the nervous and circulatory system—A population based cohort study

AimWe estimated the age and organ-specific cancer risk for children with a congenital malformation (CM) in the nervous or in the circulatory system.MethodsWe identified 1,709,456 live born singletons in Denmark between 1 January 1977 and 31 December 2007 and excluded children with chromosomal birth defects. Information on CMs was obtained from the Danish National Hospital Register. Information on cancer occurrence was obtained from the Danish Cancer Registry. We applied Cox proportional hazards regression model to estimate hazard ratios (HR) for cancer. Children entered into the CM cohort on the day of birth regardless of when the CM was diagnosed or on the day of CM diagnosis in an alternative analysis.ResultsOverall, 4484 (0.26%) and 24,643 (1.44%) children were diagnosed with a CM in the nervous and in the circulatory system, respectively. Compared with children without any CM, children with a CM in the nervous system had a 5.97 fold (95%CI [confidence interval]: 4.66–7.64) higher risk of cancer, including cancer in the central nervous system (HR = 18.84, 95%CI: 12.67–28.01), in the mesothelial and soft tissue (HR = 15.64, 95%CI: 7.99–30.60), in the skin (HR = 4.91, 95%CI: 2.19–11.0). The associations were stronger early in life. Children with a CM in the circulatory system had a 2.64 fold (95%CI: 2.21–3.16) higher risk of cancer, including cancer in the lymphatic and haematopoietic tissues (HR = 3.22, 95%CI: 2.43–4.27) and cancer in the CNS (HR = 2.40, 95%CI: 1.43–4.02). Some of these associations were weaker in the alternative analysis. Children with subtypes of CM in the two systems showed a higher cancer risk.ConclusionsChildren who were diagnosed with a CM in the nervous system had a substantially higher cancer risk especially early in life. Children diagnosed with a CM in the circulatory system had a moderately higher cancer risk.     

Protective and pathogenic role of collagen subtypes genes COL4A3 and COL4A4 polymorphisms in the onset of keratoconus in South-Asian Pakistani cohort

Collagen sub-types have an important role in corneal structure and are reported to be an important genetic predictor for keratoconus (KC) development, therefore we assessed the association of collagen subtypes by screening non-synonymous polymorphisms of COL4A3 and COL4A4 in South-Asian (Pakistani) patients.MethodsA total of 257 KC sporadic cases, gender and ethnicity matched 253 control individuals were screened for three non-synonymous single nucleotide polymorphisms (SNPs) rs55703767and rs10178458 in COL4A3 and rs2229814 and one synonymous SNP rs2228555 in COL4A4. The genotyping was done by Competitive Allele specific polymerase chain reaction (PCR) and the data were analyzed statistically.ResultsAmong the studied SNPs, the COL4A3 rs55703767 GT genotype (dominant model (DM): odds ratio (OR) = 0.243, (95 %CI) = 0.16–0.36, p=>0.0001), and allele-G (OR = 0.35, 95 %CI = 0.26–0.48, p < 0.000)), showed protective association against KC development. While COL4A3 rs10178458 CT genotype (DM: OR = 2.11(95 %CI = 1.16–3.85), COL4A4 rs2229814 TT genotype (RM: OR = 147.778(95 %CI = 20.401–1070.439), (p > 0.05) and allele-T (OR = 2.351(95 %CI = 1.826–3.028), (p > 0.05); COL4A4 rs2228555 AG genotype (DM: OR = 2.370(95 %CI = 1.594–3.524) (<0.0001) and GG genotype (RM: OR = 2.347(95 %CI = 1.587–3.472), (p < 0.0001); and allele-G (OR = 2.024(95 %CI = 1.577–2.597), (p > 0.0001) were observed to be disease associated.ConclusionCOL4A3 rs10178458 and COL4A4 SNPs rs2229814 and rs2228555 were found to be pathogenic for KC, whereas COL4A3 rs55703767 was found to play a protective role against KC development in South-Asian (Pakistani) Cohort.     

Safety and Efficacy of Apixaban versus warfarin in patients with atrial fibrillation or Venous Thromboembolism and End-Stage renal disease on hemodialysis: A systematic review and meta-analysis

BackgroundWarfarin is traditionally the drug of choice for stroke prophylaxis or treatment of venous thromboembolism in patients with end-stage renal disease (ESRD) on hemodialysis as data on apixaban use is scarce. We aimed to assess the safety and efficacy of Apixaban in patients with ESRD on hemodialysis when compared with warfarin.MethodsA comprehensive literature search in PubMed, Google Scholar, and Cochrane databases from inception until Nov 25, 2019, was performed. Studies reporting clinical outcomes comparing Apixaban (2.5 mg BID or 5 mg BID) versus Warfarin in ESRD patients on hemodialysis were included. Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data.ResultsFour studies (three retrospective and one randomized) with a total of 9862 patients (apixaban = 2,547, warfarin = 7315) met inclusion criteria. The overall mean age was 66.6 ± 3.9 years and mean CHA2DS2-VASc score 4.56 ± 0.58. Apixaban was associated with lower rates of major bleeding (RR 0.53, 95% CI 0.45–0.64, p < 0.0001], gastrointestinal (GI) bleed (RR 0.65, 95% CI 0.55–0.76, p < 0.0001), intracranial bleed (RR 0.56, 95% CI 0.36–0.89, p = 0.01), and stroke/systemic embolism [RR 0.65, 95% CI 0.52–0.83, p = 0.0004] compared with warfarin in patients with ESRD on hemodialysis. There was no significant increased risk of all-cause mortality with the apixaban vs. warfarin (RR 0.90, 95% CI 0.41–1.96, p = 0.78).ConclusionApixaban had an overall favorable risk-benefit profile, with significant reductions in ischemic stroke, major bleeding, and intracranial bleeding compared to Warfarin in ESRD patients on hemodialysis with non-valvular AF and/or venous thromboembolism.     

Impact of comorbidity on survival by tumour location: Breast,colorectal and lung cancer (2000–2014)

BackgroundTo assess the impact of comorbidity, measured by the Charlson Comorbidity Index (CCI), on survival in breast, colorectal and lung cancer.MethodsWe identified 3455 breast cancer, 3336 colorectal cancer and 2654 lung cancer patients through the Hospital del Mar cancer registry. The prevalence of comorbidities according to the CCI was calculated. Kaplan-Meier curves and the log-rank test were used to compare survival curves for each cancer location. Cox regression was used to calculate survival hazard ratios and 1-, 3- and 5-year mortality rate ratios adjusted by age, sex, CCI, place of first consultation, stage, treatment and period of diagnosis.ResultsThe overall unadjusted 5-year follow-up survival proportion was 82.6% for breast cancer, 55.7% for colorectal cancer, and 16.3% for lung cancer. Overall survival was associated with CCI ≥ 3 in breast cancer (HR: 2.33 95%CI: 1.76–3.08), colorectal cancer (HR: 1.39; 95%CI: 1.13–1.70) and lung cancer (HR: 1.22; 95%CI: 1.06–1.40). In breast cancer, the higher the CCI, the higher the adjusted mortality rate ratio and differences were greater in 5-year than in 1-year follow-up survival.ConclusionsComorbidity is a significant predictor of overall survival in cancer patients; however, it has a stronger impact on survival in breast cancer than in colorectal and lung cancer.     

Analgesic use and the risk of renal cell carcinoma – Findings from the Consortium for the Investigation of Renal Malignancies (CONFIRM) study

PurposeThe incidence of renal cell carcinoma (RCC) is rising. Use of analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol may affect renal function. The aim of this study was to assess associations between analgesic use and risk of RCC.MethodsA population-based case-control family design was used. Cases were recruited via two Australian state cancer registries. Controls were siblings or partners of cases. Analgesic use was captured by self-completed questionnaire. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for RCC risk associated with regular analgesic use (at least 5 times per month for 6 months or more) and duration and frequency of use.ResultsThe analysis included 1064 cases and 724 controls. Regular use of paracetamol was associated with an increased risk of RCC (OR 1.41, 95%CI 1.13–1.77). Regular use of NSAIDs was associated with increased risk of RCC for women (OR 1.71, 95% CI 1.23–2.39) but not men (OR 0.83, 95% CI 0.58–1.18; p-interaction=0.003). There was no evidence of a dose-response for duration of use of paracetamol (linear trend p = 0.77) and weak evidence for non- aspirin NSAID use by women (linear trend p = 0.054).ConclusionThis study found that regular use of paracetamol was associated with increased risk of RCC. NSAID use was associated with increased risk only for women.     

A prospective cohort study of physical activity in relation to lung cancer incidence among Black women

BackgroundBlack women have higher lung cancer incidence and mortality rates despite a lower smoking prevalence than White women. Physical activity may reduce lung cancer risk through several pathways, including the immune and inflammatory systems, as well as those with effects on sex hormones and metabolism.MethodsWe examined vigorous physical activity, walking for exercise, sitting watching television, and metabolic equivalents (METs) in relation to lung cancer risk among 38,432 participants in a prospective cohort of Black women. We used Cox proportional hazards models adjusted for covariates to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsIn 1995–2017, 475 incident lung cancer cases accrued. Participants who engaged in ≥ 1 h/week of vigorous physical activity or expended the highest tertile of METs experienced a decreased risk of lung cancer (HR: 0.85, 95% CI: 0.65–1.10; 0.89, 0.68–1.18; respectively). An increased risk was observed for sitting watching television (≥1 h/week: 1.27, 0.72–2.21). In stratified models, an inverse association between walking for exercise and lung cancer risk was only present among former smokers (≥1 h/week: 0.71, 0.52–0.98), while inverse associations between vigorous physical activity (≥1 h/week: 0.45, 0.28–0.73) and METs (tertile 3: 0.54, 0.34–0.85) and lung cancer risk were present among smokers with ≥ 20 pack-years.ConclusionPhysical activity may play a role in reducing lung cancer risk among Black women, particularly among smokers. Future studies should explore biologic mechanisms whereby physical activity may influence carcinogenesis and investigate the role of exercise interventions in reducing lung cancer risk among smokers.     

Associations between oral hygiene habits,diet, tobacco and alcohol and risk of oral cancer: A case–control study from India

ObjectiveThis study examines the association between the incidence of oral cancer in India and oral hygiene habits, diet, chewing and smoking tobacco, and drinking alcohol. We also assessed the effects of oral hygiene habits with oral cancer risk among chewers versus never chewers.MethodsA hospital-based case–control study was conducted in Pune, India, based on face-to-face interviews, anthropometry, and intra-oral examinations conducted for 187 oral cancer cases and 240 controls.ResultsPoor oral hygiene score was associated with a significant risk of oral cancer (adjusted OR = 6.98; 95%CI 3.72–13.05). When stratified by tobacco-chewing habit, the poor oral hygiene score was a significant risk factor only among ever tobacco chewers (adjusted OR = 14.74; 95%CI 6.49–33.46) compared with never chewers (adjusted OR = 0.71; 95%CI 0.14–3.63). Dental check-ups only at the time of pain by ever-chewers with poor oral hygiene was associated with an elevated risk (adjusted OR = 4.22; 95%CI 2.44–7.29), while consumption of green, yellow, and cruciferous vegetables and citrus fruits was protective. A linear dose–response association was observed between oral cancer and chewing tobacco in terms of age at initiation, duration, and frequency of chewing per day (P < 0.001). Smoking more than 10 bidis/cigarettes per day (adjusted OR = 2.74; 95%CI 1.28–5.89) and for a duration >25 years (adjusted OR = 2.31; 95%CI 1.14–4.71) elevated the risk of oral cancer.ConclusionGood oral hygiene habits – as characterized by healthy gums, brushing more than once daily, use of toothpaste, annual dental check-ups, and a minimal number of missing teeth – can reduce the risk of oral cancer significantly. In addition to refraining from chewing/smoking tobacco, a diet adequate in fruits and vegetables may protect against the disease.     

Cancer survival in the northwestern of São Paulo State,Brazil: A population-based study

BackgroundPopulation-based cancer registry (PBCR) data provide crucial information for evaluating the effectiveness of cancer services and reflect prospects for cure by estimating population-based cancer survival. This study provides long-term trends in survival among patients diagnosed with cancer in the Barretos region (São Paulo State, Brazil).MethodsIn this population-based study, we estimated the one- and five-year age-standardized net survival rates of 13,246 patients diagnosed with 24 different cancer types in Barretos region between 2000 and 2018. The results were presented by sex, time since diagnosis, disease stage, and period of diagnosis.ResultsMarked differences in the one- and five-year age-standardized net survival rates were observed across the cancer sites. Pancreatic cancer had the lowest 5-year net survival (5.5 %, 95 %CI: 2.9–9.4) followed by oesophageal cancer (5.6 %, 95 %CI: 3.0–9.4), while prostate cancer ranked the best (92.1 %, 95 %CI: 87.8–94.9), followed by thyroid cancer (87.4 %, 95 %CI: 69.9–95.1) and female breast cancer (78.3 %, 95 %CI: 74.5–81.6). The survival rates differed substantially according to sex and clinical stage. Comparing the first (2000–2005) and last (2012–2018) periods, cancer survival improved, especially for thyroid, leukemia, and pharyngeal cancers, with differences of 34.4 %, 29.0 %, and 28.7 %, respectively.ConclusionTo our knowledge, this is the first study to evaluate long-term cancer survival in the Barretos region, showing an overall improvement over the last two decades. Survival varied by site, indicating the need for multiple cancer control actions in the future with a lower burden of cancer.     

The effect of silica exposure on the risk of lung cancer: A dose-response meta-analysis

BackgroundThe relationship between silica and the risk of developing lung cancer has been established in previous literature, but how much the level of exposure to silica can increase the risk of lung cancer is a question that has been addressed in this review.MethodsThree electronic databases, including MEDLINE, Scopus, and Web of Science were searched for relevant literature. For the dose-response relationship between exposure to silica and developing lung cancer, we performed a meta-analysis using the random-effects model. For each level of exposure, we calculated the overall risk ratio (RR) with 95% confidence intervals (CI).ResultsNineteen studies were included in the meta-analysis. There was a positive and significant increasing dose-response trend between silica exposure and the risk of developing lung cancer as follows: < 0.50 mg/m³ 1.14 (95% CI: 1.05, 1.23; I² = 79%), 0.50–0.99 mg/m³ 1.34 (95% CI: 1.05, 171; I² = 45%), 1.00–1.99 mg/m³ 1.14 (95% CI: 1.00, 1.30; I² = 70%), 2.00–2.99 mg/m³ 1.47 (95% CI: 1.05, 2.06; I² = 57%), 3.00–3.99 mg/m³ 1.44 (95% CI: 0.99, 2.11; I² = 58%), and ≥ 4.00 mg/m³ 1.64 (95% CI: 1.20, 2.24; I² = 88%). The heterogeneity across studies was mild to moderate.ConclusionsThe presence of a dose-response relationship favors the causal relationship between exposure to silica and developing lung cancer.     

Regional inequalities in cancer care persist in Italy and can influence survival

BackgroundPopulation-based cancer registry studies of care patterns can help elucidate reasons for the marked geographic variation in cancer survival across Italy. The article provides a snapshot of the care delivered to cancer patients in Italy.MethodsRandom samples of adult patients with skin melanoma, breast, colon and non-small cell lung cancers diagnosed in 2003–2005 were selected from 14 Italian cancer registries. Logistic models estimated odds of receiving standard care (conservative surgery plus radiotherapy for early breast cancer; surgery plus chemotherapy for Dukes C colon cancer; surgery for lung cancer; sentinel node biopsy for >1 mm melanoma, vs. other treatment) in each registry compared to the entire sample (reference).ResultsStage at diagnosis for breast, colon and melanoma was earlier in north/central than southern registries. Odds of receiving standard care were lower than reference in Sassari (0.68, 95%CI 0.51–0.90) and Napoli (0.48, 95%CI 0.35–0.67) for breast cancer; did not differ across registries for Dukes C colon cancer; were higher in Romagna (3.77, 95%CI 1.67–8.50) and lower in Biella (0.38, 95%CI 0.18–0.82) for lung cancer; and were higher in Reggio Emilia (2.37, 95%CI 1.12–5.02) and lower in Ragusa (0.27, 95%CI 0.14–0.54) for melanoma.ConclusionsNotwithstanding limitations due to variations in the availability of clinical information and differences in stage distribution between north/central and southern registries, our study shows that important disparities in cancer care persist across Italy. Thus the public health priority of reducing cancer survival disparities will not be achieved in the immediate future.     

Effects of polymorphisms in translesion DNA synthesis genes on lung cancer risk and prognosis in Chinese men

PurposeTranslesion DNA synthesis (TLS) plays an important role in promoting replication through DNA lesions. Genetic polymorphisms in TLS genes may have potential roles in lung cancer development in humans.MethodsWe evaluated the association between genetic variants in six TLS genes and the risk and survival of lung cancer in a case–control study in China. Included in the study are 224 lung cancer patients and 448 healthy controls.ResultsCarriers of the G allele of POLκ rs5744724 had significantly reduced risk of lung cancer (odds ratio (OR) = 0.62, 95% confidence interval (CI): 0.44–0.89), comparing with those carrying the C allele, and the AA genotype of PCNA rs25406 was also associated with significantly decreased cancer risk compared with the major homozygote alleles (OR = 0.47, 95% CI: 0.25–0.86). Haplotype analysis showed that subjects with the POLκ C-G (rs5744533–rs5744724) haplotype had decreased risk of lung cancer (OR = 0.69, 95% CI: 0.49–0.98), comparing with those carrying the C-C haplotype. Besides, the heterozygote of REV1 rs3087386 and rs3792136 were independent prognostic factors for lung cancer survival with hazard radio (HR) 1.54 (95% CI: 1.12–2.12) and 1.44 (95% CI: 1.06–1.97) respectively.ConclusionsOur findings suggested that genetic variants in POLκ and PCNA genes may play roles in the susceptibility of lung cancer, and REV1 gene may have roles in lung cancer survival in Chinese men.     

Family history of cancer and the risk of bladder cancer: A case–control study from Italy

BackgroundA family history of bladder cancer has been associated with the risk of bladder cancer, but quantification of the excess risk in different populations is still a relevant issue. Further, the role of a family history of other cancers on the risk of bladder cancer remains unclear.MethodsWe analyzed data from an Italian case–control study, including 690 bladder cancer cases and 665 hospital controls. Odds ratios (ORs) were estimated through unconditional logistic regression models, adjusted for sex, age, study center, year of interview and further for education, smoking and sibling’s number.ResultsThe OR for family history of bladder cancer was 2.13 (95% confidence intervals (95%CIs) 1.02–4.49) from the model with partial adjustment, and 1.99 (95%CI 0.91–4.32) after additional adjustment for smoking and siblings’ number, based on 23 cases (3.3%) and 11 controls (1.7%) with a family history of bladder cancer. The fully adjusted OR was 3.77 when the relative was diagnosed at age below 65 years. Smokers with a family history of bladder cancer had a four-fold increased risk compared to non-smokers without a family history. Bladder cancer risk was significantly increased among subjects with a family history of hemolymphopoietic cancers (OR = 2.97, 95%CI 1.35–6.55). Family history of cancer at other sites showed no significant association with bladder cancer risk.ConclusionThis study confirms an approximately two-fold increased risk of bladder cancer for family history of bladder cancer, and indicates a possible familial clustering of bladder cancer with cancers of the hemolymphopoietic system.     

Pre-existing psychological disorders,diabetes, and pancreatic cancer: A population-based study of 38,952 Finns

BackgroundIt remains unclear how pre-existing depression, anxiety, and diabetes of different durations are associated with the risk of pancreatic cancer, its clinical characteristics, treatment modalities, and subsequent survival.MethodsFrom a register-based random sample of Finns residing in Finland at the end of the period 1987–2007, 6492 patients diagnosed with primary pancreatic cancer in 2000–2014, and 32 460 controls matched for birth cohort and sex, were identified. Pre-existing depression, anxiety, and diabetes were ascertained from the records of prescribed medication purchases. Information on pancreatic cancer outcomes was obtained from the Finnish cancer register. Data were analyzed using logistic and Cox regressions.ResultsThe risk of developing pancreatic cancer was found to be associated with long-term anxiety (treatment started 36 + months before the cancer diagnosis) (odds ratio (OR): 1.13, 95% confidence interval (95%CI): 1.04–1.22) and long-term diabetes (OR 1.72, 95%CI 1.55–1.90), as well as with new-onset (treatment started 0–24 months before the cancer diagnosis) depression (OR 1.59, 95%CI 1.34–1.88), anxiety (OR 1.76, 95%CI 1.50–2.07), and diabetes (OR 3.92, 95%CI 3.44–4.48). However, the effects of these new-onset conditions were driven by cases that began treatment within 3 months before the cancer diagnosis (concomitant period). Patients with long-term depression, anxiety and diabetes and those with new-onset anxiety had a higher risk of not receiving standard treatments. Lower survival was found for pancreatic cancer patients with new-onset depression (hazards ratio (HR) 1.38, 95%CI 1.16–1.64). Survival was not associated with pre-existing anxiety or diabetes.ConclusionsThe associations between pancreatic cancer risk and pre-existing depression and anxiety were mostly driven by concomitant effects. Individuals with diabetes, regardless of duration, should be closely monitored for pancreatic cancer. Pancreatic cancer patients with new-onset depression should be targeted to improve their survival.     

Impact of coronavirus disease 2019 on lung cancer patients: A meta-analysis

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic poses a great challenge to the treatment of lung cancer patients.Materials and methodsThe PubMed, Embase, and Web of Science databases were searched for studies published before March 15, 2022, and Stata 14.0 software was used to perform a meta-analysis with a random-effects model. The odds ratio (OR) along with the corresponding 95% confidence interval (CI) was reported.ResultsOur meta-analysis included 80 articles with 318,352 patients involved. The proportion of lung cancer patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 2.4% (95% CI: 0.02–0.03) prior to the Omicron variant outbreak. Among COVID-19 patients, those with lung cancer showed a higher mortality rate than those with other types of malignant solid tumors (OR = 1.82, 95% CI: 1.61–2.06) and non-cancer patients (OR = 4.67, 95% CI: 3.61–6.05); however, no significant difference was observed in the mortality rate between patients with lung cancer and those with hematologic malignancies (OR = 1.07, 95% CI: 0.85–1.33). SARS-CoV-2 infection significantly increased the mortality rate in lung cancer patients (OR = 8.94, 95% CI: 6.50–12.31). By contrast, the all-cause mortality rate in lung cancer patients (OR = 1.04, 95% CI: 0.69–1.57) and the proportion of patients diagnosed with advanced lung cancer (OR = 1.04, 95% CI: 0.85–1.27) did not significantly change before and after the pandemic.ConclusionsMore attention should be paid on improving the health of lung cancer patients during the COVID-19 pandemic.     

Sarcopenia and a 5-mRNA risk module as a combined factor to predict prognosis for patients with stomach adenocarcinoma

BackgroundSarcopenia is an important factor affecting the prognostic outcomes in adult cancer patients. Gastric cancer is considered an age-related disease and is one of the leading causes of global cancer mortality. We aimed to establish an effective age-related model at a molecular level to predict the prognosis of patients with gastric cancer.MethodsTCGA STAD (stomach adenocarcinoma) and NCBI GEO database were utilized in this study to explore the expression, clinical relevance and prognostic value of age-related mRNAs in stomach adenocarcinoma through an integrated bioinformatics analysis. WGCNA co-expression network, Univariate Cox regression analysis, LASSO regression and Multivariate Cox regression analysis were implemented to construct an age-related prognostic signature.ResultsAs a result, sarcopenia is not only an unfavorable factor for OS (overall survival) in patients with tumor of gastric (HR: 1.707, 95%CI: 1.437–2.026), but also increases the risk of postoperative complications in patients with gastric cancer (OR: 2.904, 95%CI: 2.150–3.922). A panel of 5 mRNAs (DCBLD1, DLC1, IGFBP1, RNASE1 and SPC24) were identified to dichotomize patients with significantly different OS and independently predicted the OS in TCGA STAD (HR = 3.044, 95%CI = 2.078–4.460, P < 0.001).ConclusionThe study provided novel insights to understand STAD at a molecular level and indicated that the 5 mRNAs might act as independent promising prognosis biomarkers for STAD. Sarcopenia and the 5-mRNA risk module as a combined factor to predict prognosis may play an important role in clinical diagnosis.     

Cancer incidence in the AGRICAN cohort study (2005–2011)

BackgroundNumerous studies have been conducted among farmers, but very few of them have involved large prospective cohorts, and few have included a significant proportion of women and farm workers. Our aim was to compare cancer incidence in the cohort (overall, by sex, and by work on farm, occupational status and pesticide use) within the general population.MethodsMore than 180,000 participants in the AGRICAN cohort were matched to cancer registries to identify cancer cases diagnosed from enrolment (2005–2007) to 31st December 2011. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (95%CIs).ResultsOver the period, 11,067 incident cancer cases were identified (7304 men and 3763 women). Overall cancer incidence did not differ between the cohort and the general population. Moreover, SIRs were significantly higher for prostate cancer (SIR = 1.07, 95%CI 1.03–1.11) and non-Hodgkin lymphoma (SIR = 1.09, 95%CI 1.01–1.18) among men, skin melanoma among women (SIR = 1.23, 95%CI 1.05–1.43) and multiple myeloma (men: SIR = 1.38, 95%CI 1.18–1.62; women: SIR = 1.26, 95%CI 1.02–1.54). In contrast, SIRs were lower for upper aerodigestive tract and respiratory cancers. Increase in risk was greater in male farm workers for prostate and lip cancer, in female farm workers for skin melanoma, and in male farm owners for multiple myeloma. Moreover, incidence of multiple myeloma and skin melanoma was higher among male and female pesticide users respectively.ConclusionWe found a decreased incidence for tobacco-related cancers and an increased incidence of prostate cancers, skin melanoma and multiple myeloma. Specific subgroups had a higher cancer incidence related to occupational status and pesticide use.     

Cancer mortality among adolescents and young adults: A historical cohort in a reference institution for cancer treatment in Santa Catarina/South of Brazil 2002–2013

ObjectiveTo identify factors associated with early mortality from cancer in adolescents and young adults in a reference institution for oncology treatment in Santa Catarina, Brazil.MethodsWe studied a retrospective cohort with an intentional sample of adolescents (ages 15–19) and young adults (ages 20–29) diagnosed with neoplasia. Secondary data were acquired from January 2002 to December 2013. Kaplan–Meier and Cox regression methods were used for survival analysis. Logistical analysis tested the association between early death (lower tertile between diagnosis and death, according to cancer type) and clinical or sociodemographic variables.ResultsWe included a total of 889 cases with an average age of 23, with similar gender distributions and a predominance of Caucasian ethnicity. Using the Cox framework of proportional risks adjusted for neoplasia types and gender, individuals with non-hematological neoplasia (solid tumors) presented a 47% higher risk of dying when compared with individuals diagnosed with leukemias and lymphomas (HR: 1.47; 95%CI: 1.12–1.93). Chances of death were 31% higher for males than for females (HR: 1.31; 95%CI: 1.02–1.69). When adjusting for type of neoplasia and age (15–24 and 25–29) the risk of death by cancer was 51% greater in individuals diagnosed with non-hematological neoplasia when compared with individuals diagnosed with leukemias and lymphomas (HR: 1.51; 95%CI: 1.15–1.99). The chance of death by cancer in patients under the age of 25 was 33% greater when compared to that in older patients between the ages of 25 and 29 (HR: 1.33; 95%CI: 1.04–1.75). In multiple regression analysis, factors associated with early mortality from cancer were the number of years in school (P = 0.011) and time between diagnosis and start of treatment (P < 0.001).ConclusionsThe sample studied with a longer period of time between diagnosis and the start of treatment (access to oncology therapy) and with fewer years in school showed that these factors had important roles in early death from cancer for the observed individuals. This must be considered when planning and identifying risk in young cancer patients in order to lower the impact of the disease on mortality for this age group.