Trends in incidence of breast cancer among women under 40 in seven European countries: A GRELL cooperative study

Young women are not usually screened for breast cancer (BC). The trends in incidence in this population may better reflect changes in risk factors. However, studies on this subject are scarce and heterogeneous. The aim of this study was to describe the trends in incidence of BC in women under 40 from 1990 to 2008, using pooled European data. Thirty-seven European population-based cancer registries from Belgium, Bulgaria, France, Italy, Portugal, Spain and Switzerland participated in this study. World age-standardized incidence rates were first analyzed graphically and then using a Poisson regression model, in order to estimate average annual percent changes (AAPCs). The overall incidence rate of BC in the area covered increased linearly during the study period by 1.19% (0.93; 1.46) on average per year. This increase varied between countries from 0.20% (?0.53; 0.64) in Bulgaria to 2.68% (1.97; 3.40) in Portugal. In Italy, after a significant rise of 2.33% (1.14; 3.54) per year, BC incidence began decreasing in 2002 by ?2.30% (?4.07; ?0.50) yearly. The rise in incidence was greater for women under 35 and for ductal carcinomas. This increase can be due to a rise in risk factors and/or changes in diagnosis and surveillance practices, but we could not clearly distinguish between these two non-exclusive explanations.     

The currently declining incidence of cancer of unknown primary

Cancer of unknown primary (CUP) is a heterogeneous group of metastatic cancers for which a primary tumor cannot be identified after a standardized work-up. The biology of CUP has not been fully elucidated and epidemiologic data may be helpful in this regard. The variations in the incidence-rate over time and between countries reflect changes in the risk factors for CUP, incidence trends of the primary tumors that potentially contribute to the burden of CUP and changes in the diagnostic technologies and practice. CUP accounted for 3–5% of cancers in the historical series but its incidence seems to decline in the recent publications. This paper reviews the published cancer-registry studies in order to identify and understand the variations in the incidence-rates of CUP.     

Cancer incidence in southern Iran, 1998-2002: results of population-based cancer registry

Purpose: The main aim of this study was to obtain population-based cancer incidence data for the entire population of Fars province in Iran, and to compare these rates with those obtained from a previous study in the same population ten years previously. Methods: Data were collected on all patients in major cities of Fars province who were diagnosed with cancer between 1998 and 2002. The data were computerized using SPSS (Chicago, IL) software, version 13.0, and MS EXCEL (Microsoft, Redmond, WA) software with Persian fonts. The results are presented as incidence rates of cases by site, sex, age, crude rates, and age-standardized rates per 100,000 person-years (ASRs), using the direct method of standardization to the world population. Results: During the 5-year study period, 8359 new cancer cases were registered. Diagnosis of cancer was based on histopathological criteria in 86.7%, clinical or radiological criteria in 9.4% and death certificate only in 3.9% of cases. According to the calculated ASRs, the 5 most frequent cancers in women were breast (13 per 100,000), stomach (4.4 per 100,000), lung and bronchus (2.9 per 100,000), uterus (2.7 per 100,000), and colon and rectum (2.6 per 100,000); and in men, the 5 most frequent types were stomach (9.2 per 100,000), bladder (6.8 per 100,000), lung and bronchus (6.3 per 100,000), lymphocytic leukemia (4.1 per 100,000), and skin melanoma (3.8 per 100,000). The ASR for all cancers in men was 64.5 per 100,000, and that for women was 55.5 per 100,000. Conclusion: Considering the limitations of this study, our results should be taken as the minimum incidence rates of cancers in Fars province, southern Iran. Significant differences were observed between the two study periods. However, we most likely have underestimated the frequencies of some tumors.     

Breast cancer trends in women younger than 40 years in Brazil

BackgroundA recent Brazilian populational database analysis showed a concerning increase in breast cancer mortality rates among patients under 40 years. We aimed to evaluate the trends in the proportion of new breast cancer cases and deaths occurring in patients younger than 40 years over the last decade in Brazil.MethodsWe evaluated all consecutive breast cancer patients treated from 2009 to 2020 in a Brazilian tertiary cancer center. The proportions of new cases and deaths in patients younger than 40 years was compared between two time periods (2015–2020 versus 2009–2014) using Chi-squared test. Linear regression was used to evaluate the trends in the proportion of new cases and deaths in young patients over the years.ResultsFrom 2009 to 2020, a total of 12,569 breast cancer patients started treatment at our institution; 1441 were younger than 40 years. From 2009 to 2014, 9.9% (95% CI 9.2–10.7%) were patients younger than 40 years compared to 12.9% (95% CI 12.1–13.8%) from 2015 to 2020. Similarly, the proportion of deaths among breast cancer patients younger than 40 years increased during the period (2009–2014: 9.6%, 95% CI 7.8–11.6%; 2015–2020: 12.4%, 95% CI 10.9–14%). The linear regression model showed a trend for an increasing proportion of new breast cancer cases occurring in patients under 40 years (P = 0.005). Proportion increased from 7.9% (95% CI 6.2–9.8%) in 2009 to 21.8% (95% CI 19.1–24.8%) in 2020. The trend for the increase in the proportion of deaths in this young population was also observed in the linear regression model (P = 0.01).ConclusionsThe proportion of new breast cancer cases and deaths among patients younger than 40 years has increased in a public Brazilian cancer center over the past decade. These results raise the concern for the need to reconsider primary and secondary prevention strategies for young women.     

Cancer in adolescents and young adults: National incidence and characteristics in Japan

ObjectiveAdolescents and young adults (AYA) with cancer are confronted with unique challenges in areas of paramount concern within their age group, such as fertility, education, career, and delayed and long-term effects of treatment. However, the extent and depth of the problem has never been examined in the Japanese population. The aim of this study was to describe the status of cancer patients in the AYA population, using data from the hospital-based cancer registry (HBCR).Study designPatients included in the HBCR from January 2011 to December 2014 were included in this study to evaluate the incidence and cancer distribution trends among AYA. The total number and the proportion of AYA (15–39 years of age) stratified by sex, age, and cancer type were obtained. The incidence of age-specific cancer among AYA was also calculated.ResultsWe identified 30,394 male (35.1%) and 56,100 female (64.9%) cancer patients in the population, which collectively constituted about 3% of all invasive cancer cases. The incidence of cancer in AYA was estimated as 86.2 per 100,000 per year, and increased with age. The most affected population was women between 35 and 39 years of age (35%). Breast cancer was the most common type of cancer, followed by cervical, uterine, and thyroid cancers.ConclusionA substantial number of AYA are diagnosed with cancer every year. The distribution of cancer types in AYA was dependent on age and sex. These diversities in cancer types can inform researchers and policy makers to fine-tune their studies and policies.     

Comparison of oropharyngeal and oral cavity squamous cell cancer incidence and trends in New Zealand and Queensland,Australia

BackgroundIncreases in the incidence of squamous cell oropharyngeal cancer (OPC) have been reported from some countries, but have not been assessed in Australia or New Zealand. This study examines trends for squamous cell OPC and squamous cell oral cavity cancer (OCC) in two similarly sized populations, New Zealand and Queensland, Australia.MethodsIncidence data for 1982–2010 were obtained from the respective population-based cancer registries for squamous cell OPC and OCC, by subsite, sex, and age. Time trends and annual percentage changes (APCs) were assessed by joinpoint regression.ResultsThe incidence rates of squamous cell OPC in males in New Zealand since 2005 and Queensland since 2006 have increased rapidly, with APCs of 11.9% and 10.6% respectively. The trends were greatest at ages 50–69 and followed more gradual increases previously. In females, rates increased by 2.1% per year in New Zealand from 1982, but by only 0.9% (not significant) in Queensland. In contrast, incidence rates for OCC decreased by 1.2% per year in males in Queensland since 1982, but remained stable for females in Queensland and for both sexes in New Zealand. Overall, incidence rates for both OCC and OPC were substantially higher in Queensland than in New Zealand. In males in both areas, OPC incidence is now higher than that of OCC.ConclusionsIncidence rates of squamous cell OPC have increased rapidly in men, while rates of OCC have been stable or reducing, showing distinct etiologies. This has both clinical and public health importance, including implications for the extension of human papilloma virus (HPV) vaccination to males.     

Increased incidence of colon cancer among individuals younger than 50 years: A 17 years analysis from the cancer registry of the municipality of Milan,Italy

BackgroundColorectal cancer (CRC) overall incidence has been decreasing in the last decade. However, there is evidence of an increasing frequency of early-onset CRC in young individuals in several countries. The aim of this study is to evaluate the trends of CRC occurrence over 17 years in the municipality of Milan, Italy, focusing on early-onset CRC.Population and methodsThis retrospective study was performed using the Cancer Registry of the municipality of Milan, including all cases of CRC diagnosed 1999-2015. Incidence rates were stratified by age and anatomic subsite, and trends over time were measured using the estimated annual percentage change. Age-period-cohort modelling was used to disentangle the different effects.Results18,783 cases of CRC were included. CRC incidence rates among individuals aged 50–60 years declined annually by 3% both in colon and in rectal cancer. Conversely, in adults younger than 50 years, overall CRC occurrence increased annually by 0.7%, with a diverging trend for colon (+2.6%) and rectal (−5.3%) cancer. Among individuals aged 60 years and older, CRC incidence rates increased by 1.0% annually up to 2007, and decrease thereafter by 4% per year, both for colon and rectal cancer. Age-period-cohort models showed a reduction of CRC risk for the cohorts born up to 1979, followed by an increase in younger cohorts. In contrast, rectal cancer among women showed a systematic risk decrease for all birth cohorts.ConclusionsThe study highlights increasing incidence of colon cancer in younger subjects and a decrease in incidence rates for rectal cancer in females.     

Young adult mortality following severe physiological stress in childhood: Skeletal evidence

Numerous studies report that early childhood biological stress impairs health in later adulthood. Overwhelmingly these studies are based on modern data, when health conditions are quite good by historical standards. Potentially much can be learned by examining the relationship within populations that lived under enormous pressure, enduring life expectancies less than one-half of those found in industrial countries of the late twentieth century. This paper uses the skeletal remains of over 3000 individuals who lived in the Western Hemisphere as long as 6000 years ago to probe the connection between several markers of early childhood stress and survival from approximately age 15 to 30. In a logit model with explanatory variables that control for sex and ethnicity, the probability of survival was systematically 7.6 percentage points less among individuals with two or more hypoplasias, 3.9 percentage points less for those with cribra orbitalia or porotic hyperostosis, and 4.6 percentage points less for individuals stunted by 20 cm in height. The paper compares these findings with those from studies on modern data and concludes with suggestions for research.     

Global variation in young adult central nervous system tumor incidence by region,age, and sex from 1988 to 2012

BackgroundCentral nervous system (CNS) tumors result in tremendous morbidity and mortality. Incidence of CNS tumors in young adults is less studied. It is unknown how young adult CNS tumor incidence has changed globally in recent decades.MethodsWe used Cancer Incidence in Five Continents (CI5) data (1988–2012) to estimate incidence rates (IR), average annual percent change in incidence (AAPC; 95% confidence intervals [95% CI]), and male-to-female incidence rate ratios (IRR; 95% CI) by six histologies and age at diagnosis (20–29years, 30–39years). Tumors were classified as astrocytic, medulloblastoma, ependymal, oligodendroglial, meninges, and other embryonal. Geographic regions were defined using the United Nations Statistics Division geoscheme.ResultsThere were 78,240 CNS tumor cases included. 20–29-year-old (yo) rates were lower than 30–39 yo in most regions for astrocytic, oligodendroglial and ependymal tumors. Globally, astrocytic tumor incidence decreased (20–29 yo AAPC: − 0.70; 95% CI: − 1.32, − 0.08) while incidence increased for oligodendroglial (20–29 yo AAPC: 3.03; 95% CI: 1.57–4.51; 30–39 yo AAPC: 2.67; 95% CI: 0.79–4.58), ependymal (20–29 yo AAPC: 1.16; 95% CI: 0.31–2.03; 30–39 yo AAPC: 2.29; 95% CI: 1.14–3.46), medulloblastoma (30–39 yo AAPC: 0.6; 95% CI: 0.04–1.24) and tumors of the meninges (20–29 yo AAPC: 1.55; 95% CI: 0.04–3.07). There was a 20–40% male incidence excess in all histologies except for meninge tumors (30–39 yo IRR: 0.71; 95% CI: 0.61, 0.84).ConclusionsIncidence of oligodendroglial and ependymal tumors increased globally in 20–39 yo suggesting better diagnoses or changes in risk factors. Males had a higher incidence of CNS tumors for most tumors studied and in most regions.     

International comparisons of the incidence and mortality of sinonasal cancer

Background: This paper reviews international patterns in sinonasal cancer incidence and mortality in light of changes in exposure to known risk factors. Sinonasal tumours are relatively rare, but they have the second highest occupational attributable fraction of all types of cancer, with a well-established link for workers exposed to wood dust. Methods: Data for a variety of countries, mainly in Europe, North America and the Asia-Pacific region, were obtained from publicly accessible sources and supplemented with information requested from selected cancer registries. Rates were directly age-standardised to the World Health Organization Standard Population. Results: The average annual incidence of sinonasal cancer was typically between 5 and 10 per million in males and between 2 and 5 per million in females between 2004 and 2008. Denmark reported the highest rates, with incidence continuing to increase, in contrast to trends in other countries which either remained relatively stable, or were decreasing slightly. There were significant recent decreases in sinonasal cancer mortality rates within two-thirds of the included countries. Conclusions: Our observations are generally consistent with efforts to limit exposure to wood dust and other potentially causal substances in the workplace, as well as a reduction in the prevalence of smoking in many developed countries. Of concern is that occupational and behavioural risks related to sinonasal cancer are likely to increase among people in less developed countries into the future. However the incentive to intervene in these countries is limited by the lack of accurate and reliable cancer data.     

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.     

Cancer incidence in ethnic German migrants from the Former Soviet Union in comparison to the host population

AimTo investigate cancer incidence patterns among ethnic German migrants (Aussiedler) from the Former Soviet Union, a large migrant group in Germany, in comparison to autochthonous Saarland population over a 20 year observation period.MethodsData were obtained from a cohort of Aussiedler residing in the federal state of Saarland (n = 18,619). Cancer incidence and vital status were ascertained through record linkage with the Saarland Cancer Registry and local population registries.ResultsDuring the follow up period from 1990 to 2009 we observed 638 incident diagnoses of malignant neoplasms (except non-melanoma skin cancer). The overall standardized incidence ratio (SIR) was 0.98 (95% confidence interval 0.92, 1.04). However, site-specific SIRs revealed great variation. Stomach cancer incidence was significantly higher among Aussiedler. Lung cancer was elevated for males, but lower among females. Additionally, diagnoses for colorectal cancer among males were significantly lower. Age-standardized rates (ASRs) over time show not all cancer rates of Aussiedler attenuate as expected to Saarland rates. For example, lung and prostate cancer incidence rates show increasing disparity from Saarland rates and female breast cancer incidence develops in parallel. Furthermore, ASR for overall cancer incidence of Aussiedler shows a yearly decrease (p = 0.06) whereas Saarland rates remain stable.DiscussionAussiedler incidence rates reflect incidence pattern observed in their countries of origin.     

Glutathione S transferase mu polymorphism and gastric cancer in the Portuguese population

The glutathione S-transferases appear to form part of a protective mechanism against the development of cancer where environmental chemical carcinogens are involved. In humans one member of the mu class gene family (GSTM1) has been shown to be polymorphic and is only expressed in ~50% of individuals. Previous studies have shown a possible link between the null phenotype and susceptibility to cancer but have been equivocal regarding stomach cancer. To evaluate any association in Portuguese gastric cancer individuals with GSTM1 variability, we performed GST M 1 polymorphism by PCR amplification in 148 gastric cancer patients and in 84 healthy control individuals. We found no statistical differences between the gastric cancer and control populations (wild type phenotype: 52%, 48%; null phenotype: 48%, 52%, respectively). A subset analysis into site of tumour also revealed no significant differences between the groups, although we found a slight increase of the wild type phenotype in the samples of the antrum compared with the control population (57% vs 48%, respectively; 2= 1.18; p 0.28) and a slight increase of the null phenotype in the signet ring cells/mucocellular group (2= 1.05; p 0.3). However, in both cases it did not reach statistical significance. A subset analysis of the histological groups following the WHO criteria revealed a statistically significant difference (2= 3.704; p 0.05) between the moderately differentiated gastric adenocarcinoma and the presence of the wild type phenotype. These results do not support the hypothesis that the GSTM1 null phenotype predisposes to gastric cancer in the Portuguese population and the moderately differentiated gastric adenocarcinoma seems to be associated with the presence of the G STM 1 wild type phenotype.     

International trends in the incidence of brain tumours in children and young-adults and their association with indicators of economic development

IntroductionChildhood brain tumours (CBTs) are the second most common type of cancer in individuals aged 0–24 years globally and cause significant morbidity and mortality. CBT aetiology remains poorly understood, however previous studies found higher CBT incidence in high-income countries (HIC) compared to low-middle income countries (LMIC), suggesting a positive relationship between incidence and wealth.Materials & methodsAggregated data from Cancer Incidence in Five Continents (CI5) were used to explore CBT epidemiology. Incidence rate ratios (IRR) compared CBT rates between twenty-five geographically and economically diverse countries. The relationship between incidence and economic development was explored using linear regression models and Spearman’s rank correlation tests. Trends in CBT incidence between 1978 and 2012 were investigated using average annual percentage changes (AAPC).ResultsCBT incidence was highest in North America and lowest in Africa. CBT incidence rates increased significantly with increasing GDP per capita (p = 0.006). Gini index was significantly negatively associated with CBT incidence. Incidence decreased with increasing income inequality within countries, indicated by higher Gini indices (p = 0.040). Increasing and decreasing CBT incidence trends were observed within individual countries, although only Italy (p = 0.02) and New Zealand (p < 0.005) experienced statistically significant changes over time.ConclusionsThe excess disease found in HIC may be explained by environmental risk factor exposure increasing CBT risk in wealthy populations. However, systematic limitations of substandard cancer detection and reporting in LMIC may mean incidence disparities result from misinformation bias rather than genuine differences in risk factor exposure. Further research is required to comprehensively describe CBT epidemiology and explain study findings.     

Mortality and incidence of new primary cancers in men with prostate cancer: A Danish population-based cohort study

Background: Prostate cancer (PC) survivors may have an increased risk of new primary cancers (NPCs) due to shared risk factors or PC-directed treatments. Methods: Using Danish registries, we conducted a cohort study of men with (n = 30,220) and without PC (n = 151,100) (comparators), matched 1:5 on age and PC diagnosis/index date. We computed incidence rates of NPCs per 10,000 person years (PY) and associated 95% confidence intervals (CI), and used Cox proportional hazards regression to compute hazard ratios (HRs) and 95%CI, adjusting for comorbidities. In order to obviate any impact of shorter survival among prostate cancer patients, we censored comparator patients when the matched prostate cancer patient died or was censored. Results: Follow-up spanned 113,487 PY and 462,982 PY in the PC and comparison cohorts, respectively. 65% of the cohorts were aged >70 years at diagnosis. Among PC patients, 51% had distant/unspecified stage, and 63% had surgery as primary treatment. The PC cohort had lower incidence of NPCs than their comparators. The adjusted HR of NPC among men with PC versus the comparators was 0.84 (95%CI = 0.80, 0.88). Lowest HRs were among older men, those with distant stage, and were particularly evident for cancers of the brain, liver, pancreas, respiratory, upper gastrointestinal, and urinary systems. Conclusions: We find no evidence of an increased risk of NPCs among men with PC. The deficit of NPCs among men with PC may be a true effect but is more likely due to lower levels of risk factors (e.g., smoking) in PC patients versus comparators, clinical consideration of cancers at new organs as metastases rather than new primaries, or under-recording/under-reporting of NPCs among PC patients.     

Clear differences in ovarian cancer incidence and trends by ethnicity among Asian Americans

BackgroundAcross major races in the United States (U.S.), ovarian cancer incidence is low among Asian American women. However, this observation aggregates Asian Americans as a single group despite their heterogeneity. Disaggregating the ethnic Asian population will produce more useful information to better understand ovarian cancer incidence among Asian women in the U.S.MethodsData from the Surveillance, Epidemiology, and End Results Program from 1990 to 2014 were used to compare age-adjusted incidence rates (AAIRs, per 100,000 women) for ovarian cancer for the six largest U.S. Asian ethnicities (Asian Indian/Pakistani, Chinese, Filipino, Japanese, Korean, Vietnamese) to non-Hispanic whites (NHWs). The race/ethnicity-specific AAIRs were calculated by time period and histotype. We examined the magnitude and direction of AAIR trends using average annual percent change (AAPC) statistics.ResultsAll Asian ethnicities had significantly lower ovarian cancer incidence rates than NHWs. However, among Asian ethnicities, Asian Indians/Pakistanis had the highest rate of ovarian cancer (AAIR = 10.51, 95% CI: 9.65–11.42) while Koreans had the lowest (AAIR = 7.23, 95% CI: 6.62–7.88). Clear cell ovarian cancer had significantly higher incidence rates among Chinese, Filipino, and Japanese women than NHW women (incidence rate ratio (IRR) = 1.49, 95% CI: 1.29–1.72, IRR = 1.30, 95% CI: 1.12–1.51, IRR = 1.64, 95% CI: 1.36–1.97, respectively). Incidence trends also differed by Asian ethnicity with significant decreases only observed for Chinese (AAPC = −1.49, 95% CI: −2.22 to −0.74) and Japanese (AAPC = −1.75, 95% CI: −2.57 to −0.92).ConclusionsExamining Asian Americans as a single group results in missed ethnic-specific disparities in ovarian cancer, hence disaggregating this heterogeneous population in future research is warranted.     

Cancers of unknown primary: Survival by histologic type,demographic features,and treatment in the U.S. Military Health System

BackgroundCancers of unknown primary (CUP), a group of heterogenous metastatic cancers lacking a known primary site, have poor prognosis. This study compared survival of CUP by histologic type, patient characteristics, and treatment in the U.S. Military Health System (MHS), which provides universal care to its members.MethodsPatients histologically diagnosed with CUP were identified from the U.S. Department of Defense (DoD)’s Automated Central Tumor Registry. Median survival with 95 % confidence intervals was calculated for demographic and treatment variables by histologic type. A multivariable accelerated failure time model estimated time ratios and 95 % confidence intervals.ResultsThe study included 3358 CUP patients. The most prevalent CUP in this study was well- and moderately-differentiated adenocarcinomas. Median survival varied by histologic type with squamous cell carcinoma having the longest at 25.1 months and poorly-differentiated carcinomas having the shortest at 3.0 months. For each histologic type, survival was generally similar by sex and active-duty status although women with well- and moderately-differentiated adenocarcinoma had longer survival than their male counterparts. Younger patients tended to have longer survival than those aged 65 years or older. Generally, there were no racial differences in survival except poorer survival for Black patients than White patients in the group of other histologic types. Patients with chemotherapy and radiation treatment generally had improved survival whereas patients with squamous cell carcinoma who received chemotherapy had shorter survival than those without.ConclusionSurvival generally did not differ between racial groups, which may be related to equal healthcare access despite racial background. Further studies are warranted to better understand how survival in the MHS compares with that in the general U.S. population.     

Gastric cancer epidemiology from 2009 to 2019 in Dnipro Region,Ukraine

BackgroundGastric cancer (GC) is in top-five the most frequent cancers in Ukrainian males and is the third cause of death among patients with cancer. GC keeps its leading position in cancer ranks despite the decline in incidence and mortality over the last 50 years. Local epidemiological information will help in better targeting medical and public health interventions.Patients and methodsThe data about 8438 patients with newly diagnosed GC between 2009 and 2019 was obtained from Dnipro Cancer Registry.ResultsIncidence decreased from 24.5 to 22.6, mortality decreased from 21.4 to 15.7 (per 100000), death rate increased from 0.64 to 1.04 between 2009 and 2019. Over 11 years of observation incidence was 23.4, mortality was 19.4, death rate was 0.721. Standardised incidence ratio was 1.42, standardised mortality rate was 1.67; age-standardised incidence was 25.5, age-standardised mortality was 21.2 (European standard). Median (95% confidence interval (95% CI)) survival of the patients was 172 (165−178) days. One-year survival rate fluctuated between 27% and 34%. Male sex and older age were associated with higher risk of death (hazard ratio (95% CI) – 1.08 (1.03–1.13) vs females and 1.15 (1.12–1.17) per 10-years increase of age, respectively).ConclusionsThe study describes the trends in epidemiology of gastric cancer in Dnipro region, Ukraine, between 2009 and 2019. The need for the national prevention strategy of GC in Ukraine was identified.     

Temporal and geospatial trends of pediatric cancer incidence in Nebraska over a 24-year period

BackgroundData from the Surveillance, Epidemiology, and End Results (SEER) revealed that the incidence of pediatric cancer in Nebraska exceeded the national average during 2009–2013. Further investigation could help understand these patterns.MethodsThis retrospective cohort study investigated pediatric cancer (0–19 years old) age adjusted incidence rates (AAR) in Nebraska using the Nebraska Cancer Registry. SEER AARs were also calculated as a proxy for pediatric cancer incidence in the United States (1990–2013) and compared to the Nebraska data. Geographic Information System (GIS) mapping was also used to display the spatial distribution of cancer in Nebraska at the county level. Finally, location–allocation analysis (LAA) was performed to identify a site for the placement of a medical center to best accommodate rural pediatric cancer cases.ResultsThe AAR of pediatric cancers was 173.3 per 1,000,000 in Nebraska compared to 167.1 per 1,000,000 in SEER. The AAR for lymphoma was significantly higher in Nebraska (28.1 vs. 24.6 per 1,000,000; p = 0.009). For the 15–19 age group, the AAR for the 3 most common pediatric cancers were higher in Nebraska (p < 0.05). Twenty-three counties located >2 h driving distance to care facilities showed at least a 10% higher incidence than the overall state AAR. GIS mapping identified a second potential treatment site that would alleviate this geographic burden.ConclusionsRegional differences within Nebraska present a challenge for rural populations. Novel use of GIS mapping to highlight regional differences and identify solutions for access to care issues could be used by similar states.     

Trends in incidence and survival analysis in non-melanoma skin cancer from 1994 to 2012 in Girona,Spain: A population-based study

IntroductionWe present an epidemiological study focused on Non-melanoma skin cancers (NMSC), including squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Merkel cell carcinoma (MCC), dermatofibrosarcoma protuberans (DFS) and adnexal and skin appendages neoplasm (ASAN), a neoplasm understudied in cancer registries.Material and methodsWe analyze trends of incidence and survival of NMSC registered with the Cancer Registry of Girona, Spain.ResultsWe found 14389 cases of NMSC, accounting 3,474 SCC, 10729 BCC, 33 MCC, 61 DFSP and 71 ASAN. Incidence increased significantly in SCC and BCC with annual percentage of change of 1.6 and 1.5, respectively, but not in MCC, DFS or ASAN. Five-year relative survival for both sexes was 90.1% in SCC, 99.8% in BCC, 44.2% in MCC, 93.7% in DFS and 84% in ASAN.ConclusionsOur study confirms the increasing incidence and good survival of SCC and BCC and enhances knowledge on the epidemiology of the less incidental NMSC.