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Public health measures necessitated by the COVID-19 pandemic have affected cancer pathways by halting screening, delaying diagnostic tests and reducing the numbers starting treatment. Specifically, this moves individuals from observed and treated pathways to unobserved and untreated pathways. We introduce a semi-Markov model that includes both, extending an industry-based multiple state model used for life and critical illness insurance. Our model includes events related to cancer diagnosis and progression based on publicly available population data for women aged 65–89 in England and on relevant medical literature. We quantify age-specific excess deaths, for a period up to 5 years, along with years of life expectancy lost and changes in cancer mortality by cancer stage. Our analysis suggests a 3–6% increase in breast cancer deaths, and a 4–6% increase in registrations of advanced breast cancer, robust under sensitivity analysis. This should be applicable to actuarial work in areas where longevity and advanced age morbidity affect healthcare, retirement and insurance. [ABSTRACT FROM AUTHOR]

Background: During 2015 in Poland, male-to-female ratio in age-adjusted cancer mortality rate amounted to 1.83, which is close to that observed in 1990 (1.94) and considerably more than in 1965 (1.38).Data and Methods: Nearest-neighbor matching and latent class model were estimated to assess gender gap in cancer prevention in 2006 and 2014. The analysis is based on nationally representative data from a two-wave survey carried out on a stratified random sample of n=7991+8079 adults.Results: Even when controlling for socio-demographic characteristics, health status, and basic knowledge of cancer, three behavioral health characteristics are dramatically lower in men: uptake of preventive health care (ATE of -0.106), perceived caring for own health (-0.070), and fruit and vegetable intake (-0.034). Between 2006 and 2014 the gender gap in uptake of preventive health care and perceived caring for own health had increased, particularly in individuals aged over 40. The adjusted difference in leisure-time physical activity between men and women is near the significance threshold in individuals aged over 40.Conclusion: The gender differences are higher for the behavioral component of cancer prevention than cognitive domains. Without modifying behavioral risk factors, gender gap in cancer mortality is not expected to close. [ABSTRACT FROM AUTHOR]

Aims: To estimate the extent to which the approvals of new pharmacological therapies were associated with cancer mortality in the USA between 2000 and 2016.Materials and Methods: The analysis quantified cancer drug approvals across the 15 tumor types with the highest incidence. Number of approvals in a given time period for each tumor was translated into a treatment stock measure, defined as a weighted sum of new indication approvals since 1976. The primary outcome was the annual tumor-specific cancer mortality, defined as the number of deaths per 100,000 U.S. population. The analysis used a multivariable ordinary least squares and a fixed effects model, controlling for incidence (new cases per 100,000 U.S. population) and the primary exposure, the treatment stock measure by year.Results: Between 2000 and 2016, deaths per 100,000 population across the 15 most common tumor types declined by 24%. Additionally, 10.2 new indications were approved per year across the 15 most common tumor types. Cancer drug approvals were associated with statistically significant deaths averted in 2016 for colorectal cancer (4,991, p = 0.004), lung cancer (33,825, p < 0.001), breast cancer (11,502, p < 0.001), non-Hodgkin's lymphoma (6,636, p < 0.001), leukemia (4,011, p < 0.001), melanoma (1,714, p < 0.001), gastric cancer (758, p = 0.019), and renal cancer (739, p < 0.001). Between 2000 and 2016, new cancer treatments were correlated with 1,291,769 (p < 0.001) total deaths prevented across the 15 most common tumor types.Limitations and Conclusions: Cancer drug approvals between 2000 and 2016 were associated with significant reduction in deaths from the most common cancers in the USA. Mortality changes were largest in prevalent tumor types with relatively more approvals, i.e. lung cancer, breast cancer, melanoma, lymphoma and leukemia. Future research evaluating the relationship between drug approvals and cancer mortality post 2016 is needed. [ABSTRACT FROM AUTHOR]

Purpose: The present study attempts to calculate organ-absorbed and effective doses for cancer patients to estimate the possible cancer induction and cancer mortality risks resulting from 64-slice abdominopelvic computed tomography (CT) simulations for radiotherapy treatment planning (RTTP). Material and methods: A group of 70 patients, who underwent 64-slice abdominopelvic CT scan for RTTP, voluntarily participated in the present study. To calculate organ and effective doses in a standard phantom of 70 kg, the collected dosimetric parameters were used with the ImPACT CT Patient Dosimetry Calculator. Patient-specific organ dose and effective dose were calculated by applying related correction factors. For the estimation of lifetime attributable risks (LARs) of cancer incidence and cancer-related mortality, doses in radiosensitive organs were converted to risks based on the data published in Biological Effects of Ionizing Radiation VII (BEIR VII). Results: The mean ± standard deviation (SD) of the effective dose for males and females were 13.87 ± 2.37 mSv (range: 9.25-18.82 mSv) and 13.04 ± 3.42 mSv (range: 6.99-18.37 mSv), respectively. The mean ± SD of LAR of cancer incidence was 35.34 ± 13.82 cases in males and 34.49 ± 9.63 cases in females per 100,000 persons. The LAR of cancer mortality had the mean ± SD value of 15.38 ± 4.25 and 16.72 ± 3.87 cases per 100,000 persons in males and females respectively. Conclusion: Increase in the LAR of cancer occurrence and mortality due to abdominopelvic treatment planning CT simulation is noticeable and should be considered. [ABSTRACT FROM AUTHOR]

Background: A small change in tea consumption at population level could have large impact on public health. However, the health benefits of tea intake among Americans are inconclusive. Objective: To evaluate the association between tea consumption and all-causes, cardiovascular disease (CVD) and cancer mortality in the Aerobics Center Longitudinal study (ACLS). Methods: 11808 participants (20-82 years) initially free of CVD and cancers enrolled in the ACLS and were followed for mortality. Participants provided baseline self-report of tea consumption (cups/day). During a median follow-up of 16 years, 842 participants died. Of others, 250 died from CVD, and 345 died from cancer, respectively. A Cox proportional hazard model was used to produce hazard ratio (HR) and 95% confidence interval (CI). Results: Compared with participants consuming no tea, tea drinkers had a survival advantage ( Log-2 = 10.2, df = 3, P = 0.017); however, the multivariate hazard ratios (HRs) of all-cause mortality for those drinking 1–7, 8–14, and >14 cups/week were 0.95 (95% CI, 0.81–1.12), 1.00 (95% CI, 0.82–1.22), and 0.98 (95% CI, 0.76–1.25), respectively (P for linear trend = 0.83). The multivariate HR were 1.16 (95% CI, 0.86–1.56), 1.22 (95% CI, 0.85–1.76), and 0.94 (95% CI, 0.56–1.54) for CVD mortality (P for linear trend = 0.47), and 0.97 (95% CI, 0.75–1.25), 0.85 (95% CI, 0.60–1.16), and 0.94 (95% CI, 0.64–1.38) for cancer mortality (P for trend = 0.62). Conclusions: There were week or null relationships between tea consumption and mortality due to all-cause, CVD disease or cancer were observed in ACLS. [ABSTRACT FROM PUBLISHER]

The study investigated the age-adjusted mortality rate and disease odds among deceased residents living in areas exposed to wastewater and cleanwater from 2007 to 2011, in Shijiazhuang, China. Mortality data for eight villages exposed to wastewater and 16 villages not exposed to wastewater were collected and crosschecked from multiple sources. Overall mean age-adjusted mortality rate for wastewater areas was 798/105 (95 % Confidence Interval (CI) = ± 68), insignificantly higher than the mean mortality rate for cleanwater area, 726/105 (95 % CI = ± 46),p > 0.05. Malignant neoplasms and respiratory mortality and disease odds were higher in wastewater areas than in cleanwater areas, OR = 1.7 (95 % CI = 1.3–2.2,p < 0.01) and OR = 1.9 (95 % CI = 1.1–3.4,p < 0.05), respectively. Wastewater area mortality and disease odds for Lung and Stomach cancers after adjustments were OR = 1.6 (95 % CI = 1.1–2.4,p < 0.05) and OR = 1.8 (95 % CI = 1.2–2.7,p < 0.01), respectively, significantly higher than those of cleanwater areas. There is a possibility that exposure to wastewater might be associated with cancer and respiratory disease mortality. The study recommends that the use of wastewater be limited, discouraged, or discontinued. [ABSTRACT FROM PUBLISHER]

Perceived stress is associated with poor health outcomes including negative affect, increased susceptibility to the common cold and cardiovascular disease; the consequences of perceived stress for mortality, however, have received less attention. This study characterizes the relationship between perceived stress and 11-year mortality in a population of Taiwanese adults aged 53+ years. Using the Survey of Health and Living Status of the Near Elderly and Elderly of Taiwan, we calculated a composite measure of perceived stress based on six items pertaining to the health, financial situation, and occupation of the respondents and their families. Proportional hazard models were used to determine whether perceived stress predicted mortality. After adjusting for sociodemographic factors only, we found that a one standard deviation increase in perceived stress was associated with a 19% increase in all-cause mortality risk during the 11-year follow-up period (hazard ratio, HR = 1.19, 95% confidence interval, CI 1.13-1.26). The relationship was greatly attenuated when perceptions of stress regarding health were excluded, and was not significant after adjusting for medical conditions, mobility limitations and depressive symptoms. We conclude that the association between perceived stress and mortality is explained by an individual's current health; however, our data do not allow us to distinguish between two possible interpretations of this conclusion: (a) the relationship between perceived stress and mortality is spurious, or (b) poor health acts as the mediator. [ABSTRACT FROM AUTHOR]

Objectives. The general aim was to assess the pattern and trend in cancer mortality among the indigenous people of coastal Chukotka during the period 1961-1990. Methods. All cases of cancer deaths of indigenous residents of the Chukotsky district in the north-easternmost coast of Chukotka Autonomous Okrug were copied from personal death certificates. There were a total of 219 cancer deaths during the study period. The average annual number of cases, percent, crude, and age-standardized cancer mortality rates (ASMR) per 100,000 among men and women for all sites combined and selected sites were calculated. Data were aggregated into six 5-year periods to assess temporal trends. Direct age-standardization was performed with the Segi-Doll world standard population used by the International Agency for Research on Cancer. Results. The indigenous Chukchi and Eskimo people living in Chukotsky district were at higher risk of death from cancer during the 30-year period between 1961 and 1990, with ASMR among men twice that of Russia, and among women 3.5 times higher. The excess can be attributed to the extremely high mortality from oesophageal cancer and lung cancer. Conclusions. The indigenous people of coastal Chukotka were at very high risk of death from cancer relative to the Russian population nationally. The mortality data from this study correspond to the pattern of incidence reported among other indigenous people of the Russian Arctic. Little information is available since 1990, and the feasibility of ethnic-specific health data is now severely limited. [ABSTRACT FROM AUTHOR]

Corporate crime remains more costly and arguably more harmful than street crime and such harms include environmental, air, and water pollution resulting in increasing cancer mortality rates around the globe. More importantly, these corporate crimes are global in nature and facilitated by transnational corporations’ capture of the USA Environmental Protection Agency. [ABSTRACT FROM AUTHOR]

According to the hypothesis of circadian disruption, external factors that disturb the function of the circadian system can raise the risk of malignant neoplasm and reduce life span. Recent work has shown that the functionality of the circadian system is dependent not only on latitude of residence but also on the region's position in the time zone. The purpose of the present research was to examine the influence of latitude and time zone on cancer incidence, cancer mortality, and life expectancy at birth. A stepwise multiple regression analysis was carried out on residents of 59 regions of the European part of the Russian Federation (EPRF) using age-standardized parameters (per 100,000) of cancer incidence (CI), cancer mortality (CM), and life expectancy at birth (LE, yrs) as dependent variables. The geographical coordinates (latitude and position in the time zone) of the regions were used as independent variables, controlling for the level of economic development in the regions. The same analysis was carried out for LE in 31 regions in China. Latitude was the strongest predictor of LE in the EPRF population; it explained 48% and 45% of the variability in LE of women and men, respectively. Position within the time zone accounted for an additional 4% and 3% variability of LE in women and men, respectively. The highest values for LE were observed in the southeast of the EPRF. In China, latitude was not a predictor of LE, whereas position in the time zone explained 15% and 18% of the LE variability in women and men, respectively. The highest values of LE were observed in the eastern regions of China. Both latitude and position within the time zone were predictors for CI and CM of the EPRF population. Latitude was the best predictor of stomach CI and CM; this predictor explained 46% and 50% of the variability, respectively. Position within the time zone was the best predictor of female breast CM; it explained 15% of the variability. In most cases, CI and CM increased with increasing latitude of residence, from the eastern to the western border of the time zone, and with increasing level of economic development within the region. The dependence of CI, CM, and LE on the geographical coordinates of residence is in agreement with the hypothesis of circadian disruption. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

The authors investigated a possible association between background gamma radiation (BGR) and cancer and infant mortality rates. In an in-country ecological study, they performed a population-weighted linear regression of cancer (infant) mortality rates on BGR, adjusted for unemployment rate and population density. Crude cancer rates showed a highly significant increase with BGR: 38 excess cases per 100,000 person-years per millisievert/year (p < .0001). After adjusting for unemployment rate and population density, the authors found that the excess absolute risk reduced to 23.6 cases per 100,000 person-years per mSv/year (p = .0014). The corresponding excess relative risk was 10.2% (95% confidence interval = 3.9-16.7) per mSv/year. The excess relative risk for infant mortality rates was 24% (95% confidence interval = 9-42) per mSv/year. The cancer risk derived from this ecological study is 0.24/Sv, which compares with an International Commission on Radiological Protection value of 0.05/Sv. However, because they are based on highly aggregated data, the results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

The problem of childhood cancer cannot be evaluated separately from developmental levels and states of health of the countries. Rapid increase in population, poverty, poor hygiene, lack of education, and multitude health problems impede the development of pediatric oncology and success of the management of childhood cancer in developing countries. More than 85% pediatric cancer cases occur in developing countries that use less than 5% of world resources. The rate will exceed 90% in the next two decades, due to the increase of youth population in favor of developing countries. Incidence rates, pathology, and clinical characteristics of various cancers seem different in developing and developed countries. Different environments, life styles, dietary habits, and hygienic conditions are the main reasons for those differences. Unprecedented changes in diagnostic techniques, treatment methods and supportive care have occurred during the last decades. Consequently, management has improved and the mortality rates have decreased. Most of the children with cancer living in developing countries could not profit from those advances in pediatric oncology because of the cost. [ABSTRACT FROM AUTHOR]

Exposure to quartz dust or quartz-containing dusts is suspected to initiate or promote the development of cancer, especially lung cancer.In Germany, coal miners of the Saar area are exposed to respirable coal mine dust with a quartz content of about 12 percent. An historical followup study was conducted on a group of 4628 Saar coal miners who worked at least 5 years underground. External comparisons with the male Saar area population were performed by SMR and RSMR (= SMRPspec/SMRoverall) analyses. Three hundred and seventeen deaths occurred in the study period between January 1, 1980 and December 31, 1991. The SMR (with 0.95 confidence limits) was estimated as 0.63 (0.6--0.7) for overall mortality, 0.65 (0.5--0.8) for cancer mortality, 0.70 (0.5--1.0) for lung cancer mortality, 0.62 (0.2--1.4)for stomach cancer mortality, and 1.27 (0.7-- 2.2) for malignancies of the lymphatic and hematopoietic tissue. RSMRs were not significantly different from expected except for malignancies of the lymphatic and hematopoietic tissue. Breaking down RSMRs by time since first exposure indicates a rising risk for malignancies of the lymphatic and hematopoietic tissue, but no association was found for cancer or lung cancer risk. Taking into account that smokers are more frequent among coalminers (approx. = 50%) than in the general male population of theSaar area (approx. = 33%), no indication of an increased cancer or lung cancer risk in coal miners was found (even when considering RSMRsto adjust for the pronounced healthy worker selection). In general, these results are in line with findings from Great Britain, the United States. and The Netherlands. Not-significant results for stomach cancer and malignancies of the lymphatic and hematopoietic tissue suffer from small numbers. A further followup and a more detailed analysisof the healthy worker selection effects are necessary to validate these results. ) 1997 AIH. [ABSTRACT FROM AUTHOR]