Search

Even 30 years after the accident, an association between breast cancer incidence and ionizing radiation exposure from Chernobyl fallout remains uncertain. We studied breast cancer incidence in the most contaminated regions of Belarus (Gomel and Mogilev) and Ukraine (Kyiv, Zhytomyr and Chernihiv) before (1978‐1986) and after (1987‐2016) the accident. Breast cancer cases and female population size data were received from the national cancer registries and the state departments of statistics. The study included 85 132 breast cancers with 150 million person‐years at risk. We estimated annual rayon (district)‐average absorbed doses to the breast from external and internal irradiation of the adult female population over the period of 1986‐2016. We studied an association between rayon‐average cumulative absorbed breast dose with 5‐year lag, that is, excluding the exposure in 5 years prior to breast cancer diagnosis, and breast cancer incidence using negative binomial regression models. Mean (median) cumulative breast dose in 2016 was 12.3 (5.0) milligray (mGy) in Belarus and 5.7 (2.3) mGy in Ukraine, with the maximum dose of 55 mGy and 54 mGy, respectively. Breast cancer incidence rates statistically significantly increased with calendar year and attained age, and were higher in urban than in rural residents. Adjusting for time, age and urbanicity effects, we found no evidence of increasing incidence with rayon‐average 5‐year lagged cumulative breast dose. Owing to ecological study design limitations, a case‐control study covering this area with individually reconstructed absorbed breast doses is needed testing for association between low‐dose protracted radiation exposure and breast cancer risk after Chernobyl. What's new? The Chernobyl nuclear accident in 1986 exposed various populations, including nearby residents and cleanup workers, to low‐dose ionizing radiation. Here, using national cancer data and data on radionuclide fallout, the authors investigated associations between breast cancer incidence and ionizing radiation exposure in female populations in the most contaminated regions of Belarus and Ukraine following the Chernobyl accident. Analyses indicate that over the period 1986‐2016, breast cancer incidence did not increase in relation to the average 5‐year lagged cumulative breast dose in urban and rural populations. Possible dose misclassification warrants additional investigation via a case‐control study applying individual breast doses. [ABSTRACT FROM AUTHOR]

Season of birth, a surrogate of seasonal variation of environmental exposures, has been associated with increased risk of several cancers. In the context of a Southern‐Eastern Europe (SEE) consortium, we explored the potential association of birth seasonality with childhood (0–14 years) central nervous system (CNS) tumors. Primary CNS tumor cases (n = 6,014) were retrieved from 16 population‐based SEE registries (1983–2015). Poisson regression and meta‐analyses on birth season were performed in nine countries with available live birth data (n = 4,987). Subanalyses by birth month, age, gender and principal histology were also conducted. Children born during winter were at a slightly increased risk of developing a CNS tumor overall [incidence rate ratio (IRR): 1.06, 95% confidence intervals (CI): 0.99–1.14], and of embryonal histology specifically (IRR: 1.13, 95% CI: 1.01–1.27). The winter peak of embryonal tumors was higher among boys (IRR: 1.24, 95% CI: 1.05–1.46), especially during the first 4 years of life (IRR: 1.33, 95% CI: 1.03–1.71). In contrast, boys <5 years born during summer seemed to be at a lower risk of embryonal tumors (IRR: 0.73, 95% CI: 0.54–0.99). A clustering of astrocytomas was also found among girls (0–14 years) born during spring (IRR: 1.23, 95% CI: 1.03–1.46). Although the present exploratory results are by no means definitive, they provide some indications for age‐, gender‐ and histology‐related seasonal variations of CNS tumors. Expansion of registration and linkage with cytogenetic reports could refine if birth seasonality is causally associated with CNS tumors and shed light into the complex pathophysiology of this lethal disease. What's new? Does the risk of developing childhood central nervous system (CNS) tumors depend on the season of birth? The answer is yes. Age‐, gender‐ and histology‐related seasonal variations of CNS tumors were found, namely a winter birth clustering among boys with embryonal tumors, mostly marked in the course of the first four years of life. The authors recommend an expansion of cancer registration and linkage with cytogenetics that could refine if birth seasonality is a potential indicator of early‐life exposures associated with CNS tumor risk. [ABSTRACT FROM AUTHOR]

Childhood (0-14 years) lymphomas, nowadays, present a highly curable malignancy compared with other types of cancer. We used readily available cancer registration data to assess mortality and survival disparities among children residing in Southern-Eastern European (SEE) countries and those in the United States. Average age-standardized mortality rates and time trends of Hodgkin (HL) and non-Hodgkin (NHL; including Burkitt [BL]) lymphomas in 14 SEE cancer registries (1990-2014) and the Surveillance, Epidemiology, and End Results Program (SEER, United States; 1990-2012) were calculated. Survival patterns in a total of 8918 cases distinguishing also BL were assessed through Kaplan-Meier curves and multivariate Cox regression models. Variable, rather decreasing, mortality trends were noted among SEE. Rates were overall higher than that in SEER (1.02/106 ), which presented a sizeable (-4.8%, P = .0001) annual change. Additionally, remarkable survival improvements were manifested in SEER (10 years: 96%, 86%, and 90% for HL, NHL, and BL, respectively), whereas diverse, still lower, rates were noted in SEE. Non-HL was associated with a poorer outcome and an amphi-directional age-specific pattern; specifically, prognosis was inferior in children younger than 5 years than in those who are 10 to 14 years old from SEE (hazard ratio 1.58, 95% confidence interval 1.28-1.96) and superior in children who are 5 to 9 years old from SEER/United States (hazard ratio 0.63, 95% confidence interval 0.46-0.88) than in those who are 10 to 14 years old. In conclusion, higher SEE lymphoma mortality rates than those in SEER, but overall decreasing trends, were found. Despite significant survival gains among developed countries, there are still substantial geographic, disease subtype-specific, and age-specific outcome disparities pointing to persisting gaps in the implementation of new treatment modalities and indicating further research needs. [ABSTRACT FROM AUTHOR]

For the last three decades, the world surgical community successfully adopted different surgical strategies for colorectal cancer (CRC) patients with liver metastases (LM), however, we are still seeing the evolution of treatment guidelines. The purpose of the study was to analyze a 20-year evolution of CRC patients with LM being treated in a specialized state Ukrainian oncological center., Materials and Methods: The retrospective analysis of 1118 CRC patient cases using prospectively collected patient data from the National Cancer Institute registry. The time ranges between 2000-2010 and 2011-2022 and the LM manifestation - metachronous (M0)/synchronous (M1) were the two main grouping criteria., Results: The overall survival 5-year survival of patients who had surgery between 2000-2011 and 2012-2022 was 51.3 and 58.2% ( P =0.61) for the M0 cohort and 22.6 and 34.7% at M1 ( P =0.002), respectively. The results of the multivariate analysis in 1118 cases revealed that liver re-resection and regional lymph node dissection ≥D2 were associated with better overall survival [hazard ratio (95% CI)=0.76 (0.58-0.99) P =0.04] in the M0 cohort and receiving at least 15 courses of chemotherapy had better recurrence-free survival rates [hazard ratio (95% CI)=0.97 (0.95-0.99), P =0.03] for both M0 and M1., Conclusions: It was shown the improvement of the oncological prognosis for CRC patients with synchronous LM who were treated after 2012. The adaptation of world experience algorithms and the surgical strategy evolution have become the root cause of the above., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Neuroblastoma comprises the most common neoplasm during infancy (first year of life). Our study describes incidence of neuroblastoma in Southern-Eastern Europe (SEE), including - for the first time - the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)/Greece, compared to the US population, while controlling for human development index (HDI). Age-adjusted incidence rates (AIR) were calculated for 1,859 childhood (0-14 years) neuroblastoma cases, retrieved from 13 collaborating SEE registries (1990-2016), and were compared to those of SEER/US (N = 3,166; 1990-2012); temporal trends were assessed using Poisson regression and Joinpoint analyses. The overall AIR was significantly lower in SEE (10.1/million) compared to SEER (11.7 per million); the difference was maximum during infancy (43.7 vs. 53.3 per million, respectively), when approximately one-third of cases were diagnosed. Incidence rates of neuroblastoma at ages <1 and 1-4 years were positively associated with HDI, whereas lower median age at diagnosis was correlated with higher overall AIR. Distribution of primary site and histology was similar in SEE and SEER. Neuroblastoma was slightly more common among males compared to females (male-to-female ratio: 1.1), mainly among SEE infants. Incidence trends decreased in infants in Slovenia, Cyprus and SEER and increased in Ukraine and Belarus. The lower incidence in SEE compared to SEER, especially in infants living in low HDI countries possibly indicates a lower level of overdiagnosis in SEE. Hence, increases in incidence rates in infancy noted in some subpopulations should be carefully monitored to avoid the unnecessary costs health impacts of tumors that could potentially spontaneously regress., (© 2017 UICC.)