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Background: Lung cancer (LC) survivors are at increased risk for developing a second primary cancer (SPC) compared to the general population. While this risk is particularly high for smoking-related SPCs, the published standardized incidence ratio (SIR) for lung cancer after lung cancer is unexpectedly low in countries that follow international multiple primary (IARC/IACR MP) rules when compared to the USA, where distinct rules are employed. IARC/IACR rules rely on histology-dependent documentation of SPC with the same location as the first cancer and only classify an SPC when tumors present different histology. Thus, SIR might be underestimated in cancer registries using these rules. This study aims to assess whether using histology-specific reference rates for calculating SIR improves risk estimates for second primary lung cancer (SPLC) in LC survivors. Methods: We (i) use the distribution of histologic subtypes of LC in population-based cancer registry data of 11 regional cancer registries from Germany to present evidence that the conventional SIR metric underestimates the actual risk for SPLC in LC survivors in registries that use IARC/IACR MP rules, (ii) present updated risk estimates for SPLC in Germany using a novel method to calculate histological subtype-specific SIRs, and (iii) validate this new method using US SEER (Surveillance, Epidemiology, and End Results Program) data, where different MP rules are applied. Results: The adjusted relative risk for lung cancer survivors in Germany to develop an SPLC was 2.98 (95% CI 2.53–3.49) for females and 1.15 (95% CI 1.03–1.27) for males using the novel histology-specific SIR. When using IARC/IACR MP rules, the conventional SIR underestimates the actual risk for SPLC in LC survivors by approximately 30% for both sexes. Conclusions: Our proposed histology-specific method makes the SIR metric more robust against MP rules and, thus, more suitable for cross-country comparisons. [ABSTRACT FROM AUTHOR]

Background Cancer diagnostic pathways in general practice are often nonlinear, and several events can delay timely diagnosis. Objectives To explore cancer diagnostic processes in general practice, examining how patients' symptom presentations, sex, and age are associated with the occurrence of predefined potentially delaying events and the first referrals. Method General practices in 3 Danish Regions were invited to participate in a questionnaire survey, addressing patient's symptom presentation, diagnostic process events, and first referral. The general practitioners (GPs) received a list of their incident cancer patients from the preceding 2 years. Results In total 187 general practices participated, including 5,908 patients with the cancer diagnostic pathways initiated in general practice. Presenting with nonspecific symptoms was associated with potentially delaying events, even when the patient also had specific symptoms. Almost half of the patients were referred to a cancer patient pathway (CPP) first, men more often than women, and 10% were referred for acute hospitalization. In 23% of the diagnostic processes, GPs initially treated or referred patients on suspicion of another disease rather than cancer and waited due to normal examinations in 1 out of 20 patients. Excluding sex-specific cancers, these 2 events were more prevalent in women. Men less often complied to the follow-up agreement. Younger patients were less often first referred to a CPP and together with older patients more often first acutely hospitalized. Conclusion In cancer diagnostic processes in general practice, first referrals and the occurrence of potentially delaying events are associated with the patient's age, sex, and specificity of symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Cancer is a global health challenge with complex characteristics. Despite progress in research and treatment, a universally effective prevention strategy is lacking. Access to reliable information, especially on occurrence rates, is vital for cancer management. This study aims to create a database containing individual and spatially integrated data on commonly diagnosed cancers in Iran from 2014 to 2017, serving as a valuable resource for spatial-epidemiological approaches. Data description: This database encompasses several files related to cancer data. The first file is an Excel spreadsheet, containing information on newly diagnosed cancer cases from 2014 to 2017. It provides demographic details and specific characteristics of 482,229 cancer patients. We categorized this data according to the International Agency for Research on Cancer (IARC) reporting rules to identify cancers with the highest incidence. To create a geodatabase, individual data was integrated at the county level and combined with population data. Files 2 and 3 contain gender-specific spatial data for the top cancer types and non-melanoma skin cancer. Each file includes county identifications, the number of cancer cases for each cancer type per year, and gender-specific population information. Lastly, there is a user's guide file to help navigate through the data files. [ABSTRACT FROM AUTHOR]

Simple Summary: While males exhibit higher incidence and mortality rates for most non-sex-specific cancers compared to females, the reasons behind these differences remain unclear. By analyzing the male-to-female rate ratios (MF IRRs) of non-sex-specific cancers by race and ethnicity, this research aims to shed light on whether sex-based differences are rooted in intrinsic biological variations or environmental exposures. Similarities of MF IRRs across race and ethnicity may suggest underlying biological variations that drive sex differences, while variations in MF IRRs may point to external factors driving these incidence differences. The results may help us understand the etiology of non-sex-specific cancers and the complex interplay between biology and environment in cancer development. Men have 2–3 times the rate of most non-sex-specific cancers compared to women, but whether this is due to differences in biological or environmental factors remains poorly understood. This study investigated sex differences in cancer incidence by race and ethnicity. Cancer incidence data from the Surveillance, Epidemiology, and End Result (SEER) program (2000–2019) were used to calculate male-to-female incidence rate ratios (MF IRRs) for each cancer site, stratified by race and ethnicity, and age-standardized to the 2000 U.S. population for individuals ages ≥ 20 years. Among 49 cancer sites, 44 showed male predominance (MF IRR > 1), with seven inconsistencies across race and ethnicity, including cancers of the lip, tongue, hypopharynx, retroperitoneum, larynx, pleura cancers, and Kaposi sarcoma. Four cancers exhibited a female predominance (MF IRR < 1), with only gallbladder and anus cancers varying by race and ethnicity. The MF IRRs for cancer of the cranial nerves and other nervous system malignancies showed no sex differences and were consistent (MF IRR = 1) across race and ethnicity. The MF IRRs for most cancers were consistent across race and ethnicity, implying that biological etiologies are driving the observed sex difference. The lack of MF IRR variability by race and ethnicity suggests a minimal impact of environmental exposure on sex differences in cancer incidence. Further research is needed to identify biological drivers of sex differences in cancer etiology. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer is a significant contributor to morbidity and mortality worldwide. The purpose of this study was to analyze the cancer burden and trends of 29 groups of malignant neoplasms in Mexico by sex and age from 1990 to 2019. In 2019, there were 222.1 thousand incident cases and 105.6 thousand deaths due to cancer in the general population. The number of new cases and deaths from the 29 cancer groups increased between 10% and 436% from 1990 to 2019, with different patterns by sex and age. Breast, cervical, and colorectal cancers were the leading causes of death among women, while prostate, lung, and colorectal cancers were the leading causes of death among men. In Mexico, malignant neoplasms were the third leading cause of death in 2019, causing significant health loss. The existence of gender disparities emphasizes the need for cancer-specific targeted prevention, diagnosis, and treatment. The global burden of cancer is on the rise, with varying national patterns. To gain a better understanding and control of cancer, it is essential to provide national estimates. Therefore, we present a comparative description of cancer incidence and mortality rates in Mexico from 1990 to 2019, by age and sex for 29 different cancer groups. Based on public data from the Global Burden of Disease Study 2019, we evaluated the national burden of cancer by analyzing counts and crude and age-standardized rates per 100,000 people with 95% uncertainty intervals for 2019 and trends using the annual percentage change from 1990 to 2019. In 2019, cancer resulted in 222,060 incident cases and 105,591 deaths. In 2019, the highest incidence of cancer was observed in non-melanoma skin cancer, prostate cancer, and breast cancer. Additionally, 53% of deaths were attributed to six cancer groups (lung, colorectal, stomach, prostate, breast, and pancreatic). From 1990 to 2019, there was an increasing trend in incidence and mortality rates, which varied by 10–436% among cancer groups. Furthermore, there were cancer-specific sex differences in crude and age-standardized rates. The results show an increase in the national cancer burden with sex-specific patterns of change. These findings can guide national efforts to reduce health loss due to cancer. [ABSTRACT FROM AUTHOR]

Background: There is an overall surge of malignancies in most of the developing countries including India. Dearth of data from Kashmir prompted us to embark upon a study on burden and pattern of cancer in Kashmir over previous 5 years. Methods: Data acquisition from January 2016 to December 2020 was accomplished from the departmental archives of a large tertiary care institute of Kashmir valley. All histologically proven malignant cases were included for the present study. Information regarding the age, gender, site of primary malignancy and histological diagnosis was obtained. Results: A total of 5,392 cases of malignancies were considered for final analysis with a mean age at diagnosis of 56.73 years (SD = 15.96). Maximum number of cases were recorded in the age group of 60–69 years. Maximum number of malignancies were encountered in year 2018 with substantial drop in subsequent years. Gastrointestinal malignancies constitute more than one-third of total number of malignancies across both genders. In males, stomach was the common site of malignancy followed by lung and colorectal region whereas in females most common sites were breast, colorectal, and stomach. Conclusion: This study portrays close reflection of the cancer patterns within the valley in recent years which is strikingly different from rest of the country and world. [ABSTRACT FROM AUTHOR]

Uterine endometrial cancer (EC) is the most common gynecological malignancy in Taiwan. This study aimed to investigate the association between human papillomavirus (HPV) infection and the development of uterine EC among Taiwanese women. A nationwide population cohort research approach was employed, leveraging longitudinal health insurance databases (LHID 2007 and 2015) from the National Health Insurance Research Database alongside data from the Taiwan Cancer Registry datasets. A comparative analysis examined 472,420 female patients with HPV infection and 944,840 without HPV infection. The results demonstrated that the HPV cohort exhibited a significantly elevated risk of uterine EC, as evidenced by an adjusted hazard ratio (aHR) of 1.588 (95% CI: 1.335–1.888). Furthermore, this elevated risk extended to type 1 EC with an aHR of 1.671 (95% CI: 1.376–2.029), specifically the endometrioid adenocarcinoma subtype with an aHR 1.686 (95% CI: 1.377–2.065). Importantly, these findings were statistically significant (p < 0.001). In conclusion, this research unveils a potential association between HPV infection and an increased risk of uterine EC, particularly the type 1 endometrial cancer subtype, within the Taiwanese female population. These findings have implications for preventive measures and screening programs targeting HPV infection to reduce the risk of this prevalent gynecological malignancy in Taiwan. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of mortality and morbidity in the world. Cancer incidence varies widely throughout India from east to west and from north to south making the prevention and control programs difficult the alarming increase of cancer cases in low and middle-income countries like India warrants us to have a better knowledge about the transition in the epidemiology in various parts of the country. Aims and Objectives: The aim of this study was to assess the incidence of different cancers among patients visiting a tertiary care cancer hospital in central India. Materials and Methods: The data were collected retrospectively from the medical record database of a tertiary care cancer hospital in Central India from the time period between January 2017 and December 2021. A total of 13011 patients were registered at our hospital between this time period. Data were analyzed for the site of disease and tabulated, and then, the percentage distribution was calculated. Results: Head-and-neck cancer was the most commonly reported one followed by cervical cancer and breast cancer. Among gynecological malignancies, cervical cancer dominated the spectrum followed by ovarian cancer and endometrial cancer. Tobacco-related cancers were seen in high number each year. Less commonly reported cancers were that of urethral, adrenal, germ cell tumors, and choriocarcinoma followed by that of eye and ear. Conclusion: There is an urgent need to set up stringent hospital-based and population-based cancer registration system to understand the profile of cancer in each geographical region for a better understanding and implementation of cancer control programs. [ABSTRACT FROM AUTHOR]

We examined in NORDCAN database how the annual age group-specific incidence rates (IR) of gastric cancer (GCA), and correspondingly the GCA risk, have declined in Finland during the twentieth century, and whether this decline corresponds to a decrease in the cohort-specific prevalence rate of Helicobacter pylori (Hp) gastritis that is considered an important precancerous risk condition for GCA. In modelling with partial least squares regression (PLSR), the logarithmically transformed IRs (ln(IR) of GCA were well explained with age and birth cohort as explanatory model variables. By considering the observed (actual) and the PLSR-modelled IRs, the IR of GCA (and the risk of GCA) has decreased gradually in Finland from 1900 onward, cohort by cohort. By prediction of the future with PLSR, the IRs of GCA will be markedly lower in all cohorts during the twenty-first century than in the twentieth century. By PLSR modelling, less than 10 GCA cases per 100,000 people are predicted to appear annually in cohorts (generations) born at the turn of the 20th and 21st centuries, even when these people will be 60–80 years old in the years 2060–2070. The IR of GCA and GCA risk progressively declined by cohort in Finland during the whole twentieth century. This decline corresponds in extent and time window to earlier observations in the decline of the prevalence rate of Hp gastritis in the same birth cohorts and supports the hypothesis of the role of Hp gastritis as an important risk condition of GCA. [ABSTRACT FROM AUTHOR]

Background: Hitherto, the association of vitamin D intake and digestive system cancers occurrence still causes disputation among the researchers. This study aimed to investigate the genetic relation between vitamin D ingestion and digestive system cancers (which are esophageal, gastric, hepatic, pancreatic, and colorectal cancers) by a two-sample Mendelian randomization (MR) analysis, using datasets derived from IEU OpenGWAS database. Methods: This study is based on a genome-wide association study (GWAS) for vitamin D and digestive system cancers, with a sample amount ranging from 218,792 to 496,946 European ancestry individuals. The study first investigated the causal relationship between vitamin D and each digestive system cancers using inverse-variance weighting (IVW), weighted medians, and MR-Egger regression and then used meta-analysis to summarize the IVW results for the different cancers. We also performed additional sensitivity tests to assess the validity of the results. Results: In this study, we screened out 117 SNPs as potential instrumental variables for 25(OH)D and identified 101 fixed SNPs as instrumental variables for digestive system cancers. The results of the IVW failed to reveal any causal relationship between the genetically predisposed vitamin D level and the risk of digestive system cancers (esophageal cancer p = 0.400, OR = 1.397, 95% CI 0.642–3.040; gastric cancer p = 0.796, OR = 0.939, 95% CI 0.585–1.510; hepatic cancer p = 0.347, OR = 1.445, 95% CI 0.671–3.109; pancreatic cancer p = 0.905, OR = 0.969, 95% CI 0.581–1.618; colorectal cancer p = 0.127, OR = 0.0.841, 95% CI 0.673–1.051). The pooled ORs (odds ratio) are 0.918 (95% CI 0.770–1.097, p = 0.348). Conclusion: There is no causal relationship between vitamin D and the occurrence of digestive system cancers. The risk of digestive system cancers cannot be alleviated by merely increasing vitamin D intake. [ABSTRACT FROM AUTHOR]

Background: There is an overall surge of malignancies in most of the developing countries including India. Dearth of data from Kashmir prompted us to embark upon a study on burden and pattern of cancer in Kashmir over previous 5 years. Methods: Data acquisition from January 2016 to December 2020 was accomplished from the departmental archives of a large tertiary care institute of Kashmir valley. All histologically proven malignant cases were included for the present study. Information regarding the age, gender, site of primary malignancy and histological diagnosis was obtained. Results: A total of 5,392 cases of malignancies were considered for final analysis with a mean age at diagnosis of 56.73 years (SD = 15.96). Maximum number of cases were recorded in the age group of 60-69 years. Maximum number of malignancies were encountered in year 2018 with substantial drop in subsequent years. Gastrointestinal malignancies constitute more than one-third of total number of malignancies across both genders. In males, stomach was the common site of malignancy followed by lung and colorectal region whereas in females most common sites were breast, colorectal, and stomach. Conclusion: This study portrays close reflection of the cancer patterns within the valley in recent years which is strikingly different from rest of the country and world. [ABSTRACT FROM AUTHOR]

Background: The survival of women with early‐stage breast cancer varies by racial group. Filipino women with breast cancer are an understudied group and are often combined with other Asian groups. We compared clinical presentations and survival rates for Filipino and White women with breast cancer diagnosed in the United States. Methods: We conducted a retrospective cohort study of women with breast cancer diagnosed between 2004 and 2015 in the SEER18 registries database. We compared crude survival between Filipino and White women. We then calculated adjusted hazard ratios (HR) in a propensity‐matched design using the Cox proportional hazards model. Results: There were 10,834 Filipino (2.5%) and 414,618 White women (97.5%) with Stage I–IV breast cancer in the SEER database. The mean age at diagnosis was 57.5 years for Filipino women and 60.8 years for White women (p < 0.0001). Filipino women had more high‐grade and larger tumors than White women and were more likely to have node‐positive disease. Among women with Stage I–IIIC breast cancer, the crude 10‐year breast cancer‐specific survival rate was 91.0% for Filipino and 88.9% for White women (HR 0.81, 95% CI 0.74–0.88, p < 0.01). In a propensity‐matched analysis, the HR was 0.73 (95% CI 0.66–0.81). The survival advantage for Filipino women was present in subgroups defined by age of diagnosis, nodal status, estrogen receptor status, and HER2 receptor status. Conclusion: In the United States, Filipino women often present with more advanced breast cancers than White women, but experience better breast cancer‐specific survival. [ABSTRACT FROM AUTHOR]

Introduction: Pancreatic cancer (PC) in solid organ transplant (SOT) recipients is not well studied. Some PC cases may be incidentally detected during hepatobiliary imaging. Methods: We evaluated PC among 374,106 SOT recipients during 1995–2017 in the United States using linked data from the national transplant registry and multiple state/regional cancer registries. Standardized incidence ratios (SIRs) were used to compare PC risk in recipients to the general population. We used multivariate Poisson regression to identify independent risk factors for PC. We assessed survival after PC diagnosis using Kaplan–Meier curves and log-rank tests. Results: SOT recipients had elevated incidence for PC compared with the general population (SIR 1.40, 95% CI 1.29–1.52), and this increase was strongest in liver recipients (1.65, 1.41–1.92). Among all recipients, PC incidence was especially increased for cases arising in the head of the pancreas (SIR 1.50, 95% CI 1.34–1.68) and for cases diagnosed at localized stage (1.85, 1.37–2.44). Among SOT recipients, factors independently associated with increased incidence were consistent with those in general population including male sex, older age, non-O blood type, and history of diabetes. Additionally, compared to other organ recipients, liver transplant recipients had higher PC incidence (adjusted incidence rate ratio 1.28; 95% CI 1.06–1.54). Overall survival after PC diagnosis was poor (median 4 months) and similar between liver and other organ transplant recipients (p = 0.08). Conclusions: PC incidence is elevated among SOT recipients, and more commonly diagnosed in liver transplant recipients perhaps related to incidental detection. However, survival is poor even in liver recipients, arguing against routine PC screening. [ABSTRACT FROM AUTHOR]

Simple Summary: It is thought that allergic diseases could hamper or trigger carcinogenesis by enhancing host immune defenses or persisting inflammation, respectively. The gastrointestinal (GI) tract plays a crucial role in building the immune system via the gut barrier and through communicating with the microbiome. We hypothesized that allergic diseases may be linked with the occurrence of GI tract cancers. Analyzing national health check-up data, we found that, overall, allergic diseases which consist of allergic rhinitis, asthma, and atopic dermatitis reduced the risk of malignancy in the esophagus, stomach, colorectum, and liver. Given that gastric and liver cancers are typical infection-related malignancies, the inverse associations between allergic diseases and the subsequent development of GI cancers in the present study supports the cancer immunosurveillance hypothesis. This result could provide a clue for the novel approach to the prevention and treatment of GI cancers. The aim of this study was to investigate the effect of allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, on the development of gastrointestinal (GI) cancers. We analyzed 9,892,633 Korean adults who underwent a medical check-up in the year 2009, and they were followed up until the year 2017. Allergic diseases and cancers were defined using the International Classification of Disease Codes. A Cox proportional hazards model was adapted to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). During a 7.3-year follow-up period, 48,045 patients were diagnosed with cancer. For all-combined allergic diseases, significant inverse associations were observed for cancers of the esophagus, stomach, colorectum, and liver (adjusted hazard ratios (aHRs [95% confidence interval, CI] 0.86 [0.82–0.91], 0.93 [0.91–0.94], 0.95 [0.93–0.96], and 0.90 [0.88–0.92], respectively). The sex-stratified analysis showed that the preventive effect of allergic diseases was persistent in gastric, colorectal, and liver cancers regardless of sex, while the inverse associations with esophageal and pancreatic cancers were observed only in men (aHR [95% CI] 0.84 [0.80–0.89] and 0.96 [0.93–0.99]). Allergic diseases, particularly allergic rhinitis, in adults were significantly associated with a decreased risk of most GI cancers, except for gallbladder and biliary tract cancers. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates cancer in migrants in Southern Italy, who represent a neglected but vulnerable population. We used data from the Eastern Sicily Cancer Registry collected between 2004 and 2019 to compare the adjusted proportionate morbidity ratio for the most common cancer types in migrants and non-migrants, and we calculated the odds of migrant status for one cancer compared to all cancers. The migrants/non-migrants odds of cancer was 2.1%, with most cancers occurring in migrant women. We observed increased proportions in cervical and lung cancer, with higher odds of cervical cancer and lower odds of colorectal cancer in migrants. Measures should be implemented to enhance the access of migrants to prevention, early diagnosis and care for cancer. These interventions should account for the migrant's country of origin. Particular attention should be given to HPV vaccination, cervical cancer screening and tobacco control to reduce the cancer burden in this population. Background: Migrants are a vulnerable and neglected population. We aimed at investigating cancer proportionate rates in migrants in Sicily, Southern Italy. Methods: We extracted data on new cancer cases diagnosed between 2004 and 2019 from the Eastern Sicily cancer registry. We compared the adjusted proportionate morbidity ratio (PMR) for the most common cancer types among migrants and non-migrants. We fitted multivariate logistic regression models comparing one cancer to all other cancers to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for migration status. The analysis was stratified by region of origin. Results: Overall, 4726 new cancer cases occurred in migrants between 2004 and 2019, 63.5% of those among women and 224,211 in non-migrants, including 54.5% among men, with odds for migrants/non-migrants of 2.1%. Migrants had an increased proportion of cervical (PMR = 2.68, 95% CI = 2.29–3.10) and lung cancer (PMR = 1.20, 95% CI = 1.07–1.33). The highest OR in migrants was observed for cervical cancer (OR = 3.54, 95% CI = 2.99–4.20). Colorectal cancer was decreased among migrants (OR = 0.86, 95% CI = 0.77–0.96). Conclusions: Migrants to Sicily have higher odds of cervical cancer and a decreased risk of colorectal cancer compared to non-migrants. Increased odds were also detected for lung cancer, in particular in women. Different cancer patterns could be observed based on the region of origin. HPV-related cancers need targeted attention in migrants living in Sicily. [ABSTRACT FROM AUTHOR]

Background: Long‐term Helicobacter pylori infection increases the risk of gastric malignancies. Since the symptoms for H. pylori gastritis, as well as for several malignancies, may be nonexisting or highly unspecific, even H. pylori‐positive subjects with underlying malignancies may receive eradication therapy. The aim was to assess the incidence of gastrointestinal and various other malignancies in individuals after eradication therapy for H. pylori infection. Materials and Methods: A cohort of 217,554 subjects (120,344 women and 97,210 men), who had purchased specific combinations of drugs for H. pylori eradication therapy in 1994–2004, was identified by the Finnish National Prescription Registry and followed for cancer incidence until the end of 2008 (1.89 million person‐years at risk). Results: A total of 22,398 malignancies were identified in the cohort. In both genders, for the first 6 months after drug prescription, the standardized incidence ratios (SIRs) were between 5 and 32 for gastric, colorectal, and pancreatic cancers, and 2 and 3 for several other malignancies. Although later on the SIRs of most malignancies fell rapidly, those of gastric noncardia and lung cancers remained elevated up to 5 years of follow‐up. The only SIRs below unity were seen in men for gastric cancers (cardia 0.61, 95% CI: 0.37–0.95; intestinal noncardia 0.74, 95% CI: 0.56–0.97) during the post‐therapy period covering years 5–15. Conclusion: Incidence levels significantly above the population rates were detected for many malignancies. Although eradication of H. pylori may have a long‐lasting protective effect against gastric cancer, H. pylori therapy may postpone the detection of malignancies possibly underlying unspecific gastrointestinal symptoms. Therefore, it should be emphasized that the diagnostic work‐up for malignancies should not be stopped in case of detection and treatment of H. pylori infection. [ABSTRACT FROM AUTHOR]

In the 1990s, the large-scale collaboration Kreftbildet i Norden (KIN) drew attention to the need for timely cancer statistics for cancer control planning in the Nordic countries. Supported by the Nordic Cancer Union (NCU), a web-based version of NORDCAN was continually developed by the Association of Nordic Cancer Registries (ANCR) from 2003, with website support and hosting by the International Agency for Research on Cancer (IARC). Despite empirical evidence of its global reach, the question of whether recurrent investment in NORDCAN brings added value was raised; we sought to formally assess this. Scientific value was determined by extracting publications citing NORDCAN from PubMed. We compared the funds allocated to the KIN project and later Nordic studies on cancer predictions and survival, with those allocated to NORDCAN. 96 publications in 43 journals were retrieved. Two publication peaks, in 2010 and in 2016 relate to Nordic cancer survival and Danish age care projects, respectively. Papers citing NORDCAN increased substantially from 4 published in 2017 to the 24 papers in 2022. The integration of survival and prediction projects into NORDCAN reduced the costs of investment to one-quarter of the those required in earlier years, in real terms. User statistics and scientific output clearly points to NORDCAN bringing added value given resources expended, even with the additional costs imposed to ensure GDPR compliance. Research funding indicates that the databases and interactive tools are critical as both research and education resources. Nonetheless, a sustainable funding model is needed if NORDCAN is to continue to fulfill its utility in cancer control, health care planning and cancer research. [ABSTRACT FROM AUTHOR]

For statistical inference on regression models with a diverging number of covariates, the existing literature typically makes sparsity assumptions on the inverse of the Fisher information matrix. Such assumptions, however, are often violated under Cox proportion hazards models, leading to biased estimates with under‐coverage confidence intervals. We propose a modified debiased lasso method, which solves a series of quadratic programming problems to approximate the inverse information matrix without posing sparse matrix assumptions. We establish asymptotic results for the estimated regression coefficients when the dimension of covariates diverges with the sample size. As demonstrated by extensive simulations, our proposed method provides consistent estimates and confidence intervals with nominal coverage probabilities. The utility of the method is further demonstrated by assessing the effects of genetic markers on patients' overall survival with the Boston Lung Cancer Survival Cohort, a large‐scale epidemiology study investigating mechanisms underlying the lung cancer. [ABSTRACT FROM AUTHOR]

Aim: Appendiceal neoplasms are rare subtypes of colorectal tumours that mainly affect younger patients some 20 years earlier than other colon tumours. The aim of this study was to gain more insight into the histological subtypes of this rare disease and include cases previously excluded, such as mucinous neoplasia. Method: The cohort study included 1097 patients from the Munich Cancer Registry (MCR) diagnosed between 1998 and 2020. Joinpoint analysis was used to determine trend in incidence. Baseline demographic comparisons and survival analyses using competing risk and univariate/multivariate methods were conducted according to tumour histology: adenocarcinoma (ADENO), neuroendocrine neoplasia (NEN), mixed adeno‐neuroendocrine carcinoma (MANEC), and low‐ (LAMN) and high‐grade mucinous neoplasia (HAMN). Results: Up to 2016 the number of cases increased significantly [annual per cent change (APC) = 6.86, p < 0.001] followed by a decline in the following years (APC = −14.82, p = 0.014; average APC = 2.5, p = 0.046). Comparison of all patients showed that NEN (48.4%) and mucinous neoplasms (11.6%) had a considerably better prognosis than ADENO (36.0%) and MANEC (3.0%, p < 0.0001). A multivariate analysis within the NEN and ADENO subgroups revealed that further histological classification was not prognostically relevant, while older age and regional tumour spread at diagnosis were associated with a poor prognosis. ADENO histology with high tumour grade and appendectomy only was also associated with poorer survival. Conclusion: Appendiceal neoplasms are histologically heterogeneous; however, this diversity becomes less relevant compared with the marked difference from cancers of the remaining colon. The previously observed increase in cases appears to be abating; fewer cases of appendicitis and/or appendectomies or changes in histopathological assessment may be behind this trend. [ABSTRACT FROM AUTHOR]

To facilitate high-quality register-based research on colorectal cancer (CRC) in Sweden by constructing a database consisting of CRC patients, matched comparators, and relatives. Patients with adenocarcinoma in the colon and/or rectum were identified in the Swedish Colorectal Cancer Register, a nationwide quality-of-care register. For each patient, six comparators from the general population were matched on birth year, sex, year of CRC diagnosis, and county. Comparators were free from CRC at the time of matching, but could later become cases. For both patients and comparators, first-degree relatives (parents, siblings, and children) were identified. Information from nationwide population-based registers was retrieved and linked to each individual in the database using the personal identification number unique to all Swedish residents. A total of 76,831 CRC patients diagnosed between 1995 and 2016 were identified (51% colon, 49% rectal; before 2007 only rectal cancer patients were included). Among all patients, 37% were stage I–II, 22% stage III, and 22% stage IV. The median follow-up time was 11.9 years (inter-quartile range, IQR: 8.6–15.3). Together with comparators and relatives, the database contains 2,413,139 individuals with information on demographics, dates and causes of death, in- and outpatient healthcare records, cancer diagnoses, prescribed and dispensed drugs, childbirths (among women), and social security information (such as sick leave and early retirement). The Colorectal Cancer Database Sweden (CRCBaSe) is a large and unique register-based data research platform, which opens up for clinically important, large epidemiological studies with innovative design in the field of colorectal adenocarcinoma. [ABSTRACT FROM AUTHOR]

Simple Summary: In this analysis, we look at the number of new breast, lung, colorectal and prostate cancer diagnoses among women who have sex with women and men who have sex with men. In order to do this, we used data from UK Biobank, which is a research database that contains in-depth health information from approximately half a million people in the UK. We found no differences in the number of new cases for breast, prostate and colorectal cancer, but we did find that sexual minority adults have a higher risk for lung cancer, due to greater exposure to smoking. Background. There is limited evidence about cancer incidence for lesbian, gay and bisexual women and men, although the prevalence of cancer risk factors may be higher. Aim. To describe cancer incidence for four common cancers (breast, lung, colorectal and prostate). Methods. This project used UK Biobank participant data. We explored risk factor prevalence (age, deprivation, ethnicity, smoking, alcohol intake, obesity, parity, and sexual history), and calculated cancer risk, for six groups defined based on sexual history; women who have sex exclusively with men (WSEM), or women (WSEW), women who have sex with men and women (WSWM); men who have sex exclusively with women (MSEW), or men (MSEM), and men who have sex with women and men (MSWM). Results. WSEW, WSWM, MSEM, and MSMW were younger, more likely to smoke, and to live in more deprived neighbourhoods. We found no evidence of an association between sexual history and breast, colorectal, or prostate cancer in age-adjusted models. Lung cancer incidence was higher for WSWM compared with WSEM, HR (95%CI) 1.78 (1.28–2.48), p = 0.0005, and MSWM compared with MSEW, 1.43 (1.03–1.99), p = 0.031; after adjustment for smoking, this difference was no longer significant. Conclusions. Sexual minority groups have a higher risk for lung cancer, due to greater exposure to smoking. [ABSTRACT FROM AUTHOR]

Simple Summary: Efficient health interventions in individual populations should be based on evidence-based data. Our study provides new insights on melanoma (except primary uveal melanoma) mortality trends in European Union (EU) countries, as well as in three non-EU countries, from a wide-time perspective (1960–2020), by sex and age groups. To the best knowledge, our study is the most up-to-date and broad analysis of melanoma mortality in Europe. It can be used as a reference for public-health actions aiming at a national and international melanoma-mortality reduction. Investigated melanoma-mortality trends vary in individual countries and age groups; however, a highly concerning phenomenon—an increasing melanoma mortality in both sexes—was observed in the case of 7 countries for the younger age group and 26 countries for the older one. There is a need for coordinated systemic actions to address this issue. Background: In 2020, in 27 European Union (EU) Member States, melanoma accounted for 4% of all new cancer cases and 1.3% of all cancer deaths, making melanoma the fifth most common malignancy and placing it in the 15 most frequent causes of cancer deaths in the EU-27. The main aim of our study was to investigate melanoma mortality trends in 25 EU Member States and three non-EU countries (Norway, Russia, and Switzerland) in a broad time perspective (1960–2020) in a younger (45–74 years old) vs. older age group (75+). Methods: We identified melanoma deaths defined by ICD-10 codes C-43 for individuals aged 45–74 and 75+ years old between 1960–2020 in 25 EU Member States (excluding Iceland, Luxembourg, and Malta) and in 3 non-EU countries—Norway, Russia, and Switzerland. Age-standardized melanoma mortality rates (ASR) were computed using the direct age-standardization for Segi's World Standard Population. To determine melanoma-mortality trends with 95% confidence intervals (CI), Joinpoint regression was applied. Our analysis used the Join-point Regression Program, version 4.3.1.0 (National Cancer Institute, Bethesda, MD, USA). Results: Regardless of the considered age groups, in all investigated countries, in general, melanoma standardized mortality rates were higher for men than women. Considering the age group 45–74, the highest number of countries was characterized by decreasing melanoma-mortality trends in both sexes—14 countries. Contrarily, the highest representation of countries in the age group 75+ was connected with increasing melanoma-mortality trends in both sexes—26 countries. Moreover, considering the older age group—75+—there was no country with a decreasing melanoma mortality in both sexes. Conclusions: Investigated melanoma-mortality trends vary in individual countries and age groups; however, a highly concerning phenomenon—increasing melanoma-mortality rates in both sexes—was observed in 7 countries for the younger age group and in as many as 26 countries for the older age group. There is a need for coordinated public-health actions to address this issue. [ABSTRACT FROM AUTHOR]

Oncogerontology is a term that describes an interdisciplinary discipline dealing with the broadly understood relationship between oncology and human aging. The problems that pose a challenge for oncogerontology include, among others, the deteriorating cancer epidemiological situation, as well as the impact of the COVID pandemic on this situation, age restriction of screening tests in the elderly and the inequalities for older patients in accessing medical services and their participation in clinical trials. Data from the National Cancer Registry show an increase in the incidence and mortality of malignancies, especially in the elderly population. The epidemiological situation of cancer in Poland has been negatively affected by the COVID pandemic. New EU recommendations increase the number and quality of screening tests in the elderly. This group of patients has limited access to some oncological services and clinical trials. Artificial intelligence is an opportunity to improve diagnostics, therapy and oncology care in older patients. [ABSTRACT FROM AUTHOR]

Gingivobuccal and oral tongue squamous cell carcinomas are commonly considered together as a single clinical entity for staging and treatment purposes. Though there is data suggesting a significant difference between SCC of various oral cavity subsites, very few studies have compared clinicopathological characteristics between the tongue and gingivobuccal primaries. We retrospectively analysed 225 patients with biopsy-proven gingivobuccal (GB) and oral tongue (OT) SCC operated between April 1, 2018 and April 30, 2021 in All India Institute of Medical Sciences, Rishikesh, India to compare their clinicopathological characteristics. Demographic, clinical and histopathological data were collected from electronic medical records. An independent sample t-test was used to compare means and Pearson chi-square test or Fisher exact test was applied to compare the distribution of categorical variables. A relative male preponderance (12:1 vs. 5:1, p = 0.036) and increased smokeless tobacco consumption (82% Vs. 69%, p = 0.003) was seen in GB-SCC. Significantly higher proportion of patients with OT-SCC presented with early primaries (T1/T2) (54.1% vs. 24.8%, p < 0.001). Similarly, a higher proportion of GB-SCC patients presented with palpable neck nodes (cN +) (81% Vs. 67%, p = 0.02). Due to early primary tumours at presentation, stage I/II disease was also significantly higher in cases of OT-SCC (36.5% Vs.13.7%, p < 0.001). No difference was noticed in age at presentation, neck node status, and other clinicopathological parameters. GB-SCC has a higher male preponderance than OT-SCC due to relatively higher consumption of smokeless tobacco in males. Oral tongue cancers presented at an earlier stage than gingivobuccal malignancies. No difference in neck node status, however, suggests a relatively aggressive disease behaviour and early regional metastasis in tongue cancers. Follow up data regarding recurrence and survival is required to further characterise the differences between these two common OSCC subsites. [ABSTRACT FROM AUTHOR]

This population-based study is the first to provide a detailed analysis of trends in incidence and survival of children and adolescents diagnosed with renal malignancies in the Netherlands. Data on all renal malignancies diagnosed in paediatric patients (0–18 years) between 1990 and 2014 [N = 648, 92% Wilms tumour (WT)] were extracted from the Netherlands Cancer Registry. Five-year overall survival (OS) was estimated using the actuarial method. Time trends in incidence were assessed by calculating average annual percentage change. A parametric survival model was used to compare the multivariable-adjusted risk of dying from WT between two diagnostic periods. The incidence was 8 per million person-years and was constant over time (average annual percentage change -0.8%, p = 0.29). Patients with WT had a favourable outcome in both time periods; 5-year OS was 88% in 1990–2001 and 91% in 2002–2014. Multivariable analysis showed that the risk of dying from WT was not significantly decreased in the latest period (hazard ratio, 95% CI: 0.7, 0.4–1.3). Five-year OS decreased with increasing disease stage, ranging from 95 to 100% for stage I-II and about 80% for stage III–IV to 74% for bilateral disease. Five-year OS were 81% for renal cell carcinoma, 77% for clear cell sarcoma of the kidney and 20% for malignant rhabdoid tumour of the kidney. Incidence of paediatric renal malignancies in the Netherlands has been stable since the 1990s. Five-year OS of WT reached 91% and was similar to findings for other developed countries. Contrary to the excellent outcome for WT, the outcome of malignant rhabdoid tumour of the kidney remained inferior. • The incidence of paediatric renal tumours in the Netherlands was stable between 1990 and 2014. • 5-year OS of Wilms tumour reached 91% and was similar to rates in other developed countries. • 5-year OS were 81% for renal cell carcinoma, 77% for clear cell sarcoma of the kidney and 20% for malignant rhabdoid tumour of the kidney. • Particular attention should be paid to adverse prognostic subgroups, especially malignant rhabdoid tumour of the kidney. [ABSTRACT FROM AUTHOR]

Purpose: We quantified the contributions of prognostic factors to socioeconomic disparities in colorectal cancer survival in a large Australian cohort. Methods: The sample comprised 45 and Up Study participants (recruited 2006–2009) who were subsequently diagnosed with colorectal cancer. Both individual (education attained) and neighbourhood socioeconomic measures were used. Questionnaire responses were linked with cancer registrations (to December 2013), records for hospital inpatient stays, emergency department presentations, death information (to December 2015), and Medicare and Pharmaceutical Benefits claims for subsidised procedures and medicines. Proportions of socioeconomic survival differences explained by prognostic factors were quantified using multiple Cox proportional hazards regression. Results: 1720 eligible participants were diagnosed with colorectal cancer after recruitment: 1174 colon and 546 rectal cancers. Significant colon cancer survival differences were only observed for neighbourhood socioeconomic measure (p = 0.033): HR = 1.55; 95% CI 1.09–2.19 for lowest versus highest quartile, and disease-related factors explained 95% of this difference. For rectal cancer, patient- and disease-related factors were the main drivers of neighbourhood survival differences (28–36%), while these factors and treatment-related factors explained 24–41% of individual socioeconomic differences. However, differences remained significant for rectal cancer after adjusting for all these factors. Conclusion: In this large contemporary Australian cohort, we identified several drivers of socioeconomic disparities in colorectal cancer survival. Understanding of the role these contributors play remains incomplete, but these findings suggest that improving access to optimal care may significantly reduce these survival disparities. [ABSTRACT FROM AUTHOR]

Background: In China, colorectal cancer (CRC) incidence and mortality have been steadily increasing over the last decades. Risk models to predict incident CRC have been developed in various populations, but they have not been systematically externally validated in a Chinese population.  This study aimed to assess the performance of risk scores in predicting CRC using the China Kadoorie Biobank (CKB), one of the largest and geographically diverse prospective cohort studies in China.Methods: Nine models were externally validated in 512,415 participants in CKB and included 2976 cases of CRC. Model discrimination was assessed, overall and by sex, age, site, and geographic location, using the area under the receiver operating characteristic curve (AUC). Model discrimination of these nine models was compared to a model using age alone. Calibration was assessed for five models, and they were re-calibrated in CKB.Results: The three models with the highest discrimination (Ma (Cox model) AUC 0.70 [95% CI 0.69-0.71]; Aleksandrova 0.70 [0.69-0.71]; Hong 0.69 [0.67-0.71]) included the variables age, smoking, and alcohol. These models performed significantly better than using a model based on age alone (AUC of 0.65 [95% CI 0.64-0.66]). Model discrimination was generally higher in younger participants, males, urban environments, and for colon cancer. The two models (Guo and Chen) developed in Chinese populations did not perform better than the others. Among the 10% of participants with the highest risk, the three best performing models identified 24-26% of participants that went on to develop CRC.Conclusions: Several risk models based on easily obtainable demographic and modifiable lifestyle factor have good discrimination in a Chinese population. The three best performing models have a higher discrimination than using a model based on age alone. [ABSTRACT FROM AUTHOR]

Simple Summary: Worldwide, prostate cancer (PC) causes high morbidity and mortality. Thus, developing effective strategies for the prevention, diagnosis, and control of this disease is fundamental to providing updated and reliable estimations of the PC burden both nationally and subnationally. Herein, we analyzed data from the Global Burden of Disease study to estimate PC incidence and mortality, and their trends in Mexico at the national and subnational levels from 2000 to 2019. Our results show that PC was the top ranked cause of death among malign neoplasms in males from Mexico during 2019. Males from 70 to 79 years of age were the most affected by PC, and there was an increasing trend in the burden of this cancer. There was substantial subnational heterogeneity that suggested differential geographical patterns of change. These results provide both comprehensive and comparable estimates to assist the effort to reduce health loss due to PC. In 2019, the Global Burden of Disease (GBD) estimated that prostate cancer (PC) was the 16th most common cause of death globally in males. In Mexico, PC epidemiology has been studied by a number of metrics and over various periods, although without including the most up-to-date estimates. Herein, we describe and compare the burdens and trends of PC in Mexico and its 32 states from 2000 to 2019. For this study, we extracted online available data from the GBD 2019 to estimate the crude and age-standardized rates (ASR per 100,000 people) of the incidence and mortality of PC. In Mexico, PC caused 27.1 thousand (95% uncertainty intervals, 20.6–36.0 thousand) incident cases and 9.2 thousand (7.7–12.7 thousand) deaths in males of all ages in 2019. Among the states, Sinaloa had the greatest ASR of incidence, and Guerrero had the highest mortality. The burden of PC showed an increasing trend, although the magnitude of change differed between metrics and locations. We found both an increasing national trend and subnational variation in the burden of PC. Our results confirm the need for updated and timely estimates to design effective diagnostic and treatment campaigns in locations where the burden of PC is the highest. [ABSTRACT FROM AUTHOR]

The founding of the National Cancer Institute in 1937 was attended by the formation of the National Advisory Council on Cancer. A seminal action by this Council was the funding of the First National Cancer Survey, the first population-based cancer surveillance activity of the federal government. Francis Carter Wood, distinguished cancer researcher and editor of the American Journal of Cancer (predecessor to Cancer Research), was a member of that Council, through which he was a prime mover in the funding of this survey. This action reflected Wood's commitment to population-based cancer surveillance, voiced over more than two decades. Such commitment reflected his view that only such data could identify the optimal treatment modality for cancer patients. The implications of this view, with epidemiologic data providing insights on treatment rather than prevention of disease, as the basis for the development of cancer epidemiology are then considered. [ABSTRACT FROM AUTHOR]

• Early mortality after radical RT/CRT in HNSCC patients is often not cancer-related. • An early non-cancer risk prediction model was developed. • After internal validation, the AUC was 0.74 and calibration was good. • Pneumonia was estimated to be the cause of death in 32% of early non-cancer deaths. • The provided risk estimates can help select patients for supportive interventions. In patients with head and neck squamous cell carcinoma (HNSCC), curative-intent radiotherapy (RT) and chemoradiotherapy (CRT) are associated with substantial acute morbidity and 5–10% of patients die within 180 days of treatment initiation. Most of these early deaths occur without HNSCC recurrence or progression and may therefore be preventable to some extent. We developed a prediction tool to estimate the risk of non-HNSCC mortality occurring within the first 180 days following RT/CRT initiation. Patients with HNSCC treated with RT/CRT, including postoperative RT/CRT, at Rigshospitalet or Herlev Hospitals between 2010–2017 were identified in the Danish Head and Neck Cancer Group (DAHANCA) database. Predictor variables included age, stage, performance status, tumor subsite including p16 status, comorbidity, postoperative status, smoking and pre-treatment albumin levels. The 180-day non-HNSCC mortality risk was estimated by combining cause-specific Cox regression models. We included 2209 patients. The 180-day non-HNSCC mortality rate was 4.4% and almost one third (31.6%) of non-HNSCC deaths were caused by pneumonia. After internal model validation, the area under the receiver operating curve was 0.74 (95% CI: 0.66–0.81) and calibration was good for risk predictions ranging from 0% to 20%. We developed a prediction tool to estimate the 180-day non-HNSCC mortality risk. This tool can be used to select high-risk patients for supportive interventions aiming to improve survival rates, and is available for interactive use at https://emriskpred.shinyapps.io/EMNED_App/. [ABSTRACT FROM AUTHOR]

Background: Childhood and young adult survivors of Hodgkin lymphoma (HL) are at elevated risk of developing breast cancer, yet little data exist on the tumor characteristics that develop in this high‐risk patient population. Methods: The National Cancer Institute's Surveillance, Epidemiology, and End Results database was used to identify breast cancers diagnosed between 1990 and 2016 in women who had received prior radiation therapy for HL at age 30 years or younger. Clinicopathologic features of subsequent breast cancers (breast cancer after radiation therapy for HL [BC‐HL]) were examined and compared with breast cancers diagnosed in women who had no prior malignancy (breast cancer with no prior malignancy [BC‐NPM]). Results: In total, 321 breast cancers were identified in 257 women who had a history of radiation therapy for HL. The median age at HL diagnosis was 22 years (interquartile range, 18‐26 years), and nearly all patients in the BC‐HL group (97.9%) were diagnosed ≥8 years after radiation therapy. Overall, 56 patients in the BC‐HL group (21.8%) developed bilateral breast cancer. Compared with women who had BC‐NPM, those who had BC‐HL were younger (43 vs 60 years; P <.001) and were less likely to present with ductal carcinoma in situ (8.4% vs 14.9%; P =.001). On multivariable analysis that included adjustment for age, invasive BC‐HL was associated with smaller (≤2 cm) tumor size (odds ratio, 1.64; 95% CI, 1.25‐2.15) and upper outer quadrant tumors (odds ratio, 1.37; 95% CI, 1.04‐1.81) compared with BC‐NPM. In a subset analysis of 102 women who had HER2/neu status available, the distribution of biologic subtype was not significantly different between BC‐HL and BC‐NPM (P =.16). Conclusions: Breast cancers in women who previously received radiation therapy for HL are characterized by earlier onset disease, although most remain estrogen receptor‐positive and have early stage disease at presentation. Lay Summary: Women who have had radiation therapy for Hodgkin lymphoma at a young age are at increased risk of developing early onset breast cancer; however, most of these breast cancers are sensitive to hormones (estrogen receptor‐positive) and are diagnosed at early stages.Because these breast tumors are estrogen receptor‐positive, medications that prevent breast cancer by blocking the effect of or lowering hormone levels (also termed endocrine prevention) may be useful in this group of high‐risk women. Breast cancers in women who have received radiation therapy for Hodgkin lymphoma are characterized by younger age at diagnosis, although the majority are estrogen receptor‐positive/HER2‐negative tumors and are early stage at presentation. Based on the characteristics of tumors that develop in Hodgkin lymphoma survivors, this population represents suitable candidates for trials exploring endocrine prevention. [ABSTRACT FROM AUTHOR]

Breast cancer is a common malignancy and a common cause of cancer-related mortality in women. Pre-treatment workup of breast cancer does not routinely include positron emission tomography scans. We aimed to review cases of women with breast cancer and a synchronous second primary malignancy. We present three cases of women with non-metastatic cancer in whom a synchronous second primary malignancy was found. Synchronous, second primary malignancies which were identified included rectal cancer, gastrointestinal stromal tumor, and non-small cell lung cancer. All second primary malignancies were identified by a PET-CT scan. In conclusion, PET-CT may be used for detection of secondary primary malignancies in select breast cancer patients. [ABSTRACT FROM AUTHOR]

With epidemiologic analyses of population-based trends in incidence and outcomes, we ascertained progress against non-Hodgkin's lymphoma (NHL) in children and young adolescents in the Netherlands since 1990. Tumour characteristics were extracted from the Netherlands Cancer Registry for patients aged <18 years at diagnosis, between 1990 and 2015. Mortality data for 1980–2016 were derived from Statistics Netherlands. NHL subtypes comprised lymphoblastic lymphoma (LBL), Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL) and anaplastic large cell lymphoma (ALCL). Time trends in incidence and mortality rates and 5-year overall survival (OS) rates were evaluated by average annual percentage change (AAPC) analyses and parametric survival models, respectively. Overall incidence of NHL remained stable at 11 per million person-years (AAPC -0.2%, p = 0.68), with a marked decrease among children of 5–9 years (AAPC -2.6%, p < 0.01), especially among those with BL. Treatment regimens comprised less radiotherapy over time, especially for LBL and BL. Since 2004, most 15–17-year-old patients with NHL have been treated at a paediatric oncology centre. Five-year OS improved from 71% in 1990–94 to 87% in 2010–15 (p < 0.01), the most gain has been achieved in patients with DLBCL and ALCL from 60% and 73%, respectively, to both 90%. Population-based mortality from NHL decreased significantly towards 1.4 per million person-years (AAPC -4.2%, p < 0.01). This population-based epidemiological study exhibited significant progress against childhood and young adolescent NHL in the Netherlands since 1990, before the advent of a national paediatric oncologic centre in 2018: incidence decreased among children of 5–9 years, survival improved, and mortality steadily decreased over time. • Incidence of non-Hodgkin's lymphoma remained stable at 11 per million person-years. • Radiotherapy combined with chemotherapy decreased in favour of chemotherapy only. • Five-year overall survival improved from 71% in early 90's to 87% in 2010–15. • Mortality decreased by 4% per year towards 1.4 per million person-years. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the use of artificial intelligence and machine learning techniques for biomedical informatics, security and privacy concerns over the data and subject identities have also become an important issue and essential research topic. Without intentional safeguards, machine learning models may find patterns and features to improve task performance that are associated with private personal information. OBJECTIVE: The privacy vulnerability of deep learning models for information extraction from medical textural contents needs to be quantified since the models are exposed to private health information and personally identifiable information. The objective of the study is to quantify the privacy vulnerability of the deep learning models for natural language processing and explore a proper way of securing patients' information to mitigate confidentiality breaches. METHODS: The target model is the multitask convolutional neural network for information extraction from cancer pathology reports, where the data for training the model are from multiple state population-based cancer registries. This study proposes the following schemes to collect vocabularies from the cancer pathology reports; (a) words appearing in multiple registries, and (b) words that have higher mutual information. We performed membership inference attacks on the models in high-performance computing environments. RESULTS: The comparison outcomes suggest that the proposed vocabulary selection methods resulted in lower privacy vulnerability while maintaining the same level of clinical task performance. [ABSTRACT FROM AUTHOR]

Deaths from liver cancer are on the rise and disproportionately affect minority racial/ethnic groups. In this study, we examined associations between physicians’ recommendations for hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and sociodemographic and lifestyle factors among minority populations in the areas of Greater Philadelphia and New York City. Using Poisson regression with robust variance estimation, we evaluated potential associations for 576 Hispanic American (HA), African American (AA), and Asian Pacific American (APA) adults, using blood tests as an outcome measure, with adjustment for sociodemographic factors We found that APAs (34.2%) were most likely to have a physician recommend HBV and HCV screening tests (34.2% and 27.1%, respectively), while HAs were least likely to receive an HBV recommendation (15.0%) and AAs were least likely to receive an HCV recommendation (15.3%). HAs were significantly likely to have never received a blood test for either HBV or HCV (RR = 1.25, 95% CI: 1.05, 1.49). APAs were significantly more likely to receive a screening recommendation for HBV (RR = 1.10, 95%CI: 1.01, 1.20) and to have a blood test (RR = 1.57, 95% CI: 1.06, 2.33). Our findings show that, among HAs, AAs, and APAs, physician recommendations are strongly associated with patients undergoing blood tests for HBV and HCV and that minority populations should increasingly be recommended to screen for HBV and HCV, especially given their elevated risk. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems have adopted different strategies to reduce the burden of cervical cancer. In Poland, a population-based screening program was implemented in 2006, leading to a downward trend in cervical cancer burden. However, screening rates are still low in relation to other EU member states. In Poland, Pap smears are mainly performed by gynecologists rather than Primary Health Care (PHC) physicians. Little is known about the experiences and attitudes of the latter regarding cervical cancer screening in a PHC setting. Methods: A cross-sectional questionnaire-based survey was carried out among 43 PHC physicians from the Malopolska region in Poland. Barriers and attitudes towards cytology in a PHC setting were evaluated. Results: Approximately 35% of surveyed physicians reported having experience in performing cytology. Almost 75% of PHC physicians lacked the necessary equipment in their office to perform the screening. None of the studied physicians performed Pap smears in their office at the time. The reasons included: shortage of competence (78.57%) and time (69.05%), the perception of Pap smears as a task for gynecologists (69.05%), the lack of financial incentives (61.90%), and the belief that their patients would be unwilling to undergo the test in their PHC physician's office (33.33%). More than three quarters (76.74%) declared they would be ready to perform Pap smears if the tests were additionally paid. No significant associations between PHC physicians' characteristics and their willingness to perform cytology screening were found. Conclusion: The primary barrier to perform Pap smears by PHC physicians does not lie in their personal reluctance but in the organization of the healthcare system. Provision of required training and proper funding allocation can likely improve the screening rate of cervical cancer in Poland. [ABSTRACT FROM AUTHOR]

Purpose: Cancer remains the most common cause of disease-related death among young people and carries a significant burden. In the absence of prior state-based Australian epidemiological studies, this retrospective cohort study reviewed all cases of invasive cancer diagnosed in Queensland children, adolescents, and young adults (AYAs) (0–39 years) from 1987 to 2016 using the Queensland Oncology Repository (QOR). Methods: Cancers were classified according to Surveillance, Epidemiology and End Results (SEER) AYA site recode. Age-standardized rates (ASRs) were calculated. JoinPoint regression examined trends in ASRs across three age cohorts, for three decades (1987–1996, 1997–2006, and 2007–2016). Results: In total, 3,576 children aged 0–14 years (ASR = 15.2/100,000), 6,441 aged 15–24 years (ASR = 39.3/100,000), and 29,923 (ASR = 122.6/100,000) aged 25–39 years were diagnosed. Incidence increased for female children, and leukemia was the most common diagnosis. For those 15–24 years, incidence increased initially before decreasing and was higher than other nationally reported rates. For those 25–39 years, incidence increased. For the older cohorts, the most common diagnosis was melanoma. All cohorts demonstrated a decline in mortality and improvement in 5-year relative survival, with those 0–14 years demonstrating the greatest gains. The lowest survival for all cohorts was associated with central nervous system tumors. Conclusion: These results highlight areas in need of further investigation to improve survival, reduce the burden of cancer for young people, and aid service delivery. Future studies should focus on cancer biology, early detection, barriers in access to clinical trials, innovative models of care, improved data collection, and patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Developing functional insight into the causal molecular drivers of immunological disease is a critical challenge in genomic medicine. Here, we systematically apply Mendelian randomization (MR), genetic colocalization, immune-cell-type enrichment, and phenome-wide association methods to investigate the effects of genetically predicted gene expression on ten immune-associated diseases and four cancer outcomes. Using whole blood-derived estimates for regulatory variants from the eQTLGen consortium (n = 31,684), we constructed genetic risk scores for 10,104 genes. Applying the inverse-variance-weighted MR method transcriptome wide while accounting for linkage disequilibrium structure identified 664 unique genes with evidence of a genetically predicted effect on at least one disease outcome (p < 4.81 × 10−5). We next undertook genetic colocalization to investigate cell-type-specific effects at these loci by using gene expression data derived from 18 types of immune cells. This highlighted many cell-type-dependent effects, such as PRKCQ expression and asthma risk (posterior probability = 0.998), which was T cell specific. Phenome-wide analyses on 311 complex traits and endpoints allowed us to explore shared genetic architecture and prioritize key drivers of disease risk, such as CASP10 , which provided evidence of an effect on seven cancer-related outcomes. Our atlas of results can be used to characterize known and novel loci in immune-associated disease and cancer susceptibility, both in terms of elucidating cell-type-dependent effects as well as dissecting shared disease pathways and pervasive pleiotropy. As an exemplar, we have highlighted several key findings in this study, although similar evaluations can be conducted via our interactive web platform. [ABSTRACT FROM AUTHOR]

This is the first national study on trends in cancer survival and mortality for children and young adolescents in the Netherlands including unique information on stage at diagnosis. All neoplasms in patients <18 years, diagnosed between 1990 and 2015 (N = 14,060), were derived from the Netherlands Cancer Registry. Cohort and period survival analyses were used to estimate observed survival (OS). Time trends in OS and mortality rates were evaluated by parametric survival models and average annual percentage change, respectively. Between 1990 and 2015, 5-year OS and 10-year OS of childhood and young adolescent cancer have improved significantly by 9 percent points, reaching 81% and 78%, respectively. Favourable trends in survival were observed for all age groups and most diagnostic (sub)groups, being particularly pronounced for advanced disease. Non-Hodgkin lymphomas Ann Arbor stage III, metastatic neuroblastomas (age ≥18 months) and Ewing bone sarcomas showed significant improvements in 5-year OS. Compared with 1990–99, the risk of dying within five years of diagnosis was decreased significantly during 2000–09 (hazard ratio [HR] = 0.8) and 2010–15 (HR = 0.6), after adjustment for age, gender and follow-up time. Nonetheless, the prognosis of young patients suffering from central nervous system tumours, neuroblastoma and osteosarcomas remained modest, with 5-year OS <70% and 10-year OS <65%. Childhood and young adolescent cancer mortality decreased by an average of 2.0% annually between 1990 and 2018. Significant progress has been realised in the prognosis of childhood and young adolescent cancer in the Netherlands since the 1990s. Survival improvements were especially evident for patients with advanced stages and were also reflected in the declining mortality rates. • Cancer survival of Dutch children and young adolescents has improved significantly. • In 2015, 5-year and 10-year observed survival were 81% and 78%, respectively. • Favourable survival trends were observed for all ages and most diagnostic groups. • Survival improvements were especially evident for patients with advanced stages. • The increase in survival was also reflected in declining mortality rates. [ABSTRACT FROM AUTHOR]

A focus of cancer epidemiologic research has become the identification of risk factors that influence specific subtypes of disease, a phenomenon known as etiologic heterogeneity. In previous work we developed a novel strategy to cluster tumor markers and identify disease subtypes that differ maximally with respect to known risk factors for use in the context of case-control studies. The method relies on the premise that unsupervised k -means clustering will find candidate solutions that are closely aligned with the sought-after etiologically distinct clusters, which may not be true in the presence of clusters of tumor markers that are not related to risk of disease. In this article, we investigate in detail the ability of the method to identify the "true" clusters in the presence of clusters that are unrelated to risk factors, what we term "counterfeit" clusters. We find that our method works when the strength of structure is larger in the clusters that truly represent etiologic heterogeneity than in the counterfeit clusters, but when this condition is not met, or when there are many tumor markers that simply represent noise, the method will not find the correct solution without first performing variable selection to identify the tumor markers most strongly related to the risk factors. We illustrate the results using data from a breast cancer case-control study. [ABSTRACT FROM AUTHOR]

Aim: Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims to describe the prevalence and patterns of having one (comorbidity) or ≥ 2 chronic diseases (multimorbidity) among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and short-term mortality risk at six months after cancer diagnosis.Methods: In this population-based cohort study, data were drawn from two Spanish population-based cancer registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients, diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex, smoking status, province of residence, surgery, cancer stage, histology, and body mass index.Results: We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men, those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities were chronic obstructive pulmonary disease (36.6%), diabetes (20.7%) and heart failure (16.8%). The strongest pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40% higher overall mortality risk than those without comorbidities (aHR for comorbidity: 1.4, 95%CI: 1.1-1.7; aHR for multimorbidity: 1.4, 95%CI: 1.1-1.8), when relevant confounding factors were considered.Conclusions: The presence of comorbid diseases, rather than the number of comorbidities, was associated with increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients with one or more comorbidities in Spain. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a heterogeneous disease, divided into subtypes based on the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Subtypes have different biology and prognosis, with accumulating evidence of different risk factors. The purpose of this study was to compare breast cancer risk factors across tumor subtypes in a large, diverse mammography population. Methods: Women aged 40–84 without a history of breast cancer with a screening mammogram at three United States health systems from 2006 to 2015 were included. Risk factor questionnaires were completed at mammogram visit, supplemented by electronic health records. Invasive tumor subtype was defined by immunohistochemistry as ER/PR+HER2−, ER/PR+HER2+, ER, and PR−HER2+, or triple‐negative breast cancer (TNBC). Cox proportional hazards models were run for each subtype. Associations of race, reproductive history, prior breast problems, family history, breast density, and body mass index (BMI) were assessed. The association of tumor subtypes with screen detection and interval cancer was assessed using logistic regression among invasive cases. Results: The study population included 198,278 women with a median of 6.5 years of follow‐up (IQR 4.2–9.0 years). There were 4002 invasive cancers, including 3077 (77%) ER/PR+HER2−, 300 (8%) TNBC, 342 (9%) ER/PR+HER2+, and 126 (3%) ER/PR−HER2+ subtype. In multivariate models, Black women had 2.7 times higher risk of TNBC than white women (HR = 2.67, 95% CI 1.99–3.58). Breast density was associated with increased risk of all subtypes. BMI was more strongly associated with ER/PR+HER2− and HER2+ subtypes among postmenopausal women than premenopausal women. Breast density was more strongly associated with ER/PR+HER2− and TNBC among premenopausal than postmenopausal women. TNBC was more likely to be interval cancer than other subtypes. Conclusions: These results have implications for risk assessment and understanding of the etiology of breast cancer subtypes. More research is needed to determine what factors explain the higher risk of TNBC for Black women. [ABSTRACT FROM AUTHOR]

Background: Pre-existing conditions interfere with cancer diagnosis by offering diagnostic alternatives, competing for clinical attention or through patient surveillance.Objective: To investigate associations between oesophagogastric cancer stage and pre-existing conditions.Methods: Retrospective cohort study using Clinical Practice Research Datalink (CPRD) data, with English cancer registry linkage. Participants aged ≥40 years had consulted primary care in the year before their incident diagnosis of oesophagogastric cancer in 01/01/2010-31/12/2015. CPRD records pre-diagnosis were searched for codes denoting clinical features of oesophagogastric cancer and for pre-existing conditions, including those providing plausible diagnostic alternatives for those features. Logistic regression analysed associations between stage and multimorbidity (≥2 conditions; reference category: no multimorbidity) and having 'diagnostic alternative(s)', controlling for age, sex, deprivation and cancer site.Results: Of 2444 participants provided, 695 (28%) were excluded for missing stage, leaving 1749 for analysis (1265/1749, 72.3% had advanced-stage disease). Multimorbidity was associated with stage [odds ratio 0.63, 95% confidence interval (CI) 0.47-0.85, P = 0.002], with moderate evidence of an interaction term with sex (1.76, 1.08-2.86, P = 0.024). There was no association between alternative explanations and stage (odds ratio 1.18, 95% CI 0.87-1.60, P = 0.278).Conclusions: In men, multimorbidity is associated with a reduced chance of advanced-stage oesophagogastric cancer, to levels seen collectively for women. [ABSTRACT FROM AUTHOR]

To estimate overall survival, disease-specific survival, and progression-free survival among high grade endometrial carcinoma cases and to determine factors impacting survival for non-Hispanic white and non-Hispanic black women. We identified high grade endometrial carcinoma cases among non-Hispanic white and non-Hispanic black women from ongoing institutional studies, and determined eligibility through medical record and pathologic review. We estimated effects of demographic and clinical variables on survival outcomes using Kaplan Meier methods and Cox proportional hazards modelling. Non-Hispanic Black women with BMI <25.0 had poorest overall survival compared to non-Hispanic white women with BMI <25.0 (HR 3.03; 95% CI [1.35, 6.81]), followed by non-Hispanic black women with BMI 25.0+ (HR 2.43; 95% CI [1.28, 4.60]). A similar pattern emerged for disease-specific survival. Non-Hispanic black women also had poorer progression-free survival than non-Hispanic white women (HR 1.40; 95% CI [1.01, 1.93]). Other significant factors impacting survival outcomes included receipt of National Cancer Center Network (NCCN) guideline-concordant treatment (GCT), earlier stage at diagnosis, and fewer comorbid conditions. BMI and race interact and modify the association with high grade endometrial carcinoma survival. Other potentially modifiable factors, such as reducing comorbidities and increasing access to GCT will potentially improve survival after diagnosis of high grade endometrial carcinomas. A better understanding of the molecular drivers of these high grade carcinomas may lead to targeted therapies that reduce morbidity and mortality associated with these aggressive tumors. • Race and body mass index interact in high grade endometrial carcinoma survival. • Comorbidities negatively impact high grade endometrial cancer survival. • Guideline-concordant treatment decreases hazard of endometrial carcinoma death. [ABSTRACT FROM AUTHOR]

Aim: Postoperative complications are believed to result in poorer long‐term oncological outcomes. The contribution of time to chemotherapy has not been analysed in detail. Our aim was to examine the association between postoperative complications and long‐term oncological outcomes and overall survival, and the influence of delay in chemotherapy on these outcomes. Method: The study was a nationwide register‐based observational study that included patients undergoing surgery for colorectal cancer and receiving adjuvant chemotherapy in Denmark between 2010 and 2015. Information regarding postoperative complications was obtained from the Danish Colorectal Cancer Group national clinical registry. A Cox regression model was used to estimate disease‐free survival, recurrence‐free survival and all‐cause mortality in patients surviving for 180 days or more after surgery. Results: A total of 4083 patients were included, of whom 690 had postoperative complications. Postoperative complications were associated with increased odds of delay to adjuvant chemotherapy (odds ratio 4.56, 95% CI 3.67–5.66, p < 0.0001). An unadjusted analysis revealed that patients with complications had poorer disease‐free survival and recurrence‐free survival and had increased all‐cause mortality. In multivariate analysis, postoperative complications were not associated with poorer disease‐free survival [hazard ratio (HR) 1.02, 95% CI 0.88–1.18, p = 0.80] recurrence‐free survival (HR 1.05, 95% CI 0.89–1.25, p = 0.56) or all‐cause mortality (HR 1.04, 95% CI 0.86–1.26, p = 0.67). Conclusion: This study showed no association between the occurrence of postoperative complications and long‐term prognosis when adjusting for time to adjuvant chemotherapy. [ABSTRACT FROM AUTHOR]

Aim: Colorectal cancer (CRC) is the third most common cancer in Australia, and survival after diagnosis of metastatic disease is improving. Our aim was to assess trends in epidemiology, treatment, molecular testing and survival in patients with metastatic CRC (mCRC). Methods: Clinical data from February 2013 to December 2018 was recorded in a prospective, observational, multicenter cohort study conducted in Queensland, Australia, examining clinical and molecular biomarkers in cases of mCRC. Results: A total of 159 patients who had metastasis diagnosed after February 2013 were included in survival analysis. Median age at diagnosis was 63.9 years, but 29% had early‐onset disease (diagnosis aged <50 years). Median overall survival was 2.5 years (95% confidence interval [CI], 2.2–3.0) for the 159 patients included in survival analysis. Independent factors correlated with poor prognosis included right‐sided primary tumor, neutrophil–lymphocyte ratio >5, increased alkaline phosphatase level (ALP) and an increasing number of sites of metastatic disease. In contrast, metastasectomy was associated with improved overall survival (adjusted HR = 0.29' 95% CI, 0.16–0.54), with similar survival between patients who had liver and non‐liver metastasectomy sites. Half (10/20) of the BRAF mutant CRC were also microsatellite unstable. The proportion of detected mutations amongst tested samples increased over time for Kirsten Rat Sarcoma (KRAS; OR [per year] = 1.19; 95% CI, 1.01–1.39). Concurrently, the methods of molecular genetics testing employed in routine clinical practice changed towards the adoption of next‐generation sequencing. Conclusions: Metastasectomy in mCRC may be beneficial regardless of the anatomical site of metastasis. The adoption of next‐generation sequencing techniques for molecular genetics testing coincided with a slightly increased rate of detection of KRAS and BRAF mutations, potentially reflecting greater test sensitivity. Further translational research is required in mCRC to define novel targets for treatment. [ABSTRACT FROM AUTHOR]

Traditional approaches and study design in cancer epidemiology have not been very successful in identifying and evaluating adequately the potential risk and/or protective factors associated with the disease. The main reasons for the failure are often due the small study sample size, and inadequate exposure information. In this paper, issues and approaches relevant to these two challenges are discussed. Multicentre study is proposed as a way to increase study size and to mitigate criticism about meta-analysis of independent studies. A multicentre study of large cohort or case-control studies also offer an exciting opportunity to study the contribution of epigenetic events that may be associated with lifestyle and environmental risk factors for human health. Optimizing methods for exposure assessment and how to reduce exposure to misclassification represent a difficult component in epidemiological studies. A potentially useful approach for improving exposure estimation is to rely on biomarkers of exposures. An example is provided to demonstrate how biomarkers of exposures could provide valuable information in addition to exposure measurements in traditional epidemiological studies. Finally, it is argued that risk assessment and the precautionary principle should not be viewed as conflicting paradigms but, rather, as a complementary approach for developing appropriate policies to address risks posed by exposure to carcinogens and a wide spectrum of other health hazards. [ABSTRACT FROM AUTHOR]

Background: Cancer incidence and mortality is increasing worldwide. In 2018, there were an estimated 18.1 million new cancer cases and 9.6 million cancer deaths. In Nigeria, it is estimated that 100,000 new cases occur annually, with a high case fatality ratio. The burden of cancer in Nigeria is significant, as the country still grapples with infectious diseases and has limited data on cancer epidemiology. Our study is descriptive using data from a hospital-based registry. Objectives: This retrospective study assesses the characteristics of patients that presented to a private cancer center in Lagos, Nigeria. We aimed to update knowledge on the current trends of cancer in Nigeria as exemplified by the experience of this cancer center and set a foundation for guiding future research and policy efforts in cancer screening, prevention, and control. Methods: The records of all the 548 oncology patients registered at the Lakeshore Cancer Center (LCC) cancer registry from January 2015 to June 2018 were reviewed for this study. Results: Most common cancer types were breast cancer for females (46%) and prostate cancer for males (32%). 92% of the tumors were malignant and 97% of the patients were symptomatic. Among patients diagnosed with cancer, 49% were ≤ 50 years old, 90% paid for their healthcare out of pocket, and 67% did not complete treatment. Conclusions: This study highlights the state of cancer care in Nigeria and should guide future research, with a focus on public awareness, screening programs and implementation of novel cancer control policies and infrastructure that supports early detection. [ABSTRACT FROM AUTHOR]

Summary: Data on cause‐specific mortality after lymphoplasmacytic lymphoma (LPL) and Waldenström macroglobulinaemia (WM) are lacking. We identified causes of death amongst 7289 adults diagnosed with incident first primary LPL (n = 3108) or WM (n = 4181) during 2000–2016 in 17 USA population‐based cancer registries. Based on 3132 deaths, 16‐year cumulative mortality was 23·2% for lymphomas, 8·4% for non‐lymphoma cancers and 14·7% for non‐cancer causes for patients aged <65 years at diagnosis of LPL/WM, versus 33·4%, 11·2% and 48·7%, respectively, for those aged ≥75 years. Compared with the general population, patients with LPL/WM had a 20% higher risk of death due to non‐cancer causes (n = 1341 deaths, standardised mortality ratio [SMR] 1·2, 95% confidence interval [CI] 1·1–1·2), most commonly from infectious (n = 188; SMR 1·8, 95% CI 1·6–2·1), respiratory (n = 143; SMR 1·2, 95% CI 1·0–1·4), and digestive (n = 80; SMR 1·8, 95% CI 1·4–2·2) diseases, but no excess mortality from cardiovascular diseases (n = 477, SMR 1·1, 95% CI 1·0–1·1). Risks were highest for non‐cancer causes within 1 year of diagnosis (n = 239; SMR<1year 1·3, 95% CI 1·2–1·5), declining thereafter (n = 522; SMR≥5years 1·1, 95% CI 1·1–1·2). Myelodysplastic syndrome/acute myeloid leukaemia deaths were notably increased (n = 46; SMR 4·4, 95% CI 3·2–5·9), whereas solid neoplasm deaths were only elevated among ≥5‐year survivors (n = 145; SMR≥5years 1·3, 95% CI 1·1–1·5). This work identifies new areas for optimising care and reducing mortality for patients with LPL/WM. [ABSTRACT FROM AUTHOR]

Background: Acute myeloid leukemia (AML) is a common leukemia subtype and has a poor prognosis. The risk of AML is highly related to age. In the context of population aging, a comprehensive report presenting epidemiological trends of AML is evaluable for policy-marker to allocate healthy resources. Methods: This study was based on the Global Burden of Disease 2017 database. We analyzed the change trends of incidence rate, death rate, and disability-adjusted life year (DALY) rate by calculating the corresponding estimated annual percentage change (EAPC) values. Besides, we investigated the influence of social development degree on AML's epidemiological trends and potential risk factors for AML-related mortality. Results: From 1990 to 2017, the incidence of AML gradually increased in the globe. Males and elder people had a higher possibility to develop AML. Developed countries tended to have higher age-standardized incidence rate and death rate than developing regions. Smoking, high body mass index, occupational exposure to benzene, and formaldehyde were the main risk factors for AML-related mortality. Notably, the contribution ratio of exposure to carcinogens was significantly increased in the low social-demographic index (SDI) region than in the high SDI region. Conclusion: Generally, the burden of AML became heavier during the past 28 years which might need more health resources to resolve this population aging-associated problem. In the present stage, developed countries with high SDI had the most AML incidences and deaths. At the same time, developing countries with middle- or low-middle SDI also need to take actions to relieve rapidly increased AML burden. [ABSTRACT FROM AUTHOR]