Global cancer transitions according to the Human Development Index (2008-2030): a population-based study.
ABSTRACT Cancer is set to become a major cause of morbidity and mortality in the coming decades in every region of the world. We aimed to assess the changing patterns of cancer according to varying levels of human development.
We used four levels (low, medium, high, and very high) of the Human Development Index (HDI), a composite indicator of life expectancy, education, and gross domestic product per head, to highlight cancer-specific patterns in 2008 (on the basis of GLOBOCAN estimates) and trends 1988-2002 (on the basis of the series in Cancer Incidence in Five Continents), and to produce future burden scenario for 2030 according to projected demographic changes alone and trends-based changes for selected cancer sites.
In the highest HDI regions in 2008, cancers of the female breast, lung, colorectum, and prostate accounted for half the overall cancer burden, whereas in medium HDI regions, cancers of the oesophagus, stomach, and liver were also common, and together these seven cancers comprised 62% of the total cancer burden in medium to very high HDI areas. In low HDI regions, cervical cancer was more common than both breast cancer and liver cancer. Nine different cancers were the most commonly diagnosed in men across 184 countries, with cancers of the prostate, lung, and liver being the most common. Breast and cervical cancers were the most common in women. In medium HDI and high HDI settings, decreases in cervical and stomach cancer incidence seem to be offset by increases in the incidence of cancers of the female breast, prostate, and colorectum. If the cancer-specific and sex-specific trends estimated in this study continue, we predict an increase in the incidence of all-cancer cases from 12·7 million new cases in 2008 to 22·2 million by 2030.
Our findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors. Targeted interventions can lead to a decrease in the projected increases in cancer burden through effective primary prevention strategies, alongside the implementation of vaccination, early detection, and effective treatment programmes.
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ABSTRACT: To evaluate the association between polymorphisms of interleukin-4 (IL-4) and IL-4 receptor (IL-4R) genes and risk of renal cell cancer (RCC), bladder cancer (BC), and prostate cancer (PC) based on meta-analysis. PubMed, Web of Science and SpecilalSCI(TM) were searched for studies published up to May 2014 that reported the association between IL-4 or IL-4R and RCC, BC or PC risk. Odds ratio (OR)/Hazard ratio (HR) and 95% confidence interval (CI) were analyzed to evaluate the association. Meta-analysis showed that the IL-4R polymorphism rs1805010 was associated with increased RCC risk (CC/CT vs. TT: OR=1.266, 95% CI 1.09-1.472, P=0.002). The IL-4 haplotypes, IL4-589T and IL4-33T, were associated with higher survival rate of the patients comparted with the haplotype IL-4-589C-33C (P<0.05). The IL-4 polymorphism rs2243250 was associated with an increased risk of developing multiple BCs (OR=2.52, P=0.033). The IL-4 polymorphisms rs2243228, rs2243250, and rs22272480 were significantly associated with PC risk (rs2243228 CC vs. OR=0.27, 95% CI 0.09-0.84, P=0.03; rs2243350 TT vs. OR=2.16, 95% CI 1.06-4.40, P=0.03, CC vs. OR=1.31, 95% CI 1.05-1.65, P=0.02; rs2227284 TT vs. OR=1.98, 95% CI 1.30-3.00, P=0.001). In addition, IL-4 polymorphism rs2070874 was associated with PC mortality. Three polymorphisms (rs2070874, rs1805015, and rs1801275) were not associated with RCC, BC, and PC. The IL-4R polymorphism rs1805015 might be associated with RCC risk. IL-4 rs2243250 carriers had increased risk of developing multiple BCs. IL-4 polymorphisms rs2243228, rs2243250, rs2227284, and rs2070874 were associated with PC risk or mortality.International Journal of Clinical and Experimental Medicine 01/2015; 8(1):1227-33. · 1.42 Impact Factor
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ABSTRACT: To analyze the prognostic role of revised version of International Federation of Gynecology and Obstetrics (FIGO) stage (2013) in epithelial ovarian cancer and compare with previous version staging classification. We retrospectively enrolled patients with epithelial ovarian cancer treated at Samsung Medical Center from 2002 to 2012. We reclassified the patients based on the revised FIGO staging classification. Eight hundred seventy-eight patients were enrolled (stage I, 22.8%; stage II, 10.4%; stage III, 56.2%; stage IV, 10.7%). Previous stage IC (98, 11.1%) was subdivided into IC1 (9, 1.0%), IC2 (57, 6.4%), and IC3 (32, 4.1%). In addition, previous stage IV (94, 1.7%) was categorized into IVA (37, 4.2%) and IVB (57, 6.5%) in new staging classification. Stage IIC (66, 7.5%) has been eliminated and integrated into IIA (36, 4.1%) and IIB (55, 6.2%) in revised classification. Revised FIGO stage IC3 had significant prognostic impact on PFS (hazard ratio [HR], 3.840; 95% confidence interval [CI], 1.361 to 10.83; P=0.011) and revised FIGO stage IIIC appears to be an independent, significant poor prognostic factor for PFS (HR, 2.541; 95% CI, 1.242 to 5.200; P=0.011) but not in the case of previous version of FIGO stage IIIC (HR, 1.070; 95% CI, 0.502 to 2.281; P=0.860). However, any sub-stages of both previous and revised version in stage II and IV, there was no significant prognostic role. Revised FIGO stage has more progressed utility for informing prognosis than previous version, especially in stage I and III. For stage II and IV, further validation should be needed in large population based study in the future.03/2015; 58(2):124-34. DOI:10.5468/ogs.2015.58.2.124
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ABSTRACT: Despite long-term or permanent health problems, cancer survivors are often motivated to return to work. For cancer survivors who have lost their job, return to work can be more challenging compared to employed survivors, as they generally find themselves in a more vulnerable social and financial position. Cancer survivors with job loss may therefore be in need of tailored return to work support. However, there is a lack of return to work intervention programs specifically targeting these cancer survivors. The number of cancer survivors with job loss in developed countries is rising due to, amongst others, increases in the incidence and survivor rate of cancer, the retirement age and the proportion of flexible employment contracts. Hence, we consider it important to develop a tailored return to work intervention program for cancer survivors with job loss, and to evaluate its effectiveness compared to usual care. This study employs a two-armed randomised controlled trial with a follow-up period of 12 months. The study population (n = 164) will be recruited from a national sample of cancer survivors (18-60 years), who have been sick-listed for 12-36 months. Participants will be randomised by using computerized blocked randomisation (blocks of four). All participants will receive usual care as provided by the Dutch Social Security Agency. Additionally, participants in the intervention group will receive a tailored return to work intervention program, which includes vocational rehabilitation and supportive psychosocial components, as well as (therapeutic) placement at work. The primary outcome measure is duration until sustainable return to work; the secondary outcome measure is rate of return to work. Other parameters include, amongst others, fatigue, coping strategy and quality of life. We will perform Cox regression analyses to estimate hazard ratios for time to sustainable return to work. The hypothesis of this study is that a tailored approach for cancer survivors with job loss is more effective, regarding return to work, compared to usual care. The results of this study will provide insight into the ways in which return to work can be facilitated for cancer survivors with job loss. Netherlands Trial Register: NTR3562 .BMC Cancer 12/2015; 15(1). DOI:10.1186/s12885-015-1051-1 · 3.32 Impact Factor