Age-period-cohort analysis of cancers not related to tobacco, screening, or HIV: Sex and race differences

Department of Epidemiology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15232, USA.
Cancer Causes and Control (Impact Factor: 2.74). 04/2010; 21(8):1227-36. DOI: 10.1007/s10552-010-9550-5
Source: PubMed


To identify trends in a residual category of cancers not typically associated with tobacco, screening, or human immunodeficiency virus (HIV) infection.
For persons aged 20-84, we used sex- and race-specific age-period-cohort (APC) models to describe temporal patterns of incidence (1975-2004) and mortality (1970-2004) in the U.S. for a residual cancer category that excluded non-Hodgkin lymphoma, Kaposi sarcoma, and cancer of the oral cavity and pharynx, esophagus, pancreas, larynx, lung and bronchus, urinary bladder, kidney and renal pelvis, colon and rectum, prostate, female breast, and cervix uteri.
Age-specific incidence rose (0.1-0.9% per year, on average) in every sex-race group, with factors related to both time period and birth cohort membership appearing to accelerate the increases in women. Age-specific mortality fell (0.6-0.9% per year, on average) for black and white men and women, with the declines decelerating in white women but accelerating in the other sex-race groups. Extrapolations of APC models predicted higher age-adjusted incidence rates in white women (11%), black women (5%), and white men (4%) in 2005-2009, relative to 2000-2004, and lower rates in black men (-3%), accompanied by lower age-adjusted mortality rates in every sex-race group (-8% in black men, -3% in black women, -1% in white men, and -1% in white women).
The possibility that increased incidence in women over time reflects changes in underlying risks, diagnostic practices, or better case ascertainment should be actively explored. Declining mortality may signify improvements in cancer care.

Download full-text


Available from: Yueh-Ying Han,
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity is associated with increased tumorigenesis. Previously, we demonstrated that inflammation in obesity caused cancer fighting cells to display greater surface receptor levels, predisposing them to early cell death. We measured the inflammatory tumor growth factor levels to determine whether inflammation in obesity increases expression of these factors, potentially predisposing these patients to greater rates of neoplasia. A total of 24 patients undergoing weight loss surgery had samples collected preoperatively and at 6 and 12 months after surgery. The growth factors analyzed included tumor necrosis factor (TNF)-α, granulocyte-macrophage colony-stimulating factor, interferon-γ, interleukin (IL)-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, vascular endothelial growth factor, hepatocyte growth factor, TNF-receptor I (TNF-RI), TNF-RII, death receptor 5, leptin, and adiponectin. Control samples were obtained from 10 healthy, normal weight volunteers. The tumor growth factors TNF-α, TNF-RI, TNF-RII, vascular endothelial growth factor, hepatocyte growth factor, interferon-γ, IL-2, IL-5, and IL-6 all decreased significantly (P <.05) compared with the preoperative values. The IL-4, IL-8, leptin, death receptor 5, adiponectin, and granulocyte-macrophage colony-stimulating factor levels did not change significantly over time. The IL-1b and IL-10 levels were less than the detection limit at all points. When obese patient serum was compared with healthy volunteer pooled serum, we found that the leptin, death receptor 5, hepatocyte growth factor, vascular endothelial growth factor, TNF-RI, TNF-RII, TNF-α, IFN-γ, granulocyte-macrophage colony-stimulating factor, IL-4, IL-5, IL-6, and IL-8 levels were all 2-37 times greater than the levels in the controls at baseline. The concentrations of these same growth factors had decreased levels only 1-3.5 times greater than those of the controls at 12 months postoperatively. Many inflammatory tumor growth factors are present in greater concentrations in obese individuals. This could explain the greater prevalence of neoplasia in the morbidly obese population.
    Surgery for Obesity and Related Diseases 09/2010; 6(5):538-41. DOI:10.1016/j.soard.2010.04.011 · 4.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cancer in the older person is increasingly common. The biological interactions of cancer with age are only partly understood and may provide some clues to future forms of cancer prevention and treatment. Management-related decisions in a population with limited life expectancy and limited functional reserve should be based on the natural history of the cancer, the patient’s life expectancy, and the patient’s tolerance of treatment. In addition, financial and caregiver considerations are important in assessing the treatment’s benefits and risks. Cooperation between geriatricians and oncologists seems to be essential to generate predictive models, as well as outcome information to improve the decision making in older cancer patients. It may also be essential in caring for a host of older cancer survivors. In France, this cooperation is already a reality that finds its expression in a network of units of oncogeriatrics distributed throughout the country.
    Clinics in Geriatric Medicine 02/2012; 28(1):1-18. DOI:10.1016/j.cger.2011.09.001 · 3.19 Impact Factor