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Global cancer statistics. Cancer
... This makes CRC the second most common cancer globally in terms of incidence and the third leading cause of cancer-related deaths [3,4]. Historically, the incidence of CRC in China was relatively low compared to developed countries in Europe and North America [5]. However, in recent decades, with rapid economic development and significant changes in dietary patterns and lifestyle habits, the incidence and mortality rates of CRC have risen sharply. ...
... Inclusion criteria: (1) The study design was a case-control or cohort study; (2) The study population consisted of patients aged ≥ 18 years, diagnosed with CRC through endoscopy or pathology, and who underwent surgical treatment; (3) The study focused on the incidence of UR and associated risk factors within 31 days after CRC surgery; (4) Studies were required to provide multivariate analysis results, including odds ratios (OR) and 95% confidence intervals (CI) for readmission risk factors. (5) Only studies published from 2000 to the present were included, ensuring relevance to contemporary clinical practices. ...
Background
The high incidence of unplanned readmissions within 31 days after colorectal cancer surgery remains a significant challenge. However, the identified risk factors for these readmissions are inconsistent across the literature. This study aims to perform a comprehensive meta-analysis to estimate the incidence of unplanned readmissions and systematically identify the factors associated with this risk, providing robust evidence for targeted interventions to reduce readmission rates.
Methods
This study was conducted in accordance with the PRISMA guidelines. All study steps, including study selection, data extraction, and quality assessment, were independently performed by two authors, with any disagreements resolved through consultation with a third author. A comprehensive search for published studies was conducted across the following databases up to January 2025: VIP Journal Database, Wanfang Data, CNKI, SinoMed, PubMed, Embase, Web of Science, and the Cochrane Library. Statistical analyses were performed using RevMan 5.4 and Stata 17.0, with a p-value of less than 0.05 considered statistically significant.
Results
This meta-analysis identified several significant risk factors associated with unplanned readmission during this period (P < 0.05), including age (OR = 1.13), postoperative complications (OR = 1.87), tumor stage (TNM ≥ III) (OR = 2.01), tumor site in the rectum (OR = 1.64), stoma creation (OR = 1.70), Complicated diabetes (OR = 1.56), Charlson Comorbidity Index (CCI) (OR = 1.27), blood transfusion (BT) (OR = 1.24), Length of hospital stay (LOS) (OR = 1.65), and surgical approach (OR = 1.22). Notably, female (OR = 0.85) was identified as a protective factor against unplanned readmission.
Conclusion
The unplanned readmission rate within 31 days after colorectal cancer surgery was 11.73%. Current evidence suggests that age, postoperative complications, TNM ≥ III, tumor site in the rectum, stoma creation, complicated diabetes, Charlson Comorbidity Index (CCI), blood transfusion (BT), length of hospital stay (LOS), and surgical approach are significant risk factors for unplanned readmission. Conversely, female has been identified as a protective factor. To mitigate these risks and reduce readmission rates, healthcare professionals should implement targeted educational and clinical interventions.
... Urinary bladder carcinoma is the second most common cancer of the genitourinary tract and ninth most common cancer worldwide. [1] Both neoplastic and non-neoplastic lesions of urinary bladder are common. Almost 90% cases of primary urinary bladder tumor is accounted by urothelial carcinoma. ...
... It is three to four times more common in males than in woman. [1] It's incidence and mortality increases with age and two-third cases occur in patients older than 65 years of age. [3] Risk factors associated with urinary bladder tumor are smoking, pelvic irradiation, cyclophosphamide, chronic cystitis, parasite infestation like schistosomal infection, aniline dyes and urachal remnants. ...
... Infectious carcinogens cause a disproportionate burden of cancers in Africa compared to highincome countries, with two-thirds of these IACs occurring in low-and middle-income countries (LMICs), where infectious diseases remain a top public health problem [2,3] One of the most common virally-induced cancers in West Africa is cervical cancer, which is entirely attributable to sexually transmitted HPV infection [4]. HCC is another highly prevalent virus-associated cancer in Africa [5]. In sub-Saharan Africa (SSA), HBV is endemic, with an estimated lifetime risk of infection of 60%, and over 8% of the population in high-risk chronic carrier state will progress to HCC [5]. ...
... HCC is another highly prevalent virus-associated cancer in Africa [5]. In sub-Saharan Africa (SSA), HBV is endemic, with an estimated lifetime risk of infection of 60%, and over 8% of the population in high-risk chronic carrier state will progress to HCC [5]. The introduction of antiretroviral therapies has certainly improved patients' quality of life. ...
Les cancers associés aux infections (CAI) constituent une menace importante pour la santé publique dans les pays à revenu faible et intermédiaire (PRFI) comme le Mali, où les taux d'infection sont très élevés. Les CAI représentent plus d'un quart (27%) de tous les cancers au Mali. Cependant, les possibilités limitées de formation pour les étudiants, les professeurs, les chercheurs et les professionnels entravent la recherche nécessaire au développement de nouvelles stratégies pour faire face aux tendances épidémiologiques actuelles. Le Centre de Recherche et Formation sur les Pathologies Moléculaires (CREFPAM), en collaboration avec ses partenaires internationaux aux États-Unis, vise à combler cette lacune. Il propose une combinaison de programmes de formation à court, moyen et long terme afin de doter la prochaine génération de chercheurs des compétences nécessaires pour s'attaquer efficacement à cette menace émergente. Ce programme unique devrait avoir un impact durable et à long terme sur le contrôle et la gestion de ces cancers dans les PRFI
... Quantitative data was expressed as mean and standard deviation; qualitative data was expressed as frequency distribution and percentage. The data were analyzed using SPSS 22 Figure 1 shows that the majority (31%) of our patients were in the age group of 60-69 years, followed by 28% of them aged >70 years, 23% & 18% of patients were in the 50-59 & 40-49 years age group respectively. ...
... Mohamed [20]. Many previous studies were consistent with these findings [21][22][23]. The majority of this study patients (61%) were males and (39%) were females with male to female ratio of 1 [20]. ...
Background: Urinary bladder cancer is the 10th most common worldwide cancer type, accounting for 3% of global cancers, with more than 573,000 reported new cases in 2020. Clinicopathological variables, particularly grading and staging systems, have been recognized as important prognostic factors in urinary bladder carcinoma. Aim: This study aimed to evaluate the clinicopathological features of non-muscle invasive bladder carcinoma. Methods: This retrospective observational study was conducted in the. We included 100 patients with non-muscle invasive bladder carcinoma (T1 tumor stage) who attended the urology department of our institution. Result: The majority of patients (31%) were aged 60-69 years, with a mean age of 58.21 ± 11.44 years and a male-to-female ratio of 1.56:1. Most participants lived in rural areas (62%) and were primarily workers (47%). The most common risk factors were smoking (38%), age >55 years (29%), and exposure to chemicals (21%). Comorbidities included hypertension (38%), arthritis (22%), and diabetes mellitus (23%). Tumor analysis revealed that all patients were at stage T1 and 72% were Grade II. Lymph node metastasis was rare (7%). Burning micturition (32%) and hematuria (27%) were the predominant clinical presentations. A recurrence rate of 14% was observed, but no deaths were reported during the study period. Conclusion: This study found that non-muscle invasive bladder carcinoma particularly among older males in rural settings, shows significant clinical and pathological diversity. Most patients presented with burning micturition and hematuria, with a significant proportion of Grade II tumors.
... Also, HBsAg seroprevalence is estimated to be around 6%-20% [18,19]. Sub-Saharan Africa is known to have one of the utmost HBVassociated liver cancer rates globally [20]. HBV-associated liver cancer exists as the first and third most common cancer in males and females, respectively, in the African continent [21,22]. ...
Background and Aims
The influence of age and gender on the manifestations of Hepatitis B (HB) disease is underexplored and yields varied findings. This study assessed the impact of age and gender on HB disease manifestations in a Ghanaian population.
Methods
This retrospective study evaluated 569 patients at Tamale Teaching Hospital. Disease manifestations were compared separately between male and female patients across different age groups and among four distinct age groups within male and female patients.
Results
It revealed a male‐to‐female ratio of 5.1:1, with significant differences observed among age categories. HBsAg was significantly more prevalent in adult males (p < 0.05), while polydipsia showed equal prevalence between genders (p < 0.05). Female adults exhibited higher rates of constipation and palpitation compared to males (p < 0.05). In older patients, females had higher ALT and HBeAg prevalence than males (p < 0.05). Disease manifestation did not significantly differ by gender among children and younger patients (p > 0.05). Among males, viral load differed significantly across age groups and correlated positively with age (p < 0.05). Females showed positive correlations of jaundice, HBeAg, low globulin, and high AST with age (p < 0.05), but nausea was negatively correlated (p < 0.05).
Conclusion
This study highlights unique clinical and laboratory features in reproductive‐aged female HB patients.
... Lung cancer has the highest incidence rate among men worldwide, resulting in approximately 1.2 million deaths annually. Lung and prostate cancer are among the most common cancers in men in terms of incidence (Parkin et al., 2005). Lung cancer, originating from bronchial epithelium, is a type of cancer that has a very high incidence rate in men and women between the ages of 60 and 70. ...
The treatment of lung cancer continues to be a significant challenge for many oncologists and their patients. Treatment using epidermal growth factor receptor inhibitors is connected to a positive outcome. Cetuximab, a chimeric monoclonal antibody targeting the epidermal growth factor receptor (EGFR), in conjunction with monoterpene phenol thymol, is recommended for the treatment of lung cancer. While a mild acne-like skin rash is quite frequent in patients using cetuximab, a severe rash is rare. The goal of the current study was to assess whether thymol could enhance the anticancer effectiveness of cetuximab in A-549, non-small cell lung cancer (NSCLC) cell line. We found that the combination of cetuximab and thymol synergistically suppressed cell proliferation by inducing membrane damaging, oxidative stress, and apoptosis in A-549 cells. Taken together, our results indicate that the combination of thymol and cetuximab could improve anticancer responses and may notably enhance treatment outcomes in NSCLC.
... Oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSMF) are two significant and related oral health disorders, particularly in regions with high tobacco and areca nut consumption. 1 Inflammation and progressive fibrosis of the submucosal tissues are the characteristic features of OSMF, a chronic, progressive disease that can cause burning, a decreased capacity to open the mouth, and in certain cases, malignant transformation. 2 It is well known that OSMF has the potential to become malignant; research indicates that the progression rate to OSCC can range from 1.5% to 15% over time. 3 In contrast, OSCC makes up more than 90% of all malignant neoplasms in the oral cavity, making it the most prevalent type of oral cancer. ...
ABSTRACT
Aim: The purpose of this study was to examine the clinical and demographic
characteristics linked to HPV positivity as well as the prevalence of HPV-16
and HPV-18 in OSCC, OSMF, and healthy controls.
Materials and Methods: This prospective study included 82 subjects in total,
split into three groups: OSCC (n=40) patients, OSMF(n=21) patients, and
healthy controls(n=21). Histopathological examination was performed in order
to confirm the clinical diagnosis and HPV-16 & HPV-18 DNA were extracted
and quantified from tissue samples using the polymerase chain reaction (PCR)
assay. Additionally, demographic information such as age, gender, tobacco
use, and socioeconomic status was recorded. Associations between HPV status
and different clinicopathological parameters were assessed using statistical
tests, such as χ² and t-tests.
Results: HPV-16 was found in 32.5% of OSCC patients, significantly more
than the 14.3% of healthy controls (χ² = 8.41, p = 0.003). Similarly, 20% of
OSCC patients had HPV-18, whereas 9.5% of healthy controls did (χ² = 3.66,
p = 0.05). There was no discernible difference in the prevalence of HPV-16
and HPV-18 between OSMF patients and healthy controls. OSCC patients
with HPV were younger (mean age 43.77 years) than those without HPV
(mean age 53.33 years) (t = 2.25, p = 0.03), and females were more likely to
be HPV-positive (p = 0.04). There were no discernible correlations between
HPV status and clinical staging, socioeconomic status, or tobacco use.
Conclusion: High-risk HPV, particularly HPV-16, is strongly associated with
oral squamous cell carcinoma (OSCC), with a notable prevalence among
younger patients and females.
Keywords: HPV-16, HPV-18, Oral Squamous Cell Carcinoma, Oral
Submucous Fibrosis, polymerase chain reaction (PCR)
... In 1994, H. pylori were recognized as a type I carcinogen, and now it is considered the most common etiologic agent of infection-related cancers, which represent 5.5% of the global cancer burden. In 2005, Marshall and Warren were awarded the Nobel Prize of medicine for their seminal discovery of this bacterium and its role in peptic ulcer disease [2]. ...
This study aims to assess the invasive methods [endoscopy and rapid urease test] and noninvasive method [PCR technique] in the detection of H. pylori. The patients were referred to the gastroenterology clinic of Azadi Teaching Hospital and private Kirkuk clinic for upper and lower and bronchoscopy fiberoptic GIT endoscopy in Kirkuk city. The present study had carried out from November 2019 to February 2021. The number of the patient's group was 120. The patients were aged 3 to 75years. Selected eligible patients subjected to examination by invasive methods (endoscopy and rapid urease test) and non-invasive method using PCR technique. Biopsies had taken from 120 patients, 50(55.6%) showed positive for rapid urease test (RUT) in the antrum, and 25(83.3%) were positive in proximal stomach negative in the antrum in the same patients. Fifty antrum biopsies positive of H. pylori for detection virulence genes by using PCR technique. Gastric biopsy taken from multiple gastric areas is more accurate than taking only the antrum region, especially patients who underwent eradication therapy to the H. pylori infection. There is a significant association between PCR methods and the detection of H. pylori from the gastric biopsy. This work is licensed under a Creative Commons Attribution Non-Commercial 4.0 International License.
... Oral squamous cell carcinoma (OSCC) is the most common malignant tumor affecting the oral cavity and compromising over 90% of all oral tumors (2), with an increase in mortality rate of 0.4% per year from 2010 to 2019 (3). According to the Global Cancer Observatory (GCO), the annual incidence of OSCC has increased to 377,713 cases in -49 -2020 (1), compared to 274,300 cases in 2002 (4). In Jordan, the number of all new cancer cases was 12,328 in 2022 (5), and oral cancer accounts for 0.84% of this total number, ranking 20 th among the most common cancers affecting Jordanians (5). ...
Objectives: The aim of this study was to investigate the prevalence and patterns of oral squamous cell carcinoma (OSCC)-associated risk factors and patient characteristics in a sample of Jordanian population for further consideration of the results in oral cancer preventive programs. Materials and Methods: The archives of Pathology Department at King Abdullah University Hospital were searched in the period from 2003 to 2023 for patients diagnosed with OSCC. The recorded data included demographics, tumor-related information and risk factors. Data was analyzed using (IBM SPSS Statistics 27.0.1). Results: 168 cases out of which 54 had a full history of risk factors were identified. Age average was 63.5 years. Male: female ratio was 1.7:1. Lateral border of the tongue and lower lip were the most frequent locations. Lower lip was the most common site among outdoor workers. OSCC risk factor analysis revealed low socio-economic status (SES) in 64.8%, smoking in 55.6%, positive family history of other malignancies in 51.9% who all were in the 40s of age, urban area residence in 50%, outdoor working in 38.9%, graduate degree holders in 29.6%, and office workers in 27.8%. Smoking prevalence was 90% in males, 76.2% in outdoor workers, 60.7% in OSCC patients with positive family history of other malignancy, 63.3% in low-SES patients, 56.7% in urban residents, 53.3% in office workers, and 50% in graduate degree holders. OSCC female patients were non-smokers with a percentage of 85% and were nonemployed with a percentage of 75%. Conclusions: Low-SES patients, smokers, patients with positive family history of malignancy, urban residents, outdoor workers, graduate degree holders, and office workers are recommended to be targeted in oral cancer preventive programs. Smoking is still the most prevalent OSCC risk factor in our sample. Smoking cessation clinics will be of utmost importance. Wide-scale national studies of OSCC differe
... Cervical cancer continues to be a major health care problem worldwide. Cervical cancer is the second leading cause of cancer death in women in developing countries, although cytological screening programs have substantially reduced its toll in developed countries (Parkin et al 1999). It is known that oncogenic human papillomaviruses (HPVs) are the primary causal agent of cervical cancer (Walboomers et al 1999). ...
Cervical cancer continues to be the second largest cause of cancer deaths in women worldwide. Persistent infection with high-risk types of human papillomavirus (HPV) is a necessary cause of cervical cancer. Thus, prophylactic vaccination against HPV is an attractive strategy to prevent cervical cancer. Current strategies for the development of safe and effective preventive vaccines are based on the induction of neutralizing antibodies against the major capsid protein, L1 of HPV. Cervarix™ is one of the preventive HPV vaccines that has been approved in the Europe and Australia and is currently under review by the US Food and Drug Administration. Cervarix is composed of HPV16 and HPV18 L1 virus-like particles (VLPs) formulated in ASO4 adjuvant. Vaccination with Cervarix has been shown to protect women against a high proportion of precursor lesions of cervical cancer caused by these two HPV types. This review explores the various features of this new vaccine candidate and discusses the future directions in the field of HPV vaccine development.
... Although it is only the thirteenth most common cause of cancer worldwide, it is the eighth most common cause of cancer-related death. 1 Gemcitabine remains the standard first-line cytotoxic agent for metastatic disease since demonstrating superiority over fluorouracil monotherapy. 2 Median survival of gemcitabine-treated patients with advanced disease is 5 to 6 months. ...
Pancreatic adenocarcinoma is a common malignancy that remains refractory to available therapies. Gemcitabine has long been the standard, first-line agent in advanced disease. The epidermal growth factor receptor (EGFR) is a commonly expressed target in pancreatic cancer that is involved in tumor proliferation, metastasis, and induction of angiogenesis. The addition of the EGFR inhibitor erlotinib to gemcitabine has recently been demonstrated to provide a small, yet statistically significant, survival benefit in advanced disease. This has prompted further research into the applications of EGFR-targeted therapy in pancreatic cancer, albeit with disappointing results. Resistance to these therapies seems highly prevalent and has been implicated in their limited efficacy. The development of rash is associated with treatment efficacy and suggests that predictive factors may one day be identified to guide appropriate patient selection for these agents. Preclinical research has shown promise that resistance to EGFR-targeted therapies can be overcome through a variety of approaches. Application of this research in clinical trials may ultimately yield an unquestioned role for EGFR-targeted therapy in the management of this disease.
... Hepatocellular carcinoma (HCC) is one of the most prevalent (5th in serial order) cancer types that leads to a high mortality rate (about 1/3rd of affected persons) worldwide. 1 The treatment for hepatic cancer is regarded as a challenging task. Some drugs have adverse side-effects or sometimes cancer cells acquire resistance to them after repeated use. ...
Objective: In homeopathy, ethanolic extract of Carduus marianus (EECM), is used against various liver disorders including cancer. This investigation aims at evaluating hepatoprotective potential of EECM, if any, against p-dimethylaminoazobenzene (pDAB)-induced hepatocarcinogenesis in mouse models in vivo and elucidating its possible underlying mechanism(s). Methods: Randomized sets of inbred mice were chronically fed with different food regimens for varying periods of time and divided accordingly, 6 mice in each group, into control (Normal I and Alcohol II) and treated groups (III-V); group I: fed Normal diet, group II: Normal diet þ Alcohol, group III: pDAB þ Phenobarbital (PB), group IV: pDAB þ PB þ Alcohol, group V: pDAB þ PB þ EECM. They were sacrificed at day 30, 60, 90 and 120. All routine protocols were deployed for cytogenetical, enzymatic, and histopathological studies. Expressions of B-cell lym-phoma 2 (Bcl-2), B-cell lymphoma-extra large (Bcl-xl), Bcl-2 associated X protein (Bax), Cysteine aspartic acid protease-3 (Caspase-3), and Matrix metalloproteinase 9 (MMP-9) were evaluated at day 90 and 120 only. The DPPH free-radical scavenging activity of EECM was estimated to determine the antioxidant properties. Results: No mice of groups I and II developed tumors in liver at any fixation intervals while all mice of groups (III-IV) developed liver tumors at three fixation intervals. But in group V mice, 4 each of 6 mice at 90 and 120 days, did not show tumor nodules in their livers, signifying that feeding of EECM could combat carcinogenesis. EECM reduced genotoxic effects and favorably modulated expression of Caspase 3 and MMP-9 as compared to control. Conclusion: The treatment of EECM clearly demonstrated protective action against pDAB induced hep-atocarcinogenesis in mice for delaying tumor progression, decreasing total tumor load and genotoxic effects, and also evidenced by favourable modulations of the apoptotic signal proteins like Bcl2, Bcl-xl. Bax, Caspase 3 and other marker enzymes AST (Aspartate amino transferase), ALT (Alanine amino transferase) etc. However, the molecular mechanism of this protective action still needs to be further elucidated.
... Hepatocellular carcinoma (HCC), the primary liver malignancy, ranks as the seventh most commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide, representing a significant global healthcare challenge [1,2]. Although patients with early-stage HCC can be treated with surgical resection, liver transplantation or radiofrequency ablation, more than 70% of patients are diagnosed at advanced stages, leading to a dismal 5-year survival rate of only 12% for patients with advanced HCC [3,4]. ...
Sorafenib, a first-line targeted drug for advanced hepatocellular carcinoma (HCC), has limited clinical application due to intrinsic/acquired resistance. In this study, we have identified the RNA-binding protein RBMS3 as a pivotal regulator involved in sorafenib resistance among patients with HCC. Loss- and gain-of-function experiments further demonstrate that downregulation of RBMS3 promotes angiogenesis and confers resistance to sorafenib by augmenting the capacity of HCC cells to express and secrete ANGPT2, while upregulation of RBMS3 reverse these phenotypes.Through immunoprecipitation mass spectrometry experiments and co-immunoprecipitation (co-IP), we further verified that RBMS3 can facilitate the K48-linked ubiquitination and subsequent protein degradation of ANGPT2 by recruiting the ubiquitin E3 ligase TRIM21 in an RNA-independent manner.Additionally, RBMS3 is found to be deleted in HCC tissues and exhibits a significant positive correlation with angiogenesis and resistance to sorafenib treatment. Importantly, the combination of ANGPT2 antibody in RBMS3-deficient HCC cells restores sensitivity to sorafenib both in vitro and in vivo. These findings uncovered a novel molecular basis for post-translational upregulation of ANGPT2, suggesting that RBMS3-loss plays an oncogenic role in HCC by promoting angiogenesis and conferring resistance to sorafenib treatment.
... Karcinom prostaty má nejvyšší výskyt kostních metastáz ze všech urologických malignit (31). Růstem metastatických nádorových buněk a jejich kostní destrukcí může docházet ke kostním příhodám (SREs -skeletal related events). ...
... Bladder cancer is the second most common cancer of the urinary system and accounts for 3-5% of all cancer-related deaths [1].Approximately 70% of bladder cancers are nonmuscle-invasive (NMIBC), while 30% are muscle-invasive (MIBC) or metastatic [2]. Worldwide, over 100,000 cases of muscle-invasive or advanced-stage bladder tumors are diagnosed annually [3]. ...
Purpose
Obesity has been linked to an increased incidence of various cancers, including bladder cancer. Among the different types of adipose tissue, visceral fat is recognized as the most metabolically active. However, there is a notable scarcity of studies investigating the impact of fat distribution, as measured by computed tomography (CT), on the prognosis of bladder cancer patients undergoing radical cystectomy (RC).
Materials and methods
Between January 2013 and January 2024, preoperative CT images of 34 patients who underwent RC were analyzed to measure total perivesical fat area (TPFA, mm²), fat density (FD, %), and subcutaneous fat thickness (SFT, mm). Multivariate Cox regression analysis was used to assess the effects of these variables on prognosis.
Results
The median age (IQR) of the patients was 65.5 years (12.5), and the median BMI (IQR) was 26.05 (5.98) kg/m². The median follow-up period (IQR) was 11 (31.2) months. A positive correlation was observed between BMI, TPFA, and SFT (r = 0.39, p = 0.02; r = 0.69, p < 0.001, respectively). According to Cox regression analysis, SFT, T stage, and N stage were found to be predictive factors for progression (HR = 1.11, p = 0.007; HR = 4.01, p = 0.04; HR = 6.47, p = 0.02, respectively), and T stage was also identified as an independent predictor for overall survival (HR = 5.32, p = 0.04).
Conclusion
SFT measurement alongside clinical staging would be beneficial in determining progression following RC. Future randomized controlled trials supporting our findings will highlight the significance of these measurements.
Graphical abstract
... Globally, breast cancer incidence has risen due to increased mammography use in screening programs, but mortality rates have declined, likely due to earlier detection and advances in Treatment [16][17][18][19][20][21][22] . ...
This study analyzed breast cancer patients treated with trastuzumab in Brazil’s unified health system (SUS) from 2008 to 2015. A non-concurrent cohort study using SUS data applied propensity score matching to reduce bias between trastuzumab and non-trastuzumab groups. Survival probabilities were estimated via Kaplan-Meier, with subgroup analysis using the log-rank test. Hazard ratios (HR) were calculated using Cox proportional hazards models. Among 20,852 patients, the overall survival rate was 92%, with 94% in the trastuzumab group and 90% in the non-trastuzumab group. Younger, black patients and those in the North region had poorer survival. Advanced disease stages and palliative treatments were linked to higher mortality, while adjuvant therapy and radiotherapy were protective. During follow-up, 8.1% of patients died, with better outcomes observed in the trastuzumab group (p < 0.0001). Late initiation of trastuzumab (after 16 months) improved survival, especially in early stages (I and II). Invasive tumors and stage IV disease were associated with worse prognoses. The study demonstrates trastuzumab’s effectiveness in SUS, underscores survival disparities related to sociodemographic factors, and emphasizes the need for early detection, equitable access, and optimized treatment timelines to improve outcomes in public healthcare.
... Breast cancer (BC) is a complex heterogeneous group of genetic disorder and chromosome aberrations (CA) play a relevant role to increase risk for the development of disease. Globally, the incidence of 2.26 million new cases of BC registered world-wide and is tremendous increase 24.00% in Asia including China, Indonesia and Japan perhaps due to changes in life -style that lead endocrine dysfunction [1,2]. CAs are significantly associated with activation of proto oncogenes and inactivation of tumor suppressor gene (p53) during progression of disease [3]. ...
Chromosome aberrations (CAs) play an important role in tumor initiation, followed by metastasis. Short-term peripheral blood lymphocyte (PBL) cultures using RPMI-1640 media with 5 % FBS were used to evaluate the frequency of structural and numerical chromosome aberrations in breast cancer patients. Highest frequency of aneuploidy (11.53%) were observed followed by trisomy -21(8.93%) in karyotypes. De-novo mutation involving 12q21 with loss of 16.38 Mbp DNA fragment is the most relevant finding in breast cancer (BC) patients and has not been reported earlier. Secondly, role of trisomy-21 (8.93%) might have increase genetic susceptibility of disease because of “giant satellites”, are the active sites of rRNA sub unit of 18S and 28S. These active sites might have increase gene-expression of truncated protein during tumor Significant increase in the frequency of aneuploidy with increased number of non-homologous chromosome was the striking feature due to increase of non-disjunction event followed by unequal crossing-over and synapse formation by known environmental factors like arsenic. However, the present study is small, but interesting to explore the etiopathology of BC patients associated chromosome instability. However, further study is required to confirm these changes, whether these mutations are either familial (inherited) or spontaneous in nature.
... Oral cancers are among the most common malignancies worldwide. Head and neck squamous cell carcinoma (HNSCC) is the sixth-most common malignancy [75]. Hypopharyngeal squamous cell carcinoma (HSCC) is one of the subtypes of HNSCC, accounting for around 2-6% of HNSCC cases [76]. ...
Absent in melanoma 2 (AIM2) is a member of the innate immune sensors that recognizes cytosolic nucleic acids, leading to inflammasome assembly. In recent years, several studies in the oncology field have highlighted the presence of cytoplasmic double-stranded DNA (dsDNA) following necrosis and/or genomic instability, which is typical of malignant transformation. The recognition of dsDNA by the AIM2 inflammasome either in cancer cells or in immune cells can further exacerbate inflammatory processes on the basis of cancer progression. In this context, the role of AIM2 in cancer is still controversial in that some authors assume that AIM2 activation has pro-tumor activities, while others define it as anti-tumor. This discrepancy may be due to the nature of the cells where AIM2 is expressed or the histology of the tumor. This review aims to provide an overview of the controversial role of AIM2 in cancer, taking into consideration the pharmacological tools currently available to modulate AIM2 activity in cancer.
... Cancer was considered a western disease in the past, but now cancer is affecting and killing more people in the developing world than in the industrialized nations [1]. In 2012, about 65% of all deaths that occurred globally due to cancer were in the low-and middle-income countries (LMICs) [2,3]. Because of relatively low awareness, late diagnosis, and the lack of access to affordable curative services, patients with cancer in the LMICs have a poorer prognosis about the diseases [4,5]. ...
External beam radiotherapy, often known as teletherapy, is one of the most efficient ways to treat cancer since it targets harmful cells with radiation. Dosimetric accuracy of a recently installed Cobalt-60 teletherapy unit (Theratron Equinox100#2149, Initial Activity: 12000 Ci) at the Bangladesh Atomic Energy Commission's Secondary Standard Dosimetry Laboratory (SSDL), Savar, Dhaka, has been the main focus of this work. Several measurements are made that are necessary to ensure the accuracy of the Cobalt-60 teletherapy unit in terms of dosimetric level, specifically the accuracy of absolute and relative dosimetry. These measurements include the following dosimetric parameters: absorbed dose to water, percentage depth dose (PDD), beam profile, inter-chamber comparison (to ensure the highest level of dosimetry accuracy), and comparison of absorbed doses using two protocols named IAEA TRS-277 and IAEA TRS-398. The absorbed dose rate at reference field size (10 × 10 cm2) was found to be 1.548 Gy/min with an uncertainty of ±0.020. In the case of the inter-chamber comparison, the maximum deviation among values of absorbed dose to water for four Farmer chambers was 0.27% for Dw(Zref) and 0.26% for Dw(Zmax). The resultant output of this study may contribute to developing the treatment planning system in the realm of cancer treatment. Bangladesh Journal of Physics, 28(1), 1-10, June 2021
... As per American Cancer Society 2008, Prostate cancer has been the most common malignancy in U.S. Asia records lowest yearly incidence with 1.9 cases per 100,000 in China while the highest is seen in African-Americans with a rate of 249 cases per 100,000. 1 Selective use of Trans rectal less. 3 Prostate gland biopsy involves obtaining cancerous tissue to diagnose the cancer. ...
Prostate cancer has been the most common malignancy in men accounting for one fourth of cancers. Use of Trans rectal ultrasonography (TRUS) in men with an abnormal PSA and/or digital rectal examination acting as a guide to direct prostate biopsies will lead to decrease in number of early deaths
It is a prospective observational study.All the patients attending the Urology Out patient Department with a suspicion of Ca prostate from clinical signs and symptoms were clinically evaluated using Digital Rectal Examination and screened for serum PSA levels. All the patients in whom abnormality was detected on DRE and/or an elevated serum PSA level were included in the study and TRUS biopsy was done. The statistical analysis was executed by SPSS version 20 continuous variables were analyzed with student t -test.
The present study includes 95 men in whom abnormality detected in DRE or in the levels of serum PSA.10 core biopsy was done in 53 patients and 16 core biopsy was done in 42 patients. Among the total number of patients subjected to TRUS guided prostate biopsy either 10 core or 16 core, 31 patients detected with prostatic adenocarcinoma which accounts for 32.6%, 12 patients had High grade PIN accounting for 12.62%, 30 patients (31.57%) detected with fibroadenoleiomyomatous hyper plasia , 5 patients had fibroadenoleiomyomatous hyperplasia with chronic prostatitis which is 5.20% and chronic prostatitis is found in 15 patients attributing to 15.78%.
Cancer detection rate with abnormalities in PSA alone was found to be 15% while it was 70% when both DRE and PSA showed abnormal results which is significantly higher. It shows that both DRE and PSA has to be considered while estimating the cancer rate. Detection rate with 16 core TRUS guided biopsy is 54.76% which is significantly (P value 0.0037) higher than that of 10 core biopsy (15.09 %).
... The high mortality and low survival rates for cervical cancer in Sub-Saharan Africa are attributed to various factors, including limited access to medical facilities, particularly in rural areas where 60%-70% of affected women reside. Other contributing factors include poor nutrition and co-morbid conditions like anemia and malaria, HIV infection, late-stage disease presentation, large tumor size at diagnosis, substandard quality of care in many health services, high rates of loss to follow-up, and treatment non-completion due to poverty-related barriers (2,11,13,18,19). ...
Background
Despite the availability of vaccination and early treatment, cervical cancer remains a significant public health concern globally, particularly in Sub-Saharan Africa, where access to screening and treatment is often limited.
Methods
In this study, researchers conducted a survey of four international databases—Medline/PubMed, Scopus, Web of Science, and Henare—along with Google Scholar to search for gray literature. The keywords used for searching the international databases included “Uterine Cervical Neoplasms [Mesh],” “Survival OR Survival Analysis OR Survival Rate,” and “Sub-Saharan countries” (including the names of specific countries). Six researchers independently screened and extracted data from the articles. All studies published in English were included without restriction and assessed for quality using the adapted Newcastle–Ottawa Scale for cohort and cross-sectional studies. The results of this systematic review were reported in accordance with the PRISMA checklist.
Results
Out of the 2,180 articles initially identified, 23 were deemed eligible and reported on the survival status of patients with cervical cancer in Sub-Saharan Africa. This study assessed the multi-year survival rates (1, 2, 3, 4, and 5 years) of patients with cervical cancer. Based on the random-effects model, the overall pooled 1-year survival was 65.0% [95% confidence interval (CI), 52–78] with I² = 99.31 and p-value < 0.001. The 2-year survival rate was 60% (95% CI, 46–74) with I² = 99.12 and p-value < 0.001, the 3-year survival was 48% (95% CI, 35–62) with I² = 98.45 and p-value < 0.001, the 4-year survival was 42.9% (95% CI, 32.7–53.1) with I² = 96.80 and p-value < 0.001, and the 5-year survival was 35% (95% CI, 27–44) with I² = 98.74 and p-value < 0.001.
Conclusions
This systematic review and meta-analysis found that the survival rates for patients with cervical cancer in Sub-Saharan Africa are much lower than the global averages. The results show that the 5-year survival rate can be as low as 35%, highlighting serious challenges in managing cervical cancer in this region. To address this issue, collaboration among governments, healthcare providers, and international organizations is essential to enhance the availability and quality of care. Future research should focus on developing effective early detection and treatment strategies and monitoring long-term survival outcomes.
... Oral cancer accounts for 48% of head and neck cancer cases, making head and neck cancer the sixth most frequent cancer in humans [1][2][3] oral squamous cell carcinomas (OSCCs) are the histologically determined cause of 90% of mouth cancer cases [4]. In most countries, the 5-year survival rate for oral cancer remains below 50%, even with the use of innovative management regimens [5]. ...
Introduction The heterogeneity of head and neck cancers poses challenges in treatment planning, necessitating a nuanced approach.Materials and methods We have carried out a literature review that highlights the risk factors in the onset of oral and head and neck cancers. We also addressed the therapeutic aspects and the influence of epigenetics.Results In identifying risk factors, our literature research highlights systemic causes such as age, gender, heredity, race, socioeconomic status, and immunodeficiency. Local causes, including tobacco and alcohol use, chronic traumas, chronic infections, and the role of viruses, underscore the multifactorial nature of oral cancer etiology. Addressing prevention strategies, our review underscores the potential of probiotics in suppressing oral cancer cell proliferation, with specific strains demonstrating efficacy in reducing mucositis caused by radiotherapy and chemotherapy. Additionally, the role of vitamins, omega-3 fatty acids, and compounds like curcumin in chemoprevention is explored. The Mediterranean diet emerges as a potential preventive measure, given its association with reduced cancer risk due to its rich content of monounsaturated fatty acids, antioxidants, and dietary fiber. Conclusions In conclusion, the intricate interplay of various risk factors underscores the multifactorial nature of oral cancer, with systemic and local influences contributing to its onset and progression. Age, gender, heredity, race, socioeconomic status, immunodeficiency, and lifestyle choices such as tobacco, alcohol, and poor oral hygiene collectively elevate the risk. Specific chronic infections, the role of viruses, and even certain medications further contribute to the complexity of this disease.
... The spectrum of bacteria causing infection in these patients is quite big. In the past few decades major changes have occurred in the type and range of bacteria causing infection in such patients 3 . Upto mid-1980s, Gram negative bacteria accounted for majority of bacterial infections in these patients 4 . ...
Bacterial infections are a major cause of illness in patients with hematological malignancy and can lead to mortality, if not treated early and properly. The incidence of bacterial infection in these patients and the spectrum of causative organisms are liable to change according to region & time. This observational study was designed to isolate and identify the aerobic bacteria causing infection in patients with hematological malignancy. The Study was done in the Department of Microbiology and Immunology, BSMMU from March 2012 to August 2012. Forty diagnosed patients of hematological malignancies who were admitted in the Hematology Department and in The Paediatric Hemato-oncology Department of BSMMU with symptoms of sepsis &/ or UTI or RTI were enrolled in this study. Blood, throat swab and urine were collected from each patient and sputum was collected from four patients. Infection was microbiologically detected in 37.5% of patients. Gram negative bacteria were most frequently isolated from various specimens except throat swab from which only S. pyogenes were isolated. J. Dhaka National Med. Coll. Hos. 2015; 21 (01): 3-5
... Globally, the number of new colorectal cancer (CRC) cases is increasing each year. In 2002, the estimated number of new CRC cases worldwide was 1.02 million, and by 2018, this figure had risen to approximately 1.8 million, presenting a significant challenge for CRC prevention and treatment [1][2][3][4]. The primary focus of CRC treatment lies in the control of distant metastasis. ...
Objective
Trifluridine/tipiracil (FTD/TPI) is one of the options for late-line treatment of colorectal cancer (CRC). However, the specific patient populations that would particularly benefit from it remain unclear. This study attempted to identify predictive markers of chemotherapy efficacy with trifluridine/tipiracil (FTD/TPI), focusing on the RNA-editing enzyme adenosine deaminase acting on RNA 1 (ADAR1) expression and neutrophil–lymphocyte ratio (NLR).
Methods
To assess the effectiveness of FTD/TPI in CRC patients, we retrospectively analyzed 72 CRC patients at Okayama University Hospital from 2014 to 2022.
Results
Adding bevacizumab to FTD/TPI resulted in a more prolonged progression-free survival (PFS), consistent with the SUNLIGHT study findings (p = 0.0028). Among the participants, those with a high NLR had a shorter PFS (p = 0.0395). Moreover, high ADAR1 expression was associated with longer PFS (p = 0.0151). In multivariate analysis, low ADAR1 (HR = 3.43, p = 0.01) and absence of bevacizumab (HR = 4.25, p = 0.01) were identified as factors shortening PFS. The high ADAR1 group demonstrated fewer cases of progressive disease and a higher proportion of stable disease than the low ADAR1 group (p = 0.0288). Low NLR and high ADAR1 were predictive markers of prolonged PFS in the bevacizumab-treated group (p = 0.0036).
Conclusion
Low NLR and high ADAR1 were predictive markers for a positive response to the FTD/TPI plus bevacizumab regimen associated with prolonged PFS. The FTD/TPI plus bevacizumab regimen should be proactively implemented in the low NLR and high ADAR1 subgroups.
... Esophageal cancer. Esophageal cancer is the eighth most diagnosed cancer and the sixth most common cause of cancer-related death worldwide (59). Esophageal cancer represents a group of histologically and etiologically varying entities, the two most common ones are adenocarcinoma and squamous cell carcinoma. ...
Microbiome and radiotherapy represent bidirectionally interacting entities. The human microbiome has emerged as a pivotal modulator of the efficacy and toxicity of radiotherapy; however, a reciprocal effect of radiotherapy on microbiome composition alterations has also been observed. This review explores the relationship between the microbiome and extracranial solid tumors, particularly focusing on the bidirectional impact of radiotherapy on organ-specific microbiome. This article aims to provide a systematic review on the radiotherapy-induced microbial alteration in-field as well as in distant microbiomes. In this review, particular focus is directed to the oral and gut microbiome, its role in the development and progression of cancer, and how it is altered throughout radiotherapy. This review concludes with recommendations for future research, such as exploring microbiome modification to optimize radiotherapy-induced toxicities or enhance its anti-cancer effects.
... Global cancer statistics are disseminated by the International Agency for Research on Cancer (IARC) as per its mandate as the specialized cancer agency of the World Health Organization (WHO). [1][2][3][4] These statistics serve to inform our understanding the global and regional burden of cancer and are a critical resource in developing and prioritising effective cancer control policies. As with previous reports, [5][6][7] we document here the data sources and methods used to estimate global cancer statistics for the year 2022. ...
The data sources and methods used to develop global cancer incidence and mortality statistics—the GLOBOCAN estimates—for the year 2022 are documented in this article, alongside a brief overview of the global cancer burden. The estimates, made available in 185 countries or territories worldwide for 36 cancer sites by sex and age, are based on the best available local data sources, namely population‐based cancer registries (for incidence) and national vital statistics (for mortality). In males, lung cancer was the most commonly diagnosed cancer worldwide in 2022 (1.57 million new cases [95% UI: 1.56–1.58]), followed by prostate cancer (1.47 million [1.46–1.48]). With 2.30 million (2.28–2.30) new cases estimated in 2022, breast cancer was the most diagnosed cancer in females, followed by lung cancer (0.91 million [0.90–0.91 million]) and cervical cancer (0.66 million [0.66–0.67]). The most common causes of cancer death in males and females were lung cancer (1.23 million [1.22–1.24]) and breast cancer (0.67 million [0.66–0.67]), respectively.
... Head and neck cancers are malignancies located in the oral cavity, hypopharynx, and oropharynx [1]. The oropharynx is located at the back of the mouth, extending from the soft palate to the base of the tongue.With an estimated yearly burden of 563,826 incident cases (including 274,850 oral cavity cancers, 159,363 larynx cancers, and 52,100 oropharynx cancers) and 301,408 deaths, head and neck cancer is the sixth most frequent cancer in the world [2]. In general, head and neck cancer incidence has declined in recent years in the United States, which is consistent with the country's declining cigarette use [3,4]. ...
Human Papillomavirus (HPV) is the most prevalent sexually transmitted infection, posing a significant public health concern with HPV-associated oropharyngeal cancer emerging as the most common HPV-associated cancer (HPV-aOC). Risky sexual behaviours, notably, oral sex emerge as a critical risk factor for HPV-aOC. Despite its profound impact, there exists a poor awareness of the connection between HPV and oropharyngeal cancer, coupled with suboptimal vaccine uptake. By elucidating the nexus between sexual behaviour and HPV-aOC, this paper aims to foster a paradigm shift towards modified sexual activity, ultimately leading to a reduced risk of HPV-aOC. This study also advocates for multi-faceted approaches such as the use of protective barriers, reducing the number of oral sex partners, increasing awareness through public health education, and augmenting vaccine uptake to limit the prevalent risks of HPV-aOC. Through these concerted efforts, it is envisaged that the incidence and prevalence of HPV-aOC can be mitigated.
... Head and neck cancers are malignancies located in the oral cavity, hypopharynx, and oropharynx [1]. The oropharynx is located at the back of the mouth, extending from the soft palate to the base of the tongue.With an estimated yearly burden of 563,826 incident cases (including 274,850 oral cavity cancers, 159,363 larynx cancers, and 52,100 oropharynx cancers) and 301,408 deaths, head and neck cancer is the sixth most frequent cancer in the world [2]. In general, head and neck cancer incidence has declined in recent years in the United States, which is consistent with the country's declining cigarette use [3,4]. ...
Human Papillomavirus (HPV) is the most prevalent sexually transmitted infection, posing a significant public health concern with HPV-associated oropharyngeal cancer emerging as the most common HPV-associated cancer (HPV-aOC). Risky sexual behaviours, notably, oral sex emerge as a critical risk factor for HPV-aOC. Despite its profound impact, there exists a poor awareness of the connection between HPV and oropharyngeal cancer, coupled with suboptimal vaccine uptake. By elucidating the nexus between sexual behaviour and HPV-aOC, this paper aims to foster a paradigm shift towards modified sexual activity, ultimately leading to a reduced risk of HPV-aOC. This study also advocates for multi-faceted approaches such as the use of protective barriers, reducing the number of oral sex partners, increasing awareness through public health education, and augmenting vaccine uptake to limit the prevalent risks of HPV-aOC. Through these concerted efforts, it is envisaged that the incidence and prevalence of HPV-aOC can be mitigated.
... According to recent global cancer statistics, prostate cancer constitutes the fifth most common type of cancer in the world and the second most common in men [2]. The medical treatment cost of prostate cancer runs into millions of dollars annually, while the emotional cost to the patients and the members of their families is incalculable. ...
The size and geometry of the prostate are known to be pivotal quantities used by clinicians to assess the condition of the gland during prostate cancer screening. As an alternative to palpation, an increasing number of methods for estimation of the above-mentioned quantities are based on using imagery data of prostate. The necessity to process large volumes of such data creates a need for automatic segmentation tools which would allow the estimation to be carried out with maximum accuracy and efficiency. In particular, the use of transrectal ultrasound (TRUS) imaging in prostate cancer screening seems to be becoming a standard clinical practice due to the high benefit-to-cost ratio of this imaging modality. Unfortunately, the segmentation of TRUS images is still hampered by relatively low contrast and reduced SNR of the images, thereby requiring the segmentation algorithms to incorporate prior knowledge about the geometry of the gland. In this paper, a novel approach to the problem of segmenting the TRUS images is described. The proposed approach is based on the concept of distribution tracking, which provides a unified framework for modeling and fusing image-related and morphological features of the prostate. Moreover, the same framework allows the segmentation to be regularized via using a new type of "weak" shape priors, which minimally bias the estimation procedure, while rendering the latter stable and robust.
... This is due to the fact that the precursors, denoted as cervical intraepithelial neoplasia (CIN) or squamous intraepithelial lesions (SIL) can take 3 to 20 yr to develop into cancer. However, due to lack of resources and infrastructure, 238,000 women die every year of cervical cancer; more than 80% of these deaths occur in developing countries [1], [3]. We are interested in applying optical technologies to replace expensive infrastructure for cervical cancer screening in the developing world. ...
Uterine Cervical Cancer is one of the most common forms of cancer in women worldwide. Most cases of cervical cancer can be prevented through screening programs aimed at detecting precancerous lesions. During Digital Colposcopy, colposcopic images or cervigrams are acquired in raw form. They contain specular reflections which appear as bright spots heavily saturated with white light and occur due to the presence of moisture on the uneven cervix surface and. The cervix region occupies about half of the raw cervigram image. Other parts of the image contain irrelevant information, such as equipment, frames, text and non-cervix tissues. This irrelevant information can confuse automatic identification of the tissues within the cervix. Therefore we focus on the cervical borders, so that we have a geometric boundary on the relevant image area. Our novel technique eliminates the SR, identifies the region of interest and makes the cervigram ready for segmentation algorithms.
... Cervical cancer is the second most common cancer among women worldwide, with persistently high incidence and mortality in developing countries (Soo et. al., 2010;Parkin et. al., 2005;Vistad, Fossa & Dahl, 2006;Pearman, 2003). The increasing survival rates of women with cervical cancer increased the importance of health-related quality of life (HRQOL) of the survivors (Soo et. al., 2010;. The multiple treatment modalities (surgery, radiation, and chemotherapy) of gynecological malignancies induce a significant morbidi ...
p>Background: Malignant diseases represent one of the most important worldwide morbidity and mortality causes. In Romania, the number of new cancer cases is 78800/year and the number of cancer deaths is 48300/year. In Galati County the number of oncology patients under observation is continuously increasing, ranging from 11426 cases in 2008 to 17083 cases in 2017. Methods and materials: We are presenting psycho-oncology reactions manifested by an oncology patient during his evolution from pre-therapeutic evaluation, to diagnostic set-up, treatment and further evolution. Anxiety and depression prevalence among oncology patients vary in very large limits, function of malignant site, but also, within the pale of the same disease, the highest incidence of depression being in patients with breast, lung, colorectal, head and neck cancers. In the specialty literature the following influence factors for psychological and psychiatrically reactions are mentioned: age, neoplasia sites, emotional, psychological status, and depressive status prior to cancer diagnostic. Psychic reactions are various and variable from one patient to another, progressing from denial, revolt, anger, sadness, anxiety to depression and suicidal tendencies. Taking into consideration that depression BRAIN – Broad Research in Artificial Intelligence and Neuroscience Volume 10, Special Issue (June, 2019), ISSN 2067-3957 78 symptoms are overlapping with those given by neoplasia itself and with toxicities of the oncologic treatment, the evolution of depression is complicated.
Conclusions: The polymorphism of psycho-oncology reactions manifested on the entire route of malignant diseases requires psychological counseling in all disease stages. Efficient communication with the oncologic patient, psychological counseling of patient, of their family, of medical staff and group therapy can be achieved only with specialized personnel employed in oncology centers: psychologist, psychiatrist, social assistant, and priest.</p
... accessed on 14 October 2024, Fig. 1). Because of the decline in smoking rates, the histologic types of lung cancer have shifted from LSCC, more strongly associated with cigarette smoking, to nonsmoking LAD, suggesting that other factors such as genetic predisposition, lifestyle, and environmental risk factors may contribute to the development of LAD [4]. ...
Objective
The incidence of lung adenocarcinoma (LAD) is increasing worldwide. Single-nucleotide polymorphisms in aldehyde dehydrogenase 2 family member gene ( ALDH2 ) rs671 and alcohol dehydrogenase 1B ( ADH1B ) rs1229984 are common and functionally important genetic variants to metabolize endogenous and exogenous aldehyde chemicals, related to cancer.
Methods
This is a case–control study. A total of 150 newly diagnosed LAD patients were from Kaohsiung Medical University Hospital, Taiwan, between 2019 and 2022. Two control groups, TWB-1 ( n = 600) and TWB-2 ( n = 29 683), were selected from Taiwan Biobank (TWB), and the case patients were frequency-matched with TWB-1 based on age category (30–60 or >60 years old), sex, and education levels. Logistic regression models were employed to analyze the association between two genetic variants and LAD risk.
Results
A significant association was noted between ALDH2 and LAD risk. Those with ALDH2 rs671 *2/*2 in TWB-1 and TWB-2 controls had a 2.68-fold (95% CI = 1.43–4.99) and a 1.83-fold (95% CI = 1.07–3.11) increased risk of LAD, respectively, compared with those with ALDH2 rs671 *1/*1 or *1/*2 , after adjusting for covariates. This association was particularly pronounced in females. No overall significant association between ADH1B rs1229984 and LAD risk was observed.
Conclusion
The findings indicate a strong and robust risk association between ALDH2 rs671*2/*2 and LAD in the Taiwan population, particularly in Taiwanese female adults.
Background
MicroRNAs (miRNAs) are suggested to be very important in the development of lung cancer. This study assesses the association between polymorphisms in miRNA-related (miR)-26a-1, miR-605, and miR-16-1 genes and risk of lung cancer, as well as the effect of gene–environment interaction between miRNA polymorphisms and cooking fume exposure on lung cancer.
Methods
A case–control study including 268 diagnosed nonsmoking female lung cancer patients and 266 nonsmoking female controls was carried out. Three miRNA polymorphisms (miR-26a-1 rs7372209, miR-605 rs2043556, and miR-16-1 rs1022960) were analyzed. Both additive and multiplicative interactions were assessed.
Results
MiR-16-1 rs1022960 may be associated with the risk of lung cancer. Carriers with TT genotype of miR-16-1 rs1022960 were observed to have a decreased risk of lung cancer compared with CC and CT genotype carriers (odds ratio =0.550, 95% confidence interval =0.308–0.983, P=0.044). MiR-26a-1 rs7372209 and miR-605 rs2043556 showed no statistically significant associations with lung cancer risk. There were no significant associations between the three single nucleotide polymorphisms and lung adenocarcinoma. People with exposure to both risk genotypes of miR-26a-1 rs7372209 and cooking oil fumes were more likely to develop lung cancer than those with only genetic risk factor or cooking oil fumes (odds ratios were 2.136, 1.255, and 1.730, respectively). The measures of biological interaction and logistic models indicate that gene–environment interactions were not statistically significant on additive scale or multiplicative scale.
Conclusion
MiR-16-1 rs1022960 may be associated with the risk of lung cancer in a Chinese nonsmoking female population. The interactions between miRNA polymorphisms (miR-26a-1 rs7372209, miR-605 rs2043556, and miR-16-1 rs1022960) and cooking oil fumes were not statistically significant.
Master thesis is divided into four parts. The first one gives an overview of speech-language disorders; describes their etiology, the plurality of classifications and ultimately describes characteristics of the disorders themselves.
The second part includes description of the evidence-based scientific practice, after which modern approaches to speech-language disorders therapy, which are evidence-based, are described: the role of early intervention, an overview of the approach based on “scaffolding”, overview of traditionalistic and functionalistic speech-language disorders therapy approaches, as well as environmental method, listening-based method, production-oriented methods, cognitive-linguistic method and finally an overview of combined methods.
The third part describes the Verbotonal method, after which the fourth part compares Verbotonal method with the above-mentioned modern approaches for the rehabilitation of speech-language disorders. The comparison showed that the principles of the Verbotonal method are based on evidence, which indicates the validity of the use of the Verbotonal method. Also, the comparison showed that the Verbotonal method has contact points with modern methods of rehabilitation of speech-language disorders: with “scaffolding” it shares a gradual mode of work, with functionalism an individual approach to each person, with traditionalism the use of imitation, exercising expression and repeating, with the method focused on production similar principles of speech correction, with the method based on listening the use of sound stimulation, while with the cognitive-linguistic method it shares the global structuralism principle.
Introduction: Ovary is complex in its embryology, histology and steroid genesis with potential to develop non-neoplastic and neoplastic lesions. No denite screening program and the difculty in early detection are main reasons for poor prognosis of ovarian cancer. To study frequency, Aim: clinical ndings and histopathological spectrum of non- neoplastic and neoplastic lesions of ovary. Methods: The Study was descriptive observational cross sectional and conducted in the Pathology department from January 2019 to June 2022 at a tertiary care Hospital. The Results: commonest age presentation was 21-50 years of age group (67%). The symptoms of ovarian lesions were not very specic and pain in abdomen and menstrual disturbance were common symptoms. Most of the ovarian tumors were unilateral (86.92%) and of cystic in consistency (48.46%). Out of 214 lesions, 64 (30%) were non- neoplastic and 150 (70%) were neoplastic. Simple cyst was most common (29.9%) non-neoplastic lesion. Out of total 150 neoplastic lesions 89 (59.4%) were benign, 6 (04%) were borderline and 55 (36.6%) were malignant lesions. Among the neoplastic lesions, epithelial tumor (80%) was the most common. Out of them serous epithelial tumors (53.33%) were the common. The commonest germ cell tumor was mature teratoma and commonest sex cord stromal tumors was adult granulosa cell tumors. Non Conclusion: -neoplastic and neoplastic ovarian lesions include various morphological features with particular age wise distribution and majority lesions were neoplastic.
Objectives: In order to improve the care provided at a rural consultorio, we obtained patients’ perspectives on the successes and failures of the Chilean healthcare system under the AUGE (Acceso Universal de Garantías Explícitas, Universal Access with Explicit Guarantees) plan. Background: In 2000, Chile’s AUGE Plan established a set of guarantees for specific medical conditions. All citizens are now guaranteed access to appropriate treatment, quality care, and financial protection for what are currently 80 conditions. All registered members can access either public or private healthcare; insurance payments are based on income. However, while Chile has been successful in increasing access to care, the system still faces challenges. Methods: In order to understand the patient perspective on access to healthcare, a survey was administered in a rural general medical clinic in the public sector. The questions covered general demographic information, measures of health, satisfaction with care, and access to care. Results: Fifty patients responded to the survey. 64% of patients reported not being able to afford their preferred treatments for their illness(es) and only 59% reported knowing their rights under the national health plan. 61% reported having a doctor who knows them well. Patients reported not taking their prescribed medications due to forgetfulness (42%), not feeling sick (34%), or a belief that they were not necessary (22%). Wait times for non-urgent specialist care of up to two years were reported. 8.8% of women reported not feeling comfortable discussing domestic abuse with their physician and/or felt they would have problems finding resources elsewhere. 84% of women age 21-75 reported receiving their screening Papanicolau smear and 80% of women between age 50-75 reported receiving their screening mammogram in accordance with government guidelines. Discussion: The rural site studied has been successful at implementing women’s health screening, providing preventive care for chronic disease patients, and maintaining general patient satisfaction. However, despite explicit guarantees to quality medical care, many survey respondents indicated perceived deficiencies in the care they are receiving in the public sector clinic. Lack of patient education, preference for natural remedies, and long wait-times for specialist care appear to be challenges faced by this population. Work still remains in assuring the full delivery of AUGE’s promises and in increasing patient awareness of their rights under the national health plan.
The approach we followed to review the epidemiology of prostate cancer was to divide this chapter into three major sections. The first section provides a brief summary of the prevalence, incidence, and mortality data worldwide and in the United States. These data are compared for different geographic areas and among different ethnic groups, with an attempt to address how suspected risk factors for prostate cancer may relate to the observed global discrepancies with respect to incidence and mortality rates. The data provided in the first section pertain primarily, although not exclusively, to clinically evident prostate cancer. As it is becoming increasingly recognized that prostatic neoplasia covers a wide biological spectrum, the second section reviews available epidemiological data on the early “phases” of the diseases, specifically precursor lesions and preinvasive neoplasia, and the category of pre-clinical or the so-called “latent” prostate cancer. Finally, the third section highlights some of the changes in the clinicopathological profile of prostate cancer diagnosed in the prostate-specific antigen (PSA) era of the 1990s: During the last decade, the Western Hemisphere in particular has witnessed significant changes in the profile of both the patients diagnosed with prostate cancer and the characteristics of their tumors.
Two components of arachidonic acid (AA) metabolism are strongly associated with carcinogenesis—the leukotriene and prostaglandin (PG) synthesis pathways. Both pathways are inhibited by antioxidants and anti-inflammatory agents. Blocking the PG synthesis pathway by inhibiting the activity of the cyclooxygenase (COX) component of prostaglandin H (PGH) synthase using nonsteroidal anti-inflammatory drugs (NSAIDs), and particularly COX-2 selective inhibitors, is a prominent and highly promising strategy for cancer chemoprevention (1–6). The rationale for suppressing COX activity or expression in chemoprevention is strengthened by the observation of COX elevation in many cancers and precancerous lesions.
Prostate cancer is now the most commonly diagnosed cancer and the second leading cause of death among men, surpassing lung cancer. It is estimated that 179,300 new cases will be diagnosed in the United States in 1999, and approx 37,000 men will die from this disease. In the past 12 yr, the incidence has increased 50%, but recently it is starting to decline (1).
Background: Prostate cancer is the most common urologic malignancy in men, it is witnessing a huge burden in developing countries. Prostate-specific antigen has served as a tool in diagnosis and prognostication. To improve its sensitivity, Prostate-specific antigen density is being used to discriminate between benign and malignant conditions to avoid the incidence of unnecessary biopsy. Similarly, it is important to establish the importance of Prostate-specific antigen density in prognostication to help in treatment stratification. The aim of this study, therefore, is to assess the relationship between Prostate-specific antigen density and tumour grade using the Gleason score. Methodology: This study was a prospective cross-sectional study carried out between 2015-2016. It involved 191 consecutive patients who were either asymptomatic or symptomatic with elevated prostate-specific antigen (PSA)/abnormal digital rectal examination findings or both. They had a Prostate volume assessment and digitally guided prostate biopsy. Prostate-specific antigen density was calculated, and histopathology reports were evaluated. Data were analysed using SPSS version 20.0. Pearson correlation coefficient and test of ANOVA were used to assess the relationship between prostate-specific-antigen and Gleason score while a scatterplot was used to determine the relationship between prostate-specific antigen and prostate volume. The level of significance was set at p< 0.05 Results: All patients in this study were Nigerians, mean age of the study population was 68.2+ 9.4 years. The median PSA for patients with prostate cancer was 76.9ng/ml and 14.5ng/ml for patients with benign disease, the difference was statistically significant (p<0.001), and median prostate volume was 84.5mls while the median PSAD was 0.25. PSAD for Gleason score 2-4,5-7,8-10 was 0.4,0.8 and1.1 respectively which was statistically significant using a test of ANOVA (p=0.001). Pearson correlation coefficient revealed a statistically significant correlation between Prostate-specific antigen and Gleason score (r= 0.375, p=0.024). Using Fisher's exact test there was a statistically significant difference between PSAD for benign prostatic disease and carcinoma of the prostate, p<0.001. Conclusion: The study revealed that Prostate-specific antigen density has a statistically significant predictive value for tumour grade using Gleason score, however no statistically significant correlation was observed between prostate-specific antigen and prostate volume in prostate cancer.
Background
PTEN (phosphatase and tensin homologue) is a tumour suppressor gene which is well known for its negative regulation on phosphatidylinositol 3-kinase ( PI3K ) pathway, thereby controlling the cellular growth and proliferation in the process of carcinogenesis. In the present study, the frequency of the genotypes of the PTEN gene, ( rs2943773 , rs1234224 , rs9651495 , rs3827678 , and rs11202600 ) has been observed in individuals with oral squamous cell carcinoma (OSCC) using real-time polymerase chain reaction (RTPCR).
Methodology
Saliva samples were collected from healthy individuals and individuals with OSCC. DNA extraction was done, followed by PCR using fluidigmn technique to observe the frequency of the genotypes.
Results
Variation was observed in the distribution of frequencies of the alleles ( rs9651495 and rs1234224 ) of the PTEN gene between the healthy individual and those with occurrence of OSCC. The other genotypes did not show any statistically significant difference in the distribution between the study group and the control group, nor any association was observed with OSCC.
Conclusion
The variation in the frequency of rs9651495 and rs1234224 of the PTEN gene suggests an association between the “ PTEN ” gene and “OSCC” and hence its use in the panel of diagnostic markers. This also opens the field for future research in the therapeutic applications of the PTEN gene.
Background
The vascular endothelial growth factor (VEGF) signaling pathway is closely related to pathological angiogenesis in liver disease. Anti-angiogenesis is an effective intervention in the clinical treatment of liver disease. Some antiangiogenic drugs are resistant and have limitations in clinical use.
Methods
This research uses bibliometric methods to assess the literature on the VEGF signaling pathway in liver disease from 2008 to 2023.
Results
The number of publications has generally increased over the past 16 years, meaning that enormous researchers are interested in this field. China and the USA have published the most articles and cooperate closely with each other. Plos one has published the largest number of articles in this area, and Hepatology and Journal of Hepatology is the most authoritative journal. Llovet JM is an outstanding researcher in the field with the highest citations. Keywords and research hotspots analysis indicated that researchers are very concerned about the application and clinical research status of anti-angiogenic drugs in hepatocellular carcinoma (HCC). Continuing to deepen the research on the use of anti-angiogenic drugs alone and in combination is necessary. In addition, the resistance of anti-angiogenic therapeutic drugs leads to a complex mechanism of angiogenesis response caused by hypoxia, which requires further research.
Conclusions
This study analyzed the research situation related to the VEGF signaling pathway in liver disease from a bibliometric and visual perspective. Our analysis helps researchers better understand the research directions and hotspots in this area, enabling them to better carry out research in the future.
This study examined the attitude among the student nurses towards breast cancer in and around dindigul district. The study exposed that the majority of the student nurse especially GNM are highly knowledged and having good attitude about the breast cancer and its risk factors, but the study also revealed that a only rare number of the student nurse are not aware about the problems. The study also helped the investigators to promote awareness, prevalence and prevention of the breast cancer. The student nurses possess adequate knowledge about breast cancer but they need more information on breast cancer and its risk towards women's health. This paper pursues student nurses attitude towards breast cancer awareness in and around dindigul district.
This article tries to meet the need to address the knowledge of women health gaps on breast cancer and breast self- examination, how to diagnose it, signs and symptoms of breast cancer, treatments, its side effects, its cautious methods and dietary patterns. The main purpose of this study is that awareness can be developed among on breast cancer, breast self examination, to assist in early breast cancer detection as well as reducing late breast cancer presentation.
This study examines the safety, tolerability, and efficacy of anticancer drugs in the treatment of multiple myeloma, a malignancy of plasma cells characterized by overproduction of monoclonal proteins that damage bones and organs. The disease remains largely incurable despite advances in treatment, necessitating ongoing evaluation of therapeutic approaches. This review focuses on the role of key medications like bortezomib, lenalidomide, and daratumumab, highlighting their mechanisms, clinical efficacy, and associated adverse effects. Bortezomib, a proteasome inhibitor, has shown significant efficacy in both newly diagnosed and relapsed/refractory cases, particularly in combination regimens. However, it is associated with adverse effects such as peripheral neuropathy and hematologic and gastrointestinal toxicities, which require careful management. Strategies such as optimized dosing and subcutaneous administration have improved its safety profile. Future directions include enhancing therapeutic outcomes through personalized medicine, combination regimens, and mitigating resistance. This research underscores the critical need for tailored treatment strategies to improve patient survival and quality of life in multiple myeloma. Keywords: BiPN – Bortezomib-induced Peripheral Neuropathy, RRMM –Relapsed and Refractory Multiple Myeloma, NDMM –Newly Diagnosed Multiple Myeloma, PN –Peripheral Neuropathy.
Background: Materials and Methods: All the uterine cervical biopsies and hysterectomy specimens (for cervical lesions) received in our institution were evaluated retrospectively from January 2022 to August 2023. After standard grossing and processing procedure, the tissues were examined in hematoxyline and eosin stained slides and histopathological evaluation was done and pap staining are also performed. The findings were correlated with age, symptoms, gravida, parity and other relevant clinical details wherever deemed necessary. The biostatical analysis was performed using program IBM SPSS (Statistical Package for the Social Sciences), for quantitative data student’s t- test was applied. P value was considered statistically significant if P < 0.05, and highly statistically significant if P < 0.01. Result: A total of 158 cases were of neoplasia cervix. Majority of cases were squamous cell carcinoma type, i.e., 96.6% (174 cases) followed by adenocarcinoma constituting only 2.8% (5 cases) with a mean age of 50 years and average gravida of 3.78. Majority of cases (50.01%) complained of postmenopausal bleeding followed by abnormal spotting (26.67%) and lower abdominal pain (7.78%). The most common presentation was in Stage IIB with 45.56% (82) cases. Conclusion: Histomorphology remains the mainstay of diagnosis of cervical cancers. In low compliance settings such as ours, colposcopy‑guided biopsy is the preferred course of management, especially in elderly females to be definite to rule out or diagnose neoplasia. National level cervical cancer program is immediate need of the hour and should include human papilloma virus vaccine, awareness, and screening programs as well as treatment assistance for low socioeconomic strata.
Incidence rates have risen rapidly for esophageal adenocarcinoma and moderately for gastric cardia adenocarcinoma, while rates have remained stable for esophageal squamous cell carcinoma and have declined steadily for noncardia gastric adenocarcinoma. We examined anthropometric risk factors in a population-based case-control study of esophageal and gastric cancers in Connecticut, New Jersey, and western Washington.
Healthy control subjects (n = 695) and case patients with esophageal squamous cell carcinoma or noncardia gastric adenocarcinoma (n = 589) were frequency-matched to case patients with adenocarcinomas of esophagus or gastric cardia (n = 554) by 5-year age groups, sex, and race (New Jersey only). Classification of cases by tumor site of origin and histology was determined by review of pathology materials and hospital records. Data were collected using in-person structured interviews. Associations with obesity, measured by body mass index (BMI), were estimated by odds ratios (ORs). All ORs were adjusted for geographic location, age, sex, race, cigarette smoking, and proxy response status.
The ORs for esophageal adenocarcinoma rose with increasing adult BMI. The magnitude of association with BMI was greater among the younger age groups and among nonsmokers. The ORs for gastric cardia adenocarcinoma rose moderately with increasing BMI. Adult BMI was not associated with risk of esophageal squamous cell carcinoma or noncardia gastric adenocarcinoma.
Increasing prevalence of obesity in the United States population may have contributed to the upward trends in esophageal and gastric cardia adenocarcinomas.
The incidence of non-Hodgkin's lymphoma among white men in the United States was measured as 6.9/100,000 person-years in 1947-1950 and as 17.4 in 1984-1988. We have estimated how much the known and suspected diagnostic and risk factors might have contributed to this apparent increase of 152%. Firm conclusions cannot be drawn without more data on risk and changes in prevalence, but a reasonable range of impacts can be constructed. After accounting for the likely effects of misdiagnosis of Hodgkin's disease as non-Hodgkin's lymphoma, of the acceptance of new entities of non-Hodgkin's lymphoma, of familial factors, of human immunodeficiency virus and other immunosuppressive conditions or drugs, and of occupation, we estimate that the percentage increase in incidence was still 80% among all males and 42% among those aged 0-64. An agent carrying a relative risk of 2.0 rising in prevalence from 0 to 42% would account for the latter rise. Diet, hair dyes, and general environmental exposures to pesticides may be contributing, but currently estimated risks and changes in exposure levels do not appear large enough to account for the residual rise. Among men aged 75-84, some of the residual rise of 109% probably is diagnostic, but only further research will clarify the issue.
Data from the São Paulo Cancer Registry (Brazil) for the period 1969-1974 are used to investigate ethnic differentials in cancer risk. Risks for specific cancers were estimated for mulattos and blacks relative to whites, using a case-control approach with other cancers as controls. For both sexes, blacks and mulattos are at higher risk than whites for cancer of the esophagus, stomach, and liver and for myeloma; for prostate cancer in males; and for gall bladder, pancreas, and cervix uteri cancers in females. Blacks and mulattos are at lower risk than whites for cancer of the colon, lung, larynx (males only), bladder, bone, testis, breast, and corpus uteri and for melanoma and leukemia. Except for lung and colon cancers, for which life-style habits are the main risk factors, these ethnic differences are similar to those observed in the United States.
The seroprevalence of IgG antibodies to Helicobacter pylori was determined using a standard enzyme linked immunosorbent assay in a population of 749 randomly selected men, aged 30-75 years, from Caerphilly, South Wales. The overall prevalence of H pylori was 56.9%, increasing sharply in middle age from 29.8% in those aged 30-34 to over 59% in those aged 45 or older (p less than 0.0001). Age standardised seroprevalence rates were lowest in combined social class categories I and II (49.2%), intermediate in categories IIIN and M (57.5%), and highest in categories IV and V (62.2%) (p = 0.01). In those aged 30-34 years, the prevalence rate for those in combined social class categories IV and V was 57.9% - double the rate for social class categories IIIM and N (28.3%) and five times the prevalence rate in those in social class categories I and II (11.1%). These differences in the infection patterns of H pylori by social class are consistent with patterns of peptic ulcer disease and gastric cancer.
Rates of stomach cancer vary from place to place within England and Wales. To determine whether this reflects influences acting earlier or later in life, we have analysed mortality from the disease by county of birth and county of death. Among 749,035 men and women who died during 1969-72 in a different county from that in which they were born, proportional mortality from stomach cancer was more closely related to county of birth than of death. This association with place of birth was found in migrants both out of and into high-risk areas. We conclude that studies seeking to explain local differences in the incidence of stomach cancer within England and Wales should focus on the environment of patients in their youth.
Cholangiocarcinoma is a relatively rare cancer; worldwide it accounts for an estimated 15% of liver cancers. In most areas, the etiology is rather obscure, and identified risk factors such as hepatolithiasis, inflammatory bowel disease, and exposure to Thorotrast can account for only a small proportion of cases. In certain areas of southeast and eastern Asia, however, incidence rates are very high, and here there is a strong association with infection with the liver flukes Clonorchis sinensis and Opisthorchis viverrini. The mechanisms of carcinogenesis in O. viverrini infection have been the subject of considerable research; it seems that the presence of parasites induces DNA damage and mutations as a consequence of the formation of carcinogens/free radicals and of cellular proliferation of the intrahepatic bile duct epithelium. Preventive strategies in areas endemic for liver flukes appear straightforward, but breaking the cycle of infection has proved difficult in practice.
Relatively little is known about the size and makeup of the growing population of cancer survivors or about the social implications of a diagnosis of cancer. To explore these issues, we analyzed cancer survivorship information from the 1992 National Health Interview Survey (NHIS), and resulting cancer prevalence estimates were compared with those derived from cancer registry data.
According to the NHIS, there were an estimated 7.2 million adult survivors of cancer-excluding nonmelanoma skin cancer-in 1992, representing 3.9% of the U.S. adult population. Comparisons with prevalence estimates from cancer registry data suggest that cancer is underreported in the NHIS. Nearly three fifths (58.0%) of cancer survivors self-identified on the NHIS reported that their cancer was first detected when they noticed something wrong and went to a doctor. The majority (55.7%) of cancer survivors had obtained a second opinion or multiple opinions regarding their treatment. Most (58.0%) had received patient educational materials from a health care provider. However, relatively few had received counseling or participated in support groups (14.2%), contacted cancer organizations after their diagnosis (10.9%), or participated in a research study or clinical trial as part of their cancer treatment (4.7%). One ninth (10.7%) of the survivors had been denied health or life insurance coverage because of their cancer. Nearly one fifth (18.2%) of the cancer survivors who worked before or after their cancer was diagnosed experienced employment problems because of their cancer.
While cancer appears to be underreported on the 1992 NHIS, the survey provides valuable information about the medical, insurance, and employment experience of cancer survivors selected from a nationally representative sample of U.S. households.
In health services planning, in addition to the basic measures of disease occurrence incidence and mortality, other indexes expressing the demand of care are also required to develop strategies for service provision. One of these is prevalence of the disease, which measures the absolute number, and relative proportion in the population, of individuals affected by the disease and that require some form of medical attention. For most cancer sites, cases surviving 5 years from diagnosis experience thereafter the same survival as the general population, so most of the workload is therefore due to medical acts within these first 5 years. This article reports world-wide estimates of 1-, 2-3- and 4-5-year point prevalence in 1990 in the population aged 15 years or over, and hence describes the number of cancer cases diagnosed between 1986 and 1990 who were still alive at the end of 1990. These estimates of prevalence at 1, 2-3 and 4-5 years are applicable to the evaluation of initial treatment, clinical follow-up and point of cure, respectively, for the majority of cancers. We describe the computational procedure and data sources utilised to obtain these figures and compare them with data published by 2 cancer registries. The highest prevalence of cancer is in North America with 1.5% of the population affected and diagnosed in the previous 5 years (about 0.5% of the population in years 4-5 and 2-3 of follow-up and 0.4% within the first year of diagnosis). This corresponds to over 3.2 million individuals. Western Europe and Australia and New Zealand show very similar percentages with 1.2% and 1.1% of the population affected (about 3.9 and 0.2 million cases respectively). Japan and Eastern Europe form the next batch with 1.0% and 0.7%, followed by Latin America and the Caribbean (overall prevalence of 0.4%), and all remaining regions are around 0.2%. Cancer prevalence in developed countries is very similar in men and women, 1.1% of the sex-specific population, while in developing countries the prevalence is some 25% greater in women than men, reflecting a preponderance of cancer sites with poor survival such as liver, oesophagus and stomach in males. The magnitude of disease incidence is the primary determinant of crude prevalence of cases diagnosed within 1 year so that differences by region mainly reflect variation in risk. In the long-term period however different demographic patterns with long-life expectancy in high-income countries determine a higher prevalence in these areas even for relatively uncommon cancer sites such as the cervix.
Incidence and mortality from prostate cancer were rising in most countries until the late 1980s. Following a number of advances in the management of prostate cancer, including introduction of the prostate-specific antigen (PSA) test, there have been reports of declines in mortality in Canada, the United States and the United Kingdom. To investigate the extent to which this pattern was seen in other industrialised countries, we used routinely collected data to explore recent changes in prostate-cancer mortality. Trends in age-standardised death rates between 1979 and 1997 for men aged 50 to 79 years in 24 industrialised countries were compared using join point regression. Join point regression allows estimation of the annual percentage change in death rates and tests for significant changes in trend. During the period studied, age-standardised mortality increased at 1% to 2% per year in most countries. In 7 countries (Canada, United States, Austria, France, Germany, Italy and United Kingdom), a significant down-turn in age-standardised mortality was observed over the period 1988-1991. Trends in age-specific rates within these countries support a period effect on prostate-cancer mortality. Declines in mortality could result from any combination of either artefact, reduction in prostate-cancer incidence, a rise in competing causes of death or changes in the risk of death from prostate cancer. There are inconsistencies in the relationship between national mortality trends and uptake of PSA screening; further research is required to determine whether changes in death rates can be explained by international and secular variations in the treatment of prostate cancer.
The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented.
We have reviewed the evidence for 'causality' with respect to infectious agents linked with cancer, and estimated the fraction of all cancer cases concerned that are attributable to it. The aetiological fraction was applied to the estimated annual incidence of the specific cancer site in 1990, and the number of attributable cases obtained. We estimate that 14.8% (1.2 million cases) of the worldwide incidence of cancer in 1990 can be attributed to infection with either the hepatitis B and C viruses, the human papillomaviruses, EBV, HTLV I, HIV, the bacterium H pylori, schistosomes or liver flukes. There would be 22.5% fewer cancers in developing countries (920 000 cases per year) and 6.8% in developed countries (272 000 cases) if these infectious diseases were prevented. The attributable fraction at the specific sites varies from 88% of cervical cancers attributable to the papillomaviruses to 1% of leukaemias attributable to HTLV I.
The annual incidence rates (crude and age-standardized) and numbers of new cases of 25 different cancers have been estimated for the year 1990 in 23 areas of the world. The total number of new cancer cases (excluding non-melanoma skin cancer) was 8.1 million, just over half of which occur in the developing countries. The most common cancer in the world today is lung cancer, accounting for 18% of cancers of men worldwide, and 21% of cancers in men in the developed countries. Stomach cancer is second in frequency (almost 10% of all new cancers) and breast cancer, by far the most common cancer among women (21% of the total), is third. There are large differences in the relative frequency of different cancers by world area. The major cancers of developed countries (other than the 3 already named) are cancers of the colon-rectum and prostate, and in developing countries, cancers of the cervix uteri and esophagus. The implications of these patterns for cancer control, and specifically prevention, ave discussed. Tobacco smoking and chewing are almost certainty the major preventable causes of cancer today. Int. J. Cancer 80:827-841, 1999. (C) 1999 Wiley-Liss, Inc.
Non-Hodgkin lymphoma affects 5% to 10% of patients with acquired immunodeficiency syndrome (AIDS) in the United States. Usually of B-cell or indeterminate phenotype and high-grade histology, the disease shows a predilection to involve extranodal sites such as the bone marrow and the central nervous system. The pathogenesis involves chronic antigen stimulation producing B-cell hyperplasia in a setting of progressive immunologic deterioration. Treatment is not standardized and is tailored to the patient's immune function and clinical status. New approaches, validated by clinical trials, are needed.
This book reviews epidemiological and other knowledge about cancer to provide an overview of what is known, what is not known, and where important knowledge should be sought about practicable means of avoiding cancer. Although the perspective offered will be of interest to specialists in cancer research or regulation, no specialist knowledge by the reader is assumed, so students of many subjects will enjoy the clarity of thought and style which it offers.
The incidence of adult T-cell leukemia/lymphoma (ATL) and its impact on that of total non-Hodgkin lymphoma (NHL) were evaluated in Nagasaki, an area in southwestern Japan where human T-cell lymphotropic virus type I (HTLV-I) is endemic. The first study area comprised 4 towns located on the K Islands, which had a population of 26,870 in 1990. The overall HTLV-I seroprevalence estimated from the serologic survey of 18,485 subjects was 16.2%. By using the data from the Nagasaki Prefectural Cancer Registry (NPCR) and reviewing clinical and laboratory information, we identified 40 cases of ATL and 35 cases of other NHL diagnosed between 1985 and 1995. The crude annual incidence of ATL among 100,000 HTLV-I carriers aged 30 or older was estimated at 137.7 for men and 57.4 for women, with a significant sex difference after adjustment for age (rate ratio = 2.50, 95% confidence interval 1.32–4.73). The cumulative risk from 30 to 79 years of age was estimated at approximately 6.6% for men and 2.1% for women. Among the entire population, ATL accounted for 51 to 59% of the total NHL incidence, showing the strong impact of HTLV-I infection. The second study area comprised the whole of Nagasaki Prefecture (total population in 1990 = 1.56 million). Between 1985 and 1995, 989 cases of ATL and 1,745 cases of other NHL were registered in the NPCR. The world age-standardized annual incidence rate of ATL per 100,000 persons aged 30 or older was estimated at 10.5 for men and 6.0 for women, which accounted for approximately 37 to 41% of the total NHL incidence. Int. J. Cancer 85:319–324, 2000. ©2000 Wiley-Liss, Inc.
Prostate cancer is the most commonly diagnosed cancer in western men, and incidence is rising rapidly in most countries, including low-risk populations. Age-adjusted incidence and mortality rates from 15 and 13 countries between 1973–77 and 1988–92, respectively, were compared to provide leads for future analytic studies. Large increases in both incidence and mortality rates of prostate cancer were seen for all countries. For incidence, increases were more pronounced in the United States, Canada, Australia, France and the Asian countries, while the increases in medium-risk countries were moderate. Increases in incidence ranged from 25%–114%, 24%–55% and 15%–104% in high-, medium- and low-risk countries, respectively. Mortality rates rose more rapidly in Asian countries than in high-risk countries. Substantial differences in incidence and mortality across countries were evident, with U.S. blacks having rates that were 50–60 times higher than the rates in Shanghai, China. Increasing incidence rates in the United States and Canada are likely to be due in part to the widespread use of transurethral resection of the prostate and prostate-specific antigen testing, while increases in the Asian countries are probably related to westernization in these low-risk populations. The large disparities in incidence between high- and low-risk countries may be due to a combination of genetic and environmental factors. Future studies are needed to examine gene-gene and gene-environment interactions in various countries concurrently to shed light on the etiology of prostate cancer and to help elucidate reasons for the large differences in risk between populations. Int. J. Cancer 85:60–67, 2000. © 2000 Wiley-Liss, Inc.
The distribution of the human liver alcohol dehydrogenase, ADH2, and aldehyde dehydrogenase, ALDH2, genotypes in 21 different populations comprising Mongoloids, Caucasoids, and Negroids was determined by hybridization of the amplified genomic DNA with allele-specific oligonucleotide probes. Whereas the frequency of the ADH
1
2
allele was found to be relatively high in the Caucasoids, Mexican Mestizos, Brazilian Indios, Swedish Lapps, Papua New Guineans and Negroids, the frequency of the ADH
2
2
gene was considerably higher in the Mongoloids and Australian Aborigines. The atypical ALDH2 gene (ALDH22) was found to be extremely rare in Caucasoids, Negroids, Papua New Guineans, Australian Aborigines and Aurocanians (South Chile). In contrast, this mutant gene was found to be widely prevalent among the Mongoloids. Individuals possessing the abnormal ALDH2 gene show alcohol-related sensitivity responses (e.g. facial flushing), have the tendency not to be habitual drinkers, and apparently suffer less from alcoholism and alcohol-related liver disease.
Background:
There is a large body of epidemiologic and experimental data that have identified a number of arylamines as human bladder carcinogens. Metabolic activation is required to biotransform these arylamines into their carcinogenic forms, and N-hydroxylation, which is catalyzed by the hepatic cytochrome P4501A2 isoenzyme, is generally viewed as the first critical step. On the other hand, the N-acetylation reaction, catalyzed by the hepatic N-acetyltransferase enzyme, represents a detoxification pathway for such compounds. The N-acetyltransferase enzyme is coded by a single gene displaying two phenotypes, slow and rapid acetylators. In the United States, cigarette smoking is a major cause of bladder cancer in men, and carcinogenic arylamines present in cigarette smoke are believed to be responsible for inducing bladder cancer in smokers.
Purpose:
Our purpose was to test the differences in three ethnic/racial groups for the prevalence of acetylator phenotypes and to ascertain whether slow acetylators actually have higher levels of activated arylamines in comparison with rapid acetylators.
Methods:
One hundred thirty-three male residents of Los Angeles County who were either white, black, or Asian (Chinese or Japanese) and over the age of 35 years were assessed for their acetylator phenotype and levels of 3- and 4-aminobiphenyl (ABP) hemoglobin adducts. Subjects were either lifetime nonsmokers (n = 72) or current cigarette smokers of varying intensity (n = 61).
Results:
The proportion of slow acetylators was highest among whites (54%), intermediate among blacks (34%), and lowest among Asians (14%). Similarly, geometric mean levels of both 3- and 4-ABP-hemoglobin adducts were highest in whites (1.80 and 49.2 pg/g hemoglobin [Hb], respectively), intermediate in blacks (1.54 and 38.5 pg/g Hb), and lowest in Asians (0.73 and 36.0 pg/g Hb). As expected, cigarette smokers had significantly higher mean levels of both 3- and 4-ABP-hemoglobin adducts relative to nonsmokers, and the levels increased with the number of cigarettes smoked per day (P < .0005 for both adducts). Slow acetylators consistently exhibited higher mean levels of ABP-hemoglobin adducts relative to rapid acetylators, independent of race and level of smoking.
Conclusion:
The present cross-sectional survey supports acetylation phenotype as an important determinant of bladder cancer risk and a possible major factor in the varying bladder cancer risk among whites, blacks, and Asians.
Incidence rates for 27 cancers in 23 countries and mortality rates for 14 cancers in 32 countries have been correlated with a wide range of dietary and other variables. Dietary variables were strongly correlated with several types of cancer, particularly meat consumption with cancer of the colon and fat consumption with cancers of the breast and corpus uteri. The data suggest a possible role for dietary factors in modifying the development of cancer at a number of other sites. The usefulness and limitations of the method are discussed.
Over the period 1972-1985, 2729 cases of Hodgkin's disease were diagnosed in Los Angeles County, and 2492 were subclassified using the Rye classification. The occurrence of these cases was examined in relation to age, sex, race, place of birth, social class, occupation, and year of diagnosis. The pattern of nodular sclerosis occurrence conformed to expectations, supporting the polio model of etiology for this subtype. However, the risk pattern of mixed cell disease was quite distinct from that of nodular sclerosis, suggesting that the two may not share a common etiology. The pattern of lymphocyte predominance in Hodgkin's disease, with a special prominence in younger blacks, resembled neither that of nodular sclerosis nor that of mixed cell disease. The cases of lymphocyte-depletion Hodgkin's disease showed no distinctive epidemiological features, and its continued classification with nodular sclerosis and/or mixed cellularity can be justified solely by histological or biological evidence.
International variations and national time trends in disease rates suggest major associations between dietary fat and several important cancers. In contrast, case-control and cohort studies of dietary fat in relation to the same cancers generally report weak associations, or have failed to detect any association with fat intake. This study was undertaken in an attempt to understand the apparent discrepancy between these observations. The results provide an insight into the magnitude of cancer risk reduction that may follow from a practical reduction in dietary fat.
Regression analyses of international variations in cancer incidence rates were used to estimate relative risks (RR) as a function of fat intakes for both males and females. These analyses focused on cancers of the breast, colon, rectum, ovary, and endometrium in females, and colon, rectum, and prostate cancers in males.
Ages 55–69 and 30–44 were considered in order to compare RR estimates between an older and younger age group, and between post- and pre-menopausal women. Corresponding RR estimates were also calculated, based on the regression of changes in disease rates from the mid-1960s to 1980 on changes in dietary fat, using data from several countries. A strong degree of consistency with the RR estimates from international comparisons was observed. The international regression analyses were also used to project changes in cancer rates among Japanese migrants to the United States. A high level of consistency with the observed disease-rate changes was noted. Similarly, the international data analyses were used to project RRs for the fat intake categories used in specific case-control and cohort studies, while acknowledging measurement error in individual dietary assessment. Although certain exceptions are noted, considerable consistency was found between the aggregate and analytic data results, leaving open the strong possibility that a practical reduction in dietary fat could result in a major reduction in the incidence of several prominent cancers in the United States and in other nations having high fat consumption.
We examined the association between prostatic cancer incidence rates and the rates of transurethral prostatectomy to explore reasons for the nationally reported dramatic increases in incidence rates of prostatic cancer from 1973 through 1986. There was a strong correlation between both incidence of all stages of prostatic cancer combined and of localized disease and the increasing use of transurethral resection, a common surgical procedure usually performed to relieve urinary obstruction due to benign enlargement of the prostate. Our analyses suggest that increased detection of existing tumors via transurethral resection was the primary reason for the observed increase in incidence rates of prostatic cancer. However, analyses of mortality trends, particularly among nonwhites, and laboratory studies of the histologic nature of clinically asymptomatic tumors suggest that part of the increase may reflect changes in the real risk of prostatic cancer.
The incidence of Kaposi's sarcoma (KS) was examined with the use of data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. KS is a manifestation of the recent epidemic of acquired immunodeficiency syndrome (AIDS) that has occurred particularly among homosexual men. The incidence of KS in 1973-79 was found to be higher (0.29 male and 0.07 female cases/100,000/yr) than is usually cited for the pre-AIDS KS incidence rates. Collectively, the 9 SEER registries in the United States showed only a slight increase in the incidence of KS between 1973-79 and 1980-81. However, the SEER registry covering San Francisco, which is a high-risk area for AIDS, showed a marked excess of KS in 1981. The KS case rate among never-married men younger than 50 years old, a surrogate index of homosexuality, was found to be markedly elevated in the post-AIDS period, compared with the case rate of a reference disease, mycosis fungoides. Never-married men younger than 50 years old, therefore, constitute a SEER-identifiable population who can be monitored for risk of KS and other neoplasms that might be related to AIDS. In addition, the incidence rate of KS in the SEER registry of Puerto Rico was generally higher than that in the U.S. SEER registries, despite data that suggested that KS may be underreported. The demographic characteristics of patients diagnosed as having KS in Puerto Rico suggested the classical rather than the AIDS-related form of KS.
By examination of incidence, mortality amd relative frequency data an estimate has been made of the number of cancer cases in twelve sites and of all cancers that occurred in 1975 in the 24 areas of the world for which the United Nations publishes population data. While several cancers are of importance in localized areas or regions, e.g., cancer of the larynx, these are infrequent on the world level and are not included in this review. While the relative importance of the selected sites varies from one area to another, on a global basis the first six ranking cancer sites in males are lung, stomach, colon/rectum, mouth/pharynx, prostate, and oesophagus; in females, they are breast, cervix uteri, stomach, colon/rectum, lung, and mouth/pharynx. Cancers of these sites, together with the leukaemias and cancers of the liver, bladder, and lymphatic tissues, account for 75% of the estimated 5.9 million new cancers that occurred in 1975. When the two sexes are combined, stomach cancers are first rank, followed closely by lung; it is suggested that, given current trends, their rank order will soon be reversed. There are clear opportunities for prevention of cancer by controlling tobacco smoking, reducing infection by hepatatis B virus, and curbing the excessive intake of alcohol. The increasing and adoption of high fat diets may lead to more cancers of the large bowel., breast, and prostate.
Several aspects of Western diets, alcohol use, and exercise patterns which are related to the risk of colorectal cancer have systemic effects in common. Those which increase the risk of colorectal cancer are positively associated with serum triglycerides and plasma glucose; those which decrease risk are negatively associated with serum triglycerides and plasma glucose. These observations suggest the hypothesis that serum triglycerides and/or plasma glucose may themselves be associated with colorectal cancer risk. Evidence for associations between colorectal neoplasia and triglycerides and glucose comes from two recent studies of adenomatous polyps, presumed precursors for colorectal cancer, and from previous studies of diabetes and cancer. In addition, three randomized trials, one in humans and two in animal models, suggest that diets which would be expected to increase serum triglycerides and plasma glucose increase the levels of cellular indicators of colorectal cancer risk. Biological mechanisms explaining associations between colorectal neoplasia and serum triglycerides and/or plasma glucose might involve luminal or circulatory effects: (a) triglycerides and/or glucose may be associated with fecal bile acids, acids which are positively associated with colorectal cancer risk in epidemiological studies and which promote colorectal cancer in animal models; (b) serum triglycerides and/or plasma glucose might influence circulating hormones, such as insulin, which might themselves be involved in cancer development; (c) serum triglycerides and/or plasma glucose might be indicators of energy available through the circulation for neoplastic cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Tobacco smoking is accepted as a major cause of cancers of the lung, larynx, oral cavity and pharynx, oesophagus, pancreas, kidney and bladder. The proportions of these cancers that are due to smoking were estimated for the year 1985 for 24 areas of the world. Fifteen percent--1.1 million new cases per year--of all cancer cases are attributed to cigarette smoking, 25% in men and 4% in women. In developed countries, the tobacco burden is estimated at 16% of all annual incident cases. In developing countries, the corresponding figure is 10%. In total, 85% of the 676,000 cases of lung cancer in men are attributable to tobacco smoking. The highest attributable fractions (AF: 90-93%) are estimated in areas where the habit of cigarette smoking in men has been longest established: North America, Europe, Australia/New Zealand and the former USSR. Among the other 6 cancer sites considered in this analysis, those with the largest fractions of tobacco-related cases are the larynx, mouth and pharynx (excluding nasopharynx) and oesophagus. In regions where males have smoked for several decades, 30 to 40% of all cancers in this sex are attributable to tobacco. Unless tobacco-control efforts in developing countries are strengthened, the massive rise in cigarette consumption over the last few decades will produce a comparable rise in cancer in these countries within the next 20 to 30 years.
To clarify the demographic characteristics of the prevalence of hepatitis C virus (HCV) infection in Osaka, Japan, where hepatocellular carcinoma is common, we investigated the screening data of antibody to HCV (anti-HCV, DAINABOTHCVPHA, second generation assay) in 197,600 voluntary blood donors residing in Osaka. The study found that age-standardized prevalence of anti-HCV was significantly higher than that of HBsAg (2.25 cf 0.86 percent among males, P < 0.001; 2.17 cf 0.55 percent among females, P < 0.001. It was much higher in the blood donors aged 55-64 years than in those aged 16-54 years (8.49 cf 1.32 percent among males, P < 10(-5); 7.26 cf 1.42 percent among females, P < 10(-5)). The prevalence of anti-HCV among males was significantly higher than that of females in the younger (25-34 years) generations (1.02 to 1.49 percent cf 0.71 to 1.13 percent, P < 0.05). A similar tendency was observed in the prevalence of high-titer (> or = 2(12)) anti-HCV. The number of coinfection (both HBsAg and anti-HCV seropositive) was very small, and it was not statistically different from the expected number.
This report presents worldwide estimates of annual mortality from all cancers and for 18 specific cancer sites around 1985. Crude and age-standardized mortality rates and numbers of deaths were computed for 24 geographical areas. Of the estimated 5 million deaths from cancer (excluding non-melanoma skin cancer), 56% occurred in developing countries. The most frequent neoplasm is lung cancer, accounting for 22% of cancer deaths in men. Among women breast cancer is the leading malignancy, accounting for 16% and 11% of all cancer deaths in developed and developing countries, respectively. In developing countries, cancer of the cervix uteri ranks first, breast cancer second. The second most frequent cause of death from cancer in both sexes is cancer of the stomach, followed by liver cancer in men and by colon/rectum cancer in women. Cancers of the colon/rectum and prostate maintain a high rank in men living in developed countries, while cancers of the lung, ovary and pancreas occupy similar ranks among women. In developing countries, cancers of the oesophagus and mouth/pharynx follow those previously mentioned in both sexes. If the estimated rates continue to prevail, increases in the numbers of deaths of 20.4% in developed and 18.1% in developing countries are expected by the year 2000, simply as a consequence of demographic trends towards ageing and population growth. Our results provide an indication of the potential impact of preventive practices. It is estimated that 20% of all cancer deaths (1 million) could be prevented by eliminating tobacco smoking. Mortality from cancers of the liver and uterine cervix, both major problems in developing countries, could be substantially reduced by immunization against hepatitis B virus infection and early detection through Pap smears, respectively.
The annual incidence rates (crude and age-standardized) and numbers of new cases of 18 different cancers have been estimated for the year 1985 in 24 areas of the world. The total number of new cancer cases (excluding non-melanoma skin cancer) was 7.6 million, 52% of which occur in developing countries. The most common cancer in the world today is lung cancer, accounting for 17.6% of cancers of men worldwide, and 22% of cancers in men in the developed countries. Stomach cancer is now second in frequency (it was slightly more common than lung cancer in 1980) and breast cancer--by far the most important cancer of women (19.1% of the total)--is third. There are very large differences in the relative importance of the different cancers by world area. The major cancers of developed countries (other than the 3 already named) are cancers of the colon-rectum and prostate, and, in developing countries, cancers of the cervix uteri, mouth and pharynx, liver and oesophagus. The implications of these patterns for cancer control, and specifically prevention, are discussed. Tobacco smoking and chewing are almost certainly the major preventable causes of cancer today.
A total of 631 serum samples collected in 1969, 1979, and 1989 from adults and children were screened for Helicobacter pylori by Western blot analysis. Results showed that H. pylori seroprevalenee has become less frequent over the 20-year period. By studying seropositivity by year of birth, the magnitude
of a cohort effect of H. pylori seropositivity was estimated. The odds of being seropositive decreased by 26% per decade, P = .008 (95% confidence interval, 8%–41%). Estimates of seroprevalence adjusted for both age-specific variation and the cohort
effect suggest that most seropositivity in adults occurs by the age of 15 years. The implication of these findings is that
H. pylori infection is becoming less frequent and is predominantly acquired in childhood.
Cigarette smoking is the major cause of bladder cancer in men in the United States, and the arylamines contained in cigarettes smoke, including 4-amino-biphenyl (4-ABP), are believed to play an important role in the induction of bladder cancer among smokers. N-acetylation, which is catalyzed by the genetically controlled hepatic N-acetyltransferase enzyme displaying two phenotypes (slow versus rapid), is a detoxification pathway for arylamines with regard to bladder carcinogenesis. In Los Angeles, CA, non-Hispanic white (white), black, and Asian males have comparable smoking habits and yet dramatically different risks of bladder cancer (31 of 100,000 in whites, 16 of 100,000 in blacks, and 13 of 100,000 in Chinese and Japanese). Previously, we have demonstrated that the prevalence of slow acetylators (the high-risk phenotype) was highest in whites (54%), intermediate in blacks (34%), and lowest in Asians (14%). We also showed that mean 3- and 4-ABP hemoglobin adduct levels were significantly higher in cigarette smokers relative to nonsmokers, and that the level increased with increasing number of cigarettes smoke/day. Most importantly, slow acetylators consistently exhibited higher mean levels of ABP hemoglobin adducts relative to rapid acetylators, regardless of race and level of cigarette smoking. We assessed 151 residents of Los Angeles County (CA) who were either white, black, or Asian (Chinese or Japanese) and over the age of 30 years for their glutathione S-transferase M1 (GSTM1) genotype (null versus non-null), acetylator phenotype (slow versus rapid), levels of 3- and 4-ABP hemoglobin adducts, and current use of tobacco products. Whites (27%) had the highest prevalence of the highest risk profile (slow acetylator, GSTM1 null), followed by blacks (15%) and Asians (2.7%), and the difference was statistically significant (P = 0.006). Whites also had less than one-half the prevalence of the "protective" profile (rapid acetylator, GSTM1 non-null) relative to blacks and Asians (23 versus 57%; P = 0.0001). Regardless of race and level of cigarette smoking, mean levels of 3- and 4-ABP hemoglobin adducts were higher in subjects possessing the higher risk (GSTM1/acetylator profile. Mean level of 4-ABP hemoglobin adduct (adjusting for race, cigarette smoking, and acetylator phenotype) was significantly higher in subjects possessing the GSTM1-null versus GSTM1-non-null genotype (46.5 versus 36.0 pg/g Hb; P = 0.037). The comparable difference in mean levels of 3-ABP hemoglobin adduct was borderline significant (1.6 versus 1.1 pg/g Hb; P = 0.07). Thus, our results suggest that GSTM1 is involved in the detoxification of 3- and 4-ABP and may contribute to the racial variation in bladder cancer incidence among white, black, and Asian males in Los Angeles, CA.
Hodgkin's disease (HD) has long been suspected to have an infectious precursor, and indirect evidence has implicated Epstein-Barr virus (EBV), a ubiquitous herpesvirus, as a causal agent. Recent molecular studies using EBER in situ hybridization or latency membrane protein-I (LMP-I) immunohistochemistry have identified EBV latent infection in up to 50% of HD tumors. However, the epidemiologic features of these cases have not been examined in detail. To explore the epidemiology of EBV-positive HD so as to understand the role of EBV in HD etiology more clearly, this project accumulated patient data from 14 studies that had applied these EBV assays to HD tumors. With information on age at diagnosis, sex, ethnicity, histologic subtype, country of residence, clinical stage and EBV tumor status from 1,546 HD patients, we examined risk for EBV-positive disease using logistic regression. Forty percent of subjects had EBV-positive tumors, and EBV prevalence varied significantly across groups defined by the study variables. Odds ratios (OR) for EBV-associated HD were significantly elevated for Hispanics vs. whites (OR = 4.1), mixed cellularity vs. nodular sclerosis histologic subtypes (OR = 7.3, 13.4, 4.9 for ages 0-14, 15-49, 50+ years), children from economically less-developed vs. more-developed regions and young adult males vs. females (OR = 2.5). These findings suggest that age, sex, ethnicity and the physiologic effects of poverty may represent biologic modifiers of the EBV association and confirm that this association is strongly but variably linked to histologic subtype. The data augment biologic evidence that EBV is actively involved in HD pathogenesis in some cases but describe epidemiologic complexity in this process.
Huge differences in incidence rates of invasive cervical cancer occur among populations. These differences reflect the influences of both etiological environmental factors and removal of precursor lesions detected upon screening. The purposes of this article are (i) to describe similarities and differences in the shapes and magnitudes of age-specific incidence rates of invasive cervical cancer before screening had an effect, (ii) to provide baseline data for further global study of screening effects, and (iii) to provide baseline incidence data for the design of optimal screening programs. To eliminate the impact of screening effects, we have selected age-specific incidence rates from times when and from populations in which screening was insignificant. The selected rates were suitably scaled and compared regarding age at onset of increase in incidence, age at peak incidence, and rate of subsequent decline. Despite a 16-fold difference in incidence rates, all curves had the same basic structure, with an increase to a peak followed by a decline or a plateau. Although all populations but one had an onset around age 25, 7 European countries showed an earlier peak age (mean = 46 vs. 59) and a more rapid decline after the peak than most other populations. The common basic shape of the age-specific incidence curve, overall, suggests a relatively similar development of invasive cervical cancer in different populations. These results illustrate the underlying similarities in the markedly different age-specific incidence rates of invasive cervical cancer. They also provide a basis for studying screening effects and for optimizing screening programs in specific geographic areas.
It seems unlikely that the large ethnic differences in prostate cancer risk can be explained completely by ethnic differences in diet or other lifestyle characteristics. Instead, the differences may be due to ethnic variation in endogenous factors, such as androgen metabolism or inherited susceptibility.
We have reviewed the literature for evidence and support of ethnic variation in genetic susceptibility to prostate cancer as a reason for the ethnic differences in rates.
We distinguish two types of ethnic variation: 1) variation in the prevalence of certain alleles of specific genes that confer modestly increased risk. Such variation might be reflected in ethnic differences in serum levels of androgens, their metabolites, or indicators of metabolism in the prostate; 2) variation in the prevalence of rare germline mutations conferring substantially increased risk. Such variation would be reflected in ethnic differences in familial aggregation of prostate cancer. We discuss the evidence in support of each of these two possibilities.
Ethnic variation in polymorphic alleles of genes associated with modest fluctuations in risk could explain a large proportion of the ethnic difference in cancer risk. In contrast, rare mutations associated with substantially increased risk are likely to account for a smaller fraction of these differences.
To investigate whether the decrease in rate of Helicobacter pylori infection in subsequent birth cohorts has continued during the last decades.
Determination by ELISA of IgG H. pylori antibodies in 314 serum samples from Dutch children (age 6-8 yr, n = 154) and young adolescents (age 12-15 yr, n = 160), collected in 1978 and 1993.
The prevalence of H. pylori declined from 19% to 9% at age 6-8 yr and from 23% to 11% at age 12-15 yr. For the whole study population, a decline from 21% to 10% (p = 0.01) was observed between 1978 and 1993. On the basis of these data and an incidence of infection with H. pylori of 0.3% per year during the same period, a model for both past and future prevalence rates of H. pylori in the Dutch population was calculated. The outcome demonstrates a decrease from more than 50% around World War II to less than 20% for the whole population around year 2040.
H. pylori infection rates in childhood have continued to decline until recent decades, demonstrating a persistent birth cohort effect. This decline will result in a very low prevalence of H. pylori infection in the Dutch population during the next decades, becoming even lower as the observed decline in children and young adolescents continues.
The most recent estimates of the world-wide incidence of cancer indicate that gastric cancer was in 1990 the second most frequent cancer in the world (after lung cancer), with about 900000 new cases diagnosed every year. Steady declines in the rates have been observed everywhere in the last few decades, but the absolute number of new cases per year is increasing mainly because of ageing of the population. The exact causes of the decline of gastric cancer are not well understood, but must include improvements in diet, food storage (e.g., refrigeration) and, possibly, the decline of Helicobacter pylori infection. Dietary modifications and, possibly, vitamin supplements remain one of the most important tool for the prevention of gastric cancer. Control of H. pylori infection, by means of eradication or immunization, is also likely to offer great potential for the prevention of this important malignancy.
Screening for and the aggressive treatment of prostate carcinoma are controversial, but they are nevertheless being practiced in the U.S. Current clinical studies of the effectiveness of screening will take years to complete. Meanwhile, screening for prostate carcinoma is already having an effect on society.
National and regional trends in prostate carcinoma incidence and data on patient mortality and survival from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute are described in this article. SEER is a population-based cancer data base comprised of nine discrete areas. Fundamental principles of screening are used in this article to explain the impact that prostate carcinoma screening has had in the U.S.
According to the data in the SEER registries, overall prostate carcinoma incidence rates increased at a far greater pace than prostate carcinoma mortality rates during the period 1973-1994. During that period, there was a shift in stage at diagnosis characterized by an increase in local and regional disease, and a decline in distant disease at diagnosis. Overall 5-year survival rates for prostate carcinoma patients also increased. The increase in incidence rates, the shift in stage at diagnosis, and the increase in survival rates are all evidence of increasing early detection. However, these changes are consistent with lead-time bias, length bias, a decline in mortality, and all three could have occurred. In the geographic SEER registries, the prostate carcinoma incidence rates vary markedly. These variations in incidence rates are due to regional variations in practice patterns and screening efforts. On the other hand, the SEER registries have comparable mortality rates. This is evidence of both lead-time bias and length bias.
Substantial regional variations in incidence were found, but regional mortality rates were similar. This is evidence that screening and early detection efforts are resulting in the diagnosis of prostate carcinoma in some men who do not need therapy; thus, prostate carcinoma screening can lead to unnecessary treatment for such men. Furthermore, epidemiologic data do not demonstrate that screening is decreasing mortality. The benefits of screening and early detection, although theoretically possible, are yet unproven, whereas the risks and harms of screening and resultant treatment are definite.
Descriptive epidemiology of oral and pharyngeal cancer over the last four decades is reviewed, with specific focus on Europe. Substantial rises in mortality rates have been observed for younger males, mostly in eastern Europe. The independent role of alcohol and tobacco and their interaction on oral carcinogenesis is discussed, since these factors account for about three quarters of oral cancers in Europe. The influence of dietary factors, and in particular of a diet poor in fresh fruit and vegetables on oral carcinogenesis, is also discussed, since diet may account for 10-15% of oral cancer cases in Europe. Finally, among other carcinogens, the possibility of human papillomavirus involvement in the aetiology of cancer of the oral cavity and pharynx is overviewed. Implications for prevention are discussed.
The aim of the study was to assess whether co-infection by hepatitis-B virus (HBV) and hepatitis-C virus (HCV) is associated with a higher risk of developing hepatocellular carcinoma (HCC) than each infection alone. A meta-analysis of data published up to June 1997 was performed. HBsAg and anti-HCV antibodies or HCV RNA (anti-HCV/HCV RNA) were considered as serological markers of current HBV and HCV infection respectively. A total of 32 case-control studies were suitable for a quantitative overview. The summary odds ratios (OR) were 13.7 for HBsAg positivity and 11.5 for anti-HCV/HCV RNA positivity. The OR for anti-HCV was lower among studies using second- or third-generation anti-HCV or HCV RNA (OR, 8.2) with respect to studies with first-generation anti-HCV test (OR, 19.1). When combining data from the studies with second- or third-generation anti-HCV or HCV RNA, the OR for HBsAg positivity and anti-HCV/HCV RNA negativity was 22.5 (95% confidence interval (CI), 19.5-26.0), the OR for anti-HCV/HCV RNA positivity and HBsAg negativity was 17.3 (95% CI, 13.9-21.6), and the OR for both markers positivity was 165 (95% CI: 81.2-374, based on 191 cases and 8 controls exposed). A synergism was found between HBV and HCV infections, the OR for co-infection being greater than the sum and lower than the product of those for each infection alone. The interaction was therefore negative according to the multiplicative model, providing epidemiological evidence both of an independent effect and of interference between the 2 viruses in the carcinogenic process.
The incidence of esophageal and gastric cardia adenocarcinoma is, for unknown reasons, increasing dramatically. A weak and inconsistent association between body mass index (BMI) and adenocarcinoma of the esophagus and gastric cardia has been reported.
To reexamine the association between BMI and development of adenocarcinoma of the esophagus and gastric cardia.
Nationwide, population-based case-control study.
Sweden, 1995 through 1997.
Patients younger than 80 years of age who had recently received a diagnosis were eligible. Comprehensive organization ensured rapid case ascertainment. Controls were randomly selected from the continuously updated population register. Interviews were conducted with 189 patients with adenocarcinoma of the esophagus and 262 patients with adenocarcinoma of the gastric cardia; for comparison, 167 patients with incident esophageal squamous-cell carcinoma and 820 controls were also interviewed.
Odds ratios were determined from BMI and cancer case-control status. Odds ratios estimated the relative risk for the two adenocarcinomas studied and were calculated by multivariate logistic regression with adjustment for potential confounding factors.
A strong dose-dependent relation existed between BMI and esophageal adenocarcinoma. The adjusted odds ratio was 7.6 (95% CI, 3.8 to 15.2) among persons in the highest BMI quartile compared with persons in the lowest. Obese persons (persons with a BMI > 30 kg/m2) had an odds ratio of 16.2 (CI, 6.3 to 41.4) compared with the leanest persons (persons with a BMI < 22 kg/m2). The odds ratio for patients with cardia adenocarcinoma was 2.3 (CI, 1.5 to 3.6) in those in the highest BMI quartile compared with those in the lowest BMI quartile and 4.3 (CI, 2.1 to 8.7) among obese persons. Esophageal squamous-cell carcinoma was not associated with BMI.
The association between BMI and esophageal adenocarcinoma is strong and is not explained by bias or confounding. The carcinogenic mechanism, however, remains to be clarified. The increasing prevalence of obesity in western countries could be important in understanding the increasing occurrence of this tumor.
Despite a dramatic reduction in incidence and mortality rates, gastric cancer (GC) is still one of the most common malignant neoplasias worldwide. Surgical and medical treatments have not substantially improved during the last decades, and large-scale early diagnosis programs have proven feasible in only one high-risk country, Japan. A large number of studies have indicated that salted, smoked, pickled, and preserved foods (rich in salt, nitrite, and preformed N-nitroso compounds) are associated with an increased risk of GC. In contrast, strong evidence has been provided that high consumption of fresh fruit and raw vegetables and a high intake of antioxidants are associated with a reduced risk of GC. Domestic refrigeration and reduced salt consumption are considered to play a role in explaining the decreasing temporal trend and the geographical patterns of GC. Familial factors have been suspected to play a role in GC susceptibility, and recently germ line mutations in the E-cadherin gene were identified in a few families. Evidence of a positive association between Helicobacter pylori infection and GC risk has been provided by most prospective studies that overall suggest a two- to threefold increase in risk. Randomized intervention studies on H. pylori eradication and its effects on GC predisposing conditions (atrophic gastritis and intestinal metaplasia) are in progress and represent a priority for epidemiological research in view of the potential preventive applications. Overall, it is evident that several factors (including diet, individual susceptibility and H. pylori infection) interact in a complex multifactorial process, leading over a long period of time to GC.
There is growing evidence that excess body weight increases the risk of cancer at several sites, including kidney, endometrium, colon, prostate, gallbladder and breast in post-menopausal women. The proportion of all cancers attributable to overweight has, however, never been systematically estimated. We reviewed the epidemiological literature and quantitatively summarised, by meta-analysis, the relationship between excess weight and the risk of developing cancer at the 6 sites listed above. Estimates were then combined with sex-specific estimates of the prevalence of overweight [body mass index (BMI) 25-29 kg/m(2)] and obesity (BMI > or = 30 kg/m(2)) in each country in the European Union to obtain the proportion of cancers attributable to excess weight. Overall, excess body mass accounts for 5% of all cancers in the European Union, 3% in men and 6% in women, corresponding to 27,000 male and 45,000 female cancer cases yearly. The attributable proportion varied, in men, between 2.1% for Greece and 4.9% for Germany and, in women, between 3.9% for Denmark and 8.8% for Spain. The highest attributable proportions were obtained for cancers of the endometrium (39%), kidney (25% in both sexes) and gallbladder (25% in men and 24% in women). The largest number of attributable cases was for colon cancer (21,500 annual cases), followed by endometrium (14,000 cases) and breast (12,800 cases). Some 36,000 cases could be avoided by halving the prevalence of overweight and obese people in Europe.
Previous age-period-cohort analyses of lung cancer incidence and mortality rates in the United States have demonstrated a decrease in risk by birth cohort through 1950, consistent with declining trends in smoking prevalence. This study was conducted to examine recent lung cancer trends, including trends among the cohorts born after 1950.
Lung cancer mortality rates from 1970 through 1997 for whites aged 24--83 years and for blacks aged 30--83 years were investigated. Using age--period--cohort analyses with 2-year age and 2-year calendar-period intervals, we examined changes in the slope of the trends in birth-cohort and calendar-period effects. All statistical tests are two-sided.
There was an unexpected, statistically significant moderation in the rate of decrease of the birth-cohort trend in lung cancer mortality for whites born after 1950, with a corresponding smaller and statistically nonsignificant moderation for blacks. These data are consistent with smoking initiation rates: Rates of both cigarette and marijuana smoking initiation increased for children aged 12--17 years from 1965 through 1977. There was a statistically significant decrease in the slope of the calendar-period trend for lung cancer mortality in 1990 for both whites and blacks that was observed primarily in people 55 years of age and older. CONCLUSIONS and
The birth-cohort pattern of lung cancer mortality after 1950 appears to reflect the early impact of teenage cigarette smoking on lung cancer risk in people under the age of 45 years, although a contribution from marijuana smoking cannot be ruled out. This result provides additional support for increasing smoking cessation and prevention programs for teenagers. The calendar-period decrease in lung cancer mortality after 1990 may reflect the long-term benefits of reductions in tobacco carcinogens in cigarettes and increases in smoking cessation beginning around 1960.