Cancer Epidemiology[JOURNAL]
Sun
200 papers
The intersection of climate change and cancer across global populations: A bibliometric analysis (2000-2024).
Gupta S, Babu P, Haldar D … +3 more , Bag S, Zaidi I, Goel S
Cancer Epidemiol · 2025 Dec · PMID 41106204 · Publisher ↗
BACKGROUND: The convergence of climate change and cancer is an emerging research area with significant implications for public health. This bibliometric analysis aimed to map the growth, trends, contributors, collaborati...
BACKGROUND: The convergence of climate change and cancer is an emerging research area with significant implications for public health. This bibliometric analysis aimed to map the growth, trends, contributors, collaboration networks, and thematic areas related to this field. METHODS: We systematically searched PubMed and Scopus databases for peer-reviewed literature published between 2000 and 2024 using predefined keywords. One-hundred and nineteen eligible articles were analyzed for metrics like co-authorship networks and keywords co-occurrence. RESULTS: The volume of research has seen a significant rise since the 2010s. The United States, China, and the United Kingdom were leading contributors, while the Low- and Middle-Income Countries were underrepresented. Dominant research themes included climate change and cancer, pollution and cancer, sun exposure, temperature and skin cancer, and air pollution and climate change. Air pollution and particulate matter were identified as high-density and centrality motor themes. CONCLUSION: This analysis provides a first-of-its-kind mapping of 2 decades of global research at the intersection of climate change and cancer. Future research should prioritize global South perspectives, context-specific investigations, and longitudinal studies integrating registry data for in-depth studies to elucidate the causal relationships between climate change and cancer types. The oncology community should engage in climate action through mitigation and adaptation strategies.
Approaches to handle missing follow-up time: A comparative analysis of contralateral breast cancer incidence.
Haile SR, Wanner M, Korol D … +1 more , Rohrmann S
Cancer Epidemiol · 2025 Dec · PMID 41101016 · Publisher ↗
BACKGROUND: We aimed to compare various common approaches for handling missing vital status or follow-up time. As a case study for application of these methods, we estimated incidence of metachronous contralateral breast...
BACKGROUND: We aimed to compare various common approaches for handling missing vital status or follow-up time. As a case study for application of these methods, we estimated incidence of metachronous contralateral breast cancer (CBC). METHODS: For 1980-2016, incidence of metachronous CBC with follow-up through 2024 was estimated using Poisson regression with overdispersion, by age at incidence, year of incidence, histology and follow-up period. Missing follow-up time was ignored in the naive approach, simulated once using the average hazard derived from published Swiss cancer registry data, or multiply imputed using 3 different imputation models. RESULTS: 24,612 women aged 20-84 had unilateral breast cancer between 1980 and 2016 in the Swiss cantons of Zurich and Zug. Of those, 5 % (n = 1264) were lost to follow-up. Over 291,463 person-years, 1145 contralateral breast malignancies were diagnosed, corresponding to 393 per 100,000 person-years (95 % CI 353-438). Incidence rates have been decreasing over time to 238 (171-333) for the incidence period 2010-2016. The same overall pattern was observed regardless of how we handled missing follow-up times. However, using a single imputation generally produced lower incidence rates compared to the naive approach, with multiple imputation giving higher estimates. The most complex multiple imputation model gave incidence estimates that were very similar to those from the naive approach. CONCLUSION: Different methods to handle missing follow-up times yielded similar results: that CBC incidence has declined in recent decades. Multiple imputation is likely an appropriate method to handle missing follow-up data, enabling researchers to include all eligible individuals in the analysis.
Bridging data gaps: Methodological advances in extracting and analyzing genetic information from unstructured clinical records in hereditary cancer.
Cardona DS, Valencia-Arango JP, Gallo JP … +8 more , Bustamante CA, Salazar RO, Carmona CA, Vanegas MN, Jaramillo CJ, Moncada JE, Velasco HM, Lopera NG
Cancer Epidemiol · 2025 Dec · PMID 41076999 · Publisher ↗
INTRODUCTION: The global impact of cancer, driven by both acquired and hereditary mutations, underscores the necessity for extensive research efforts. Despite the increasing volume of genetic data, significant gaps remai...
INTRODUCTION: The global impact of cancer, driven by both acquired and hereditary mutations, underscores the necessity for extensive research efforts. Despite the increasing volume of genetic data, significant gaps remain in data science research, particularly in Latinos and admixed populations. This study utilizes advanced data science techniques to integrate genetic and clinical data, aiming to improve the understanding of hereditary cancer in Colombia and demonstrating the transformative potential of data-driven approaches in cancer research. METHODS: This observational study analyzed healthcare databases from four regions and 11 cities in Colombia. Genetic data were extracted from PDF reports within SURA Colombia's Electronic Health Records (a Latin American health insurance provider) for individuals referred for hereditary cancer testing between October 2019 and November 2021. Variants in 30 genes, aligned with NCCN guidelines, were examined using Next-Generation Sequencing (NGS). Data extraction was automated using Python and R, followed by integration and analysis of genetic, clinical, and sociodemographic data using advanced data science tools hosted on Azure infrastructure. These tools enabled predictive modeling and cross-referencing to explore correlations between genetic variants and clinical outcomes. RESULTS: The study included 1377 patients, with a predominance of women (92.81 %) and 63 % from the northwestern region of Colombia. The largest age group (40.37 %) was between 31 and 44 years, and 95.35 % had a personal cancer history, primarily breast cancer (75.86 %). Hereditary cancer testing revealed 145 positive results and 587 uncertain outcomes. Data science-driven analysis identified higher positivity rates in patients aged 31-44 and over 50, particularly in the northeast and central regions. Among positive results, 42.6 % included variants of uncertain significance, with 95.9 % of these patients having a personal cancer history. CONCLUSION: This study highlights the significant role of data science in analyzing hereditary cancer data. Advanced computational techniques can aid in genetic variant reclassification, uncover patterns in underrepresented populations, and inform personalized interventions for hereditary cancer management in Latin America.
Survival disparities in non-small cell lung cancer: Disaggregating Asians from NHPI and identifying variability among common Asian subgroups - The largest single-center study in Hawai'i.
Wannaphut C, Tanariyakul M, Yoshikawa GT … +3 more , Hernandez BY, Villanueva NA, Acoba JD
Cancer Epidemiol · 2025 Dec · PMID 41067976 · Publisher ↗
BACKGROUND: The American Cancer Society and the National Cancer Institute emphasize the need to disaggregate data for U.S. Asian, Native Hawaiian, and Other Pacific Islander (NHPI) populations to better understand racial...
BACKGROUND: The American Cancer Society and the National Cancer Institute emphasize the need to disaggregate data for U.S. Asian, Native Hawaiian, and Other Pacific Islander (NHPI) populations to better understand racial disparities in cancer outcomes. Asian populations are diverse, with distinct genetic, cultural, and socioeconomic backgrounds that differ from those of NHPI, influencing cancer prognosis. This study analyzes non-small cell lung cancer outcomes among Asian and NHPI populations. METHODS: This retrospective cohort study identified NSCLC patients treated at Queen's Medical Center in Honolulu, Hawai'i, from 2000 to 2022. Patients were categorized into six racial/ethnic groups: White, Chinese, Japanese, Filipino, Other Asians, and NHPI. Survival differences were evaluated using Kaplan-Meier analysis and Cox proportional hazards models. RESULTS: The cohort comprised 4160 patients, including 977 White, 419 Chinese, 968 Japanese, 724 Filipino, 217 Other Asians, and 855 NHPI patients. NHPI had the highest proportion of individuals under 60 years old (27.5 %), the highest percentage of Medicaid/uninsured (37 %), and the lowest proportion receiving surgery (23.4 %) compared to other races (p < 0.001). Median overall survival (OS) was 20.9 (18.3-23.5) months for White patients, 22.3 (17.8-26.9) months for Chinese patients, 17.7(15.3-20.2) months for Japanese patients, 19.7(16.1-23.3) months for Filipino patients, 25.7(14.7-36.6) months for Other Asians patients and 14.7(12.0-17.3) months for NHPI patients (p < 0.001). Asian NSCLC patients had a lower risk of death compared to White patients (adjusted HR 0.89, 95 % CI 0.85-0.97, p = 0.010). In contrast, NHPI patients had a higher mortality rate compared to White patients (adjusted HR 1.15, 95 % CI 1.03-1.28, p = 0.011) in the multivariable analysis without treatment. However, both associations were no longer statistically significant after additional adjustment for treatment. Subgroup analyses of Asian patients compared to Whites patients revealed that the Chinese patients had the lowest risk of death, with this difference remaining significant even after adjusting for treatment (adjusted HR 0.82, 95 % CI 0.72-0.93, p = 0.003). CONCLUSION: Our findings demonstrate the heterogeneity in NSCLC outcomes between U.S. Asians and NHPI patients as well as among individual Asian ethnic populations. Further research is needed to validate these differences and their clinical implications.
Occupational heat exposure and stomach cancer risk in a pooled analysis of two Spanish case-control studies in the stomach cancer pooling project - StoP consortium.
Hinchliffe A, Vallbona-Vistós M, Alguacil J … +12 more , Kogevinas M, Uuksulainen S, Aragonés N, Tardón A, Vioque J, Ward MH, Rabkin CS, Camargo MC, Pelucchi C, La Vecchia C, Boffetta P, Turner MC
Cancer Epidemiol · 2025 Dec · PMID 41056765 · Publisher ↗
BACKGROUND: Occupational heat stress occurs frequently and is increasing with climate change. Studies of occupational heat exposure and stomach cancer risk are limited. We used data from the international Stomach cancer...
BACKGROUND: Occupational heat stress occurs frequently and is increasing with climate change. Studies of occupational heat exposure and stomach cancer risk are limited. We used data from the international Stomach cancer Pooling (StoP) Project to investigate the relationship between occupational heat exposure and stomach cancer risk in a pooled analysis of two Spanish case-control studies, including 566 stomach cancer cases and 2984 controls. METHODS: The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to participant occupations. We evaluated three exposure indices: ever vs. never exposed, cumulative exposure and duration (years). We calculated odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) using unconditional logistic regression models including terms for potential confounders. RESULTS: Overall, 60.6 % of cases and 42.7 % of controls were ever occupationally exposed to heat. Occupational heat exposure was associated with a moderately elevated risk of stomach cancer (OR 1.31; 95 % CI 1.05, 1.63) when comparing ever vs. never exposed individuals in both studies combined. Elevated ORs were also observed across categories of cumulative exposure and duration (p-trend = 0.01 and 0.03, respectively). Findings were robust to additional covariate adjustment and in analysis of never smokers. There was no clear evidence for interaction according to exposure status to other suspected occupational stomach carcinogens. CONCLUSION: Findings from this study provide some evidence for a positive association between occupational heat exposure and stomach cancer risk. Further research is needed to advance occupational heat assessment tools for epidemiological research as well as studies in more geographically diverse populations.
Calcium intake and gastric cancer risk: A systematic review and dose-response meta-analysis of observational studies.
Silva ARC, Fagundes MA, Guandalini VR … +1 more , Curado MP
Cancer Epidemiol · 2025 Dec · PMID 41045682 · Publisher ↗
Calcium has been proposed as a protective factor against certain types of cancer, but findings related to gastric cancer (GC) are inconsistent. This meta-analysis aimed to assess the association between calcium intake an...
Calcium has been proposed as a protective factor against certain types of cancer, but findings related to gastric cancer (GC) are inconsistent. This meta-analysis aimed to assess the association between calcium intake and the risk of GC. A comprehensive search was conducted in PubMed, Scopus, EMBASE, LILACS, and Web of Science for cohort and case-control studies published up to August 19, 2024. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Publication bias was tested using Egger's and Begg's tests. Relative risks (RRs) and 95 % confidence intervals (CIs) were pooled through a random-effects model. Given the substantial heterogeneity and potential variation in intake levels across populations, a dose-response analysis was conducted to explore potential trends across the full range of calcium consumption. Thirteen studies involving 1,610,992 participants met the inclusion criteria. A non-significant inverse association was observed between total calcium intake and GC risk when comparing the highest vs lowest intake categories (RR: 0.85; 95 % CI: 0.70-1.05). While this categorical comparison was not statistically significant, the dose-response analysis revealed a significant linear protective effect, with a 10 % reduction in risk per 300 mg/day increase in dietary calcium intake (RR: 0.90; 95 % CI: 0.82-0.99). To account for potential variations across intake levels, a non-linear model was also applied, indicating a clearer risk reduction above 400 mg/day (p for non-linearity < 0.001). Overall, this dose-response meta-analysis suggests that higher dietary calcium intake may have a protective effect against GC, reinforcing the importance of considering calcium in dietary strategies for GC prevention, although more studies are needed to confirm these findings.
Response to 'reverse causality' comment.
Zhang S, Wang H, Ji J … +4 more , Chai R, Song S, Shi J, Liu S
Cancer Epidemiol · 2025 Dec · PMID 41027377 · Publisher ↗
This document is the authors' response to the received comments for manuscript CANEP-D-25-00912.
This document is the authors' response to the received comments for manuscript CANEP-D-25-00912.
10 Years of breast cancer treatment trends in Fars Province, report of Shiraz Breast Cancer Registry.
Akrami M, Moosazadeh A, Taghva M … +5 more , Tavakolian N, Karami Rad M, Keumarsi Z, Ghoddusi Johari M, Zangouri V
Cancer Epidemiol · 2025 Dec · PMID 41016324 · Publisher ↗
BACKGROUND: Despite global recommendations favoring breast-conserving surgery (BCS) with radiotherapy for early-stage breast cancer, there is limited long-term evidence on surgical trends and survival outcomes in low- an...
BACKGROUND: Despite global recommendations favoring breast-conserving surgery (BCS) with radiotherapy for early-stage breast cancer, there is limited long-term evidence on surgical trends and survival outcomes in low- and middle-income countries such as Iran. Understanding these patterns is crucial to improving treatment equity and patient outcomes. This study aimed to evaluate two-decade trends in surgical approach selection for breast cancer and to compare survival outcomes between BCS and mastectomy in Fars province, Iran. METHODS: Data from 10,091 women diagnosed with breast cancer between 2000 and 2022 were extracted from the Shiraz Breast Cancer Registry. Patients were categorized into four groups based on type of surgery (BCS or mastectomy) and receipt of radiotherapy. Logistic regression was used to identify factors influencing treatment selection. Survival and recurrence were analyzed using Kaplan-Meier and factors affecting survival were evaluated using the Cox regression model. RESULTS: Between 2000 and 2022, the proportion of patients undergoing BCS plus radiotherapy increased from 30.5 % to 73.8 %, surpassing mastectomy. The BCS plus radiotherapy group showed the most favorable outcomes, with the lowest breast cancer-specific mortality (6.2 %), recurrence rate (10.2 %), and the highest 10-year BCSS (96.01 %). These associations remained significant after multivariable adjustment. CONCLUSION: This study reveals a significant shift toward BCS plus radiotherapy in southern Iran over the past two decades. BCS with radiotherapy is associated with superior survival outcomes compared to mastectomy. However, access barriers continue to prevent many women from receiving the optimal surgical approach, indicating the need for policy and health system interventions.
Global burden and international trends of laryngeal cancer incidence: A population-based study of recorded data and national estimates.
da Cunha AR, Rumgay H, Vignat J … +9 more , Laversanne M, Colombet M, Curado MP, Garvey G, Ghosh-Laskar S, O'Sullivan B, Virani S, Soerjomataram I, Piñeros M
Cancer Epidemiol · 2025 Dec · PMID 40997398 · Publisher ↗
Laryngeal cancer shows considerable variation in global incidence, which has primarily been studied through national estimates. This study aims to analyse the global incidence of laryngeal cancer, comparing estimated and...
Laryngeal cancer shows considerable variation in global incidence, which has primarily been studied through national estimates. This study aims to analyse the global incidence of laryngeal cancer, comparing estimated and high-quality recorded data, and examine temporal trends to inform targeted prevention strategies. Estimated incidence rates for 2022 were obtained from the GLOBOCAN 2022 database for 185 countries. Recorded incidence data from population-based cancer registries (PBCRs) for the five-years period 2013-2017 were sourced from Cancer Incidence in Five Continents (CI5-XII). Temporal trends and the Estimated Annual Percent Change were assessed for 34 countries using the Global Cancer Observatory - Cancer Over Time database. The highest estimated age-standardized incidence rates (ASIRs) were observed in Cuba, Moldova, and Romania, particularly among males: 14.8, 12.2, and 10.3 per 100,000, respectively. Recorded data showed significant regional variability, with the highest ASIRs for males in Pskov, Russia (13.3 per 100,000) and the Azores, Portugal (11.8 per 100,000). Most countries exhibited a decline in laryngeal cancer rates among males, while trends among females remained largely stable. Our findings underscore the importance of PBCRs in identifying high-risk populations for developing laryngeal cancer. While national estimates are essential for understanding the global distribution of laryngeal cancer and other malignancies, they may overlook subnational variations. Expanding the coverage and quality of PBCRs is crucial for improving cancer surveillance and enhancing prevention and control efforts at national and global level.
Socioeconomic, health-related and geographical risk factors for locally advanced keratinocyte carcinoma: A nationwide population-based study in Denmark.
Holdam ASK, Rahr HB, Frostberg E … +2 more , Rønlund K, Koudahl V
Cancer Epidemiol · 2025 Dec · PMID 40992084 · Publisher ↗
BACKGROUND: Most keratinocyte carcinomas (KC) are localized and slow-growing. However, for some patients, KC can become locally advanced lesions and cause substantial tissue damage that require extensive surgery to manag...
BACKGROUND: Most keratinocyte carcinomas (KC) are localized and slow-growing. However, for some patients, KC can become locally advanced lesions and cause substantial tissue damage that require extensive surgery to manage. We wanted to explore risk factors for locally advanced disease with the overall aim to offer more timely diagnosis and treatment. METHODS: This nationwide, register-based cohort study examined the association of demographic factors, educational level, disposable income, cohabitating status, comorbidity, and region of residence with tumor (T) category for patients with a first-time diagnosis of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) from 2007 to 2021, using multivariable logistic regression analyses. RESULTS: We identified 166,467 BCC and 36,609 SCC patients. Male sex, old age, lower educational level and disposable income, living alone, and comorbidity were linked to higher odds of developing a ≥T2 tumor. Residence outside the Capital Region increased the risk of locally advanced BCC, while the risk of locally advanced SCC was higher in the Zealand, Central, and Northern regions. CONCLUSION: There are significant associations between socioeconomic status, comorbidity, and region of residence and the risk of developing ≥T2 tumors in both BCC and SCC. Efforts to enhance early detection and treatment should focus on vulnerable individuals.
Trends and disparities in locoregional treatment of programme-detected ductal carcinoma in situ in New Zealand women, 1999-2022.
Chen Q, Campbell I, Elwood M … +3 more , Cavadino A, Aye PS, Tin Tin S
Cancer Epidemiol · 2025 Dec · PMID 40992083 · Publisher ↗
PURPOSE: Ethnic and socioeconomic disparities exist in treatment of invasive breast cancer in New Zealand. This study investigated trends and disparities in locoregional treatment of ductal carcinoma in situ (DCIS) detec...
PURPOSE: Ethnic and socioeconomic disparities exist in treatment of invasive breast cancer in New Zealand. This study investigated trends and disparities in locoregional treatment of ductal carcinoma in situ (DCIS) detected by BreastScreen Aotearoa (BSA), the national breast screening programme. METHODS: Women with programme-detected DCIS from 1999 to 2022 were identified from BSA records linked to the national cancer registry and hospital discharge records. Logistic regression identified associated factors. RESULTS: Of the 6087 cases identified, 39.7 % received breast-conserving surgery (BCS) with radiotherapy (RT), 31.5 % had mastectomy and 28.8 % had BCS alone. BCS with RT increased from 27.6 % in 1999 to 41.1 % in 2006, followed by a modest increase to 46.7 % in 2022, while mastectomy decreased from 33.3 % in 1999 to 25.4 % in 2022. The post-BCS RT use was less common among Pacific women. Sentinel lymph node biopsy (SLNB) increased from 6.2 % in 2004 (when it was implemented nationwide) to 26.0 % in 2007, then reached 37.1 % in 2013, before declining to 24.5 % in 2022. Pacific and Asian women who had mastectomy were more likely to have SLNB. Immediate breast reconstruction (IBR) after a mastectomy increased from 11.4 % in 1999 to 39.8 % in 2009, then underwent a modest decline to 22.7 % in 2022. Māori, older women, and those living in the deprived or rural areas were less likely to receive IBR. CONCLUSION: Locoregional treatment for programme-detected DCIS has improved over time; however, ethnic and socioeconomic disparities persist, underscoring the need to improve equity of cancer care in New Zealand.
Patient demographic and prognostic factors of vulvar squamous cell carcinoma: A National Cancer Database Study.
Folino G, Byrne E, Hendry M … +2 more , Silberstein P, DiBlasi M
Cancer Epidemiol · 2025 Dec · PMID 40966926 · Publisher ↗
BACKGROUND: Vulvar Squamous Cell Carcinoma (VSCC) incidence rates and clinical outcomes are correlated with demographic factors, but no study expansively investigates demographic and prognostic factors of VSCC in relatio...
BACKGROUND: Vulvar Squamous Cell Carcinoma (VSCC) incidence rates and clinical outcomes are correlated with demographic factors, but no study expansively investigates demographic and prognostic factors of VSCC in relation to survival in the post-Gardasil era. This study aims to investigate underlying disparities in VSCC and correlate these factors with survival. METHODS: Patients were identified from the National Cancer Database using ICD-10 codes specific for vulvar structures, ICD-O-3 histology codes for squamous cell carcinoma and pre-malignant vulvar intraepithelial neoplasia Grade III (VIN3), and patient data from 2007 to 2021. Statistical analyses utilized IBM SPSS and GraphPad Prism to determine variable frequency with cross analysis and Chi-Squared tests, Kaplan Meier Survival Curves with Log-Rank Pairwise Comparison, and Cox Proportional Hazards Regression Models. RESULTS: The total patient population was 58,732 patients after inclusion criteria. The median age of diagnosis was 64.0 years old. Significant prognostic factors resulting in better survival included VIN3 histology, lower Charlson-Deyo Score, Black race, receiving care from Academic/Research Programs, private insurance, and median income greater than $63,000. Surgical procedures were significant in improving survival. Black patients are diagnosed younger than White and Other races. A histology type of VIN3 was associated with increased survival time, indicating early identification and treatment for better outcomes. CONCLUSION: Key demographic and prognostic factors that influence survival were identified across the VSCC population. This study may serve as a tool in reevaluation of current gynecological screening protocols to promote early diagnosis and management for the entire VSCC patient population.
Description and recent trends (2011-2019) of early-onset colorectal cancer incidence in Texas.
Zhang Y, Kang HA, Ivatury SJ … +1 more , Sokas C
Cancer Epidemiol · 2025 Dec · PMID 40961874 · Publisher ↗
BACKGROUND: Early-onset colorectal cancer (EO-CRC), diagnosed in individuals under 50, has seen rising incidence rates, while average-onset colorectal cancer rates decline. To understand EO-CRC burden across regions and...
BACKGROUND: Early-onset colorectal cancer (EO-CRC), diagnosed in individuals under 50, has seen rising incidence rates, while average-onset colorectal cancer rates decline. To understand EO-CRC burden across regions and patient characteristics, detailed incidence data are essential. With Texas's large population and unique demographics, this study examines recent trends in age-adjusted EO-CRC incidence. METHODS: This cross-sectional analysis used 2011-2019 Texas Cancer Registry (TCR) data. The incidence rate of EO-CRC was adjusted to the 2000 US standard population and was stratified by cancer type, sex, race/ethnicity, and stage at diagnosis. The number of EO-CRC cases between 2011 and 2019 was mapped to the Texas counties. RESULTS: In the study period, a total of 11,848 EO-CRC (7511 colon cancer [EO-CC] and 4337 rectal cancer [EO-RC]) cases were identified. Over 50 % of cases were diagnosed before the age of 45. The age-adjusted incidence rate (AAIR) of EO-CRC showed a slightly increasing trend over the study period (AAIR range: 10.4/100,000 persons [95 % CI = 9.8-11.0]- 12.7/100,000 persons [95 % CI = 12.0-13.3]). The AAIRs of EO-CRC among males were higher than that of females. Non-Hispanic (NH) White population had the highest AAIR, followed by the Black population and Hispanic population, while other races/ethnicities had the lowest AAIR of EO-CRC. The incidence rate of EO-CRC diagnosed at the regional stage was the highest and showed the steepest increasing trend. While EO-CRC case density by county reflects the population density, incidence rates were higher in rural counties. CONCLUSION: The incidence of EO-CRC in Texas showed an increasing trend from 2011 to 2019, with notable disparities by sex, race/ethnicity, and cancer stage.
Prevalence of advanced-stage breast cancer at diagnosis in Arab countries: A systematic review and meta-analysis.
Elhadi YAM, Al-Rifai RH, Elbarazi I … +6 more , Suliman A, Alabass SO, Abufatima IO, Mohamed SOO, Khogali M, Masuadi E
Cancer Epidemiol · 2025 Dec · PMID 40946600 · Publisher ↗
Breast cancer is the most commonly diagnosed malignancy among women in Arab countries, where a substantial proportion present with advanced-stage disease. This systematic review and meta-analysis aimed to quantify the pr...
Breast cancer is the most commonly diagnosed malignancy among women in Arab countries, where a substantial proportion present with advanced-stage disease. This systematic review and meta-analysis aimed to quantify the prevalence of stage III-IV breast cancer at diagnosis across the region. We systematically searched PubMed, Scopus, Web of Science, and the WHO Virtual Health Library on March 22, 2025, for studies reporting stage at diagnosis among women with breast cancer in Arab countries. Two reviewers independently screened and extracted data, and risk of bias was assessed using the Joanna Briggs Institute checklist. Random-effects meta-analyses were performed to estimate the pooled prevalence of advanced-stage presentation overall and by country. From 678 screened records, 26 studies from 13 countries comprising 14,176 women were included. The pooled prevalence of stage III-IV breast cancer at diagnosis was 46·0 % (95 % CI 43·0-50·0; I²=93·6 %), with marked heterogeneity across settings (range 13·0 % in Bahrain to 67·0 % in Libya and Yemen). Country-level subgroup differences were statistically significant (χ²=3271·72, df=12; p < 0·001), suggesting that national context may substantially influence diagnostic stage. Egger's test showed evidence of small-study effects (intercept=1·23; p = 0·048). These findings highlight the enduring challenge of late breast cancer diagnosis in the Arab region. Urgent investment in early detection strategies through population-based screening, public awareness, and timely access to diagnostic services is critical to reducing mortality and improving outcomes.
Trends and characteristics of early-onset colorectal cancer in the state of Florida, 2002-2021.
Hong YR, Revere L, Ross KM … +4 more , Qiu P, Prosperi M, George TJ, Virnig BA
Cancer Epidemiol · 2025 Dec · PMID 40946599 · Publisher ↗
BACKGROUND: Early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is a growing public health concern. Despite increasing national incidence among younger adults, state-specific analyses for Florida r...
BACKGROUND: Early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is a growing public health concern. Despite increasing national incidence among younger adults, state-specific analyses for Florida remain limited. Florida's large and demographically unique population necessitates investigation into EOCRC trends and patient characteristics. METHODS: This population-based study utilized colorectal cancer incidence data for Florida residents aged 25-49 diagnosed between 2002 and 2021, from the Florida Cancer Data System and National Program of Cancer Registries. Joinpoint regression evaluated age-adjusted incidence trends across demographic and clinical factors. Age-period-cohort analysis explored generational effects, while multivariate logistic regression identified factors associated with advanced-stage diagnosis (regional or distant). RESULTS: Among 16,318 EOCRC cases identified during 2002-2021, overall incidence increased significantly (AAPC=1.48 %, P < .001), driven primarily by colon cancers (AAPC=1.53 %, P < .001), while rectal cancers showed non-significant increase (AAPC=0.53 %, P = 0.185). A concerning shift toward advanced stages at diagnosis emerged (P < 0.001), with localized disease decreasing from 32.8 % to 26.2 %, while regional (34.6-41.0 %) and distant metastases (21.9-26.8 %) increased substantially. This stage migration was confirmed by significant increases in regional (AAPC=2.10 %, P < .001) and distant disease (AAPC=2.71 %, P < .001) incidence. Strong birth cohort effects, indicating increasing risk with rate ratios exceeding 2.0 for recent cohorts, were evident predominantly in non-Hispanic White individuals. Conversely, Hispanic and non-Hispanic Black patients showed no significant cohort effects but consistently presented with higher odds of advanced-stage disease compared to non-Hispanic Whites (AOR=1.13 and AOR=1.11, respectively). Uninsured (AOR=1.23) and Medicaid-covered patients (AOR=1.52) faced significantly higher odds of advanced presentation compared to privately insured individuals. CONCLUSION: Florida experienced sustained EOCRC incidence increases from 2002 to 2021, accompanied by advanced-stage diagnosis increases and notable disparities. Birth cohort effects primarily drove increased risk in non-Hispanic White populations, while barriers to timely care, including insurance status, likely contributed to delayed diagnoses in minority communities, underscoring urgent needs for targeted interventions.
Aspirin use associated with a decreased risk of gastric cancer.
Liao KF, Lai SW
Cancer Epidemiol · 2025 Dec · PMID 40945236 · Publisher ↗
Abstract loading — click title to view on PubMed.
Temporal trends and spatial distribution of prostate cancer incidence and mortality in a northeastern Brazilian state.
de Santana ACCS, Santos ESR, Batista JFC … +4 more , Moura AR, Sardeiro SSS, da Silva BEB, Lima CA
Cancer Epidemiol · 2025 Dec · PMID 40945235 · Publisher ↗
BACKGROUND: Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution...
BACKGROUND: Prostate cancer incidence and mortality exhibit regional variation often linked to disparities in healthcare access and disease management. This study aimed to analyze temporal trends and spatial distribution of prostate cancer incidence (1996-2017) and mortality (1996-2022) in Sergipe, Brazil, to support targeted cancer control strategies. METHODS: We analyzed prostate cancer data from the Aracaju Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were calculated using the World Standard Population. Joinpoint regression estimated Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess trends. The Mortality-to-Incidence Ratio (MIR) and its complement (1-MIR) were used as proxies for survival. Spatial distribution was examined using Empirical Bayesian Kriging and local empirical Bayes smoothing in QGIS and TerraView. RESULTS: Between 1996 and 2017, 10,133 incident prostate cancer cases were recorded. Incidence increased until 2007 (APC=11.9 %; p < 0.001), then declined (APC=-2.0 %; p = 0.027, with peaks in men aged ≥55. Mortality increased from 1996 to 2007 (APC=12.2 %; p < 0.001) and subsequently stabilised between 2007 and 2022 (APC=-0.8 %; p = 0.228), resulting in an overall AAPC of 2.4 % (p = 0.002) for the entire study period. By age group, mortality rose among men ≥ 75 years (AAPC=3.2 %; p = 0.001) but declined in those aged 15-54 (AAPC=-2.4 %; p = 0.004). The MIR remained flat over time, but estimated survival dropped substantially among men aged ≥ 75 years, from 63 % to 38 %. Spatial analysis revealed higher incidence in central/coastal municipalities, while elevated mortality clustered in southern/coastal areas. CONCLUSIONS: Despite improvements in incidence rates, prostate cancer remains a significant burden in Sergipe, with persistent regional disparities in outcomes. Spatial and temporal analyses highlight the need for targeted public health interventions to improve early detection and access to care, especially in areas of high social vulnerability and among older men.
Chemotherapy use in ovarian cancer patients diagnosed 2012-2017 in Australia, Canada, Norway and the UK: An International Cancer Benchmarking Partnership (ICBP) population-based study.
Barclay ME, McPhail S, Johnson SA … +31 more , Swann R, Butler J, Finley CJ, Barisic A, Bennett D, Bucher O, Creighton N, Denny CA, Dewar RA, Donnelly DW, Downie L, Finn N, Habbous S, Huws DW, May L, Møller B, Morrison DS, Musto G, Nilssen Y, Saint-Jacques N, Shack L, Te Marvelde L, Tian X, Thomas RJS, Thomson CS, Walton R, Wong THT, Woods RR, You H, Lyratzopoulos G, ICBP Module 9 Ovarian Study Group
Cancer Epidemiol · 2025 Dec · PMID 40940184 · Publisher ↗
OBJECTIVE: To describe use of chemotherapy in patients with ovarian cancer in national or sub-national populations of Australia, Canada, Norway and the UK. METHODS: Linked population-based data sources were used to descr...
OBJECTIVE: To describe use of chemotherapy in patients with ovarian cancer in national or sub-national populations of Australia, Canada, Norway and the UK. METHODS: Linked population-based data sources were used to describe use and time to chemotherapy initiation in ovarian cancer patients diagnosed in study periods during 2012-2017. Random-effects meta-analysis characterised the size of interjurisdictional variation. RESULTS: Among 39,879 patients, chemotherapy use ranged from 49 % (Wales) to 75 % (Manitoba). Across jurisdictions, chemotherapy use was higher in advanced disease (79 %, 95 %CI: 74 %-83 %), and lower for stages 1-2 or localised/regional disease (54 %, 95 %CI: 48 %-60 %). Within jurisdictions, chemotherapy use was similar in patients aged 15-64 and 65-74 and then decreased sharply with increasing age. There was large interjurisdictional variation in chemotherapy use in patients aged 85-99 years with advanced disease, being, for example, 23 % (95 %CI: 20 %-25 %) in England and 61 % (95 %CI: 51 %-70 %) in Ontario. However, jurisdictions with the highest chemotherapy use in recorded advanced stage, including Ontario, tended to have higher percentage of missing stage information. Overall, time from diagnosis to chemotherapy initiation was shorter in New South Wales and Victoria and longer in Scotland and Wales. In patients with advanced disease, interjurisdictional variation in time-to-treatment was limited. CONCLUSIONS: Even within the same age groups and stage strata, use of chemotherapy varied substantially between jurisdictions during the mid-2010s. Future work should examine use of surgery in combination with chemotherapy. The reasons for the international variation in chemotherapy use and its contribution to international variation in survival should be established.
Half a century of cancer transition in Hungary: A visualization and assessment of mortality dynamics in the Lexis diagram, 1970-2020.
Wéber A, Bray F, Árvai M … +5 more , Hilbert L, Kelemen D, Nagy P, Kenessey I, Polgár C
Cancer Epidemiol · 2025 Dec · PMID 40939417 · Publisher ↗
OBJECTIVES: Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools...
OBJECTIVES: Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools. The Lexis diagram provides a means to depict age, period and cohort influences on long-term cancer mortality trends. METHODS: Age-specific mortality rates for six cancer localizations were constructed based on the Deaths Register of the Hungarian Central Statistical Office and the Human Mortality Database, then smoothed (p-splines) within the cells of the Lexis diagram assuming Poisson distribution. After calculating the annual percentage change in mortality rates, the results were visualized using heat maps. RESULTS: Substantial reduction in mortality was observable from the mid-1990s in both sexes as a strong period effect, depicting two distinct epidemiological eras in Hungary. Since 2010, breast cancer mortality in women among ages 70-90 (those born between 1930 and 1950) has been rising. Women born between 1940 and 50 experienced two plateaus in lung cancer mortality, unlike men, emphasizing the delayed nature of the smoking epidemic. CONCLUSIONS: The results align with cancer transition patterns observed in similarly developed countries and emphasize a critical need to expand the implementation of effective primary and secondary prevention measures. This includes sustaining organized screening and anti-smoking programs, as well as introducing lung cancer screening with low-dose CT.
Long-term environmental background radiation is associated with urinary tract cancer incidence: A population-based study from Finland.
Li P, Myrskylä M, Martikainen P
Cancer Epidemiol · 2025 Dec · PMID 40934653 · Full text
BACKGROUND: The long-term carcinogenic effects of natural radioactive elements in the environmental background on urinary tract cancer (UTC) have not been fully investigated in the general population. METHODS: The entire...
BACKGROUND: The long-term carcinogenic effects of natural radioactive elements in the environmental background on urinary tract cancer (UTC) have not been fully investigated in the general population. METHODS: The entire Finnish population was linked to long-term municipality-level data on concentrations of uranium and radon in water and radon in indoor air by residential location annually between 1987 and 2016, and UTC incidence was tracked until 2021 based on multiple registries. The first principal component (PC1) of the three radiation exposures was used as a proxy for radiation exposure, and was assessed using the Cox proportional hazards model for its association with UTC risk. Age-standardized incidence rates (ASR) and population attributable fractions (PAF) of radiation exposure were estimated. Spatial association between regional radiation exposure and UTC risk was assessed. RESULTS: Among a total of 2,816,495 residents with 30-year exposure data, 6718 primary UTC cases were diagnosed during 2017-2021. UTC risk increased significantly with each standard deviation (SD) increase in PC1 (hazard ratio [HR] = 1.05, 95 %CI 1.02-1.07). Dose-response relationship was observed when exposure was modelled via natural cubic splines. Increasing UTC incidence was observed across exposure quintiles (lowest quintile: ASR = 47, 95 % CI 45-50; highest quintile: ASR = 53, 95 %CI 50-55). About 5.1 % (PAF, 95 %CI 0.5 %-9.7 %) of UTC incidence was attributable to radiation exposure. Stronger association (HR=1.06, 95 %CI 1.03-1.09, per 1-SD increase) and attributable fraction (PAF = 9.0 %, 95 %CI 3.2 %-14.8 %) were observed among men than among women. Regional UTC risk was significantly associated with regional radiation exposure adjusted for the spatial lag effect in the total population (β = 0.08, p < 0.01), men (β = 0.07, p < 0.01) and women (β = 0.1, p = 0.02). CONCLUSION: Association between long-term environmental radiation exposure and UTC risk was observed in the Finnish population. Dose-response patterns were observed, especially among men. UTC risks attributable to radiation exposure and geographical patterns warrant further investigations.
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