Cancer Epidemiology[JOURNAL]
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200 papers
Changes in childhood cancer incidence rates and trends in Canada (2001-2023): Results from the Cancer in Young People in Canada surveillance program.
Xie L, Gibson P, Barber R … +10 more , Zakaria D, Demers A, Aziz S, Onysko J, Pelland-Marcotte MC, Frechette M, Winch N, Airhart A, Kaur J, Sung L
Cancer Epidemiol · 2026 May · PMID 42166872 · Publisher ↗
INTRODUCTION: We aimed to describe trends in age-standardized incidence rates (ASIRs) of childhood cancer in Canada during 20012023 and evaluate changes in ASIRs during the COVID-19 pandemic. METHODS: Data were obtained...
INTRODUCTION: We aimed to describe trends in age-standardized incidence rates (ASIRs) of childhood cancer in Canada during 20012023 and evaluate changes in ASIRs during the COVID-19 pandemic. METHODS: Data were obtained from the Cancer in Young People in Canada surveillance system. Trends in ASIRs of childhood cancer (age 0-14 years) between 2001 and 2023 were examined using joinpoint regression to estimate annual percent changes (APCs) by demographic and diagnostic categories, with comparisons across models excluding various combinations of pandemic (2020-2022) and post-pandemic (2023) years. Interventional autoregressive integrated moving average (ARIMA) models and rate ratios (RRs) were also used to examine changes in ASIRs during the pandemic. RESULTS: The overall ASIR increased by an average of 1.39% (95% CI: 0.89, 2.39) per year from 150.33 per million children in 2001 to 182.50 in 2013, then decreased by 0.65% (95% CI: -1.82, -0.03) per year to 176.97 in 2023. The recent observed decline, beginning in 2013 for all cancers combined, was attenuated and became non-significant when diagnosis years 2020-2022 or 2021-2022 were excluded. Trend discrepancies were supported by interventional ARIMA analysis, which showed monthly ASIRs for all cancers combined in 2021 and 2022 averaged about 7.5% lower than no-pandemic counterfactuals (p-values < 0.01), and rate ratios, which indicated the overall ASIR in 2021 and 2022 were both 7% lower than the ASIR for 2013-2019 (p-values < 0.05). Trends and changes in ASIRs during the pandemic varied by type of cancer. CONCLUSION: The ASIR for all childhood cancers combined has been declining since 2013. In addition, significantly fewer childhood cancers were reported during pandemic years 2021 and 2022, followed by a rebound in 2023. Incidence rates and trends incorporating pandemic years require cautious interpretation because of the difficulty in disentangling pandemic effects from changes in cancer diagnostic criteria, registration and coding practices, and the true underlying risk of childhood cancer.
Lower breast cancer risk among women with two Hakka parents in Taiwan: A nationwide population-based study.
Wu CC, Nfor ON, Hsu SY … +2 more , Wang KS, Liaw YP
Cancer Epidemiol · 2026 May · PMID 42166871 · Publisher ↗
BACKGROUND: Breast cancer is the most common cancer among women in Taiwan, yet most epidemiological studies treat Taiwanese Han women as a homogeneous population. Whether breast cancer occurrence differs across major Han...
BACKGROUND: Breast cancer is the most common cancer among women in Taiwan, yet most epidemiological studies treat Taiwanese Han women as a homogeneous population. Whether breast cancer occurrence differs across major Han subgroups, such as Hakka and Min-nan, remains insufficiently explored. METHODS: We conducted a nationwide, population-based study by linking the Taiwan Biobank (TWB) with the National Cancer Registry (NCR) and the National Health Insurance Research Database (NHIRD). A total of 78,530 women aged 30-70 years were included, comprising 879 breast cancer cases and 77,651 controls. Parental ethnic/dialect background was determined by the self-reported ethnicity of both parents and categorized as Min-nan, Hakka, or Mainland Chinese. Multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for breast cancer risk associated with parental ethnicity, adjusting for demographic characteristics, lifestyle behaviors, reproductive factors, family history of breast cancer, and metabolic comorbidities. RESULTS: After multivariable adjustment, women with two Hakka parents had a significantly lower odds of breast cancer compared with those with two Min-nan parents (aOR, 0.75; 95% CI, 0.60-0.95). No significant associations were observed for other parental ethnic combinations. Advancing age was strongly associated with increased breast cancer risk, as was diabetes mellitus (aOR, 1.28; 95% CI, 1.07-1.52). A family history of breast cancer in first-degree relatives, including mothers and sisters, was also independently associated with higher odds. Lifestyle factors, anthropometric measures, and reproductive variables showed no significant associations after adjustment. CONCLUSIONS: In this nationwide cohort, breast cancer occurrence differed within the Taiwanese Han population, with a lower risk observed among women with Hakka ancestry on both parental sides. These findings highlight meaningful within-population heterogeneity and underscore the importance of considering ethnic and cultural subgroups in breast cancer epidemiology and risk stratification.
Response to: "Accurate index event definitions are crucial in TriNetX-based cancer epidemiology studies".
Lai SW, Liao KF
Cancer Epidemiol · 2026 May · PMID 42160992 · Publisher ↗
Abstract loading — click title to view on PubMed.
Lung cancer in primary care: Development & validation of a prediction algorithm.
Lapi F, Marconi E, Bianchini E … +4 more , Gorini M, Bate R, Medea G, Cricelli I
Cancer Epidemiol · 2026 May · PMID 42150375 · Publisher ↗
BACKGROUND: Lung cancer (LC) is among the most common and life-threatening cancer worldwide. Early identification in primary care through robust predictive models can enhance early referral and improve outcomes. METHODS:...
BACKGROUND: Lung cancer (LC) is among the most common and life-threatening cancer worldwide. Early identification in primary care through robust predictive models can enhance early referral and improve outcomes. METHODS: This cohort study included 3,454,735 patients aged ≥ 30 years from an Italian federated network of general practitioners' (aggregated) data, spanning 2002-2021. We developed and validated a multivariable prediction algorithm for 5-year LC risk. Risk factors included demographics, lifestyle exposures, comorbidities, and symptoms. A Cox proportional hazard model was estimated and performance assessed using pseudo-R, AUC, and calibration metrics. Model overfitting was assessed via bootstrap methodology. Risk thresholds were established with the goal of developing a decision support tool. RESULTS: Incidence rate of LC was 1.5/1000 person-years in development and validation cohorts. Multivariate analysis showed smoking (HR=14.75), COPD (HR=2.3), and advanced age (HR=1.29 for ≥80) as strong predictors as well as female sex (HR=2.46). Obesity (HR=0.74), diabetes (HR=0.91), and family history of LC (HR=0.48) showed inverse associations. The final model achieved pseudo-R of 0.609, AUC of 0.822, and calibration slope of 1.06 (p value 0.65). Bootstrap analysis confirmed model accuracy. The 5-year predicted risk of LC was 0.73%. Based on risk, low (<0.11%), intermediate (0.11-0.89%), and high (≥0.9%) risk groups were identified. CONCLUSIONS: This LC risk model is a viable predictive tool for primary care. Though future refinements should sustain inclusion of other risk factors, the tool can support timely referral and resource prioritization. Clinical decision support systems using this algorithm might therefore enhance early LC detection.
Geographic differences in breast cancer incidence and trends in young women ages <40 in the United States.
Lee AW, Aguilar-Cruz D, Siddiqui S … +3 more , La Flair A, Tubman S, Wells N
Cancer Epidemiol · 2026 May · PMID 42140177 · Publisher ↗
PURPOSE: Incidence of breast cancer in young women is on the rise. This study examined breast cancer incidence and trends in young women in the U.S. by tumor characteristics and geography. METHODS: Using the U.S. Cancer...
PURPOSE: Incidence of breast cancer in young women is on the rise. This study examined breast cancer incidence and trends in young women in the U.S. by tumor characteristics and geography. METHODS: Using the U.S. Cancer Statistics Public Use Research Database, age-adjusted incidence rates (AAIRs) of breast cancer in women ages < 40 for the U.S. Census Bureau's nine geographic divisions were calculated by tumor stage and subtype for 2011-2022. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated comparing each division's AAIR to the Pacific division's AAIR as a comparison group. Average annual percent changes (AAPCs) were determined using joinpoint regression models. RESULTS: Incidence of distant and triple negative breast cancer was highest in the South Atlantic, with AAIRs that were 20% and 25% higher than the Pacific (IRR=1.20, 95% CI 1.13-1.28 and IRR=1.25, 95% CI 1.20-1.30, respectively). The largest increasing trend was observed in the Middle Atlantic for distant breast cancer (AAPC=4.28, 95 CI 2.40-7.53). CONCLUSION: There are important geographic differences in the burden of distant stage and triple negative breast cancer in young women that should be further studied to help clarify the etiology of young breast cancer.
Reassessing the incidence of uveal melanoma in Germany: Insights from current cancer registry data.
Lever M, Kreis S, Flühs D … +4 more , Guberina M, Stuschke M, Bechrakis NE, Stang A
Cancer Epidemiol · 2026 May · PMID 42127869 · Publisher ↗
BACKGROUND: Uveal melanoma (UM), the most common adult primary intraocular malignancy, has its highest frequency in Europe. Because of the current diagnostic and therapeutic practices, calculating UM incidence can be err...
BACKGROUND: Uveal melanoma (UM), the most common adult primary intraocular malignancy, has its highest frequency in Europe. Because of the current diagnostic and therapeutic practices, calculating UM incidence can be error prone. Using cancer registry data, the aim here was to estimate UM incidence in Germany and North Rhine-Westphalia (NRW), its largest federal state. METHODS: All UM cases from the German Centre for Cancer Registry Data (RKI) in 2019-2021 were analyzed. Data were compared to the 2019-2022 data of NRW's cancer registry. We calculated crude incidence and age-standardized rates (ASR) using the 2013 European standard population. RESULTS: Overall, 2047 German and 830 NRW UM cases were included. In both datasets, the mean age at diagnosis was 65 years; men and women were equally affected. Ciliary body and iris melanomas represented 11-13% of total cases. In Germany (RKI dataset), ASR was 7.4 per million person-years (pyrs). Highest ASR was in the North (Schleswig-Holstein: 16.6 per million pyrs), followed by North-Eastern federal states (ASR: 11-13 per million pyrs in Brandenburg, Berlin, Saxony-Anhalt, Mecklenburg-Western Pomerania), and ASR was 4-8 per million pyrs in the remaining federal states. ASR in NRW was 6.2 (RKI dataset) but 10.6 per million pyrs using the state's cancer registry data. CONCLUSION: Determining UM incidence in Germany remains challenging. High incidence variations between both datasets and German federal states point to a probable incompleteness of the RKI UM-dataset. Incidence is likely higher than previously assumed, but similar to rates observed in Northern Europe (around 10-12 per million pyrs).
Multiple myeloma mortality in Latin America: Heterogeneous patterns and challenges in cross-country comparisons.
Valcarcel B, Riva E, Peña C … +4 more , von Glasenapp A, Leautaud V, Malpica L, Hildebrandt MAT
Cancer Epidemiol · 2026 May · PMID 42119330 · Publisher ↗
INTRODUCTION: Differences in death certification practices may affect cross-country comparisons of multiple myeloma (MM) mortality estimates. In Latin America, where access to transplantation and novel therapies remains...
INTRODUCTION: Differences in death certification practices may affect cross-country comparisons of multiple myeloma (MM) mortality estimates. In Latin America, where access to transplantation and novel therapies remains limited, MM mortality patterns have not consistently aligned with expected differences. We describe MM mortality rates across Latin American countries and compare them to those of Hispanic individuals in the United States (US). METHODS: In this population-based study, we analyzed mortality data from 15 Latin American countries (World Health Organization Mortality Database) and the US (National Center for Health Statistics data). MM deaths among adults (≥20 years) during 2008-2019 were examined using US Hispanic individuals as reference. RESULTS: The highest mortality (per 100,000 persons) in Latin American countries was observed in Chile (4.12), Uruguay (4.11), and Costa Rica (3.57). Mortality for US Hispanic individuals was 3.8. Most countries exhibited lower or comparable mortality rate ratios (MMRs) relative to US Hispanic individuals. Stratified analyses by sex showed similar findings. However, this pattern was not consistent across age groups. Young adults (20-59 years) generally experienced higher mortality, particularly in Cuba (MRR=2.04, 95% CI=1.88-2.21; P<0.0001). Countries with higher Human Development Index tended to exhibit mortality estimates more closely aligned with those of US Hispanic individuals. CONCLUSION: MM mortality patterns across Latin America were heterogeneous and often lower than those observed among US Hispanic individuals, despite known differences in access to care. Strengthening MM surveillance systems is needed to improve the interpretation of mortality patterns across the region.
Mapping melanoma in Hawai'i with inpatient discharge data from 2016 to 2023: Community determinants and anatomic distribution patterns.
Zimmerman HM, Xie K, Matsunaga M … +2 more , Withy K, Martiniano R
Cancer Epidemiol · 2026 May · PMID 42105514 · Publisher ↗
BACKGROUND: Hawai'i has above average rates of melanoma, with head and neck melanoma (HNM) considered the most severe. Analysis of discharge records can reveal disease patterns, and demographic and geographic disparities...
BACKGROUND: Hawai'i has above average rates of melanoma, with head and neck melanoma (HNM) considered the most severe. Analysis of discharge records can reveal disease patterns, and demographic and geographic disparities. OBJECTIVE: To describe community and individual factors associated with Hawai'i's melanoma inpatients between 2016 and 2023. METHODS: Patients diagnosed with melanoma were identified from inpatient discharge records filed between 2016 and 2023. Multivariable logistic regression identified factors associated with HNM for inpatients. Zero-truncated negative binomial regression examined factors associated with length of stay (LOS). RESULTS: Of 409 inpatients with melanoma diagnoses, 67 had it as a principal diagnosis. HNM was less likely to be a secondary diagnosis. HNM was more commonly observed among males, age > 80, or Maui residents. Among patients with principal diagnoses, non-White patients (including Native Hawaiian and Pacific Islanders (NH-PI)) were more likely to have longer LOS than White patients, as did those with more secondary diagnoses LIMITATIONS: The prevalence of melanoma in Hawai'i cannot be inferred, given the focus on inpatient data, along with the absence of data from the self-governed health systems. Melanoma subtypes were not analyzed due to insufficient data. CONCLUSION: Hospitalization for melanoma in Hawai'i was associated with male sex, age, and resident area. NH-PI, and those having a greater number of secondary diagnoses had longer LOS.
Time to treatment initiation delays in cervical cancer worldwide: A systematic review and meta-analysis.
Debanth A, Achary T, Halder P … +10 more , Dasgupta A, Mandal I, Charag S, Panwar N, Mondal A, Goswami B, Rao S, Purkait AT, Sarkar S, Das A
Cancer Epidemiol · 2026 May · PMID 42092224 · Publisher ↗
BACKGROUND: Cervical cancer disproportionately affects women in LMICs, with treatment delays worsening outcomes. Despite WHO's 90-70-90 elimination goal, global disparities persist. This study systematically reviews worl...
BACKGROUND: Cervical cancer disproportionately affects women in LMICs, with treatment delays worsening outcomes. Despite WHO's 90-70-90 elimination goal, global disparities persist. This study systematically reviews worldwide delays from diagnosis to treatment, identifying contributing factors across income levels, healthcare systems, and treatment approaches. METHOD: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. Observational studies reporting the interval between histopathological diagnosis of cervical cancer and initiation of first-line definitive treatment (surgery, chemotherapy, radiotherapy, or combination therapy) were eligible. Search was performed in PubMed, Embase, Web of Science, and Scopus up to October 30, 2025. Two reviewers independently screened records, extracted data, and assessed study quality using the JBI Critical Appraisal Checklist. Pooled mean delays were estimated using random-effects models in STATA 19.5. Subgroup analyses and meta-regression explored heterogeneity by income level, data source, and treatment modality. Sensitivity analyses and publication bias assessments were performed using Galbraith plots, leave-one-out methods, Egger's test, and trim-and-fill procedures. RESULT: The pooled mean delay from diagnosis to treatment initiation was 71.42 days (95% CI: 47.96-94.88), exceeding recommended benchmarks of 30-60 days. Across studies, 59% of patients experienced treatment initiation delays exceeding 30 days, 54% exceeded 45 days, and 33% exceeded 90 days. Subgroup analysis revealed that high-income countries experienced shorter delays (40.50 days), while upper-middle-income countries faced significantly longer waits (94.63 days). Among treatment types, radiotherapy had the longest delay (79.90 days). The causes of delay were multifaceted, involving patient-level challenges such as stigma and financial constraints, systemic issues like inefficient referral processes and limited radiotherapy access, and disease-related factors. Despite substantial heterogeneity across studies (I² = 99.98%), sensitivity analyses validated the consistency and reliability of the pooled estimates. CONCLUSION: This study provides the most comprehensive global estimate of cervical cancer treatment delays to date. The findings highlight critical disparities across income settings and healthcare systems, with actionable insights for policy and practice. Addressing these delays is essential to improving survival outcomes and achieving WHO's cervical cancer elimination targets. Strengthening referral systems, expanding radiotherapy infrastructure, and tailoring interventions to local barriers are key priorities.
The impact of social inequalities on cancer incidence and mortality in a Brazilian City: Data from the population-based cancer registry.
von Zuben APB, do Carmo Ferreira M, de Azevedo Barros MB … +3 more , Nativo J, Correa MEP, de Souza CA
Cancer Epidemiol · 2026 May · PMID 42092223 · Publisher ↗
BACKGROUND: Cancer represents one of the leading global public health challenges, with its burden shaped not only by biological factors but also by social and economic inequalities. In Brazil, even municipalities with a...
BACKGROUND: Cancer represents one of the leading global public health challenges, with its burden shaped not only by biological factors but also by social and economic inequalities. In Brazil, even municipalities with a very high Human Development Index (HDI) exhibit persistent disparities. This study assessed temporal changes in cancer incidence, mortality, and social inequalities in Campinas, São Paulo State, Brazil. METHODS: A repeated cross-sectional study was conducted using incidence and mortality rates of the most frequent neoplasms among men and women residing in Campinas, SP, Brazil from 2010 to 2014 and 2015-2019 from the Population-Based Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were estimated for the most common cancers, stratified by levels of social vulnerability based on the São Paulo Social Vulnerability Index. Inequalities were analyzed using the Relative Index of Inequality (RII). RESULTS: Among men, prostate cancer (RR= 0.94; 95% CI: 0.89-0.99) and stomach cancer (RR= 0.82; 95% CI: 0.72-0.93) incidence declined, while mortality remained stable for most cancers, except for an increase in colorectal cancer mortality (RR 1.15; 95% CI: 1.00-1.32 - p = 0.032 and a reduction in stomach cancer mortality (RR= 0.83; 95% CI: 0.66-1.04). Socially vulnerable men showed persistently higher mortality from prostate, stomach, and oral cavity cancers. Among women, breast cancer incidence increased (RR= 1.14; 95% CI: 1.08-1.20), and overall mortality rose (RR= 1.06; 95% CI: 1.01-1.12), particularly from lung cancer (RR= 1.25; 95% CI: 1.07-1.47). Vulnerable women exhibited consistently higher cervix uteri cancer incidence (2010-2014: RII= 2.90; 95% CI: 1.90-4.43 vs. 2015-2019: RII= 2.36; 95% CI: 1.58-3.53) and mortality (2010-2014: RII= 2.74; 95% CI: 1.42-5.26 vs. 2015-2019: RII= 3.60; 95% CI: 1.89-6.85), while breast cancer incidence remained higher among less vulnerable women (2010-2014: RII= 0.42; 95% CI: 0.37-0.49 vs. 2015-2019: RII= 0.49; 95% CI: 0.43-0.56). Inequalities in colorectal cancer incidence narrowed over time for both sexes; however, mortality inequality among men reversed, becoming higher among the most vulnerable in 2015-2019 (RII= 0.92; 95% CI: 0.66-1.29). CONCLUSION: Despite high socioeconomic development, substantial social inequalities in cancer incidence and mortality persist in Campinas, with some disparities widening over time. These findings highlight the need for targeted and equity-oriented cancer control strategies to improve access to early diagnosis, treatment, and care among socially vulnerable populations.
Time trends in the incidence of multiple primary melanomas in Australia.
Ni Y, Espinoza D, McLoughlin K … +2 more , Lo SN, Cust AE
Cancer Epidemiol · 2026 May · PMID 42092222 · Publisher ↗
BACKGROUND: The incidence of first primary melanoma has increased in many countries, but less is known about the incidence of multiple primary melanomas. We investigated trends in the incidence of multiple primary melano...
BACKGROUND: The incidence of first primary melanoma has increased in many countries, but less is known about the incidence of multiple primary melanomas. We investigated trends in the incidence of multiple primary melanomas over time in Australia, and whether the trends differed by sex, age, and anatomical site. METHODS: We examined the cumulative frequency and age-standardised incidence rates of second and higher-order primary melanomas in a population-based Australian cohort from seven cancer registries, comprising 299,535 individuals diagnosed with a first primary invasive melanoma between 1982 and 2016, and 221,973 individuals in a subset with a first invasive or in situ melanoma. RESULTS: The age-standardised incidence rate of second primary invasive melanoma within 5 years of a first primary invasive melanoma increased for males from 4.7 (95% confidence interval (CI):3.3-6.1) per 1000 person-years in 1982-1986 to 9.7 (95% CI:8.3-11.1) per 1000 person-years in 2012-2016, and for females from 3.1 (95% CI:2.6-3.6) to 8.0 (95% CI:6.8-9.2) respectively. When in situ and invasive melanomas were considered together, the incidence rates surged from 7.0 (95% CI:5.0-8.9) to 29.5 (95% CI:18.0-41.0) per 1000 person-years for males and from 4.8 (95% CI:3.9-5.7) to 20.4 (95% CI:18.7-22.2) for females. Incidence trends over time were similar by sex and age-group but differed by anatomical site. CONCLUSIONS: Over three decades in Australia, age-standardised incidence rates for second primary melanoma approximately doubled for invasive melanoma and increased by four-fold when in situ melanomas were included. These findings highlight the need for strengthened prevention and early detection to manage this burden.
Epidemiology of childhood cancer in the Republic of Kazakhstan: A population-based registry analysis (2015-2024).
Saliyeva SS, Manzhuova LN, Bazarbayeva AA … +7 more , Kussainov AZ, Sarsekbayeva FM, Kalieva AZ, Manapova MM, Kyzdarbekova ZN, Nurgaliev DZ, Taukebayev KT
Cancer Epidemiol · 2026 May · PMID 42085927 · Publisher ↗
BACKGROUND: Studying the epidemiology of cancer in any country allows us to identify problems in the healthcare system as a whole and predict their future burden. However, no large-scale studies of the epidemiology of ch...
BACKGROUND: Studying the epidemiology of cancer in any country allows us to identify problems in the healthcare system as a whole and predict their future burden. However, no large-scale studies of the epidemiology of childhood cancer have been conducted in Kazakhstan to date. This study is the first to analyze cancer incidence rates among children in the Republic of Kazakhstan using data from the country's population-based registry of childhood cancers. METHODS: We performed a population-based descriptive analysis of childhood cancer incidence in Kazakhstan from 2015 to 2024, using annual case counts and age-specific denominators from Electronic Registry of Oncological Patients (EROP). Incidence rates were calculated per 1,000,000 children; age-standardized rates used world-standard weights for ages 0-14 and 0-17. Temporal trends were measured by annual percent change (APC) via log-linear regression and average annual percent change (AAPC) with segmented log-linear regression. RESULTS: Between 2015 and 2024, EROP reported 507-638 childhood cancer cases annually, with crude incidence rates of 86.8-108.5 per 1,000,000 children (highest in 2017, lowest in 2019). The overall incidence remained stable (APC -1.20%/year, p = 0.112), and was consistently higher in males (IRR 1.13-1.48). Children aged 0-4 years had the highest age-specific incidence (123.5 per 1,000,000), while a significant decrease was seen in ages 10-14 (APC -1.99%/year, p = 0.014). Hepatic tumors increased (APC +3.86%/year, p = 0.044), retinoblastoma declined sharply (APC -8.61%/year, p = 0.001), with other groups showing no significant changes. CONCLUSION: Overall childhood cancer incidence in Kazakhstan remained broadly stable during 2015-2024, with consistently higher rates in males than females. Diagnosis-specific analyses identified increasing hepatic tumors and a marked decline in retinoblastoma, underscoring the importance of continued registry-based surveillance to monitor subtype-specific trends.
Adherence to the 2018 WCRF/AICR cancer prevention recommendations and all-cause and cancer-specific mortality: A prospective study.
Mathew AA, Peng Y, Bassett JK … +9 more , Hodge AM, Afshar N, MacInnis RJ, Lynch BM, Smith-Warner SA, Shams-White MM, Giles GG, Milne RL, Jayasekara H
Cancer Epidemiol · 2026 May · PMID 42070396 · Publisher ↗
BACKGROUND: We investigated the associations between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle-related Cancer Prevention Recommendations and all-cause a...
BACKGROUND: We investigated the associations between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle-related Cancer Prevention Recommendations and all-cause and cancer-specific mortality in a prospective cohort study. METHODS: We included 17,332 participants from the Melbourne Collaborative Cohort Study who participated in the second follow-up assessment in 2003-07 and were re-assessed for diet, body size, and lifestyle. Participants were followed for mortality outcomes through June 2021. We constructed a diet score and a standardised lifestyle score based on core WCRF/AICR recommendations, as well as a lifestyle score including abstinence from smoking. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for associations between quintiles of the diet and lifestyle scores and all-cause and cancer-specific mortality using Cox regression. RESULTS: During follow-up (mean=17 years), 4742 total deaths and 1343 deaths due to cancer were documented. Higher WCRF/AICR standardised lifestyle score (i.e., greater adherence) was associated with lower cancer-specific (HR 0.74; 95% CI: 0.61-0.90 for highest quintile vs lowest quintile) and overall mortality (HR 0.90; 95% CI 0.81-0.99). CONCLUSION: Our findings reinforce the importance of adhering to established lifestyle-based cancer prevention guidelines for improving longevity.
Impact of treatment for childhood acute lymphoblastic leukemia on later education, paid labor, and sickness- or activity compensation: A registry study from Sweden.
Zhou O, Harila A, Hovén E … +1 more , Lönnerblad M
Cancer Epidemiol · 2026 Apr · PMID 42066742 · Publisher ↗
Acute lymphoblastic leukemia (ALL) in childhood now carries survival rates above 90%, yet treatment may result in late effects that influence later educational and labor market outcomes. Previous studies have shown incon...
Acute lymphoblastic leukemia (ALL) in childhood now carries survival rates above 90%, yet treatment may result in late effects that influence later educational and labor market outcomes. Previous studies have shown inconsistent results, and few have used population-based registry data with matched controls while distinguishing between different treatment intensities. The aim of this study was to assess post-compulsory educational and labor market outcomes among children treated for ALL categorized into standard-risk (SR) and high-risk (HR) treatment groups. We conducted a nationwide registry-based cohort study including 490 survivors, and 2212 matched population controls. Educational outcomes included attendance in the final year of upper secondary school, enrollment in municipal adult education, attendance at folk high schools, and participation in tertiary education. Labor market outcomes included ever having participated in paid labor and ever having received sickness or activity compensation. Differences were analyzed using logistic regression, and all analyses were adjusted for maternal educational level. Analyses were made for the entire cohort, by sex and by risk group. We found no statistically significant differences between survivors and controls for any post-compulsory educational outcome in any of the analyses. In contrast, we found that survivors overall were significantly less likely to have participated in paid labor (OR 0.72; 95% CI 0.54-0-95) and significantly more likely to have received sickness or activity compensation compared with controls (OR 2.87; 95% CI 1.82-4.53). In subgroups these disparities were concentrated in the HR group. In conclusion, survivors of childhood ALL participated in post-compulsory education at rates similar to their peers, but experienced challenges in entering the workforce. Our subgroup analysis identified that this labor market impairment was primarily experienced by survivors treated with high-intensity therapy. Our findings highlight the need for targeted long-term support strategies to reduce labor market impairment especially among survivors exposed to more intensive treatment.
Accurate index event definitions are crucial in TriNetX-based cancer epidemiology studies.
Wang J
Cancer Epidemiol · 2026 Apr · PMID 42066741 · Publisher ↗
Abstract loading — click title to view on PubMed.
Predisposing factors for metastatic disease at initial diagnosis of synovial sarcoma: A big data analysis (n = 2162).
Hanna G, Abdou M, Kamil R … +2 more , Bryk E, Hansen D
Cancer Epidemiol · 2026 Apr · PMID 42066740 · Publisher ↗
BACKGROUND: Synovial sarcoma (SS) is an aggressive soft tissue malignancy of mesenchymal origin. We reexamined potential predisposing factors predictive of metastatic disease at initial diagnosis of SS using Big Data Ana...
BACKGROUND: Synovial sarcoma (SS) is an aggressive soft tissue malignancy of mesenchymal origin. We reexamined potential predisposing factors predictive of metastatic disease at initial diagnosis of SS using Big Data Analysis. METHODS: The U.S. Surveillance, Epidemiology, and End Results (SEER) Program database was queried to identify patients diagnosed with SS from 2000 to 2018. Cases were stratified at presentation as metastatic or localized disease. Patient demographics and tumor characteristics were analyzed using univariate and multivariable logistic regression models to identify factors independently associated with metastatic presentation including age greater than 50 years, tumor in the pelvic area, and relative tumor size. RESULTS: A total of 2162 cases of histologically confirmed SS were identified, of which 382 (17.7%) presented with metastatic disease at diagnosis. Based on an unadjusted logistic regression analysis, patients had the highest odds of metastatic disease at initial diagnosis if they were over the age of 50 (odds ratio [OR] = 2.77; 95% confidence interval [CI], 2.00-3.80), had tumors located in the pelvic region (OR = 3.28; 95% CI, 2.13-5.06), or had a tumor size greater than 10 cm (OR = 8.98; 95% CI, 5.87-13.74). These factors remained significant when combined in a multivariable model controlling for age, sex, race, tumor location, histology, size, and socioeconomic factors. CONCLUSION: SS patients who are over the age of 50 years, have tumors in the pelvic region, or have tumors larger than 10 cm in size are more likely to present with metastatic disease at initial diagnosis.
Advanced adenomas among young endurance runners: A prospective hypothesis-generating prevalence study.
Swain WR, Bonomelli S, Johnston L … +19 more , Kaltman R, Pereanu W, Hall B, Wang H, Winer A, Mani H, Xia M, Randall J, Slocum M, Harnden I, Donet JA, Nguyen V, Cabello R, Shah R, Abuhamda E, Al-Kawas F, Nigam N, Wadlow R, Cannon TL
Cancer Epidemiol · 2026 Apr · PMID 42066739 · Publisher ↗
BACKGROUND: Extreme long-distance running can produce recurrent gastrointestinal stress, including splanchnic hypoperfusion, mucosal injury, and post-exercise rectal bleeding, but its relationship to colorectal neoplasia...
BACKGROUND: Extreme long-distance running can produce recurrent gastrointestinal stress, including splanchnic hypoperfusion, mucosal injury, and post-exercise rectal bleeding, but its relationship to colorectal neoplasia is unclear. We therefore prospectively estimated the prevalence of advanced adenomas in endurance runners aged 35-50 years. This prevalence estimate is hypothesis-generating. METHODS: In this prospective, single-center, single-arm prevalence (cross-sectional) study (NCT05419531), participants had completed at least 2 ultramarathons (50 km or longer) or at least 5 marathons and had no colonoscopy within 10 years; key exclusions were inflammatory bowel disease, familial adenomatous polyposis, or Lynch syndrome. Participants completed a questionnaire and underwent colonoscopy. Advanced adenomas were defined as lesions 10 mm or larger, villous or tubulovillous histology (or > 25% villous component), or high-grade dysplasia. Prevalence was compared with a 1.2% historical rate reported in asymptomatic, average-risk adults aged 40-49 undergoing screening colonoscopy. RESULTS: Participants were recruited and consented from November 2022 to November 2024, and 94 participants (54.3% female; median age, 42 years) underwent colonoscopy between December 2022 and January 2025. Adenomas were found in 39 participants (41.5%), and advanced adenomas in 14 (15.0%; 95% binomial CI, 8.4-23.7%); no cancers were detected. Most advanced lesions were right-sided. The average number of adenomas per participant with non-advanced adenomatous polyps was 1.8. The average number of adenomas found amongst the participants with advanced adenomas was slightly higher at 2.2. CONCLUSIONS: In this endurance-runner sample, advanced adenomas were observed at a prevalence of 15.0% overall. Compared with historical screening benchmarks, prevalence appeared higher, supporting further evaluation of colorectal neoplasia risk in endurance runners. However, differences in symptom profile and other risk factors between this study population and historical screening populations limit direct comparability, and the findings should be considered hypothesis-generating. Larger controlled studies and mechanistic work are needed. TRIAL REGISTRATION: ClinicalTrials.gov NCT05419531.
Multi-level disparities in survival among patients diagnosed with oral cavity cancer in Texas between 1995 and 2020.
Tortolero GA, Sturgis EM, Yamal JM … +3 more , Peskin MF, Bauer C, Murphy CC
Cancer Epidemiol · 2026 Apr · PMID 42066738 · Publisher ↗
BACKGROUND: Multi-level factors, including demographic and neighborhood social conditions, related to disparities in oral cavity cancer (OCC) are not fully understood. We examined the association between these factors an...
BACKGROUND: Multi-level factors, including demographic and neighborhood social conditions, related to disparities in oral cavity cancer (OCC) are not fully understood. We examined the association between these factors and survival outcomes among patients diagnosed with OCC. METHODS: We identified 14,416 patients diagnosed with OCC from 1995 to 2020 using population-based data from the Texas Cancer Registry. Neighborhood-level social vulnerability was measured using the 2010 US Centers for Disease Control and Prevention's Neighborhood Social Vulnerability Index (CDC-SVI). We examined race and ethnicity, CDC-SVI (as sample-based quintiles), and their joint effects with survival outcomes. RESULTS: Five-year survival probability was 38.6% (95% CI: 35.3, 42.0) for non-Hispanic Black patients, 55.1% (95% CI: 54.1, 56.0) for non-Hispanic White patients, 44.8% (95% CI: 42.9, 46.6) for patients in the most vulnerable neighborhoods, and 61.5% (95% CI: 59.6, 63.2) for patients in the least vulnerable neighborhoods. In adjusted models, Non-Hispanic Black patients (hazard ratio (HR) 1.79, 95% CI: 1.63, 1.95) and patients in the most vulnerable neighborhoods (HR 1.50, 95% CI: 1.40, 1.61) had a higher risk of all-cause mortality compared to non-Hispanic White patients and those in the least vulnerable neighborhoods, respectively. There were no racial and ethnic differences in all-cause mortality in the least vulnerable neighborhoods compared to non-Hispanic White patients (Non-Hispanic Black: HR 1.44, 95% CI: 0.95, 2.18). CONCLUSIONS: Findings underscore the importance of mitigating inequities in survival outcomes among patients with OCC and demonstrate that racial and ethnic disparities in survival outcomes were largely attenuated among patients living in the least socially vulnerable neighborhoods.
Forecasting mortality and decomposition analysis for cancer deaths in Egypt (2014-2030).
Elshishiney G, Li M, Zou Y … +2 more , Abdel-Razek W, Hu Y
Cancer Epidemiol · 2026 Jun · PMID 42054879 · Publisher ↗
BACKGROUND: Cancer represents a significant public health challenge in Egypt, with its burden projected to rise due to ongoing epidemiological and demographic transitions. Understanding the drivers of cancer mortality is...
BACKGROUND: Cancer represents a significant public health challenge in Egypt, with its burden projected to rise due to ongoing epidemiological and demographic transitions. Understanding the drivers of cancer mortality is crucial for effective public health planning. METHODS: We used a time series analysis of national vital registration data for 19 cancer types from 2014 to 2023. We employed a hybrid forecasting model combining ARIMA and ETS to project mortality trends through 2030. A decomposition analysis was performed to quantify the influence of population growth, population aging, and age-specific mortality rates on the observed and projected CMR. RESULTS: Our analysis revealed a 14.1% [95% CI: 12.7, 15.5] increase in total cancer deaths, while the ASMR rose by a more modest 8.2% [95% CI: 3.1, 13.3], primarily driven by demographic factors. Despite this, ASMR for most major cancer types stabilized or declined; liver cancer ASMR decreased by 12.1% [95% CI: -20.8,-3.4] and female breast cancer deaths fell by 29.0% [95% CI: -33.3,-24.6]. A notable epidemiological shift was also observed, with CMR from less common cancers like multiple myeloma increasing by over 700% and skin cancer by 349%. Forecasting models project a continued decline for these major cancers through 2030, with a projected 12.3% decrease in lung cancer CMR for both sexes and a 41.5% reduction for female breast cancer. CONCLUSION: The growing cancer mortality burden in Egypt is primarily a function of demographic shifts rather than an increase in age-standardized risk. The decline in ASMR for major cancers demonstrates the success of targeted interventions specifically, liver cancer ASMR reflecting the success of national Hepatitis C elimination. These findings highlight the need for a dual-pronged strategy: sustaining efforts to combat prevalent cancers while proactively developing new programs to address the emerging threats posed by lifestyle- and aging-related malignancies, particularly those disproportionately affecting women.
Melanoma in older patients in Switzerland: A comparison across age groups including patients over the age of 80 years.
Preisig J, Wildisen L, Dummer R … +3 more , Mangana J, Staehelin K, Bastiaannet E
Cancer Epidemiol · 2026 Jun · PMID 42054878 · Publisher ↗
BACKGROUND: With the ageing population and the increasing incidence of melanoma in recent years, melanoma management in the oldest is becoming increasingly important. We aimed to assess Breslow thickness (BT), relative s...
BACKGROUND: With the ageing population and the increasing incidence of melanoma in recent years, melanoma management in the oldest is becoming increasingly important. We aimed to assess Breslow thickness (BT), relative survival (RS) and trends in immunotherapy use in younger, older, and the oldest Swiss patients. MATERIAL AND METHODS: Patients diagnosed with invasive cutaneous melanoma and reported to Swiss cantonal cancer registries between 2012 and 2021 were included. Age was divided in three categories: < 70, 70-79 and ≥ 80 years. Differences in median BT at diagnosis and changes over time were assessed. Percentages of stage 3 and 4 patients receiving immunotherapy by age and year were calculated. Relative survival was calculated and multivariable analyses estimating the Relative Excess Risk of death (RER) were conducted. RESULTS: Overall, 27 649 patients were included. Age-standardized incidence rates increased across all age categories, with the steepest rise observed in older patients (EAPC: 2.9% (95% CI: 1.0-4.8) for 70-79 years and 2.6% (1.6-3.6) for ≥ 80 years vs. 1.2% (0.2-2.3) for < 70 years). Median BT increased with age, with patients aged ≥ 80 years having the highest median BT at diagnosis (0.80 (IQR: 0.40-2.50)). The percentage of stage 3 and 4 patients aged ≥ 80 years receiving immunotherapy increased from 3.45% in 2012 to 42.47% in 2021 (p < 0.001) but remained lower than in younger patients. Survival decreased with increasing age: Patients younger than 70 years had a 5-year survival of 96.2% (95% CI: 95.8-96.6), compared to 93.7% (95% CI: 92.6-94.9) among those aged 70-79 years, and 88.7% (95% CI: 86.0-91.4) among patients aged 80 years and older. Relative survival of patients aged ≥ 80 years was worse compared to younger patients (<70 years), even after adjusting for sex, BT, stage, and location (RER: 2.378; std. error: 0.108; p < 0.001). CONCLUSION: Swiss melanoma patients aged ≥ 80 years are diagnosed with thicker melanomas, receive more conservative treatment, and experience worse survival. These findings highlight the need to include the oldest patients in future melanoma research, strengthen secondary prevention efforts, and ensure they benefit from optimal therapeutic advances.
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