Cancer Epidemiology[JOURNAL]
Sun
200 papers
Quantifying treatment-related travel burden and its association with mortality in pediatric cancer: An analysis of state cancer registry data.
Hymel E, Ratnapradipa KL, Zheng C … +5 more , Allison J, Peters ES, Nash SH, Hsieh MC, Watanabe-Galloway S
Cancer Epidemiol · 2026 Jun · PMID 41950538 · Publisher ↗
BACKGROUND: Most children with cancer receive care at specialized tertiary centers in urban areas, creating substantial travel demands for many patients and their families. Prior studies on the relationship between trave...
BACKGROUND: Most children with cancer receive care at specialized tertiary centers in urban areas, creating substantial travel demands for many patients and their families. Prior studies on the relationship between travel burden and pediatric cancer survival have yielded inconsistent findings, in part due to limitations in how travel burden is measured. METHODS: This population-based cohort study analyzed data from the Iowa Cancer Registry and the Louisiana Tumor Registry, including all cancer cases diagnosed at ages 0-19 from 2000 to 2020. Travel distance was estimated with ArcGIS Pro using the great-circle distance (miles) between patients' residences and treatment facilities. For cases diagnosed in Iowa, travel time (minutes) was estimated using the Origin-Destination Cost Matrix tool. We applied Cox proportional hazards models to examine associations between travel burden and mortality, with confounders selected using a directed acyclic graph approach. RESULTS: A total of 4871 patients were included (2151 in Iowa; 2720 in Louisiana). Overall, the median travel distance was 32.54 miles (IQR: 8.46-76.47). Travel distance was higher for children residing in rural census tracts and more deprived neighborhoods. The hazard of cancer death among those with a high travel distance (Q4) was 1.41 times higher (95% CI: 1.20-1.65) than those with a low travel distance (Q1-Q3). For the Iowa subset, travel distance was a good approximation of travel time. CONCLUSIONS: Children experiencing high travel distance have poorer survival than those with lower travel burden. These findings underscore the need for interventions and policies to reduce treatment-related travel burden in pediatric cancer care.
European expert consensus on cancer recurrence and progression data collection by population based cancer registries.
Hawkins ST, Mitchell HJ, Bennett D … +28 more , Maso LD, Farré X, Giusti F, Graham K, Huws DW, Lai J, Lyratzopoulos G, Marcos-Gragera R, Martos C, Manson C, Michalek I, Morgan E, Morrison D, Mousavi M, Carvalho RN, Nennecke A, Ortelli L, Randi G, Rous B, Smith K, Trojanowski M, Eycken LV, Neamtiu L, Verdoodt F, Visser O, Wicker T, Zadnik V, Gavin AT
Cancer Epidemiol · 2026 Jun · PMID 41946283 · Publisher ↗
BACKGROUND: As cancer survival improves, the risk of recurrence and progression (RP) places increasing demands on services. Population based cancer registries (PBCR) recognise the importance of recording these data items...
BACKGROUND: As cancer survival improves, the risk of recurrence and progression (RP) places increasing demands on services. Population based cancer registries (PBCR) recognise the importance of recording these data items and seek defined standardised variables for routine collection of RP events. METHODS: Experts from 14 European countries under direction of the European Network of Cancer Registries (ENCR) defined RP for solid and haematological malignancies, standardised variables and coding formats for PBCRs. A seven-step modified-nominal group technique was used. A survey of RP data recording in 2023, an ENCR workshop in 2023 which included wider representation than from Europe and consultation with all ENCR members followed. RESULTS: Definitions were agreed with a tiered approach to data collection and guidance prepared: Cancer recurrence defined as cancer return after a disease-free period post tumour-reductive treatment (TRT) where cancer had a complete clinical or microscopic treatment response. Cancer progression - an increased disease load post TRT where a verified complete response was not achieved. Transformation where tumour changes from indolent to aggressive is covered in RP definitions. Survey responses indicated 31% of PBCRs collect data on RP for all cancer sites 11% for selected sites. Many identified additional resources, training and better access to clinical data required to collect RP data. Guideline implementation began January 2025 irrespective of primary diagnosis date. CONCLUSION: RP data, standardised and collected by adequately resourced PBCRs, is a key step in quantifying service needs and outcomes of this increasing group of cancer patients. Registries need adequate resources to collect RP data.
Explainable machine learning with SHAP decodes the heterogeneous burden of nasopharyngeal carcinoma in high-risk aging Asia.
Yan X, Xiao H, Zhang Y … +3 more , Yang F, Wang X, Ma R
Cancer Epidemiol · 2026 Jun · PMID 41946282 · Publisher ↗
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a global public health concern, with a particularly high burden concentrated in East Asia, Southeast Asia, and high-income Asia-Pacific and disproportionately affecting older...
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a global public health concern, with a particularly high burden concentrated in East Asia, Southeast Asia, and high-income Asia-Pacific and disproportionately affecting older adults. However, the diverging long-term epidemiological trajectories across these high-risk subregions remain unquantified. METHODS: Using GBD 2023 data, we analyzed NPC burden (incidence, mortality, prevalence, DALYs) among adults ≥ 55 years in these regions (1990-2023). We employed trend analysis, explainable machine learning (Random Forest with SHAP) and negative binomial regression to identify and quantify key modifiable risk factors, constructed a Composite Risk Index, and projected future trends to 2050. RESULTS: NPC burden showed sharply diverging trends: rising in high-income Asia-Pacific, declining in East Asia, and stable in Southeast Asia. Explainable machine learning identified a core cluster of modifiable risk factors (high intake of red/processed meat and sodium, smoking, high alcohol use) significantly associated with the burden. The geographic pattern of the Composite Risk Index closely matched the highest-burden regions. The disease showed strong male predominance and increased with age. Projections indicate these divergent trajectories will persist. CONCLUSION: The heterogeneous NPC burden in aging Asia is driven by a modifiable risk factor cluster and mediated by regional healthcare disparities. Findings necessitate precision public health strategies: enhanced primary prevention and early diagnosis in Southeast Asia, sustaining therapeutic gains in East Asia, and developing survivorship care in high-income Asia-Pacific.
Age-specific melanoma incidence trends in Canada.
O'Sullivan DE, Nicolau I, Tilley D … +4 more , Hutchinson JM, Ruan Y, Warkentin MT, Brenner DR
Cancer Epidemiol · 2026 Jun · PMID 41932245 · Publisher ↗
BACKGROUND: Melanoma is a rapidly increasing cancer in Canada, largely due to ultraviolet radiation (UVR) exposure. The objective of this study was to examine age- and sex-specific melanoma incident trends in Canada to d...
BACKGROUND: Melanoma is a rapidly increasing cancer in Canada, largely due to ultraviolet radiation (UVR) exposure. The objective of this study was to examine age- and sex-specific melanoma incident trends in Canada to determine if public health efforts related to UVR exposure are having an impact on melanoma incidence. METHODS: Data on melanoma incidence was obtained from the Canadian Cancer Registry (1992-2022). Annual percent changes in age-specific incidence rates were analyzed with segmented regression. Birth cohort effects were estimated with age-period-cohort models and reported as cohort incidence rate ratios (IRRs) with respect to the 1953-57 cohort. RESULTS: From 1992-2022, the incidence of melanoma has steadily increased for females over 40 and males over 50 with larger increases for older age groups. In contrast, melanoma rates have been decreasing for females under 30 and males under 40. Compared to the baby boom generation, recent birth cohorts (1998-2007 for males and 1993-2007 for females) have a lower incidence of melanoma. CONCLUSIONS: While melanoma rates continue to increase for older adults, incidence among younger Canadians is declining. These results may indicate that public health efforts are having an impact on melanoma prevention for recent birth cohorts.
Psychosocial outcomes of low-dose computed tomography screening for lung cancer in high-risk populations: A systematic review update.
Jubane A, Peters JL, Robinson S … +1 more , Hyde CJ
Cancer Epidemiol · 2026 Jun · PMID 41926804 · Publisher ↗
Low dose computed tomography (LDCT) screening programmes for lung cancer are being implemented worldwide, and the psychological impacts of LDCT screening need to be understood. We have updated, and expanded, a systematic...
Low dose computed tomography (LDCT) screening programmes for lung cancer are being implemented worldwide, and the psychological impacts of LDCT screening need to be understood. We have updated, and expanded, a systematic review of the health-related quality of life (HRQoL) outcomes associated with LDCT for lung cancer in high-risk individuals which was published in 2018. The original systematic review sought HRQoL from randomised controlled trials (RCTs) only. In this update review, we have expanded the inclusion criteria so that HRQoL data from any study design are relevant. We searched electronic databases from January 2017. Titles and abstracts, and subsequent full-texts, were screened by one person against pre-defined criteria. Data extraction was conducted by one person and checked by a second. After screening 29,097 articles, we did not identify any new HRQoL evidence from RCTs. Thirteen non-RCTs met our inclusion criteria. No statistically significant impacts of LDCT screening were observed in the nine studies measuring general QoL; two out of nine studies reported increases in measures of anxiety (and depression in one study); two out of eleven studies observed short-term negative impacts on psychological cancer-specific outcomes; a further two studies reported statistically significant negative impacts for sub-groups of participants. Our findings suggests that LDCT screening does not markedly impact the psychosocial outcomes of individuals being screened. However, the included studies measured the outcomes at different timepoints and had diverging participant inclusion criteria. Large differences in sample size and loss to follow-up may also affect the validity of the results from the included studies. Although there is limited evidence to indicate that LDCT screening impacts significantly on psychosocial outcomes, it is necessary to ensure that all stages of screening delivery and communication promote wellbeing, motivate positive behaviour change and maximise patient benefit.
Association between pioglitazone use and prostate cancer in patients with type 2 diabetes: A retrospective cohort study.
Lai SW, Liao KF
Cancer Epidemiol · 2026 Jun · PMID 41905181 · Publisher ↗
OBJECTIVE: Pioglitazone is commonly prescribed for glycemic control in type 2 diabetes mellitus (T2DM), yet its potential impact on prostate cancer risk remains uncertain. This study aimed to assess the association betwe...
OBJECTIVE: Pioglitazone is commonly prescribed for glycemic control in type 2 diabetes mellitus (T2DM), yet its potential impact on prostate cancer risk remains uncertain. This study aimed to assess the association between pioglitazone use and incident prostate cancer among men with T2DM. METHODS: We conducted a retrospective cohort study using data from the TriNetX network. Men with T2DM aged 55-84 years were included. To form the pioglitazone and pioglitazone-naïve groups, men were matched 1:1 based on demographic and clinical characteristics. The primary outcome was the incidence of prostate cancer. Cumulative probability, hazard ratios, and 95% confidence intervals were calculated using the TriNetX "Compare Outcomes" module. RESULTS: After matching and applying a 3-month lag exclusion, 19,449 patients in the pioglitazone group and 19,455 patients in the pioglitazone-naïve group were included. During follow-up period, the proportions of men diagnosed with prostate cancer was about 0.566% in the pioglitazone group and 0.329% in the pioglitazone-naïve group. The hazard ratio for prostate cancer was 1.655 in the pioglitazone cohort compared to the pioglitazone-naïve cohort (95% confidence interval: 1.214-2.256). CONCLUSION: Pioglitazone use was associated with prostate cancer in men with T2DM aged 55-84 years, highlighting the need for careful risk assessment and further investigation.
Gender differences in cancer epidemiology in Italy, 2013-2017.
Tagliabue G, Mazzucco W, Tittarelli A … +9 more , Fruscione S, Amodio R, Pesce MT, Perotti V, Fabiano S, Zarcone M, Stracci F, Contiero P, AIRTUM Working Group
Cancer Epidemiol · 2026 Jun · PMID 41903435 · Publisher ↗
Gender differences in cancer burden have been consistently reported worldwide, with men exhibiting higher incidence and mortality rates for most non-sex-specific cancers. However, the extent and patterns of these dispari...
Gender differences in cancer burden have been consistently reported worldwide, with men exhibiting higher incidence and mortality rates for most non-sex-specific cancers. However, the extent and patterns of these disparities across cancer sites, age groups, and geographical regions in Italy remain poorly investigated. We analysed data from population-based cancer registries belonging to the AIRTUM network, including 1359,053 cancer cases diagnosed between 2013 and 2017, overall and stratified by age group (0-49, 50-69, ≥70 years) and by geographic macro-areas (North, Centre, South & Islands). Differences in five-year net survival between men and women were also assessed. Overall, cancer incidence was markedly higher in men (male-to-female incidence rate ratio [M/F IRR] 1.38; 95% confidence interval [CI]: 1.38-1.39), and this gap increased when excluding breast cancer (M/F IRR = 1.90; 95% CI: 1.89-1.90). Male predominance was observed in 29 of 30 sites, most notably laryngeal (M/F IRR = 8.74; 95% CI: 8.31-9.19), bladder (5.23; 95% CI: 5.15-5.32), mesothelioma (3.60; 95% CI: 3.40-3.82), and lung (2.92; 95% CI: 2.89-2.95) cancers, while thyroid cancer was more common in women (0.37; 95% CI: 0.36-0.38). Incidence gender gaps were greater in the South & Islands than in the North and Centre. Women showed higher five-year survival rates than men for most major cancers, including colorectal and lung. In Italy, men bear a substantially higher cancer burden than women, with significant geographical variability, while women consistently achieve better survival outcomes. Biological, behavioural, and sociocultural factors likely contribute to these differences. Addressing these disparities requires incorporating a gender perspective into cancer prevention, early detection, and treatment strategies.
Mixed effects of area-level deprivation and healthcare access and individual-level health insurance on late-stage colorectal cancer diagnosis in Pennsylvania.
Snead R, Henry KA, Wilson RT … +1 more , Jones RM
Cancer Epidemiol · 2026 Jun · PMID 41903434 · Publisher ↗
BACKGROUND: Despite screenings successful reduction of colorectal cancer (CRC) incidence, about one-third of diagnoses in the United States are late-stage, negatively impacting survival rates. Furthermore, Pennsylvania C...
BACKGROUND: Despite screenings successful reduction of colorectal cancer (CRC) incidence, about one-third of diagnoses in the United States are late-stage, negatively impacting survival rates. Furthermore, Pennsylvania CRC incidence and mortality has been consistently above national rates even with screening coverage from the Affordable Care Act and Medicaid expansion. PURPOSE: Investigate the role of area-level deprivation, healthcare access, and individual factors, including health insurance status, on late-stage CRC. METHODS: Screening age-eligible adults diagnosed with a primary CRC (2008-2017) were identified from Pennsylvania Cancer Registry data (N = 34,250). Late-stage CRC combines "Distant" and "Regional" stage diagnoses defined by the National Cancer Institute's Summary Staging. Area-level healthcare access was estimated using a Multi-modal Two-Step Floating Catchment Area, and neighborhood deprivation via Weighted Quantile Sum regression. The risk of late-stage CRC in association with insurance coverage (private, government, none), was modeled using spatial two-level generalized linear mixed models, adjusted for individual age, sex, race/ethnicity, rurality, and area-level deprivation and healthcare access. RESULTS: Compared to having private health insurance, individuals with government insurance were more likely to be diagnosed with late stage during the 2010-2013 and 2014-2017 time periods (OR range=1.12-1.19). Having no health insurance (OR range=2.10-2.69 vs. private health insurance) was significantly associated with increased likelihood of late-stage diagnosis at all three time periods (2008-2009, 2010-2013, 2014-2017). Late-stage CRC was significantly less likely among older individuals (OR range=0.98-0.99), Black (OR range=0.80-0.85) and other race (OR=0.57) vs. white race, and suburban (OR=0.78) vs. urban residence and varying by time period. Area-level deprivation and healthcare access was not significantly associated with late-stage CRC diagnosis. CONCLUSION: Health insurance type appears to be a major factor associated with late-stage CRC diagnosis in Pennsylvania, independent of age, sex, race/ethnicity, rurality, area-level deprivation, and healthcare access. Given CRC is covered for preventive screening by the Affordable Care Act and Pennsylvania's Medicaid expansion, these results suggest improving health insurance coverage awareness and utilization may reduce incidence and mortality from late-stage CRC.
Prevalence and correlates of clinical skin checks for skin cancer among Australians.
Reyes-Marcelino G, Espinoza D, Watts CG … +5 more , Kang YJ, Smit AK, Goldsbury DE, Steinberg J, Cust AE
Cancer Epidemiol · 2026 Jun · PMID 41894939 · Publisher ↗
BACKGROUND: In Australia, early detection of melanoma relies on opportunistic skin checks, yet information on skin check behaviours in the general population is limited. We aimed to examine the prevalence and correlates...
BACKGROUND: In Australia, early detection of melanoma relies on opportunistic skin checks, yet information on skin check behaviours in the general population is limited. We aimed to examine the prevalence and correlates of clinical skin checks in a large Australian cohort. METHODS: The 45 and Up Study recruited 267,357 New South Wales residents between 2005 and 2009. We assessed self-reported clinical skin checks in the previous 12 months among 43,799 participants who responded to the 2020 follow-up survey (52.8% response). Multivariable multinomial logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for associations between participant characteristics and skin checks, classified as whole-body, partial (part-body or specific mole/spot), and no skin check. RESULTS: Participants' mean age was 70.3 years (SD 8.3, range 56-103) and 55.9% were female. The prevalence of skin checks over the past 12 months was 43.2% for whole-body, 21.0% for partial, and 35.8% for no skin check; 21.8% of participants reported more than one skin check during the year. The highest odds of having a whole-body skin check were for participants with a personal history of melanoma (aOR=3.74, 95% CI: 3.39-4.13) or non-melanoma skin cancer (aOR=4.05, 95% CI: 3.83-4.29), many moles (aOR=3.26, 95% CI: 2.79-3.80 versus no moles), and very fair, fair or olive skin (aOR ≥2.6 versus black/brown skin). Other factors significantly associated with whole-body skin checks included being male, age 70-79 years, Australia/New Zealand country of birth, university education, private health insurance, being retired, household income > $90,000, family history of melanoma, inability to tan, longer time spent outdoors, participation in other cancer screening programs, and frequent sunscreen use. There were some differences for the associations with partial skin checks. CONCLUSION: Our findings provide valuable insights into skin checking behaviours in older adults in New South Wales, Australia, highlighting associations with sociodemographic, personal risk, and behavioural factors.
Comparisons between individual- and area-level measures of socioeconomic status among childhood cancer patients: A report from the Children's Oncology Group (COG).
Cha J, Clark CJ, Li Y … +7 more , Parsons H, Spector LG, Poynter JN, Olshan AF, Sample J, Van Riper D, Marcotte E
Cancer Epidemiol · 2026 Jun · PMID 41886800 · Full text
Observational studies often utilize area-level socioeconomic status (aSES) data when individual-level (iSES) data are unavailable. However, correlations between iSES and aSES in pediatric cancer populations are not well-...
Observational studies often utilize area-level socioeconomic status (aSES) data when individual-level (iSES) data are unavailable. However, correlations between iSES and aSES in pediatric cancer populations are not well-described. We explored correlations between aSES and iSES in childhood cancer cases co-enrolled on Children's Oncology Group registry and epidemiology protocols (n = 1379) in the United States. We created four composite measures of iSES using maternal questionnaire data for household poverty, educational attainment, occupation, and housing type for comparison with Yost and Social Vulnerability Index (SVI) socio-economic domain at the census tract (CT)- and ZIP code (ZIP)-level. CT- and ZIP- aSES were weakly to moderately correlated with iSES (ρ=0.46, 0.36, respectively); results were similar across the four composite models (range ρ=0.43-0.48 [CT-aSES], 0.34-0.36 [ZIP-aSES]). When stratifying by race and ethnicity, the highest correlations were among non-Hispanic Black and Hispanic cases, with CT-level correlations stronger than ZIP-level. Correlations were dramatically lower for all rural cases (ρ range=-0.10-0.25), particularly non-Hispanic White (ρ range=-0.15-0.23); sample size was insufficient to evaluate other subgroups. We found varying levels of correlation between aSES and iSES, dependent upon geographic resolution of aSES measure, with CT-aSES generally being more strongly correlated with iSES than ZIP-aSES, and varying by race, ethnicity, and urbanicity.
Lung cancer screening by low-dose computed tomography: A modelling study to evaluate radiation-induced cancer risks, and the influence of smoking behavior.
Nicolas M, Agnès R, Christophe B … +4 more , Julie S, Enora C, Dominique L, Marie-Odile B
Cancer Epidemiol · 2026 Jun · PMID 41886799 · Publisher ↗
INTRODUCTION: Lung cancer screening using low-dose computed tomography (LDCT) is being experimented in France. Based on the terms of a French pilot program, we estimated the risk of radiation-induced cancer for six cance...
INTRODUCTION: Lung cancer screening using low-dose computed tomography (LDCT) is being experimented in France. Based on the terms of a French pilot program, we estimated the risk of radiation-induced cancer for six cancer sites exposed to ionizing radiation during LDCT. MATERIALS AND METHODS: Three groups were considered according to smoking behavior. Baseline cancer risks in smokers were computed based on available data and literature. Radiation-induced risks of cancer following repeated LDCT from age 50 until loss of eligibility to screening, were estimated based on two reference radiation-risks models, assuming a complete adherence to the program, and a volume computed tomography dose index (CTDI) of 0·8 mGy. A benefit-risk ratio was estimated considering 5-year cancer mortality in France, and screening lung cancer specific mortality decrease, as reported in literature. RESULTS: We estimated a lifetime attributable risk of 16 radiation-induced cancers per 100,000 screened women (7 in men, respectively), including 9 (3) lung cancers, and 2 (0) breast cancers, leading to 10 (5) deaths. Compared to 232 (162) expected lung cancer deaths prevented, this leads to an estimated ratio of 23 (32). Because smoking cessation improve survival rates and decrease lung cancer incidence rates, ceasing groups face lower benefit-risk ratios: it is close to 1 in individuals weaned 15 years before screening inclusion. CONCLUSION: Our results show that the number of radiation-induced cancers following repeated LDCT remains low compared to prevented deaths, as long as weaning is recent. It underlines the importance of efforts to reduce the dose to ensure that all enrolled individuals face a favorable ratio.
Epidemiological landscape and clinical heterogeneity of ultra-rare sarcomas: A population-based study from the SEER database.
Fukuda R, Matsuoka M, Onodera T … +6 more , Iwasaki K, Sato D, Ebata T, Shimizu H, Kondo E, Iwasaki N
Cancer Epidemiol · 2026 Jun · PMID 41880717 · Publisher ↗
INTRODUCTION: Ultra-rare sarcomas (URS), defined by the Connective Tissue Oncology Society (CTOS) as subtypes with an incidence of ≤ 1 per 1000,000 individuals per year, present significant diagnostic and therapeutic cha...
INTRODUCTION: Ultra-rare sarcomas (URS), defined by the Connective Tissue Oncology Society (CTOS) as subtypes with an incidence of ≤ 1 per 1000,000 individuals per year, present significant diagnostic and therapeutic challenges. This study aimed to elucidate the epidemiological landscape and clinical characteristics of URS using a large-scale population-based registry. METHODS: Patients diagnosed with bone sarcomas (BS) and soft tissue sarcomas (STS) between 2000 and 2019 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Cases were classified into URS and non-URS groups based on the CTOS definition. Patient demographics, tumor characteristics, and survival outcomes were analyzed. RESULTS: The collective incidence rates of bone (B-URS) and soft tissue URS (ST-URS) were 2 and 14 per 1000,000 respectively. Among 14,695 BS and 94,455 STS cases included, URS accounted for 3099 (21.1%) and 15,155 (16.0%). B-URS were more frequently diagnosed in older patients (≥40 years) and presented with lower pathological grades. Conversely, ST-URS were more common in younger patients and exhibited higher rates of metastases. A substantial proportion had unknown pathological grades (53.4% in B-URS; 35.9% in ST-URS), reflecting diagnostic complexity. Although survival analysis indicated outcomes for URS were comparable to or better than non-URS, this likely reflects the prevalence of indolent subtypes rather than superior treatment efficacy. CONCLUSION: This study provides a comprehensive epidemiological description of URS based on the CTOS definition. Our findings highlight the significant clinical heterogeneity of URS, characterized by indeterminate grading and diverse biological behaviors.
Demographic and health-related characteristics associated with cancer survivorship in sexual and gender minority adults and cisgender heterosexual adults: A cross-sectional analysis of behavioral risk factor surveillance system 2021 data.
McElroy JA, Guan T, Anbari AB … +1 more , Brown MT
Cancer Epidemiol · 2026 Jun · PMID 41875605 · Publisher ↗
PURPOSE: The purpose of this study was to describe the characteristics of being a cancer survivor among those aged 45-64 and 65-80 years, inclusive of sexual and gender minority (SGM) status, using a national population-...
PURPOSE: The purpose of this study was to describe the characteristics of being a cancer survivor among those aged 45-64 and 65-80 years, inclusive of sexual and gender minority (SGM) status, using a national population-based study dataset. METHODS: We used the weighted data from the 2021 Behavioral Risk Factor and Surveillance System (BRFSS). Descriptive statistics describe the study population characteristics. Logistic regression models were used as exploratory tools to examine patterns in participant characteristics, including SGM status, with cancer survivor status as the dependent variable, stratified by sex (male and females) and by two age groups (45-64 years, 65-80 years). RESULTS: BRFSS data in 2021 comprised 87,780 females (12,260 female cancer survivors) and 71,594 males (8478 male cancer survivors). Across both age groups and sexes, cancer survivors more frequently reported poorer self-reported health, and higher number of multiple chronic conditions. Older age groups reported cancer survivorship more often. Patterns in the adjusted models indicated non-Hispanic Blacks and another race had lower odds of reporting cancer survivorship in sex-age strata. Among younger men, but not older men, current smoking and binge drinking showed lower adjusted odds of reporting cancer survivorship compared to non-SGM peers. Current BMI patterns varied across age and sex groups. CONCLUSIONS: Cancer survivorship differs across demographic and health-related characteristics, with notable variations by age, sex, and race/ethnicity. These descriptive patterns suggest a need for longitudinal and causally informed research to better understand pathways leading to survivorship disparities.
Corrigendum to "A clinical rule-based indicator to identify recurrence of colorectal cancer after curative resection using linked routinely collected national data" [Cancer Epidemiol. 100 (2026) 102962].
Almilaji O, Sharples L, Aggarwal A … +10 more , Cromwell D, Horgan K, Braun M, Arnott R, Nossiter J, Kuryba A, Lewin A, Cowling T, Van Der Meulen J, Walker K
Cancer Epidemiol · 2026 Jun · PMID 41863894 · Publisher ↗
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Evaluating eight smoking metrics for modelling survival in non-small cell lung cancer.
Lam AC, Li Y, Brown MC … +51 more , Deng Y, Hueniken K, Leighl NB, Shepherd FA, Murison K, Wang Z, Kothari J, Wenzlaff AS, Liu H, Kohno T, Pesatori AC, Harris C, Ma H, Dai J, Barnett MJ, Diver R, Leal LF, Fernandez-Tardon G, Pérez-Ríos M, Davies MP, Holleczek B, Brennan P, Zaridze D, Holcatova I, Lissowska J, Świątkowska B, Mates D, Savic M, Brenner H, Andrew AS, Taylor F, Field JK, Ruano-Ravina A, Shete SS, Tardon A, Wang Y, Marchand LL, Reis RM, Schabath MB, Neuhouser ML, Shen H, Landi MT, Shiraishi K, Zhang J, Schwartz AG, Tsao MS, Christiani DC, Yang P, Hung RJ, Xu W, Liu G
Cancer Epidemiol · 2026 Jun · PMID 41861692 · Full text
INTRODUCTION: Smoking is a strong modifiable prognostic factor for lung cancer survival. We compared eight smoking metrics to determine which metric best models the relationship between smoking exposure with overall surv...
INTRODUCTION: Smoking is a strong modifiable prognostic factor for lung cancer survival. We compared eight smoking metrics to determine which metric best models the relationship between smoking exposure with overall survival (OS) and lung cancer-specific survival (LCSS). These metrics included cigarettes-per-day, smoking duration, pack-years, square-root pack-years, logcig-years, the comprehensive smoking index, age-of-initiation, and years-since-quit. MATERIALS/METHODS: This retrospective, pooled analysis included 25 International Lung Cancer Consortium studies between June 1, 1983-December 31, 2019. The performance of smoking metrics for modelling OS was compared based on 1) strength and significance in adjusted Cox-proportional hazard models and 2) linearity based on the goodness-of-fit assuming the log-hazard varies linearly with each smoking metric (i.e. the hazard ratio is constant across different values of the smoking metric) compared to models using non-linear splines. This process was repeated across clinicodemographic subgroups and for LCSS. RESULTS: In total, 28,702 lung cancer patients were included (median age 64 [IQR: 57-71]; 53% male). Logcig-years (log(cigarettes/day+1)·years-smoked) had the highest adjusted hazard ratio per standard deviation (aHR 1.11; 95% CI: 1.09-1.13) and best goodness-of-fit when modelled linearly. Square-root pack-years had a similar effect size (aHR 1.11; 95% CI: 1.09-1.13) and had a strong linear relationship on visual assessment of spline curves. In subgroup analyses, logcig-years had a large effect size and maintained a linear relationship regardless of age, sex, stage, and histology. For lung cancer-specific survival (LCSS), logcig-years again had the highest aHR (1.09; 95% CI: 1.05-1.12) and the best linear goodness-of-fit, while square-root pack-years demonstrated the most linear relationship on visual assessment. DISCUSSION: Logcig-years best modelled the relationship between smoking exposure and OS as well as LCSS, and had consistent associations across clinicodemographic subgroups. Logcig-years should be considered in clinical and research applications for quantifying smoking exposure in lung cancer.
Secondhand smoke and lung cancer risk in never-smoking women: A cohort and meta-analysis study.
Pang G, Zhu M, Yue S … +13 more , Yuan R, He B, Zhu C, Li Q, Ji C, Jin C, Mou Y, Cai J, Zhang C, Fu Y, Ma H, Du L, Zhu M
Cancer Epidemiol · 2026 Jun · PMID 41855613 · Publisher ↗
BACKGROUND: Most existing evidence on secondhand smoke (SHS) exposure and lung cancer in never-smoking women comes from case-control studies, while findings from prospective cohort studies remain inconsistent. Regional v...
BACKGROUND: Most existing evidence on secondhand smoke (SHS) exposure and lung cancer in never-smoking women comes from case-control studies, while findings from prospective cohort studies remain inconsistent. Regional variation in SHS-associated risk is poorly understood, and the potential impact of reducing SHS exposure in never-smoking women has not been quantified. METHODS: We analyzed data from 20,401 never-smoking women in the Wenling lung cancer screening cohort (Zhejiang, China), applying Cox proportional hazards regression models to evaluate the association between SHS exposure and lung cancer risk. We further conducted a meta-analysis of published studies to examine regional variation and estimated the population attributable fraction (PAF) of SHS exposure for lung cancer incidence in never-smoking women. RESULTS: SHS exposure was associated with an increased lung cancer risk (HR=1.52, 95% CI: 1.19-1.95). Lung cancer risk tended to increase with higher smoking intensity, with a linear trend observed for cigarettes per day, years of smoking, and pack-years of co-residents and colleagues (P<0.05; P>0.05). In meta-analysis, the pooled relative risk was higher in Asia than in Europe and America [RR= 1.31 (95% CI: 1.20-1.43) vs 1.13 (95% CI: 1.04-1.23); P = 0.039]. The PAF suggested that 16.9% (95% CI: 11.6%-22.0%) of lung cancer cases among never-smoking women could be attributed to SHS exposure. CONCLUSIONS: SHS exposure is a risk factor for lung cancer in never-smoking women, with stronger effects observed in Asian populations. Reducing SHS exposure could prevent a substantial proportion of lung cancer cases, underscoring the urgent need for strengthened tobacco control policies.
The expanding cancer landscape in chronic pancreatitis.
Quammie S, Rashid A, Munyal R … +6 more , Nicholson ES, Clarke C, Venkatachalapathy SV, John Crooks C, Aithal GP, Aravinthan AD
Cancer Epidemiol · 2026 Jun · PMID 41849829 · Publisher ↗
INTRODUCTION: Chronic pancreatitis (CP) is driven by smoking, excessive alcohol use, and chronic inflammation - all known contributors to carcinogenesis. However, its association with malignancies beyond the pancreas rem...
INTRODUCTION: Chronic pancreatitis (CP) is driven by smoking, excessive alcohol use, and chronic inflammation - all known contributors to carcinogenesis. However, its association with malignancies beyond the pancreas remains underexplored. This study aimed to assess the frequency and spectrum of cancers in patients with CP. METHOD: A retrospective cohort study was conducted at Nottingham University Hospitals of patients diagnosed with CP between 1 January 2006 and 31 December 2014, identified through a multisource case ascertainment strategy. Cancer frequencies were assessed in patients residing within Greater Nottingham. Age-adjusted standardised incidence ratios (SIRs) were calculated using national cancer incidence data from England as the reference population. Statistical analyses were performed using R (version 4.3.3). RESULTS: Of the 1003 CP patients identified, 678 resided in Greater Nottingham (median age at diagnosis 68 years (IQR 53-79); 66% male; 92% Caucasians. The median follow-up period was 7.3 years (IQR 2.8-11.6). Compared to the general population, patients with CP demonstrated significantly higher SIRs for upper respiratory tract (12.4; 95%CI 6.6-21.1; p < 0.0001), pancreatic (10.8; 95%CI 6.2-17.6; p < 0.0001), liver (8.8; 95%CI 2.4-22.6; p < 0.0001), lung (5.6; 95%CI 4.0-7.7; p < 0.0001), renal tract (4.8; 95%CI 2.7-7.9; p < 0.0001) oesophageal (4.8; 95%CI 1.8-10.4; p = 0.0001) and colorectal (2.5; 95%CI 1.4-4.2; p = 0.0009) cancers. CONCLUSION: CP confers a markedly elevated risk of both pancreatic and extra-pancreatic cancers. These findings hypothesise that CP might be a high-risk state for malignancy that could warrant proactive, risk-based cancer surveillance in this vulnerable population.
Incidence, mortality, and five-year survival of bladder cancer in six population-based cancer registries in Colombia, 2003-2018.
Vanegas Cárdenas SA, Cantor EJ, de Vries E
Cancer Epidemiol · 2026 Jun · PMID 41849828 · Publisher ↗
BACKGROUND: Bladder cancer is a neoplasm with a higher prevalence in men and older adults. In Colombia, it accounts for approximately 1% of all cancer cases, with a marked difference between sexes (1.6% in men vs. 0.5% i...
BACKGROUND: Bladder cancer is a neoplasm with a higher prevalence in men and older adults. In Colombia, it accounts for approximately 1% of all cancer cases, with a marked difference between sexes (1.6% in men vs. 0.5% in women). OBJECTIVE: To determine the incidence, mortality, and 5-year relative survival (RS5) of bladder cancer in six population-based cancer registries (PBCRs) in Colombia, 2003-2018. METHODS: This retrospective observational study employed data from six population-based cancer registries (Barranquilla, Bucaramanga, Cali, Manizales, Medellín, Pasto). Crude and age-standardized incidence and mortality rates were calculated by the direct method using the Segi world standard population. Trends were evaluated using Joinpoint regression (Annual Percent Change, APC). RS5 was estimated using the Pohar-Perme method. Analyses were stratified by sex, age, PBCR, and histological subtype. RESULTS: During the study period, 3019 cases were registered (69.9% male, 30.1% female). The incidence was 2.3 times higher in men compared to women, with age-standardized rates ranging from 4.3 to 6.8 per 100,000, increasing sharply after the age of 55. Urothelial carcinoma of the bladder (UCB) was the most frequent subtype (77.9%), followed by the unspecified category (16.7%), adenocarcinoma (2.2%), and squamous cell carcinoma (1.9%). For the survival analysis (n = 2066, excluding Cali), RS5 varied significantly across registries, ranging from 42.6% (Pasto) to 83.7% (Medellín). In all registries, NS5 was consistently higher in men than in women. CONCLUSION: Bladder cancer in Colombia showed a marked male predominance, with incidence increasing sharply after the sixth decade of life. The urothelial subtype was the most frequent and exhibited the most prognosis among the reported cases.
Trends and regional patterns of cervical cancer incidence by histological subtypes: A Chinese population-based analysis from cancer registry data.
Qi M, Tian C, Di X … +1 more , Ma J
Cancer Epidemiol · 2026 Jun · PMID 41832790 · Publisher ↗
OBJECTIVE: To access the incidence trends and regional patterns of cervical cancer by histological subtypes in Chinese female population. METHODS: Data on women aged ≥ 20 years were extracted from 157 population-based ca...
OBJECTIVE: To access the incidence trends and regional patterns of cervical cancer by histological subtypes in Chinese female population. METHODS: Data on women aged ≥ 20 years were extracted from 157 population-based cancer registries across 25 provinces in China covering 13.4% of the population. The age-standardized incidence rates (ASIRs, per 100,000 women-years) were assessed for overall and histological subtypes [squamous cell carcinoma (SCC) and adenocarcinoma (AC)] of cervical cancer. For evaluating the changes in ASIRs, the annual percent change or average annual percent change was calculated. The age-specific incidence rates of cervical cancer were estimated in different age groups. RESULTS: A total of 67,042 cervical cancer cases were reported, with an ASIR of 10.91 per 100,000 women. Of which, 42,289 cases were SCC, with an ASIR of 6.93 per 100,000; 8325 cases were AC, with an ASIR of 1.37 per 100,000. The overall age-standardized incidence showed an upward trend from 1998 to 2017 among both total and different subtype populations. The highest ASIRs of SCC were concentrated in the Northeast and less developed regions, whereas AC incidence peaked in the Northwest and more developed areas. The age-specific incidence rates of total cervical cancer and different subtypes exhibited an initial increase followed by a decrease with advancing age, peaking at approximately 50-54 years. CONCLUSION: SCC was the main subtype of cervical cancer in China. The incidence of SCC and AC continued to increase. The coordinated implementation of organized screening, high-coverage human papillomavirus vaccination, and affordable treatment may represent a critical strategy for preventing the occurrent of cervical cancer.
Racial/ethnic disparities and geographic clustering in pediatric thyroid cancer incidence in the United States, 1999-2022, with forecasts to 2027.
Ghazy RM, Sun C, Alshaikh AA … +1 more , Vinh T
Cancer Epidemiol · 2026 Jun · PMID 41830688 · Publisher ↗
BACKGROUND: The burden of pediatric and adolescent thyroid cancer is increasing. This research aimed to study the long-term incidence trends among United States (U.S.) individuals aged 0-19 years from 1999 to 2022, asses...
BACKGROUND: The burden of pediatric and adolescent thyroid cancer is increasing. This research aimed to study the long-term incidence trends among United States (U.S.) individuals aged 0-19 years from 1999 to 2022, assess heterogeneity by sex, age, race/ethnicity, and state, evaluate COVID-19 pandemic-associated changes, and forecast incidence through 2027 METHODS: This population-based longitudinal ecological analysis used the U.S. Cancer Statistics Incidence Database queried via Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER). Cases were defined using ICD-O-3 site code C73.9. Age-adjusted incidence rates per 100,000 were calculated by demographic strata. Joinpoint-type segmented regression and Poisson regression were used to assess temporal trends and estimate annual percent change and incidence rate ratios (IRR). State-level geographic variation was assessed using mapped age-adjusted rates and global spatial autocorrelation (Moran's I). Forecasts (2023-2027) were generated using Autoregressive Integrated Moving Average (ARIMA) model, Exponential Smoothing State Space (ETS) model, and Poisson regression. RESULTS: From 1999-2022, 17,538 pediatric thyroid cancer cases were diagnosed. Incidence increased steeply with age, peaking at ages 15-19 (crude rate 2.58/100,000). Females had higher incidence than males (age-adjusted 1.4 vs 0.3/100,000). Rates were highest among White (1.0/100,000) and Asian/Pacific Islander (0.9/100,000) children and lowest among Black/African American children (0.3/100,000). Significant spatial clustering was observed (Moran's I=0.39, p < 0.001), with higher rates in Northeastern states and lower rates in the South. A marked decline occurred in 2020, consistent with disrupted diagnosis during the COVID-19 pandemic. Poisson models indicated a sustained upward temporal trend (IRR≈1.032 per year, p < 0.001). Forecasts suggested continued increases through 2027 (≈17% rise over 5 years; ≈37% over 10 years). CONCLUSIONS: Pediatric and adolescent thyroid cancer incidence rose steadily in the U.S. from 1999 to 2022, with pronounced socio-demographic heterogeneity and a notable diagnostic disruption in 2020. Continued surveillance and investigation of etiologic drivers and diagnostic intensity are mandatory, alongside efforts to reduce inequities in access to evaluation and care.
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