Cancer Epidemiology[JOURNAL]
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200 papers
Cancer incidence in Addis Ababa, 2018-2022: The only population based cancer registry in Ethiopia.
Gizaw M, Parkin DM, Asmare S … +7 more , Lukas K, Getachew S, Destaw A, Liu B, Assefa M, Addissie A, Kantelhardt EJ
Cancer Epidemiol · 2026 Jun · PMID 41814110 · Full text
BACKGROUND: Cancer remains a significant public health challenge worldwide, with developing regions bearing a disproportionately higher burden. In Ethiopia, the scarcity of data from population-based cancer registries (P...
BACKGROUND: Cancer remains a significant public health challenge worldwide, with developing regions bearing a disproportionately higher burden. In Ethiopia, the scarcity of data from population-based cancer registries (PBCR) has limited a comprehensive understanding of the cancer profile in the country. METHODS: Data from the PBCR in Addis Ababa, covering approximately 3.7 million people (2020), about 3% of the Ethiopian population, were analyzed for cancer cases diagnosed between 2018 and 2022. Age-standardized incidence rates (ASR) for common cancers were calculated and compared with estimated rates in East Africa, West Africa, the Black population in the USA, and global averages. RESULTS: A total of 14,053 cancer cases were recorded, with 4584 cases in men (ASR: 66.5 per 100,000) and 9469 cases in women (ASR: 113.5 per 100,000). Among males, the three most commonly diagnosed cancers were colorectal cancer (14.3% of all male cancers, with an ASR of 9.8 per 100,000), prostate cancer (12.9%, ASR 11.8 per 100,000), and mouth and pharynx cancer (6.6%, ASR 3.9 per 100,000). In females, the three most commonly diagnosed cancers were breast cancer (38.8% of all female cancers, with an ASR of 39.8 per 100,000), cervical cancer (14.3%, ASR 18.9 per 100,000), and colorectal cancer (7.2%, ASR 8.9 per 100,000). CONCLUSION: This study reveals a higher cancer burden in women, with breast and cervical cancers accounting for over two-thirds of all cancer cases, consistent with cancer patterns in other East African regions. The lower incidence of prostate and liver cancers points to possible under diagnosis or underreporting, highlighting the need for enhanced diagnostic and screening capacities. The relatively high incidence of colorectal cancer emphasizes the importance of targeted awareness and screening programs, particularly in urban areas like Addis Ababa.
Accuracy of diagnostic codes to identify metastatic prostate cancer in medicare claims database.
Zhou B, Raval AD, Zhang Y … +2 more , Sambamoorthi N, Sambamoorthi U
Cancer Epidemiol · 2026 Jun · PMID 41791349 · Publisher ↗
PURPOSE: To assess the accuracy of claims-based identification of metastatic prostate cancer (mPC) compared to Surveillance, Epidemiology, and End Results (SEER) registry classification as the gold standard using the SEE...
PURPOSE: To assess the accuracy of claims-based identification of metastatic prostate cancer (mPC) compared to Surveillance, Epidemiology, and End Results (SEER) registry classification as the gold standard using the SEER-Medicare database. METHODS: This retrospective cohort study (N = 72,840) included men aged ≥ 66 years at SEER-recorded PC diagnosis between 2016 and 2019, and continuously enrolled in Medicare fee-for-service Parts A and B for at least 2 months before and after the SEER-recorded PC diagnosis date. Claims-based mPC was identified using the International Classification of Diseases (ICD)-10 diagnosis codes. Using registry-based mPC as a gold standard, accuracy measures were estimated for claims-based mPC. Multivariable logistic regression was used to identify factors associated with discordance between registry-based and claims-based mPC. RESULTS: Overall, 9.2% (N = 6684) had registry-based mPC and 8.1% (N = 5899) had claims-based mPC at diagnosis. The claims-based method yielded an overall accuracy (95.4%) with specificity (98.0%), negative predictive value (96.9%), sensitivity (68.8%), and positive predictive value (78.0%). In adjusted logistic regression, older men (≥85 years), non-Hispanic Blacks, and those living in low socio-economic areas had higher odds of discordance. CONCLUSIONS: ICD-10 codes in claims data demonstrated high accuracy in identifying mPC at diagnosis among elderly men with prostate cancer, with moderate sensitivity.
Spatial disparities in incidence and survival of liver cancer in Australia, 2010-2019.
Bainomugisa CK, Dasgupta P, Cameron JK … +4 more , Cramb S, Strasser SI, MacLachlan JH, Baade PD
Cancer Epidemiol · 2026 Jun · PMID 41791348 · Publisher ↗
BACKGROUND: Liver cancer incidence rates are increasing, and survival rates remain among the lowest of all cancers in Australia. Geographic inequalities in incidence and survival have been partially attributed to access...
BACKGROUND: Liver cancer incidence rates are increasing, and survival rates remain among the lowest of all cancers in Australia. Geographic inequalities in incidence and survival have been partially attributed to access and socioeconomic barriers; however previous reports have been based on coarse, typically heterogenous geographic factors and so were unable to detect variation at a finer resolution. This study investigates high resolution spatial patterns of incidence and survival rates of liver cancer across Australia. METHODS: Liver cancer data were extracted from all Australian state and territory cancer registries (aged 15 and over). Incidence and 5-year relative survival spatial patterns (2010-2019) at the small-area level were modelled using Bayesian spatial Leroux models and spatial heterogeneity tested using the maximised excess events test. RESULTS: The age-standardized (Aust 2001) incidence rate was 9.4 cases per 100,000 person-years, with higher rates among males than females. Strong evidence of spatial variation in the incidence and survival of liver cancer was found at the small area level (p < 0.001). Compared to the national average, many areas in Australia's north and centre showed higher incidence, as well as some areas in most state and territory capitals. Generally, survival rates were poorer than the Australian average outside major cities; however, some city areas also had poorer survival. CONCLUSION: The spatial patterns of incidence of liver cancer reflect the geographic distribution of the priority populations in state capitals of people born overseas in hepatitis B endemic regions and First Nations Australians in the northern and central regions. Our findings highlight the need for targeted, place-based interventions to reduce the prevalence of modifiable risk factors for liver cancer in Australia. Before these evidence-based interventions can be developed, a greater understanding of what area and individual-level factors are contributing to these spatial survival disparities is required.
Early-onset cancer burden and risk: A population-based study.
Braggion A, van der Linden BWA, Tancredi S … +3 more , Rohrmann S, Cullati S, Chiolero A
Cancer Epidemiol · 2026 Jun · PMID 41791347 · Publisher ↗
BACKGROUND: The burden of early-onset cancers increases globally, raising major concerns. There is, however, confusion between trends in the number of cases and in age-standardized rates, and a lack of comparison with la...
BACKGROUND: The burden of early-onset cancers increases globally, raising major concerns. There is, however, confusion between trends in the number of cases and in age-standardized rates, and a lack of comparison with later-onset cancers. We described trends in cancer burden and risk in early- and later-onset cancers in Switzerland between 1982 and 2021. METHODS: We used data from the Swiss National Institute for Cancer Epidemiology and Registration, including all primary cancers between 1982 and 2021. A cancer was early-onset if diagnosed between ages 20-49 and later-onset at 50 or older. We calculated mean annual number of cases and deaths, crude and age-standardized incidence and mortality rates per 100,000, by 5-year period, sex, and cancer site. We estimated absolute and relative changes between 1982-1986 and 2017-2021. RESULTS: Between 1982 and 2021, the mean annual number of early-onset cancers increased by 1534 (+48%) and of later-onset cancers by 19,832 (+91%). Age-standardized incidence rates of early-onset cancers increased by 13/100,000 (+11%) and of later-onset by 92/100,000 (+8%). Population growth and ageing explained 73% of the increase of early-onset and 90% of the increase of later-onset cancers. The incidence increased in women (early-onset: +19%; later-onset: +9%) but not in men. For main cancer sites, early- and later-onset incidence showed parallel trends, except for colorectal (early-onset increased while later-onset decreased) and for lung in women (early-onset decreased while later-onset increased). All sites together, age-standardized mortality rates declined substantially (early-onset: -59%; later-onset: -38%). CONCLUSIONS: The increase in the burden of early-onset cancers was driven mainly by population growth and ageing, and to a lesser extent by an increased risk, also observed in later-onset cancers.
Epidemiology of gastrointestinal stroma tumours (GIST) in Germany 2003 - 2021: Rising incidence and improved survival.
Radespiel-Tröger M, Jakob J, Hohenberger P … +2 more , Müller-Nordhorn J, Zeissig SR
Cancer Epidemiol · 2026 Jun · PMID 41780155 · Publisher ↗
PURPOSE: This article provides an overview of changes of the incidence, stage distribution, and survival of gastrointestinal stromal tumors (GIST) in Germany between 2003 and 2021. METHODS: Data on the incidence, TNM cat...
PURPOSE: This article provides an overview of changes of the incidence, stage distribution, and survival of gastrointestinal stromal tumors (GIST) in Germany between 2003 and 2021. METHODS: Data on the incidence, TNM categories, UICC stage, and survival with respect to GIST in Germany were obtained from the national Centre for Cancer Registry data at the Robert Koch-Institute (Berlin, Germany). RESULTS: The age-standardized incidence was 1.6 (men) and 1.4 (women) per 100,000 for the 2021 diagnosis year and has increased approximately threefold in the years since 2003. The most commonly reported GIST UICC stage in 2020 was stage I (men: 53%, women: 39%). The proportion of small tumours (TNM-T category 1) has increased between 2010 and 2020. The 5-year relative survival rate for individuals with GIST improved from 74% to 82% (men) and from 80% to 88% (women) between the 2003-2008 and 2014-2021 time periods, respectively. CONCLUSION: In line with national and international data, the incidence of GIST in Germany increased between 2003 and 2021, while survival has improved in the same time period after the introduction of imatinib for adjuvant treatment of GIST in Germany in the year 2009. An increasing number of small endoscopically detected lesions may have contributed to the rising incidence of GIST. Primary care physicians should be aware of the increasing frequency of GIST. With the collection of detailed therapy data and information on prognostic markers, further evaluations of clinical issues will also be possible in the future using German cancer registry data.
The impact of morbidity burden on cancer diagnosis; a retrospective cohort study in England.
Wiering B, Mounce LTA, Price SJ … +11 more , Shotter D, Valderas JM, Merriel SWD, Moore S, Farmer L, Wagner CV, Payne RA, Renzi C, Lyratzopoulos G, Hamilton W, Abel GA
Cancer Epidemiol · 2026 Jun · PMID 41764785 · Publisher ↗
BACKGROUND: Expediting cancer diagnosis is a priority in many countries. The rising prevalence of chronic conditions may complicate the cancer diagnostic process. We investigated whether patients with pre-existing morbid...
BACKGROUND: Expediting cancer diagnosis is a priority in many countries. The rising prevalence of chronic conditions may complicate the cancer diagnostic process. We investigated whether patients with pre-existing morbidity were more likely to experience disadvantage in cancer diagnostic outcomes and processes. METHODS: We used linked primary, secondary care, and cancer registration data for patients aged 40 + years diagnosed with incident cancer in England during 2012-2018. The Cambridge Multimorbidity Score quantified morbidity burden. Logistic regressions investigated whether morbidity burden was associated with stage at diagnosis, 30-day all-cause mortality, emergency presentation- or urgent suspected cancer referral route to diagnosis. RESULTS: 277,050 patients were included. Decreasing morbidity burden was associated with an increased likelihood of advanced-stage diagnosis (e.g. high burden vs. low burden aOR: 0.86, 95 % CI: 0.84-0.89, p < 0.0001). There were u-shaped relationships between morbidity burden, emergency diagnoses and 30-day mortality, with those with high or no recorded morbidity burden most likely to be diagnosed as an emergency and to die within 30 days after diagnosis. Diagnoses via urgent suspected cancer referrals decreased with increasing morbidity burden. Associations varied across cancer sites, though high morbidity burden was only associated with advanced stage for ovarian cancer. CONCLUSION: Contrary to expectations, not having pre-existing morbidities was associated with an increased likelihood of advanced-stage diagnosis. This may reflect heightened surveillance of patients with morbidity being protective against later advanced-stage cancer diagnoses. These findings highlight the need for robust cancer surveillance processes and good comprehensive care that considers cancer alongside wider aspects of health.
Assessing Concordance of Cancer Registry Data and Electronic Health Record Data in Metastatic Cancer: a Cohort Study of Patients with Colorectal Liver Metastasis in a U.S. Integrated Health System.
Brauer DG, Sekiya A, Vobugari N … +6 more , Prakash A, Ozed-Williams B, Ecker BL, Ankeny JS, Jensen EH, Marmor S
Cancer Epidemiol · 2026 Jun · PMID 41763113 · Full text
Rates of metastatic cancer are increasing, but our knowledge of the accuracy of metastatic diagnoses within real world data is limited. In this brief report, to evaluate the accuracy of various data sources, we assessed...
Rates of metastatic cancer are increasing, but our knowledge of the accuracy of metastatic diagnoses within real world data is limited. In this brief report, to evaluate the accuracy of various data sources, we assessed concordance between cancer registry diagnoses and electronic health record (EHR) International Classification of Diseases diagnoses for the presence of colorectal liver metastases (CRLM) for patients within a single academic health care system. 1025 patients diagnosed with CRLM were evaluated. Concordance between cancer registry data and EHR data for the diagnosis of synchronous CRLM was low (k = 0.66). Additional data quality issues identified included (1) a 9 % rate of false positives in cancer registry data for the diagnosis of CRLM and (2) discordant data between the metastatic diagnosis and cancer registry stage affecting 16 % of cases. These results highlight important limitations of real world databases in the identification and study of patients with metastatic cancer.
Temporal trends of early-onset cancers among Canadian jurisdictions covered in the CiNA dataset.
Abdel-Rahman O
Cancer Epidemiol · 2026 Jun · PMID 41763112 · Publisher ↗
OBJECTIVE: To assess temporal trends in early-onset cancers across Canadian jurisdictions covered in the CiNA dataset (2010-2022). METHODS: The Cancer in North America (CiNA) dataset (2010-2022) was accessed, and data fr...
OBJECTIVE: To assess temporal trends in early-onset cancers across Canadian jurisdictions covered in the CiNA dataset (2010-2022). METHODS: The Cancer in North America (CiNA) dataset (2010-2022) was accessed, and data from nine Canadian cancer registries (representing approximately 38.5% of the Canadian population) were reviewed. Among individuals with early-onset cancers (15-39 years old), age-adjusted Annual Percent Change (APC) was assessed for all cancers, and for individual cancers, for different Canadian jurisdictions included in the dataset. RESULTS: Within the age group of 15-39 years old, incidence significantly increased during the study period (age-adjusted rate was 60 per 100,000 in 2010 vs 63.9 per 100,000 in 2022; age-adjusted APC=0.5 (95% CI: 0.1-0.9)). On further stratification, the trend has significantly increased for those aged 30-39 years old (age-adjusted APC=1 (95% CI: 0.6-1.5)), while it was significantly decreased for those aged 20-29 years old (age-adjusted APC=-0.7 (95% CI: -1.2 to -0.3)). When stratified by sex, age-adjusted APC for early-onset cancer diagnosis was significant for women (APC=0.9; 95% CI: 0.5-1.2), but not for men (APC=-0.1; 95% CI: -0.8-0.6). CONCLUSIONS: Early-onset cancers have increased in Canadian jurisdictions covered in the CiNA dataset 2010-2022, particularly among the age group of 30-39 years old. More work is needed to improve prevention, early detection, and develop a dedicated management approach to this group of patients with special needs.
Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations is associated with lower breast cancer incidence: A real-world prospective analysis from the Moli-sani Study and exploration of biological pathways.
Martínez CF, Di Castelnuovo A, Costanzo S … +7 more , Panzera T, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M, Moli-sani Study Investigators
Cancer Epidemiol · 2026 Jun · PMID 41763111 · Publisher ↗
BACKGROUND AND OBJECTIVES: The World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) provides lifestyle recommendations to reduce cancer risk. However, a limited number of studies has assessed whet...
BACKGROUND AND OBJECTIVES: The World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) provides lifestyle recommendations to reduce cancer risk. However, a limited number of studies has assessed whether following these recommendations leads to a reduction in breast cancer risk. We therefore examined the association between adherence to these recommendations and breast cancer incidence, overall, by menopausal status, and by receptor subtype in a real-world cohort, and explored potential biological mechanisms. METHODS: We longitudinally analyzed 11,312 cancer-free women from the Moli-sani Study cohort in Italy. The 2018 WCRF/AICR Score is based on seven components, ranged from 0 to 7 points, and was categorized into population-specific tertiles, with the following ranges: T1, 0.75-3.0; T2, 3.25-3.75; and T3, 4.0-6.75. Hazard ratios (HRs) were estimated with multivariable Cox models. Potential mediators, including inflammatory and metabolic biomarkers, were analyzed based on change-in-estimate. RESULTS: Over a median follow-up of 13.2 years, 290 breast cancer cases occurred. In multivariable-adjusted analyses, the highest versus lowest tertile of adherence to the 2018 WCRF/AICR Score was associated with a HR of 0.91 (95% CI: 0.68-1.21) for overall breast cancer incidence. Each 1-point increase in adherence was linked to a lower risk of estrogen receptor-positive (HR=0.85; 95%CI 0.72-1.00), progesterone receptor-negative (HR= 0.67; 95%CI 0.46-0.97), hormone receptor-positive (HR=0.84; 95%CI 0.71-0.99) and HER-2 negative breast cancer (HR=0.80; 95%CI 0.66-0.95). Lower levels of insulin and low-grade inflammation markers explained up to 25.2% of the association between the 2018 WCRF/AICR Score with risk of certain breast cancer types. CONCLUSION: Greater adherence to the 2018 WCRF/AICR lifestyle recommendations was associated with a lower incidence of specific breast cancer subtypes. Some of these associations may be explained by reduced insulin levels and lower systemic inflammation, suggesting potential underlying mechanisms.
Comparing the national cancer waiting times dataset with other linked electronic health records to measure treatment timeliness: A national cohort study of kidney cancer in England.
Varma R, Mayne E, Parry MA … +5 more , Nathan A, van der Meulen J, Bahl A, Stewart GD, Cowling TE
Cancer Epidemiol · 2026 Jun · PMID 41762537 · Publisher ↗
BACKGROUND: Timely treatment is a vital component of high-quality cancer care. We compared a national purpose-specific dataset of cancer waiting times (CWT) with routinely collected hospital datasets ('comparator dataset...
BACKGROUND: Timely treatment is a vital component of high-quality cancer care. We compared a national purpose-specific dataset of cancer waiting times (CWT) with routinely collected hospital datasets ('comparator datasets') as sources of data on the timeliness of kidney cancer treatment in England. METHODS: 11,937 patients diagnosed with kidney cancer between 1st July 2022 and 31st December 2023 were included, using national linked cancer registry and CWT records. The primary analysis compared CWT records and those in comparator datasets (Hospital Episode Statistics, Systemic Anti-Cancer Therapy, and Radiotherapy datasets) in terms of the number, percentage, and timing of patients receiving treatment. Using CWT records, a secondary analysis assessed the effects of the 'waiting time adjustment policy' to account for patient treatment deferral on distributions of waiting times at patient and provider levels. RESULTS: 6971 patients were identified as having received treatment (within 100 days of decision-to-treat) according to either CWT or comparator datasets. Of these patients, 6434 (92.3%) had treatment according to both CWT and comparator datasets, with 5836 patients (90.7% of 6434) identified as receiving treatment on the same day across both dataset groups, demonstrating strong agreement. Using the waiting time adjustment policy, the mean number of days to treatment decreased from 29.2 to 27.3 days at the patient-level and from 24.3 to 22.6 days at the provider-level. CONCLUSION: This study demonstrates strong agreement in treatment records from a national, purpose-specific, and comparator datasets. Strengths of both data sources can be harnessed in linked data to evaluate treatment timeliness, enabling more detailed assessments of specific treatments and better definition of the start of treatment pathways.
Scoping review: Investigating target trial emulation approaches in oncology research.
Desai RK, Lee G, Chatterjee S … +4 more , Zhou EJ, Yeung CYL, Tadrous M, Chan KKW
Cancer Epidemiol · 2026 Jun · PMID 41762536 · Publisher ↗
BACKGROUND: The target trial emulation (TTE) framework, proposed by Hernán and Robins, uses observational data to emulate a randomized controlled trial (RCT). TTEs are increasingly being applied in oncology research. Thi...
BACKGROUND: The target trial emulation (TTE) framework, proposed by Hernán and Robins, uses observational data to emulate a randomized controlled trial (RCT). TTEs are increasingly being applied in oncology research. This scoping review aims to describe the characteristics of oncology TTEs, evaluate their adherence to the TTE framework, and assess the concordance of results between TTEs and corresponding RCTs. METHODS: A comprehensive search was conducted in MEDLINE and Embase from inception to December 25th 2025. Only oncology TTEs evaluating treatment interventions were eligible. Data was extracted on study characteristics, adherence to the TTE framework, reported cohort characteristics, the concordance of TTEs emulating specific RCTs using Cohen's Kappa coefficient, and the correlation of Ln hazard ratio (HR) using Pearson's correlation coefficient. RESULTS: A total of 94 studies were identified, representing 106 unique TTEs. All TTEs reported on the treatment strategies, outcomes measured, and data analysis plan, while only 75.5 % presented a clearly defined time zero. In addition, only 20.8 % of TTEs reported on patient performance status, for the purpose of adjusting confounders. Additionally, among the 20 TTEs that explicitly emulated a published RCT, there was poor to fair concordance (Cohen's Kappa = 0.20) between the reported results of the statistical hypothesis testing of survival outcomes between the respective TTE and corresponding RCT. The Pearson's correlation coefficient between Ln HRs of TTE and RCT was 0.44. CONCLUSION: The TTE framework adoption and adherence in oncology has been substantial. However, the poor to fair agreement between corresponding TTEs and RCTs demonstrates the potential caveats of using TTEs as a replacement for RCTs in the evaluation of treatment efficacy, notwithstanding atypical scenarios where RCTS may not be feasible. One potential source of residual bias may be the lack of adjustments based on patient performance status. Significant gaps in reporting of critical oncology endpoints pose further challenges. Future research should continue to standardize reporting guidelines, specifically aligning with the recently published TARGET framework, to improve the utilization of TTEs in oncology.
Cervical cancer in foreign-born women living in Italy: A systematic review of population-based studies.
Boughriou M, Zendehdel K, Lotfi F … +4 more , Gorgati E, Serraino D, Boffetta P, Biagioli V
Cancer Epidemiol · 2026 Jun · PMID 41747332 · Publisher ↗
BACKGROUND: Cervical cancer (CC) incidence in Italy has declined due to organized screening and HPV vaccination programs. However, disparities persist among vulnerable populations, including foreign-born women. This stud...
BACKGROUND: Cervical cancer (CC) incidence in Italy has declined due to organized screening and HPV vaccination programs. However, disparities persist among vulnerable populations, including foreign-born women. This study aims to retrieve and synthesize evidence from population-based studies focusing on CC incidence among foreign-born women in Italy. METHODS: A systematic review was conducted to identify population-based epidemiological studies on CC in Italy. A comprehensive and systematic search was performed in PubMed, CINAHL, and Scopus. Studies were included if they reported data comparing foreign-born and Italian-born women in Italy and were based on cancer registry records. Due to heterogeneity in study designs and data, we used a descriptive and comparative approach rather than a meta-analysis. RESULTS: A total of five pertinent articles were identified and included in the review. Findings consistently indicate a higher incidence or relative risk of CC among foreign-born women in Italy, with estimates ranging from a modest increase to more than double the risk compared with Italian-born women. Higher incidence of both invasive cervical cancer and high-grade pre-malignant lesions was observed across multiple regions, particularly among women originating from countries with high HPV prevalence and high migratory pressure. CONCLUSION: These findings highlight persistent inequalities in cervical cancer risk between foreign-born and Italian-born women in Italy. Differences by country of origin may be associated with unequal access to timely and adequate care and with cultural barriers faced by specific immigrant women. Targeted policies and culturally sensitive interventions are needed to increase awareness, accessibility, healthcare navigation ability, and participation in cervical cancer screening, while addressing structural, linguistic, and informational barriers among high-risk migrant groups.
Cardiovascular disease mortality among women diagnosed with de novo metastatic breast cancer.
Ramin C, Gresham G, Li J … +4 more , Karlstaedt A, Hashibe M, Nikolova AP, Atkins KM
Cancer Epidemiol · 2026 Apr · PMID 41740513 · Full text
BACKGROUND: Women with metastatic breast cancer (mBC) are living longer than in prior decades due to advances in treatment. However, risk of cardiovascular disease (CVD) remains understudied in this patient population. M...
BACKGROUND: Women with metastatic breast cancer (mBC) are living longer than in prior decades due to advances in treatment. However, risk of cardiovascular disease (CVD) remains understudied in this patient population. METHODS: We identified 33,239 women diagnosed with de novo mBC between 2000 and 2020 (aged 20-84, survived ≥1 year) from 17 Surveillance, Epidemiology, and End Results Program registries. We estimated standardized mortality ratios (SMRs) and cumulative incidence, accounting for competing risks, for CVD mortality overall and by key characteristics. RESULTS: Over 3.1 median years of follow-up, 724 women with mBC died of CVD (554 heart disease; 127 cerebrovascular disease; 43 other CVD). Overall, women with mBC had an elevated risk of CVD mortality compared to women in the general population after accounting for age, year, and race/ethnicity (SMR=1.45, 95 % CI=1.34-1.55). SMRs for women with mBC were further elevated among those aged < 50 years at diagnosis (3.48, 95 % CI=2.67-4.46), non-Hispanic Asian American and Pacific Islander and Black women (2.18, 95 % CI=1.60-2.90; 2.14, 95 % CI=1.79-2.52, respectively), more recently diagnosed women (1.57, 95 % CI=1.32-1.86), and those with triple negative tumors (2.51, 95 % CI=1.71-3.57). Among women aged < 50 years, SMRs were further elevated among those recently diagnosed (5.44, 95 % CI=2.90-9.31) and within the first five years after diagnosis (5.02, 95 % CI=3.63-6.76). Approximately 1 in 60 women died from CVD within five years following their mBC diagnosis (cumulative incidence: 1.73 %, 95 % CI=1.58-1.88 %) with the highest cumulative incidence among those aged 50 years or older (2.13 %, 95 % CI=1.95-2.33 %). CONCLUSIONS: Women with mBC have significantly elevated CVD mortality and further research is warranted to address this heightened risk.
Temporal trends in prostate cancer incidence, mortality, and survival in the health regions of Sergipe, Brazil, 1996-2022.
Santana ACCS, Silva BEBD, Santos ESR … +3 more , Batista JFC, Moura AR, Lima CA
Cancer Epidemiol · 2026 Apr · PMID 41719758 · Publisher ↗
OBJECTIVE: to examine the temporal trends of these indicators across the state's health regions to provide evidence that supports improvements in public policies and actions aimed at disease control. MATERIAL AND METHODS...
OBJECTIVE: to examine the temporal trends of these indicators across the state's health regions to provide evidence that supports improvements in public policies and actions aimed at disease control. MATERIAL AND METHODS: Ecological study conducted in Sergipe state, Brazil. We used anonymized data on malignant prostate neoplasms (ICD-10 C61) from the Aracaju Cancer Registry (ACR) for 1996-2017. Mortality data were obtained from the Mortality Information System (SIM) for 1996-2022. Age-specific and age-standardized incidence and mortality rates were calculated. The Mortality-to-Incidence Ratio (MIR) and its complement (1-MIR) were used as indirect indicators of five-year survival. Temporal trends were assessed using Joinpoint regression (version 5.3.0), estimating APC, AAPC and 95 % confidence intervals using Monte Carlo permutation tests. RESULTS: A total of 10,133 prostate cancer cases were recorded from 1996 to 2017. The age-standardized incidence rate increased from 42.4 per 100,000 (1996-2005) to 76.8 per 100,000 (2006-2012), decreasing slightly to 72.3 per 100,000 (2013-2017). The overall annual increase was 6.63 %, with Aracaju showing 6.85 %. Declines occurred only in Nossa Senhora do Socorro from 2007 to 2017 (APC: -1.85; 95 %CI: -3.59; -0.26). Between 1980-2022, age-standardized mortality increased 4.20 % annually (95 %CI: 3.35-4.81), with marked rises in Estância (7.20 %), Propriá (6.02 %), Lagarto (5.53 %), Nossa Senhora da Glória (4.83 %), and Itabaiana (2.89 %). MIR-based survival declined from 76.57 % (1996-1999) to 71.27 % (2015-2017), with increased MIR among adults aged 75 + , decreasing MIR among individuals aged 15-54-especially in the capital-and increases across all age groups in Propriá. CONCLUSION: Prostate cancer in Sergipe demonstrates significant regional and age-related disparities in incidence, mortality, and survival. Rising incidence and mortality, along with adverse MIR trends, underscore the need for targeted health policies to improve early detection, treatment access and long-term outcomes.
Historical parallels between harms of tobacco and e-cigarettes.
Sitas F, Stewart B
Cancer Epidemiol · 2026 Feb · PMID 41702755 · Publisher ↗
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The association between body fatness and prevalent MGUS in the U.S. general population.
Ji M, Huber JH, Wang M … +4 more , Lan T, Colditz GA, Wang SY, Chang SH
Cancer Epidemiol · 2026 Apr · PMID 41702266 · Full text
OBJECTIVE: Current evidence regarding the association between obesity and monoclonal gammopathy of undetermined significance (MGUS) remains inconsistent. This study aims to evaluate the relationship between objectively m...
OBJECTIVE: Current evidence regarding the association between obesity and monoclonal gammopathy of undetermined significance (MGUS) remains inconsistent. This study aims to evaluate the relationship between objectively measured obesity markers and prevalent MGUS using nationally representative data from the U.S. METHOD: Data came from the third National Health and Nutrition Examination Survey III (1988-1994) and continuous NHANES (1999-2004). We estimated multivariable-adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) for the association between MGUS and seven obesity markers (i.e., baseline body mass index (BMI), maximum lifetime BMI, waist circumference (WC), waist-hip ratio (WHR), total body fat, fat-free mass, and body fat percentage) using logistic regression. Body composition was assessed using dual-energy X-ray absorptiometry (DXA) in NHANES 1999-2004 and tetrapolar bioelectrical impedance analysis (BIA) in NHANES III. RESULTS: The study included 200 participants with MGUS in NHANES III (1988-1994) and 164 with MGUS in NHANES 1999-2004, compared with 12,043 participants without MGUS. In multivariate logistic regression analysis with DXA measurements, each 1 %age point increase in body fat percentage was associated with a 4 % higher odds of MGUS (aOR: 1.04, 95 % CI [1.01, 1.07]) and a 6 % higher odds of non-IgM MGUS (aOR: 1.06, 95 % CI [1.02, 1.10]). No statistically significant associations were found between MGUS and other obesity markers, including baseline BMI, maximum lifetime BMI, WC, WHR, and fat-free mass. CONCLUSION: Our findings indicate that obesity is associated with an increased odds of MGUS. However, many obesity markers, including the commonly used BMI, do not adequately capture this association.
Spatial clustering of gynecological cancers in China: A countrywide migration-adjusted analysis at the district level.
Xue L, Hao S, Sun H … +8 more , Du L, Li G, Liu X, Wang X, Jin H, Guo L, Wang T, Li Q
Cancer Epidemiol · 2026 Apr · PMID 41691745 · Publisher ↗
In China, the incidence rates of major gynecological cancers have increased consistently over the past decade. Spatial epidemiological analyses are crucial for informing precision prevention strategies through visual ris...
In China, the incidence rates of major gynecological cancers have increased consistently over the past decade. Spatial epidemiological analyses are crucial for informing precision prevention strategies through visual risk mapping. However, previous studies, primarily based on residential registry data, often overlook migrant populations, potentially introducing selection bias. We conducted a countrywide, district/county-level spatial analysis of cervical, uterine corpus, and ovarian cancer incidence in China, utilizing Bayesian model-derived estimates that adjusted for internal migration. Global and local Moran's I statistics were employed to detect and visualize significant spatial clustering patterns, specifically high-high (HH) clusters (areas with high incidence surrounded by other high-incidence areas) and low-low (LL) clusters (areas with low incidence surrounded by other low-incidence areas). Significant positive spatial autocorrelation was detected for the three cancers(P < 0.000001). For cervical cancer, 836 districts/counties showed HH clustering (predominantly in central and southeastern coastal regions), while 1013 displayed LL clustering (concentrated in northeastern, northern, and western China). For uterine corpus cancer, 899 districts and counties formed HH clusters, notably in northeastern, northern, and southeastern coastal areas, while 982 districts and counties showed LL clusters, primarily in central and southwestern regions. For ovarian cancer, 794 districts and counties demonstrated HH clustering, with concentrations in northeastern, northern, and southeastern coastal zones, while 857 districts and counties exhibited LL clustering, primarily distributed across eastern, central-southern, and southwestern China. As the first countrywide spatial study to incorporate migration-adjusted data, our findings reveal marked geographic disparities in gynecological cancer incidence in China. These results underscore the necessity for region-specific prevention strategies and highlight that resource allocation must account for population mobility. This study provides a replicable framework for other regions facing similar migration-related health challenges.
Does motherhood increase the risk of developing subsequent malignant neoplasms after childhood cancer treatment?
Blagodarna S, Hosek P, Jelinkova K … +5 more , Korbelova L, Eckschlager T, Lischke R, Sramkova L, Kruseova J
Cancer Epidemiol · 2026 Apr · PMID 41691744 · Publisher ↗
BACKGROUND: Most young women who have survived childhood cancer express a desire to have children. Many of them are concerned about the potential adverse impact of pregnancy on their health, which has been affected by pr...
BACKGROUND: Most young women who have survived childhood cancer express a desire to have children. Many of them are concerned about the potential adverse impact of pregnancy on their health, which has been affected by prior cancer treatment. The aim of this study was to determine whether motherhood increases the risk of developing subsequent malignant neoplasms. METHODS: The study cohort consisted of 942 female childhood cancer survivors, median age at first cancer diagnosis 10.84 years (IQR 4.29-14.92), who had been treated at the Department of Pediatric Hematology and Oncology, Motol University Hospital, Prague, between 1965 and 2018. In this group, 363 women gave birth to 559 children. RESULTS: Seventy-three female childhood cancer survivors developed 80 subsequent malignant neoplasms. Of these, 40 subsequent malignant neoplasms occurred in women who had children. The median time from the end of primary cancer treatment to first subsequent malignant neoplasm development was 19.93 years (IQR 14.55-26.56). A comprehensive analysis revealed no difference in the risk of subsequent malignant neoplasms between mothers and "non-mothers". Only older age of the cancer survivors in follow-up and previous radiotherapy (p = 0.0133) were significant risk factors for subsequent malignant neoplasm development. CONCLUSIONS: This study revealed that motherhood does not increase the risk of subsequent malignant neoplasms. We confirmed a statistically significant increased risk of subsequent malignant neoplasms only for previous treatment modality, the length of follow-up and the age of the female childhood cancer survivors. These results are important for improving the quality of life of young cured women who are worried about a planned pregnancy. PLAIN LANGUAGE SUMMARY: This study evaluated the long-term cancer risk among women treated for cancer during childhood, with particular focus on those who later gave birth. Among 942 participants, 363 had post-treatment pregnancies. Results indicate that childbearing does not increase the risk of subsequent malignant neoplasms in this population. Instead, elevated risk for subsequent malignant neoplasms was associated with older age at follow-up and prior exposure to radiotherapy. These findings provide evidence that pregnancy is safe for female childhood cancer survivors and support informed reproductive decision-making.
The risk of multiple myeloma associated with daily low-dose exposure to ionising radiation from radon decay.
Bertelsen LD, Nielsen LH, Christensen HS … +4 more , Bøgsted M, Gregersen H, Bønløkke JH, Severinsen MT
Cancer Epidemiol · 2026 Apr · PMID 41691743 · Publisher ↗
BACKGROUND: Ionising radiation is suspected to increase the risk of multiple myeloma (MM) but has mostly been investigated at occasional high doses rather than exposure to continuous low doses at home. METHODS: In this e...
BACKGROUND: Ionising radiation is suspected to increase the risk of multiple myeloma (MM) but has mostly been investigated at occasional high doses rather than exposure to continuous low doses at home. METHODS: In this ecological study, we investigated the association between MM and radon based on the geographical distribution of MM patients in Denmark diagnosed from 2005 to 2020 and a national radon survey carried out by the Danish authorities based on 3019 random selected single-family houses. A linear association was assessed between age- and sex-standardised incidence rate (SIR) of MM and radon concentration of each municipality. Municipalities were categorised into four classes based on the estimated fraction of dwellings exceeding 200 Bq/m in each municipality, where SIR of class 1 (lowest radon exposure group) was compared to the SIRs of class 2-4 by incidence rate ratios (IRRs). RESULTS: Based on 5218 included patients distributed among 275 municipalities, no statistically significant association was found. The IRRs revealed a small inverse association due to 17 % lower SIR in class 4 as compared to class 1. CONCLUSIONS: The lack of a positive association suggests no increased risk of MM in areas with higher radon concentrations in homes based on aggregated data. These findings must be clarified in individual-level based studies.
Demographic and prognostic indicators of Adenoid cystic carcinoma in the head and neck: A National Cancer Database analysis.
Wang J, Dumonsau J, Grossmann N … +3 more , Silberstein P, Varman R, DiBlasi M
Cancer Epidemiol · 2026 Apr · PMID 41689993 · Publisher ↗
BACKGROUND: Adenoid cystic carcinoma (ACC) is a rare malignancy comprising just 1 % of all head and neck malignancies. To date, there are no National Cancer Database (NCDB) studies evaluating the demographic and prognost...
BACKGROUND: Adenoid cystic carcinoma (ACC) is a rare malignancy comprising just 1 % of all head and neck malignancies. To date, there are no National Cancer Database (NCDB) studies evaluating the demographic and prognostic factors of ACC of the head and neck. Existing studies have only utilized single-institution cohorts, other databases, and narrowly defined populations, resulting in a fragmented view. This study aims to address this by providing an NCDB analysis of all patients with ACC in the head and neck. METHODS: Utilizing retrospective 2004-2021 NCDB data, this study analyzed several variables including patient demographics, prognostic factors, and treatment modalities. Kaplan-Meier survival curves were plotted for overall survival, Cox Regression Models were utilized to assess hazard ratios (HRs), and binomial regression for surgical likelihood. RESULTS: ACC was most frequently located in the major salivary glands (45.2 %). The mean age at diagnosis was 58.75 years. Surgical intervention significantly improved survival, with hazard ratios ranging from 0.302 to 0.451 compared to no surgery. Overall, 69.8 % of patients received surgery. Factors associated with lower surgical likelihood included higher Charlson-Deyo scores, uninsured status, and older age. Tumor site influenced outcomes: surgically accessible sites such as the gums and oral cavity were associated with improved survival (HR 0.875), while less accessible sites like the nasopharynx and pharynx had worse outcomes (HR 1.868 and 1.123, respectively). CONCLUSION: Surgical treatment confers a significant survival advantage in head and neck ACC. Disparities in surgical receipt based on insurance status, comorbidities, age, and tumor location highlight the need for strategies to improve equitable access to care.
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