BACKGROUND: In South Africa, prostate, breast, and cervical cancers are prioritised under the National Cancer Strategic Framework (2017-2022), while oesophageal cancer remains a major public health concern in the Eastern...BACKGROUND: In South Africa, prostate, breast, and cervical cancers are prioritised under the National Cancer Strategic Framework (2017-2022), while oesophageal cancer remains a major public health concern in the Eastern Cape Province. This study describes the incidence patterns and temporal trends of breast, cervical, prostate, and oesophageal cancers in the Eastern Cape from 1998 to 2021. METHODS: Cancer incidence data were obtained from the Eastern Cape Population-Based Cancer Registry for 1998-2021. Population denominators were derived from the 2001 and 2011 national censuses, with intercensal and postcensal estimates used to generate annual age- and sex-specific populations. Age-standardised incidence rates were calculated using direct standardisation to the World Standard Population. Temporal trends were analysed using Joinpoint regression models. RESULTS: A total of 10 240 cancer cases were recorded, with a median age at diagnosis of 61.6 years (IQR: 50.7-71.0). Of the 10 240, oesophageal cancer accounted for 40.1% (4 108), followed by cervical cancer 36.4% (3 732), breast cancer 13.0% (1 327), and prostate cancer 10.5% (1 073). Incidence rates increased significantly for prostate cancer 9.6% (95% CI: 6.9%-12.4%), breast cancer 4.1% (95% CI: 2.4%-5.4%), and cervical cancer 3.8% (95% CI: 1.7%-5.8%). In contrast, oesophageal cancer incidence declined significantly in both sexes -3.0% (95% CI: -4.4% to -3.1%). CONCLUSIONS: Prostate, breast, and cervical cancer incidence has increased substantially in the Eastern Cape over the past two decades, while oesophageal cancer incidence decreased significantly. Strengthened cancer surveillance and targeted control strategies are needed in this predominantly rural setting.
As the burden of global cancer diagnoses rise, there is growing importance to provide accessible survival statistics to patients. Although life expectancy (LE) is often used to assess economic benefit of new treatments,...As the burden of global cancer diagnoses rise, there is growing importance to provide accessible survival statistics to patients. Although life expectancy (LE) is often used to assess economic benefit of new treatments, it is rarely provided to help patients comprehend their diagnosis as this metric often requires extrapolation. We sought to determine the best modelling framework for providing this extrapolation, the minimum follow-up required, and circumstances where reliable estimates can be obtained. We analysed United States cancer registration data collected via the Surveillance, Epidemiology and End Results (SEER) Program. 122,703 patients aged 18-89 diagnosed between 1988 and 1991 with breast, colorectal, lung, or stomach cancer at localised, regional, or distant stages were included (follow-up until 2021). Mortality risk factors included age, sex, and stage at diagnosis. All-cause mortality was modelled and extrapolated using all-cause, cause-specific, and relative survival frameworks across 2-, 3-, 5-, 10-, and 20-year follow-up. Flexible parametric models were built to assess the importance of model complexity (Simple Model(s): Main-effects, Complex Model(s): Main-effects, interactions and time-dependent-effects). Timescales for other-cause mortality within the cause-specific framework were also compared (Time-since-diagnosis, or Attained-age). For evaluation, patients were categorised into 30 risk groups (5 age-groups, 3 stages, and 2 sexes; females only for breast cancer). Using at least 10-years of follow-up, LE/30-year restricted mean survival time (RMST) can be predicted to within 1-year/10% of observed values, with at least 80% of covariate groups predicted to within this relatively small difference for breast, colorectal, and lung cancer patients of varied risks. The relative and cause-specific survival frameworks produced reasonable extrapolated estimates with attained age the recommended timescale for other-cause mortality in the cause-specific setting. Increasing model complexity improves accuracy, particularly among lower-risk patients, typically younger, localised individuals. While the study demonstrated reasonable estimates for 50% of stomach cancer patients primarily those at high risk, further research is required to calculate LE/30-year RMST for lower-risk stomach cancer patients.
Nguyen DTN, Islam R, Qin J
… +16 more, Senkomago V, Buenconsejo-Lum L, Jeong Y, Gopalani SV, Kang YJ, David M, Reichhardt M, Edilyong J, Tippins A, Lu E, Chutaro E, Scarinci I, Arriola T, Simms K, Canfell K, Palafox N
Cancer Epidemiol
· 2026 Jun · PMID 42372369
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BACKGROUND: The US-Affiliated Pacific Islands (USAPI) experience a high burden of cervical cancer, but progress toward achieving cervical cancer elimination targets is difficult to assess due to limited and fragmented da...BACKGROUND: The US-Affiliated Pacific Islands (USAPI) experience a high burden of cervical cancer, but progress toward achieving cervical cancer elimination targets is difficult to assess due to limited and fragmented data on HPV vaccination, cervical cancer screening and cancer treatment access. This narrative review aims to synthesise evidence of disease burden, risk factors, and interventions to inform region-specific strategies. METHODS: We conducted a structured narrative review of published literature (MEDLINE, Embase, Global Health), cancer registry data, surveillance reports, and health system registries for six USAPI jurisdictions from 1990 to 2025. We collated information on HPV, cervical precancers and cancers, and related risk factors. Information on HPV vaccination, cervical cancer screening, and treatment, obtained from jurisdictional health system registries and reports, was used to assess the region's trajectory towards the elimination targets. FINDINGS: Cervical cancer incidence among women aged ≥ 20 years during 2007-2022 in the USAPI (age-standardized rate:17.2/100,000;95%CI:15.6-18.8) exceeded that of the US (10.8/100,000;95%CI:10.7-10.8), with large variation across jurisdictions, from 8.4/100,000 in American Samoa to 68.9/100,000 in Republic of the Marshall Islands (RMI). Approximately 75% of cases were diagnosed at Stage III + . HPV vaccination was introduced between 2007-2016, with coverages ranging from 44.2% in Federated States of Micronesia (FSM) to 92.7% in Commonwealth of the Northern Mariana Islands (CNMI). Four jurisdictions have implemented cytology-based screening, whereas RMI/FSM primarily rely on visual inspection with acetic acid. Screening coverage varies from 14.2% (CNMI, 2019) to 67.8% (Guam, 2020). Cancer treatment capacity is limited, with most jurisdictions lacking radiotherapy and relying on off-island referrals for advanced cases. INTERPRETATION: USAPI cervical cancer burden is substantially higher than the US, compounded by late-stage diagnoses and limited treatment capacity. Although vaccination coverage has improved, major gaps remain in screening, follow-up, and access to care. Strengthening health systems through scalable, resource-appropriate strategies will accelerate progress toward elimination.
Aune D, Chang WC, Macfarlane TV
… +5 more, Sobiecki JG, Hsieh TC, Hsu WL, Chang FL, He MS
Cancer Epidemiol
· 2026 Jun · PMID 42372368
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BACKGROUND: Few studies have investigated the association between diabetes mellitus and risk of anal cancer and the results to date have been inconsistent. We analysed the relation between a history of diabetes and diabe...BACKGROUND: Few studies have investigated the association between diabetes mellitus and risk of anal cancer and the results to date have been inconsistent. We analysed the relation between a history of diabetes and diabetic retinopathy and risk of anal cancer in a nationwide cohort in Taiwan. METHODS: Data from a retrospective cohort study of 5.9 million Taiwanese men and women aged 18-90 years were used for the analysis. Multivariable proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between diabetes diagnosis and diabetic retinopathy and risk of anal cancer. RESULTS: During a mean of 7.8 years follow-up, 2315 anal cancer cases occurred. The HRs (95% CIs) of anal cancer among persons with compared to those without a history of diabetes mellitus was 1.04 (0.95-1.13), and for persons with diabetic retinopathy vs. no diabetic retinopathy was 1.52 (1.20-1.92) and proliferative diabetic retinopathy vs. no proliferative diabetic retinopathy was 1.78 (1.27-2.50), respectively. CONCLUSION: This large-scale cohort study provides evidence of no clear association between diabetes mellitus and anal cancer risk overall, however, there was indication of increased risk among persons with diabetic retinopathy and proliferative diabetic retinopathy. Additional large-scale cohort studies with more comprehensive risk factor data are needed to further clarify these findings.
Soomro MA, Varghese A, Soomro H
… +3 more, Abdallah AO, Lutfi FG, Ahmed N
Cancer Epidemiol
· 2026 Jun · PMID 42366150
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BACKGROUND: While overall cancer mortality in the United States has declined steadily for decades, systemic healthcare disruptions during the COVID-19 pandemic-including delays in screening, diagnosis, and treatment-may...BACKGROUND: While overall cancer mortality in the United States has declined steadily for decades, systemic healthcare disruptions during the COVID-19 pandemic-including delays in screening, diagnosis, and treatment-may have created heterogeneous impacts across different malignancy types that are not visible in aggregate data. OBJECTIVE: To determine whether site-specific cancer mortality during the COVID-19 pandemic (2020-2023) deviated from expected trajectories based on established pre-pandemic trends. METHODS: This population-based analysis utilized U.S. National Vital Statistics System data from 2003 through 2023. Age-standardized mortality rates (AASRs) were calculated for specific cancer sites and modeled using log-linear regression over the baseline period (2003-2019). These models were used to project counterfactual expected mortality for the pandemic period (2020-2023). Excess mortality was defined as the percent difference between observed and projected AASRs, with significance determined via bootstrap simulation and false discovery rate correction. RESULTS: Overall cancer mortality remained closely aligned with pre-pandemic declining projections. However, site-specific analysis revealed significant divergence. Positive excess mortality was observed for Hodgkin lymphoma (mean +9.5%; 95% CI, 2.7-17.2%) and prostate cancer (mean +7.9%; 95% CI, 2.8-13.2%). Additionally, mortality attributed to ill-defined malignant sites (+15.2%) and unspecified sites (+8.5%) increased significantly. Conversely, liver and intrahepatic bile duct cancers demonstrated mortality below expected levels (mean -15.5%; 95% CI, -19.5% to -11.3%). Most positive deviations peaked in 2022, suggesting a delayed effect of disrupted diagnostic and clinical pathways. CONCLUSION: Aggregate cancer mortality trends during the pandemic masked significant, disease-specific divergences. The observed excess mortality in certain highly curable or screen-detected malignancies may reflect differential vulnerability to disruptions in screening, diagnosis, treatment access, or cause-of-death attribution. These findings highlight the need for site-specific surveillance to identify long-term consequences of systemic strain and to inform targeted recovery efforts in oncologic care.
Park YJ, Yu J, Kang JH
… +5 more, Park SJ, Jeong S, Lee G, Shin HY, Park SM
Cancer Epidemiol
· 2026 Jun · PMID 42361543
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BACKGROUND: L-α-glycerylphosphorylcholine (α-GPC) is widely prescribed for cognitive impairment and Alzheimer's dementia. Previous cohort studies have reported that dietary free choline intake was associated with decreas...BACKGROUND: L-α-glycerylphosphorylcholine (α-GPC) is widely prescribed for cognitive impairment and Alzheimer's dementia. Previous cohort studies have reported that dietary free choline intake was associated with decreased kidney cancer risk. The oncologic safety of supplemental α-GPC remains uncertain given its role in producing trimethylamine N-oxide (TMAO), a metabolite implicated in renal injury and certain malignancies. This study aimed to test the hypothesis whether α-GPC use was associated with the reduction of incident kidney cancer. METHODS: Using the Korean National Health Insurance Service database, we conducted a nationwide retrospective cohort study among adults aged ≥ 50 who underwent health screening in 2009-2010. After exclusion criteria and 1:5 exact propensity score matching, 81,970 α-GPC users and 409,801 non-users were analyzed using Cox proportional hazards models. Incident kidney cancer events were identified from 2011 to 2024. RESULTS: α-GPC use was not associated with kidney cancer risk (adjusted HR 0.95, 95% CI 0.84-1.08; 280 events in α-GPC users, 1570 in non-users). Results were consistent across lag-time sensitivity analyses and subgroup analyses by age, sex, income, Charlson comorbidity index, and estimated glomerular filtration rate. CONCLUSIONS: α-GPC use was not associated with incident kidney cancer in this large Korean cohort. Further studies in diverse populations are warranted in order to confirm these findings.
Fabiani R, Chiavarini M, Giacchetta I
… +1 more, Rosignoli P
Cancer Epidemiol
· 2026 Jun · PMID 42361542
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Several studies have reported an association between circulating levels of IGFs peptides and the risk of colorectal adenoma (CRA) and colorectal cancer (CRC), but results remain inconclusive. This study examines the prec...Several studies have reported an association between circulating levels of IGFs peptides and the risk of colorectal adenoma (CRA) and colorectal cancer (CRC), but results remain inconclusive. This study examines the precise association between circulating levels of these peptides and both CRA and CRC risk. A literature search was performed on PubMed, Web of Science, and Scopus up to February 5, 2026. The studies were selected according to the PICOS framework and quality was assessed using the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed using a random-effects model on risk estimates (RR, OR, or HR). Heterogeneity and publication bias were evaluated using Cochran's Q/I² statistics and Egger/Begg tests, respectively. A total of 48 articles were included, involving 14,971 CRC cases (with 796,245 controls) and 38,124 CRA cases (with 320,433 controls). The main analysis showed an increased risk of colorectal (OR = 1.16; 95% CI: 1.00-1.34), colon (OR = 1.39; 95% CI: 1.22-1.57), and rectal cancer (OR = 1.29; 95% CI: 1.13-1.48) associated with IGF-I. A borderline significant + 37 CRC risk increment was observed for IGF-II (OR = 1.37; 95% CI: 0.99-1.90). A non-significant reduction in CRC risk was found in association with IGFBPs while a significant increment of CRC and colon cancer risk was noted in association with IGF-I/IGFBP-3 ratio. Regarding CRA, IGF-I was associated with a 98% increment of advanced adenoma risk (OR = 1.98; 95% CI: 1.47-2.67) while a positive association of CRA risk was observed with IGF-II (OR = 1.40; 95% CI: 1.05-1.86). CRA risk was significantly reduced in association with IGFBP-1 (OR = 0.75; 95% CI: 0.56-0.99). These results highlight the potential of the IGFs system as a biomarker for colorectal carcinogenesis, although further research is needed to clarify the site-specific differences and the role of IGF-binding proteins.
Cancer Epidemiol
· 2026 Jun · PMID 42341632
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INTRODUCTION: Breast cancer is the leading malignancy among women in Ethiopia and represents a growing public health concern. Although several studies have examined potential determinants, findings remain fragmented and...INTRODUCTION: Breast cancer is the leading malignancy among women in Ethiopia and represents a growing public health concern. Although several studies have examined potential determinants, findings remain fragmented and inconsistent. This study aimed to systematically synthesize evidence on risk factors associated with breast cancer among women in Ethiopia. METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases were searched for observational studies published between January 2000 and December 2025. Studies reporting associations between potential risk factors and breast cancer among Ethiopian women were included. Study quality was assessed using the Newcastle-Ottawa Scale, with most studies rated as moderate to high quality. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using random-effects models. Statistical heterogeneity was assessed using the I² statistic. RESULTS: Fourteen studies met the inclusion criteria. Overweight/obesity was significantly associated with increased odds of breast cancer (OR = 2.61; 95% CI: 1.86-3.66; I² = 0.0%; n = 4 studies), as was a family history of breast cancer (OR = 2.61; 95% CI: 1.64-4.15; I² = 0.0%; n = 3 studies). Hormonal contraceptive use (OR = 3.19; 95% CI: 1.93-5.29; I² = 0.0%; n = 3 studies) and lack of breastfeeding (OR = 3.49; 95% CI: 2.51-4.85; I² = 0.0%; n = 3 studies) were also associated with increased odds. Menopausal status showed a significant association (OR = 3.58; 95% CI: 1.39-9.27; I² = 44.4%; n = 2 studies), although based on a limited number of studies. Younger age was associated with lower odds compared with older women (OR = 0.43; 95% CI: 0.11-0.98; I² = 0.0%; n = 3 studies). CONCLUSIONS: Breast cancer risk among women in Ethiopia is influenced by metabolic, reproductive, and hormonal factors. The findings highlight the importance of obesity prevention, reproductive health education, and early detection strategies within the Ethiopian context. Further well-designed prospective studies are needed to strengthen causal inference and inform national cancer control policies.
Mmbone M, Baade P, Cameron J
… +4 more, Kou K, Cramb S, Mengersen K, Thompson H
Cancer Epidemiol
· 2026 Jun · PMID 42341631
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BACKGROUND: Comorbidities are common among women with breast cancer, yet their independent contribution to prognosis remains poorly characterised, particularly across disease stages. Most prognostic models prioritise tum...BACKGROUND: Comorbidities are common among women with breast cancer, yet their independent contribution to prognosis remains poorly characterised, particularly across disease stages. Most prognostic models prioritise tumour-related factors and when comorbidities are included, they are often summarised using aggregate indices, limiting evaluation of specific conditions. We investigated whether individual comorbidities exert effects on breast cancer-specific survival stratified by stage. METHODS: We analysed 3323 women aged 20 - 79 years diagnosed with invasive breast cancer in Queensland, Australia (2010-2013) with a follow-up to December 2020. Comorbidities were self-reported and mapped to ICD-10. Flexible parametric survival models were fitted separately for early (I-II) and late (III-IV) stages, adjusting for established clinical factors. Prognostic performance was quantified using Royston's D-statistic, R and Harrell's concordance index. RESULTS: Comorbidities had no prognostic impact on early-stage disease. In late-stage breast cancer, chronic bronchitis independently predicted poorer breast cancer-specific survival after adjusting for subtype, grade, age, family history and detection mode. The final late-stage model demonstrated good discrimination (C-statistic 0.71) and explained 26% of the variation in survival. Model-based predictions showed clinically meaningful reductions in 5- and 7-year survival among women with bronchitis, partially mitigated by a family history of breast/ovarian cancer. CONCLUSION: Stage stratification revealed prognostic signals that were obscured in pooled analyses. Chronic bronchitis worsened survival in late-stage disease, highlighting the value of assessing individual comorbidities during treatment planning. These findings support guideline recommendations for comorbidity informed management and underscore the need for stage-specific prognostic modelling frameworks.
Reis PCA, Oliveira JP, Noronha MM
… +5 more, Vellaichamy S, Braga M, Moraes FY, Cagnacci R, de Liz CD
Cancer Epidemiol
· 2026 Jun · PMID 42330711
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OBJECTIVE: Mammography screening in women aged 39-49 remains controversial despite evolving guidelines. This study aimed to provide an updated synthesis of randomized clinical trials (RCTs) evaluating the effect of mammo...OBJECTIVE: Mammography screening in women aged 39-49 remains controversial despite evolving guidelines. This study aimed to provide an updated synthesis of randomized clinical trials (RCTs) evaluating the effect of mammography screening on breast cancer (BC) mortality in this group. METHODS: We searched PubMed, Cochrane, and Embase for RCTs assessing the impact of mammography screening on BC mortality in women aged 39-49 years. Data extraction incorporated the most recent follow-up available. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was evaluated using the I² statistic. Leave-one-out sensitivity analyses were performed to assess robustness. RESULTS: Of 797 records identified, 10 RCTs met the inclusion criteria, encompassing 163,611 women in screening arms and 206,244 in control arms. Median follow-up ranged from 14 to 30 years. The pooled RR for BC mortality was 0.89 (95% CI 0.79-1.01; p = 0.07; I²=24.3%). Exclusion of the CNBSS was the only single-trial omission that yielded a statistically significant reduction in BC mortality with mammography screening (RR 0.85; 95% CI 0.76-0.95; p = 0.005; I²=1.4%). CONCLUSIONS: These findings highlight the need for cautious interpretation of historical randomized evidence when informing screening recommendations for women aged 39-49 years.
Valbuena-Garcia AM, Piñeros M, Vaccarella S
… +2 more, Acuña L, de Vries E
Cancer Epidemiol
· 2026 Jun · PMID 42322790
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PURPOSE: Despite universal health care coverage, Colombia remains among the most unequal countries worldwide, with disparities in cancer care. We evaluated inequities in breast cancer care across stage at diagnosis, time...PURPOSE: Despite universal health care coverage, Colombia remains among the most unequal countries worldwide, with disparities in cancer care. We evaluated inequities in breast cancer care across stage at diagnosis, timeliness of care, and survival by region, insurance scheme, and ethnicity. METHODS: Longitudinal study including all adult women with primary invasive breast cancer diagnosed between 2021 and 2023, reported to the Colombian administrative cancer registry. Inequities were assessed between regions of residence, ethnicity, and health insurance schemes. Outcomes included stage at diagnosis, diagnostic delay (>60 days), treatment delay (>30 days), and overall survival. Survival was estimated using Kaplan-Meier methods, with group comparisons by log-rank tests. Crude hazard ratios for death were estimated using Cox model stratified by stage at diagnosis. Absolute and relative measures quantified inequalities. RESULTS: 63.3% of the 31,476 included cases were affiliated with the contributory insurance scheme. Localized-stage diagnosis was more frequent in the contributory than in the subsidized scheme (49.2% vs 33.8%). Median time to diagnosis was shorter in the contributory versus the subsidized scheme (25 vs 35 days). 2-year OS was lower in the subsidized than in the contributory scheme (86.0% vs 92.5%). Survival was poorer for locally advanced and metastatic disease, with additional disadvantages among Indigenous women and residents of the Amazonian region. Inequities were most pronounced by insurance scheme. CONCLUSIONS: Substantial inequities in breast cancer care persist in Colombia. Indigenous and Black women, and those in the subsidized scheme experience later-stage diagnosis and lower survival, reflecting ongoing barriers to timely and equitable access to cancer care despite universal health coverage.
Jetann J, Jahan S, Li M
… +4 more, Nissen V, Carter K, Zomerdijk N, Garvey G
Cancer Epidemiol
· 2026 Jun · PMID 42302434
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The current evidence of global disparities in blood cancer incidence, mortality, and survival among Indigenous peoples are limited and fragmented. This systematic review aims to synthesize the epidemiological outcomes of...The current evidence of global disparities in blood cancer incidence, mortality, and survival among Indigenous peoples are limited and fragmented. This systematic review aims to synthesize the epidemiological outcomes of blood cancer in Indigenous peoples to provide a comprehensive global perspective. Following PRISMA guidelines, this review included original papers reporting the incidence, mortality, or survival of leukaemias, lymphomas, and myelomas among Indigenous populations. CINAHL, PubMed, PsycINFO, and Embase databases were searched from inception to January 2025. Descriptive analyses on the study outcomes was conducted and the quality of the included papers were critically appraised using the Mixed Methods Appraisal Tool (MMAT). We included 126 articles spanning 16 countries, with 47% of reports published in the last 15 years and 90% originating from the US, Canada, New Zealand, and Australia, highlighting the scarcity of data from Indigenous peoples outside high-income nations. While substantial heterogeneity limited direct comparisons of outcomes, analysis revealed that Indigenous peoples with blood cancer consistently experience poorer survival. Quality appraisal using the MMAT rated 83% of studies as high or good quality. This systematic review heavily concentrated on high-income countries, with very little evidence available from other regions. Most studies were rated high or good quality, reinforcing the reliability of these findings on poorer survival outcomes for Indigenous peoples compared to non-Indigenous groups diagnosed with a blood cancer. This underscores the urgent need for improved global data collection, greater Indigenous leadership in research, and targeted interventions to address these persistent survival disparities.
Ghazy RM, Elrewany E, Samir AA
… +3 more, Alshaikh AA, Alsamghan A, Aljohani MS
Cancer Epidemiol
· 2026 Jun · PMID 42284921
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BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. In the Kingdom of Saudi Arabia (KSA), CRC incidence has risen substantially over recent decades. This study aime...BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. In the Kingdom of Saudi Arabia (KSA), CRC incidence has risen substantially over recent decades. This study aimed to assess the burden and temporal trends of CRC in KSA from 1990 to 2023 and to forecast its future burden through 2030. METHODS: We analyzed data from the Global Burden of Disease (GBD) Study 2023 from 1990 to 2023. Age-standardized rates and case counts were extracted for prevalence, incidence, deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). We conducted decomposition analysis, age-period-cohort analysis, joinpoint regression, and forecasting through 2030 using autoregressive integrated moving average (ARIMA), error-trend-seasonal (ETS) exponential smoothing, and Poisson regression models. RESULTS: Between 1990 and 2023, age-standardized CRC prevalence rates per 100,000 population increased from 30.5 to 81.7 for prevalence (168% increase; APC: 3.91%), from 9.7 to 21.2 for incidence (118% increase; APC: 3.33%), and from 8.8 to 13.5 for mortality (53% increase; APC: 2.18%). Absolute case counts rose more steeply: prevalence increased from 2001 to 14,136 cases (606.5%), incidence from 532 to 2961 cases (456.8%), deaths from 414 to 1526 cases (268.1%), and DALYs from 12,737 to 45,774 (259.4%). Females experienced greater relative increases than males across most measures with narrowing the historical male predominance (male-to-female incidence ratio declined from 1.39 to 1.05). Decomposition analysis revealed population growth as the primary driver of increased burden (contributing 30.2-96.0% of the increase), while changes in age-specific mortality rates offset the expected rise in deaths and DALYs by approximately 50%. Joinpoint analysis showed consistent linear increases with significant trend points changes. Forecasts to 2030 project modest declines for both sexes combined (incidence: -15.9% to 17.9 per 100,000; DALYs: -6.7% to 252.5 per 100,000), with marked sex differences: females are expected to experience substantial reductions (incidence: -33.6%; prevalence: -22.6%; DALYs: -16.5%), while males show lower changes or slight increases (incidence:-6.2%; prevalence:2.9% DALYs: -1.4%). CONCLUSIONS: CRC burden in KSA increased substantially from 1990 to 2023, driven primarily by population growth and aging, with a partial offset by improvements in mortality rates. The narrowing sex gap reflects rising rates among females. While modest declines are projected toward 2030, CRC will remain a major public health challenge. Strengthened primary prevention efforts targeting modifiable risk factors and enhanced screening coverage are urgently needed.
Shah R, Kanesvaran R, Noronha V
… +1 more, Pilleron S
Cancer Epidemiol
· 2026 Jun · PMID 42269377
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The acceleration of population ageing across Asia is expected to increase the cancer burden, yet comprehensive region-wide evidence among older adults remains limited. Using GLOBOCAN 2022 estimates, we quantified cancer...The acceleration of population ageing across Asia is expected to increase the cancer burden, yet comprehensive region-wide evidence among older adults remains limited. Using GLOBOCAN 2022 estimates, we quantified cancer incidence and mortality (excluding non-melanoma skin cancer) among adults aged ≥ 60 years in 48 Asian countries and five United Nations subregions, with China and India analysed separately, and projected the burden to 2050. In 2022, an estimated 5.7 million new cancer cases and 3.8 million cancer deaths occurred among older adults in Asia, accounting for 59% of all cancer cases and 70% of cancer deaths in the region. Lung, colorectal, stomach, liver, and breast cancers comprised over half of new cases, while lung, colorectal, liver, stomach, and oesophageal cancers were the leading causes of cancer death. Substantial variation was observed across countries and subregions, with higher incidence and mortality among males. Eastern Asia exhibited the highest age-standardised incidence and mortality rates, whereas Southern Asia showed lower rates, likely reflecting both true differences and underdiagnosis. India displayed a distinct epidemiologic profile, with a high burden of breast, oral, cervical, and lung cancers. Projections based on demographic change alone indicate that by 2050, cancer cases and deaths among older adults in Asia will more than double, with the steepest increases in Southern and Western Asia. These findings underscore the urgent need to strengthen cancer prevention, early detection, equitable access to diagnosis and treatment, geriatric oncology capacity, and palliative care to address the rapidly growing and uneven cancer burden among older adults in Asia.