Evolution of COVID-19 in the State of São Paulo: Analysis of Incidence, Mortality and Lethality from 2020 to 2023

It is essential to analyze trends in cancer incidence and mortality in the evaluation of cancer control activities. Previous studies from Japan, however, described trends in cancer incidence and mortality only qualitatively. There have been few studies that evaluated the trends quantitatively. We calculated age-standardized mortality rates (1968-2006) and incidence rates (1968-2002) for overall cancer sites and for each major site (stomach, colorectal, liver, lung, prostate, breast, and uterus) in Osaka. We applied a joinpoint regression model to the trends in incidence and mortality, in order to identify the joinpoint and estimate annual percentage change. Then, we quantified the contribution of individual cancer sites to the change in overall cancer mortality rate. For the sites that made a major contribution, we estimated the contribution of the incidence reduction to the mortality reduction. In Osaka, the overall cancer mortality started to decrease from 1998. The decrease was largely attributable to the reduction of stomach and liver cancer mortality (73% for men, 53% for women). The reduction of mortality from the two cancer sites could be explained by the decrease in their incidences (more than 80% for stomach, approximately 100% for liver). Female breast cancer incidence and mortality were both increased probably due to lifestyle changes and delayed introduction of an effective screening program among Japanese. In conclusion, the decreased overall cancer mortality in Osaka during the study period was mainly due to natural decreases in the incidence of stomach and liver cancer, which were attributable to the decrease in risk factors.

Trends in breast cancer incidence, survival, and mortality

Time Trends in the Incidence and Mortality of Ovarian Cancer in Ireland, Northern Ireland, and Israel, 1994-2013.

Introduction: cardiovascular diseases are the leading causes of death in the world. Despite the reduction in CVD incidence and mortality in the 20th century, the values remain high in the 21st century. In Brazil, there is a gap in population studies that estimated standardized mortality rates from cardiovascular diseases in young adults. Objective: to assess the trend in mortality from cardiovascular diseases in young adults, according to sex, age group and regions of Brazil. Methods: ecological time series study using official secondary data from Mortality Information Systems (SIM). All deaths from cardiovascular diseases (I00-I-99) in young adults aged 20-49 years, residing in Brazil, in the period from January 1, 2008 to December 31, 2017, were considered. Data were extracted from the Department of Informatics of the SUS (DATASUS). The Prais-Winsten regression model was used and the Annual Percentage Variation (APV) was calculated. All analyzes were performed in STATA 14.0 software. Results: during the period 2008-2017, 294,232 deaths (8.7%) from cardiovascular disease were identified in young adults aged 20-49 years. A reduction in CVD mortality was identified in all regions of Brazil, except for individuals aged 20-24 years, residing in the Northeast region, which showed an increase (APC: 2.45%) (p<0.05) 2013 -2017. The greatest variation in the mortality trend occurred in the South region (APC: -25.2%). While the smallest change in mortality trend occurred in the Northeast region (APC: -8.8%). The annual decline was smaller in the second quinquennium (2013-2017) compared to the first (2008-2012). Furthermore, the decline was more pronounced among women (APC: -2.51%) (p<0.05) 2008-2012 and in young adults aged 40-44 years (APC: -2.91%) (p<0.05) 2008-2012. Furthermore, the trend in CVD mortality stabilized from 2013 onwards in males (p>0.05). Conclusion: the results demonstrate a decreasing trend in mortality from Cardiovascular Disease in young adults in Brazil, between 2008-2017. It is concluded that there is inequality in the trend of mortality from CVD according to sex, age group and regions of Brazil.

10569 Background: Epidemiological data relating to non-melanoma skin cancer (NMSC), including squamous cell carcinoma (SCC), is highly under-reported and under-studied due to its lower metastatic potential. In recent years, incidence and prevalence of SCC has increased in many countries due to earlier detection, increased ultraviolet light exposure, as well as increasing life expectancy. This investigation compared trends in SCC incidence, mortality and disability-adjusted life years (DALYs) in 33 countries. Methods: We utilized the Global Burden of Disease (GBD) database for 33 countries, including the European Union nations as well as other selected high-income countries including the UK and USA. We extracted data including age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs) and DALYs for SCC of the skin from 1990 to 2017. Joinpoint regression analysis was used to describe the trends. Results: For both sexes, the highest ASIRs were seen in the USA and Australia: ASIRs were 362.8/100,000 and 283.7/100,000 respectively for males, and 171.2/100,000 and 152.4/100,000 respectively for females. Males had higher ASIRs than females at the end of the observation period in all countries. In contrast, the highest ASMRs for males were observed in Australia (2.77/100,000) and Latvia (2.44/100,000), while the highest ASMRs for females were observed in Romania (0.95/100,000) and Croatia (0.90/100,000). The highest DALYs for both sexes were seen in Australia and Romania: DALYs were 58.4/100,000 and 43.8/100,000 respectively for males, and 16.9/100,000 and 14.9/100,000 respectively for females. Over the observation period, there were more countries demonstrating decreasing trends in mortality than in incidence. There was also a disparity between which countries had comparatively high mortality rates and which had high incidence rates – for instance, the USA, which had by far the highest SCC incidence rates, had among the lower mortality rates. Overall reductions in DALYs were observed in 24 of 33 countries for males, and 25 countries for females. Conclusions: Over the past 27 years, although trends in SCC incidence have risen in most countries, there is evidence that mortality rates have been decreasing, especially towards the end of the observation period. Overall, burden of disease as assessed using DALYs has decreased in the majority of countries. Future work will explore potential explanatory factors for the observed disparity in trends in SCC incidence and mortality.

Objectives: This study aimed to provide an overview of temporal trends in incidence and mortality of non-Hodgkin lymphoma (NHL) from 1992 to 2021 at global, regional, and national levels, with a special focus on their associations with age, period and cohort. Methods: Data were obtained from the Global Burden of Disease Study 2021. We presented temporal trends in NHL incidence and mortality for the world and 204 countries and territories from 1992 to 2021. An age-period-cohort (APC) model was adopted to estimate net drifts (overall annual percentage change), local drifts (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks. Results: The global age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for NHL were 7.14 (95% uncertainty interval [UI]: 6.58, 7.66) and 3.19 (95% UI: 2.93, 3.44) per 100,000 population in 2021, respectively. From 1992 to 2021, the global net drift of incidence rate was 0.11% (95% confidential intervals [CI]: 0.07%, 0.15%) per year, ranging from - 0.60% (95% CI: -0.66%, -0.54%) in high socio-demographic index (SDI) region to 1.51% (95% CI: 1.46%, 1.57%) in middle SDI region, with 100 countries and territories presenting increasing trends. Similar patterns can be found in the net drift of mortality rate, with 19 countries and territories showing upward trends. Age effects illustrated that incidence and mortality risks progressively increased with advancing age across different SDI regions. Period effects on incidence presented rising risks in high-middle, middle and low-middle SDI regions, whereas on mortality exhibited persistent downward trends in high and high-middle SDI regions. High-middle and middle SDI regions presented initially unfavourable and then favourable trends in incidence and mortality risks across successive birth cohorts. A strong heterogeneity was found in age, period and cohort effects on incidence and mortality across countries. Conclusions: Despite observing an increasing temporal trend in NHL incidence, coupled with a declining trend in mortality, NHL represented a substantial public health challenge worldwide. Temporal trends in NHL were not completely commensurate with socioeconomic development and varied widely across countries. Timely intervention should be conducted, especially for middle-aged and aged individuals.

Workshop report

Stroke mortality varies greatly from country to country. In 1985, the highest figures in eastern European countries were 6- to 7-fold those of countries with the lowest mortality rates,1 and the same trend has continued in the 1990s.2 The mortality rates have not, however, remained stable during the last decades. In most countries, a significant reduction has occurred, whereas in some countries the opposite is true: during 1970 to 1985, the annual changes ranged from +3.9% to −7.1%, and during 1985 to 1994, from +3.2% to −6.8%.1,2 The obvious causes of the reduced mortality rates have been either a decreased incidence of stroke or the case-fatality rate, or both. The explanations for the growing mortality rates, mainly in the eastern European countries, have been more or less speculative. In the present study, Sarti and associates have answered these questions. Their impressive patient material consisted of 36 000 young (35 to 64 years) …

To describe trends in cancer incidence and mortality among children less than 15 years of age in urban Shanghai between 1973 and 2005. Annual rates of cancer incidence were calculated per 1,000,000 children for 3-year intervals between 1973 and 2005. Linear regression models were used to analyze the annual percent change (APC) in incidence and mortality across these distinct intervals. For all cancers combined, the incidence rate during the observed time period did not substantially change in urban Shanghai. Rates for the incidence of individual cancer did exhibit variations. Leukemia incidence remained relatively stable but the incidence of myeloid leukemia decreased sharply in both males (APC -8.6%) and females (APC -9.5%). The rate of NHL varied little among males with APC 2.1% and modestly increased among females with APC 9.3%. Anatomic sites that only occasionally demonstrate malignancy, bone and joints in males and endocrines in females, showed upward trends in incidence. A significant reduction in liver cancer incidence in males was observed. Examining mortality rates, all cancer mortality decreased by -6.0% annually in males and by -3.9% in females. This trend was mainly due to the reduction in mortality for leukemia, particularly the myeloid subtype, which decreased in males (APC -7.2%) and females (APC -7.3%). Childhood cancer incidence rates showed no substantial changes but mortality demonstrated a dramatic reduction during the observed time period, suggesting an improvement in both childhood cancer diagnosis and treatment.

Global burden and temporal trends in incidence and mortality of oesophageal cancer

European Trends in Chronic Obstructive Pulmonary Disease Mortality and Incidence rates 2001 to 2017

This study aimed to assess time trends in colorectal cancer incidence from 1983 to 2012 in Latin America. This was an ecological time-series study whose population consisted of individuals aged 20 years or older diagnosed with colorectal cancer. Data from population-based cancer registries in Cali (Colombia), Costa Rica, Goiânia (Brazil), and Quito (Ecuador), were used for rates estimation, while time trends estimations were proceeded by the Joinpoint Regression Program. The study showed an increase in colorectal cancer incidence in men and women in Cali (2.8% and 3.2%, respectively), Costa Rica (3.1% and 2.1%, respectively), and Quito (2.6% and 1.2%, respectively), whereas in Goiânia, only women showed an increase in colorectal cancer rates (3.3%). For colon cancer, we observed an increasing trend in incidence rates in men and women in Cali (3.1% and 2.9%, respectively), Costa Rica (3.9% and 2.8%, respectively), and Quito (2.9% and 1.8%). For rectal cancer, we observed an increasing trend in incidence in men and women in Cali (2.5% and 2.6%, respectively), Costa Rica (2.2% and 1%, respectively), and Goiânia (5.5% and 4.6%, respectively), while in Quito only men showed an upward trend (2.8%). The study found increases in colorectal cancer, colon cancer, and rectal cancer in four Latin America regions. This findings reflect lifestyle, such as dietary changes, following the economic opening, and the prevalence variations of colorectal cancer risk factors by sex and between the four studied regions. Finally, the different strategies adopted by regions for colorectal cancer diagnosis and screening seem to influence the observed variation between anatomical sites.

Is colorectal cancer screening by fecal occult blood feasible?

Background Valvular heart disease is common globally; mitral regurgitation is the most common valve pathology in the general population and subsequently the second most frequent indication for valve surgery in Europe. Whilst the European epidemiology of aortic stenosis is well elucidated in the literature, no Europe-wide study has been undertaken to identify trends in incidence and mortality secondary to non-rheumatic degenerative mitral valve disease. Purpose Our aim is to describe trends in degenerative mitral valve disease incidence and mortality throughout Europe from 1990 to 2019. Methods We performed a temporal analysis of data deposited in the Global Burden of Disease Study Database across the European Union. We extracted age-standardised incidence and age-standardised mortality rates for 20 member states from the database. We graphically inspected the data and performed Joinpoint regression analysis to detect and summarise periods of significant change. These periods were described using estimated annual percentage change (EAPC). Results Trends in age-standardised incidence and mortality rates were heterogenous amongst the 20 member states included. A gender disparity in mortality rates favouring males were present in Austria, Belgium, Greece, Hungary and the Netherlands throughout the time period studied. Except for Hungary, this disparity was not reflected in the incidence rates for the aforementioned countries. Incidence rates of degenerative mitral valve disease in 2019 were highest in Italy for both males and females with 90.6 and 140.1 cases per 100,000 respectively. Mortality rates in 2019 were highest in the Netherlands for both males in females with 1.7 and 2.0 cases per 100,000 respectively; this was preceded by a downwards trend in mortality with an EAPC of −7.3% and −8.5% respectively. Other notable inflection points in incidence trends were observed in Italy, with an EAPC of −4.9% females between 1994 to 2004 followed by an EAPC of 0.8% between 2009 to 2019. Conclusion No overall trends in non-rheumatic mitral valve disease were observed throughout Europe, but gender disparities and some notable deviations in incidence and mortality rates from the European median were identified. Overall, however, incidence rates remained static in most countries studied despite the ubiquity of colour flow doppler echocardiography. Further analysis of the burden of mitral valve disease can help elucidate this geographical variation. Funding Acknowledgement Type of funding sources: None.

Mapping overdiagnosis of thyroid cancer in China