Age-standardized Incidence Ratios Research Articles

Association Between Type 1 Diabetes Mellitus and Incident Gastrointestinal Cancer in Korean Population: A Nationwide Retrospective Cohort Study.

The age-standardised incidence ratio of gastrointestinal cancers in type 1 diabetes (T1D) patients has been reported to be higher than that in the general population. After adjusting for shared risk factors, we aimed to explore the association between T1D and gastrointestinal cancer and examine how this relationship varies by age and sex. This retrospective cohort study included 268,179 participants from the Korean National Health Insurance Service-National Sample Cohort. The primary outcome is the incident of gastrointestinal cancers, based on diagnostic codes. Multivariate Cox regression analyses were performed to assess the association between T1D and gastrointestinal cancers. Of the 268,179 participants, 2681 had T1D at baseline and were followed for 12.98 (± 2.92) years. Compared with non-T1D, T1D patients had a significantly increased risk of all gastrointestinal cancer (adjusted hazard ratio [aHR]: 1.403, 95% confidence interval [CI]: 1.253-1.573). T1D patients increased risks of oesophageal cancer (aHR: 1.864, 95% CI: 1.038-3.349), gastric cancer (aHR: 1.313, 95% CI: 1.066-1.616), colon cancer (aHR: 1.365, 95% CI: 1.110-1.678), liver cancer (aHR: 1.388, 95% CI: 1.115-1.727), and pancreatic cancer (aHR: 1.716, 95% CI: 1.182-2.492). The consistency of this association persisted among both male and female, with its strength increasing with older age. The risk of gastrointestinal cancer was significantly increased in T1D patients. Older male T1D patients exhibit a higher risk, suggesting the need for targeted attention in their care.

Increased cancer incidence and mortality among people with opioid use-related disorders: A nation-wide cohort study.

Studies on cancer incidence and mortality among people with opioid use-related disorders are lacking. We aimed to measure cancer-specific incidence, mortality and survival among people diagnosed with opioid use-related disorders in Norway during 2010-18. This was a cohort study conducted in Norway during 2010-18. Individuals (n = 20710) diagnosed with opioid use-related disorders. We conducted a cohort study utilizing a data-linkage of national health and population registers. Information on opioid use-related disorders was extracted from specialized healthcare, malignancies from the Cancer Registry of Norway and deaths from Cause of Death Registry. Cancer incidence and mortality were compared with the general population by calculating sex-specific age-standardized incidence (SIR) and mortality (SMR) ratios. One-year survival rates were computed. Compared with the general population, people with opioid use-related disorders were at an increased risk of developing cancer overall [SIR = 1.2, 95% confidence interval (CI) = 1.1-1.3] with a higher than twofold cancer mortality rate (SMR = 2.3, 95% CI = 2.0-2.7). Excess risk was observed for liver (12.6, 95% CI = 9.1-17.0), larynx (4.7, 95% CI = 1.7-10.2), lung (3.5, 95% CI = 2.8-4.3) and pancreas cancer (2.6, 95% CI = 1.6-4.0), whereas reduced risk was found for melanoma (0.5, 95% CI = 0.3-0.9), breast (0.6, 95% CI = 0.4-0.9) and prostate cancers (0.3, 95% CI = 0.1-0.4). Site-specific SMRs were significantly elevated for liver (12.3, 95% CI = 8.5-17.2), lung (3.9, 95% CI = 3.0-5.0), pancreas (3.0, 95% CI = 1.7-4.8) and colon cancers (1.9, 95% CI = 1.1-3.1). The average 1-year survival rate after a cancer diagnosis was low in liver, pancreas and colon cancer, ranging from 10 to 15% less than that of the general population. In Norway, cancer incidence and cancer-related mortality appear to be elevated among individuals with opioid use-related disorders.

Australians with chronic lymphocytic leukaemia continue to have high rates of second primary malignancies in the modern era.

Population-based studies have demonstrated a high risk of second cancers, especially of the skin, among patients with chronic lymphocytic leukaemia (CLL). We describe age-standardised incidence ratios (SIRs) of second primary malignancies (SPM) in Australian patients with relapsed/refractory CLL treated with at least two lines of therapy, including ibrutinib. From December 2014 to November 2017, 156 patients were identified from 13 sites enrolled in the Australasian Lymphoma and Related Diseases Registry, and 111 had follow-up data on rates of SPM. At 38.4 months from ibrutinib therapy commencement, 25% experienced any SPM. SIR for melanoma and all cancers (excluding nonmelanomatous skin cancers) were 15.8 (95% confidence interval (CI): 7.0-35.3) and 4.6 (95% CI: 3.1-6.9) respectively. These data highlight the importance of primary preventive interventions and surveillance, particularly as survival from CLL continues to improve.

Ischemic heart disease and stroke in male couriers: a cohort study using the national health insurance data and national employment insurance data.

This study aimed to determine the risk of ischemic heart disease (IHD) and stroke among male couriers in Korea by linking the data from the National Health Insurance (NHI) and National Employee Insurance (NEI) databases. As of 2015, the NHI and NEI databases were linked using individual IDs. A cohort of male couriers, aged between 20 and 64 years, (N = 5,012) was constructed using the Korean Employment Insurance Occupational Classification (KECO-2007). For comparison, a cohort of male total wage workers (N = 5,429,176) and a cohort of office workers (N = 632,848) within the same age group were also constructed. The follow-up was conducted until 31 December 2020 to confirm the occurrence of IHD and stroke. The diagnoses were defined using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. The criteria included medical services for more than 1 day of hospitalization or more than 2 outpatient visits. The age-standardized incidence ratio (SIR) was calculated to evaluate the risk of occurrence. The hazard ratio (HR) was calculated using the Cox model after adjusting for age, alcohol consumption, smoking, obesity, income level, and employment duration as confounding variables. The SIR of IHD for couriers was 1.54 (95% CI 1.31-1.78), while for office workers, it was 1.08 (95% CI 1.06-1.10), compared to male total wage workers. The SIR for stroke was higher for couriers at 1.84 (95% CI 1.40-2.28) and lower for office workers at 0.86, compared to male total wage workers. Couriers had a higher SIR for stroke at 1.84 (95% CI 1.40-2.28) and lower for office workers at 0.86 (0.83-0.89). Compared to total wage workers, couriers had a significantly higher adjusted HR for IHD at 1.60 (95% CI 1.37-1.87) and a higher HR for stroke at 1.39 (95% CI 1.07-1.79). Compared to office workers, couriers had a significantly higher HR for IHD at 1.34 (95% CI 1.13-1.59) as well as for for stroke at 1.43 (95% CI 1.08-1.88). The incidence of IHD and stroke was higher among male couriers compared to male office workers and total wage workers, highlighting the need for implementing public health interventions to prevent IHD and stroke among couriers.

National and subnational burden of leukemia and its risk factors, 1990-2019: Results from the Global Burden of Disease study 2019.

Hematologic malignancies have a great essential role in cancer global burden. Leukemia which two major subtypes based on the onset, is one of the common subtypes of this malignancy. For the GBD 2019 study, cancer registry data and vital registration system were used to estimate leukemia mortality. The Meta-Regression-Bayesian Regularized Trimmed (MR-BRT), Cause of Death Ensemble model (CODEm) and Spatiotemporal Gaussian Process Regression (ST-GPR) were used to model our data and estimate each quantity of interest. Mortality to incidence ratios (MIR) were used to generate incidence and survival from mortality rate. Prevalence and survival were used to generate years lived with disability (YLDs). Age-specific mortality and life expectancy at the same age were used to estimate years of life lost (YLLs). The sum of YLLs and YLDs generates DALYs. The total national incidence of leukemia increased from 6092 (UI 95%: 3803-8507) in 1990 to 6767 (4646-7890) new cases in 2019. However, leukemia age-standardized incidence ratio(ASIR) decreased from 11.6 (8-14.8) to 8.9 (6.2-10.3) new cases per 100,000 in this exact period. At the national level, deaths from leukemia increased 1.5-fold between 1990 and 2019, from 3287 (2284-4201) to 4424 (3137-5030), whereas the age-standardized death rate(ASDR) decreased from 8.3 (6.1-9.8) in 1990 to 6 (4.3-6.8) per 100,000 in 2019. In the study period, total leukemia DALYs decreased 12.2% and reached 162850 (110681-188806), in 2019. The age-standardized DALYs decreased 36.7% from 324.3 (224.8-413.4) in 1990 to 205.3 (140.3-237.8) in 2019. ASDR, DALYs, YLLs, and YLDs rate to high BMI was increasing while smoking and occupational exposure to benzene and formaldehyde were decreasing in the study period. This study provided a better understanding of leukemia burden and to reduce controversies of leukemia across Iran. The leukemia status alteration of the country, is trackable.

QRISK3 underestimates the risk of cardiovascular events in patients with COPD

BackgroundPatients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK,...

Differences in breast cancer incidence between women with and without disabilities in South Korea

Abstract Backgrounds Breast Cancer (BRC) is a leading cause of morbidity and mortality in women. BRC incidence has steadily increased in South Korea. Women with disabilities encounter multiple challenges in accessing cancer prevention and diagnosis. This study aims to estimate the incidence of BRC among women with and without disabilities in South Korea. Methods We analyzed 2.87 million women aged ≥30 years in 2002 who participated in the National Health Screening Program in 2002-2003 retrieved from the National Health Insurance Database (NHID). Disabilities were identified by the disability registration data in the NHID from 2002-2019. BRC incidence was determined by the National Cancer Registry in 2003-2019; for women with disabilities, BRC diagnosed after registering disability were included. Age-standardized incidence rates (ASRs) and ratios (SIRs) compared to incidence in the general population were estimated for those with and without disabilities. Results During the follow-up period (2003-2019), incident cases were 2,605 (0.9%) and 46,267 (1.8%) among 296,689 women with- and 2,576,182 without disabilities, respectively. Women without disabilities had a 1.65 times higher risk of BRC than those with disabilities. The BRC risk in women with disabilities (SIR = 0.59, 95% CI 0.57-0.62; ASR = 58.2 per 100,000) was lower than the general population. However, women without disabilities (SIR = 0.98, 0.97-0.99; ASR = 96.0 per 100,000) were similar to the general population. Women with disabilities were less likely to undergo BRC screening (RR = 0.92, 0.92-0.92) and more likely to have advanced stages than women without disabilities. Even though the incidence was higher among women without disabilities, BRC mortality was similar between the two groups. Conclusions Women with disabilities had a lower BRC incidence but a similar mortality rate to those without disabilities. Lesser accessibility to healthcare services in women with disabilities may partly explain the lower incidence rate. Key messages • Women with disabilities had a lower incidence but a similar mortality rate of BRC compared to women without disabilities. • Women with disabilities were less likely to undergo BRC screening and more likely to have advanced stages than those without disabilities.

Increased incidence risks of cardiovascular disease among cancer patients: Evidence from a population-based cohort study in China

Cardiovascular disease (CVD) is becoming a major concern among cancer patients, leading to the development of a new field named cardio-oncology. However, previous studies were mainly based on the western population and focused on CVD mortality. Evidence from the Chinese population is limited. Furthermore, few studies investigated the incidence risks of CVD among cancer patients. 85,787 eligible cancer patients were included from Hangzhou city, China. Age-standardized standard incidence ratio (SIR) was used to reflect the incidence risks of CVD among cancer patients as compared with the standard population, which was defined as all residents in Hangzhou city during the same period. After three years of follow-up, cancer patients showed elevated incidence risks of CVD (SIR=1.41, 95%CI: 1.35-1.47) as compared with the standard population. The elevated risks of CVD were highest in the first year after cancer diagnosis (SIR=1.68, 95%CI: 1.58-1.78), then followed by the second (SIR=1.21, 95%CI: 1.11-1.31) and the third (SIR=1.18, 95%CI: 1.07-1.29) year. These results were consistent in males and females. Furthermore, different risks of CVD were observed among different cancer sites. Patients with pancreatic cancer showed the highest risks of CVD, then followed by liver cancer, lung cancer, kidney cancer, gastric cancer, bladder cancer, prostate cancer, and colorectal cancer. Cancer patients have increased incidence risks of CVD, especially in the first year after cancer diagnosis. The increased risks of CVD vary by different cancer sites. Our findings highlight the importance of paying close attention to the CVD risks among cancer patients.

Cancer incidence among male construction workers in the Republic of Korea: a standardized incidence ratio analysis, 2009-2015.

Construction workers face an elevated risk for several types of cancer. Nevertheless, there is a lack of large-scale epidemiological studies examining the risk of all cancers in construction workers. This study aimed to investigate the risk of various cancers in male construction workers using the Korean National Health Insurance Service (NHIS) database. We used data from the NHIS database from 2009 to 2015. Construction workers were identified using the Korean Standard Industrial Classification code. We calculated the age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for cancer occurrence in male construction workers compared to all male workers. Compared to all male workers, the SIRs for esophageal cancer (SIR=1.24; 95% CI, 1.07-1.42) and malignant neoplasms of the liver and intrahepatic bile ducts (SIR=1.18; 95% CI, 1.13-1.24) were significantly higher in male construction workers. The SIRs for malignant neoplasms of the urinary tract (SIR=1.19; 95% CI, 1.05-1.35) and non-Hodgkin lymphoma (SIR=1.21; 95% CI, 1.02-1.43) were significantly elevated in building construction workers. The SIR for malignant neoplasms of the trachea, bronchus, and lung (SIR=1.16; 95% CI, 1.03-1.29) was significantly higher in heavy and civil engineering workers. Male construction workers have an increased risk for esophageal cancer, liver cancer, lung cancer, and non-Hodgkin's cancer. Our results indicate that tailored strategies for cancer prevention should be developed for construction workers.

Incidence of Appendix Cancer after Surgery for Colorectal Cancer: Should the Appendix be Prophylactically Removed During Surgery for Colorectal Cancer?

Abstract Introduction Retrospective cohort studies with limited sample sizes suggest that the incidence of appendix cancer may be increased in patients having surgery for colorectal cancer. Aims To determine whether patients who underwent surgery for colorectal cancer are at higher risk of appendix cancer. Methods Cases of colorectal and appendix cancer were identified from the NICER (National Institute for Cancer Epidemiology and Registration, Switzerland) database based on ICD-10 codes for the period 2009-2019. Incidental cases of appendix cancer (all histological types) were extracted from patients who underwent surgery for colorectal cancer and from the general population followed by cantonal cancer registries. Standardized incidence ratios were calculated. Results Twenty-eight thousand nine-hundred and thirty-four cases of colorectal cancer and 1,350 cases of appendix cancer were identified over the study period (10 years). After exclusion of cases of appendix cancer, 22,705 patients underwent surgery for colorectal cancer (at-risk population). In these patients, 43 cases of appendix cancer occurred over the follow-up period, including 35 NETs. In the reference population without any history of surgery for colorectal cancer, 1,305 incidental cases of appendix cancer occurred during the same period. This corresponds to an age-standardized incidence of 20.52 per 100,000 person-year in the at-risk population, and of 1.61 per 100,000 person-year in the reference population. The age-standardized incidence ratio for appendix cancer is 12.74 (95% CI: 12.02-13.45) in the at-risk population when compared to the reference population. However, most of these cases were synchronous cancers. To exclude potential information bias, a sensitivity analysis including only cases of left-sided colorectal cancer (colon and rectum) was performed. In this population, the age-standardized incidence ratio for metachronous appendix cancer is 8.67 (95% CI: 7.13-10.20). Conclusions The incidence of appendix cancer is increased in patients having surgery for colorectal cancer. The incidence may, however, be too low to consider routine prophylactic appendectomy during surgery for colorectal cancer.

Diabetes Mellitus as Cancer Risk: A 14-year, Cross-Sectional Analysis

Diabetes mellitus is widely thought to be a risk factors of cancers, but evidence of the association remains inconclusive, especially in Asian countries where few relevant studies have been conducted. Our study aimed to estimate overall and specific types of cancer risks among diabetes patients in Southern Thailand. Patients diagnosed with diabetes who visited the outpatient clinic of Songklanagarind Hospital during 2004 to 2018 were included. Newly diagnosed cancer patients were identified using the hospital-based cancer registry. Age-standardized incidence ratios (ASRs) and standardized incidence ratios (SIRs) were used to estimate and compare the cancer risks among diabetes patients and the general population in Southern Thailand. Of 29,314 diabetes patients identified during the study period, 1,113 patients had developed cancer. An increased risk for overall cancer was observed in both genders, with SIRs [95% CI] of 2.99 [2.65, 3.39] in men and 3.51 [3.12, 3.96] in women. Increases in the risk of several site-specific cancers including liver cancer, non-melanoma skin cancer, colon cancer and lung cancer in both sexes; prostate cancer, lymphoid leukemia, and multiple myeloma in men; and endometrial, breast, and thyroid cancer in women were observed. Our study found that diabetes generally increased the risk of both overall and site-specific cancers.

Cancer risk in Vietnam war veterans from the Korean Vietnam war veterans' health study cohort.

During the Vietnam War, several unknown chemicals, such as Agent Orange, were used in Vietnam by the military. Therefore, there have been continuous health concerns among the Vietnamese population and veterans exposed to these hazardous chemicals. This study aimed to investigate the risk of all cancers and also organ-specific cancers among Korean veterans of the Vietnam War. This study used a national representative cohort that included all Korean Vietnam War veterans as the interest group, with 1:4 age-sex-region-matched general Korean citizens as the reference group, from 2002 to 2018. Age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated for all cancers and for 31 organ-specific cancer categories based on the medical facility visit data. An increased SIR of 1.07 (95% CI, 1.06-1.08) was observed for all cancers among the veterans. There was a significantly increased risk of cancer among 22/31 organspecific cancers, with 18 cancer categories showing a significantly higher risk than all cancers. The highest risk was observed for "malignant neoplasms of other parts of the central nervous system" (SIR, 1.71; 95% CI, 1.51-1.92). This study evaluated the risk of cancer among Korean Vietnam War veterans. Further studies are warranted to investigate various health determinants in the veterans as well as the Vietnamese population.

Risks of Leukemia in Various Industrial Groups in Korea: A Retrospective National Cohort Study

It is known that occupational exposure to specific agents is associated with leukemia. However, whether the occupational risks of leukemia differ among various industrial groups remains unclear. Therefore, the purpose of this study was to elucidate the occupational risks of leukemia among different worker groups by industry. Data for a total of 11,050,398 people from the National Health Insurance System's claim data from 2007 to 2015 were analyzed. By cohort inclusion of workers whose industry had not changed for three years and with total workers as a control group, the risk for a specific industry group was expressed as an age-standardized incidence ratio (SIR). Among groups by industry, 'Manufacture of motor vehicles and engines for motor vehicles', 'Sale of motor vehicle parts and accessories', and 'Personal care services' showed significantly higher SIRs. In division analysis, the 'Manufacture of other machinery and equipment' and 'Waste collection, treatment and disposal activities' divisions showed significantly higher SIRs than other divisions. We identified an increased risk of leukemia in workers of certain industries in Korea. Based on the results of this study, it is necessary to create a policy to protect workers at risk of leukemia. Various additional studies are needed to protect workers by revealing more precise relationships between individual hazardous substances, processes, and leukemia.

Risk and Status of Gastrointestinal Cancer According to the International Standard Industrial Classification in Korean Workers.

Simple SummaryThe risk of developing cancers varies depending on occupation, which is a well-known fact. It is crucial to investigate the risk of developing gastrointestinal (GI) cancer in the entire industry. In this study, we calculated the standardized incidence ratios (SIRs) of GI cancer by all industrial sectors as classified in the Korean Standard Industrial Classification (KSIC). There were noticeable differences among industries in the risk of GI cancer. The SIR of all GI cancer was highest among miners and quarriers, and second highest among transportation workers. These results suggest that further research is required to identify the risk factors present in each industry that contribute to the development of GI cancers. We believe this study can help to create tailored cancer prevention strategies for different industrial sectors.To compare the risk of developing gastrointestinal (GI) cancer according to industrial groups, we performed a retrospective cohort study using the database of the Korea National Health Insurance Service (NHIS). We calculated the age-standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) for the types of GI cancers according to the Korean Standard Industrial Classification (KSIC) compared with the whole employee population. The highest SIR for all GI cancer was found in the “Mining and quarrying” section (SIR, 1.30; 95% CI, 1.14–1.47), followed by the “Transportation and storage” section (SIR, 1.27; 95% CI, 1.24–1.30). Miners and quarriers had the highest risk of developing gastric cancer (SIR, 1.29; 95% CI, 1.06–1.55) and cancer of the liver and intrahepatic bile ducts (SIR, 1.48; 95% CI, 1.17–1.86). Transportation workers had the highest SIR of cancer of the lip, oral cavity, and pharynx (SIR, 1.27; 95% CI, 1.13–1.43) and cancers of the rectum, anus, and anal canal (SIR, 1.27; 95% CI, 1.19–1.35). There were distinct GI cancers with an elevated risk in each industry group. Our findings imply that distinct cancer prevention programs should be developed for each industrial sector.

Incidence and Outcomes of SARS-CoV-2 Infection in Older Adults Living with Dementia: A Population-Based Cohort Study.

Background:The identification of risk factors for SARS-CoV-2 infection and mortality in patients with dementia is a key aspect to support clinical decisions and public health interventions.Objective:To assess the incidence of SARS-CoV-2 infection and COVID-19 related death in a cohort of patients with dementia residing in the Lazio region and to investigate predicting factors for both infection and mortality.Methods:This population-based study used information from administrative databases and the SARS-CoV-2 infection surveillance system. Patients with dementia (age ≥65) were enrolled as of December 31, 2019 and followed-up until February 28, 2021. Cumulative risk of infection and death within 60 days of infection onset, and age-standardized incidence (SIR) and mortality (SMR) ratios were calculated. Logistic regression models were applied to identify factors associated with infection and mortality.Results:Among 37,729 dementia patients, 2,548 had a diagnosis of SARS-CoV-2 infection. The crude risk of infection was 6.7%. An increase in risk of infection was observed both in women (SIR 1.72; 95% CI 1.64–1.80) and men (SIR 1.43; 95% CI 1.33–1.54). Pneumonia, cerebrovascular and blood diseases, femur fracture, anxiety, antipsychotic and antithrombotic use were associated with an increased risk of infection. The crude risk of death was 31.0%, the SMRs 2.32 (95% CI 2.05–2.65) for men, and 2.82 (95% CI 2.55–3.11) for women. Factors associated with mortality included: male gender, age ≥85, symptoms at the diagnosis, antipsychotic and systemic antibiotics treatment.Conclusion:These findings emphasize the need of close and tailored monitoring of dementia patients to reduce the impact of COVID-19 on this fragile population.

A comparative analysis of factors influencing colorectal cancer's age standardized mortality ratio among Korean women in the hot and cold spots.

The study aimed at exploring factors that most influence colorectal cancer (CRC) age standardized mortality ratio (ASMR) among Korean women, as reported in previous studies. The factors used the data of 250 municipalities from the Korean Statistical Information Service (KOSIS) from 2010 to 2018. In the exploratory survey, over 70% of women aged 65 and above died of colorectal cancer. After investigating the existing literature and theories, 250 regions were classified into hot and cold spots according to age standardized mortality ratio (ASMR). The Nearest Neighbor Index (NNI), Moran’s I index and The Durbin-Watson test were also utilized. The ASMR’s regional cluster analysis showed that the inland areas were the hot spots and the cold spots were in the southwest coastal areas. The result also showed the differences in dwellers’ lifestyles between these two regions as well as the mean difference between the two. In addition, there was no significant difference in ASMR for breast cancer, CRC deaths, and agricultural product shipments between the two regions. In the multiple regression model, CRC mortality, diabetes, and CRC age standardized incidence ratio (ASIR) were analyzed as major influencing factors, demonstrated a significant result with 30.6% by examining the adjusted R-squared. However, this study showed that factors such as smoking, alcohol consumption, abdominal obesity, breast cancer, and food consumption indicated to have less influence on the occurrence of CRC. The aging rate, amount of food consumption, seafood production, livestock product shipments, and drinking rate were higher in the cold spot than in the hot spot.

Does Exposure To Environmental Pollution Increase The Incidence Of CNS Tumors In Children?

Purpose: The postulated risk factor of CNS tumors might be air pollution. In Poland, especially in the Silesian voivodship, air quality is inferior compared to other European countries. The study aimed to evaluate the effect of selected air pollution parameters on the incidence of central nervous system tumors in children. Material and methods: A group of 460 children (251 boys, 209 girls) aged 0-18 (0.17-18.75) years, diagnosed with CNS cancer were included. The age Standardized Incidence Ratios (SIR) for CNS malignancies in children were calculated. Based on the data concerning air quality, the number and location of air quality monitoring stations for 2003-2016 published by the Regional Inspectorate for Environmental Protection in Katowice, the mean concentrations of benzene (C6H6), Nitrogen dioxide (NO2), benzoalphapyrene (BaP) and particulates matter with a diameter of 2.5 micrometers (PM 2.5) and 10 micrometers (PM10) were calculated. Results: The highest PM10 (50.62µg/m3), PM2.5 (36.14µg/m3), BaP (10.9ng/m3) and C6H6 (3.67µg/m3) concentrations were recorded in the Rybnik area. The highest age-standardized CNS tumor incidence ratio (n/100,000) was also demonstrated in the Rybnik area (3.24). The analysis showed a significant positive correlation between the SIR and the concentration of PM2.5 (r=0.89, p=0.039) and PM10 (r=0.93, p=0.007). There was no significant correlation between SIR and NO2 (r=0.41, p=0.41), BaP (r=0.56, p=0.24), C6H6 (r=0,79, p=0,2). Conclusion: Exposure to high concentrations of particulate matter may increase the risk of developing CNS cancers in children. Further research is needed, especially in the pediatric population.

Association between cannabis use with urological cancers: A population-based cohort study and a mendelian randomization study in the UK biobank.

Legislation of cannabis use has been approved in many European and North American countries. Its impact on urological cancers is unclear. This study was conducted to explore the association between cannabis use and the risk of urological cancers. We identified 151,945 individuals with information on cannabis use in the UK Biobank from 2006 to 2010. Crude and age-standardized incidence ratios of different urological cancers were evaluated in the entire cohort and subgroups. Cox regression was performed for survival analysis. Previous use of cannabis was a significant protective factor for renal cell carcinoma (HR=0.61, 95%CI:0.40-0.93, p=0.021) and prostate cancer (HR=0.82, 95%CI:0.73-0.93, p=0.002) in multivariable analysis. The association between previous cannabis use and both renal cell carcinoma and bladder cancer was only observed in females (HRRCC =0.42, 95%CI:0.19-0.94, p=0.034; HRBCa =0.43, 95%CI:0.21-0.86, p=0.018) but not in men. There was no significant association between cannabis use and testicular cancer incidence. Mendelian randomization demonstrated a potential causal effect of cannabis use on a lower incidence of renal cell carcinoma. Previous use of cannabis was associated with a lower risk of bladder cancer, renal cell carcinoma, and prostate cancer. The inverse association between cannabis and both renal cell carcinoma and bladder cancer was only found in females but not in males.

Epidemiology of Urolithiasis with Sex and Working Status Stratification Based on the National Representative Cohort in Republic of Korea

This study aimed to estimate the annual prevalence and incidence of urolithiasis stratified by work status based on a large nationwide sample. This study used data from the National Health Insurance Service-National Sample Cohort from 2002 to 2015. The prevalence and incidence of urolithiasis were estimated based on work status and gender stratification. The risk of urolithiasis among workers was calculated using age-standardized incidence ratio with stratification of work type. The prevalence of urolithiasis was significantly higher in workers than in non-workers, especially men, during the follow-up period. The total estimated number of urolithiasis cases was 41,086 and the overall incidence of urolithiasis was 0.3%. The age-standardized incidence ratio of urolithiasis was significantly higher among the total workers (1.14; 95% confidence interval, 1.13-1.16), self-employed workers (1.08; 95% confidence interval, 1.06-1.11), and paid workers (1.19; 95% confidence interval, 1.17-1.21) than among the non-working population. Workers, especially paid workers and men, were vulnerable to urolithiasis. Further studies are required to investigate the effects of working conditions on urolithiasis.

Trends in incidence and mortality of brain cancer: An observational study of the Global Burden of Disease database from 1990 to 2019.

e18720 Background: Brain cancer is relatively rare accounting for approximately 1.3% of all cancer diagnoses in the US annually, however it has a particularly poor prognosis with 5-year survival at 33%. The morbidity and mortality associated with brain cancer is high, while global epidemiological data relating to it remains scarce. This study investigates brain cancer incidence, mortality and disability-adjusted life years (DALYs) in the EU 15+ countries and six WHO world regions. Methods: We extracted data for 19 countries, including the EU nations as well as other selected high-income countries including the UK and USA from the Global Burden of Disease (GBD) database. This data included age-standardized incidence ratio (ASIR), age-standardized mortality ratio (ASMR) and DALY from brain cancer (ICD 10 codes C70-C72, D42-D43.9, D44.3-D44.5) between 1990 and 2019. Joinpoint analyses were used to describe trends further. Results: Greece was noted to have the highest DALY for both sexes with 252/100,000 and 174/100,000 respectively for males and females. The majority of countries saw a drop in DALY during the study period (14/19 for males and 19/19 for females). Greece also reported the highest ASMR over the study period for both sexes at 7.8/100,000 and 5.3/100,000 respectively for males and females. The majority of countries also saw a decline in ASMR (12/19 for males and 16/19 for females) with Belgium noting the largest decline for males and females at -27.2% and -34.3% respectively. Denmark was noted to have the highest ASIR in 2019 for both sexes with 17.9/100,000 and 16.4/100,000 respectively for males and females. Most countries reported an increase in ASIR over the study period (17/19 for males and 15/19 for females). Denmark displayed the greatest increase in incidence for both sexes with an 84.5% and 64.3% increase, respectively, for males and females. Notably, the countries with the highest incidences and DALYs, Denmark, Luxembourg, and Greece, also had the highest mortality. All countries saw a decline in the mortality-to-incidence ratio over the study period, with Denmark and Ireland showing the greatest drop for both sexes. Conclusions: Over the study period, the burden of brain cancer has decreased in most countries as measured by DALY, ASMR, and mortality-to-incidence ratios. However, incidence rates have increased. The reduced disease burden may be due to the use of temazolamide which has improved outcomes in MGMT methylated and IDH mutated gliomas, with PCV chemotherapy with radiation therapy having similar effects for high risk low grade gliomas. The preferential use of bevacizumab may explain some of the differing trends between European and other developed countries. Future work is required to delineate the diverging trends between global disease burden and incidence while highlighting the etiology of these changes.