Age Standardization Research Articles

Global, regional, and national temporal trends in metabolism-related ischemic stroke mortality and disability from 1990 to 2021

BackgroundStroke ranks as the second leading cause of mortality and the third leading cause of disability worldwide. Nonetheless, the evolving burden of ischemic stroke attributable to various metabolic risk factors remains inadequately elucidated. A thorough grasp of these trends is crucial for a nuanced comprehension of stroke epidemiology and the formulation of effective preventive and interventional measures. MethodBased on the Global Burden of Disease, Injury, and Risk Factors Study 2021 (GBD), we analyzed national temporal trends in the burden of metabolism-associated ischemic stroke in 204 countries and territories globally from 1990-2021, as measured by the average annual percentage change (AAPC), using join-point regression models. The burden of disease was assessed using age-standardized (ASR) mortality rates and disability-adjusted life years (DALY) per 100 000 population. Cross-country inequalities in ischemic stroke burden were quantified using standard health equity methods and changes in ischemic stroke burden were projected to 2045. ResultsGlobally, the ASR for ischemic stroke mortality linked to overall dietary metabolic risk declined by an average of 1.6% annually, while the ASR for disability-adjusted life years saw an average annual decrease of 1.3%. High systolic blood pressure remained a primary contributor to metabolism-related ischemic stroke, accounting for 57.9% of deaths and 58.0% of disability in 2021. Disparities associated with the sociodemographic index (SDI) diminished, with the gap in DALYs between countries with the highest and lowest SDIs narrowing from 592.2 (95% CI: 440.2-744.4) to 480.4 (95% CI: 309.7-651.2) in 2021. Projections indicate a continued decline in overall metabolism-related ischemic stroke deaths, mortality rates, and ASRs through 2045, although an increase in DALYs and ASRs is anticipated within the male population. ConclusionThe global burden of metabolic risk-associated ischemic stroke has generally been decreasing from 2019 to 2021. This study highlights significant challenges in controlling and managing metabolic risk-associated ischemic stroke, including an increase in the number of cases in certain countries and regions, as well as an uneven distribution worldwide. These findings may provide valuable insights for the development of improved public health policies and the rational allocation of healthcare resources.

Temporal trends of cancer incidence rates for the most frequent cancer sites in Cyprus (2004-2017).

Cancer is one of the leading causes of morbidity and mortality, worldwide. Little information is available for the temporal trends of cancer in the Mediterranean region, including Cyprus. We aimed to analyze cancer incidence trends overall and by sex for the period 2004-2017 regarding the five most common cancer sites for the population of Cyprus. Data were obtained from the nationwide cancer registry dataset that included 27 017 total cancer cases in Cyprus (2004-2017). We estimated the crude, sex-, and age-specific, as well as age-standardized (ASR) cancer incidence rates and we analyzed the time trends of ASR using the joinpoint regression program. For the general population (0-85+ years of age), the most common cancer sites in descending order, were breast, prostate, lung, colorectal, and thyroid cancer. During the study period, breast and thyroid cancer ASR presented a significant (p < .05) increasing temporal trend. Lung cancer ASRs seemed to stabilize (no increase or decrease) during the more recent years (2009 onwards) for both sexes; a similar pattern was observed for colorectal cancer in males. The ASRs of prostate cancer in men were in steady decline from 2012 onwards and the same was observed for the female ASRs of colorectal cancer from 2007 onwards. The colorectal cancer ASR temporal patterns overall, during the whole study period appeared unchanged. This temporal analysis would feed into cancer surveillance and control programs that focus on prevention, early detection, and treatment, particularly for cancer sites of higher mortality rates or those with temporally increasing trends.

Global, regional and national burdens of reproduction-related congenital birth defects, 1990-2019.

Reproduction-related congenital birth defects (RCBDs), including Klinefelter syndrome (KS), Turner syndrome (TS), and urogenital congenital anomalies (UCA), can lead to severe physical and psychosocial disorders. The global impact of RCBDs on children and adults is unknown, which limits high-quality development of populations and increases in life expectancy per capita. Annual incidence rates, prevalence rates (PR), and disability-adjusted life year (DALY) rates were collected for KS, TS, and UCA for 204 countries and territories, including at birth, for children younger than 1 year, and age-standardized (AS) for all ages. Linear regression was used to calculate their estimated annual percentage changes (EAPCs). Finally, the relationships between EAPCs of each indicator and sociodemographic index (SDI) was investigated using Pearson correlation analysis. Globally, the age-standardized prevalence rate (ASPR) trend is decreasing in KS and TS and increasing in UCA. The DALY rates for children younger than 1 year were on a downward trend in KS and UCA, while they were still rising for TS. The AS-DALY rates were all on a downward trend in KS, TS, and UCA. The DALY rates of KS, TS and UCA were found higher in high-income countries in North America. In addition, the burdens of TS and UCA went down with increasing SDI, whereas the burden of KS increased with increasing SDI. The global burdens of RCBDs have decreased since 1990. This finding can help policymakers implement cost-effective interventions to reduce the burdens of RCBDs.

Evolving trends in prostate cancer: Disparities across income levels and global regions (1990-2019).

25 Background: Prostate Cancer, the third most commonly diagnosed cancer in 2020 and the fifth leading cause of cancer mortality worldwide, has exhibited significant disparities in global prevalence and impact over recent decades. This study assesses the trends in incidence, mortality, and disability-adjusted life years from prostate cancer in the World Bank regions based on country income levels from 1990 to 2019. Methods: The Global Burden of Disease Study database was used to extract Age-standardized incidence rates (ASIR), age-standardized (ASDR), and life years (DALYs) for prostate cancer from different World Bank regions based on income levels from 1990 to 2019. Annual percentage change was also acquired. Mortality-to-incidence ratios (MIR) were then computed. Trends were assessed using Joinpoint regression. Results: Between 1990 and 2019, ASIRs increased across all income levels, with the greatest growth in the upper middle income (+64.7%). While ASDRs decreased in high income, upper middle income, and lower middle income levels, they notably increased in low income levels (+14.3%). DALYs decreased in high income and upper middle income levels, primarily in the high income (-25.7%), and increased in lower middle and low income levels, primarily in the low income (+13.8%). MIRs decreased in all countries, with the largest decrease in high income levels (-50%). In the last 30 years, high income countries have consistently observed the highest ASIR (2019: 77.5/100,000). However, in 1990 high income countries also had the highest ASDRs and DALYs. Interestingly, by 2019 this pattern shifted, with low income surpassing high income countries in both. Conclusions: Over the last 30 years, the incidence of prostate cancer has been rising regardless of income level. Despite the universal decrease of MIRs implying improved outcomes, screening, and therapeutical strategies, the contrasting trends in ASDRs and DALYs across income levels underscore the disparities in health outcomes. Higher income countries experienced highest cancer incidence but also the highest decrease in the mortality rates while lower income countries faced the opposite challenges with lower increase but higher mortality rates. [Table: see text]

Hypopharynx Cancer Incidence in Kazakhstan: 2017-2021.

The article studies the geographical features of the incidence of hypopharynx cancer (HPC) in Kazakhstan. The retrospective study was done for the period 2017-2021. Descriptive and analytical methods of ecoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), equalized incidence rates and approximation were calculated. The dynamics of indicators was investigated using component analysis according to methodological recommendations. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. During the study period, 814 new cases of HPC were registered. The incidence rate decreased from 0.898 (2017) to 0.895 in 2021 and the overall decline was 0.003 per 100,000 population, including due to the age structure - ∑ΔA=+0.04, due to the risk of acquiring illness - ∑ΔR=-0.05 and their combined effect - ∑ΔRA=+0.01. The component analysis revealed that the increase in the number of patients with HPC was mainly due to the growth of the population (ΔP=+37.0%), changes in its age structure (ΔA=+106.1%) and changes associated with the risk of acquiring illness (ΔR=-133.4%). The cartograms were allocated according to the following criteria: low - up to 0.730/0000, average - from 0.73 to 1.180/0000, high - above 1.180/0000. The results of the spatial assessment showed the highest levels of HPC incidence in following regions: Atyrau (1.960/0000) and West Kazakhstan (1.580/0000). Thus, this is the first epidemiological study of HPC, which assessed the role of the influence of various factors, including demographic and risk of acquiring illness, on the dynamics of incidence, taking into account gender differences and geographical variability.

Abstract 16465: Cardiovascular Disease Burden in the Middle East and North Africa Region

Introduction: Cardiovascular disease (CVD) remains the leading cause of death globally, including the Middle East and North Africa (MENA) region. However, limited research has been conducted on the burden of CVD in this region. Hypothesis: Our study aims to investigate the burden of CVD and related risk factors (RFs) in the MENA. Methods: We used data from the Global Burden of Disease (GBD) 2019 to examine CVD prevalence in 21 MENA countries. Prevalence, mortality, and incidence were analyzed using Bayesian regression tools, demographic methods, and mortality-to-incidence ratios. Disability-adjusted life years (DALYs) were calculated, and RFs were evaluated under the GBD's comparative risk assessment framework. Results: Between 1990 and 2019, CVD prevalence in the MENA increased by 140.9%, while age-standardized (AS) prevalence slightly decreased (-1.3%). CVD mortality rose by 78.3%, but AS death rates fell by 28.01%. Ischemic heart disease remained the most prevalent condition, with higher rates in men, while women had higher rates of CVA. All-age DALYs increased by 53.3%, but AS DALYs decreased by 32.54%. DALY rates varied across countries and were consistently higher in males. Leading RFs included HTN, high LDL, dietary risks, and elevated BMI. Conclusions: The ongoing impact of CVD in the MENA region necessitates targeted interventions that address country-specific variations, including socio-economic factors, healthcare infrastructure, and political stability. To effectively reduce the burden of CVD in MENA, it is crucial to focus on targeting risk factors and implementing effective strategies.

Geographic Variability of Gastric Cancer Incidence in Kazakhstan.

Objective:The article studies the geographical features of the incidence of gastric cancer (GC) in Kazakhstan. Methods:The retrospective study was done for the period 2009-2018. Descriptive and analytical methods of oncoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), equalized incidence rates and approximation were calculated. The dynamics of indicators was investigated using component analysis according to methodological recommendations. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. Results:During the study period, 27,467 new cases of GC were registered. The incidence rate increased from 16.80 (2009) to 15.10 in 2018 and the overall decline was 1.70 per 100,000 population, including due to the age structure – ∑ΔA=+1.51, due to the risk of acquiring illness – ∑ΔR=−2.91 and their combined effect – ∑ΔRA=−0.31. The component analysis revealed that the increase in the number of patients with GC was mainly due to the growth of the population (ΔP=+651.8%), changes in its age structure (ΔA=+433.9%) and changes associated with the risk of acquiring illness (ΔR=−832.1%). The cartograms were allocated according to the following criteria: low – up to 14.80/0000, average – from 14.8 to 19.20/0000, high – above 19.20/0000. The results of the spatial assessment showed the highest levels of GC incidence in following regions: Akmola (22.20/0000), North Kazakhstan (22.30/0000), and Pavlodar (23.20/0000). Conclusion:Thus, as a result of the epidemiological analysis, the role of the influence of demographic factors and the risk of acquiring illness on the formation of the number of patients and the incidence of GC was evaluated, while sex differences and geographical variability were established.

Breast Cancer Incidence in Kyrgyzstan: Report of 15 Years of Cancer Registry.

Objective:The epidemiological features of the breast cancer (BC) incidence in Kyrgyzstan were studied.Methods:The retrospective study (2003-2017). Descriptive and analytical methods of oncoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), equalized incidence rates and approximation were calculated. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. Results:During the study period, 7,850 new cases of BC were registered. The average annual crude and age-standardized incidence rate were 18.8±0.5 and 24.0±0.5 cases per 100,000 population of female, respectively, and their trends tended to increase (Т=+1.0%; R2=0.242 and Т=+0.2%; R2=0.015, respectively). The analysis of ASIR showed unimodal growth with a peak at 60-64 years – 85.9±4.9 cases per 100,000 population of female. ASIR trends decreased in the age groups of 40-59 years, and the most pronounced decrease was in 50-54 years (T=−1.5%; R2=0.391), in other age groups the trend increased and were most pronounced up to 30 years (T=+4.4%; R2=0.180). Trends in ASR of BС tended to grow in almost all regions, with higher levels in Osh (Т=+3.6%; R2=0.665) and Jalal-Abad (Т=+3.8%; R2=0.551) regions. The cartograms of ASR per 100,000 population of female were allocated according to the following criteria: low – up to 17.2, average – from 17.2 to 26.5, high – above 26.5. The results of the spatial analysis showed the regions with a higher levels of BC incidence rate per 100,000 population of female: Chuy (31.3), Osh city (27.1) and Bishkek city (39.2). Conclusion:The study of the epidemiological spatio-temporal features of the incidence of breast cancer is of both theoretical and practical interest and plays an important role in monitoring and evaluating anticancer activities.

The incidence of skin melanoma in Gran Canaria (Canary Islands, Spain) is lower than expected in Southern Europe despite high-risk environmental conditions: an island-wide cross-sectional study

The Canary Islands are a leading European touristic destination. The ultraviolet index (UVI) in the region is the highest in Spain, and similar to indexes registered in Australia and New Zealand, which hold the highest incidence of skin melanoma worldwide. Yet according to cancer registry data, the incidence in the Canary Islands in the late 1990s was the lowest in Spain (among the lowest in Europe) and about six times lower than in New Zealand. To analyze the incidence rates of skin melanoma in Gran Canaria island between 2007 and 2018. The study was based in the two centres of the Canary Islands' Healthcare Service centralizing melanoma care in Gran Canaria. We analyzed crude and age-standardized (ASR) incidence rates of invasive cutaneous melanoma for the period 2007-2018 following the inclusion criteria of the International Agency for Research on Cancer (IARC). Clinical and histological characteristics of melanoma patients were assessed. A total of 1058 patients were included. The incidence rates obtained matched the latest available Canary Islands' cancer registry data, confirming its reliability (ASR, Segi-Doll world standard population: 6.4 cases per 100,000 habitants for 2008-2012). The incidence was also below the latest IARC predictions for Southern Europe (GLOBOCAN 2018). Histological characteristics of patients were similar to other Southern European series. The incidence of skin melanoma in Gran Canaria is unexpectedly low for a Southern European population exposed to such a high UVI. Further research in the Canary Islands could provide insight into a better understanding of melanoma pathogenesis.

Association of Processed Meats and Alcohol Consumption with Renal Cell Carcinoma: A Worldwide Population-Based Study

The link between diet and renal cell carcinoma (RCC) is still unclear. The purpose of this study was to evaluate the association of diet with RCC’s incidence and mortality rates worldwide. We conducted an ecological study including 170 countries, whose data on age-standardized (AS) incidence and mortality rates of RCC, dietary factors, and potentially confounding factors such as obesity, insufficient physical activity, tobacco smoking, hypertension, diabetes, and human development index (HDI) were collected and available on May 2020 from the Global Cancer Observatory, the Global Dietary Database, the Global Health Observatory data repository, the Diabetes Atlas 9th edition and the Human Development Report 2019. Univariable and multivariable linear regression analyses were performed to determine the association of dietary factors with incidence and mortality rates of RCC adjusted for the effects of population age and potentially confounding factors. Intake of processed meats and consumption of alcohol were both positively associated with AS incidence rates of RCC (β = 0.11, P < 0.001 and β = 0.1, P = 0.044, respectively). We suggest that high consumption of processed meats and/or alcohol is a risk factor for RCC. However, they were not associated with mortality. Further research is needed at an individual level. Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2020.1856388.

Statistical analysis of incidence and mortality of prostate cancer in China, 2015

Objective: To estimate the incidence and mortality rates of prostate cancer in China in 2015. Methods: The data from 501 cancer registries in China collected by the National Cancer Center were reviewed and evaluated, and the qualified data were included in the final analysis. According to the national population data in 2015, the nationwide incidence and mortality of the prostate cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: After data review, the data reported by 368 registries were included in the final analysis, covering a total population of 309 553 499, accounting for 22.52% of the national population at the end of 2015. There were 72 thousand new prostate cancer cases estimated in China in 2015, with a crude incidence rate of 10.23/100 000. The ASR China and ASR world are 6.59/100 000 and 6.47/100 000, respectively, which is the sixth incidence of male malignant tumor.The estimated number of prostate cancer death was 3.07 thousand in China in 2015, with a crude mortality rate of 4.36/100 000; The ASR China and ASR world mortality rates were 2.61/100 000 and 2.65/100 000, respectively, which is the tenth leading cause of death in male malignant tumor.The ASR China incidence and mortality of prostate cancer in males were higher in urban areas (8.40/100 000 and 3.11/100 000) than those in rural areas (4.16/100 000 and 1.90/100 000). The incidence and mortality rates in the eastern areas (8.54/100 000 and 2.99/100 000) were higher than those in the central (5.28/100 000 and 2.34/100 000) and western areas (5.32/100 000 and 2.37/100 000) of China. Conclusions: The incidence and mortality rates of prostate cancer in China are lower than the global average, but there is an increasing trend. The incidence and mortality of prostate cancer in China have obvious regional differences.

Analysis of incidence and mortality of esophageal cancer in China, 2015

Objective: To estimate the incidence and mortality rates of esophageal cancer in China in 2015. Methods: Based on the data quality review and assessment, the esophageal cancer data from 368 cancer registries in 31 provinces (autonomous regions and municipalities) in China were included in this study. According to the national population data in 2015, the nationwide incidence and mortality of the esophageal cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: The 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. There were 245 651 new esophageal cancer cases estimated in China in 2015, with a crude incidence rate of 17.87/100 000. The ASR China and ASR world were 11.14/100 000 and 11.28/100 000, respectively. The estimated number of esophageal cancer death was 188 044 in China in 2015, with a crude mortality rate of 13.68/100 000; The ASR China and ASR world mortality rates were 8.33/100 000 and 8.36/100 000, respectively. The ASR China incidence and mortality of esophageal cancer in males were higher in males (16.50/100 000 and 12.66/100 000) than those in females (5.92/100 000 and 4.17/100 000), and they were higher in rural areas (15.95/1100 000 and 11.67/100 000) than those in urban areas (7.59/100 000 and 5.87/100 000). Conclusion: The incidence and mortality of esophageal cancer in China are higher than the global average. The disparity of the incidence and mortality rates of esophageal cancer significantly differed in genders and areas.

Renal cell carcinoma trends in Latvia: incidence, mortality, and survival rates. Population-based study.

IntroductionBaltic States including Latvia are reported as having one of the highest renal cell carcinoma (RCC) incidence and mortality rates in the world. However, data are often presented without stage-specific stratification, making assessment of the overall RCC diagnosis and survival trends challenging.Material and methodsWe collected data on all newly diagnosed RCC patients from the national population-based cancer registry between 1997 and 2016. We analyzed RCC incidence, mortality and survival trends using Joinpoint analysis. Kaplan-Meier analysis was performed for 5- and 10-year cancer specific survival rate calculations.ResultsThere were a total of 7893 patients with newly diagnosed RCC. The age standardized (AS) incidence rate (per 100,000) increased slightly from 8.9 in 1997 to 9.8 in 2016. There were no specific changes in the incidence rate trend. Detection of early stage RCC increased by 5.4% annually. The AS mortality rates (per 100,000) decreased from 4.9 in 1997 to 3.9 in 2016, however, it did not reach a statistically significant change. The mortality rates decreased significantly in females and in the age group of 60-69 years. The 5-year cancer specific survival (CSS) rate increased from 55.1% in 1997-2001 to 66.6% in years 2007–2011. The 10-year CSS rate increased from 49.1% in 1997–2001 to 56.5% in years 2002–2006.ConclusionsDuring the study period, RCC incidence rates increased and overall mortality rates did not change. Similar to the rest of the world, the incidence of RCC diagnosed at an earlier stage increased and 5- and 10-year survival rates improved.

Changes in health in Belgium, 1990\u20132016: a benchmarking analysis based on the global burden of disease 2016 study

BackgroundDespite increasing of the Belgian health expenditures, several indicators related to population health showed poor results. The objectives of this study were to perform an in-depth analysis of the secular trend of Belgian health status using the Global Burden of Disease (GBD) 2016 study results for Belgium, and to compare these results with other European countries.MethodsWe collected results of the Global Burden of Disease 2016 study through the GBD results and visualization tools. We benchmarked Belgian GBD results with the other initial members of the European Union (EU15).ResultsBelgium performed significantly better in 2016 than in 1990 in terms of age-standardized (AS) Year of Life Lost (YLL) rates but not significantly different in terms of AS Year Lived with Disability (YLD) and Disability-Adjusted Life Year (DALY) rates. The contribution of AS YLDs to total of AS DALYs increased from 1990 (42%) to 2016 (54%). Although AS YLD and DALY rates did not seem to differ between Belgium and the EU15 from 1990 to 2016, the ranking of Belgium among the EU15 in terms of AS DALY and YLL rates was worse in 2016 than in 1990. Belgium had significantly higher AS YLL rates for lower respiratory infections (B: 264 AS YLLs [95% uncertainty interval [UI] 231–301] per 100,000; EU15: 188 AS YLLs [95%UI 168–212] per 100,000), chronic obstructive pulmonary disease (B: 368 AS YLLs [95%UI 331–407] per 100,000; EU15: 285 AS YLLs [95%UI 258–316] per 100,000) and tracheal, bronchus, and lung cancer (B: 785 AS YLLs [95%UI 699–879] per 100,000; EU15: 613 AS YLLs [95%UI 556–674] per 100,000).ConclusionBelgium’s ranking among the EU15 in terms of AS YLL and DALY rates decreased from 1990 to 2016. Significant health gains appear possible by acting on risk factors directly linked to a significant part of the Belgian burden of diseases, i.e., alcohol and tobacco consumption, and high body mass index. National burden of disease estimates can help defining Belgian health targets and are necessary as external validity of GBD results is not always guaranteed.

TIME TRENDS OF RECTAL CANCER INCIDENCE AND MORTALITY: A POPULATION-BASED STUDY FROM THE ARKHANGELSK REGIONAL CANCER REGISTRY

Aim. Assessment of the rectal cancer (RC) incidence and mortality in the Arkhangelsk region (AR), North-Western Russia according to population-based data of the Arkhangelsk Regional Cancer Registry (ARCR) over the period 2000-2015. Methods. Data on all cases of RC in the AR were extracted from the database of the ARCR. 3 721 cases of the RC were selected. For mortality estimation 2 187 cases of RC were taken over the study period. Age-standardized (ASR) RC rates were calculated. Population number and its age distribution were taken from the Regional Bureau of Statistics, Arkhangelskstat. Time trends were analyzed using segmented regression. Results. Incidence of RC in AR increased from 11.5 to 14.2 per 100 000; 18.6 vs 11.8 among men and women in 2015, respectively. The female RC incidence increased significantly by 4.6 % per year in 2011-2015. The incidence of both urban and rural populations was 11.8 and 18.7 per 100 000 in 2015, respectively. Mortality estimates ranged from 10.0 to 12.2 per 100 000 in 2005-2015, respectively. Mortality among males was higher than in females - 19.9 vs 8.4 per 100 000 in 2015, respectively. The trend of male mortality significantly increased by 6.5 % per year in 2011-2015, while in females the mortality has been decreasing by 0.7% per year from 2009 to 2015. Conclusion. Epidemiological model for RC in both AR and Russia shows progressively increasing incidence and mortality rates and substantially differs from that in developed countries. A higher incidence rates among males and rural population require detailed analysis.

POPULATION-BASED ASSESSMENT OF THE RECTAL CANCER STAGE STRUCTURE AND INCIDENCE AFTER IMPLEMENTATION OF THE NATIONAL PROJECT “HEALTH” AND ALL-NATIONAL DISPENSARIZATION IN THE ARKHANGELSK REGION, RUSSIA (THE RESULTS OF THE PRELIMINARY STUDY)

Objective. Assessment of the rectal cancer (RC) incidence and stage structure trends in the Arkhangelsk region (AR), Russia before and after implementation of national programs for health system reforming based on population data of the Arkhangelsk Regional Cancer Registry (ARCR) over the period 2000–2015.Materials and methods. Anonymized data on all cases of RC (C19.0‑C21.0) in the AR in 2000–2015 were extracted from the database of the ARCR. Over the study period, 3721 cases of the RC were selected. Age-standardized (ASR) RC incidence rate was calculated. Population number and its age distribution were taken from the Regional Bureau of Statistics, Arkhangelskstat. Time trends were analyzed using segmented regression.Results. Over the period, an incidence (ASR) of RC in AR increased from 11.5 to 14.2 per 100000. The incidence rates in the male population were higher than in women: 20.3 vs 12.6 in 2015. The growing trend of male incidence was stable. The ASR of RC incidence in female increased significantly by 4.6% per year in 2011–2015. RC ASRs for both urban and rural populations were growing, 12.3 and 20.4 per 100000 in 2015, respectively. StagesI, II, III and IV were established in 14%, 50%, 9% and 21% of cases, however, the stage I in urban residents was detected 4% more often. The proportion of stage I non-significantly varied from 10.6% to 13.3% in 2000–2015. After the introduction of the National Project “Health”, the proportion of the stage IV non-significantly decreased by 5.4% per year, same after the introduction of the All-national Dispensarization it non-significantly increased by 5.4% per year.Conclusion. Implementation of national programs for health system reforming didn’t provide significant improvement in earlier detection of RC. Introduction of national screening programs is necessary. A higher incidence rates among males and rural population require detailed analysis.

Cancer Incidence and Mortality: District Cancer Registry, Trivandrum, South India

Background:Cancer is emerging as a major cause of morbidity and mortality in low and middle-income countries. Cancer registry figures help for planning and delivery of health services. This paper provided the first results of cancer incidence and mortality [Crude (CR) and age-standardized (ASR)] rates (world-standard population) of Trivandrum district, South India and compared with other registries under the network of National Cancer Registry Programme (NCRP), Government of India.Materials and Methods:Trivandrum district cancer registry encompasses a population of 3.3 million, compiles data from nearly 75 sources (hospitals and diagnostic laboratories) and included under the NCRP in 2012. During 2012-2014, registry recorded 15,649 incident cases and 5667 deaths. Proportion of microscopic diagnosis was 85% and ‘Death certificate only’ was 8%.Results:Total cancer incidence (CRs) rates were 161 and 154 (ASR: 142.2 and 126) and mortality rates were 66 and 49 (ASR: 54 and 37) per 105 males and females respectively. Common cancers in males were lung (ASR: 19), oral cavity (ASR: 15), colo-rectum (ASR: 11.2), prostate (ASR: 10.2) and lymphoma (ASR: 7) and in females, breast (ASR: 36), thyroid (ASR: 13.4), cervix-uteri (ASR: 7.3), ovary (ASR: 7) and colo-rectum (ASR: 7). Nationally, the highest CRs for breast, prostate, colo-rectum, corpus-uteri and urinary bladder cancers and low incidence of cervix-uteri cancer were observed in Trivandrum.Conclusion:Cancer incidence (CR) in Trivandrum was the highest in both genders in India (except Aizwal). This is mainly due to the highest life-expectancy in Kerala. Also, an epidemiologic transition in cancer pattern is taking place and is changing to more similar to “western” jurisdictions.

Bedside cardiovascular maternal interrogation in the first trimester to predict different phenotypes of hypertensive disorders in pregnancy.

The aim is to evaluate if maternal cardiovascular indices, in the first trimester of pregnancy, might be useful to differentiate women who develop different hypertensive disorders of pregnancy (HDP). Method: 1399 pregnant women attending screening for chromosomal aneuploidies were recruited. The following parameters were measured: Doppler Velocimetry of uterine arteries; Peripheral blood pressure; Aortic Pressure derived from applanation tonometry. Primary outcome were: women who developed HDP associated with newborns with an appropriate weight for local gestational age standards (AGA) and women that developed HDP associated with a newborn weight below the 10th centile (SGA). Mean UtA PI was significantly higher in the HDP-SGA compared with controls. HDP-AGA showed a higher rate of family history of hypertension and a higher BMI. In HDP-AGA Brachial and Aortic mean pressure were higher than controls. The most significant contributors for all forms of HDP were mean UtA PI for HDP-SGA and mean arterial blood pressure for HDP-AGA. The multivariate logistic regression for HDP-SGA shows an AUC 0.88, whereas the AUC for the prediction of HDP-AGA group was 0.71. HDP-SGA were characterized by significantly higher values of UtA-PI, whereas HDP-AGA by mean aortic and brachial pressure and risk factors for endothelial dysfunction.

Abstract P3-07-15: Recent changes in breast cancer incidence and mortality trends in Mexico: A population-based study

Abstract Background: Breast cancer (BC) is the most common malignancy in Mexican women since 2006, with a high number of cases reported in the more developed northern states. However, the analysis of national BC incidence in Mexico has not been previously reported. We sought to describe BC trends in Mexico using recent population-based data and to analyze geographical differences in BC incidence and mortality rates. Methods: This population-based retrospective cohort study included all incident BC cases registered in the National Epidemiological Surveillance System and all BC deaths registered by the National Institute of Statistics and Geography in Mexico from 2001 to 2011. Yearly populations were obtained from national census data. The age-standardized (AS) incidence rate of BC was calculated using the female population over 15 years of age and standardized to the World Standard Population. AS incidence rates were calculated for 3 geographic regions of the country (North, Center and South). Joinpoint regression analysis was performed to examine trends in BC incidence and mortality. We estimated annual percentage change (APC) using weighted least squares log-linear regression. Results: From 2001 to 2011, 69,651 new cases of BC were registered in Mexico. The AS incidence of BC significantly increased, rising from 14.2/100,000 person-years (PY) (Standard Error [SE] 0.23) in 2001, to 25.2/100,000 PY (SE 0.25) in 2011, with an APC of 5.9% (95% CI 4.1-7.7, p&amp;lt;0.05). Regional AS incidence rates were significantly increased in the Center and in the South, with a non-significant increase in the North (Table 1). For the same period, 48,817 deaths attributed to BC were registered. AS mortality rate also had a significant increase, rising from 14/100,000 PY (SE 0.23) in 2001 to 14.6/100,000 PY (SE 0.2) in 2011, with an APC of 0.4% (95% CI 0.1-0.7, p&amp;lt;0.05). Regional AS mortality rates were significantly increased in all three regions (Table 1). Table 1. Regional BC incidence and mortality ratesRegion2001 AS rate per 100,000 PY (SE)2011 AS rate per 100,000 PY (SE)APC% (95% CI)pSouthIncidence6.1 (0.42)16.57 (0.53)10.5 (6-15.2)&amp;lt;0.05Mortality7.8 (0.46)9.56 (0.43)2 (1-3.2)&amp;lt;0.05CenterIncidence12.9 (0.27)26.9 (0.33)7.6 (5.7-9.6)&amp;lt;0.05Mortality14 (0.29)14.4 (0.25)0.3 (0-0.6)&amp;lt;0.05NorthIncidence24.2 (0.64)26.8 (0.54)1 (-1.6-3.7)NSMortality17.6 (0.57)18.8 (0.48)0.7 (0-1.3)&amp;lt;0.05 Conclusions: BC trends in Mexico show a continuous increase in incidence and mortality from 2001 to 2011, which could reflect population growth, ageing, lifestyle modifications and changes in access to diagnosis and treatment. These changes could be an expression of epidemiological transition in developing countries such as Mexico. A significant growth in both incidence and mortality was found in both the Center and the South. In the North, incidence rates remained unchanged while mortality rates had a significant rise, which was comparable to that of the other regions. One possible unexplored explanation for this observation could be the recent wave of drug-related violence and high criminality rates in the north of the country, which may perhaps cause underreporting of cases and disrupt availability of medical attention and access to healthcare in an otherwise developed and wealthy region. Citation Format: Enrique Soto-Perez-de-Celis, Alejandro Mohar, Yanin Chavarri-Guerra. Recent changes in breast cancer incidence and mortality trends in Mexico: A population-based study [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-07-15.

Trend Analysis of Gastrointestinal Cancer Incidences in Guilan Province: Comparing Rates over 15 Years

Cancers of gastric and esophagus are the most frequent gastrointestinal (GI) tract cancers in Iran. This study aimed to analyze time trends of GI tract cancers in Guilan province by gender and age to provide solid scientific evidence for cancer prevention and control. The data were obtained from the Guilan Cancer Registry System and Guilan Provincial Health Center, over the 15 year period between 1997 and 2011. Crude incidence and age standardized (AS)incidence rates were calculated and annual percent change was estimated by Joinpoint software for long term trend analysis. During the study period, 8,332 cases of GI malignances with a male to female ratio of 1:1.73 were registered in Guilan province. The AS rates for esophageal, gastric, colon and rectal cancers were 5.97, 14.5, 7.59 and 3.58 per 105 respectively. While the trend was declining and relatively constant for esophageal and gastric cancer, respectively, the incidence trend for colon and rectal cancers was of increase over the period of the study. The results indicated that the incidence of GI cancers was relatively low in Guilan province compared to neighboring provinces. An effective cancer control program including prevention measures, early detection and effective treatment needs to be implemented to reduce cancer morbidity and mortality.