Annual Age-adjusted Incidence Rates Research Articles

Partnership for defining the impact of 12 selected rare CNS tumors: a report from the CBTRUS and the NCI-CONNECT.

Population-based cancer statistics, including histology-specific incidence, prevalence, and survival are essential to evaluating the total burden due to disease in a population. The National Cancer Institute's (NCI) Comprehensive Oncology Network Evaluating Rare CNS Tumors (NCI-CONNECT) was developed to better understand tumor biology and patient outcomes for 12 selected brain and other central nervous system (CNS) tumor histologies that are rare in adults to improve approaches to care and treatment. The aim of this study was to determine the incidence, prevalence, and survival of these selected rare histologies. Data from the Central Brain Tumor Registry of the United States (CBTRUS) from 2000 to 2014 were used to calculate average annual age-adjusted incidence rates (AAIR) per 100,000 population overall and by sex, race, ethnicity, and age. NCI's Surveillance, Epidemiology and End Results (SEER) data were used to calculate relative survival (RS) estimates. Point prevalence for 2014 was estimated using annual age-specific incidence and survival from CBTRUS and SEER, respectively. Overall AAIR was 1.47 per 100,000 for all 12 rare histologies combined, with the highest histology-specific incidence in oligodendrogliomas (AAIR = 0.40/100,000). Overall, most histologies were more common in males, adults (age 40 + ), Whites, and non-Hispanics. Ependymomas were the most prevalent histology at 4.11 per 100,000; followed by oligodendrogliomas at 3.68 per 100,000. Relative survival at 1-, 5-, and 10-years was 82.3%, 64.0%, and 55.4%, respectively for all 12 selected brain and other CNS tumor types combined. Ependymomas had the highest RS (1-year = 94.2%, 5-year = 83.9%, 10-year = 78.6%) and gliosarcomas had the lowest relative survival rate (1-year = 42.5%, 5-year = 5.6%, 10-year = 2.9%) at all three time points. Incidence and prevalence of these rare brain and other CNS tumor histologies have not been previously reported. Along with survival, these data provide a statistical foundation to understand the impact of these cancers and provide important disease-specific data for the design of prospective clinical trials.

Glioma incidence and survival variations by county-level socioeconomic measures.

Multiple studies have reported higher rates of glioma in areas with higher socioeconomic status (SES) but to the authors' knowledge have not stratified by other factors, including race/ethnicity or urban versus rural location. The authors identified the average annual age-adjusted incidence rates and calculated hazard ratios for death for gliomas of various subtypes, stratified by a county-level index for SES, race/ethnicity, US region, and rural versus urban status. Rates of glioma were highest in counties with higher SES (rate ratio, 1.18; 95% CI, 1.15-1.22 comparing the highest with the lowest quintiles [P<.001]). Stratified by race/ethnicity, higher rates in high SES counties persisted for white non-Hispanic individuals. Stratified by rural versus urban status, differences in incidence by SES were more pronounced among urban counties. Survival was higher for residents of high SES counties after adjustment for age and extent of surgical resection (hazard ratio, 0.82; 95% CI, 0.76-0.87 comparing the highest with the lowest quintile of SES [P<.001]). Survival was higher among white Hispanic, black, and Asian/Pacific Islander individuals compared with white non-Hispanic individuals, after adjustment for age, SES, and extent of surgical resection, and when restricted to those individuals with glioblastoma who received radiation and chemotherapy. The incidence of glioma was higher in US counties of high compared with low SES. These differences were most pronounced among white non-Hispanic individuals and white Hispanic individuals residing in urban areas. Better survival was observed in high SES counties, even when adjusting for extent of surgical resection, and when restricted to those who received radiation and chemotherapy for glioblastoma. Differences in incidence and survival were associated with SES and race, rather than rural versus urban status.

Integrated West Nile Virus Surveillance in Harris County, Texas, 2003 to 2018

ObjectiveThis abstract aims to: 1) describe human WNV infections in Harris County excluding the City of Houston, Texas, 2003 to 2018; 2) explore geographical distributions of WNV positive mosquito pools in relation to human cases; 3) provide a brief overview of the county’s rigorous multidisciplinary WNV surveillance and control in mosquitoes and humans.IntroductionWest Nile virus (WNV) is the leading cause of autochthonous arboviral disease in the United States1. The virus is primarily spread to people through the bite of infected Culex species of mosquitos. WNV was first identified in Harris County, Texas, in 20022. Since then, the mosquito-borne virus has become endemic in the region, with surges in 2012 and 2014. Although majority of individuals infected are asymptomatic, WNV induced neuroinvasive infections often result in hospitalizations and adverse outcomes3-7, thus may pose a significant concern in public health and healthcare. The Harris County Public Health (HCPH) Surveillance and Epidemiology Unit (SEU) conducts surveillance of WNV in humans, in collaboration with Mosquito and Vector Control Division (MVCD) that monitors the virus in mosquito populations and birds. Mosquito abatement activities are implemented in areas where positive mosquitoes and human cases are identified. In this integrated model, clusters of WNV positive mosquito pools in relation with human cases provide comprehensive surveillance data to guide targeted efforts of mosquito control, disease prevention, and community education.MethodsSurveillance data of human WNV cases and WNV tested mosquito pools 2003 to 2018 in Harris County excluding the City of Houston were used for the analysis. Human cases included were confirmed and probable cases. Frequencies, percentages, age-adjusted annual average rates were used to describe the data. Geographical locations of WNV positive mosquito pools and human cases were mapped and analyzed using ESRI ArcGIS to determine the spatial relationship between the positive mosquito pools and human cases. Space-Time analysis was performed on 16 years of human disease data using Scan statistics in SatScan™ to test the effect of time and identify significant geographical clusters of WNV cases over time, which revealed a statistically significant cluster in 2012 to 2014 in northwest of Harris County. Subsequently, human cases and WNV positive mosquito pools of 2012 to 2014 were selected for hotspot analysis to verify the results from Satscan analysis and visualize the geographical cluster. Human cases were aggregated into census tracts and analyzed by optimized hotspot method; the positive mosquito pools were geocoded using their intersection locations and analyzed by ESRI Getis-Ord Gi hotspot method.ResultsFrom 2003 to 2018, a total of 295 confirmed and probable human WNV cases were identified, including 217 neuroinvasive and 78 fever cases. The median age of patients was 58 years old; 64.8% were male. The onset of majority of the cases (80.7%) concentrated in July to September. Among case-patients, 72.9% were hospitalized, and 3.4% died. The annual average age-adjusted incidence rate of WNV was 0.7 per 100,000 during 2003 to 2018. However, the rate was 1.8 and 2.7 per 100,000 in 2012 and 2014, respectively. Over 68% of the cases clustered in west and northwest of the county.The annual WNV positive mosquito pools ranged from 0.2% to 10.2% amongst the years. The number of WNV positive mosquito pools in 2014 was more than 4 times higher than the average number during those years, the highest record in the County.Hot spots of human cases and the positive mosquito pools were both identified in northwest Harris County. There was a significant geographical overlap between human cases and the positive mosquito pools.The space-time analysis for the 16 years detected a significant high-risk cluster in 2012 to 2014 in northwest Harris County. Findings from optimized hotspot analysis on human cases are consistent with the results from SatScan analysis. Statistically significant hot spots of positive mosquito pools identified by Getis-Ord Gi hotspot analysis displayed highly overlay with the statistically significant cluster of human cases detected by Satscan space-time analysis.ConclusionsWNV infection is underestimated. Studies suggest that every one case identified represent five infections 8-9. Therefore, the actual number of cases is likely substantially higher. Clinicians should be alerted in WNV season and consider testing and reporting as early as possible, especially in neuroinvasive patients. The public should be encouraged to utilize personal protection, particularly during peak seasons. This analysis shows that GIS mapping and optimized hotspot analysis of WNV human cases in relation to positive mosquito pools can provide statistical evidences of areas most affected, thus inform targeted mosquito control, prevention and education strategies in people living in areas with high virus activitie

Characteristics of 5015 Salivary Gland Neoplasms Registered in the Hiroshima Tumor Tissue Registry over a Period of 39 Years.

Salivary gland neoplasms are uncommon, and their epidemiology in Japan has not been well described. We conducted a retrospective review of salivary gland tumors registered in the Hiroshima Tumor Tissue Registry over a period of 39 years. The subjects were 5015 cases ranging in age from 6 to 97 (mean, 54.3) years old. The incidence of both benign tumors and malignant tumors increased with age until 60–69 years and then declined. Among the 5015 salivary gland neoplasms, 3998 (80%) were benign and 1017 (20%) were malignant. Pleomorphic adenoma (PA) was the most frequent benign tumor (68%), followed by Warthin tumor (26%). Adenoid cystic carcinoma (ACC) (27%) and mucoepidermoid carcinoma (MEC) (26%) were the two most frequent malignant tumors. Characteristically, there was a very low incidence of polymorphous adenocarcinoma in Japan. The average annual age-adjusted incidence rate per 100,000 population was 3.3 for benign tumors and 0.8 for malignant tumors. This is the large-scale multi-institutional analysis to describe the characteristics of salivary gland neoplasms, based on the pathological tissue registry data. We hope that the present data can contribute to early diagnosis and effective treatment of salivary gland tumors and to cancer prevention.

The epidemiology of central and extraventricular neurocytoma in the United States between 2006 and 2014.

Central neurocytoma (CN) and extraventricular neurocytoma (EVN) are rare intracranial tumors. There is a paucity of studies reporting the population-based incidence of these tumors. We used the Central Brain Tumor Registry of the United States (CBTRUS), which contains the largest aggregation of population-based data on the incidence of primary central nervous system tumors in the United States to describe these tumors. The CBTRUS database, provided by CDC representing approximately 100% of the US population, was queried using the following search criteria: diagnosis years 2006-2014, ICD-0-3 histology codes (9506/0: central neurocytoma, benign; 9506/1: central neurocytoma, uncertain). Annual age-adjusted incidence rates are presented per 100,000 population. Incidence was estimated by age, gender, race, and ethnicity. The combined overall annual incidence rate of CN and EVN was 0.032 [0.030-0.034]. The incidence rates were 0.022 [0.021-0.024] and 0.009 [0.008-0.010] for CN and EVN, respectively. The most frequently documented locations for EVN were frontal lobe and cerebellum, followed by temporal lobe. Peak incidence was found in the 20-34years range for both CN and EVN. The incidence rate was slightly lower in males compared to females for CN and identical for EVN. The overall incidence rate of CN and EVN combined was lower in Blacks 0.026 [0.021-0.032] and Hispanic Whites 0.020 [0.016-0.025] compared to Non-Hispanic Whites 0.035 [0.033-0.038]. CN and EVN are rare tumors with a peak incidence in the 20-34years age group. This study represents the largest population-based epidemiological study on CN and EVN in the US.

Twenty-Five Year Trends in the Incidence of Ductal Carcinoma in Situ in US Women

The rising incidence of ductal carcinoma in situ (DCIS) since the widespread enactment of mammography screening has been well documented. Patterns in DCIS incidence among women of various ages and across different racial and ethnic groups have not been well described. The Surveillance, Epidemiology, and End Results public-use data set was queried for all women aged 40 years and older diagnosed with DCIS between 1990 and 2014. Annual age-adjusted incidence rates were compared among white, black, Hispanic, and Asian-Pacific Islander women. Additionally, using mammography screening data obtained from the CDC, patterns in mammography screening over time and as they relate to DCIS incidence rates by race and ethnicity were evaluated. We identified 200,400 women aged 40 years or older with DCIS. Between 1998 and 2014, a period that saw flux in national breast screening guidelines, DCIS incidence rates increased in blacks, Hispanics, and Asian-Pacific Islanders, but remained relatively unchanged in whites (increase in number of DCIS diagnoses per 100,000 individuals in the population per year among blacks+0.66/p < 0.01, Hispanics+3.0/p < 0.01, Asian-Pacific Islanders+0.53/p < 0.01, and whites+0.07/p= 0.21). After accounting for age, year of diagnosis, and mammography screening rates, DCIS incidence was found to be similar between white and black women (0.8 fewer diagnoses per 100,000 individuals compared with whites; p= 0.36) but lower for Hispanic women (9.7 fewer diagnoses per 100,000 individuals compared with whites; p < 0.01). The DCIS incidence rates are influenced substantially by breast cancer mammography screening patterns. However, differences exist by race and ethnicity and are not fully explained by screening mammography trends alone. Consideration should be given to including race and ethnicity in determining optimal breast screening guidelines.

Spatial and temporal characteristics of cancer in the period from 2004 to 2013 in the Hashemite Kingdom of Jordan.

Cancer in Jordan is a major public health problem and the second leading cause of death after heart disease. This study aimed at studying the spatial and temporal characteristics of cancer in Jordan and its 12 governorates for the period 2004-2013 to establish a baseline for future research and identification of cancer risk factors paving the way for developing a cancer control plan in the country. Numerical and graphical summaries, time-series additive seasonal decomposition, the method of least squares, and spacetime scan statistics were applied in a geographic information systems environment. Although the results indicate that the cancer incidence in Jordan is comparatively low, it is increasing over time. In the 10-year study period, a total of 44,741 cases was reported with a mean annual crude incidence rate of 68.4 cases/100,000, mean annual age-adjusted incidence rate of 111.9 cases/100,000, and a monthly rate increase of 1.2 (cases/100,000)/month. This study also revealed that the spatial and temporal characteristics of cancer vary among the governorates. Amman, which includes the capital city and hosts more than one-third of the population of the country, reported 61.0% of the total number of cases. Amman also reported the highest annual crude incidence rate (105.3 cases/100,000), the highest annual age-adjusted incidence rate (160.6 cases/100,000), and the highest rate of increase (0.7 (cases/100,000)/month) forming a high-rate cluster. Excluding the three governorates Amman, Balqa, and Ma'daba, low-rate clusters were found with regard to the remaining governorates. All governorates, except Irbid and Mafraq, showed significant rates of increase of cancer incidence. However, no clear seasonality pattern with respect to cancer incidence was discerned.

Surveillance for Cancers Associated with Tobacco Use - United States, 2010-2014.

Problem/ConditionTobacco use is the leading preventable cause of cancer, contributing to at least 12 types of cancer, including acute myeloid leukemia (AML) and cancers of the oral cavity and pharynx; esophagus; stomach; colon and rectum; liver; pancreas; larynx; lung, bronchus, and trachea; kidney and renal pelvis; urinary bladder; and cervix. This report provides a comprehensive assessment of recent tobacco-associated cancer incidence for each cancer type by sex, age, race/ethnicity, metropolitan county classification, tumor characteristics, U.S. census region, and state. These data are important for initiation, monitoring, and evaluation of tobacco prevention and control measures.Period Covered2010–2014.Description of SystemCancer incidence data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program were used to calculate average annual age-adjusted incidence rates for 2010–2014 and trends in annual age-adjusted incidence rates for 2010–2014. These cancer incidence data cover approximately 99% of the U.S. population. This report provides age-adjusted cancer incidence rates for each of the 12 cancer types known to be causally associated with tobacco use, including liver and colorectal cancer, which were deemed to be causally associated with tobacco use by the U.S. Surgeon General in 2014. Findings are reported by demographic and geographic characteristics, percentage distributions for tumor characteristics, and trends in cancer incidence by sex.ResultsDuring 2010–2014, approximately 3.3 million new tobacco-associated cancer cases were reported in the United States, approximately 667,000 per year. Age-adjusted incidence rates ranged from 4.2 AML cases per 100,000 persons to 61.3 lung cancer cases per 100,000 persons. By cancer type, incidence rates were higher among men than women (excluding cervical cancer), higher among non-Hispanics than Hispanics (for all cancers except stomach, liver, kidney, and cervical), higher among persons in nonmetropolitan counties than those in metropolitan counties (for all cancers except stomach, liver, pancreatic, and AML), and lower in the West than in other U.S. census regions (all except stomach, liver, bladder, and AML). Compared with other racial/ethnic groups, certain cancer rates were highest among whites (oral cavity and pharyngeal, esophageal, bladder, and AML), blacks (colon and rectal, pancreatic, laryngeal, lung and bronchial, cervical, and kidney), and Asians/Pacific Islanders (stomach and liver). During 2010–2014, the rate of all tobacco-associated cancers combined decreased 1.2% per year, influenced largely by decreases in cancers of the larynx (3.0%), lung (2.2%), colon and rectum (2.1%), and bladder (1.3%).InterpretationAlthough tobacco-associated cancer incidence decreased overall during 2010–2014, the incidence remains high in several states and subgroups, including among men, whites, blacks, non-Hispanics, and persons in nonmetropolitan counties. These disproportionately high rates of tobacco-related cancer incidence reflect overall demographic patterns of cancer incidence in the United States and also reflect patterns of tobacco use.Public Health ActionTobacco-associated cancer incidence can be reduced through prevention and control of tobacco use and comprehensive cancer-control efforts focused on reducing cancer risk, detecting cancer early, and better assisting communities disproportionately affected by cancer. Ongoing surveillance to monitor cancer incidence can identify populations with a high incidence of tobacco-associated cancers and evaluate the effectiveness of tobacco control programs and policies. Implementation research can be conducted to achieve wider adoption of existing evidence-based cancer prevention and screening programs and tobacco control measures, especially to reach groups with the largest disparities in cancer rates.

An Overview of the National Cancer Institute's Initiatives to Accelerate Rural Cancer Control Research.

This article is featured in Highlights of This Issue, [p. 1237][1] A recent publication by the Centers for Disease Control and Prevention (CDC; ref. [1][2]) reported that nonmetropolitan rural counties had lower 5-year annual age-adjusted cancer incidence rates (2009–2013), but higher average

Abstract A82: Disparities in prostate cancer incidence, patient and clinical characteristics among Latino subpopulations defined by country of origin in California: Findings from the California Cancer Registry

Abstract Introduction and Objective: Latinos constitute a significantly heterogeneous population with unique national identities, sociodemographic characteristics, and ancestry. The prostate cancer (PC) incidence patterns and clinical characteristics are poorly characterized among U.S. Latinos. This gap of knowledge hinders adequate risk-stratification strategies. Particularly lacking are studies that consider Latino subpopulations defined by country of origin. We investigated sociodemographic and clinical characteristics and outcomes of 321,433 men diagnosed with PC in California from 1988-2012, accounting for ethnicity and country of origin using data from the California Cancer Registry. Materials and Methods: Latino status and country of origin were identified by the NAACCR Hispanic Identification. We grouped Latinos (15.9% of all cases) into the following origins: Mexico (MEX, 26.3%), Central/South America (CSA, 6.9%), Cuba (1.3%), Puerto Rico (PR, 0.8%), and unspecified (64.6%). Non-Latino white (NLW, 73.4%) and non-Latino Blacks (NLB, 10.4%) were used for comparison. Nativity (U.S.-born versus foreign-born Latinos) was defined based on birthplace information available in the cancer registry records. SES was based on the geocoding of the participants' residential address at diagnosis at the census block group level, using a well-established methodology. Annual age-adjusted incidence rates (AAIRs) were calculated. Pearson's Chi-square was used to test differences among ethnicities and subgroups. Logistic regression was used to test the relationship between changes in Gleason score from biopsy to surgery among all ethnicities and subgroups. Results: Among known LAT subpopulations, Mexicans had the lowest AAIR (44 per 100,000) and Central/South American LAT had the highest (90 per 100,000), followed by Cubans (85 per 100,000) and Puerto Ricans (52 per 100,000). Latinos had a slightly higher proportion of younger diagnoses than NLW, with central/south Americans having the greatest proportion. LAT were more likely to have lower SES than NLW, and more likely to be uninsured. NLB were more likely to have elevated PSA (94.2%) vs NLW (89.0%) and LAT (91.8%, p&amp;lt;0.001). Latinos had the highest proportion of nonlocalized PC relative to NLW and NLB (18.3% vs 15.6% vs 18.1%, p&amp;lt;0.001), among them MEX having the highest proportion (22.5%). MEX also had the longest time from diagnosis to treatment relative to other Latino subgroups. Among all men, surgery and radiation were the most-used treatments followed by no treatment. Cubans had the lowest receipt of treatment. Fewer Latinos reported receiving radiation therapy (28.5%) than NLB or NLW (31.8% and 32.2%, p&amp;lt;0.001), and among them PR had the highest proportion of radiation treatment whereas CSA had a greater proportion of surgery. Latinos had a greater proportion of cases with no treatment reported (15.3%) vs NLW and NLB. There were no differences among NLB, NLW, and Latinos for Gleason change from biopsy to surgery among surgical patients. Logistic regression analysis showed that among all ethnicities and subgroups, time from diagnosis to treatment had a protective effect on the risk of Gleason score change from biopsy to surgery. Among all Latinos by nativity status, foreign born were older, mainly came from MEX, of low SES, and were uninsured. Foreign-born Latinos had a higher percentage of nonlocalized PC, more cores positive for PC on biopsy, and had more cases treated with radiation. Conclusion: We observed differences in PC incidence patterns and patient and clinical characteristics among Latino men in California. This highlights the importance of considering the heterogeneity in this minority population in understanding the cancer determinants and patterns of care for PC among Latinos. Citation Format: Alexis R. Freedland, Andre E. Kim, Juanjuan Zhang, Ann Hamilton, Dennis Deapen, Lihua Liu, Inderbir S. Gill, Mariana C. Stern. Disparities in prostate cancer incidence, patient and clinical characteristics among Latino subpopulations defined by country of origin in California: Findings from the California Cancer Registry [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A82.

Abstract 1199: Adult Hispanic males experience a higher incidence of acute lymphoblastic leukemia compared to non-Hispanic Whites

Abstract Introduction: Acute leukemia is an important cause of morbidity and mortality with differences in incidence and outcomes between patients of different ethnic backgrounds. We conducted this study to examine the ethnic disparities in incidence of ALL as well as other types of acute leukemia in the Latino population in South Texas. Methods: Data were obtained from the U.S. Surveillance, Epidemiology and End Results 18 (SEER) Program and the Texas Cancer Registry (TCR) under Limited-Use Data Agreements between sources and authors. Adult patients (15 years or older) were identified in both SEER and TCR databases from 2000 to 2014 and ICD-O-3 codes were used to select specific malignancies: ALL (9727-9729, 9835-9837), acute promyelocytic leukemia (APL) (9866) and non-APL acute myeloid leukemia (AML) (9840, 9861, 9867, 9870-9874, 9891, 9895-9897, 9910, 9920, 9930, 9931). Ethnicity was classified as Hispanic (H) and non-Hispanic White (NHW) per the North American Association of Central Cancer Registry (NAACR) Hispanic Identification Algorithm. Cases were obtained from SEER 18 and TCR, including Texas and the 38 counties of South Texas. Comparisons used the SEER population of NHW as reference. We used SEER*Stat software v 8.3.4 (SEER*Stat, NIH), to generate 2000-2014 average annual age-specific and age-adjusted acute leukemia incidence rates (per 1000000), rate ratios (RR) and 95% confidence interval (CI) for Hispanic and NHW populations in SEER, Texas, and South Texas. Results: Table 1 shows Hispanic males in South Texas had significantly higher RR for development of ALL (p&amp;lt;0.05), and lower for non-APL AML; there was no statistical difference for APL RR compared to NHW. Males (15-39 and 70-79 years) had higher rates of ALL. Conclusion: Latinos in South Texas experience a higher incidence of ALL and a lower incidence of non-APL AML compared to NHW. Future studies are needed to identify specific risk factors associated with this higher burden in Hispanic population. Table 1SEERTCRTexasSouth TexasHNHWRR (95%CI)HNHWRR (95%CI)HNHWRR (95%CI)ALL213744421.50 (1.42-1.59)9789851.43 (1.33-1.53)3771071.63 (1.46-1.81)Non-APL AML3398047190.77 (0.75-0.80)216375930.41 (0.40-0.43)8488980.48 (0.45-0.51)APL77022241.22 (1.11-1.33)3094720.90 (0.80- 1.02)109510.94 (0.77- 1.14) Citation Format: Manuel R. Espinoza-Gutarra, Edgar Munoz, Dimpy P. Shah, Anand Karnad, Ruben A. Mesa, Amelie G. Ramirez. Adult Hispanic males experience a higher incidence of acute lymphoblastic leukemia compared to non-Hispanic Whites [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1199.

Adult Glioma Incidence and Survival by Race or Ethnicity in the United States From 2000 to 2014

Glioma is the most commonly occurring malignant brain tumor in the United States, and its incidence varies by age, sex, and race or ethnicity. Survival after brain tumor diagnosis has been shown to vary by these factors. To quantify the differences in incidence and survival rates of glioma in adults by race or ethnicity. This population-based study obtained incidence data from the Central Brain Tumor Registry of the United States and survival data from Surveillance, Epidemiology, and End Results registries, covering the period January 1, 2000, to December 31, 2014. Average annual age-adjusted incidence rates with 95% CIs were generated by glioma histologic groups, race, Hispanic ethnicity, sex, and age groups. One-year and 5-year relative survival rates were generated by glioma histologic groups, race, Hispanic ethnicity, and insurance status. The analysis included 244 808 patients with glioma diagnosed in adults aged 18 years or older. Data were collected from January 1, 2000, to December 31, 2014. Data analysis took place from December 11, 2017, to January 31, 2018. Overall, 244 808 patients with glioma were analyzed. Of these, 150 631 (61.5%) were glioblastomas, 46 002 (18.8%) were non-glioblastoma astrocytomas, 26 068 (10.7%) were oligodendroglial tumors, 8816 (3.6%) were ependymomas, and 13 291 (5.4%) were other glioma diagnoses in adults. The data set included 137 733 males (56.3%) and 107 075 (43.7%) females. There were 204 580 non-Hispanic whites (83.6%), 17 321 Hispanic whites (7.08%), 14 566 blacks (6.0%), 1070 American Indians or Alaska Natives (0.4%), and 5947 Asians or Pacific Islanders (2.4%). Incidences of glioblastoma, non-glioblastoma astrocytoma, and oligodendroglial tumors were higher among non-Hispanic whites than among Hispanic whites (30% lower overall), blacks (52% lower overall), American Indians or Alaska Natives (58% lower overall), or Asians or Pacific Islanders (52% lower overall). Most tumors were more common in males than in females across all race or ethnicity groups, with the great difference in glioblastoma where the incidence was 60% higher overall in males. Most tumors (193 329 [79.9%]) occurred in those aged 45 years or older, with differences in incidence by race or ethnicity appearing in all age groups. Survival after diagnosis of glioma of different subtypes was generally comparable among Hispanic whites, blacks, and Asians or Pacific Islanders but was lower among non-Hispanic whites for many tumor types, including glioblastoma, irrespective of treatment type. Incidence of glioma and 1-year and 5-year survival rates after diagnosis vary significantly by race or ethnicity, with non-Hispanic whites having higher incidence and lower survival rates compared with individuals of other racial or ethnic groups. These findings can inform future discovery of risk factors and reveal unaddressed health disparities.

Occurrence of Endocrine and Thyroid Cancers Among Alaska Native People, 1969-2013.

Nationwide, the incidence of thyroid cancer is lower among American Indian/Alaska Native (AI/AN) people than among U.S. whites (USW). However, little is known about the incidence of thyroid or other endocrine cancers specifically among Alaska Native (AN) people. Data were examined from the National Cancer Institute's Surveillance, Epidemiology, and End Results Alaska Native Tumor Registry on endocrine cancers diagnosed among AN people from 1969-2013, with a specific focus on thyroid cancers. Frequencies of endocrine cancers by site and also of thyroid cancers by histology, size, and stage at diagnosis were evaluated. Distributions were compared to USW (Surveillance, Epidemiology, and End Results 9 Registries) using the chi-square test. Five-year average annual age-adjusted incidence rates of thyroid cancers were calculated, stratified by histology, age, and five-year period of diagnosis, and compared to those observed among USW. Five-year cause-specific survival was evaluated using cause of death data from the National Death Index Plus from the National Center for Health Statistics. During the 45-year period (1969-2013), 224 endocrine cancers were diagnosed among AN people, of which 210 (94%) were thyroid cancers. Compared to USW, AN people were diagnosed at a slightly younger age, had a higher proportion of thyroid cancers diagnosed with a size of 20-40 mm, and a larger proportion of patients with regional metastases. More than 85% of AN thyroid cancers were of papillary histology. The incidence of thyroid cancers was similar between AN people and USW, and appeared to increase among AN people over the period of surveillance. Finally, five-year cause-specific survival rate was 100% for papillary carcinoma patients and 86.3% [confidence interval 54.7-96.5] for follicular thyroid cancer patients. This study is the first report of endocrine cancers and the first detailed examination of thyroid cancer among AN people. The incidence of thyroid cancer was similar among AN people and USW. However, compared to USW, AN people appear to be at risk for diagnosis at a younger age, larger size, and higher stage. Further research is needed to explore the causes of these differences.

The Incidence of Necrotizing Fasciitis in Taiwan: A Nationwide Population-Based Study.

Little is known about the national population-based incidence rates of necrotizing fasciitis (NF) and related epidemiological profiles in Asian countries. We plastic surgeons always face and treat this complicated disease in the first line at the hospital. Using Taiwan's National Health Insurance inpatient claims data from 2005 through 2010, we investigated the national annual incidence rate of NF by sex, age, year, month, beneficiary category, and region. The overall average annual incidence rate (cases per 100,000 population) of those 6 years of inpatients with NF was 11.6 (95% confidence interval [CI], 11.4-11.8) for both sexes, 14.9 (95% CI, 14.9-15.5) for males, and 8.3 (95% CI, 7.9-8.3) for females. The age-adjusted annual incidence rate was 10.7 (95% CI, 10.3-11.1) in 2005 and 12.3 (95% CI, 11.9-12.8) in 2010. The annual incidence rate increased with age, peaked in August, was the highest in southern Taiwan, and correlated with monthly temperature. The annual incidence rate of NF in Taiwan was highest between 2005 and 2009 and slightly lower in 2010 in this study. Although additional studies are needed to identify modifiable risk factors associated with NF, the aforementioned risk factors alert the first line doctors, such as plastic surgeons, to pay much more attention to this complicated disease entity and make an accurate critical decision making for the patients.

Racial/ethnic variation in incidence rates for anal cancer in New Mexico.

601 Background: Anal cancer comprises only 2.5% of all digestive system malignancies in the United States; only 8200 new cases are diagnosed annually, nevertheless, an increasing incidence rate has been noted. The goal of this study is to describe the incidence rates of anal cancer in New Mexico. New Mexico is a unique, mainly rural state, with unique demographics consisting of a large mix of patients being primarily Non-Hispanic White, Hispanics or Native Americans. Methods: All incident cases of anal cancer diagnosed among New Mexico residents during the twenty-year period 1995-2014 were identified from the population-based New Mexico Tumor Registry. Average annual age-adjusted incidence rates (US 2000 standard) were calculated by the direct method for non-Hispanic whites, Hispanics and American Indians. Incidence rates for non-Hispanic whites in nine core areas of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program served as the comparison. Results: A total of 556 anal cancers were diagnosed among New Mexico residents during the study period, an average of approximate 28 cancers annually. Anal cancer incidence rates per 100,000 were highest for non-Hispanic whites (1.80, 95% Confidence Interval (CI) 1.62-1.98) in New Mexico, which were similar to rates for non-Hispanic whites (1.70, 95% CI 1.66-1.74) in nine core areas of the SEER Program. Statistically significant lower rates were observed in New Mexico Hispanics (0.92, 95% CI 0.76-1.11) and American Indians (0.75, 95% CI 0.45-1.16). Females had higher rates than males in each of these three racial/ethnic groups. Incidence rates increased from 1995-2004 to 2005-2014 for all race/ethnic groups, with the largest increase observed in Hispanic females. Conclusions: Anal cancer incidence rates vary by race/ethnicity and sex in New Mexico. Further research is needed to characterize time trends in incidence and to identify factors that may account for observed differences in incidence rates by race/ethnicity and sex in New Mexico.

Incidence trends, rates, and ethnic variations of primary CNS tumors in Texas from 1995 to 2013.

BackgroundAlthough rare, primary central nervous system (CNS) tumors are associated with significant morbidity and mortality. Texas is a representative sample of the United States population given its large population, ethnic disparities, geographic variations, and socio-economic differences. This study used Texas data to determine if variations in incidence trends and rates exist among different ethnicities in Texas.MethodsData from the Texas Cancer Registry from 1995 to 2013 were examined. Joinpoint Regression Program software was used to obtain the incidence trends and SEER*Stat software was used to produce average annual age-adjusted incidence rates for both nonmalignant and malignant tumors in Texas from 2009 to 2013.ResultsThe incidence trend of malignant primary CNS tumors in whites was stable from 1995 to 2002, after which the annual percent change decreased by 0.99% through 2013 (95% CI, -1.4, -0.5; P = .04). Blacks and Asian/Pacific Islanders showed unchanged incidence trends from 1995 to 2013. Hispanics had an annual percent change of -0.83 (95% CI, -1.4, -0.2; P = .009) per year from 1995 through 2013. From 2009 to 2013, the incidence rates of nonmalignant and malignant primary CNS tumors were highest among blacks, followed by whites, Hispanics, Asians, and American Indians/Alaskan Natives.ConclusionsConsistent with the 2016 Central Brain Tumor Registry of the United States report, the black population in Texas showed the highest total incidence of CNS tumors of any other race studied. Many factors have been proposed to account for the observed differences in incidence rate including geography, socioeconomic factors, and poverty factors, although the evidence for these external factors is lacking.

Epidemiology of rare cancers and inequalities in oncologic outcomes

Rare cancers epidemiology is better known compared to the other rare diseases. Thanks to the long history of the European population-based cancer registries and to the EUROCARE huge database, the burden of rare cancers has been estimated the European (EU28) population. A considerable fraction of all cancers is represented by rare cancers (24%). They are a heterogeneous group of diseases, but they share similar problems: uncertainty of diagnosis, lack of therapies, poor research opportunities, difficulties in clinical trials, lack of expertise and of centres of reference. This paper analyses the major epidemiological indicators of frequency (incidence and prevalence) and outcome (5-year survival) of all rare cancers combined and of selected rare cancers that will be in depth treated in this monographic issue. Source of the results is the RARECAREnet search tool, a database publicly available. Disparities both in incidence and survival, and consequently in prevalence of rare cancers were reported across European countries. Major differences were shown in outcome: 5-year relative survival for all rare cancers together, adjusted by age and case-mix, varied from 55% or more (Italy, Germany, Belgium and Iceland) and less than 40% (Bulgaria, Lithuania and Slovakia). Similarly, for all the analyzed rare cancers, a large survival gap was observed between the Eastern and the Nordic and Central European regions. Dramatic geographical variations were assessed for curable cancers like testicular and non epithelial ovarian cancers. Geographical difference in the annual age-adjusted incidence rates for all rare cancers together varied between >140 per 100,000 (Italy, Scotland, France, Germany, and Switzerland) and <100 (Finland, Portugal, Malta, and Poland). Prevalence, the major indicator of public health resources needs, was about 7–8 times larger than incidence. Most of rare cancers require complex surgical treatment, thus a multidisciplinary approach is essential and treatment should be provided in centres of expertise and/or in networks including expert centres. Networking is the most appropriate answer to the issues pertaining to rare cancers. Actually, in Europe, an opportunity to improve outcome and reduce disparities is provided by the creation of the European Reference Networks for rare diseases (ERNs). The Joint Action of rare cancers (JARC) is a major European initiative aimed to support the mission of the ERNs. The role of population based cancer registries still remains crucial to describe rare cancers management and outcome in the real word and to evaluate progresses made at the country and at the European level.

Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence between Urban and Rural Areas in the United States (1973-2012).

Over the past 40 years, measured ambient asbestos concentrations in the United States have been higher in urban versus rural areas. The purpose of this study was to determine whether variations in ambient asbestos concentrations have influenced pleural mesothelioma risk in females (who generally lacked historic occupational asbestos exposure relative to males). Male pleural mesothelioma incidence trends were analyzed to provide perspective for female trends. Annual age-adjusted incidence rates from 1973 to 2012 were obtained from the SEER 9, 13, and 18 databases for urban and rural locations, and standardized rate ratios were calculated. Female rural rates exceeded urban rates in almost half of the years analyzed, although the increases were not statistically significant, which is in line with expectations if there was no observable increased risk for urban locations. In contrast, male urban rates were elevated over rural rates for nearly all years examined and were statistically significantly elevated for 22 of the 40 years. Trend analyses demonstrated that trends for females remained relatively constant over time, whereas male urban and rural incidence increased into the 1980s and 1990s, followed by a decrease/leveling off. Annual female urban and rural incidence rates remained approximately five- to six-fold lower than male urban and rural incidence rates on average, consistent with the comparatively increased historical occupational asbestos exposure for males. The results suggest that differences in ambient asbestos concentrations, which have been reported to be 10-fold or greater across regions in the United States, have not influenced the risk of pleural mesothelioma.

Invasive Cancer Incidence, 2004-2013, and Deaths, 2006-2015, in Nonmetropolitan and Metropolitan Counties - United States.

Problem/ConditionPrevious reports have shown that persons living in nonmetropolitan (rural or urban) areas in the United States have higher death rates from all cancers combined than persons living in metropolitan areas. Disparities might vary by cancer type and between occurrence and death from the disease. This report provides a comprehensive assessment of cancer incidence and deaths by cancer type in nonmetropolitan and metropolitan counties.Reporting Period2004–2015.Description of SystemCancer incidence data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program were used to calculate average annual age-adjusted incidence rates for 2009–2013 and trends in annual age-adjusted incidence rates for 2004–2013. Cancer mortality data from the National Vital Statistics System were used to calculate average annual age-adjusted death rates for 2011–2015 and trends in annual age-adjusted death rates for 2006–2015. For 5-year average annual rates, counties were classified into four categories (nonmetropolitan rural, nonmetropolitan urban, metropolitan with population <1 million, and metropolitan with population ≥1 million). For the trend analysis, which used annual rates, these categories were combined into two categories (nonmetropolitan and metropolitan). Rates by county classification were examined by sex, age, race/ethnicity, U.S. census region, and cancer site. Trends in rates were examined by county classification and cancer site.ResultsDuring the most recent 5-year period for which data were available, nonmetropolitan rural areas had lower average annual age-adjusted cancer incidence rates for all anatomic cancer sites combined but higher death rates than metropolitan areas. During 2006–2015, the annual age-adjusted death rates for all cancer sites combined decreased at a slower pace in nonmetropolitan areas (-1.0% per year) than in metropolitan areas (-1.6% per year), increasing the differences in these rates. In contrast, annual age-adjusted incidence rates for all cancer sites combined decreased approximately 1% per year during 2004–2013 both in nonmetropolitan and metropolitan counties.InterpretationThis report provides the first comprehensive description of cancer incidence and mortality in nonmetropolitan and metropolitan counties in the United States. Nonmetropolitan rural counties had higher incidence of and deaths from several cancers related to tobacco use and cancers that can be prevented by screening. Differences between nonmetropolitan and metropolitan counties in cancer incidence might reflect differences in risk factors such as cigarette smoking, obesity, and physical inactivity, whereas differences in cancer death rates might reflect disparities in access to health care and timely diagnosis and treatment.Public Health ActionMany cancer cases and deaths could be prevented, and public health programs can use evidence-based strategies from the U.S. Preventive Services Task Force and Advisory Committee for Immunization Practices (ACIP) to support cancer prevention and control. The U.S. Preventive Services Task Force recommends population-based screening for colorectal, female breast, and cervical cancers among adults at average risk for these cancers and for lung cancer among adults at high risk; screening adults for tobacco use and excessive alcohol use, offering counseling and interventions as needed; and using low-dose aspirin to prevent colorectal cancer among adults considered to be at high risk for cardiovascular disease based on specific criteria. ACIP recommends vaccination against cancer-related infectious diseases including human papillomavirus and hepatitis B virus. The Guide to Community Preventive Services describes program and policy interventions proven to increase cancer screening and vaccination rates and to prevent tobacco use, excessive alcohol use, obesity, and physical inactivity.

Abstract LB-175: Gender and racial disparities in incidence trends of tobacco-related cancers from 2010 to 2013

Abstract Over one in three cancer-related deaths are associated with tobacco use. Although the overall incidence trend of tobacco-related cancers (TRCs) has been decreasing in the past a few decades, evidence suggests that not all TRCs have decreasing incidence and there exists gender and racial disparities in the TRC trends. Prior studies of TRC incidence have used the Surveillance, Epidemiology, and End Results Program (SEER) database. However, the SEER database includes limited information regarding the United States southeastern region and has been shown not to be representative of the US. In this study, we analyzed TRC incidence trends from 2010 to 2013 using the Florida cancer registry data, collected from a large ethno-racially diverse state. We computed annual age-adjusted incidence rates and annual percentage change (APC) to characterized the incidence trends of the following cancers: oral cavity, cervical, respiratory (lung, bronchitis, and larynx), urinary (bladder, kidney, and renal pelvis), digestive (esophagus, stomach, and pancreas), non-Hodgkin’s lymphoma, and pharyngeal. All incidence trends were also evaluated stratifying by gender (men and women) and race (Non-Hispanic (NH) Whites, NH Blacks, and Hispanics). Overall, all TRCs had a significant decrease in age-adjusted incidence rates for the study period, except for non-Hodgkin’s lymphoma and pharyngeal cancer for which the incidence remained unchanged. Oral cavity cancer had the biggest decline in age-adjusted incidence rates (APC= −2.5; 95% CI= −3.4, −1.6), while cancers of the digestive system had the smallest decline in incidence rates (APC= −0.6; 95% CI= −1.0, −0.2). When broken down by gender, males have a greater decrease in incidence rates than women for urinary and respiratory cancers. In addition, while pharyngeal cancer incidence rate stayed unchanged overall, there was a significant increase in the rate among male (APC= 1.0; 95% CI= 0.3, 1.7), but not female. When broken down by race and ethnic groups, NH Blacks and Hispanics had greater decline in cancer incidence for cervical cancer, oral cavity cancer, and respiratory cancer. For pharyngeal cancer, there was a significant decrease in incidence among NH Blacks (APC= −3.7; 95% CI= −5.5, −1.9), while the incidence significantly increased among NH Whites (APC= 1.6; 95% CI= 0.7, 2.5). In summary, there was an overall decreasing trend of TRC incidence. However, increasing incidence of pharyngeal cancer was observed for male and NH Whites. Citation Format: Danyell S. Wilson, Alice Parish, Yi Guo. Gender and racial disparities in incidence trends of tobacco-related cancers from 2010 to 2013 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-175. doi:10.1158/1538-7445.AM2017-LB-175