Annual Age-specific Incidence Rates Research Articles

EPID-01. ESTIMATING THE BURDEN DUE TO BRAIN AND OTHER CNS TUMORS IN ADOLESCENTS IN THE UNITED STATES

Abstract BACKGROUND Brain and other central nervous system (CNS) tumors in adolescents have unique biological and behavioral distinctions from both children and adults. As a result, they pose challenges to treatment and reporting. Here, we describe the epidemiology of brain and other CNS tumors in adolescents (ages 15-19 years) in the United States, including mortality, survival, and prevalence. METHODS The Central Brain Tumor Registry of the United States (CBTRUS) data (containing data from the CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology and End Results (SEER) data) were used to calculate average annual age-specific incidence rates (AASIR) per 100,000 population overall and by sex and race/ethnicity. Average annual age-specific mortality rates (AASMR) per 100,000 population for deaths resulting from all primary malignant brain and other CNS tumors were calculated using mortality data from NCHS. NPCR survival data were used to calculate relative survival (RS). Estimated prevalence counts as of December 31, 2024 were estimated using incidence from CBTRUS and SEER, and survival from SEER. RESULTS AASIR for all brain and other CNS tumors among adolescents was 7.51/100,000. Tumors of the sellar region had the highest incidence (AASIR=2.74/100,000). Overall, incidence was higher for females and non-Hispanic White persons. Overall AASMR was 0.56/100,000. Total five-year RS was 92.0%. Tumors of the pituitary had the highest RS (five-years=99.9%) and glioblastoma had the lowest (five-years=16.4%). As expected, prevalence was highest for tumors of the sellar region (3,720 cases). CONCLUSION Incidence, prevalence, and survival patterns for brain and other CNS tumors vary between adolescents, adults, and children. An accurate statistical assessment of these tumors in adolescents is required to understand risk and impact on this unique population, and to serve as a reference for afflicted individuals, for researchers investigating new therapies, and for the clinicians who treat them.

CBTRUS Statistical Report: American Brain Tumor Association & NCI Neuro-Oncology Branch Adolescent and Young Adult Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2016-2020.

Recent analyses have shown that, whereas cancer survival overall has been improving, it has not improved for adolescents and young adults ages 15-39 years (AYA). The clinical care of AYA with primary brain and other central nervous system (CNS) tumors (BT) is complicated by the fact that the histopathologies of such tumors in AYA differ from their histopathologies in either children (ages 0-14 years) or older adults (ages 40+ years). The present report, as an update to a 2016 publication from the Central Brain Tumor Registry of the United States and the American Brain Tumor Association, provides in-depth analyses of the epidemiology of primary BT in AYA in the United States and is the first to provide biomolecular marker-specific statistics and prevalence by histopathology for both primary malignant and non-malignant BT in AYA. Between 2016 and 2020, the annual average age-specific incidence rate (AASIR) of primary malignant and non-malignant BT in AYA was 12.00 per 100,000 population, an average of 12,848 newly diagnosed cases per year. During the same period, an average of 1,018 AYA deaths per year were caused by primary malignant BT, representing an annual average age-specific mortality rate of 0.96 per 100,000 population. When primary BT were categorized by histopathology, pituitary tumors were the most common (36.6%), with an AASIR of 4.34 per 100,000 population. Total incidence increased with age overall; when stratified by sex, the incidence was higher in females than males at all ages. Incidence rates for all primary BT combined and for non-malignant tumors only were highest for non-Hispanic American Indian/Alaska Native individuals, whereas malignant tumors were more frequent in non-Hispanic White individuals, compared with other racial/ethnic groups. On the basis of histopathology, the most common molecularly defined tumor was diffuse glioma (an AASIR of 1.51 per 100,000). Primary malignant BT are the second most common cause of cancer death in the AYA population. Incidence rates of primary BT overall, as well as specific histopathologies, vary significantly by age. Accordingly, an accurate statistical assessment of primary BT in the AYA population is vital for better understanding the impact of these tumors on the US population and to serve as a reference for afflicted individuals, for researchers investigating new therapies, and for clinicians treating these patients.

Incidence of Breast Cancer in Younger Women: A Canadian Trend Analysis.

Purpose: Breast cancer (BC) incidence is increasing globally. Age-specific BC incidence trend analyses are lacking for women under age 50 in Canada. In this study, we evaluate the incidence trends in breast cancer in women under age 50 in Canada and compare them with corresponding trends among women 50 to 54. Methods: BC case counts were obtained from the National Cancer Incidence Reporting System (1984-1991) and the Canadian Cancer Registry (1992-2019) both housed at Statistics Canada. Population data were also obtained from Statistics Canada. Annual female BC age-specific incidence rates from 1984 to 2019 were derived for the following age groups: 20 to 29, 30 to 39, 40 to 49, 40 to 44, 45 to 49, and 50 to 54. Changes in trends in age-specific BC incidence rates, if any, and annual percent changes (APCs) for each identified trend, were determined using JoinPoint. Results: Statistically significant increasing trends in BC incidence rates were noted for almost all age groups: since 2001 for 20 to 29 (APC = 3.06%, P < .001); since 2009 for 30 to 39 (APC = 1.25%, P = .007); since 1984 for both 40 to 49 (APC = 0.26%, P < .001) and 40 to 44 (APC = 0.19%, P = .011), increased since 2015 for 40 to 49 (APC = 0.77%, P = .047); and since 2005 for 50 to 54 (APC = 0.38%, P = .022). Among women 45 to 49 there was a non-significant increase since 2005 (APC = 0.24, P = .058). Statistically significant average annualized increases in BC incidence rates were observed for each age group studied. Conclusions: Examining age-specific incidence rates formed a more complete picture of BC time trends with significant increasing trends in the incidence of BC among women in their 20s, 30s, 40s, and early 50s. A greater awareness regarding the increasing number of cases of BC in women younger than 50 is critical to allow for earlier diagnosis with its resultant reduced mortality and morbidity.

Incidence and clinical characteristics of paediatric keratitis

Background/aimsTo report the incidence and clinical characteristics of paediatric keratitis diagnosed over a 10-year period in a well-defined population.DesignRetrospective, population-based study.MethodsSetting: multicentre. Population: patients (<19 years) diagnosed with keratitis as...

Mumps in Vaccinated Children and Adolescents

Source: Shepersky L, Marin M, Zhang J, et al. Mumps in vaccinated children and adolescents: 2007–2019. Pediatrics. 2021;148(6): e2021051873; doi.10.1542/peds.2021-051873Investigators from the CDC, Atlanta, GA, conducted a retrospective study to describe the incidence of mumps in children in the US and assess demographic and vaccination characteristics of those with mumps. For the study, they reviewed data in the National Notifiable Diseases Surveillance System (NNDSS) and identified cases of mumps in youths <18 years old in the US between 2007 and 2019. Data from the entire study period were analyzed to characterize pediatric mumps cases by age, state of residence, mumps vaccination status, and whether cases were outbreak-associated. Annual age-specific incidence rates were calculated. A focused analysis was conducted on pediatric mumps cases during the period 2015–2019. In addition to demographic information, data on import status (defined as a case in a child following international travel), parotitis, and complications (orchitis, deafness, meningitis, and encephalitis) were collected. Patients 1-4 years old were classified as up-to-date (UTD) for mumps vaccination if they had received 1 dose of mumps vaccine, and those 5-17 years old were classified as UTD if they had received 2 doses.Between 2007 and 2019, 28,306 mumps cases were reported to NNDSS, including 9,172 (32%) in children. Mumps was reported in all 50 states and the District of Columbia. The annual median number of pediatric mumps cases was 349, with peaks in 2009– 2010 (2,627 pediatric cases) and 2016–2017 (4,093 pediatric cases). Overall, the median annual incidence of mumps in children was 4.7 cases/1,000,000 population. Median annual incidence was 5.8 cases/1,000,000 population in children 5-10 years old and 5.8 cases/1,000,000 population in those 1-4 years of age. During the study period, 64% of pediatric mumps cases with available data were outbreak-associated. Among children with mumps, 89% had ≥1 dose of mumps vaccine.Between 2015 and 2019, 5,461 mumps cases were reported in children. During this period, 54% of pediatric mumps cases occurred in youths 11-17 years old, 33% in those 5-10 years old, 13% in children 1-4 years old, and 1% in infants <1 year old. Only 2% of pediatric cases were associated with international travel. During this period, 74% of children 1-4 years old with mumps and 86% of those 5-17 years old were UTD for mumps vaccination. Among 4,471 cases of pediatric mumps, parotitis was present in 97%. Complications occurred in 75 cases (1%), including orchitis in 2% of boys, deafness in 10 children, meningitis in 3, and encephalitis in 2.The authors conclude that since 2007, 32% of mumps cases in the US occurred in children, most of whom had been vaccinated.Dr Brady has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.Mumps can occur in fully vaccinated individuals. (See AAP Grand Rounds. 2017;37[6]:64.)1 Two explanations have been suggested for the occurrence of mumps in vaccinated persons: waning of vaccine-induced immunity and antigenic mismatch between the vaccine strain and the circulating wild-type mumps strains.2 Rubin et al3 reported that mumps antibodies declined to near baseline levels 10 years after vaccination for children vaccinated with the second dose at age 4 to 6 years. Additionally, these vaccine-induced antibody responses were lower against the circulating wild-type strains (predominantly genotype G in the US) than against the vaccine strain (genotype A).3-4The current authors noted that 97% of children with mumps presented with parotitis. As prior mumps vaccination does not exclude mumps, diagnostic testing is a consideration when children present with parotitis or mumps complications (eg, orchitis). The preferred test is a buccal swab specimen to detect mumps virus nucleic acid by quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR).5 When buccal swab specimens were collected <2 days after symptom onset, the sensitivity of RT-qPCR was about 83%.1 Therefore, failure to detect mumps virus RNA by RT-qPCR in samples from persons with parotitis does not exclude mumps as a diagnosis. Vaccinated persons may shed small amounts of virus for short periods.5 In previously vaccinated persons who acquire mumps, the mumps-specific immunoglobulin (Ig) M response may be transient, delayed, or not detected.5 Thus, a negative IgM also does not exclude mumps as a diagnosis.With the 2-dose measles-mumps-rubella (MMR) vaccine policy, mumps cases in the US decreased by >99%.6 However, mumps still occurs in vaccinated persons. Parotitis is the hallmark of mumps, and RT-qPCR to detect mumps RNA from a buccal swab specimen is the preferred diagnostic test.A third dose of the current MMR vaccine has been administered during mumps outbreaks.4 A third dose of a mumps vaccine using an alternative mumps strain, however, is a consideration to boost and broaden immunity in vaccine recipients.4

P640 Incidence, prevalence, disease phenotype and maximal therapeutic step in Crohn’s disease patients in Western Hungary – a population-based study between 2007–2018, data from the Veszprem county cohort

Abstract Background The number of epidemiological population-based studies are still limited from Eastern Europe. The present study is a continuation of the Veszprem IBD population based cohort with a follow-up of the incidence and disease course of IBD since 1977. Our aim was to analyze the incidence and disease phenotype at diagnosis, and the maximal therapeutic step distributions during follow-up in a prospective population-based database from Veszprem Province, including incident Crohn’s disease (CD) patients diagnosed between January 1, 2007 and December 31, 2018. Methods Data of 421 incident CD patients were analyzed (male/female: 237/184; median age at diagnosis: 29 years(y) [IQR: 21–42]). Both in-hospital and outpatient records were collected and comprehensively reviewed at diagnosis and during clinical follow-up. The source of age- and gender-specific demographic data was derived from the national population census in 2011. Results Adjusted mean incidence rate was 9.94(CI95%: 9.0–10.9)/105 person-years in this 12 year period[males:11.5(CI95%:10.2–13.2)/105; females:8.4(CI95%:7.3–9.7)/105]. Prevalence rate was 191.18(CI95%:177.0–205.7)/105 persons in 2011 and 236.78(CI95%:220.8–252.8) in 2015. For detailed annual incidence rates and age-specific mean incidence rates see Figure1 and 2. Peak onset age in CD was 20–29 years of age. Diagnostic delay from symptom onset was ≥1year in 26.6%, and ≥3 years in 10% of the patients. Disease location was ileal(L1) in 29.7%, colonic(L2) in 24.5%, and ileo-colonic(L3) in 45.8% at diagnosis. Upper gastrointestinal manifestation or perianal disease were present in 7.6% and 13.5%. Disease behavior at diagnosis was luminal(B1) in 62.5%, stenosing(B2) in 17.6%, penetrating(B3) in 16.4%, and B2+B3 in 3.6%. Patients with ileocolonic disease were younger (29.2y,SD:14.6) at diagnosis compared to patients with ileal(35.7y,SD:15.5;p&amp;lt;0.001) or colonic disease(37.7y;SD:18.1;p&amp;lt;0.001). Extraintestinal manifestations were as follows: hepatic5.0%(PSC 1.9%), arthritis13.8%, ocular1.7%, cutan4.3%. Active smokers at diagnosis were 35.4%. Distribution of maximal therapeutic steps during the course of follow-up (8.53y,SD: 3.3) were 5-ASA in 15.7%, systemic corticosteroids in 14.3%, immunosuppressive therapy in 42.5%; anti-TNF biologic therapy in 23.3% and other biologic therapy in 2.9%. Conclusion The incidence of CD in this 12 year period was high, comparable to high-incidence areas in Western European countries, and comparable to previous data from the Veszprem cohort, while prevalence rates continue to rise.(Lakatos 2011, IBD). Ileocolonic location and penetrating disease behavior were somewhat higher compared to previous population-based data from Western Europe.(Burisch 2018, JCC).

P635 Incidence, prevalence, disease phenotype and maximal therapeutic step in Ulcerative Colitis patients in Western Hungary – a population-based study between 2007–2018, data from the Veszprem County cohort

Abstract Background Recent trends indicate a change in the epidemiology of inflammatory bowel disease (IBD) with previously low incidence areas now reporting progressive rise. The number of epidemiological population-based studies are still limited from Eastern Europe. The present study is a continuation of the Veszprem IBD population-based cohort with a follow-up of the incidence and disease course of IBD since 1977. Our aim was to analyze the incidence and disease phenotype at diagnosis, and the maximal therapeutic step distributions during follow-up in a prospective population-based database from Veszprem Province, including incident ulcerative colitis (UC) patients diagnosed between January 1, 2007 and December 31, 2018. Methods Data of 467 incident UC patients were analyzed (male/female:236/231; median age at diagnosis:36 years(y)[IQR: 25–54]). Both in-hospital and outpatient records were collected and comprehensively reviewed at diagnosis and during clinical follow-up. The source of age- and gender-specific demographic data for statistical analysis was derived from the results of a national population census in 2011. Results Adjusted mean incidence rate was 11.02(CI95%:10.1–12.1)/105 person-years in this 12 year period[males:11.53(CI95%:10.2–13.1)/105; females:10.54(CI95%:9.3–12.0)/105]. Prevalence rate was 283.51(CI95%:265.7–300.7)/105 persons in 2011 and 317.79(CI95%:298.8–335.8) in 2015. For detailed annual incidence rates and age-specific mean incidence rates see Figure 1 and 2. Peak onset age in UC was 20–29 years of age. Diagnostic delay from symptom onset was ≥1year in 19.1%, and ≥3 years in 4.1% of the patients. Disease extension was proctitis(E1) in 22.3%, left sided colitis(E2) in 43.9%, and extensive colitis(E3) in 33.8% of the patients at diagnosis. Patients with extensive colitis were younger(32.9y,SD:16.6) at diagnosis compared to patients with proctitis(40.1y,SD:15.9;p&amp;lt;0.001) or left sided colitis(44.0y;SD:19.1;p&amp;lt;0.001). Extraintestinal manifestations were as follows: hepatic5.4%(PSC 2.1%), arthritis10.7%, ocular0.9%, skin3.6%. Active smokers at diagnosis were 12.6%. Distribution of maximal therapeutic steps during the course of follow-up (8.34y,SD: 3.5) were 5-ASA in 46.9%, systemic corticosteroids in 16.3%, immunosuppressive therapy in 19.3%; anti-TNF biologic therapy in 12.2% and other biologic therapy in 4.3%. Conclusion The incidence of UC in this 12 year period was high, comparable to high-incidence areas in Western European countries, and comparable to previous data from the Veszprem cohort, while prevalence rates continue to rise compared to our previous data.(Lakatos 2011, IBD). Disease extension at diagnosis and distribution of highest treatment step was comparable to European population-based data.(Burisch 2019, JCC).

Kretanje obolevanja i umiranja od raka pankreasa u Centralnoj Srbiji, u periodu od 1999. do 2019. godine

Introduction: Pancreatic cancer is the fourteenth leading cause of disease and the seventh leading cause of death among all malignant diseases. The aim of the research was to analyze the trends in the incidence and death of pancreatic cancer in central Serbia for the period 1999-2019. years. Methods: The data about diseased and dead, as well as population by sex and age, in the period 1999-2015 were taken over from the Cancer registry of Central Serbia, and the data for 2016, 2017, 2018 and 2019 were obtained from the Institute of Public Health of Serbia. Based on obtained data, we counted crude, specific and standardized rates of incidence and mortality for pancreatic cancers, for all ages. Trends rate in incidence and mortality were counted using joinpoint regression analysis. Results: In the period 1999-2019. In central Serbia, the average annual number of patients was 378 men and 305 women, and the average number of deaths was 406 men and 336 women. The average annual standardized incidence rate (per 100,000) was 7.7 for men and 5.0 for women, and the standardized mortality rate (per 100,000) was 7.9 for men and 5.1 for women. In men, the highest average annual agespecific incidence rate was recorded at the age of 60-69 (39.7 per 100,000), and the mortality rate at the age of 70 and over (42.4 per 100,000). Among women, the highest incidence and mortality rates were in the oldest age (70 and over) and were 25.7 and 34.8 per 100,000. During the observed period, there was a significant increase in standardized incidence rates for men of 2.9% and for women of 3.7% per year. Also, a trend of increasing standardized mortality rates was observed in men (of 1.2%) and women (of 0.6%), but significance was achieved only in men. Conclusion: In the period 1999-2019. in central Serbia, incidence and mortality rates are on the rise. Research on risk factors for the development of this disease is necessary in order to take preventive measures. Also, early detection and timely therapy should contribute to the reduction of death from this malignancy.

Incidence of Type 1 Diabetes Among Children and Adolescents During Peace and War Times in Yemen

Background: The incidence of type 1 diabetes (T1D) among children and adolescents has been reported to be steadily increasing worldwide with considerable regional, national and ethnic differences. We aimed in this study to present a 30-year registry-based incidence data on T1D in Yemen, a low-income country, during peace and war times. Methods: A total of 461 children and adolescents aged more than 6 months to 18 years with newly-diagnosed diabetes were registered between1989-2018. We used a standardized registry protocol according to that established in the 155 center WHO Multinational (DiaMonod) Project for childhood diabetes. The registry as with other WHO DiaMond centers was primarily concerned with counting the frequency of new-onset cases of childhood diabetes over time across Sana’a city according to a standard set of specific criteria. Case reports registered were validated on the basis of a physician’s diagnosed diabetes in the records. Eligibility for registration was based on age < 19 years and permanent residence in Sana’a city. The annual incidence rates (cases/100,000 persons/year) were calculated from the numbers of new reported cases for each year (1989-2018) divided by the estimated numbers of person-years ‘at risk’ (population < 19 years) according to age and sex for that year. Completeness of case ascertainment for the identified number of cases was assessed with the use of the 2-source capture-recapture method throughout the study period. Findings: The mean annual incidence rate in children aged 0-14 years over the full observation period was 1.83/100,000/yr with 95% CI: (0.9, 2.74). With the use of 3-year time periods, the mean annual incidence rate was intermediate (5 per 100,000/yr) in the first time-period (1989-1991), low (1.56-2.3/100,000/yr) during subsequent 5 time-periods (1992-2006) and (1.2/100,000/yr) during the next 2 time-periods (2007-2012). Ultimately, there was a precipitous decline in incidence to a very low rate (0.5/100,000/yr) during the last two time-periods (2013-2018) which was the time when Yemen has experienced the conflict and war. The age-specific mean T1D annual incidence rates with the use of 3-year time periods for children aged 0-4 yr, 5-9 yr, 10-14 yr, and adolescents aged 15-18 yr over the full observation period (1989-2018) were 0.83, 1.82, 3.14, and 2.31/100,000/yr, respectively. On temporal trend analysis of incidence rates with the use of 3-years moving average, all trend curves indicated a decline for all participants aged 0-14 years and for other age groups, especially during the last 6 years of the observation period. The mean annual age-specific and sex-specific incidence rates over the full observation period were found to be increasing with increased age in both males and females, peaking at puberty (10-14 year old) with the associated gender effect. A seasonal trend in incidence of T1D was noted with more diagnoses of cases in the winter and autumn months and fewer in the summer months, a feature that was observed in both sexes and in all age groups. Interpretation: The mean incidence rate of T1D in children and adolescents in Sana’a city was found to be low. In children aged 0-14 years in particular, the rate was low during peace time, followed by a precipitous decline to a very low rate during the time of war. Economic destruction, poverty and shortage of food supply to a large sector of children and adolescents were likely associated with decreased incidence of childhood diabetes during war. Undernutrition and low standards of environmental hygiene with exposure to infections very early in childhood might have operated as a protective factor against pediatric-onset autoimmune diabetes. Funding Statement: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Declaration of Interests: None declared. Ethics Approval Statement: Patient consent for publication was obtained from patients’ families. Ethical approval statement: This work was approved by the Ethical Committee at the Faculty of Medicine and Health Sciences, University of Sana’a

Risk of pacemaker implantation in patients treated for breast cancer: A study based on French nationwide health database sample

Cardiotoxicity of some medical anti-cancer treatments and radiotherapy for breast cancer (BC) patients is well known, but knowledge for conduction disorders or sinus node disease remains poor. To examine the risk of pacemaker (PM) implantation subsequent to BC treatment by comparing PM incidence in BC patients to that in the general population on an age-specific basis. Our study was based on the Échantillon généraliste de bénéficiaires (EGB), the 1/97 random sample, the French nationwide health database (SNDS). The study population consisted of adult women treated for a primo BC between 2008 and 2014, with no previous history of PM implantation, followed until 2016. For each year from 2008 to 2016, the reference population included all women present in the EGB with no PM or BC implantation. PM implantations were identified according to the Classification commune des actes médicaux . The standardised incidence ratio (SIR) was calculated as the ratio of the observed number of PM in the BC population to the expected number of PM computed using annual age-specific PM incidence rates from the reference population, weighted according to the age structure of the BC population. Between 2008 and 2016, the annual reference population consisted of nearly 193,000 individuals with an incidence rate of PM implantation that varied from 1case/100,000 in the younger category (< 40 years) to 552 cases/100,000 for women ≥ 85 years. The BC population included 2821 patients (approximately 400 per year, 50% aged > 60 years) in whom 18 PM implantations were observed compared with 11.5 expected yielding a SIR of 1.56 (95% CI: 0.93–2.36), indicating a 56% higher incidence of PM in the BC population. These preliminary results indicate that treatment for BC may be associated with an increased risk of PM implantation. Further analysis according to the type of treatment (radiotherapy, chemotherapy…) is ongoing.

Bladder Cancer Incidence and Survival in the United States and Texas Non-Latino Whites and Latinos

BACKGROUND: Bladder cancer (BC) poses an enormous burden on health care systems. Latinos in Texas (TX) were underrepresented in previous studies on racial/ethnic disparity of BC in the US. OBJECTIVE: To examine whether BC incidence and survival rates differ among Latinos compared to non-Latino whites (NLW) in South TX, TX, and the US SEER. METHODS: Data was collected from the US SEER Program and the Texas Cancer Registry. Annual age-specific and age-adjusted BC incidence rates and annual 5-year relative survival were calculated. RESULTS: South TX and TX had significantly lower BC incidence rates than SEER for both Latinos and NLW regardless of gender (Ps &lt; 0.05). South TX women had worse BC survival rates than SEER women for both Latinos and NLW (Ps &lt; 0.05). TX NLW had worse BC survival rates than SEER NLW for both genders together and men only (Ps &lt; 0.05). All Latino groups had lower incidence but worse survival rates than NLW groups for both men and women in each geographic area (all Ps &lt; 0.05). Women had significantly lower BC incidence but worse survival rates than men regardless of race/ethnicity in each geographic area (all Ps &lt; 0.05). CONCLUSIONS: South TX women had lower BC incidence but worse survival rates than US SEER women for both Latinos and NLW. Latinos had worse survival but lower incidence rates than NLW. Women had lower BC incidence but worse survival rates than men. The study identifies the BC distribution and high-risk population, racial/ethnic disparities, and geographic differences. It facilitates health care services planning.

Incidence of Symptomatic Pediatric Tarsal Coalition in Olmsted County: A Population-Based Study.

Tarsal coalitions are an important reason for foot pain in children. Early estimates placed the prevalence at up to 2%, while more recent data suggest that it is as high as 11% to 13%. To our knowledge, there have been no population-based studies to determine the true incidence of symptomatic tarsal coalitions in a pediatric population. A population-based database was used to identify all new diagnoses of symptomatic tarsal coalitions in children 18 years old or younger between 1966 and 2018. Patient records were reviewed for clinical data, and comparisons were made between the types and characteristics of the coalitions identified to determine differences in the affected populations. The annual age-specific, sex-specific, and type-specific incidence rates were estimated. During the study period, 58 patients with a total of 79 symptomatic tarsal coalitions were identified (annual incidence = 3.5 per 100,000 children). There were 43 calcaneonavicular (CN) coalitions (annual incidence = 1.9 per 100,000 children), 27 talocalcaneal (TC) coalitions (annual incidence = 1.2 per 100,000 children), as well as 9 other coalitions (7 talonavicular, 1 naviculocuboid, and 1 naviculocuneiform) (annual incidence = 0.4 per 100,000 children). The overall incidence peaked between the ages of 10 and 14 years for both boys and girls (8.1 per 100,000 and 7.4 per 100,000 children, respectively). Statistical differences were identified between the types of tarsal coalitions. TC coalitions present at an older age relative to CN and other coalitions (mean,13.9, 12.7, and 11.4 years, respectively; p = 0.02). While CN and TC coalitions were similar in composition (23% and 30%, respectively, were osseous as opposed to fibrocartilaginous), other coalitions were more likely to be osseous (78%) (p = 0.0035). Other coalitions were also less likely to require surgery than CN and TC coalitions (11%, 74%, and 56%, respectively; p = 0.0015). This population-based study demonstrates differences in the clinical presentation of tarsal coalitions and provides an estimate of the true incidence of symptomatic tarsal coalitions in a pediatric population.

Effects of bodybuilding supplements on the kidney: A population-based incidence study of biopsy pathology and clinical characteristics among middle eastern men

BackgroundThe incidence of kidney diseases among bodybuilders is unknown.MethodsBetween January 2011 and December 2019, the Iraqi Kurdistan 15 to 39 year old male population averaged 1,100,000 with approximately 56,000 total participants and 25,000 regular participants (those training more than 1 year). Annual age specific incidence rates (ASIR) with (95% confidence intervals) per 100,000 bodybuilders were compared with the general age-matched male population.ResultsFifteen male participants had kidney biopsies. Among regular participants, diagnoses were: focal segmental glomerulosclerosis (FSGS), 2; membranous glomerulonephritis (MGN), 2; post-infectious glomeruonephritis (PIGN), 1; tubulointerstitial nephritis (TIN), 1; and nephrocalcinosis, 2. Acute tubular necrosis (ATN) was diagnosed in 5 regular participants and 2 participants training less than 1 year. Among regular participants, anabolic steroid use was self-reported in 26% and veterinary grade vitamin D injections in 2.6%. ASIR for FSGS, MGN, PIGN, and TIN among regular participants was not statistically different than the general population. ASIR of FSGS adjusted for anabolic steroid use was 3.4 (− 1.3 to 8.1), a rate overlapping with FSGS in the general population at 2.0 (1.2 to 2.8). ATN presented as exertional muscle injury with myoglobinuria among new participants. Nevertheless, ASIR for ATN among total participants at 1.4 (0.4 to 2.4) was not significantly different than for the general population at 0.3 (0.1 to 0.5). Nephrocalcinosis was only diagnosed among bodybuilders at a 9-year cumulative rate of one per 314 vitamin D injectors.ConclusionsKidney disease rates among bodybuilders were not significantly different than for the general population, except for nephrocalcinosis that was caused by injections of veterinary grade vitamin D compounds.

Retrospective analysis of the 13-year trend in acute and elective surgery for patients aged 60 years and over at Auckland City Hospital, New Zealand

BackgroundAs the worldwide population has aged, the number of surgical procedures performed on older patients has increased. It is not known whether this increase has been proportional to growth in...

Incidence, clinical distribution, and patient characteristics of childhood cancer in Saudi Arabia: A population-based analysis.

Information regarding the incidence and patterns of childhood malignancies is disproportionately overrepresented by high-income countries, representing mainly the Caucasian population. There is a need to evaluate and disseminate information for other ethnicities, particularly from the Middle East. Data from the National Cancer Registry, Saudi Arabia (SA-NCR), for pediatric patients (age 0-14 years) diagnosed between 2005 and 2009 and for similar patients at our institution during the same period were analyzed. Population numbers reported in the 2007 national census were used to calculate the annual incidence of childhood cancer. Data from SA-NCR on 3885 patients were included in this analysis. The median age was 5.58 years, and 57.3% were males. The annual age-specific cancer incidence rate (ASR) for children in SA is 99.83 per million population; ASR per million for lymphoid leukemia is 25.75, 12.05 for brain tumors, and 9.82 for Hodgkin lymphoma. Of all childhood cancers in SA, 35% were treated at our institution. The five-year overall survival for these 1350 patients is 74.6% (median follow-up 7.52 years [95% confidence interval: 7.36-7.68]). Significant differences in the distribution of childhood malignancy subtypes were evident compared with other countries. We have reported differences in the cancer ASR and cancer subtype distribution for children in SA as compared with the worldwide incidence and with other populations. This paper provides a comprehensive epidemiological overview of childhood cancer in SA, which could be extrapolated to other regional Arab populations.

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.

Epidemiology of pediatric primary malignant central nervous system tumors in Iran: A 10 year report of National Cancer Registry

BackgroundCNS tumors are the leading cause of cancer related deaths among children and adolescents. Nonetheless, the incidence of pediatric CNS tumors in developing countries is poorly understood. We aimed to provide epidemiologic features of primary malignant CNS tumors in Iranian children 0–19 years of age using National Cancer Registry (NCR) data bank. MethodsThe data recorded by NCR over a 10 year period (2000–2010) were reviewed. ResultsOf 1948 tumor cases, 93.3% were located in brain, 5.1% were found in the spinal cord & cauda equina, and 1.6% affected cranial nerves and other parts of the nervous system. The overall average annual age specific incidence rate was 1.43 per 100,000. Males were more likely to develop CNS tumors (1.65 per 100,000) compared to females (1.21 per 100,000, p<0.01). Children under 5 years of age had the highest age specific incidence rate (1.86 per 100,000). Astrocytic tumors with the incidence rate of 0.61 per 100,000 were the most frequent specific histology followed by embryonal (0.38 per 100,000), and ependymal tumors (0.10 per 100,000). With regard to the histological distribution of tumors, some unique features including the high proportion of unspecified malignant neoplasms (7.6%) were noted. ConclusionThe overall incidence rate was markedly lower than western findings. Major differences were also observed in incidence rates of specific histologies. Although the discrepancies may be attributable to diversity in classification schemes and registration practices, a real ethnic and geographical variation in predisposition to development of pediatric CNS cancers is strongly suggested.

Population-Based Effects of Mammography Screening in Bavaria on the Distribution of TNM-T Categories with Respect to Different Histological Subgroups

Background: Organized mammography screening was implemented in Bavaria in 2003, with a target population of about 1.5 million women (aged 50–69 years). We evaluated the population-based effects of mammography screening on the distribution of tumor-node-metastasis (TNM)-T categories with regard to different histological subgroups of breast cancer. Patients and Methods: Women diagnosed with breast cancer between 2002 and 2008 were included. The annual agespecific incidence rates separated by T category were calculated for different histological subgroups and plotted against time. Time trends were analyzed not only in the screening population but also based on women aged 15–49 and ≥70 years, respectively. Furthermore, correlation coefficients were calculated in order to evaluate the possible association between participation rate and incidence of certain TNM-T categories. Results: With ductal carcinomas, the incidence of early-stage tumors shows a strong increase in the screening population and a significant correlation with the participation rate, whereas with lobular carcinomas there is a stagnation of incidence in women aged 50–69 years irrespective of TNM-T category. Conclusions: Short-term effects of mammography screening can already be demonstrated. However, depending on breast cancer type, not all women appear to benefit from screening. The expected long-term reduction of breast cancer mortality remains to be seen.

The Gulf War era multiple sclerosis cohort: age and incidence rates by race, sex and service

We characterize here a new nationwide incident cohort of multiple sclerosis from the US military-veteran population. This cohort provides an update to the only other US nationwide incidence study of multiple sclerosis performed during the 1970s. Medical records and data from the Department of Defense and Department of Veterans Affairs for cases of multiple sclerosis who served in the military between 1990, the start of the Gulf War era, and 2007 and who were service-connected for this disorder by the Department of Veterans Affairs from 1990 on, were reviewed. A total of 2691 patients were confirmed as having multiple sclerosis: 2288 definite, 190 possible, 207 clinically isolated syndrome and six neuromyelitis optica. Overall racial categories were White, Black and other, which included all Hispanics. There were 1278 White males and 556 females; 360 Black males and 296 females; and 200 others, 153 (77%) of whom were Hispanic. Mean age at onset of 30.7 years did not differ significantly by race or sex. Age at onset was 17-50 years in 99%, the same age range as 99% of the military. Average annual age specific (age 17-50 years) incidence rates per 100 000 for the entire series were 9.6 with 95% confidence interval of 9.3-10.0. Rates for Blacks were highest at 12.1 with confidence interval 11.2-13.1, Whites were 9.3 (interval 8.9-9.8) and others 6.9 (interval 6.0-7.9). For 83 Hispanics defined for 2000-07, the rate was 8.2 (interval 6.5-10.1). Much smaller numbers gave rates of 3.3 for Asian/Pacific Islanders and 3.1 for native Americans. Rates by sex for Whites were 7.3 and 25.8 male and female, respectively, for Blacks 8.4 and 26.3, and for Hispanics 6.6 and 17.0. Rates by service were high for Air Force (10.9) and Army (10.6), medium for Navy (9.1) and Coast Guard (7.9), and low for Marines (5.3). Relative risk of multiple sclerosis was 3.39 female:male and 1.27 Black:White. These new findings indicate that females of all races now have incidence rates for multiple sclerosis some three times those of their male counterparts and that among these groups, Blacks have the highest and others (probably including Hispanics) the lowest incidence rates regardless of sex or service. The low rate for Marines is unexplained. This Gulf War era multiple sclerosis cohort provides a unique resource for further study.

Incidence and Risk Factors for Hepatocellular Carcinoma in Texas Latinos: Implications for Prevention Research

BackgroundHepatocellular carcinoma (HCC) is increasing in the U.S. despite a decline in cancer overall. Latinos have higher rates of HCC than the general population according to the Surveillance, Epidemiology, and End Results (SEER) Program. Not included in SEER, Texas Latinos make up one-fifth of the U.S. Latino population. To determine whether HCC incidence differs among U.S. and Texas Latinos, this descriptive study compares HCC incidence from 1995 through 2006 among three Latino populations: U.S. SEER, Texas overall and a South Texas subset. To identify lines of prevention research, we compare prevalence of known HCC risk factors among these Latino groups.MethodsData were collected from the U.S. SEER Program, Texas Cancer Registry and Texas Department of State Health Services (TDSHS). Annual age-specific and age-adjusted HCC incidence rates, annual percent changes (APCs) and 95% confidence intervals were calculated as well as prevalence of obesity, diabetes, heavy alcohol use and cigarette smoking.ResultsOf the three Latino groups compared, South Texas Latinos had the highest age-adjusted HCC incidence rates and SEER Latinos had the lowest (10.6/100,000 (10.1–11.1) and 7.5/100,000 (7.2–7.7), respectively). HCC incidence significantly increased over time (APCs>0) among Latinos in all three geographic groups. Between 1995 and 2006, there was an increase in obesity among all three populations, and obesity was highest among South Texas Latinos. Diabetes increased among U.S. Latinos, and Latino women in South Texas had significantly higher diabetes prevalence than U.S. Latino women. Cigarette smoking and heavy alcohol use were similar among groups.ConclusionsThe incidence of HCC among Latinos in South Texas is higher than elsewhere in the United States. Higher rates of HCC among Texas and South Texas Latinos may be associated with greater prevalence of obesity and diabetes, risk factors for HCC that are amenable to intervention.