Annual Age-standardized Incidence Research Articles

Sex-specific temporal trends in incidence and prevalence of chronic kidney disease: a Danish population-based cohort study

Abstract Background Rates of chronic kidney disease (CKD) may change with ageing populations, rising metabolic and cardiovascular disease prevalence, increasing CKD awareness and new treatments. We examined sex-specific temporal trends in CKD incidence and prevalence from 2011 through 2021. Methods We conducted a population-based cohort study among adults residing in the North and Central Denmark Regions (population ∼1.5 million in 2021), utilising routinely collected individual-level laboratory data. We identified individuals with incident or prevalent CKD, using data on plasma creatinine and urine albumin-creatinine ratios from samples performed in outpatient hospital settings or primary care. We estimated annual sex-specific crude and age-standardised incidence and prevalence and tabulated clinical characteristics. Results Throughout 2011–2021, CKD incidence and prevalence remained higher among females than males. A transient increase in the crude incidence was observed during 2011–2013, followed by a decrease from 11.8 per 1000 person-years in 2013 (95% confidence interval (CI): 11.5–12.1) to 10.7 in 2021 (95% CI: 10.5–11.0) among females and from 10.9 (95% CI: 10.7–11.2) to 10.6 (95% CI: 10.3–10.8) among males. During 2011–2021, the crude prevalence increased among females from 85.1 per 1000 individuals (95% CI: 84.4–85.8) to 99.9 (95% CI: 99.2–100.6) and among males from 55.3 (95% CI: 54.7–55.9) to 82.4 (95% CI: 81.8–83.0). After age-standardisation, declines in incidence persisted, while the prevalence was stable among females, and the increase persisted among males. Conclusions The CKD incidence and prevalence remained higher among females than males during 2011–2021. Despite a notable decline in incidence rates from 2013 onwards, the crude prevalence increased during 2011–2021.

Chordoma incidence, treatment, and survival in the 21st century: a population-based Ontario cohort study.

This study estimates the incidence, treatment patterns, and overall survival for patients with chordoma treated in Ontario. A 17-year (2003-2019) population-based cohort study was conducted, including all patients in the Ontario Cancer Registry with histologically proven chordoma. Primary outcomes of interest were age-standardized annual incidence, overall survival, and rates of radiation therapy, chemotherapy, and open resection. A total of 208 patients were diagnosed with chordoma over the study period: 97 patients with skull base chordoma, 37 with mobile spine chordoma, and 65 with sacropelvic chordoma. A total of 133 patients were treated with either open or endoscopic surgery, of whom 99 were also treated with some form of radiation therapy. Across the 17-year study period, the average annual age-standardized incidence was 12.04 cases per 10 million (95% CI 9.31-14.78 cases per 10 million). There was no significant change in the annual incidence rate over the study period (average annual percent change 2.27, 95% CI -1.74 to 6.44; p = 0.25). The odds of receiving radiation therapy or chemotherapy significantly increased by 8% per year (95% CI 1%-16% per year, p = 0.036) over the study period. The odds of receiving open resection significantly decreased by 14% per year (95% CI 8%-20% per year, p < 0.001). The odds of receiving endoscopic surgery among patients with skull base chordoma increased by 38% per year (95% CI 22%-60% per year, p < 0.001), while the odds of patients receiving biopsy alone did not change significantly over the study period (p = 0.684). After diagnosis of chordoma, the 5-, 10-, and 15-year overall survival probabilities were 0.74 (95% CI 0.69-0.81), 0.58 (95% CI 0.51-0.67), and 0.48 (95% CI 0.40 to 0.59), respectively. There was no significant association between hazard of death and year of diagnosis (p = 0.126) or anatomical location (p = 0.712, skull base vs mobile spine chordoma; p = 0.518 skull base vs sacropelvic chordoma). Chordoma is a rare disease with no significant change in the average annual incidence rate between 2003 to 2019. During this time, treatment with less invasive modalities increased, particularly for skull base chordoma. Overall survival exceeds 10 years for many patients, with no change in the hazard of death across the study period.

Trends in hip fracture rates in US male veterans.

In the United States, the annual incidence of osteoporotic hip fracture is estimated to be 250,000 to 300,000; the one-year mortality in some studies has been as high as 32%. Reports that hip fracture rates in US women 65years and older may no longer be declining led to this investigation of hip fracture in men, a less studied population. We assessed the trends in the incidence of hip fracture in US male veterans 50years and older of age as well as the rates of diagnosis and treatment in such men. We assessed the recent trends of hip fracture incidence in a nation-wide male veteran population 50years and older of age. Using data from the US Veterans Affairs Informatics and Computing Infrastructure (VINCI) 2002-2019, we calculated the annual age-standardized hip fracture incidence. Secondary objectives included evaluating the annual proportion of hip fracture patients who underwent dual-energy X-ray absorptiometry (DXA) before or after the fracture and/or received osteoporosis medication after the hip fracture over the study period. Hip fracture incidence increased in male veterans from 2006 to 2019. Fewer than 6% of men underwent a DXA scan and fewer than 0.5% received osteoporosis medications up to two years after a hip fracture. Despite available screening methods such as DXAs and medications for primary and secondary prevention of osteoporotic fractures, hip fracture incidence is not decreasing in older male veterans. Our study highlights a need for closerattention to fracture risk in men.

Geographic Variation in First Lower Extremity Amputations Related to Diabetes and/or Peripheral Arterial Disease

BackgroundTo assess trends of first cases of lower extremity amputation (LEA) related to diabetes and/or peripheral arterial disease (PAD), according to areas of residency and neighbourhood material and social deprivation quintiles, in the province of Quebec, Canada. MethodsUsing the Quebec Integrated Chronic Disease Surveillance System, we calculated crude and age-standardized annual incidence rates of first LEA (total, minor, and major) among adults 40 years of age and older with diabetes and/or PAD in fiscal years 2006 and 2019. Area of residency was compiled in 3 categories: (1) Montreal and other census metropolitan areas; (2) midsize agglomerations (10,000-100,000 inhabitants); and (3) small towns and rural areas (< 10,000 inhabitants). We also stratified according to neighbourhood material and social deprivation quintiles. One-year and 5-year all-cause mortality after first LEA were compared according to area of residency. ResultsAmong the 10,275 individuals who had a first LEA, age-standardized LEA rates remained stable between 2006 and 2019, whereas major LEA rates declined in all geographical areas and minor LEA rates increased (31.6%) in small towns and rural areas. In 2019, age-standardized LEA rates were higher in midsize agglomerations and small towns and rural areas compared with census metropolitan areas. Age-standardized LEA rates in 2019 were higher among the most deprived quintile compared with the most privileged quintile for material and social deprivation. No difference was observed in mortality after first LEA according to area of residency. ConclusionsThere are health disparities in the burden of diabetes and PAD related to first LEA in the province of Quebec. To improve preventive care and reduce the burden of LEA, targeted actions should be taken among the most deprived groups and rural settings.

A population-based study on incidence trends of small intestine cancer in the United States from 2000 to 2020.

Although rare, small intestine cancer is on the rise in the developed world. We aimed to investigate the incidence trends of small intestine cancer by sex, race/ethnicity, age, and histological subgroups in the United States (US) over 2000-2020. Also, we evaluated the COVID-19 impacts on the incidence trends of this cancer. Data were collected from the Surveillance, Epidemiology, and End Results 22 database. Both the average annual percent change (AAPC) and age-standardized incidence rates (ASIRs) were determined. The findings were expressed as counts and incidence rates adjusted for age per 100,000 people with 95% confidence intervals (CIs). A total of 67,815 cases of small intestine cancer across all age groups were reported in the US between 2000 and 2019. Neuroendocrine carcinoma was the most often reported subtype (54.26%). The age group of 55 to 69 years (38.08%), men (53.10%), and Non-Hispanic Whites (69.07%) accounted for the majority of cases. Over 2000-2019, the ASIRs for small intestine cancer among men and women were 2.61 (95% CI: 2.59-2.64) and 1.92 (95% CI: 1.89-1.94) per 100,000, indicating a significant increase of 2.01% and 2.12%, respectively. Non-Hispanic Black men had the highest ASIR (4.25 per 100,000). Also, those aged 80-84 age group had the highest ASIR. During COVID-19, the ASIR of small intestine cancer decreased by 8.94% (5.06-12.81%). Small intestine cancer incidence raised in all sexes and ethnicities. Following COVID-19, reported cases declined, possibly due to pandemic-related diagnostic challenges. The impact of underdiagnosis on patient survival needs further investigations.

Decreasing trend in thyroid cancer incidence: a study from central Italy (2007-2019).

Due to overdiagnosis, the incidence of thyroid cancer (TC) has increased in high-income countries, including Italy. Efforts have been made to address this issue since the mid-2010s, but more information is needed about how TC incidence has changed. We aim to examine the trend in TC incidence in the Lazio Region (central Italy) and assess the impact of the 2014 Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) to identify potential changes in TC diagnosis. To identify TC cases, we conducted a population-based study (period 2007-2019) using the data from the Lazio Region Cancer Registry (5.8 million residents). We calculated the annual age-standardized incidence rates of TC for both sexes and analyzed the impact of ICCRTC on monthly incidence rates using segmented linear regression applied to interrupted time-series (ITS). Throughout the 13 years, there was a significant decline in TC annual incidence rates, more pronounced in females. Our results are consistent with reports from outside Europe (United States and South Korea). Following ICCRTC implementation in 2014, a step-change reduction in both sexes was revealed. Our study indicates a significant decrease in the incidence of TC, particularly among females. The ITS analysis highlights the possible role of ICCRTC in reducing overdiagnosis. As the Lazio Region reflects the Italian population in terms of various demographic, health, and lifestyle indicators, our findings can be applicable at the national level.

Active surveillance of hepatitis E: a 10-year epidemiological analysis in a city in eastern China

ABSTRACT Hepatitis E virus (HEV) is an important cause of acute hepatitis, however, is highly neglected and largely underreported. This study aimed to describe the detailed epidemiology of hepatitis E (HE) through a 10-year surveillance. A community-based active hepatitis surveillance was conducted between November 2007 and October 2017 in 11 townships of Dongtai City in China, involving 355,673 residents. Serum samples were obtained from patients presenting with hepatitis symptoms for more than 3 days. Serum alanine aminotransferase (ALT) levels greater than 2.5 times the upper limit of normal (ULN) were considered acute hepatitis. Samples were subsequently tested for IgG and IgM anti-HEV antibodies, HEV RNA, and hepatitis B surface antigen (HBsAg). The data indicated the incidence of HE fluctuated downward from 2007 to 2017, with an average annual age-standardized incidence of 17.50 per 100,000, exceeding the 10.26 per 100,000 in the National Notifiable Disease Report System (NNDRS). The incidence was notably higher among males (20.95 per 100,000) and individuals aged 50–69 years (37.47 per 100,000). Genotype 4 (HEV-4) was the predominantly circulating genotype during the study period. Furthermore, the study revealed the incidence of hepatitis with HEV and hepatitis B virus (HBV) co-infection was 4.99 per 100,000. The active surveillance system identified a higher incidence of HE compared to NNDRS, with a decreased prevalence over a 10-year period. While efforts are still needed to prevent HE in high-risk populations, including individuals with hepatitis B and the elderly.

Incidence of pregnancy related pulmonary embolism in Spain 2016-2021: an observational population-based retrospective study

ObjectiveThis study aimed to estimate the overall and annual age-standardized incidence of pregnancy-related pulmonary embolism (PE) in Spain from 2016 to 2021, explore the distribution of PE events during pregnancy and the postpartum period, identify potential risk factors, and estimate mortality rates during hospital admission. MethodsIn a retrospective, observational, population-based study, data from the Spanish National Hospital Discharge Database were analyzed to identify women with hospital episodes of pregnancy-related-PE. The primary outcome was the overall and annual age-standardized incidence of pregnancy-related-PE, with secondary aims including the distribution of events during pregnancy and postpartum and the calculation of age-standardized mortality rates during admission. ResultsAmong 2,178,805 births from 2016 to 2021, 522 women were diagnosed with pregnancy-related PE, yielding an overall age-standardized incidence of 2.83 cases per 10,000 births. A non-significant increasing trend was observed from 2.43 to 4.18 cases per 10,000 births (p = 0.06). Comorbidities were low, with a notable association between PE and SARS-CoV-2 infection during the last two years. The mortality rate among women with pregnancy-related PE was 2.8%, with a higher incidence of PE reported during the postpartum period. ConclusionThe incidence of pregnancy-related-PE in Spain exhibits a non-significant increasing trend, with a significant risk of mortality. The association with SARS-CoV-2 infection underscores the importance of vigilant monitoring and management of pregnant women, particularly during pandemics. This study contributes specific data on the incidence and characteristics of pregnancy-related-PE in Spain, emphasizing the need to consider PE in the differential diagnosis and management strategies for pregnant and postpartum women.

Strategies to accelerate the elimination of cervical cancer in British Columbia, Canada: a modelling study.

To eliminate cervical cancer in Canada by 2040, defined as an annual age-standardized incidence rate (ASIR) lower than 4.0 per 100 000 women, the Canadian Partnership Against Cancer (CPAC) identified 3 priorities for action: increasing human papillomavirus (HPV) vaccine coverage, implementing HPV-based screening and increasing screening participation, and improving follow-up after abnormal screen results. Our objective was to explore the impact of these priorities on the projected time to elimination of cervical cancer in British Columbia. We used OncoSim-Cervical, a microsimulation model led and supported by CPAC and developed by Statistics Canada that simulates HPV transmission and the natural history of cervical cancer for the Canadian population. We updated model parameters to reflect BC's historical participation rates and program design. We simulated the transition to HPV-based screening and developed scenarios to explore the additional impact of achieving 90% vaccination coverage, 95% screening recruitment, 90% ontime screening, and 95% follow-up compliance. We projected cervical cancer incidence, ASIR, and year of elimination for the population of BC for 2023-2050. HPV-based screening at current vaccination, participation, and follow-up rates can eliminate cervical cancer by 2034. Increasing on-time screening and follow-up compliance could achieve this target by 2031. Increasing vaccination coverage has a small impact over this time horizon. With the implementation of HPV-based screening, cervical cancer can be eliminated in BC before 2040. Efforts to increase screening participation and follow-up through this transition could potentially accelerate this timeline, but the transition from cytology- to HPV-based screening is fundamental to achieving this goal.

P.094 Incidence of pathologically confirmed primary malignant brain tumours in Newfoundland and Labrador: an eight-year review spanning 2015-2022

Background: Considering regional and temporal trends, we sought to explore the incidence of primary malignant brain tumours in Newfoundland and Labrador. Methods: We reviewed all primary, malignant brain tumour cases from 2015-2022 confirmed by St. John’s Health Sciences Centre pathology reports. Incidence rates were standardized using the 2011 Canadian standard population. Results: We included 362 cases. The average annual age-standardized incidence rate of primary, malignant brain tumours per 100,000 was 7.0 (95% CI: 6.3-7.7), lower than the national average (7.93; 95% CI: 7.78-8.08). The incidence of glioblastoma (5.1; 95% CI: 4.5-5.7) was significantly higher than the national average (4.05; 95% CI: 3.95-4.16). Temporal trends revealed that oligodendroglioma incidence spiked from 0.5 (95% CI: 0.2-0.7) in 2015-2019 to 1.5 (95% CI: 0.4-2.6) in 2020 before returning to baseline in 2022. Regional trends indicated a lower incidence of malignant tumours in Labrador-Grenfell (5.1; 95% CI: 2.5-7.6), compared to 6.9 (95% CI: 6.2-7.6) averaged elsewhere. Conclusions: Higher rates of glioblastoma in Newfoundland and Labrador could have a genetic or multi-factorial cause. The increased occurrence of oligodendroglioma during the COVID-19 pandemic necessitates broader investigation, potentially linked to delays in patient care during this period. Regional trends could suggest less access to care in rural populations and underestimated incidence.

P.092 Incidence of tissue-sampled brain metastases pre- and post-COVID-19 in Newfoundland and Labrador: an eight-year review

Background: Brain metastases indicate an advanced tumour stage for many cancers. We sought to investigate the incidence change of tissue-sampled brain metastases and its relation to staging challenges during the COVID-19 pandemic in Newfoundland and Labrador. Methods: We reviewed all brain metastasis cases from 2015-2022 requiring first-time tissue sampling according to pathology reports from the St. John’s Health Sciences Centre. Incidence rates were calculated using yearly population data by regional health authorities and standardized using the 2011 Canadian standard population. Results: We included 173 cases. The average annual age-standardized incidence rate of brain metastases requiring tissue sampling per 100,000 increased from 2.5 (95% CI: 2.0-3.1) pre-COVID-19 to 4.1 (95% CI: 3.3-5.0) post-COVID-19. Brain metastases from lung primaries accounted for 69% of this increase. While incidence declined to near-baseline in the Eastern provincial population by 2022 (3.3; 95% CI: 1.5-5.1), incidence rose into 2022 in the Western population (8.6; 95% CI: 3.9-13.2). Conclusions: These data suggest a delayed presentation of malignancies during the COVID-19 pandemic and underscore the importance of prioritized staging during times of strain on healthcare systems. Regional, temporal trends suggest regions distant from tertiary care centres could face challenges in resolving cases with delayed presentation post-COVID-19.

New opioid prescription claims and their clinical indications: results from health administrative data in Quebec, Canada, over 14 years

ObjectivesDescribe new opioid prescription claims, their clinical indications and annual trends among opioid naïve adults covered by the Quebec’s public drug insurance plan (QPDIP) for the fiscal years 2006/2007–2019/2020.Design and...

Abstract 4854: Breast cancer incidence trends in Ukraine 2010-2019: Rising incidence at young ages

Abstract Background. BC commonly affects women of older age, however, in developing countries around 20-25% cases of BC presented in young woman. Age-specific clinical characteristics or outcomes data for young women are lacking. Most of the standard treatments used in this subpopulation currently are derived from older patients. Early onset BC is often defined aggressive in nature. Several research have attributed this to a hidden unique biology. However, findings remain controversial. Purpose: The aim of this study is to describe recent trends for BC incidence in Ukraine since 2010 by age groups and interpret them to seek clue for improvement. Methods: We analyzed records from the NCR on 143420 BC cases (C50, International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10)) diagnosed in 2010-2019 in female Ukrainian population. The data were submitted on the beginning of 2022. We calculated annual age-standardized incidence rates (ASRWs) for three age groups. The estimated annual percent change (EAPC) of the rates was calculated using the generalized linear regression. The difference of the rates with its statistical significance was determined with the standardized rate ratio. Results: During 2010-2019, the proportion of BC in all cancers detected at the age of 20-44 increased from 21.7% to 25.9%, while the frequency of BC detection at the age of 45+ did not change and ranged 19.3-20.2%. During the study period, the BC incidence rate has increased significantly (≤0.01): the ASRW of females aged 0-85+ grew with EAPC=0.6% amounting to 42.4-45.7 per 100,000 population, the incidence rate of women aged 45+ grew with EAPC=0.3% ranging from 130.0 to 139.6 per 100,000 population, while the incidence rate of women aged 20-44 grew with EAPC=1.8% amounting to 22.8-27.8 per 100,000 population. In age group 20-44 years, EAPC of BC incidence (1.8%) significantly exceeds the EAPC of the incidence for all cancers combined (0.2%). The dynamics of stage distribution showed increasing proportion of BC cases detected in women aged 20-44 in stage 1 (by 4.1% from 2010 to 2019) and its decreasing for BC cases detected in stage 2 by 4.5%; the proportion of cases diagnosed in stage 4 decreased by 0.5% along with increase in number of cases with undefined stage by 0.6%. Conclusions: The obtained results indicate trends for increasing the incidence of Early Onset BC in Ukraine and justify need for the further research elucidating prognosis and validating novel biomarkers for customizing therapy for this patient group . Citation Format: Nataliia Verovkina, Olena Sumkina, Liubov Syvak, Wafik El-Diery. Breast cancer incidence trends in Ukraine 2010-2019: Rising incidence at young ages [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4854.

Incidence trend of type 2 diabetes from 2012 to 2021 in Germany: an analysis of health claims data of 11 million statutorily insured people.

The aim of the study is to describe the time trend of type 2 diabetes incidence in the largest state of Germany, Bavaria, from 2012 to 2021, and to compare the incidence rates during the pandemic period (2020-2021) to the pre-pandemic period (2012-2019). This secondary data analysis uses health claims data provided by the Bavarian Association of Statutory Health Insurance Physicians (KVB), covering approximately 11 million insurees, accounting for 85% of the total population of Bavaria, Germany. Newly diagnosed type 2 diabetes cases in adults (≥20 years) coded as E11 (Diabetes mellitus, Type 2) or E14 (Unspecified diabetes mellitus) under ICD-10, German modification (ICD-10-GM) for the study period 2012 to 2021 were included. Annual and quarterly age-standardised incidence rates (ASIR) stratified by sex, age and region were calculated using the European standard population. Sex-specific crude incidence rates (CIR) were calculated using 10-year age groups. Regression analyses adjusted for time trends, seasonal effects, and pandemic effects were used to analyse the incidence trend and to assess the effect of the pandemic. Overall, 745,861 new cases of type 2 diabetes were diagnosed between 2012 and 2021: 50.4% (376,193 cases) in women. The male/female ratio remained stable over the observation period, while the median age at diagnosis decreased from 61 to 58 years in men and from 66 years to 61 years in women. ASIR were consistently higher for men compared with women, with the yearly difference remaining stable over time (2012: 18%; 2021: 20%). An overall decreasing trend in ASIR was observed during the study period, with a strong decrease from 2012 to 2017, followed by a less pronounced decline from 2018 to 2021 for both sexes. For men, ASIR decreased from 1514 per 100,000 person-years in 2012 to 995 per 100,000 person-years in 2021 (4.6% average annual reduction), and for women from 1238 per 100,000 person-years in 2012 to 796 per 100,000 person-years in 2021 (4.8% average annual reduction). This downward trend was also observed for age groups above 50 years. Regression analyses showed no significant change in incidence rates during the pandemic period (2020 and 2021) compared with the pre-pandemic period. For the first time, a 10-year incidence trend of type 2 diabetes is reported for Germany, showing a strong decline from 2012 to 2017, followed by a less pronounced decline from 2018 to 2021. The incidence trend of type 2 diabetes appears not to have been affected by the first 2 years of the COVID-19 pandemic. Despite an overall increasing prevalence, the incidence is decreasing, potentially resulting from robust screening by family physicians, reducing the median age at diagnosis by 3 to 5 years. However, further investigation is needed to fully identify the reasons for the declining incidence trend. Continued incidence monitoring is necessary to identify the long-term trend and the potential effect of the pandemic on diagnoses of type 2 diabetes.

Improving cancer incidence evaluation through local government area matching: a study of the Edo-Benin cancer registry in Nigeria.

Cancer registries in Nigeria, as well as in other sub-Saharan African countries, face challenges in adhering to international cancer registration standards. We aimed to improve cancer incidence estimation by identifying under-reporting of new cancers through matching patient-reported local government areas (LGAs) in Edo state, Nigeria, to their respective catchment populations. Information on cancers was obtained from records of hospitals, medical clinics, pathology laboratories, and death certificates according to IARC guidelines. We utilized normalized scores to establish consistency in the number of cancers by calendar time, and standardized incidence ratios (SIR) to assess the variation in cancer incidence across LGAs compared to Edo state average. Subsequently, we estimated sex- and site-specific annual incidence using the average number of cancers from 2016 to 2018 and the predicted mid-year population in three LGAs. Age-standardization was performed using the direct method with the World Standard Population of 1966. The number of incident cancers consistent between 2016-2018 in Egor, Oredo, and Uhunmwonde showed a significantly increased SIR. From 2016 to 2018 in these three LGAs, 1,045 new cancers were reported, with 453 (42.4%) in males and 592 (57.6%) in females. The average annual age-standardized incidence rate (ASR) was 50.6 (95% CI: 45.2 - 56.6) per 105. In men, the highest incidence was prostate cancer (ASR: 22.4 per 105), and in women, it was breast cancer (ASR: 16.5 per 105), and cervical cancer (ASR: 12.0 per 105). Microscopically verified cancers accounted for 98.1%. We found lower age-standardized incidence rates than those reported earlier for the Edo state population. Collecting information on the local government areas of the cancers allows better matching with the respective target population. We recommend using LGA information to improve the evaluation of population-based cancer incidence in sub-Saharan countries.

Pooling of primary care electronic health record (EHR) data on Huntington’s disease (HD) and cancer: establishing comparability of two large UK databases

ObjectivesTo explore whether UK primary care databases arising from two different software systems can be feasibly combined, by comparing rates of Huntington’s disease (HD, which is rare) and 14 common...

Epidemiology of Scabies in Korea (2010~2021): An Updated Report

Background: Scabies is a neglected disease that significantly affects the daily lives of patients and their cohabitants. Objective: To investigate the current epidemiological data regarding scabies in Korea. Methods: This was a nationwide population-based observational study using data from the National Health Insurance claims database (reference period: 2010~2021). The primary outcome measure was the annual incidence of scabies. Subgroup analyses were performed disaggregated by sex, age, and region of residence. Results: A total of 517,296 scabies cases were identified, with a male-to-female ratio of 0.83. The annual age-standardized incidence rates steadily decreased from 2010 (97.6 per 100,000 person-years [PY]) to 2021 (43.4 per 100,000 PY), with an average annual percent change of -5.0%. A steep decrease was observed in 2015 (-12.9%), 2020 (-12.7%), and 2021 (-22.8%). An aging trend in patients with scabies was observed, with patients aged ≥50 years accounting for 36.5% and 63.8% of patients in 2010 and 2021, respectively. The ≥80 years age group showed the highest age-specific incidence rate. Although all age groups showed a reduction in annual incidence, the extent of the reduction was relatively greater in patients aged &lt;50 years. The number of patients with scabies was the highest in Gyeonggi, Seoul, and Busan, while the regional incidence rates were highest in Gwangju, Jeonbuk, Jeonnam, Daejeon, and Jeju. Conclusion: During the last 12 years, there has been a gradual decrease in the overall prevalence of scabies. However, the incidence remains relatively higher among the elderly population.

Seasonality of syphilis in males through the 2011 to 2019 mandatory surveillance period: A cross-sectional study in South Korea.

Although the effects of seasonality on syphilis have been discussed previously, no previous study has evaluated the seasonality of syphilis incidence by sex and age group. We examined the seasonality of syphilis incidence by sex and age group in Korea from 2011 to 2019. The incidence of syphilis was calculated on the basis of Korea Diseases Control and Prevention Agency data, and an autoregressive integrated moving average (ARIMA) model and seasonal and trend decomposition using Loess were used to analyze the seasonality of the incidence in relation to epidemiological factors. The annual age-standardized incidence rates of primary, secondary, and congenital syphilis were 21.1, 8.8, and 64.0 cases/million persons, respectively, from 2011 to 2019. The highest incidence rates for primary and secondary syphilis were observed among those aged 20 to 29, 13 to 19, and 30 to 49 years, but not among the lower age groups. In analyses based on the ARIMA model, all univariate time series showed the highest goodness-of-fit results with ARIMA for primary syphilis (1,1,2), secondary syphilis (1,1,1), and congenital syphilis (0,1,2) (2,0,0) models. This study suggests that the incidence of secondary syphilis shows a summer seasonality for males and the highest incidence rate in the 20 to 29-year age group for both males and females in Korea. Public health action is needed to prevent an increase in syphilis incidence associated with sex, age group, and seasonal patterns.

The levels and trends of cancer incidence in the elderly population at national and sub-national scales in Iran from 1990 to 2016.

Cancer is most commonly associated with aging. It is necessary to gain a better understanding of cancer's trend and distribution among elderlies and provide comprehensive cancer care for this population. The aim of the current study was to show the trends in cancer incidence focusing on the population aged 60+ from 1990 to 2016 in Iran. We used the dataset of the Iran Cancer Registry to estimate cancer incidences by sex, age, province, and year. In order to account for incomplete data we used a two-stage spatiotemporal model along with random intercept mixed effect models. We calculated annual age-standardized incidence rates (ASIRs) for age groups 60+ and 5-interval age groups. There was an increasing trend of 25.3% to 936.9% (95% uncertainty interval: 769.6-1141.8) in ASIR in the elderly in 2016. ASIR of all cancers were 889.7 (731.3-1083.6) in women and 988.1 (811.1-1205) in men in 2016, per 100 000 respectively, which had an increasing trend comparing 1990. Skin, breast, and stomach cancers in women and prostate, skin, and stomach cancers in men were the most common types in 2016. All the most incident cancer subtypes underwent an increasing trend in both sexes, except for the bladder, esophageal, and skin cancers which almost had a similar level in 1990 and 2016. Most provinces had an increasing trend in ASIR in all cancers combined from 1990 to 2016 except Zanjan with a decreasing trend. Regarding the persistent increasing trend of most elderly cancers' incidence, this is crucial for policymakers to establish preventive plans, determine proper resource allocation, and develop specific treatments for elderly cancer patients.

Temporal trends in the utilization, referral patterns, and complications of catheter ablation for atrial fibrillation in the Netherlands, 2013-2021

Abstract Background Over the past decade, atrial fibrillation (AF) ablation technologies have evolved, operator experience has improved, and indications for referral to AF ablation has expanded. A recent population-level assessment is warranted to assess the impact of these changes on trends in the utilization, referrals, and adverse events (AEs) of AF ablation. Purpose Our aim was to describe temporal trends in the population-level incidence, patients referred, and AEs of AF ablation in the Netherlands from 2013 to 2021. Methods Temporal trend analyses were conducted using the AF ablation population in the Netherlands Heart Registration and included all consecutive patients treated with catheter ablation for AF between 2013 and 2021 at 16 hospitals in the Netherlands. Annual crude, sex- and age-standardized incidence rates of AF ablation were calculated. Poisson regression models with robust variances were used to evaluate trends in the incidence of AF ablation. Trends in patient characteristics, AEs, and repeat ablations over the study period were evaluated with ANOVA tests. Results Between 2013 and 2021, 37,538 AF ablations were performed in the Netherlands, of which 27,027 (72.0%) were index ablations. Repeat ablations (10,511 procedures) were performed within a median time to repeat ablation of 1 (IQR 1-2) year. AF ablation patients were a median age 63 (IQR 56-69) years, 32.8% women, 70.7% had paroxysmal AF, and median CHA2DS2-VASC score was 1 (IQR 1-2). Most patients underwent radiofrequency ablation (55.4%), followed by cryoballoon (33.4%), PVAC (0.6%), pulse-field (0.3%), laser balloon ablation (0.1%), and other (0.1%) (10.1% missing). Over the 9-year period, there was a statistically significant increase in index [incidence rate ratio (IRR) 1.07 (95% CI 1.05-1.08)] and repeat [IRR 1.09 (95% CI 1.05-1.12)] ablations from 2013 to 2021 (Figure 1). The annual sex-standardized incidence rates of AF ablations were approximately double for men compared to women throughout follow-up (Figure 2). In recent years, AF ablation patients had more persistent AF, higher CHA2DS2-VASC scores, and lower LVEF (p&amp;lt;0.05 for all). Minor vascular AEs within 30 days were the most frequent AE of AF ablation (1.1%), followed by phrenic nerve paralysis (0.6%), in-hospital bleeding (0.6%), cardiac tamponade (0.5%), thrombosis (0.3%), major vascular AEs (0.2%) and all-cause mortality (0.1%). Incidence of most AEs remained stable over time (p&amp;gt;0.05 for all). CONCLUSION In the Netherlands, the utilization of AF ablation increased by 7% from 2013 to 2021. In recent years, populations referred for AF ablation were increasingly older, had more persistent AF, higher CHA2DS2-VASC scores, and lower LVEF; however, men remained twice as likely to undergo AF ablation compared to women. Reasons for the lower rate of AF ablation among women requires further investigation.