Average Age-standardized Incidence Rate Research Articles

Relationship Between Population Density, Availability of Gynecological Services, and Cervical Cancer Incidence and Mortality Across Administrative Units in Serbia and Bosnia and Herzegovina During 2016–2020

Background and Objectives: Burden of cervical cancer in Central and Eastern Europe is higher than in other parts of Europe. We analyzed cervical cancer epidemiology in Serbia and Bosnia and Herzegovina (the Federation of Bosnia and Herzegovina and the Republic of Srpska) from January 2016 to December 2020, exploring the role of available sociodemographic factors and healthcare service parameters on incidence and mortality rates, using an ecological approach based on aggregated data. Materials and Methods: Incidence and mortality rates are standardized using the method of direct standardization with the World-ASR-W. Administrative units are grouped by tertiles of incidence and mortality to explore sociodemographic factors and healthcare parameters across these groups. Results: Average age-standardized incidence rates of cervical cancer per 100,000 females were 19.28 in Serbia, 12.48 in the Federation of Bosnia and Herzegovina, and 22.44 in the Republic of Srpska. Mortality rates per 100,000 females were 6.67, 5.22, and 4.56 in Serbia, the Federation of Bosnia and Herzegovina, and the Republic of Srpska, respectively. Several parameters of sociodemographics and health service usage differed significantly across units grouped by tertiles based on incidence level, i.e., female population ≥ 15 years old (p = 0.028), population density (p = 0.046), percent of gynecologists in the primary healthcare (p = 0.041), number of gynecologists per 10,000 females ≥ 15 years (p = 0.007), and the area-to-gynecologist ratio (p = 0.010). A moderate negative correlation was found between incidence and population density (rho = −0.465, p = 0.017), and a moderate positive correlation between incidence and area-to-gynecologist ratio (rho = 0.534, p = 0.005). Conclusions: Cervical cancer remains a leading cause of cancer among women in developing countries. Implementing tailored activities, such as educational programs, preventive services, and investments in healthcare infrastructure, particularly at the administrative units’ level, can help in reducing health disparities and improving health outcomes.

Incidence and Temporal Patterns of Differentiated Thyroid Carcinoma in Children and Adolescents in Germany: A Pooled Analysis Based on Data from the German Malignant Endocrine Tumor Registry and the German Childhood Cancer Registry.

Introduction: The increasing incidence of differentiated thyroid carcinoma (DTC) in children and adolescents has become a growing concern. This study provides the first extensive assessment of incidence patterns and temporal trends of pediatric DTC in Germany, using the best available data from the German Malignant Endocrine Tumor (MET) Registry and the German Childhood Cancer Registry (GCCR) covering a period of 25 years. Patients and Methods: We conducted a register-based incidence and time series analysis, identifying all children and adolescents diagnosed with DTC at ages 0-17 years between 1997 and 2021 in Germany, as recorded in the German MET Registry and/or the GCCR. Age-specific and age-standardized incidence rates (ASR) over time, average annual percentage changes (AAPC), and cross-tabulations were used to evaluate incidence and temporal patterns. Results: We identified 469 DTC cases, including 85.7% papillary thyroid cancer and 9.4% follicular thyroid cancer. The average ASR for the period 1997-2021 was 1.16 per million, with higher rates in females compared with males (1.64 vs. 0.72 per million, respectively). Incidence rates increased with increasing age. The overall ASR increased from 0.84 per million in 1997-2001 to 1.48 per million in 2017-2021, with an AAPC of 3.46% [confidence interval or CI: 2.12-4.83]. The increase was most pronounced in adolescents aged 15-17 years (AAPC: 6.79% [CI: 4.43-9.19]). The proportion of incidentalomas rose from 5% in 1997-2001 to 26% in 2017-2021, yet we observed no marked shift in tumor size between symptomatic and incidental cases. Conclusions: Our study revealed a significant increase in pediatric DTC incidence in Germany, most pronounced among adolescents. The observation of an increasing incidence mirrors global trends and presents a complex public health challenge. While improved detection likely contributes to this trend, the stable tumor size distribution suggests that other factors are also in play. The rising detection of incidentalomas suggests enhanced diagnostic practices unrelated to symptoms of thyroid neoplasia. These findings highlight the need to carefully evaluate diagnostic and screening practices in pediatric populations.

Disparities in incidence and mortality of hematologic cancers in Southeast Asia: A 2020 analysis.

e23291 Background: Hematologic cancers (HCs) in Southeast Asia (SEA), a diverse population of over 680 million, are still understudied. Data from the 2020 Global Cancer Observatory (GCO) was used to estimate the incidence and mortality of HCs in the region to provide direction for effective disease control and improve population outcomes. Methods: The International Agency for Research on Cancer’s publicly available GCO data aggregates global cancer incidence and mortality. We report cumulative incidence rate (CIR) and cumulative mortality rate (CMR) defined per 100,000 people, and weighted average age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) in 2020. Data for Hodgkin Lymphoma (HL), Non-Hodgkin's Lymphoma (NHL), Leukemia, and Multiple Myeloma (MM) in the world, in SEA, and in the 11 individual SEA countries are presented. Results: The table presents CIR, ASIR, CMR, and ASMR of hematologic cancers in SEA compared to overall global data. CIR, ASIR, CMR, and ASMR were higher for males than females in SEA. For NHL, CIR was highest in Singapore (18.8), Thailand (10.2), and Brunei (9.6) and lowest in Myanmar & Cambodia (3.6), and Timor-Leste (2.7). ASIR trends were parallel albeit differences were smaller. CMR was highest in Singapore (6.2) and Thailand (5.9) and lowest in Timor-Leste (1.5). ASMR was highest in Brunei (4.5) and lowest in Timor-Leste (2.0). For leukemia, CIR was highest in Singapore (11.1) and lowest in Myanmar (3.1) and Timor-Leste (2.6); ASIR was highest in Singapore (8.9) and lowest in Myanmar (3.2) and Timor-Leste (2.9). CMR was highest in Singapore (5.2) and lowest in Myanmar (2.6) and Timor-Leste (2.3). ASMR was highest in Lao PDR (4.7) and Vietnam (4.5), and lowest in Singapore (3.1) and Timor-Leste (2.9). For MM, CIR was highest in Singapore (4.1), ASIR was highest in Brunei (2.4) and both are lowest in Myanmar (0.4). CMR was highest in Singapore & Thailand (1.8) and lowest in Myanmar (0.35); ASMR rates were similar. For HL, CIR was highest in Brunei Darussalam (1.8) and Singapore (1.4) and lowest in Myanmar (0.2). ASIR trends were similar. CMR was highest in Vietnam (0.26) and lowest in Singapore (0.1) and Myanmar (0.08). ASMR trends were similar. Conclusions: Despite lower regional average incidence and mortality, significant intra-regional variations exist reflecting disparities in the management of HCs. In addition, while data suggests lower disease burden in SEA, mortality rates are still comparable and in some cases worse than the global average. More work is needed to investigate HC epidemiology in SEA to inform cancer control in the region and improve its blood cancer outcomes. [Table: see text]

Cervical cancer in the Autonomous Province of Vojvodina, Serbia, 2016-2021

Background: Cervical cancer is a major global health problem, and one of the most common causes of cancer in women. This descriptive epidemiological study aimed to provide an overview of the cervical cancer incidence and mortality in Vojvodina. Methods: The data from the Serbian Cancer Registry regarding the cervical cancer incidence and mortality for the period 2016?2021 were analyzed. Results: During the observed 6-year period, the average age-standardized incidence rates of cervical cancer in Vojvodina and Serbia were 20.4 and 19.1 per 100,000 women, respectively. The average age-standardized incidence rates by the district of Vojvodina ranged from 16.8 to 30.2/100,000. The average age-standardized cervical cancer mortality rate in Vojvodina and Serbia was 7.0 and 6.6/100,000, respectively. The average mortality rates by the district of Vojvodina ranged between 5.6/100,000 and 9.9/100,000. Conclusion: The cervical cancer incidence and mortality rates in Vojvodina exhibited significant variation across different districts and observed years, with their average values surpassing the national average. To improve the epidemiological situation of cervical cancer in Vojvodina, it is imperative to enhance the implementation of organized screening at the district level, coupled with intensified efforts to promote HPV vaccination throughout Vojvodina. Additionally, more research on screening coverage and vaccination rates and improved reporting cervical cancer cases and deaths are needed.

A Bayesian approach to correct the under-count of cancer registry statistics before population-based cancer registry program.

This study aims to correct undercounts in cancer data before initiating a population-based cancer registry program, employing an innovative Bayesian methodology. Underestimation is a widespread issue in cancer registries within developing countries. This secondary study utilized cancer registry data. We employed the Bayesian approach to correct undercounting in cancer data from 2005 to 2010, using the ratio of pathology to population-based data in the Golestan province as the initial value. The results of this study showed that the lowest percentage of undercounting belonged to Khorasan Razavi province with an average of 21% and the highest percentage belonged to Sistan and Baluchestan province with an average of 38%.The average age-standardized incidence rate (ASR) for all provinces of the country except Golestan province was equal to 105.72 (Confidence interval (CI) 95% 105.35-106.09) per 100,000 and after Bayesian correction was 137.17 (CI 95% 136.74-137.60) per 100,000. In 2010 the amount of ASR before Bayesian correction was 100.28 (CI 95% 124.39-127.09) per 100,000 for women and 136.49 (CI 95% 171.20-174.38) per 100,000 for men. Also, after implementing the Bayesian correction, ASR increased to 125.74 per 100,000 for women and 172.79 per 100,000 for men. The study demonstrates the effectiveness of the Bayesian approach in correcting undercounting in cancer registries. By utilizing the Bayesian method, the average ASR after Bayesian correction with a 29.74 percent change was 137.17 per 100,000. These corrected estimates provide more accurate information on cancer burden and can contribute to improved public health programs and policy evaluation. Furthermore, this research emphasizes the suitability of the Bayesian method for addressing underestimation in cancer registries. It also underscores its pivotal role in shaping the trajectory of future investigations in this field.

Uterine and Cervical Cancer in Iran: An epidemiologic analysis of the Iranian National Population-Based Cancer Registry.

Gynecologic cancers, including neoplasms of the cervix and uterine, are the fourth most common malignancies, causing 3.46% of deaths in women aged 15 to 59. We aimed to report the Iranian National Population-based Cancer Registry (INPCR) results for Cervical and Uterine cancers in 2017. The total population of Iran in 2017 was 80881792. INPCR collected data on cervical and uterine cancer incidence from 31 provinces of Iran. In this project, we retrospectively examined all the country's regions in terms of screening for the existence of these two cancers. The registry data bank in Iran was used. Overall, 3481 new cervical and uterine cancer cases were registered in INPCR, including 842 cases of cervical cancer (with a crude rate of 1.04) and 2639 cases of uterine cancer (with a crude rate of 3.26). The average age-standardized incidence rate (ASR) was 0.99 for cervical cancer and 3.29 for uterine cancer. Out of 3481 new cervical and uterine cancer cases, 2887 were registered with pathological findings and 594 without pathological confirmation. In cervical cancers, the highest rate was related to squamous cell carcinoma, with 486 cases (57.72%). Our results showed that Iran is a low-risk area for the incidence of cervical and uterine cancers. In this study, the highest rate of cervical cancer was related to squamous cell carcinoma, confirming previous reports. However, this rate was lower than previous studies and suggested an increase in other types of cervical cancer in Iran.

Hepatocellular carcinoma incidence is decreasing in Korea but increasing in the very elderly.

A comprehensive analysis of trends in the incidence of hepatocellular carcinoma (HCC) is important for planning public health initiatives. We aimed to analyze the trends in HCC incidence in South Korea over 10 years and to predict the incidence for the year 2028. Data from patients with newly diagnosed HCC between 2008 and 2018 were obtained from Korean National Health Insurance Service database. Age-standardized incidence rates (ASRs) were calculated to compare HCC incidence. A poisson regression model was used to predict the future incidence of HCC. The average crude incidence rate (CR) was 22.4 per 100,000 person-years, and the average ASR was 17.6 per 100,000 person-years between 2008 and 2018. The CR (from 23.9 to 21.2 per 100,000 person-years) and ASR (from 21.9 to 14.3 per 100,000 person-years) of HCC incidence decreased during the past ten years in all age groups, except in the elderly. The ASR of patients aged ≥80 years increased significantly (from 70.0 to 160.2/100,000 person-years; average annual percent change, +9.00%; P<0.001). The estimated CR (17.9 per 100,000 person-years) and ASR (9.7 per 100,000 person-years) of HCC incidence in 2028 was declined, but the number of HCC patients aged ≥80 years in 2028 will be quadruple greater than the number of HCC patients in 2008 (from 521 to 2,055), comprising 21.3% of all HCC patients in 2028. The ASRs of HCC in Korea have gradually declined over the past 10 years, but the number, CR, and ASR are increasing in patients aged ≥80 years.

Incidence of myelodysplastic syndromes in Finland 1997–2016

Myelodysplastic syndromes (MDS) are a diverse group of clonal hematopoietic stem cell diseases that may progress to acute myeloid leukemia. Here, we present incidence of myelodysplastic syndromes based on a nationwide, registry-based study. A total of 1906 MDS cases were reported to the Finnish Cancer Registry during 1997-2016. We analysed the age-standardized incidence rates using the new European standard population, incidence trend and changes in trend by sex, age group and calendar year using Poisson regression and joinpoint regression. The average age-standardized incidence rate was 3.92 per 100,000 person-years. The incidence of MDS increased in a linear-quadratic fashion across 10-year age groups and was higher among men (5.43 versus 3.14 per 100,000). The incidence trend increased during the first 15 years followed by a decline towards the end of the study period. A similar trend was found in subgroups by sex and age. Our results show a similar or slightly higher MDS incidence in Finland as in other Western countries, with an increasing trend, but some decrease in the end. The increasing incidence may reflect improved reporting and coding, or there could be a genuine increase in MDS over time.

Trends in Breast Cancer Incidence in Iraq During the Period 2000-2019.

Background:Breast cancer is the most common cancer among women around the world. Objective:This study aims to explore the time trends in the incidence of breast cancer in Iraq in twenty years period (2000 to 2019) to assist health officials and decision-makers in planning and organizing programs to controlling breast cancer growth and enhance women’s health. Methods: Breast cancer data from 2000 to 2019 were obtained from the Iraqi Cancer Registry’s yearly book series (Ministry of Health). The United Nations Population Division provides annual population estimates by 5-year age groups and gender. Joinpoint regression analysis was used to calculate and assess age-specific and age-standardized incidence rates. Results:A total of 72,022 breast cancer cases were identified among women in Iraq between 2000 and 2019. The average age-standardized incidence rate (ASIRs) was 37.883/100,000. Breast cancer ASIR Iraq exhibited a significantly rising trend during the study period, with an average annual percentage change (AAPC) of +3.192%. Furthermore, a significant increase in breast cancer incidence for the age group 40–49 (AAPC = +2.162%), 50–59 (AAPC=+3.210%), 60–69 (AAPC=+5.551%), and age 70 and over (AAPC=+7.943%) were observed. When compared to other countries in the world, Iraq had a moderate rate of breast cancer ASIR. Conclusions:In summary, our finding revealed an increase in the incidence rates of breast cancer among Iraqi women from 2000 to 2019. Further research is needed to explore risk factors including levels of overweight, dietary changes, physical inactivity, obesity, smoking, high marriage age, and low birth rates to prevent and control breast cancer.

The Burden of Penile Cancer in Bali Compared to Other Provinces in Indonesia

Objective: In Indonesia, 45% of the total penile cancer cases are concentrated in Bali province, where penile cancer is ranked as the most common cancer during 2013. However, the incidences of penile cancer in Bali and other provinces in Indonesia are still unknown. The purpose of this study is to determine the age-standardized incidence rate (ASR), age-specific incidence rate (AR), and crude rate incidence (CRI) of penile cancer in Bali and other provinces in Indonesia.&#x0D; Methods: The data were obtained from 11 provinces in Indonesia over a period of 10 years (2004-2013). The samples were 1032 new cases of penile cancer collected manually from the registry. ASR, AR, and CRI were calculated based on the number of new penile cancer cases per 100,000 men in a given province. Indonesian population standard was used to calculate the age-standardized incidence rate.&#x0D; Result: There were variations on ASR, AR, and CRI for penile cancer in Indonesia. We found that the average CRI in Indonesia is 0.1 per 100,000 men. The incidence is found to be higher in Bali compared to other provinces. The average ASR in Bali is 2.1 per 100,000 men, CRI is 2.5 per 100,000 men, and the peak of AR being 12.9 per 100,000 men in the age group of 55-64 years old. The incidence of penile cancer is found to increase with age. In Bali, the peak incidence is in the 6th and 7th decades of life. The ASR and CRI of penile cancer in other provinces were less than 1 per 100,000 males.&#x0D; Conclusion: The highest incidence of penile cancer is found in the Bali province compared to other provinces in Indonesia. This problem requires more serious attention and further research to identify the risk factors.&#x0D;

Trends in the incidence and morbidity of Merkel cell carcinoma in Brazil.

Aims: The current study aims to present epidemiologic changes and clinical aspects of Merkel cell carcinoma (MCC) in Brazil. Methods: Data were collected fromthe Brazilian Population-Based Cancer Registries (2000-2015) and Hospital-Based Cancer Registries (2000-2017). Results: The average age-standardized incidence rates significantly increased in men between the years 2000 (0.31/1,000,000) and 2015 (1.21/1,000,000), with an annual percentage change of 9.4 (95%CI: 4.7-14.4;p<0.001). In women, the incidence rates rose insignificantly in the period with an annual percentage change of 3.1 (95%CI: 0.0-6.2;p<0.10). From the hospital-based database, 881 MCC patients were identified. Most of the patients were females (51.2%), aged>60years (82.2%), White (67.6%) and diagnosed at stages III or IV (50.5%). Conclusions: A key aspect of public health promotion is to understand the incidence and morbidity of MCC.

Epidemiološke karakteristike akutnog koronarnog sindroma u Šumadijskom okrugu

Introduction: Acute coronary syndrome is one of the most common causes of emergency recurrence and sudden death in developed parts of the world, and in the last decades in developing countries. The Aim: Analysis of epidemiological characteristics and trends in the movement of incidence and mortality from acute coronary syndrome on the territory of the Sumadija district in the period 2007-2016 years. Material and Methods: The study was designed as a descriptive epidemiological study. The Register of Acute Coronary Syndrome was used as a source of information about patients and deaths. Linear trend and regression analysis were used to analyze the trend of incidence and mortality. Results: The average age-standardized incidence rate of acute coronary syndrome in men was 186.6/100000 and in women it was 88.6/100000. The average standardized mortality rate from acute coronary syndrome was 45.4/100000 in men and 20.8/100000 in women. Conclusion: Research contributes to the consideration of the society's burden of cardiovascular diseases, as well as for developing specific prevention programs.

Trends in childhood type 1 diabetes mellitus incidence in Beijing from 1995 to 2010: a retrospective multicenter study based on hospitalization data.

The incidence of type 1 diabetes mellitus (T1DM) is increasing rapidly worldwide for children of every age group. A retrospective analysis of hospital registration data from five tertiary hospitals in Beijing, China, identified 485 patients (210 boys, 275 girls) younger than 15 years of age with newly diagnosed T1DM between 1995 and 2010. From 1995 to 2010, the incidence of T1DM in patients <15 years of age ranged from 0.935-3.26 per 100,000 per year. During this period, the average age-standardized incidence rate was 1.7 per 100,000 per year, and the average annual increase in T1DM incidence was 4.36%. The highest rate increases occurred in boys and in patients <5 years of age. For both genders and all age groups, T1DM incidence increased at an accelerated rate after 2006. By 2020, the incidence of T1DM among children in Beijing is projected to increase by a factor of 1.69. The incidence of T1DM among patients younger than 15 years of age in Beijing increased from 1995 to 2010, with rates growing at an accelerated pace since 2006. Based on recent trends, we project continued rapid growth in the number of new childhood T1DM cases in Beijing.

The incidence of type 1 diabetes mellitus among 15-34 years aged Lithuanian population: 18-year incidence study based on prospective databases

BackgroundThe aim of this prospective study was to determine the incidence of type 1 diabetes mellitus in 15-34-year-aged Lithuanian males and females during 1991 - 2008MethodsA contact system with general practitioners covering 100% of the 15-34-year-aged Lithuanian population was the primary data source. Reports from regional endocrinologists and statistical note-marks of State patient insurance fund served as secondary sources for case ascertainment.ResultsThe average age-standardized incidence rate was 8.30 per 100,000 persons per year (95% Poisson distribution confidence interval [CI] 7.90-8.71) during 1991 - 2008 and was statistically significantly higher among males (10.44 per 100,000 persons per year, 95% CI 9.82-11.10) in comparison with females (6.10 per 100,000, 95% CI 5.62-6.62). Male/female rate ratio was 1.71 (95% CI 1.63-1.80). Results of the linear 1991 - 2008 regression model showed that the incidence of Type 1 diabetes in 15-34-year-aged males and females decreased slightly over the time (r = -0.215, p > 0.05).ConclusionsOur data demonstrated the male predominance in primary incidence of type 1 diabetes mellitus in 15-34-year-aged population in Lithuania. The incidence of type 1 diabetes mellitus in 15-34-year-aged males and females decreased slightly during 1991-2008.

Cutaneous melanoma in Latin America: a population-based descriptive study

Cutaneous melanoma incidences vary between geographic regions and are a health concern for Caucasians and for all ethnic populations. In Latin America, data from population-based cancer registries of cutaneous melanoma incidence rates have rarely been reported. We searched the Cancer Incidence in Five Continents volume IX (CI5-IX) database for cutaneous melanoma and select cases by topography (C43) from 11 population-based cancer registries in Latin America. Between 1998 and 2002, a total of 4,465 cutaneous melanoma cases were reported in Latin America. The average age-standardized incidence rates (per 100,000 persons-year) was 4.6 (male) and 4.3 (female). This study presents an overview of cutaneous melanoma incidence in Latin America, highlighting the need to enhance coverage of population-based cancer registries in Latin America, to allow for a better understanding of this neoplasm in the region. Thus it can help in implementing primary prevention programs for the whole Latino population. At this point in time, early detection messages should target young women and older men in Latin America.

Temporal trends of esophageal cancer during 1995–2004 in Nanao Island, an extremely high-risk area in China

The purpose of our study was to investigate the temporal malignant tumor incidence rates among the 70,000 residents at the relatively isolated Nanao Island in South China Sea. The data on all malignant tumor cases from Nanao Cancer Registry during 1995-2004 were coded, computerized, and analyzed using the software SPSS10.0. The tumor incident cases, crude incident rate, age-standardized incidence rate, their sex distribution and temporal trend were assessed. A total of 1450 new cancer cases (990 males and 460 females) were identified. The annual average age-standardized incidence rate (ASR) of malignant tumors was 208.18/100,000. The age-standardized incidence rate of the ten leading cancers in both sexes combined per 100,000 population were 74.47 for esophageal cancer (EC), 34.81 for cardiac cancer (CC), 25.66 for liver cancer, 26.01 for lung cancer, 18.52 for stomach cancer, 4.45 for nasopharyngeal cancer, 3.91 for breast cancer, 2.53 for colon/rectum cancer, 2.45 for bladder cancer and 1.92 for pancreatic cancer. These ten types of cancers make up to 93% of all cancer cases, with EC and CC being the most prevalent and making up 52% of the total cases. The incidence rates of esophagus, liver, lung, breast, nasopharyngeal, and colon/rectum cancers showed increasing trends during the period from 1995 to 2004 in Nanao Island. Astounding the EC ASR were 72-150/100,000 among male and 26-64/100,000 among female in Nanao Island during 1995-2004. The EC incidence rate in Nanao population is among the highest across the world, which suggests that there are potential genetic and/or environmental factors affecting this particular population.

Hodgkin's disease in children in the West Midlands, 1957-1986: a large population-based study.

One hundred forty-one children were diagnosed with Hodgkin's disease between 1957 and 1986 in the West Midlands Health Authority Region (1991 population, 1.1 million children). Eighty-seven were boys and 54 were girls, representing a significant male:female ratio of 1.5:1 (P < 0.01). The average age-standardized incidence rate was 3.6 per million per year with a significant increase in the older age group (> or = 10 years) in the second half of the period (P = 0.02). The mixed cellularity subtype was more common in those younger than 10 years, with nodular sclerosing disease being seen more in those < or = 10 years. Overall survival at 5 years was 76% (65% at 10 years) with a significant difference (P < 0.001) in survival between the first and last decades. There was six second malignancies, five of which could have been treatment related. A positive history of cancer in close relatives was found in 11 patients, and higher social class was found in more older than younger children. These findings support the hypothesis that Hodgkin's disease may have a viral etiology and may be linked with socioeconomic conditions.