Cancer Trends Research Articles

Epidemiology of Cancer Incidence Estimates and Statistics 2000–2025: Analysis from National Cancer Registry Programme in India

Abstract Introduction Several hospital-based and population-based cancer registries (PBCRs) have been collecting cancer data systematically since 1982, according to the National Cancer Registry Programme-National Centre for Disease Informatics and Research, an initiative of the Indian Council of Medical Research. Objective Planning, observing, and assessing cancer control efforts require knowledge of current cancer statistics. This article's goal is to provide an update on cancer incidence projections for India by age groups, sex, and anatomical sites for the period 2020 to 2025. Materials and Methods The cancer incidence, patterns, trends, projections, and mortality from 28 PBCRs were analyzed in this study, along with the kind of therapy and stage of presentation of cancer patients from 58 HBCRs (N = 667,666) from the pooled analysis for the composite period 2012 to 2016. Data regarding the population at risk were obtained from the Indian Census (2001 and 2011) to estimate the age- and sex-stratified population. To gain a better understanding of the epidemiology of cancer, the states and areas of the nation were divided into PBCR groups. Result For both males and females, the districts with the highest age-adjusted incidence rates were Aizawl (269.4) and Papum Pare (219.8). It is anticipated that there will be 1392,179 cancer patients in India by 2020 and 1569,793 by 2025. In Delhi, the northern region of India, the incidence rates of tobacco-related malignancies were high (62.1% for men and 18.5% for women). High incidence rates were seen in the southern districts of Kollam (males: 52.9) and Bangalore (20.1), respectively. Age-adjusted rates (AARs) for males and females in Kolkata, East, were 42.3 and 13.7, respectively. Western cities with high AARs were Mumbai (18.2) and Ahmedabad Urban (54.3) for men and women, respectively. For lung cancer, in terms of male and female incidence rates, Aizawl district ranked highest at 38.8 and 37.9 per 100,000, respectively. Conclusion This study offers a methodology for evaluating cancer trends and status in India. To meet the national targets for noncommunicable diseases and the sustainable development goals, it will direct adequate support for action to boost efforts to promote cancer prevention and control.

Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021

BackgroundThe incidence and mortality rates of pancreatic cancer are rising globally. This study examines global and regional trends in pancreatic cancer incidence, Disability Adjusted Life Years (DALYs), and mortality from 1990 to 2021, utilizing data from the most recent Global Burden of Disease (GBD) 2021 database.MethodsData were sourced from the GBD database over the period from 1990 to 2021. Age-standardized rates for incidence, DALYs, and mortality were calculated per 100,000 population. We also calculated the proportion of DALYs and mortality attributable to risk factors. The Bayesian age-period-cohort model was applied to project future trends until 2050.ResultsBetween 1990 and 2021, the global incidence of pancreatic cancer increased significantly, with the number of cases rising from approximately 207,905 to 508,533 and the age-standardized incidence rate (ASIR) increasing from 5.47 to 5.96 per 100,000 population. The global burden of pancreatic cancer, measured in DALYs, rose from 5.21 million to 11.32 million. Mortality rates showed a similar upward trend, with the number of deaths increasing from around 211,613 to 505,752, and the age-standardized mortality rate (ASMR) rising from 5.655 to 5.948 per 100,000 population. Notable increases in ASIR and ASMR were observed in low-middle and low sociodemographic index regions with males experienced higher rates compared to females. Age-standardized DALYs rate (ASDR) and ASMR worldwide were attributable to tobacco smoking, high BMI, and high fasting plasma glucose. Furthermore, our projection model estimates that the ASIR and ASMR of pancreatic cancer will significantly decline, while the ASDR is anticipated to maintain a steady downward trend by 2050.ConclusionThis study offers a comprehensive analysis of pancreatic cancer trends, providing crucial insights for public health planning and policy-making. Addressing identified risk factors and targeting high-risk populations are essential for effective strategies to reduce the global burden of pancreatic cancer.

Trends in cancer mortality in the elderly and oldest old in South America.

Little is known about trends in cancer among the older segments of the population, even less for South America. To describe time trends in mortality of the most frequent causes of cancer death among the population aged 70 and over. Using the World Health Organization´s Cancer Mortality Database, we studied trends in mortality from lung, colorectal, stomach, liver, prostate, breast, and cervical cancer from 1985 onwards. Joinpoint analyses allow discerning changes in average annual percent change (i.e., slope AAPC) of these trends over time. The region has a 2-3-fold variation in absolute age-specific cancer mortality rates, with the lowest rates in Argentina and Paraguay and the highest in Chile, Uruguay, and Venezuela. In most countries except for Brazil and Paraguay (both sexes), Peru (females and males 80 +), and Venezuela (males), overall cancer mortality rates were declining in the studied age range, with some fluctuations during the period. The most common causes by sex vary throughout the continent and by age group, but overall, increasing trends were observed for colorectal and breast cancer. In all countries, time trends show reductions in mortality from stomach cancer (AAPC up to -4.77 %) and in some countries (Argentina, Chile, Colombia, and Ecuador AAPC between -0.04 % and -4.37 %) for cervical cancer. In the other countries, cervical cancer mortality remained stable. Lung cancer declined in all countries in males (AAPC between -0.39 % and -2.24 %) except Brazil, Paraguay and the eldest males in Venezuela but among females, increases were observed in most countries (AAPC between +0.47 % and +4.05 %). Cancer-specific mortality rates vary considerably between countries in South America and the high cancer mortality rates in the oldest segments of the population. Effective primary prevention strategies, vaccination implementation, early detection, effective treatment programs, and better access to healthcare overall can positively impact the trends.

Cervical cancer incidence and trends among women aged 15-29 years by county-level economic status and rurality - United States, 2007-2020.

Variations in cervical cancer incidence rates and trends have been reported by sociodemographic characteristics. However, research on economic characteristics is limited especially among younger women in the United States. We analyzed United States Cancer Statistics data to examine age-standardized cervical cancer incidence rates among women aged 15-29 years during 2007-2020. We used an index-based county-level economic classification to rank counties in the top 25 %, middle 25 %-75 %, and bottom 25 %. We assessed differences in incidence using rate ratios and trends using annual percent changes (APCs) from joinpoint regression. Due to impact from the COVID-19 pandemic, trend analysis excluded 2020 data. Analyses were conducted during August-October 2023. During 2007-2020, incidence rates were lower in the top 25 % counties economically than the bottom 25 % or middle 25 %-75 % (1.6 vs 2.1 vs 1.9 per 100,000, respectively). Rates were higher in nonmetropolitan than metropolitan counties across economic groups. Overall, rates declined in all county-level economic strata, especially in the bottom 25 % during 2015-2019 (APC -10.6 %). Rates appeared to decrease in metropolitan counties and women of all races across economic categories. decreases were most evident in the top 25 % of non-Hispanic White women during 2016-2019 and nonmetropolitan counties during 2017-2019. In women aged 15-29 years, declining rates of cervical cancer during 2007-2019 across county-level economic strata may partly reflect effects of human papillomavirus vaccination and cervical cancer screening. Further observed differences by race and rurality may help inform efforts to increase implementation of preventive measures in populations with the highest burden.

Global epidemiological trends of trachea, bronchus, and lung cancer in the elderly.

Despite most patients with trachea, bronchus, and lung (TBL) cancer being elderly, epidemiological data specific to this population remain scarce. This study aims to update and delineate the global epidemiological profile of TBL in older adults. An analysis was conducted on data from the Global Burden of Diseases (GBD) 2021 for individuals aged 60 and older. We evaluated the worldwide impact of TBL cancer by socio-demographic index (SDI), gender, and age across 204 countries and territories, including their spatial and temporal trends. The main outcomes comprised age-standardized incidence rates (ASIR), mortality rates (ASMR), disability-adjusted life years (DALY) rates (ASDR), and average annual percent change (AAPC). From 1992 to 2021, the estimated cases of TBL cancer, along with associated deaths and DALYs, increased among the elderly. The ASIR, ASMR, and ASDR all exhibited a declining trend. In 2021, East Asia faced a substantial TBL cancer burden, whereas Western Sub-Saharan Africa exhibited a notable increase over the last thirty years. In 2021, Monaco and Greenland recorded the highest ASIR, ASMR, and ASDR, while Egypt experienced the most significant rise in these rates from 1992 to 2021. The greatest affected age group was those aged 85-89. The TBL cancer burden followed distinct patterns by SDI and sex, with higher SDI regions and females facing a particularly notable increase in burden. From 1992 to 2021, smoking was the leading risk factor for TBL cancer-related deaths and DALYs in older adults, with particulate matter air pollution as a close second. The burden of TBL cancer varies widely across different regions and demographics. More attention should be paid to the elderly in higher SDI regions and females. Recognizing these trends is crucial for enhancing tertiary prevention strategies for TBL cancer and exploring innovative approaches to diagnosis and treatment.

Trends in Incidence, Mortality and Survival of Gastric Cancer in Xiamen, China from 2011 to 2020: a population-based study

Gastric cancer remains one of the most common cancers and the leading cause of death in China. This study aims to describe the incidence, mortality, survival rates, and their changing trends of gastric cancer in Xiamen, China from 2011 to 2020. Population-based cancer registry data were used to calculate the incidence, mortality, and survival rates of gastric cancer. The study population consisted of gastric cancer patients diagnosed from January 1, 2011, to December 31, 2020, and followed up until September 30, 2023. The relative survival of gastric cancer was calculated using period methods. The change in trends was analyzed using Joinpoint regression. From 2011-2020, a total of 4716 new cases of gastric cancer and 3520 related deaths were reported. The crude incidence rate and age-standardized incidence rate (ASIR) were 21.82/100,000 and 16.74/100,000. The crude mortality rate and age-standardized mortality rate (ASMR) were 16.29/100,000 and 12.30/100,000. The ASIR and ASMR in males (ASIR: 24.71/100,000, ASMR: 18.75/100,000) were both more than those in females (ASIR: 9.6/100,000, ASMR: 6.55/100,000). The observed 5-year survival rate was 25.83 %, with an age standardized survival of 27.60 %. The incidence and mortality of gastric cancer showed a decreasing trend, and the 5-year ARS between 2016 and 2020 (30.03 %, 95 %CI: 28.07-32.12 %) was higher than between 2011 and 2015 ( 24.79 %, 95 %CI: 22.53-27.27 %). Furthermore, the survival rate decreased with increasing age. From 2011-2020, the incidence and mortality of gastric cancer in Xiamen City have shown a decreasing trend, and the survival rate has significantly improved. Despite improved survival, the 5-year ARS remains low.

Trends in breast cancer among elderly women: Development in estrogen and HER2 subtypes in the last ten years.

Increasing life expectancy increases breast cancer (BC) rates in elderly, where better health allows for improved tolerance of treatments. We assessed trends in BC incidence of tumor subtypes for women with focus on the elderly. Changes in BC incidence in women by age from 2012 to 2021 were assessed using data from the Nordic countries. We calculated the incidence of BC subtypes by age group using data from the Danish Breast Cancer Group (DBCG) database. We used generalized linear models assuming a Poisson distribution. In the Nordic countries, 205305 women were diagnosed with BC between 2012 and 2021. In Denmark, 50858 BC patients were diagnosed between 2012 and 2022, identified with tumor characteristics. Incidence of BC among women aged 80+ increased significantly across the Nordic Countries, with 1.24% per year (95% CI: 0.07 %: 2.41 %). In Denmark, in the 80+ group, the ER+/HER2- subtype had the highest increase, with 1.98% per year (95% CI: 1.10 %: 2.87 %). Across the Nordic countries, incidence of BC in women aged 80+ increased. In Denmark, rising incidence of BC is driven by the ER+/HER2- subtype in the 80+ group, which has the best prognosis and gentle treatments. More elderly BC patients will require treatment and follow-up in the future.

Global Trends of Early, Middle, and Late-Onset Lung Cancer From 1990 to 2021: Results From the Global Burden of Disease Study 2021.

Although the global burden of lung cancer has generally declined in recent decades, the variation in onset age-related trends remains insufficiently explored. In the current study, we aimed to systematically evaluate the most update temporal trends in incidence, mortality and DALYs of early, middle, and late-onset lung cancer (EOLC, MOLC, and LOLC) from 1990 to 2021, with stratifications of gender, location, and socio-demographic development. We retrieved cross-sectional data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The global, regional, and national burden of lung cancer from 1990 to 2021 was evaluated primarily by age-standardized rates of incidence (ASIR), mortality (ASMR), and DALYs (ASDR). Joinpoint regression analysis was employed to assess temporal trends and turning point years. Frontier analysis was applied to examine the lowest achievable DALYs, and cross-country inequalities were evaluated sing the slope index of inequality (SII) and concentration index. We also forecasted the burden from 2022 to 2035. The global ASIR of EOLC decreased from 4.81 per 100,000 in 1990 to 3.13 in 2021 (AAPC: -1.38, 95% confidence interval [CI]: -1.53 to -1.22, p < 0.001), with a steeper decline in males (AAPC: -1.79) compared to females (AAPC: -0.63). MOLC incidence also declined from 92.77 to 72.47 per 100,000 (AAPC: -0.81, 95% CI: -0.9 to -0.73, p < 0.01), while LOLC demonstrated a slight increase from 195.39 to 225.8 per (AAPC: 0.43, 95% CI: 0.37 to 0.5, p < 0.01). Notably, LOLC in females showed a consistent rise in incidence rate (AAPC: 1.13, 95% CI: 1.05 to 1.21, p < 0.01). In contrast to EOLC and MOLC, 11, 10, and 9 out of 21 GBD regions showed a rising trend for ASIR, ASMR, and ASDR of LOLC, respectively. East Asia showed the steepest increase in ASIR (from 229.26 in 1990 to 375.90 in 2021, AAPC = 1.6, 95% CI: 1.31 to 1.89, p < 0.001) of LOLC. Moreover, according to socio-demographic index (SDI) quintiles, the middle SDI region demonstrated the largest rise in ASIR of LOLC. Frontier analysis revealed that countries with higher SDIs had a greater capacity for reducing lung cancer burdens. Cross-country inequalities of lung cancer burden in females were found to improve much slower than in males. The projections implied that, although lung cancer would generally decline in the next decade, the incidence, mortality, and DALY rates of LOLC in females might remarkably increase. The global incidence, mortality, and DALY rates of lung cancer showed a general decline from 1990 to 2021. However, concerning trends of LOLC burden, especially among females and in specific regions or countries, were observed in this study. This study could help to guide more targeted prevention and intervention strategies for lung cancer control.

Predicting mortality in upper gastrointestinal tract cancer using long short-term memory neural networks.

340 Background: Upper gastrointestinal (GI) tract cancers represent a significant global health burden, characterized by high morbidity and mortality rates, with an increasing incidence among aging populations and varying outcomes based on gender and ethnicity. Early prediction of mortality rates in upper gastrointestinal cancer can significantly enhance treatment strategies and patient outcomes. This study describes current trends in upper gastrointestinal cancer and proposes a predictive model, developed using Long Short-Term Memory (LSTM) neural networks to project future trends using demographic data. Methods: We extracted mortality data from the Center for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiological Research (WONDER) Database spanning 1999, normalized it and encoded categorical variables such as age, sex, ethnicity, and race numerically. Using Studio R to analyze mortality trends, we developed an LSTM model known for its ability to capture and utilize long term data patterns. The model, trained with a sequence length of 20, predicted future data points based on the previous 20. We then assessed its accuracy and generalization with a test set. Ultimately, our model is able to utilize demographic variables to forecast annual mortality and survival rates. Results: The mortality rates for upper GI tract cancers are notably higher among elderly individuals, particularly those aged 80 and above, with males and certain ethnic groups, such as Hispanics. The accuracy of the trained model was evaluated by calculating the Mean Squared Error (MSE), a measure of the difference between the predicted and actual value, with zero indicating no difference between the two. Our LSTM model achieved a training MSE of 0.00085 and a validation MSE of 0.0016, indicating good reliability and accuracy. Conclusions: Our analysis highlighted clear mortality trends and demonstrated the model’s effectiveness in improving mortality predictions in upper gastrointestinal cancer. However, limitations due to the dataset’s lack of clinical variables (such as comorbidities, cancer stage, and prior treatments) and its reliance on a single dataset may affect external validity. Future research is needed to determine if the model can be applied for clinical prognosis or strategic planning. We ultimately created and validated an LSTM neural network model with the CDC WONDER dataset, showing promising results. Future development will aim to include clinical characteristics to create a more personalized predictive tool.

Trends in early onset colorectal cancer–related mortality among adults in the United States from 1999-2020.

42 Background: Colorectal cancer (CRC) has witnessed a decrease in incidence and mortality in the United States (US) for the past few decades likely due to increased screening and improvements in treatment . Despite the overall burden of CRC has declined and survival has been made for older adults, there is a simultaneous and alarming increase in CRCs diagnosed in individuals younger than 50 years of age. These Early Onset CRC (EOCRC) which now account for roughly 10% of new CRC cases in the US. The purpose of this study was to assess the trends and regional differences in EOCRC-related mortality among adults in the United States. Methods: Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research) database were examined from 1999 to 2020 for -related mortality in adults &lt;45 years of age. Age-adjusted mortality rates (AAMRs) per 10,000 persons and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, and geographic region. Results: Between 1999 and 2020, 32,850 EOCRC-related deaths occurred among adults 25-44 years. The AAMR increased from 2.1 in 1999 to 2.6 in 2020. Men had consistently higher AAMR than women from 1999 (AAMR men: 2.0 vs women: 1.6) to 2020 (AAMR men: 2.6 vs women: 2.0). Non Hispanic (NH) African Americans had the highest overall AAMR (3.1), followed NH White (2.2), NH Asians (1.6) and Hispanics (AAMR 1.5) Caucasians have had a significant increase in mortality over the past 2 decades ( APC 1.4 (95%Cl 1.1-.7)) whereas the Hispanics have shown an APC of 4 (95% Cl 2.3-5.8 from 2012-2020). AAMR also varied substantially by region (overall AAMR: Midwest 2.1; South: 2.4; West: 1.9; Northeast: 2.0). States in the top 90th percentile of EOCRC-related AAMR were Mississippi, Arkansas, Oklahoma, South Carolina, Alabama West Virginia, Louisiana ,Kentucky and Tennessee which had approximately double the AAMRs compared with states that fell into the lower 10th percentile. Conclusions: EOCRC-related mortality in U.S. adults has been steadily increasing over the past two decades . The highest AAMRs were observed among African American adults and men, and among patients living in the Southern , Midwestern regions and those living in the nonmetropolitan United States. Targeted strategies are needed to prevent and treat EOCRC among older adults to curb increasing levels of EOCRC-related mortality.

Incidence trends of early-onset colorectal cancer (EOCRC) in the United States, by age, sex, race and ethnicity, and urbanicity (2000-2021).

26 Background: Research is needed to understand the extent to which the incidence of early onset colorectal cancer (EOCRC)is rising across population sub-groups, including by age, sex, race/ethnicity, and urbanicity, to inform hypotheses regarding its causes and strategies for screening and prevention. Methods: We used data on colorectal cancer cases diagnosed among adults 20-49 years (yr) between 2000-2021 in the delay-adjusted Surveillance, Epidemiology, and End Results (SEER) database (April 2024). We calculated delay- and age-adjusted annual incidence rates (IR) per 100,000, overall and by age, sex, race/ethnicity, and urbanicity. Urbanicity was defined using USDA Rural-Urban Continuum Codes for county; 1-3 were classified as urban and 4-9, 98, and 99 were classified as non-urban. We used NCI’s Joinpoint regression models (Joinpoint version 5.2.0.0) to estimate annual percent change (APC) and 95% confidence intervals (CI). We also calculated IRs for the most recent 5-year period (2017-2021) and used incidence rate ratios (IRR) to compare across groups; IRs and IRRs were calculated using SEER*Stat version 8.4.3. Results: Analyses included 155,500 cases of EOCRC. Most cases (72%) occurred among adults 40-49 yr; 22% occurred among those 30–39 yr and 6% in people 20-29 yr. Among adults 40-49 yr, the incidence of EOCRC increased 4.4% / yr on average between 2018-2021 (95%CI: 2.5, 5.6). Among adults 30-39 yr, incidence of EOCRC increased 3.0% / yr, on average, starting in 2010 (95%CI: 2.4, 4.5). For adults ages 20-29 yr, there were large increases in incidence from 2000-2016 (2000-2013, APC: 3.5; 95%CI: 2.4, 4.1; 2013-2016, APC: 11.2; 95%CI: 6.8, 13.5) but no change from 2016-2021. For the most recent 5-yr period (2017-2021), females had lower IR compared to males (IRR: 0.90; 95%CI: 0.88, 0.91), but trends over time were similar by sex. The incidence of EOCRC increased across races and ethnicities between 2000-2021, albeit at different rates. In the most recent period (2017-2021), the IR per 100,000 was 22.0 for Non-Hispanic American Indian and Alaskan Native (AIAN), 15.0 for Non-Hispanic White, 14.9 for Non-Hispanic Black, 12.4 for Hispanic or Latino, and 11.2 for Non-Hispanic Asian American or Pacific Islander adults. People in non-urban areas had a higher incidence of EOCRC compared to those in urban areas (IRR: 1.18; 95%CI: 1.14, 1.22), with similar trends over time. Conclusions: The incidence of EOCRC is highest among adults 40-49 yr, males, Non-Hispanic AIAN adults, and in non-urban areas. Trend analyses generally showed similar increases in incidence (3-5%/yr) in recent periods across sex, race/ethnicity, and urbanicity.

Survival feature and trend of female breast cancer: A comprehensive review of survival analysis from cancer registration data.

To better understand global patterns, chronological changes, and international comparisons of female breast cancer survival, we reviewed published data from population-based cancer registries worldwide. Using PubMed, Embase, Web of Science, SEER, and SinoMed, a comprehensive literature search was conducted for female breast cancer survival from the population-based cancer registries through 31 December 2023. Observed, relative, and net survival rates and their corresponding age-standardized survival rates since the 1990s were collected and further stratified by prognostic factors. The prognosis of female breast cancer patients was favorable, with 5-year relative survival rates above 80% in most regions. The trend in breast cancer survival showed annual increases in most countries but was accompanied by geographical disparities. The highest age-standardized 5-year relative survival rate was identified in the USA (2010-2014) at 90.2%, while the lowest was in India (2010-2014) at 66.1%. Overall, North America and Oceania had the best survival, and, for Europe, survival was worst in Eastern Europe. The survival in some Asian countries was disturbing. Younger age groups had a better prognosis than those aged 75 years and over. The lowest survival rates were observed in patients with distant metastatic and triple-negative breast cancer. Worldwide, there has been a steady improvement in female breast cancer survival. However, the survival gap between developed and developing countries has remained wide over the past 30 years. Differences in age, stage at diagnosis, and molecular subtype may explain some of the disparities, providing evidence for targeted management strategies.

Trend and characteristics of endometrial cancer in Guangzhou from 2000 to 2020.

To explore temporal trends in the age of endometrial cancer in Guangzhou over the past 21years. We conducted a retrospective analysis of women diagnosed with endometrial cancer from 2000 to 2020 at a major teaching hospital in Guangzhou, China. One-way analysis of variance was utilized to compare the average age of onset for each year, while the t-test was employed to compare groups A (2000-2009) and B (2010-2020) over the 21-year period. Stratified analysis was conducted based on age group and pathological type. Chi-square and Fisher's exact tests were utilized to compare histopathological types across different groups. Multiple linear regression analysis was used to analyze the independent factors. The number of endometrial cancer cases increased annually over the 21-years period. A total of 610 patients were included in the study. The age of onset ranged from 14 to 89years, with a mean age of 52.9±9.3years. One-way variance analysis revealed no statistically significant difference in the mean age between years (F=1.518, p=0.069). When grouped into decades, the mean ages of the 2000-2009 and 2010-2020 were 53.91±10.23years and 52.69±9.79years respectively, with no statistically significant difference observed (p=0.23). From 2000 to 2020, patients aged≤45years accounted for 18.4% of cases, with a significant increasing trend observed over time (F=11.10, p<0.001). However, there was no statistically significant difference in the composition ratio of patients aged≤45years (χ2=13.885, p=0.836). Patients aged≥60years accounted for 22.8% of cases, with no significant change observed over time (F=4.782, p=0.017) and there was no difference in the composition ratio of elderly patients aged≥60years (χ2=28.489, p=0.098). Stratified analysis by age group and pathological type revealed no statistically significant difference in the mean age between Type 1 and Type 2 Endometrial Cancer (p=0.18). While the proportion of Type 1 Endometrial Cancer slightly increased over time, the difference was not statistically significant (p=0.52). Similarly, there was no statistically significant difference in the proportion of different pathological types between patients aged≤45years and patients>45years old (p=0.17); however, Type 2 Endometrial Cancer, associated with higher risk, was more prevalent in patients>45years old. The mean age of endometrial cancer in this region remained relatively stable over the past 21years, with no observable trend towards younger or older. The proportion of young patients in this region was higher than that of other countries.

Temporal trends of liver cancer burden, comparative analysis of risk factors and trend forecasts to 2024 in China, USA, the Republic of Korea, and Mongolia: an analysis based on multiple data sources from Global Burden of Disease 2019, the Global Cancer Observatory, and Cancer Incidence in Five Continents.

Liver cancer represents a significant burden of disease globally, with variations in liver cancer status among countries. In this study, we aimed to evaluate the epidemiological burden of liver cancer in four representative countries - China, the USA, the Republic of Korea, and Mongolia - and cover the highest number of incidence cases, the highest prevalence rates and the burden in developed countries. In addition, we intended to predict the trends in liver cancer in these countries over the next six years. We collected epidemiological data on liver cancer from the Global Burden of Disease 2019, the Global Cancer Observatory, and Cancer Incidence in Five Continents databases to conduct data source triangulation. We calculated time trends using Joinpoint regression and predicted incidence rates using an autoregressive integrated moving average model. Aetiological studies were conducted for different countries based on changes in incidence causes. Between 1990-2019, age-standardised rates (ASR) values for liver cancer declined globally. The downward trend was most pronounced in China, where the average annual percentage change of age-standardised incidence rate (ASIR) reached -3.13 (95% confidence interval (CI) = -2.90, -3.35), much higher than the world average of -1.16 (95% CI = -0.96, -1.36). The ASIR in the USA continued improving and reached 5.23 × 105 in 2019. With age, the ASR for liver cancer in various countries generally shows an upward trend. Hepatitis B virus (HBV) remains the main causative agent of liver cancer in China and Korea. In Mongolia, both HBV and hepatitis C virus account for a large proportion of liver cancer. In the USA, the proportion of liver cancer cases from alcohol consumption has increased annually. The ASR for liver cancer has declined over the past 30 years in most countries but has worsened in some due to ageing and unhealthy lifestyles.

Laryngeal Squamous Cell Carcinoma Incidence and Survival Trends in the United States: A Population-Based Analysis of Two Decades.

Laryngeal cancer has undergone a complex evolution in incidence, management, and standards of care over the past 20 years. Disease-wide demographic and survival risk factors have yet to be elucidated. Examine incidence, management, and survival trends in laryngeal cancer from 2000 to 2019. The Surveillance, Epidemiology, and End Results database was utilized to identify age-adjusted incidence rates (AAIRs) of laryngeal squamous cell carcinoma (LSCCa) from 2000 to 2019. Joinpoint regression was conducted to identify annual percentage changes (APCs). Chi-squared analysis was used to find changes in demographic, clinicopathologic, and treatment changes over the study period. Finally, univariate Kaplan-Meier and COX multivariate regressions were conducted to identify survival differences. There were 46 266 cases of LSCCa identified between 2000 and 2019 with AAIR of 2.7 per 100 000 person-years with APC of -2.6% [95% CI: -2.8% to 2.4%]. These rates have largely been down-trending among demographic substratifications. Age at initial diagnosis has been increasing (64.6 → 66.0, p < 0.001). Higher median household income was associated with lower AAIR (35 000 5.3; > $75 000 2.2) and increased annual percentage decrease (< $35 000, -1.1%*; > $75 000, -3.2%*). There were no other clinically significant differences in demographic and clinicopathologic trends although persistent demographic differences were noted. Late T-stage at diagnosis has increased over the study period (T3, 18% → 23%, p < 0.001). Treatment with primary chemoradiotherapy has increased significantly (20.0% → 27.0%, p < 0.001). On univariate analysis, there were no significant differences in survival; however, on multivariate analysis, there has been a progressive improvement in disease-specific and overall survival over 5-year bins. Late-stage disease had a progressive improvement in survival with each treatment period on both univariate and multivariate analysis. There has been a progressively significant decrease in age-adjusted incidence of LSCCa with increased utilization of primary chemoradiotherapy. When adjusted for associated characteristics, there has been a continuing improvement in survival over the study period, primarily in late-stage disease.

Emerging trends in cervical cancer incidence among younger Taiwanese generations: an urban–rural comparison

Background Despite global declines in cervical cancer incidence, certain regions observe unexpected rising trends among younger generations. Methods This study uses the age–period–cohort model to examine long-term incidence trends of invasive cervical cancer in Taiwan. Data were sourced from the Taiwan Cancer Registry. Results From 2000 to 2019, both urban and rural areas of Taiwan saw a marked decrease in incidence rates, a trend largely attributed to the cytology-based screening program introduced in 1995. Yet, rising incidence rates emerged in younger Taiwanese generations, specifically those born post-1975 in urban and post-1980 in rural settings. The 1990-born urban cohort faced a risk 1.9 times higher than their 1975-born counterparts, while the risk for the 1990-born rural cohort was 1.4 times greater than those born in 1980. In addition, post-1980 urban cohorts exhibited greater risks than their rural counterparts. Conclusions The rising trends in cervical cancer incidence among younger Taiwanese generations may be influenced by factors such as increased sexual permissiveness and urbanization. Although current prevention efforts, such as human papillomavirus vaccination, are noteworthy, there is a need for ongoing surveillance and improved strategies that specifically target recent cohorts.

The burden and temporal trend of early onset pancreatic cancer based on the GBD 2021

In the context of the global increase in early-onset tumours, investigating the global disease burden caused by early-onset pancreatic cancer (EOPC) is imperative. Data on the burden of EOPC were obtained from the Global Burden of Disease Study 2021. A joinpoint regression model was used to analyse the temporal trend of the EOPC burden, and an age‒period‒cohort (APC) model was used to analyse the influence of age, period, and birth cohort on burden trends. Globally, the number of EOPC cases increased from 24,480 to 42,254, and the number of deaths increased from 17,193 to 26,996 between 1990 and 2021. The results of the APC model showed that the burden of EOPC increases with increasing age, whereas the variations in period and cohort effects exhibited a complex pattern across different sociodemographic index regions. Consequently, the disease burden of EOPC is increasing worldwide, highlighting the need for effective interventions.

Spatiotemporal Correlation Analysis for the Incidence of Esophageal and Gastric Cancer From 2010 to 2019: Ecological Study.

Esophageal and gastric cancer were among the top 10 most common cancers worldwide. In addition, sex-specific differences were observed in the incidence. Due to their anatomic proximity, the 2 cancers have both different but also shared risk factors and epidemiological features. Exploring the potential correlated incidence pattern of them, holds significant importance in providing clues in the etiology and preventive strategies. This study aims to explore the spatiotemporal correlation between the incidence patterns of esophageal and gastric cancer in 204 countries and territories from 2010 to 2019 so that prevention and control strategies can be more effective. The data of esophageal and gastric cancer were sourced from the Global Burden of Disease (GBD). Spatial autocorrelation analysis using Moran I in ArcGIS 10.8 (Esri) was performed to determine spatial clustering of each cancer incidence. We classified different risk areas based on the risk ratio (RR) of the 2 cancers in various countries to the global, and the correlation between their RR was evaluated using Pearson correlation coefficient. Temporal trends were quantified by calculating the average annual percent change (AAPC), and the correlation between the temporal trends of both cancers was evaluated using Pearson correlation coefficients. In 2019, among 204 countries and territories, the age-standardized incidence rates (ASIR) of esophageal cancer ranged from 0.91 (95% CI 0.65-1.58) to 24.53 (95% CI 18.74-32.51), and the ASIR of gastric cancer ranged from 3.28 (95% CI 2.67-3.91) to 43.70 (95% CI 34.29-55.10). Malawi was identified as the highest risk for esophageal cancer (male RR=3.27; female RR=5.19) and low risk for gastric cancer (male RR=0.21; female RR=0.23) in both sexes. Spatial autocorrelation analysis revealed significant spatial clustering of the incidence for both cancers (Moran I>0.20 and P<.001). A positive correlation between the risk of esophageal and gastric cancer was observed in males (r=0.25, P<.001). The ASIR of both cancers showed a decreasing trend globally. The ASIR for esophageal and gastric cancer showed an AAPC of -1.43 (95% CI -1.58 to -1.27) and -1.76 (95% CI -2.08 to -1.43) in males, and -1.93 (95% CI -2.11 to -1.75) and -1.79 (95% CI -2.13 to -1.46) in females. In addition, a positive correlation between the temporal trends in ASIR for both cancers was observed at the global level across sexes (male r=0.98; female r=0.98). Our study shows that there was a significant spatial clustering of the incidence for esophageal and gastric cancer and a positive correlation between the risk of both cancers across countries was observed in males. In addition, a codescending incidence trend between both cancers was observed at the global level.

Spectrum and trends of cancer among HIV patients in Southwestern Uganda.

Antiretroviral therapy (ART) restores cellular immunity, significantly reducing AIDS-related mortality and morbidity thus improving the quality of life among People living with HIV (PLHIV). Studies done in several countries show a decline in AIDS defining cancers (ADCs) with the introduction of ART however the increased longevity has led to the increase of Non-AIDS defining cancers (NADCs). The study was aimed at studying the changing spectrum and trends of cancer among Human Immunodeficiency Virus (HIV) patients in southwestern Uganda. The study was a retrospective chart review of records of HIV-positive patients attending/receiving care from the Oncology clinic and ISS clinic of Mbarara Regional Referral Hospital (MRRH) who were, diagnosed with cancer for the past 10 years (January 2012-2021). Data were statistically analyzed using STATA version 17 (Stata Corp, Texas, US) at P < 0.05. Males were more common at 64.5% while the median age was 37 years (IQR 29-47 years). ADCs were seen in 77.5% of the population while participants with NADCs were older (p < 0.001). The majority 73.3% (283/386) were in later stages (3 and 4). Having either ADCs or NADCs was different across HIV stages (p < 0.001). The median baseline CD4 count was 205 cells/μl (IQR: 90-400 cells/μl). The median duration on ART was 15 months (IQR 3-65 months). Participants with ADCs had been on ART for a shorter duration of time (p < 0.001). Only the outcome of patients with ADCs were available. The outcome varied with sex (p < 0.036), baseline CD4 (p < 0.048), and HIV stage (p < 0.002). Males were more likely to die (30/38 or 78.95%) and lost to follow-up (26/41 or 60.98%). Participants with baseline CD4 cell count > 200 cells/μl were more than twice likely to be active in care. The Commonest ADC was Kaposi Sarcoma (KS) while the commonest NADC was Squamous cell carcinoma, Not otherwise specified. Age above 50 years was associated with a significantly reduced risk of ADCs (OR: 0.11; 95% CI: 0.03-0.43; p value: 0.002). The risk of ADCs increased from stage 2 (OR: 0.46, p-value: 0.03; 95% CI: 0.23-0.91) to stage 3 (OR: 1.13; p-value: 0.66; 95% CI: 0.65-1.97) but this was not statistically significant. The risk of ADCs decreased with increasing ART duration (P value < 0.05). ADCs are still a major health challenge in Southwestern Uganda despite the increasing the coverage and uptake of ART in region. These have mostly affected the young people, people who have been on HAART for a shorter period and those with lower CD4 cell count at initiation of ART.

Trends and ethnic disparity in endometrial cancer mortality in South Africa (1999-2018): A population-based Age-period-cohort and Join point regression analyses.

Endometrial cancer is the sixth leading cause of cancer among females and about 97,000 global deaths of endometrial cancer. The changes in the trends of obesity, fertility rates and other risk factors in South Africa (SA) may impact the endometrial cancer trends. The aim of this study was to utilise the age period cohort and join point regression modelling to evaluate the national and ethnic trends in endometrial cancer mortality in South Africa over a 20year period (1999-2018). Data from Statistics South Africa was obtained to calculate the annual number of deaths, and annual crude and age standardised mortality rates (ASMR) of endometrial cancer from 1999-2018. The overall and ethnic trends of endometrial cancer mortality was assessed using the Join point regression model, while Age-period-cohort (APC) regression modelling was conducted to estimate the effect of age, calendar period and birth cohort. During the period 1999-2018, 4,877 deaths were due to endometrial cancer which constituted about 3.6% of breast and gynecological cancer deaths (3.62%, 95% CI: 3.52%-3.72%) in South Africa. The ASMR of endometrial cancer doubled from 0.76 deaths per 100,000 women in 1999 to 1.5 deaths per 100,000 women in 2018, with an average annual rise of 3.6% per annum. (Average Annual Percentage change (AAPC): 3.6%, 95%CI:2.7-4.4, P-value < 0.001). In 2018, the overall mean age at death for endometrial cancer was was 67.40 ± 11.04 years and, the ASMR of endometrial cancer among Indian/Asians (1.69 per 100,000 women), Blacks (1.63 per 100,000 women) and Coloreds (1.39 per 100,000 women) was more than doubled the rates among Whites (0.66 deaths per 100,000 women). Indian/Asians had stable rates while other ethnic groups had increased rates. The Cohort mortality risk ratio (RR) of endometrial cancer increased with successive birth cohort from 1924 to 1963 (RR increased from 0.2 to 1.00), and subsequently declined among successive cohorts from 1963 to 1998 (1.00 to 0.09). There was strong age and cohort but not period effect among the South African women. Ethnic disparity showed that there was age effect among all the ethnic groups; Cohort effect among Blacks and Coloureds only, while Period effect occurred only among Blacks. The mortality rates of endometrial cancer doubled over a twenty-year period in South Africa from 1999-2018. There was strong ethnic disparity, with age and cohort effect on endometrial cancer trends. Thus, targeted efforts geared towards prevention and prompt treatment of endometrial cancer among the high-risk groups should be pursued by stake holders.