Cancer Registry Data Research Articles

Use of mortality tables by level of deprivation in the study of social inequalities in cancer survival.

Previous studies have reported lower net survival probabilities for socioeconomically deprived patients, using non-deprivation specific lifetables. Not accounting for the social gradient in background mortality could potentially overestimate the effect of deprivation on net survival. The aim of this study was to estimate the impact of taking into account the social gradient of expected mortality in the general population on the study of the social gradient of survival of people with cancer. French cancer registry data was analyzed, with 190,902 incident cases of nineteen cancer sites between 2013 and 2015. Deprivation was measured using the European deprivation index (EDI). Net survival was estimated thanks to additive models with French lifetables stratified on deprivation level with the EDI, using the non-parametric Pohar-perme method and flexible excess hazard modelling with multidimensional penalized splines, firstly with non-specific lifetables then with the deprivation specific-lifetables. A significant effect of EDI on excess mortality hazard (EMH) remained when using the deprivation-specific lifetables for colorectal, lung cancer and melanoma in both sexes, and esophagus, bladder, head and neck and liver cancer for men, and breast, cervix and uterine cancer for women. The only site where the effect of EDI on EMH was no longer significant when using deprivation-specific lifetables was prostate cancer. The use of deprivation-specific lifetables confirms the existence of a social gradient in cancer survival, indicating that these inequalities do not result from inequalities in background mortality. Development of such deprivation-specific lifetables for future years is crucial to understand mechanisms of social inequalities and work towards reducing the social burden.

The challenge of calculating EUSOMA quality indicators with administrative data – A pilot study in Belgium

Introduction: The study aimed to assess the feasibility of calculating the European Society of Breast Cancer Specialists (EUSOMA) quality indicators (QIs) using Belgian cancer registry data coupled to administrative health data, and to provide national results. Methods: Women diagnosed with ductal carcinoma in situ (DCIS) or invasive breast cancer (IBC) in 2014-2018 were selected from the cancer registry. Fourteen EUSOMA QIs were chosen to assess the quality of care. Results: Overall, 46,035 patients with IBC and 3,973 patients with DCIS were included. Most QIs had to be rephrased so that they could be calculated with the available data. None of the selected QIs on systemic treatment could be calculated due to a lack of reliable receptor status information. For some QIs there is ample room for improvement in Belgian clinical practice: cTNM stage reporting, multidisciplinary team meetings, sentinel lymph-node biopsy only in IBC with clinically negative lymph nodes. The result was 1-5% lower than the target for mammography and breast ultrasound, pTNM reporting, start of treatment, single breast surgery in DCIS, and no axillary clearance in DCIS. For histological or cytological assessment, receptor status assessment, start of radiotherapy, and single breast surgery in IBC, the results were at or above the target. Conclusion: Several EUSOMA QIs can be calculated with routinely collected data, while for several important aspects of care additional data collection is indicated so that its quality can be assessed. The validity of the obtained results depends on the reporting accuracy.

Chondrosarcoma in Japan: an analytic study using population-based National Cancer Registry.

Chondrosarcoma (CS) is a rare malignant bone tumor exhibiting diverse histological features and clinical behaviors. This study aimed to investigate the epidemiological characteristics, clinical features, prognostic factors, and subtype-specific differences of CS in Japan using National Cancer Registry data. We analyzed data from CS cases diagnosed between 2016 and 2019, calculating age-adjusted incidence, estimating overall survival, and identifying prognostic factors through multivariate analysis. The study identified 1015 CS cases with an age-adjusted incidence of 0.159 per 100 000 population and a mean overall survival of 1205.2days. Multivariate analysis revealed that female sex, younger age (15-39years), histological subtypes other than dedifferentiated CS, localized disease, and surgical treatment were associated with better prognoses. Conversely, male sex, older age (≥75years), dedifferentiated subtype, advanced stage, and non-surgical treatment were linked to a higher risk of death. Significant differences in sex distribution, age at diagnosis, tumor location, disease stage, and tumor differentiation were observed among CS subtypes. This comprehensive analysis provides valuable insights into CS epidemiology, prognostic factors, and subtype-specific characteristics in Japan. The identification of high-risk groups emphasizes the need for improved therapeutic strategies and supportive care. The observed heterogeneity among CS subtypes underscores the importance of individualized management approaches in treating this complex malignancy.

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.

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

BackgroundGastric 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. MethodsPopulation-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. ResultsFrom 2011 to 2020, a total of 4,716 new cases of gastric cancer and 3,520 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% to 32.12%) was higher than between 2011 and 2015 ( 24.79%, 95%CI: 22.53% to 27.27%). Furthermore, the survival rate decreased with increasing age. ConclusionsFrom 2011 to 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.

Association between Healthy Eating Index-2020, alternative Mediterranean Diet scores, and gastrointestinal cancer risk in NHANES 2005–2018

Diet quality is closely related to the occurrence of gastrointestinal (GI) cancers; however, few studies have investigated the association between the Healthy Eating Index (HEI-2020) and the alternative Mediterranean diet (aMED) scores and GI (GI) cancers. This study aims to assess the association between HEI-2020, aMED scores and GI cancers. Information from a total of 26,320 participants was included in the National Health and Nutrition Examination Survey (NHANES). In our sub-analysis, we focused on participants with complete dietary and health data, specifically assessing the relationship between diet quality and GI cancers outcomes. The 24-hour recall questionnaire was used to collect and assess the participants’ average dietary intake. Diagnoses of GI cancers were based on self-reported medical history confirmed through physician interviews or linked cancer registry data, ensuring diagnostic reliability. Logistic regression models, restricted cubic splines (RCS), subgroup analysis, and interaction methods were employed to fully evaluate the associations between HEI-2020, aMED scores, and GI cancers. Mediation analysis was also conducted to identify potential mediators of this relationship. Even after fully adjusting for potential confounders, participants with high adherence to the HEI-2020-2020 and aMED scores were significantly associated with a reduced risk of GI cancers. Compared to the lowest tertile of HEI-2020, participants in the highest tertile had a 30% reduced risk of GI cancers (OR 0.70, 95% CI 0.50 to 0.98, p = 0.037). Compared to the lowest tertile of aMED scores, participants in the highest tertile had a 37% reduced risk of GI cancers (OR 0.63, 95% CI 0.44 to 0.92, p = 0.014). RCS analysis indicated that both HEI-2020 and aMED scores were significantly associated with GI cancers; however, no significant non-linear relationship was observed. The primary findings confirm that higher adherence to HEI-2020 and aMED scores is associated with a lower risk of GI cancers. These results suggest that maintaining a high-quality diet may play a crucial role in the prevention and management of these cancers. Further research is needed to elucidate the mechanisms and effects of healthy diet management and high-quality diets in the prevention of GI cancers.

Temporal changes in regional variations in cancer survival rates in Osaka, Japan (1997–2015)

The variation in survival rates among patients with cancer based on residential areas has become a significant concern globally. Japan’s Basic Plan to Promote Cancer Control Programs (BPPCCP), implemented in 2007, aimed to reduce this variation by designating cancer care hospitals in each cancer medical area (CMA) where patients resided. From the Osaka Cancer Registry data, we extracted 407,489 patients aged 15–74 years with cancer who received treatment in Osaka Prefecture between 1997 and 2015 and analyzed regional variations in survival rates for each patient’s residential CMA before and after the implementation of the BPPCCP. By standardizing the distribution of the patients’ background factors (sex, age, stage, and socioeconomic status) to the distribution of the whole prefecture, 5-year relative survival rates for each CMA were calculated, and regional variations were assessed. Before BPPCCP, survival variation reached 2.00 percentage points (p-values < 0.05); post-BPPCCP, it decreased to 0.98 percentage points and was no longer significant. In conclusion, the introduction of the BPPCCP in 2007 may have reduced regional variation in the survival rate of patients with cancer in Osaka Prefecture. Measures such as the BPPCCP could potentially equalize the cancer care delivery system.

Semiparametric Sieve Estimation for Survival Data with Two-layer Censoring

Abstract Disease registry data provide important information on the progression of disease conditions. However, reports of death or dropout of patients enrolled in the registry are always subject to a noticeable delay. Reporting delays, together with the administrative censoring that arises from a freeze date in data collection, lead to two layers of right censoring in the data. The first layer results from random dropout and acts on the survival time. The second layer is the administrative censoring, which acts on the summation of the reporting delay and the minimum of the survival time and random dropout time. The heterogeneities among patients further complicate data analysis. This paper proposes a novel semiparametric sieve method based on phase-type distributions, in which covariates can be readily accommodated by the accelerated failure time model. A well-orchestrated EM algorithm is developed to compute the sieve maximum likelihood estimator. We establish the consistency and rate of convergence of the proposed sieve estimators, as well as the asymptotic normality and semiparametric efficiency of the estimators for the regression parameters. Comprehensive simulations and a real example of lung cancer registry data are used to demonstrate the proposed method. The results reveal substantial biases if reporting delays are overlooked.

An Investigation of Travel Distance and Timeliness of Breast Cancer Treatment Among a Diverse Cohort in the United States

Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administrative data from Medicaid and a private insurance plan, 2155 BC patients were successfully linked to create the cohort. ArcGIS was used to geocode all case residences and treatment facility addresses and calculate network distance between the residence and each facility. Logistic regression models were used to calculate the adjusted odds of being delayed versus timely by street distance. Odds of late surgery were increased by 1% (95% CI: 1.00, 1.01) for each one-mile increase from the patient’s residence to the treatment facility. In race-stratified models, the odds of late treatment for Black patients increased by 3% per mile (95% CI 1.01, 1.06) for radiation. Increased travel distance appears to significantly increase treatment delays for surgical, radiation, and chemotherapeutic treatments for women with BC, especially among Black women.

Diabetes Risk After Treatment for Childhood and Young Adult Cancer.

Diabetes is a potential late consequence of childhood and young adult cancer (CYAC) treatment. Causative treatments associated with diabetes have been identified in retrospective cohort studies but have not been validated in population-based cohorts. Our aim was to define the extent of diabetes risk and explore contributory factors for its development in survivors of CYAC in the United Kingdom. Cancer registration data (n = 4,238) were linked to electronic health care databases to identify cases of diabetes through clinical coding or HbA1c values. Total effect of prespecified treatment exposures on diabetes risk was estimated using flexible parametric modeling and standardized cause-specific cumulative incidence functions (CIFs). After median follow-up of 14.4 years, 163 individuals (3.8%) were identified with diabetes. Total body irradiation (TBI) increases diabetes risk over time, with a 40-year CIF reaching 21.0% (95% CI 13.8-31.9) compared with 8.4% (95% CI 6.1-11.5) without TBI. Survivors treated with corticosteroids had a 7.7% increased risk at 40 years after cancer diagnosis. Hematopoietic stem cell transplant (HSCT) survivors had markedly higher risk, with a 40-year CIF of 19.6% (95% CI 13.4-28.6) versus 8.2% (95% CI 6.0-11.3) for patients who had not undergone HSCT. Among patients who received allogeneic HSCT, the 40-year CIF of diabetes was 25.7% (95% CI 17.4-38.0), compared with 7.9% (95% CI 3.3-19.1) in patients who received autologous transplants. This evaluation of a hospital-based cohort of patients with CYAC identifies these patients' increased long-term risk of developing diabetes and how this varies temporally according to treatment modalities. Notable contrasts in risk by treatment were detected as early as 10 years after cancer diagnosis. Findings should inform the development of risk-stratified evidence-based screening.

Surgery lengthens survival for collecting duct carcinoma: analysis of hospital-based cancer registry data in Japan

BackgroundTo identify the prognosis of Japanese patients with collecting duct carcinoma (CDC).MethodsWe used a hospital-based cancer registry data in Japan to extract CDC cases that were diagnosed in 2013, histologically confirmed, and determined the first course of treatment. We further investigated treatment modalities and estimated overall survival (OS) by the Kaplan–Meier method.ResultsA total of 61 CDC patients were identified. The 5-year OS rate for all CDC patients who were diagnosed in Japan during 2013 was 23.6% (95% CI: 15.0–37.4), with a median OS of 14 months (95% CI: 12–24). The 5-year OS rate for CDC patients at stages I, III, and IV were 53.0% (95% CI: 29.9–94.0), 35.7% (95% CI: 19.8–64.4), and 3.4% (95% CI: 0.5–23.7), respectively. Noteworthy, the 1-year OS for stage IV patients was 27.6% (95% CI: 0.5–23.7) and the median OS was only 5 months (95% CI: 4–12). We further examined the OS for advanced disease according to treatment modalities. The median OS of patients who undertook chemotherapy alone was significantly shorter than patients who undertook surgery alone for advanced disease (4 months [95% CI: 4-NA] vs. 15 months [95% CI: 13–68]; p < 0.001) and surgery-only patients had a similar median OS as surgery-plus-chemotherapy patients (19 months [95% CI: 13-NA]; p < 0.001). Moreover, a multivariable analysis for the OS in advanced disease revealed that surgery-plus-chemotherapy patients had significantly more favorable prognoses (HR 0.21, 95% CI: 0.07–0.57).ConclusionsJapanese CDC patients face poor prognoses similar to Western countries, especially in advanced cases that receive only chemotherapy. Surgery appears necessary for advanced disease.

Cervical cancer incidence rates considering migration status in mainland China using Bayesian model-Estimation based on 2016 cancer registry data.

In mainland China, cancer registration relies on household-registered populations, overlooking migrant populations. Estimating cervical cancer incidence among permanent residents, including migrants, offers a more accurate representation of the true burden. The data from 487 cancer registries across China in 2016 were analyzed using a Bayesian spatial regression model with the integrated nested Laplace approximation-stochastic partial differential equation method. The study estimated cervical cancer incidence among household-registered populations and adjusted for migrant populations using a weighting method based on interprovincial distribution and age stratification to derive the incidence of cervical cancer in the permanent residents. Data from the China Population Census, the China Migrants Dynamic Survey, and the Urban Statistical Yearbook were incorporated. The estimated crude incidence rate of cervical cancer among permanent residents was 17.4/100,000 in mainland China, with an age-standardized incidence rate (ASIR) of 17.2/100,000. The largest disparities in cervical cancer crude incidence rate between permanent residents and household-registered populations were observed in Guizhou (2.4/100,000, 95% CI 1.9-2.9/100,000), Zhejiang (-1.2/100,000, 95% CI -1.8 to -0.6/100,000) and Tianjin (-1.1/100,000, 95% CI -1.5 to -0.7/100,000). The number of the estimated cervical cancer incident cases was 8948. Guangdong saw an increase of 887 cases, while Henan had a decrease of 1430 cases. Guizhou had the highest ASIR (28.1/100,000), and Beijing had the lowest ASIR (11.0/100,000). The significance of this study is that it improves the accuracy of cervical cancer data in China. These findings provide evidence for developing cervical cancer prevention and control strategies, and offer insights for other countries and regions facing migration challenges.

Challenges in determining the global burden of non-malignant central nervous system tumors: an analysis of international incidence and mortality data sources.

Non-malignant tumors of the CNS contribute substantially to the morbidity and mortality from CNS tumors. It is critical to understand the epidemiology of non-malignant CNS tumors separately from CNS malignancies to inform resource allocation and policy since treatment and prognosis can differ. High quality international data on non-malignant CNS tumor burden are needed to accomplish this goal. We assessed cancer registry and vital registration data available to the Global Burden of Disease study by its inclusion of non-malignant CNS tumors, reporting on the availability of data over time and by World Bank income group. We analyzed preliminary age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and proportions of CNS tumors by behavior for adults, children, and all ages. Non-malignant CNS tumors were reported separately in 17·2% (N=66) of registry reports and in aggregate with malignant CNS tumors in 18·0% (N=69) of reports. Only seven low- and middle-income countries (LMICs) had data reporting CNS tumors separately by behavior. Across all ages combined, the median ASIR of non-malignant CNS tumor data was 0·31 (interquartile range: 0·15-0·50) and ASMR was 0·24 (0·10-0·44) per 100,000 in LMICs compared to median ASIR of 3·62 (2·62-4·97) and ASMR of 0·32 (0·16-0·65) in high-income countries (HICs). A larger proportion of incident CNS tumors across were reported as non-malignant in HIC data than LMIC data (p<0.0001). Our study alludes to current challenges in understanding global non-malignant CNS tumor burden and a need for increased international data collection. Further research is needed to comprehensively investigate opportunities for future data inclusion.

Comparative effectiveness of laparoscopic versus open colectomy in colon cancer patients: a study protocol for emulating a target trial using cancer registry data

Introduction: The objective of this study is to compare the 5 year overall survival of patients with stage I–III colon cancer treated by laparoscopic colectomy versus open colectomy. Methods: Using Mecklenburg-Western Pomerania Cancer Registry data from 2008 to 2018, we will emulate a phase III, multicenter, open-label, two-parallel-arm hypothetical target trial in adult patients with stage I–III colon cancer who received laparoscopic or open colectomy as an elective treatment. An inverse-probability weighted Royston‒Parmar parametric survival model (RPpsm) will be used to estimate the hazard ratio of laparoscopic versus open surgery after confounding factors are balanced between the two treatment arms. Further to the hazard ratio, we will also compute differences in the absolute risk (at 1, 3, and 5 years) and restricted mean survival time (up to 1, 3, and 5 years). A weighted Kaplan‒Meier curve will be used to compare five-year overall survival in both treatment arms. Various comparator and sensitivity analyses will be performed to check the robustness of the results that will be estimated by the RPpsm main model. Treatment period- and stage-specific results will also be provided. Discussion: This study aims to causally model the effect of laparoscopic versus open colectomy on 5 year overall survival using a target trial emulation approach. As the cancer registry data do not cover BMI, comorbidity, and previous abdominal surgery for non-malignant indications, the potential for residual confounding arising from these factors is a limitation of this study. This will be approached in a quantitative bias analysis using the E-method. The results will substantiate existing evidence on the comparative effectiveness of laparoscopic versus open colectomy in patients with stage I–III colon cancer and may guide clinical decisions as to whether a laparoscopic approach is as safe as an open approach in terms of improving 5-year overall survival in these patient groups.

Impacts of Postoperative Adjuvant Therapies on the Survival of Women with High-Risk Early-Stage Endometrial Cancer: A Cohort Study.

Background/Objectives: The survival outcomes according to postoperative adjuvant therapeutic strategy in women with high-risk early-stage endometrial cancer (EEC) have not been clearly compared. This study examined the impacts of various postoperative adjuvant therapies on the survival of women with high-risk EEC. Methods: Korean Health Insurance Review and Assessment Service data related to Korean cancer registration data were used. The data of 1341 women who met the eligibility criteria for high-risk EEC were selected. The overall survival (OS) after the women had received various postoperative adjuvant therapies was analyzed. Results: The mean age of the women was 58.2 ± 10.3 years, and they were followed up for 5.9 ± 4.0 years. When compared with primary surgery alone, the OS was similar in the women who had received adjuvant external beam radiation therapy (EBRT) ± vaginal brachytherapy (VB), adjuvant VB alone, adjuvant chemotherapy, or adjuvant hormone therapy in combination with primary surgery, but the OS was significantly lower in the women who had received adjuvant chemoradiotherapy combined with primary surgery (HR 3.083; 95% CI 1.311-7.247; p = 0.010). In addition, compared to adjuvant EBRT ± VB, the OS was significantly lower in the group given adjuvant radiotherapy after chemotherapy (HR 11.87; 95% CI 4.595-30.664; p < 0.001), but the OS was similar in the women who had received adjuvant VB alone, adjuvant concurrent chemoradiotherapy, or adjuvant chemotherapy after radiotherapy. Conclusions: Except for adjuvant radiotherapy after chemotherapy, postoperative adjuvant therapies have similar impacts on the survival of women with high-risk EEC.

Estimated Incidence and Prevalence of Metastatic Breast Cancer in Northern Ireland, 2009 to 2020

This cohort study examines the incidence and prevalence of metastatic breast cancer in Northern Ireland using population-based cancer registry data and health records.

Incidence Rate Trends of Breast Cancer Overall and by Molecular Subtype by Race and Ethnicity and Age.

Black and Hispanic women in the US experience higher incidence rates of aggressive molecular subtypes of breast cancer, including triple-negative disease. However, how these rates are changing, particularly across different age groups, has not been well documented. To assess changes in overall and subtype-specific breast cancer incidence rates in the US by age and race and ethnicity. This cohort study used Surveillance, Epidemiology, and End Results program cancer registry data from 22 US cancer registries on 1 123 658 females who received a diagnosis of invasive breast cancer from 2010 to 2019. Statistical analysis was conducted from August 2023 to October 2024. Age and race and ethnicity. Age-adjusted incidence rates of invasive breast cancer overall and across the 4 major molecular subtypes by age and by race and ethnicity, as well as their associated annual percentage changes using Joinpoint Trend Analysis software. Of the 1 123 658 participants in the study, 219 112 (19.5%) were younger than 50 years, 409 257 (36.4%) were aged 50 to 64 years, and 495 289 (44.1%) were 65 years or older. A total of 141 703 participants (12.6%) were Hispanic, 3253 (0.3%) were non-Hispanic American Indian or Alaska Native, 78 306 (7.0%) were non-Hispanic Asian or Pacific Islander, 124 560 (11.1%) were non-Hispanic Black, 769 043 (68.4%) were non-Hispanic White, and 6793 participants (0.6%) had an unknown race and/or ethnicity. Overall, breast cancer incidence rates increased 0.5% per year from 2010 to 2019. Variation by race and ethnicity was observed, with increases of 1.4% per year among Hispanic females, 1.9% per year among non-Hispanic American Indian or Alaska Native females, and 2.1% per year among non-Hispanic Asian or Pacific Islander females, while rates increased only 0.8% per year among non-Hispanic Black females and 0.5% per year among non-Hispanic White females. In subtype analyses, increases of the greatest magnitude in recent years were observed in the incidence rates of triple-negative breast cancer per year among participants aged 65 years or older (Hispanic females, 2.3%; non-Hispanic Asian or Pacific Islander females, 5.5%; and non-Hispanic Black females, 4.3%), while remaining unchanged among non-Hispanic White females. In this cohort study of 1 123 658 females with breast cancer over the 10-year period from 2010 to 2019, there were substantial differences in trends in the incidence rates of breast cancer overall and by subtype across different racial and ethnic groups. Further research is needed to understand the factors associated with these trends.

Association between health insurance coverage and stage of diagnosis for cervical cancer among females in Indiana from 2011 - 2019.

Health insurance status is an important determinant of health outcomes for patients with cancer. This study aimed to assess the extent to which health insurance coverage in Indiana is a contributing factor to the stage of cervical cancer diagnosis. We examined reported cervical cancer cases among females (N=2518) using cancer registry data from the Indiana Department of Health from 2011 to 2019. Analyses were carried out in SPSS. Using multinomial logistic regression, we examined associations of both insurance status and race/ethnicity with stage of diagnosis after adjusting for age at diagnosis. The multinomial analysis showed that uninsured females (OR=2.42, 95% CI=1.35-4.35) and those who have Medicaid (OR=2.36, 95% CI=1.62-3.42) were significantly more likely to be diagnosed at the regional stage than the in-situ stage compared to females with private insurance. Additionally, Black (OR=1.98, 95% CI=1.21-3.24) and Hispanic females (OR=2.19, 95%CI=1.04-4.61) were significantly more likely to be diagnosed at the regional stage than the in-situ stage when compared to Non-Hispanic White females. Females who are uninsured (OR=4.43, 95% CI=2.23-8.44) and those who have Medicaid (OR=3.03, 95% CI=1.91-4.80) were significantly more likely to be diagnosed at the distant stage than in-situ, compared to females with private insurance. Insurance status and race/ethnicity are associated with later stages of cervical cancer diagnosis. Increased coverage for routine cervical cancer screening and preventive care services is recommended, especially for racial/ethnic minority populations, the uninsured and those with public insurance.

Epidemiology and survival analysis according to the histologic subtype of pancreatic cancer: a population-based cohort study.

This study investigated epidemiologic features of patients with pancreatic cancer in Korea, according to the histologic subtypes. The Korea Central Cancer Registry data on patients with pancreatic cancer from 1999 to 2019 were reviewed. The 101,446 patients with pancreatic cancer (C25 based on the International Classification of Diseases, 10th revision) were allocated according to the following morphological codes: A, endocrine; B, carcinoma excluding cystic and mucinous; C, cystic or mucinous; D, acinar cell; and E, sarcoma and soft tissue tumor. The distribution of each pancreatic cancer subtype group in Korea from 1999 to 2019 was as follows: A, n = 3,101 (3.1%); B, n = 95,051 (93.7%); C, n = 2,856 (2.8%); D, n = 299 (0.3%); and E, n = 139 (0.1%). In group B, 49.2% of patients were aged >70 years, and half of them did not receive treatment within 4 months of diagnosis. In addition, only 30.9% of the patients were in the localized and regional stage in which surgical treatment was possible. Pancreatic cancer occurred more frequently in females than in males only in group C. Between 1999 and 2019, the average annual percentage changes in the age-specific incidence rates were positive in groups A (13.9%, P < 0.001), B (1.0%, P < 0.001), and C (6.5%, P = 0.025). Significant improvements in 5-year survival rates over time were observed in subtypes A, B, and C. The subgroups of pancreatic cancer show different epidemiologic features, including incidences, treatment rates, and prognoses.

A Comparative Study of Merkel Cell Carcinoma and Melanoma Incidence and Survival in the United States, 2000-2021.

Merkel cell carcinoma (MCC) and melanoma are important contributors to skin cancer mortality in the United States. We evaluated their epidemiology using the United States cancer registry data. In 2000-2021, 19,444 MCCs and 646,619 melanomas of the skin were diagnosed. Ninety percent of MCCs and 95% of melanomas were in non-Hispanic White individuals. More than 70% of MCCs versus 37% of melanomas occurred in people aged ≥70 years. Excess MCCs and melanomas were observed on the head and neck (observed:expected: MCC, 5.15; melanoma, 2.47). Among non-Hispanic White individuals, ambient UVR exposure was associated with melanoma arising on the head and neck (incidence rate ratios of 1.15-1.20 for MCC and 1.24-1.49 for melanoma, comparing quintiles 3-5 with quintile 1). Cancer-specific mortality was higher among patients with MCC than among those with melanoma (hazard ratio= 2.33, 95% confidence interval= 2.26-2.42) but improved in both groups after 2011 when BRAF and checkpoint inhibitors were introduced. In conclusion, melanoma exhibited stronger associations with race and ambient UVR exposure, while MCC was more likely to arise on the head and neck (perhaps reflecting the distribution of precursor cells). To ensure prompt treatment, clinicians should be on alert when diagnosing these cancers.