Decline In Incidence Research Articles

Divergent trends in gastric cancer incidence by sex and age in Spain (1990-2019).

To investigate trends in gastric cancer (GC) incidence in Spain from 1990 to 2019, analysing variations by sex and age. GC incidence data from the Global Burden of Disease database and population data from the Spanish National Institute of Statistics were used to calculate age-specific and age-standardized incidence rates (ASIR) with the European population as the reference. Temporal trends by sex and age groups were analyzed using joinpoint regression. While the total number of cases rose slightly, ASIR showed a consistent annual decrease of 1.8% for both men and women. Both sexes experienced this increase in total cases (women: 4,023 to 4,359; men: 6,243 to 6,591). Men consistently had a higher GC burden compared to women (approximately 2.2:1 ratio). Younger adults (<35 years) of both sexes saw significant decreases in ASIR. However, the joinpoint analysis revealed a recent increase in young men (25-34 years) during the period 2014-2019. Adults aged 35-64 showed a decrease in ASIR for both sexes, with a slightly steeper decline in men. Adults over 65 had a similar decrease in ASIR for both sexes, but the joinpoint analysis suggests different patterns within this age group. Our study reveals a decline in overall age-adjusted GC incidence in Spain. However, the recent rise observed in young men warrants further investigation to understand potential risk factors in this specific population group.

Restaging magnetic resonance imaging of the rectum after neoadjuvant therapy: a practical guide.

Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death. Rectal cancer accounts for approximately one-third of new colorectal cancer cases, with adenocarcinoma as the predominant subtype. Despite an overall decline in colorectal cancer incidence and mortality, due to advancements in screening, early diagnosis, and treatment options, there is a concerning increase in incidence rates among young patients. Recent significant advances in managing locally advanced rectal cancer, such as the establishment of different surgical approaches, neoadjuvant treatment using different protocols for high-risk cases, and the adoption of organ-preservation strategies, have increased the importance of the role played by radiologists in locoregional assessment on magnetic resonance imaging at baseline, at restaging, and during active surveillance of patients with rectal cancer. In this article, we review the role of restaging rectal magnetic resonance imaging after neoadjuvant therapy, providing radiologists with a practical, step-by-step guide for assessing treatment response.

Incidence of community-acquired pneumonia among children under 5 years in Suzhou, China: a hospital-based cohort study

ObjectivesTo depict the seasonality and age variations of community-acquired pneumonia (CAP) incidence in the context of the COVID-19 impact.DesignRetrospective cohort study.ParticipantsThe observational cohort study was conducted at Soochow University Affiliated...

The Surprising Decline of Workplace Sexual Harassment Incidence in the U.S. Federal Workforce

The Surprising Decline of Workplace Sexual Harassment Incidence in the U.S. Federal Workforce

HIV-2 Incidence Decline in West Africa - A Perspective on the Need for Vigilance

HIV-2 Incidence Decline in West Africa - A Perspective on the Need for Vigilance

Advances and Challenges in Hepatocellular Carcinoma: A Comprehensive Review

Hepatocellular carcinoma (HCC) stands as a pressing global health concern. It is the predominant form of liver cancer and ranks among the leading causes of cancer-related death globally. Hepatitis B virus infection and hepatitis C infection remain the primary risk factors for the development of HCC. However, recently other factors such as cirrhosis due to chronic alcohol intake and non-alcoholic steatohepatitis have been becoming an increasingly common risk factor. The advancement and refinement of diagnostic methods play a crucial role in early diagnosis and surveillance, especially in high-risk populations. Patients diagnosed with hepatocellular carcinoma face a challenging prognosis, despite advancements in surgical techniques and other therapeutic interventions. This underscores the importance of sustained attention to this issue. Continuous research into systemic therapies and refining diagnostic strategies is imperative to address the dynamic landscape of HCC. Efforts to reduce risk factors, coupled with improved surveillance, may contribute to a decline in HCC incidence in the future. This comprehensive review delves into current research on HCC, focusing on risk factors, symptoms, diagnosis, and treatment options.

Ebola incidence and mortality before and during a lockdown: The 2022 epidemic in Uganda.

On September 20, 2022, an Ebola Disease (EBOD) outbreak was declared in Mubende district, Central Uganda. Following a rapid surge in the number of cases and mortality, the Government of Uganda imposed a lockdown in the two most affected districts, Mubende and Kassanda. We describe the trends in EBOD incidence and mortality nationally and in the two districts before and during the lockdown and the lessons learned during the epidemic response. We retrieved data from the Ministry of Health situation reports from September 20, 2022, when the EBOD outbreak was declared until November 26, 2022, when the lockdown ended. We graphed trends in EBOD morbidity and mortality during a 3-week and 6-week lockdown, computed the EBOD case fatality rate, and summarized the major lessons learned during the epidemic response. We found case fatality rate during the pre-lockdown, 3-week lockdown, and 6-week lockdown period was 37.9% (22/58), 39.3% (53/135), and 38.7% (55/142), respectively. In the early weeks of the lockdown, EBOD incidence and mortality increased nationally and in Kassanda district while Mubende district registered a decline in incidence and stagnation in mortality. With the extension of the lockdown to six weeks, the EBOD incidence and mortality during the 4-6-week lockdown declined compared to the pre-lockdown period. In conclusion, the EBOD incidence and mortality remained higher in the early weeks of the lockdown than during the pre-lockdown period nationally and in one of the two districts. With extended lockdown, incidence and mortality dropped in the 4-6-week period than the pre-lockdown period. Therefore, reliance on known public health measures to control an EBOD outbreak is important.

Hip fractures in Israel during the COVID-19 pandemic

Efforts to contain the COVID-19 pandemic temporarily changed socializing behaviors as well as health care, including orthopedic trauma care. The Israeli National Program for Quality Indicators (NPQI) has been monitoring the incidence, timeliness, and outcomes of Hip Fracture (HF) surgical repair in all Israeli hospitals since 2013. The aim of this study is to examine the effect of the COVID-19 outbreak on HF incidence, treatment, and outcomes. An NPQI Quality Indicator requires surgical repair within 48 h of hospitalization. Records from 2018 through 2021 were compared. We found annual HF incidence relatively stable, with a drop in 2020. The median Length of Stay (LoS) was shorter in 2020 than in the pre-pandemic period, as was the median admission-to-surgery time. However, in 2021, the LoS and admission-to-surgery times rebounded towards pre-pandemic values. There was a noticeable decline in HF incidence during the two strict lockdown periods, followed immediately by short-term relative rises. 30-day mortality, median age, and gender distribution remained stable over the study period. In conclusion, the COVID-19 pandemic lockdown periods had a noticeable impact on HF incidence in Israel, with a decrease during lockdowns followed by a rebound effect. Additionally, the pandemic situation had an effect on the timing of surgical repairs, with shorter LoS and time to surgery. In 2021, there was a gradual return to pre-pandemic values. These findings point to a need for continued monitoring and adaptation of healthcare systems to respond to changing circumstances and ensure optimal care for patients with HF. The fact that HF incidence decreased during strict lockdowns and rebounded afterward points to a need to adapt public places to be safer for the elderly.

Trends in Gastrointestinal Infections during the COVID-19 Pandemic and Concerns of Post-Pandemic Resurgence in Japan.

The impact of the COVID-19 pandemic was very broad and substantial, affecting a variety of fields worldwide. In Japan, the infection began spreading in March 2020. At that time, the government alerted people to cancel overseas travel, and encouraged wearing of masks, handwashing, sanitizing and keeping social distance. We sought to determine how COVID-19 infections affected other infectious diseases by investigating the trends in seven gastrointestinal infections that are listed among the 77 important infectious diseases designated by the National Institute of Infectious Diseases. We compared seven gastrointestinal infectious diseases, namely cholera, bacterial dysentery, enterohemorrhagic Escherichia coli, typhoid fever, paratyphoid fever, amoebic dysentery, and giardiasis, in terms of numbers of new cases before the COVID-19 pandemic (2012-2019) and during the pandemic (2020-2022). During the COVID-19 pandemic period (2020-2022), the incidence of the seven infections decreased significantly (p < 0.05) compared with before the pandemic (2012-2019). The sharp and significant decline in incidence of these seven infections in Japan during the COVID-19 pandemic period (2020-2022) appears to be due to restrictions on overseas travel and strict anti-infection measures, such as self-quarantine and encouragement of handwashing and sanitizing. The number of new cases of gastrointestinal infections in Japan is expected to increase in 2024 as these measures lapse. It is important for physicians to continue to monitor trends in gastrointestinal infections and educate people about proper infection prevention.

DOWNWARD DEMENTIA TREND GOES INTO REVERSE IN ENGLAND AND WALES? ENGLISH LONGITUDINAL STUDY OF AGING 2002–2019

Abstract Recent evidence suggests dementia incidence rates are declining in high-income countries. However, data for the trend after 2010 are scarce. We examined the temporal trend in England and Wales from 2002-2019, considering bias and non-linearity. We used population-based panel data linked to the mortality register across wave 1 (2002-2003) to wave 9 (2018-2019) of the English Longitudinal Study of Ageing. Uniform standard criteria based on cognitive and functional impairment were used to ascertain incident dementia cases. Crude incidence rates were determined in seven overlapping initially dementia-free sub-cohorts followed over four years. We estimated the age- and sex-adjusted trend of dementia incidence with Cox and multi-state models. Restricted cubic splines allowed for potential non-linearity. 19 806 people were included in the study. Crude dementia incidence declined from 2002 to 2008 (8.7 to 7.4 per 1000 person-years), and increased from 2008 to 2019 (7.4 to 10.3 per 1000 person-years). Adjusting for age and sex, and accounting for missing dementia cases due to death, estimated dementia incidence declined by 28.8% from 2002 to 2008 (incidence rate ratio 0.71, 95% CI 0.58-0.88), and increased by 25.2% from 2008 to 2016 (incidence rate ratio 1.25, 1.03-1.54). The higher education group had a sharper decline of dementia incidence from 2002 to 2008, and a smaller increase after 2008. Dementia incidence may not be declining. There was a rebound after 2008 in England and Wales. If the upward dementia incidence trend continues, along with population ageing, the burden on health and social care may be large.

Decline in Incidence of Extra-Articular Manifestations of Rheumatoid Arthritis: A Population-Based Cohort Study.

The focus of this study was to assess changes in the cumulative incidence of extra-articular manifestations of rheumatoid arthritis (ExRAs) and associated mortality risk. This study evaluated trends in occurrence of ExRAs using a population-based inception cohort that included all adult patients with incident rheumatoid arthritis (RA) from 1985 through 2014 meeting the 1987 American College of Rheumatology criteria. Patients were divided into two cohorts based on the incidence date of RA, 1985 to 1999 and 2000 to 2014. The occurrence of ExRAs was determined by manual chart review, and the 10-year cumulative incidence was estimated for each ExRA in both cohorts. Cox proportional hazard models were used to determine associations between specific demographic and RA disease characteristics and ExRAs and between ExRAs and mortality. There were 907 patients included, 296 in the 1985 to 1999 cohort and 611 in the 2000 to 2014 cohort. The 10-year cumulative incidence of any ExRA decreased significantly between the earlier and later cohorts (45.1% vs 31.6%, P < 0.001). This was largely driven by significant declines in subcutaneous rheumatoid nodules (30.9% vs 15.8%, P < 0.001) and nonsevere ExRAs (41.4% vs 28.8%, P = 0.001). Identified risk factors for the development of any ExRAs include rheumatoid factor positivity (hazard ratio [HR] 2.02, 95% confidence interval [CI] 1.43-2.86) and current smoking (HR 1.61, 95% CI 1.10-2.34). Mortality was increased in patients with either nonsevere (HR 1.83, 95% CI 1.18-2.85) or severe ExRAs (HR 3.05, 95% CI 1.44-6.49). The incidence of ExRAs has decreased over time. Mortality remains increased in patients with ExRAs.

Trends in the prevalence of dementia in LMIC: findings from 10/66 studies in Latin America and the Caribbean.

AbstractBackgroundPopulation ageing will lead to a dramatic increase in dementia prevalence globally. Recent evidence suggest a decline in dementia incidence in High Income Countries due to increasing education levels and improvements in cardiovascular health. Although, most of the increase will occur in low and middle‐income countries (LMICs), there are no recent estimates of dementia prevalence and incidence in LMICs. The present study aimed to examine new trends on dementia prevalence and incidence in Latin‐America and associations of socioeconomic determinants and cardiovascular risk factors.MethodSample size included older adults from Latin America (Cuba, Dominican Republic [DR], Puerto Rico [PR], and Mexico) drawn from the 10/66 Dementia Research Group study. We compare wave 1 (2003‐2006) with wave 3 (2016‐2019) of 10/66 studies. The main outcome was dementia prevalence relative to previous waves. Dementia diagnosis was determined according to 10/66 dementia criteria. All the 10/66 waves used the same standardized assessments and protocols.ResultDementia prevalence is stable Cuba, standardized dementia prevalence rates was 12.4% in wave I and 10.1% in wave III. Relative to wave I, Dominican Republic (wave I 11.5% vs wave II 13.6%), Peru (wave I 9.2% vs wave II 16.8%) and Mexico (wave 1 8.3% vs wave 2 17.1%) experience a significant increase in dementia prevalence. Despite, improvements in levels of education, increases in dementia prevalence were associated with higher rates of cardiovascular disease and cardiovascular risk factors, including diabetes, hypertension, obesity and heart disease in the later‐born cohorts. Self‐reported stroke is also rising.ConclusionThe prevalence of dementia in the older Latin American and Caribbean population is high and increasing relative to the previous decade. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries

Abstract B028: Antiproliferative effect of a cathepsin L inhibitor on hepatocellular carcinoma

Abstract Liver cancer has emerged as one of the fastest-growing malignancies in the United States, despite an overall decline in cancer incidence and mortality rates. Hepatocellular carcinoma (HCC) exhibits significant gender and race/ethnicity differences in incidence and mortality. The need to address this escalating problem necessitates the development of novel and effective chemotherapeutic agents for HCC. The antiproliferative actions of two cathepsin L inhibitors (compounds 1 and 2) using in vitro and mice HCC xenograft models were investigated in this study. In addition, the ability of the compounds to inhibit CatB and generate ROS in HCC cell lines was investigated. The inhibitors have antiproliferative effects on Hep G2 and Hep 3B cell lines with low micromolar IC 50 values. Compound 1 preferentially inhibits both recombinant and endogenous CatL in a time-dependent manner compared to CatB. The levels of ROS produced when cells were treated with compound 1 were non-significant compared with vehicle-treated controls . Given the superior efficacy of compound 1 over its analog in antiproliferative studies, it was advanced to in vitro ADME studies. The inhibitor has bidirectional cellular permeability and is not a substrate for the P-glycoprotein efflux pump (P-gp). In mice, it produced a significant reduction in the sizes of subcutaneous tumors with no gross toxicity. Transcriptomics analysis using RNA-Seq revealed that the cell migration pathway was enriched in a time and dose-dependent manner. In addition, genes responsible for apoptosis and cell structural organization were overexpressed. Overall, the CatL inhibitors under investigation appear as promising starting points for investigation as potential chemotherapy against HCC. Citation Format: Olamide O. Crown, Ifedayo V. Ogungbe, Felicite K. Noubissi. Antiproliferative effect of a cathepsin L inhibitor on hepatocellular carcinoma [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B028.

Decline in the Incidence of Distant Recurrence of Breast Cancer: A Population-Based Health Record Linkage Study, Australia 2001-2016.

We investigated differences in cumulative incidence of first distant recurrence (DR) following non-metastatic breast cancer over a time period when new adjuvant therapies became available in Australia. We conducted a health record linkage study of females with localized (T1-3N0) or regional (T4 or N+) breast cancer in the New South Wales Cancer Registry in 2001 to 2002 and 2006 to 2007. We linked cancer registry records with administrative records from hospitals, dispensed medicines, radiotherapy services, and death registrations to estimate the 9-year cumulative incidence of DR and describe use of adjuvant treatment. The study included 13,170 women (2001-2002 n = 6,338, 2006-2007 n = 6,832). The 9-year cumulative incidence of DR was 3.6% [95% confidence interval (CI), 2.3%-4.9%] lower for 2006-2007 diagnoses (15.0%) than 2001-2002 (18.6%). Differences in the annual hazard of DR between cohorts were largest in year two. DR incidence declined for localized and regional disease. Decline was largest for ages <40 years (absolute difference, 14.4%; 95% CI, 8.3%-20.6%), whereas their use of adjuvant chemotherapy (2001-2002 49%, 2006-2007 75%) and HER2-targeted therapy (2001-2002 0%, 2006-2007 16%) increased. DR did not decline for ages ≥70 years (absolute difference, 0.9%; 95% CI, -3.6%-1.8%) who had low use of adjuvant chemotherapy and HER2-targeted therapy. This whole-of-population study suggests that DR incidence declined over time. Decline was largest for younger ages, coinciding with changes to adjuvant breast cancer therapy. Study findings support the need for trials addressing questions relevant to older people and cancer registry surveillance of DR to inform cancer control programs.

The History of Bovine Genital Campylobacteriosis in the Face of Political Turmoil and Structural Change in Cattle Farming in Germany.

Contagious bovine genital campylobacteriosis (BGC), also known as bovine venereal campylobacteriosis, is a disease relevant to international trade listed by the World Organization for Animal Health (WOAH). It is caused by Campylobacter fetus subsp. venerealis (Cfv), one of three subspecies of Campylobacter fetus. Bulls are the reservoir but BGC may also be spread by artificial insemination (AI). BGC is characterized by severe reproductive losses such as infertility, early embryonic death and abortion with considerable economic losses. This significant economic impact has prompted several countries to adopt stringent eradication and surveillance measures to contain the disease. While there are commercial and autologous vaccines available, scientific evidence for the effectiveness of vaccination is still lacking. In Germany, BCG was already found to be endemic in the 1920s, shortly after the agent and the disease had been described for the first time. It can be assumed that BCG had already circulated uncontrolled for a long time in the predecessor states of Germany, influenced only by the political situation and trading networks of the time. After WW II, BCG was eradicated in the German Democratic Republic due to industrialized cattle production based on AI but it was still endemic at low levels in the Federal Republic of Germany with its diverse cattle production. There has been a steady decline in BGC incidence in re-unified Germany over the past 28 years. A single genetic Cfv lineage was identified which probably emerged in the 19th century and diversified over time. Interestingly, no recurrent cross-border introduction became evident. This review gives insight into the history of bovine genital campylobacteriosis considering the structural change in cattle farming in Germany and reflecting on the political background of the time.

Changes in cancer incidence rates by stage during the COVID-19 pandemic in the US.

The coronavirus disease 2019 (COVID-19) pandemic led to health care disruptions and declines in cancer diagnoses in the United States. However, the impact of the pandemic on cancer incidence rates by stage at diagnosis and race and ethnicity is unknown. This cross-sectional study calculated delay- and age-adjusted incidence rates, stratified by stage at diagnosis and race and ethnicity, and rate ratios (RRs) comparing changes in year-over-year incidence rates (eg, 2020 vs 2019) from 2016 to 2020 for 22 cancer types based on data obtained from the Surveillance, Epidemiology, and End Results 22-registry database. From 2019 to 2020, the incidence of local-stage disease statistically significantly declined for 19 of the 22 cancer types, ranging from 4% (RR = 0.96; 95%CI, 0.93-0.98) for urinary bladder cancer to 18% for colorectal (RR = 0.82; 95%CI, 0.81-0.84) and laryngeal (RR = 0.82; 95%CI, 0.78-0.88) cancers, deviating from pre-COVID stable year-over-year changes. Incidence during the corresponding period also declined for 16 cancer types for regional-stage and six cancer types for distant-stage disease. By race and ethnicity, the decline in local-stage incidence for screening-detectable cancers was generally greater in historically marginalized populations. The decline in cancer incidence rates during the first year of the COVID-19 pandemic occurred mainly for local- and regional-stage diseases across racial and ethnic groups. Whether these declines will lead to increases in advanced-stage disease and mortality rates remain to be investigated with additional data years. Nevertheless, the findings reinforce the importance of strengthening the return to preventive care campaigns and outreach for detecting cancers at early and more treatable stages.

Resistance to immune checkpoint inhibitors in gastric cancer.

Gastric cancer (GC) is one of the most common gastrointestinal malignancies worldwide. In the past decade, with the development of early diagnostic techniques, a clear decline in GC incidence has been observed, but its mortality remains high. The emergence of new immunotherapies such as immune checkpoint inhibitors (ICIs) has changed the treatment of GC patients to some extent. However, only a small number of patients with advanced GC have a durable response to ICI treatment, and the efficacy of ICIs is very limited. Existing studies have shown that the failure of immunotherapy is mainly related to the development of ICI resistance in patients, but the understanding of the resistance mechanism is still insufficient. Therefore, clarifying the mechanism of GC immune resistance is critical to improve its treatment and clinical benefit. In this review, we focus on summarizing the mechanisms of primary or acquired resistance to ICI immunotherapy in GC from both internal and external aspects of the tumor. At the same time, we also briefly discuss some other possible resistance mechanisms in light of current studies.

Epidemiology and transmission of hepatitis A in Shaanxi (western China) after more than ten years of universal vaccination.

Hepatitis A (HepA) vaccination and economic factors can change the epidemiology of HepA. In China, the implementation of free vaccination for children under 1.5 years of age in 2008 has resulted in a decline in the overall incidence of HepA. Nevertheless, further investigation is required to comprehensively understand the epidemiological patterns of HepA in economically disadvantaged regions of China. In this study, we evaluated the incidence, seroprevalence, and transmission characteristics of HepA in Shaanxi with less economically developed. We obtained data on reported cases of HepA from 2005 to 2020. Blood samples from 1,559 individuals aged 0 to 60 years were tested for anti-hepatitis A (HAV) antibodies. A questionnaire survey and blood sample collection were conducted in two sentinel sites from 2019 to 2021. Between 2008 to 2020, the number of reported cases of HepA decreased from 3.44/100,000 person-years to 0.65/100,000 person-years, indicating an 81.1% decrease, which was particularly pronounced among younger age groups (0-19 years). From 2015-2020, infections were more likely to occur in people in their 40s and those over the age of 60. Farmers were still the most common occupation of HepA in the last decade. The results of the serological investigation showed the highest anti-HAV seroprevalence was observed in adults aged 39-60 years (94.6%) and those aged 28-38 years (87.8%). The 10-15 years group had the lowest seroprevalence at 49.3%. During the study period, a total of 22 cases were reported by sentinel sites, but the common risk factors (like raw food exposure, travel history, and closed contact with patients) were not identified. Given the greater severity of illness in the adult population and the ambiguous transmission routine, enhanced surveillance for HepA and evaluations that identify feasible approaches to mitigate the risk of HAV transmission are urgent priorities.

Abstract 16963: A Nation-Wide Study on Incidence, Mortality and Case Fatality of Acute Coronary Syndrome Reveals Levelling Off of the Incidence Decrease Among Young Women Aged 35-54 Years in 1996-2021 in Finland

Introduction/background: Incidence and case fatality (CF) of acute coronary syndrome (ACS) have declined in the last decades, but cardiovascular disease remains one of the leading causes of death in the Western world. The knowledge of the current trends in incidence, mortality, and CF of ACS from Finland and even worldwide is sparse, though some studies have suggested slowed incidence decrease and even increase in younger age groups. Thus, we set out to investigate the changes in these event rates in Finland from 1996 to 2021. Research questions/hypothesis: To examine how the ACS burden has evolved in Finland from 1996 to 2021, especially after 2010. Methods/approach: We used Finnish country-wide registers, i.e., Hospital Discharges Register (HDR, from Care register for health care) and the National Causes of Death Register with complete coverage of non-fatal and fatal ACS events. We analyzed incidence and mortality rates, and CF, as well as the significance of their trends using negative binomial and logistic regression adjusting for age and sex. Results/data: Altogether, 186 489 non-fatal and 72 907 fatal incidents of ACS events were included in the analysis. ACS incidence decreased in men (Annual percentage change (APC) -2.0% [95% CI -2.2 to -1.8]) and in the older age groups of women (APC of 55-64-year-old -1.5% [-1.7 to -1.2] and 65-74-year-old -3.3% [-3.5 to -3.1]), but the decrease in incidence slowed down over the last decade. Importantly, in 35-54-year-old women ACS incidence decrease halted (APC of 35-44-year-old 0.4% [-0.3 to 1.0] and 45-54-year-old 0.2% [-0.1 to 0.5]). ACS mortality and case-fatality declined steadily in both sexes and all age groups throughout the study period (APC of the mortality in men -4.5% [-4.7 to -4.3] and in women -5.1% [-5.3 to -4.7]. APC of the CF in men -2.7% [-2.9 to -2.6] and in women -3.4% [-3.6 to -3.2]). Conclusions: In concordance with other recent reports, we showed that the ACS mortality in both men and women was steadily decreasing. However, we observed that ACS incidence decline slowed down in older age groups and even halted in women aged 35-54. These alerting results emphasize the need for cardiovascular prevention, particularly in young and middle-aged women.

Updated Trends in Incidence and Survival of Mantle Cell Lymphoma from 2000 to 2020

While the incidence of non-Hodgkin's lymphoma (NHL) has declined ~1% per year (Y) since 2015, it is not known if this trend holds true for mantle cell lymphoma (MCL). The Surveillance, Epidemiology and End Results (SEER) 17 database includes MCL data collected from 12 US states between 2000 and 2013. However, since the launch of the new SEER 22 database, there has not yet been a study analyzing MCL trends. SEER 22 added seven more years of follow up (up to 2020) compared to SEER 17 (up to 2013), as well as the states of Illinois, Texas, Idaho, Massachusetts, and New York to the 12 states of SEER 17. Here we provide updated trends in MCL incidence and survival using the SEER 22 database, with subset analysis of age, race, and gender. Age-adjusted incidence (per 100,000 Persons/Y) of reported MCL cases were extracted from SEER 22 and tabulated at 5Y intervals (2000-2019). We found an initial increase in MCL incidence from 0.675 (2000-2004) to 0.789 (2005-2009) to 0.833 (2010-2014), followed by a slight decrease to 0.826 (2015-2019) (Fig. 1A). Using the SEER*Stat platform, we calculated the Annual Percent Change (APC) of MCL incidence from 2000 to 2019. The APC is a standard way to statistically characterize trends in MCL rates over time assuming the rates are to change at a constant percentage of the rate of the previous year. While the MCL APC from 2000 to 2014 was +2.02% signaling an annual increase, that for the years 2015 to 2019 was -0.49% indicating an average 0.49% annual decline in MCL incidence since 2015. This decline was found to be statistically significant when compared the 2000-2014 APC. Unsurprisingly, the incidence of MCL in 2020, the first year of the COVID-19 pandemic, declined to 0.767 compared to 0.814 in 2019, translating into a -5.77% percent change (PC). The PC was calculated as follows: PC=100 x [rate (2020)/rate (2019)-1]. This decrease in MCL rate is less pronounced than the -7.76% PC in NHL incidence in 2020. While these remarkable PCs reflect a drop in reporting and delayed/postponed diagnosis during the first year of the pandemic, the MCL incidence is expected to be less affected considering the aggressive nature of this disease prompting immediate diagnosis and medical care. Notably, the PC in diffuse large B-cell lymphoma (DLBCL) incidence in 2020 compared to 2019 was -3.77%, which contrasts with a larger PC of -8.69% in follicular lymphoma (FL). While DLBCL is aggressive and warrants immediate attention, FL is indolent, and diagnosis tended to be postponed during the early months of the pandemic. Collectively, the observed decrease in MCL incidence in 2020 could potentially reflect a real trend in the continuous MCL decline over time. When we included the 2020 data in the APC analysis, the 2014-2020 APC further decreased to -0.89% compared to -0.49% (2014-2019). The initial increase in MCL incidence (2000-2014) can be explained by improved reporting (access to electronic medical records, MCL being reported as MCL rather than NHL) and improved diagnostic identification of MCL (SOX11, CD5-negative MCL, indolent MCL, adoption of colonoscopy leading to early MCL detection). Following the observed peak in 2014, MCL incidence seems to follow the overall NHL downward trend. Subset analysis of age, gender, and race will be included in the presentation. Overall, we observed no major trends, except for an uptrend in the MCL incidence in the Black population potentially reflecting improved access to healthcare. To compare trends in MCL survival, we analyzed the 5Y observed overall survival (OS). Additionally, we calculated the relative survival rate (RSR) as the ratio of the observed OS divided by the expected OS of an age-matched comparable group from the general population. The 5Y observed OS improved over time: 45.2% (2000-2004), 49.1% (2005-2009), 53.8% (2010-2014), and 57.1% (2015-2019). This translated in a marked improvement in the 5Y RSR reaching 65.5% in 2015-2019. Unfortunately, while the 5Y RSR of the Hispanic population improved over time, it continues to be significantly lower than the non-Hispanic populations, reflecting either a disparity in access to healthcare or an overall worse prognosis. This dramatically contrasts with the 5Y RSR of the Black population, which once was among the lowest (47.3%, 2000-2004), became the highest 72.5%, (2015-2019) reflecting not only a better access to healthcare, but also a shift to a previously unrecognized better overall prognosis of MCL in Black patients (Fig. 1B).