Excess Cancer Cases Research Articles

Exploring tectonic sites with radon from groundwater sources and dose evaluation in various age groups in Baramulla, J&K, India

Maintaining water quality is essential to protect human health from elevated levels of radon, a water-soluble radioactive gas that can pose serious risks when levels are above safe thresholds. This study evaluated the radon levels in groundwater sources in the Baramulla district of Jammu and Kashmir using a scintillation-based smart RnDuo detector. The levels of radon showed significant fluctuations, ranging from 19 ± 0.7 to 93 ± 1.5 Bq L−1, with an arithmetic mean of 41.3 ± 1.0 Bq L−1. Notably, 51 % of the samples exceeded the limits set by USEPA (11 Bq L−1) and UNSCEAR (40 Bq L−1), yet all of them remained below the WHO's guideline of 100 Bq L−1. Furthermore, 13 % of the samples exceed 60 Bq L−1. Annual inhalation and ingestion doses vary across age groups surpassing the WHO recommendations for drinking water quality but lying below the UNSCEAR 1000 μSv y−1 suggested levels. Importantly, the mean annual effective dose throughout all age groups falls well below the ICRP range (3–10 mSv y−1). The analysis suggested that radon exposure could lead to 0.52 to 3 excess cancer cases per thousand people, with average values for all age groups remaining less than the permitted value of 1.45 × 10−3 as suggested by UNSCEAR. The study also explores physiochemical parameters, aiding future epidemiological studies and fault investigations.

Renal cell carcinoma and risk of second primary cancer: A Danish nationwide cohort study.

To examine the risk of second primary cancer in patients with incident renal cell carcinoma (RCC). We identified all patients diagnosed with incident RCC during 1995-2019, using population-based Danish medical registries. Patients were followed from the date of RCC diagnosis until any second primary cancer diagnosis, death, emigration, or December 31, 2019, whichever came first. We computed the absolute risk, standardized incidence ratio (SIR), and excess absolute risk of second primary cancer, with 95% confidence intervals (CIs), among patients with RCC compared to the general population. The absolute 1- and 20-year risks of any second primary cancer were 2.8% and 17.8%, respectively. Within 1 year after RCC diagnosis, we detected 20 excess cancer cases per 1000 person-years (PY) (SIR, 2.3; 95% CI: 2.1-2.6). Moreover, we detected an additional four excess cancer cases per 1000 PY during 1 to <5 years of follow-up (SIR, 1.3; 95% CI: 1.2-1.4), and 6 per 1000 PY beyond 5 years of follow-up (SIR, 1.4; 95% CI: 1.3-1.5). The sustained elevated cancer risk beyond 1 year of follow-up was mainly attributed to excess risk of lung and bladder cancer. The risk of second primary cancer was higher in 2006-2019 than in 1995-2005, but only during the first year of follow-up. Patients with incident RCC have a sustained 40% elevated long-term risk of second primary cancer, compared with the general population. This increased risk is mainly attributed to lung and bladder cancer.

Carcinogenic formaldehyde in U.S. residential buildings: Mass inventories, human health impacts, and associated healthcare costs

Formaldehyde, a human carcinogen, is formulated into building materials in the U.S. and worldwide. We used literature information and mass balances to obtain order-of-magnitude estimates of formaldehyde inventories in U.S. residential buildings as well as associated exposures, excess morbidity, and healthcare costs along with other economic ramifications. Use of formaldehyde in building materials dates to the 1940s and continues today unabated, despite its international classification in 2004 as a human carcinogen. Global production of formaldehyde was about 32 million metric tons (MMT) in 2006. In the U.S., 5.7 ± 0.05 to 7.4 ± 0.125 MMT of formaldehyde were produced annually from 2006 to 2022, with 65 ± 5 % of this mass (3.7 ± 0.03 to 4.8 ± 0.08 MMT) entering building materials. For a typical U.S. residential building constructed in 2022, we determined an average total mass of formaldehyde containing chemicals of 48.2 ± 10.1 kg, equivalent to 207 ± 40 g of neat formaldehyde per housing unit. When extrapolated to the entire U.S. housing stock, this equates to 29,800 ± 5760 metric tons of neat formaldehyde. If the health threshold in indoor air of 0.1 mg/m3 is never surpassed in a residential building, safe venting of embedded formaldehyde would take years. Using reported indoor air exceedances, up to 645 ± 33 excess cancer cases may occur U.S. nationwide annually generating up to US$65 M in cancer treatment costs alone, not counting ~16,000 ± 1000 disability adjusted life-years. Other documents showed health effects of formaldehyde exist, but could not be quantified reliably, including sick building syndrome outcomes such as headache, asthma, and various respiratory illnesses. Opportunities to improve indoor air exposure assessments are discussed with special emphasis on monitoring of building wastewater. Safer alternatives to formaldehyde in building products exist and are recommended for future use.

Investigations of indoor radon levels and its mapping in the Greater Accra region, Ghana

In this work, the indoor radon concentration and radiation dose risks were studied in dwellings within the Greater Accra region, using CR-39 detectors. The indoor radon concentrations ranged from 36.1 ± 2.7 to 92.0 ± 5.2 Bq m−3 with an annual average of 50.8 ± 3.4 Bq m−3. The annual mean effective dose was estimated as 1.3 mSv year−1. Excess lifetime cancer risk and lung cancer cases were assessed with 5% annual lung cancer deaths due to radon was realized. Indoor radon maps created with ArcGIS software over a 5 × 5 km2 grid showed radon prone areas in the region.

POCUS-first for nephrolithiasis: A Monte Carlo simulation illustrating cost savings, LOS reduction, and preventable radiation

ObjectivesNon-contrast computed tomography (NCCT) is the gold standard for nephrolithiasis evaluation in the emergency department (ED). However, Choosing Wisely guidelines recommend against ordering NCCT for patients with suspected nephrolithiasis who are <50 years old with a history of kidney stones. Our primary objective was to estimate the national annual cost savings from using a point-of-care ultrasound (POCUS)-first approach for patients with suspected nephrolithiasis meeting Choosing Wisely criteria. Our secondary objectives were to estimate reductions in ED length of stay (LOS) and preventable radiation exposure. MethodsWe created a Monte Carlo simulation using available estimates for the frequency of ED visits for nephrolithiasis and eligibility for a POCUS-first approach. The study population included all ED patients diagnosed with nephrolithiasis. Based on 1000 trials of our simulation, we estimated national cost savings in averted advanced imaging from this strategy. We applied the same model to estimate the reduction in ED LOS and preventable radiation exposure. ResultsUsing this model, we estimate a POCUS-first approach for evaluating nephrolithiasis meeting Choosing Wisely guidelines to save a mean (±SD) of $16.5 million (±$2.1 million) by avoiding 159,000 (±18,000) NCCT scans annually. This resulted in a national cumulative decrease of 166,000 (±165,000) annual bed-hours in ED LOS. Additionally, this resulted in a national cumulative reduction in radiation exposure of 1.9 million person-mSv, which could potentially prevent 232 (±81) excess cancer cases and 118 (±43) excess cancer deaths annually. ConclusionIf adopted widely, a POCUS-first approach for suspected nephrolithiasis in patients meeting Choosing Wisely criteria could yield significant national cost savings and a reduction in ED LOS and preventable radiation exposure. Further research is needed to explore the barriers to widespread adoption of this clinical workflow as well as the benefits of a POCUS-first approach in other patient populations.

Concentration level, health risk assessment and source apportionment of nitrosamines in PM2.5 in Urumqi during winter time

Nitrogen-containing organic compounds (NOCs) in atmospheric particulate matter are important species for the formation of brown carbon. N-nitrosamines are a class of NOCs which are carcinogenic to humans. In this paper, nine nitrosamines of PM2.5 were analyzed by gas chromatography-tandem triple quadrupole mass spectrometry (GC-MS/MS) in a multiple reaction monitoring (MRM) mode in Urumqi, Xinjiang. The aim is to reveal the concentration level, assess the carcinogenic risk and identify the possible emission source of nitrosamines during winter time. The results show that total nitrosamine concentrations range from 1.54 to 23.22 ng m−3, with a daily average of 4.47 ng m−3. N-nitrosodimethylamine (NDMA), N-nitrosodi-n-butylamine (NDBA), N-nitrosodiethylamine (NDEA), N-nitrosopyrrolidine (NPYR) and N-nitrosodiphenylamine (NDPhA) are predominant compounds for more than 80% of the total nitrosamines. The average concentrations of nitrosamines in each carcinogenic classification are 2.68, 1.45, and 0.34 ng m−3, respectively. Cumulative lifetime cancer risk assessment indicates that adult exposure to nitrosamine concentrations of 1 h per day results in 1.15 excess cancer cases per million population. Furthermore, based on correlation analysis and Positive Matrix Factorization, NDMA and NDBA may from disinfection process for water treatment, landfills, cooking and vehicle exhaust; NPYR and NDEA may be mainly emitted from cooking and tobacco combustion. However, NDPhA presents a negative correlation with other nitrosamines, probably resulting from the atmospheric reaction source. These findings not only draw attention to the systematic research of nitrosamines in PM2.5 but also provide a new perspective on the monitoring and management of regional air pollutants.

Comparative study of radon sources and associated health risk in four underground uranium mines.

This paper presents a comparative study of the quantitative estimation of 222Rn and its health risk from various sources in four underground uranium mines. 222Rn exhalation rates from uranium-bearing rocks and backfill materials were estimated by calculating the 222Rn concentration accumulated in an enclosed chamber into which radon was exhaled. This comparative study indicates a more significant effect of porosity on the exhalation rates. Dissolved 222Rn in mine water was estimated using scintillation cell and bubbler kit. The discrepancy in 222Rn concentration in the mines might be attributed to the variation in geological features, ore grade, and porosity. This study revealed that the maximum radon exposure was produced from the backfill mill tailings, followed by uranium ore and mine water in the mines. The radon dose values in the individual mines remained under the safe dose limit of 20mSvyear-1. The excess lifetime cancer risk (ELCR) and 222Rn-induced lung cancer cases (RnLCC) per million persons per year were also estimated.

INFLUENCE OF IONIZING RADIATION ON THE DEVELOPMENT OF BREAST CANCER.

Breast cancer (BC) is one of the urgent problems of health care, which is due to a constant trend of growth. One of the risk factors for the development of breast cancer is ionizing radiation (IR). Numerous epidemiological and experimental studies have shown the high sensitivity of the mammary gland (MG) to this factor. Consideration of models of absolute and relative risks of the occurrence of radio-induced tumors of the MG in irradiated persons showed the importance of such factors as age at the time of irradiation, multiplicity. frequency of exposure, dose level and concomitant non-neoplastic diseases of the mammary and thyroid gland (TG). Excess radiation-induced cases of cervical cancer were found among irradiated women after the atomic bombings of Hiroshima and Nagasaki.Epidemiological features of the development of breast cancer under the influence of IV are presented in detail, which is one of the environmental factors involved in the formation of the modern carcinogenic situation. In con-nection with the significant sensitivity of the MG to the carcinogenic effect of IR, this form of neoplasms attracted special attention after the Chornobyl accident. The effect of small doses of radiation after the Chornobyl disaster led to a wave-like change in the incidence of breast cancer in certain periods of the year, and the radiation-induced incidence of this pathology can occur spontaneously.

Breast cancer risk among thyroid cancer survivors and the role of I-131 treatment.

Female thyroid cancer survivors are more likely to have a higher risk of breast cancer compared to the general population, and the underlying causes are yet to be understood. The potential role of I-131 treatment on this association remains controversial. We pooled individual data of women who were treated for differentiated thyroid cancer from 1934 to 2005 in France, Italy and Sweden. Standardized incidence ratios (SIRs) for breast cancer were estimated by comparison with age, sex and calendar-year expected values of the general population in each country. We estimated breast cancer risk in relation to I-131 treatment using time-dependent Poisson models. Of 8475 women (mean age at diagnosis: 45 years, range 2-90 years), 335 were diagnosed with breast cancer [SIR = 1.52, 95% confidence interval (CI): 1.36-1.69] during a median follow-up time of 12.7 years since diagnosis. Overall, breast cancer risk did not differ between women treated or not with I-131 (relative risk=1.07, 95% CI 0.84-1.35). However, breast cancer risk increased with increasing cumulative I-131 activity, without significant departure from linearity (excess relative risk per 100 mCi=17%, 95% CI: 2% to 38%). The higher risk associated with a cumulative I-131 activity of ≥100 mCi and ≥400 mCi was translated into 4 (95% CI -4 to 13) and 42 (95% CI -8 to 93) excess breast cancer cases per 10,000 person-years, respectively. An elevated risk was observed for the highest cumulative administered activity (>=400 mCi), and a significant dose-dependent association was observed among thyroid cancer survivors who were treated with I-131. However, overall, I-131 treatment might only explain partly the increase in breast cancer risk among female thyroid cancer survivors.

Impact and Recovery from COVID-19-Related Disruptions in Colorectal Cancer Screening and Care in the US: A Scenario Analysis.

Many colorectal cancer-related procedures were suspended during the COVID-19 pandemic. In this study, we predict the impact of resulting delays in screening (colonoscopy, FIT, and sigmoidoscopy) and diagnosis on colorectal cancer-related outcomes, and compare different recovery scenarios. Using the MISCAN-Colon model, we simulated the US population and evaluated different impact and recovery scenarios. Scenarios were defined by the duration and severity of the disruption (percentage of eligible adults affected), the length of delays, and the duration of the recovery. During recovery (6, 12 or 24 months), capacity was increased to catch up missed procedures. Primary outcomes were excess colorectal cancer cases and -related deaths, and additional colonoscopies required during recovery. With a 24-month recovery, the model predicted that the US population would develop 7,210 (0.18%) excess colorectal cancer cases during 2020-2040, and 6,950 (0.65%) excess colorectal cancer-related deaths, and require 108,500 (8.6%) additional colonoscopies per recovery month, compared with a no-disruption scenario. Shorter recovery periods of 6 and 12 months, respectively, decreased excess colorectal cancer-related deaths to 4,190 (0.39%) and 4,580 (0.43%), at the expense of 260,200-590,100 (20.7%-47.0%) additional colonoscopies per month. The COVID-19 pandemic will likely cause more than 4,000 excess colorectal cancer-related deaths in the US, which could increase to more than 7,000 if recovery periods are longer. Our results highlight that catching-up colorectal cancer-related services within 12 months provides a good balance between required resources and mitigation of the impact of the disruption on colorectal cancer-related deaths.

Modelling the Potential Impact of Weight Gain During the COVID-19 Pandemic on the Future Burden of Cancer

ObjectivesTo understand potential long-term consequences of the impacts of the COVID-19 pandemic and resulting public health measures on daily life, specifically shifts in health behaviours which contribute to weight gain. MethodsData on unintentional weight gain among adults during the first year of the COVID-19 pandemic was applied to national survey data to simulate pre and post weight gain body mass index (BMI). Population impact measures were estimated using OncoSim, a web-based microsimulation tool, which simulates the trajectory of cancer, calibrated using Canadian cancer incidence and mortality data along with measurable risk for specified cancers from lifestyle risk factors. Projections were estimated until 2042, assuming a 12-year latency period. ResultsFollowing a mean weight gain of 11.4 lbs, the proportion of underweight, overweight, obese and morbidly obese BMI were: 37%, 36%, 18% and 9%, respectively. The projected excess cancer cases would reach 8,651 and 16,915 by 2037 and 2042. The additional cancer burden will disproportionately impact women. The largest projected increases were observed for uterine, kidney and liver cancers among women, with mean potential impact fractions (PIF) of 4.26%, 2.58% and 2.08%, respectively. Among men, the largest mean PIFs were observed for esophageal (3.03%), kidney (2.28%) and liver (1.81%) cancers. The projected excess cancer deaths would reach 6,254 by 2042, with the largest burden projected for colorectal, esophageal and pancreatic cancer (N = 1,087, N = 945, and N = 813). ConclusionsThese projections highlight the possible long-term consequences of changes in health behavior during the COVID-19 pandemic on the burden of cancer in Canada. This underscores the critical need for timely investment into effective cancer prevention strategies, to minimize the likelihood that unhealthy lifestyle changes during the COVID-19 pandemic are sustained. Funding SourcesMichael Smith Foundation for Health Research, the Canadian Partnership Against Cancer, Health Canada.

Projected Impact of Weight Gain During the COVID-19 Pandemic on the Future Burden of Cancer in Canada

The COVID-19 pandemic and resulting public health measures have had significant impacts on daily life, including shifts in health behaviours which contribute to weight gain and may increase subsequent risk of chronic diseases such as cancer. Using OncoSim, a web-based microsimulation tool, we estimated the future burden of cancer in Canada by incorporating data on unintentional weight gain among adults during the first year of the COVID-19 pandemic. Population impact measures were estimated until 2042, assuming a 12-year latency period. We estimated 14,194 excess cancer cases and 5,324 excess cancer deaths by 2042 due to COVID-19 related weight gain. Particularly large impacts were estimated for endometrial and breast cancer among women, with 2,983 and 2,151 excess cases by 2042. For men, 1,700 excess colorectal cases and 1,188 excess kidney cancer cases were projected by 2042. Changes in health behavior during the COVID-19 pandemic are likely to have significant and long-lasting impacts on cancer burden. These projections highlight the immediate need for investment into the development and implementation of effective cancer prevention strategies.

Long-term spatiotemporal variation and lung cancer risk of atmospheric polycyclic aromatic hydrocarbons (PAHs) in the Yangtze River Delta, China.

The Yangtze River Delta (YRD), which is the most developed region in China, suffers from atmospheric polycyclic aromatic hydrocarbons (PAH) pollution. However, the long-term spatiotemporal variation of atmospheric PAHs and the lung cancer risk caused by PAH exposure in the YRD remain unclear. Herein, we simulated the daily atmospheric concentration of benzo[a]pyrene (BaP, the most carcinogenic PAH) from 2001 to 2016 using an atmospheric transport model. During this period, the atmospheric BaP concentration showed a general trend of first increasing and then decreasing (average BaP concentration = 0.50 ± 0.12ng/m3) and was highest in 2005 (0.72ng/m3). Moreover, the BaP concentration in Jiangsu and Shanghai was 5.17- and 4.98-fold higher than that in Zhejiang. BaP pollution was severe in Jiangsu during the winter. The average area proportion of BaP exceeding the national standard in winter in Jiangsu was 69.09%. The population-weighted incremental lifetime cancer risk from 2001 to 2016 ranged 6.67 × 10-6-1.50 × 10-5, and the excess lung cancer cases ranged 1054-2130. Compared with 2005, excess lung cancer cases in the YRD decreased by 49.49% in 2016. Reducing BaP pollution in winter in Jiangsu is crucial for reducing lung cancer risk in the YRD.

Point-of-care ultrasound-first for the evaluation of small bowel obstruction: National cost savings, length of stay reduction, and preventable radiation exposure.

Computed tomography (CT) has long been the gold standard in diagnosing patients with suspected small bowel obstruction (SBO). Recently, point-of-care ultrasound (POCUS) has demonstrated comparable test characteristics to CT imaging for the diagnosis of SBO. Our primary objective was to estimate the annual national cost saving impact of a POCUS-first approach for the evaluation of SBO. Our secondary objectives were to estimate the reduction in radiation exposure and emergency department (ED) length of stay (LOS). We created and ran 1000 trials of a Monte Carlo simulation. The study population included all patients presenting to the ED with abdominal pain who were diagnosed with SBO. Using this simulation, we modeled the national annual cost savings in averted advanced imaging from a POCUS-first approach for SBO. The model assumes that all patients who require surgery or have non-diagnostic POCUS exams undergo CT imaging. The model also conservatively assumes that a subset of patients with diagnostic POCUS exams undergo additional confirmatory CT imaging. We used the same Monte Carlo model to estimate the reduction in radiation exposure and total ED bed hours saved. A POCUS-first approach for diagnosing SBO was estimated to save a mean (±SD) of $30.1 million (±8.9 million) by avoiding 143,000 (±31,000) CT scans. This resulted in a national cumulative decrease of 507,000 bed hours (±268,000) in ED LOS. The reduction in radiation exposure to patients could potentially prevent 195 (±56) excess annual cancer cases and 98 (±28) excess annual cancer deaths. If adopted widely and used consistently, a POCUS-first algorithm for SBO could yield substantial national cost savings by averting advanced imaging, decreasing ED LOS, and reducing unnecessary radiation exposure in patients. Clinical decision tools are needed to better identify which patients would most benefit from CT imaging for SBO in the ED.

Oral Contraceptive Use in BRCA1 and BRCA2 Mutation Carriers: Absolute Cancer Risks and Benefits.

BackgroundTo help BRCA1 and 2 mutation carriers make informed decisions regarding use of combined-type oral contraceptive preparation (COCP), absolute risk-benefit estimates are needed for COCP-associated cancer.MethodsFor a hypothetical cohort of 10 000 women, we calculated the increased or decreased cumulative incidence of COCP-associated (breast, ovarian, endometrial) cancer, examining 18 scenarios with differences in duration and timing of COCP use, uptake of prophylactic surgeries, and menopausal hormone therapy.ResultsCOCP use initially increased breast cancer risk and decreased ovarian and endometrial cancer risk long term. For 10 000 BRCA1 mutation carriers, 10 years of COCP use from age 20 to 30 years resulted in 66 additional COCP-associated cancer cases by the age of 35 years, in addition to 625 cases expected for never users. By the age of 70 years such COCP use resulted in 907 fewer cancer cases than the expected 9093 cases in never users. Triple-negative breast cancer estimates resulted in 196 additional COCP-associated cases by age 40 years, in addition to the 1454 expected. For 10 000 BRCA2 mutation carriers using COCP from age 20 to 30 years, 80 excess cancer cases were estimated by age 40 years in addition to 651 expected cases; by the age of 70 years, we calculated 382 fewer cases compared with the 6156 cases expected. The long-term benefit of COCP use diminished after risk-reducing bilateral salpingo-oophorectomy followed by menopausal hormone therapy use.ConclusionAlthough COCP use in BRCA1 and BRCA2 mutation carriers initially increases breast, ovarian, and endometrial cancer risk, it strongly decreases lifetime cancer risk. Risk-reducing bilateral salpingo-oophorectomy and menopausal hormone therapy use appear to counteract the long-term COCP-benefit.

Particulate matter in a motorcycle-dominated urban area: Source apportionment and cancer risk of lung deposited surface area (LDSA) concentrations

Source-apportioned particle concentrations are necessary to properly evaluate the health impacts of air pollution. In this study, a measurement station was established at an urban roadside in northern Taiwan to the investigate lung deposited surface area (LDSA) concentration, a relevant metric for the adverse health effects of aerosol exposure, along with PM1 and equivalent black carbon (eBC) concentrations, particle number concentration (PNC), and particle size distribution (PSD). Through positive matrix factorization and multi-linear regression analysis, we attributed 57% of LDSA to traffic emissions over the entire study. During rush hour, the motorcycle fraction increased to 0.83 and LDSA (77.6 ± 9.9 µm2/cm3) and PNC (14,000 ± 2400 particles/cm3) values peaked, while 74% of LDSA was attributed to traffic. The LDSA ratio, defined as the ratio of measured LDSA to that estimated from the particle size distribution with a spherical assumption, also increased, highlighting the greater degree of fractal morphology during rush hour. The relationship between LDSA emitted by traffic and PNC yielded a higher r2 (0.92) than the r2 between traffic LDSA and eBC (0.82). Finally, the excess lifetime cancer risk linked with traffic emission was 1.56 × 10-4 (i.e. 15.6 excess cancer cases for a population of 100,000 people) based on the LDSA apportionment results.

Annual exposure to polycyclic aromatic hydrocarbons in urban environments linked to wintertime wood-burning episodes

Abstract. Polycyclic aromatic hydrocarbons (PAHs) are organic pollutants in fine particulate matter (PM) long known to have mutagenic and carcinogenic effects, but much is unknown about the importance of local and remote sources for PAH levels observed in population-dense urban environments. A year-long sampling campaign in Athens, Greece, where more than 150 samples were analyzed for 31 PAHs and a wide range of chemical markers, was combined with positive matrix factorization (PMF) to constrain the temporal variability, sources, and carcinogenic risk associated with PAHs. It was found that biomass burning (BB), a source mostly present during wintertime intense pollution events (observed for 18 % of measurement days in 2017), led to wintertime PAH levels that were 7 times higher than in other seasons and was as important for annual mean PAH concentrations (31 %) as diesel and oil (33 %) and gasoline (29 %) sources. The contribution of non-local sources, although limited on an annual basis (7 %), increased during summer, becoming comparable to that of local sources combined. The fraction of PAHs (12 members that were included in the PMF analysis) that was associated with BB was also linked to increased health risk compared to the other sources, accounting for almost half the annual PAH carcinogenic potential (43 %). This can result in a large number of excess cancer cases due to BB-related high PM levels and urges immediate action to reduce residential BB emissions in urban areas facing similar issues.

Reducing Poverty-Related Disparities in Cervical Cancer: The Role of HPV Vaccination.

Near elimination of cervical cancer in the United States is possible in coming decades, yet inequities will delay this achievement for some populations. We sought to explore the effects of human papillomavirus (HPV) vaccination on disparities in cervical cancer incidence between high- and low-poverty U.S. counties. We calibrated a dynamic simulation model of HPV infection to reflect average counties in the highest and lowest quartile of poverty (percent of population below federal poverty level), incorporating data on HPV prevalence, cervical cancer screening, and HPV vaccination. We projected cervical cancer incidence through 2070, estimated absolute and relative disparities in incident cervical cancer for high- versus low-poverty counties, and compared incidence with the near-elimination target (4 cases/100,000 women annually). We estimated that, on average, low-poverty counties will achieve near-elimination targets 14 years earlier than high-poverty counties (2029 vs. 2043). Absolute disparities by county poverty will decrease, but relative differences are estimated to increase. We estimate 21,604 cumulative excess cervical cancer cases in high-poverty counties over the next 50 years. Increasing HPV vaccine coverage nationally to the Healthy People 2020 goal (80%) would reduce excess cancer cases, but not alter estimated time to reach the near-elimination threshold. High-poverty U.S. counties will likely be delayed in achieving near-elimination targets for cervical cancer and as a result will experience thousands of potentially preventable cancers. Alongside vaccination efforts, it is important to address the role of social determinants and health care access in driving persistent inequities by area poverty.

Preventable causes of cancer in Texas by race/ethnicity: tobacco smoking.

OBJECTIVESTobacco smoking is classified as carcinogenic to humans (International Agency for Research on Cancer Group 1). We aimed to estimate the percentage and number of incident cancer cases diagnosed in Texas in 2015 that were attributable to tobacco smoking, and we examined differences in the proportions of smoking-attributable cancers between the major racial/ethnic subgroups of the population.METHODSWe calculated population-attributable fractions for cancers attributable to tobacco smoking using prevalence data from the Texas Behavioral Risk Factor Surveillance System and relative risks associated with smoking status from pooled analyses of cohort studies or meta-analyses. Cancer incidence data were collected from the Texas Cancer Registry.RESULTSWe estimated that 19,000 excess cancer cases or 18.4% of all cancers diagnosed in 2015 in Texans aged ≥ 25 years were caused by tobacco smoking. Males had a higher overall proportion of cancers attributable to tobacco smoking than females (male, 23.3%, 11,993 excess cases; female, 13.5%, 7,006 cases). Approximately 20% of cancer cases in non-Hispanic Whites and non-Hispanic Blacks were attributable to tobacco smoking compared to 12.8% among Hispanics.CONCLUSIONSDespite ongoing public health campaigns combatting tobacco use, this preventable behavior still contributes significantly to cancer incidence in Texas. Racial/ethnic differences in smoking prevalence and smoking-attributable cancer incidence should be considered when designing cancer prevention programs.

Radon study around earthquake affected areas of Nepal

Indoor radon concentrations were measured in dwellings of the earthquake-affected areas of Kathmandu valley, Gorkha, and Sindhupalchowk districts of Nepal using passive radon dosimeter LR115, a Solid State Nuclear Track Detector, SSNTD. The radon concentrations in dwellings of Kathmandu valley ranged from 11±6 Bq/m3 to 135±26 Bq/m3 with a mean of 67.63 Bq/m3. For Gorkha, it ranged from 18±7 Bq/m3 to 363±65 Bq/m3 with an average of 104.64 Bq/m3 while minimum, maximum and average radon concentrations for Sindhupalchowk were 14±6 Bq/m3, 397±71 Bq/m3, and 78.46 Bq/m3 respectively. The average annual effective dose to the inhabitants of Kathmandu valley, Gorkha, and Sindhupalchowk districts was calculated as 1.46 mSv/y, 2.26 mSv/y, and 1.69 mSv/y respectively. These annual doses were well below the action level of 10 mSv/y recommended by the International Commission on Radiological Protection which implies no significant radiological health hazards. Also, Excess Lifetime Cancer Risk and Lungs Cancer Cases per year per million people were determined.&#x0D; BIBECHANA 18 (2) (2021) 61-67