Incidence Rates In Europe Research Articles

Systematic Literature Review on the Incidence of Herpes Zoster in Populations at Increased Risk of Disease in the EU/EEA, Switzerland, and the UK.

Older adults and patients with underlying conditions such as immunocompromised (IC) populations (e.g., due to medical conditions or immunosuppressive medication) are at increased risk for herpes zoster (HZ). The first HZ recombinant vaccine for IC patients was approved in 2020. Limited evidence exists to inform decision-makers on HZ incidence in high-risk patients in Europe. This systematic literature review (SLR) assessed HZ incidence across 14 high-risk populations in the European Union/European Economic Area, Switzerland, and the United Kingdom. An SLR (Embase, Medline, 2002-2022, observational studies) was performed to identify HZ incidence (i.e., primary outcomes: rate or cumulative; secondary: relative incidence) in type 1 and 2 diabetes mellitus (DM); chronic obstructive pulmonary disease and asthma; depression; rheumatic disorders (RD); multiple sclerosis (MS); inflammatory bowel diseases (IBD); psoriasis; lupus; human immunodeficiency virus (HIV); solid organ transplantation (SOT); solid organ malignancy (SOM); hematologic malignancy (HM); and stem cell transplantation (SCT). Of 776 unique records screened, 59 studies were included (24 reported incidence rate per 1000 person-years; two, cumulative incidence per 1000 persons; and 33, relative incidence). The highest incidence rates were reported for SOT (12.1-78.8) and SCT (37.2-56.1); HM (2.9-32.0); RD (0.41-21.5); lupus (11.0-16.5); IC mixed population (11.3-15.5); HIV/AIDS (11.8-13.0); chronic respiratory diseases (4.7-11.4); SOM (8.8-11.0); IBD (7.0-10.8); DM (4.3-9.4); depression (7.2-7.6); MS (5.7-6.3); and psoriasis (5.3-6.1). In many high-risk populations, HZ incidence was higher for older age groups, women, and some treatments. The HZ incidence rate in Europe increased with age and varied across high-risk populations, with high rates for solid organ and stem cell transplants, cancer, and rheumatoid arthritis. Most studies were retrospective with methodological differences affecting generalizability and comparability. Future studies should stratify data by IC population, age, sex, severity, medication, and study timeframe.

Potential cellular intravesical therapy for non-muscle invasive bladder cancer: Nectin-4 targeted CAR-T cell therapy

Bladder cancer poses a significant global health challenge, particularly with its prevalence in males and the increasing incidence rates in Europe. While non-muscle invasive bladder cancer can be managed with localized treatments, its recurrence remains a concern. Intravesical Bacillus Calmette-Guérin therapy triggers an immune response against cancer cells, yet recurrences post- transurethral resection of bladder tumor persist. Thus, innovative strategies are needed. We propose the use of Nectin-4 targeted chimeric antigen receptor T cell therapy to prevent non-muscle invasive bladder cancer recurrence and progression. Nectin-4 is expressed in non-muscle invasive bladder cancer, making it an ideal target. CAR-T cells engineered with Nectin-4 receptors can specifically eliminate cancer cells. By directly applying these cells intravesically, the limitations of CAR-T cell access to solid tumors are circumvented. However, challenges persist, such as the immunosuppressive microenvironment of bladder cancer. This can be addressed by combining intravesical Bacillus Calmette-Guérin with CAR-T therapy or utilizing immune checkpoint inhibitors. CAR-T therapy-related toxicities, like cytokine release syndrome, can be managed with IL-6 and IL-1 receptor inhibitors. Our hypothesis suggests that Nectin-4 targeted CAR-T cells have the potential to revolutionize bladder cancer treatment. This therapy could not only eliminate cancer cells but also prevent recurrence and progression by inducing immune memory. Although further research is needed, this innovative approach shows promise in the treatment of non-muscle invasive bladder cancer.

BREAST CANCER SCREENING IN ROMANIA: CHALLENGES AND OPPORTUNITIES FOR EARLY DETECTION.

Breast cancer has surpassed lung cancer as the most common type of cancer globally, representing approximately 25% of all cancer cases and leading in cancer-related mortality among women. In Romania, breast cancer accounts for 26.9% of all female cancer diagnoses, with an increasing incidence and significant mortality rate despite one of the lowest incidence rates in Europe. The study highlights the disparities in breast cancer outcomes across Europe, with Romania showing lower survival rates compared to Western European countries. This disparity is partly attributed to the low participation in breast cancer screening programs, where only 9% of eligible Romanian women underwent mammography in 2020, far below the European average of 60%. The World Health Organization (WHO) and European Commission emphasize the importance of organized population-based screening for women aged 50-69, yet many barriers, including low health literacy, lack of awareness, and socio-economic challenges, hinder effective participation, especially among vulnerable populations. This study, conducted over three years at the "Alessandrescu Rusescu " National Institute for Mother and Child Health, involved 1,705 patients and aims to provide insights into improving breast cancer screening participation and outcomes in Romania.

Circulation, viral diversity and genomic rearrangement in mpox virus in the Netherlands during the 2022 outbreak and beyond.

Mpox is an emerging zoonotic disease which has now spread to over 113 countries as of August 2023, with over 89,500 confirmed human cases. The Netherlands had one of the highest incidence rates in Europe during the peak of the outbreak. In this study, we generated 158 near-complete mpox virus (MPXV) genomes (12.4% of nationwide cases) that were collected throughout the Netherlands from the start of the outbreak in May 2022 to August 2023 to track viral evolution and investigate outbreak dynamics. We detected 14 different viral lineages, suggesting multiple introductions followed by rapid initial spread within the country. The estimated evolutionary rate was relatively high compared to previously described in orthopoxvirus literature, with an estimated 11.58 mutations per year. Genomic rearrangement events occurred at a rate of 0.63% and featured a large deletion event. In addition, based on phylogenetics, we identified multiple potential transmission clusters which could be supported by direct source- and contact tracing data. This led to the identification of at least two main transmission locations at the beginning of the outbreak. We conclude that whole genome sequencing of MPXV is essential to enhance our understanding of outbreak dynamics and evolution of a relatively understudied and emerging zoonotic pathogen.

Understanding the contribution of lifestyle in breast cancer risk prediction: a systematic review of models applicable to Europe

BackgroundBreast cancer (BC) is a significant health concern among European women, with the highest prevalence rates among all cancers. Existing BC prediction models account for major risks such as hereditary, hormonal and reproductive factors, but research suggests that adherence to a healthy lifestyle can reduce the risk of developing BC to some extent. Understanding the influence and predictive role of lifestyle variables in current risk prediction models could help identify actionable, modifiable, targets among high-risk population groups.PurposeTo systematically review population-based BC risk prediction models applicable to European populations and identify lifestyle predictors and their corresponding parameter values for a better understanding of their relative contribution to the prediction of incident BC.MethodsA systematic review was conducted in PubMed, Embase and Web of Science from January 2000 to August 2021. Risk prediction models were included if (i) developed and/or validated in adult cancer-free women in Europe, (ii) based on easily ascertained information, and (iii) reported models’ final predictors. To investigate further the comparability of lifestyle predictors across models, estimates were standardised into risk ratios and visualised using forest plots.ResultsFrom a total of 49 studies, 33 models were developed and 22 different existing models, mostly from Gail (22 studies) and Tyrer-Cuzick and co-workers (12 studies) were validated or modified for European populations. Family history of BC was the most frequently included predictor (31 models), while body mass index (BMI) and alcohol consumption (26 and 21 models, respectively) were the lifestyle predictors most often included, followed by smoking and physical activity (7 and 6 models respectively). Overall, for lifestyle predictors, their modest predictive contribution was greater for riskier lifestyle levels, though highly variable model estimates across different models.ConclusionsGiven the increasing BC incidence rates in Europe, risk models utilising readily available risk factors could greatly aid in widening the population coverage of screening efforts, while the addition of lifestyle factors could help improving model performance and serve as intervention targets of prevention programmes.

Healthcare outcomes in patients with HIV infection at a tertiary hospital during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has affected the care of patients with other diseases. Difficulty in access to healthcare during these months has been especially relevant for persons with HIV infection (PWH). This study therefore sought to ascertain the clinical outcomes and effectiveness of the measures implemented among PWH in a region with one of the highest incidence rates in Europe. MethodsRetrospective, observational, pre-post intervention study to compare the outcomes of PWH attended at a high-complexity healthcare hospital from March to October 2020 and during the same months across the period 2016–2019. The intervention consisted of home drug deliveries and preferential use of non face-to-face consultations. The effectiveness of the measures implemented was determined by reference to the number of emergency visits, hospitalisations, mortality rate, and percentage of PWH with viral load >50copies, before and after the two pandemic waves. ResultsA total of 2760 PWH were attended from January 2016 to October 2020. During the pandemic, there was a monthly mean of 106.87 telephone consultations and 2075 home deliveries of medical drugs dispensed to ambulatory patients. No statistically significant differences were found between the rate of admission of patients with COVID-HIV co-infection and that of the remaining patients (1172.76 admissions/100,000 population vs. 1424.29, p=0.401) or in mortality (11.54% vs. 12.96%, p=0.939). The percentage of PWH with viral load >50copies was similar before and after the pandemic (1.20% pre-pandemic vs. 0.51% in 2020, p=0.078). ConclusionOur results show that the strategies implemented during the first 8 months of the pandemic prevented any deterioration in the control and follow-up parameters routinely used on PWH. Furthermore, they contribute to the debate about how telemedicine and telepharmacy can fit into future healthcare models.

Cervical cancer screening history among women diagnosed with cervical cancer in Estonia 2017-18.

Despite the national cervical cancer screening programme launched in 2006, Estonia has one of the highest cervical cancer incidence rates in Europe. While the overall coverage of cervical cytology is high, the factors related to cancer screening history prior to cancer diagnosis need to be studied. In this study, we aimed to examine the 10-year screening history of women diagnosed with cervical cancer in Estonia in 2017-18, using data collected from laboratory reports from 2007 to 2018. From each report, we extracted information on the date and result of cytology and on the laboratory where the sample was assessed. We analysed these data across cancer histology, the time interval between the last test result and cancer diagnosis and the laboratory type (local or regional). Among 319 women with cervical cancer, 181 (56.7%) did not have any cytology reports available. Among 138 women with at least one cytology, 60% had 1-3, 24% 4-6 and 16% ≥7 tests (mean 3.7) before cancer. In 78% of women, the last test was performed less than 5 years before cancer diagnosis and 62% of these tests did not report any abnormalities. The last cytology results differed significantly between the regional and local laboratories (P = 0.028). Women received the cervical cancer diagnosis in Estonia despite having several screening tests 10 years prior to the diagnosis. The proportion of cytology tests without any abnormalities less than 5 years before the diagnosis was worryingly high and needs further investigation together with the difference between laboratory types.

ASSESSING THE IMPACT OF AIR PASSENGER TRAFFIC IN AIRPORTS ON COVID-19 RATES IN EUROPEAN REGIONS

This study provides the result of statistical analysis of weekly airport passenger traffic data and the rate of new COVID-19 cases (COVID-19 incidence rate) in Europe at both the country and sub national level during 2020, controlling for the prior incidence rate, the level of stringency of government measures, and the mobility of people. This paper focuses on the relationship between air travel and the COVID-19 incidence rate during the second half of the year because this addresses the real problem faced in Europe about whether to permit air travel after a novel virus was already highly present in the community. The paper does not seek to add to the literature about the role of air travel in the initial propagation of a novel virus, nor does it consider the impact of vaccine availability.
 The analysis provides evidence that a 10% increase in airport passengers is correlated with a 0.14% increase in the COVID-19 incidence rate in Europe’s subnational regions during the second half of 2020. As comparison, an increase of 10% in the index of the stringency of government measures is correlated with a 4.3% reduction in the COVID-19 rate, and 10% more mobility in the population with a 2.9% increase in the COVID-19 rate. The paper uses a model that is based in literature and applies ordinary least squares (OLS) regression techniques for fixed effects and pooled panel data.
 The finding that increases in air transport traffic when a novel virus is already widely present suggests that efforts to restrict or control air travel are not likely to be efficient.

GIS-based spatio-temporal analysis and modeling of COVID-19 incidence rates in Europe

The COVID-19 epidemic has emerged as one of the most severe public health crises worldwide, especially in Europe. Until early July 2021, reported infected cases exceeded 180 million, with almost 4 million associated deaths worldwide, almost a third of which are in continental Europe. We analyzed the spatio-temporal distribution of the disease incidence and mortality rates considering specific periods in this continent. Further, we applied Global Moran's I to examine the spatio-temporal distribution patterns of COVID-19 incidence rates and Getis-Ord Gi* hotspot analysis to represent high-risk areas of the disease. Additionally, we compiled a set of 40 demographic, socioeconomic, environmental, transportation, health, and behavioral indicators as potential explanatory variables to investigate the spatial variations of COVID-19 cumulative incidence rates (CIRs). Ordinary Least Squares (OLS), Spatial Lag model (SLM), Spatial Error Model (SLM), Geographically Weighted Regression (GWR), and Multiscale Geographically Weighted Regression (MGWR) regression models were implemented to examine the spatial dependence and non-stationary relationships. Based on our findings, the spatio-temporal distribution pattern of COVID-19 CIRs was highly clustered and the most high-risk clusters of the disease were situated in central and western Europe. Moreover, poverty and the elderly population were selected as the most influential variables due to their significant relationship with COVID-19 CIRs. Considering the non-stationary relationship between variables, MGWR could describe almost 69% of COVID-19 CIRs variations in Europe. Since this spatio-temporal research is conducted on a continental scale, spatial information obtained from the models could provide general insights to authorities for further targeted policies.

Temporal and geographical variations of thyroid cancer incidence and mortality in France during 1986–2015: The impact of overdiagnosis

BackgroundFrance is among the countries showing fastest growth of thyroid cancer (TC) incidence and highest incidence rates in Europe. This study aimed to clarify the temporal and geographical variations of TC in France and to quantify the impact of overdiagnosis. MethodsWe obtained TC incidence data in 1986–2015, and mortality data in 1976–2015, for eight French departments covering 8% of the national population, and calculated the age-standardised rates (ASR). We estimated the average annual percent changes (AAPC) of TC incidence, overall and by department and histological subtype. Numbers and proportions of TC cases attributable to overdiagnosis were estimated by department and period, based on the comparison between the shape of the age-specific curves with that observed prior to changes in diagnostic practice. ResultsDuring 1986–2015, there were 13,557 TC cases aged 15–84 years. Large variations of TC incidence were observed across departments, with the highest ASR and the fastest increase in Isère. Papillary subtype accounted for 82.8% of the cases, and presented an AAPC of 7.0% and 7.6% in women and men, respectively. Anaplastic TC incidence decreased annually 3.0% in women and 0.8% in men. Mortality rates declined consistently for all departments. The absolute number (and proportion) of TC cases attributable to overdiagnosis grew from 1074 (66%) in 1986–1995 to 3830 (72%) in 2006–2015 in women, and varied substantially across departments. ConclusionsOverdiagnosis plays an important role in the temporal and regional variations of TC incidence in France. Monitoring the time trends and regulating the regional healthcare practice are needed to reduce its impact.

Healthcare outcomes in patients with HIV infection at a tertiary hospital during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has affected the care of patients with other diseases. Difficulty in access to healthcare during these months has been especially relevant for persons with HIV infection (PWH). This study therefore sought to ascertain the clinical outcomes and effectiveness of the measures implemented among PWH in a region with one of the highest incidence rates in Europe. MethodsRetrospective, observational, pre-post intervention study to compare the outcomes of PWH attended at a high-complexity healthcare hospital from March to October 2020 and during the same months across the period 2016–2019. The intervention consisted of home drug deliveries and preferential use of non face-to-face consultations. The effectiveness of the measures implemented was determined by reference to the number of emergency visits, hospitalisations, mortality rate, and percentage of PWH with viral load >50copies, before and after the two pandemic waves. ResultsA total of 2760 PWH were attended from January 2016 to October 2020. During the pandemic, there was a monthly mean of 106.87 telephone consultations and 2075 home deliveries of medical drugs dispensed to ambulatory patients. No statistically significant differences were found between the rate of admission of patients with COVID-HIV co-infection and that of the remaining patients (1172.76 admissions/100,000 population vs. 1424.29, p=0.401) or in mortality (11.54% vs. 12.96%, p=0.939). The percentage of PWH with viral load >50copies was similar before and after the pandemic (1.20% pre-pandemic vs. 0.51% in 2020, p=0.078). ConclusionOur results show that the strategies implemented during the first 8 months of the pandemic prevented any deterioration in the control and follow-up parameters routinely used on PWH. Furthermore, they contribute to the debate about how telemedicine and telepharmacy can fit into future healthcare models.

Incidence of Vaccine-Preventable Childhood Diseases in the European Union and in the European Free Trade Association Countries.

Introduction: Despite the widespread availability of vaccines, the incidence of vaccine-preventable childhood diseases (VPCD) started to grow in recent years. The aim of the study was to compare the annual incidence of selected VPCDs in the EU (European Union) and EFTA (European Free Trade Association) countries in the period of the last 5 years (2014–2019 or other intervals, depending on data availability), and the country-specific vaccine schedules. Methods: VPCD incidence rates in Europe were based on “The Surveillance Atlas of Infectious Diseases” by the ECDC (European Centre for Disease Prevention and Control); vaccination schedules were based on ECDC reports. Results: The obligation to vaccinate was not universal, and it generally only applied to two preparations: the MMR (measles, mumps, rubella) vaccine and the one against polio. During the study, the situation associated with mumps did not change or improve in individual countries; the median incidence amounted to 30 cases. The median incidence associated with rubella amounted to 1 case, but in a few countries, it grew very rapidly, i.e., in Germany, Italy, and Romania; in Poland, the incidence was clearly decreasing, from 5923 to 1532 cases. The most dynamic situation concerned measles. The total median was 2.4 cases per 100,000 population; the only one country with falling incidence was Germany. The diseases associated with Streptococcus pneumoniae and Neisseria meningitidis remained at a stable level in all analyzed countries. Conclusion: Vaccine schedules differ among the countries, so does the epidemiological situation of selected diseases. Morbidity on measles was the most disturbing phenomenon: the incidence rate increased in almost 40% of all countries, regardless of the obligation to vaccinate. The increasing incidence of VPCD may be due to anti-vaccine movements, the activity of which is often caused by mistrust and spreading misinformation. In order to better prevent the increase in morbidity, standardization of vaccine schedules and documentation should be considered in the EU countries.

Time Trends Analysis of Cervical Cancer Incidence in Cluj County, Romania, Using Data from a Population-Based Cancer Registry.

(1) Background: Romania has one of the highest cervical cancer incidence rates in Europe. In Cluj County, the first screening program was initiated in 1998. We aimed to investigate the time trends of cervical cancer incidence in women from Cluj County and to evaluate the data quality at the Cancer Registry. (2) Methods: We calculated time trends of standardized incidence rates in the period 1998–2014 and the Annual Percent Change (APC%). To assess data quality, we used the indicators: mortality/incidence ratio (M/I), percentage of cases declared only at death (DOD%), and percentage of cases with pathological confirmation (PC%). (3) Results: The standardized incidence rate increased steadily, from 23.74 cases/100,000 in 1998, to 32/100,000 in 2014, with an APC% of 2.49% (p < 0.05). The rise in incidence affected both squamous cell carcinoma (APC% 2.49%) (p < 0.05) and cervical adenocarcinoma (APC% 10.54%) (p < 0.05). The M/I ratio was 0.29, DOD% 2.66%, and MC% 94.8%. The last two parameters are within the silver standard concerning data quality. (4) Conclusions. Our study revealed an ascending trend of cervical cancer incidence, more consistent for adenocarcinoma, in the context of a newly introduced screening program and partially due to the improvement of the quality of case reporting at the Cancer Registry from Cluj.

Climatological aspects of the increase of the skin cancer (melanoma) incidence rate in Europe

AbstractUltraviolet radiation (UVR) has a detrimental impact on human health. Overexposures can lead to erythema and DNA damage causing various skin cancers, including the most dangerous melanoma. Recently, a large increase in melanoma incidents has been detected in Europe. We search for a link between the increase of the skin cancer incidence rate and early spring (April) trends in surface UVR and meteorological parameters (temperature, cloudiness, and precipitation) for several European sites: Belsk (Poland), Oslo (Norway), Reading (UK), and Uccle (Belgium). The trends are calculated for the periods of 1980–2004 and 2005–2018 using ground‐based UV measurements and the reconstructed data by a multilinear regression model. The April trends are of special interest because after winter the human skin is not adapted to high UVR intensity and thus susceptible to solar exposure. Statistically insignificant UV trends are found for all stations except for Belsk with the trend of ~5% per 10 years in the former period. Positive trends of 0.5–1.0°C per 10 years (statistically significant) were calculated for all stations in the mean daily maximum temperature of April in the period 1980–2018. In April, total ozone values are negatively correlated with the daily maxima of the surface temperature, so if the temperature is higher than 15°C, the corresponding total ozone values will go below the long‐term mean, causing more intense surface UVR. Moreover, high temperatures in April may encourage people to stay longer in the sun and expose parts of the body previously covered by winter clothing, which may result in numerous sunburns yielding a higher risk of melanoma. Thus, social campaigns promoting healthy scenarios of outdoor activities should start earlier than before, that is, at the beginning of spring not just before the summer vacation.

Cervical cancer risk in women living with HIV across four continents: A multicohort study.

We compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. We analyzed cohort data from the International Epidemiology Databases to Evaluate AIDS (IeDEA) and the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) in EuroCoord. We used flexible parametric survival models to determine regional ICC rates and risk factors for incident ICC. We included 64,231 women from 45 countries. During 320,141 person-years (pys), 356 incident ICC cases were diagnosed (Europe 164, South Africa 156, North America 19 and Latin America 17). Raw ICC incidence rates per 100,000 pys were 447 in South Africa (95% confidence interval [CI]: 382-523), 136 in Latin America (95% CI: 85-219), 76 in North America (95% CI: 48-119) and 66 in Europe (95% CI: 57-77). Compared to European women ICC rates at 5 years after ART initiation were more than double in Latin America (adjusted hazard ratio [aHR]: 2.43, 95% CI: 1.27-4.68) and 11 times higher in South Africa (aHR: 10.66, 95% CI: 6.73-16.88), but similar in North America (aHR: 0.79, 95% CI: 0.37-1.71). Overall, ICC rates increased with age (>50 years vs. 16-30 years, aHR: 1.57, 95% CI: 1.03-2.40) and lower CD4 cell counts at ART initiation (per 100 cell/μl decrease, aHR: 1.25, 95% CI: 1.15-1.36). Improving access to early ART initiation and effective cervical cancer screening in women living with HIV should be key parts of global efforts to reduce cancer-related health inequities.

Differential gene expression in growth factors, epithelial mesenchymal transition and chemotaxis in the diffuse type compared with the intestinal type of gastric cancer.

Gastric cancer (GC) is a highly heterogeneous disease and one of the major causes of cancer-related mortality worldwide. Diffuse-type gastric adenocarcinoma (or poorly cohesive- with independent cells) is characterized by aggressive behavior (rapid invasion, chemoresistance and peritoneal metastasis), as compared with intestinal-subtype adenocarcinoma. Diffuse subtype GC additionally has a substantially increasing incidence rate in Europe and the USA, and was often associated with younger age. Our objective was to analyze the expression and clinical significance of genes involved in several signaling pathways in diffuse-type GC. Tumors samples and non-malignant gastric tissues were obtained from patients with GC (diffuse-type and intestinal-subtype adenocarcinoma). The expression of 33 genes coding for proteins involved in four categories, growth factors and receptors, epithelial-mesenchymal transition, cell proliferation and migration, and angiogenesis was determined by reverse transcription-quantitative polymerase chain reaction. The expression of 22 genes was significantly upregulated in diffuse-type GC and two were downregulated (including CDH1) compared with normal tissues. Among these genes, acompared with intestinal-subtype adenocarcinoma, diffuse-type GC revealed elevated levels of IGF1 and IGF1R, FGF7 and FGFR1, ZEB2, CXCR4, CXCL12 and RHOA, and decreased levels of CDH1, MMP9 and MKI67. The expression of selected genes was compared with other genes and according to clinical parameters. Furthermore, TGF-β expression was significantly increased in linitis, a sub-population of diffusely infiltrating type associated with extensive fibrosis and tumor invasion. Our study identified new target genes (IGF1, FGF7, CXCR4, TG-β and ZEB2) whose expression is associated with aggressive phenotype of diffuse-type GC.

PIN105 - THE PUBLIC HEALTH IMPACT OF TICK-BORNE ENCEPHALITIS VACCINATION ON THE SLOVENIAN ADULT POPULATION

Despite Slovenia having one of the highest Tick-Borne Encephalitis (TBE) incidence rates in Europe, TBE vaccination coverage in Slovenia remains low in the general population. This study evaluates the potential public health impact of implementing an additional TBE universal mass vaccination (UMV) campaign for Slovenian adults of 45-50 years of age (YOA). A lifetime Markov cohort model was developed to reproduce the natural history of TBE infection in Europe. The study population of Slovenian adults, 45-50 YOA (total cohort size: 177,353), was followed using a 1-year cycle length, during which the probability of infection and moving to a specific health state was determined by age- and gender-specific incidence rates (corrected for underreporting) and specific state-to-state transition probabilities. It was assumed that the vaccination coverage was 50% and that the vaccinated population would be fully compliant with the conventional TBE vaccination schedule. Following the outcomes of recently published literature on the sustained immune response after TBE vaccination, an extension of the booster time-interval was explored from 3 or 5 years to 10 years irrespective of age. Implementing a UMV campaign for Slovenian adults of 45-50 YOA would reduce the total number of TBE cases by 761 cases (23.4%), of primary phase symptoms by 282 cases (23.4%) as well as of secondary phase symptoms by 19 cases (22.5%). Consequently, 332 to 498 days of hospitalization could be averted. An extension of the booster time-interval would prevent 52 cases (6.8%) less while the amount of secondary phase symptoms would increase by 1 case (5.2%). Nevertheless, the total amount of required booster doses would be reduced by 230,867 doses (39.5%). Implementing a TBE UMV campaign in the 45-50 YOA adult Slovenian population would result in a significant public health impact irrespective of an extended booster time-interval for the TBE-vaccine schedule.

Uveal Melanoma in Ireland

Purpose: To report the clinical features and epidemiology of uveal melanoma in Ireland. Methods: This was an observational study of 253 patients with a new diagnosis of uveal melanoma between June 2010 and December 2015. Main outcome measures included demographics, clinical features, age-adjusted incidence, relative survival, overall survival, and distant metastases-free survival. Results: The mean patient age was 61.7 years. Tumour location was choroidal in 82%, ciliochoroidal in 9%, iridociliary in 2%, and iris in 7%. Treatment modalities included brachytherapy (ruthenium-106 and iodine-125 [64%]), enucleation (27%), and proton beam radiation (8%). The mean age-adjusted incidence of uveal melanoma in Ireland from 2010 to 2015 was 9.5 per million of the population (95% confidence interval [CI]: 8.4–10.7). Four-year relative survival was 81.3% (95% CI: 72.8–87.3). Four-year overall survival was 84% (95% CI: 78–90) and 4-year distant metastases-free survival was 79% (95% CI: 73–86). Conclusion: Based on this data, the incidence of uveal melanoma in Ireland is high when compared with other reported incidence rates in Europe and worldwide. Relative and observed survival were in keeping with other reported European survival rates.

Childhood and Adolescence Cancers in the Palermo Province (Southern Italy): Ten Years (2003⁻2012) of Epidemiological Surveillance.

Italy has one of the highest paediatric cancer incidence rates in Europe. We compared cancer incidence and survival rates in children (0–14 years) and adolescents (15–19 years) residing in Palermo Province (PP) with statistics derived from Italian and European surveillance systems. We included all incident cancer cases, malignant tumours and non-malignant neoplasm of central nervous system (benign and uncertain whether malignant or benign), detected in children and adolescents by the Palermo Province Cancer Registry (PPCR) between 2003 and 2012. A jointpoint regression model was applied. Annual Average Percentage Changes were calculated. The Besag–York-Mollie model was used to detect any cluster. The 5-year survival analysis was computed using Kaplan-Meier and actuarial methods. We identified 555 paediatric cancer incident cases (90% “malignant tumours”). No difference in incidence rates was highlighted between PPCR and Italy 26 registries and between PPCR and Southern Europe. No jointpoint or significant trend was identified and no cluster was detected. The 5-year overall survival didn’t differ between PP and the Italian AIRTUM pool. A borderline higher statistically significant survival was observed in age-group 1–4 when comparing PPCR to EUROCARE-5. The epidemiological surveillance documented in the PP was a paediatric cancer burden in line with Italy and southern Europe. The study supports the supplementary role of general population-based cancer registries to provide paediatric cancer surveillance of local communities.

AB172. 16. A systematic review of sentinel lymph node biopsy in cutaneous melanoma

Background: Cutaneous melanoma is the 15th most common cancer worldwide. Ireland has the 4th highest incidence rate in Europe in women and the 8th highest incidence rate in men. Sentinel lymph node biopsy (SLNB) is an essential part of the melanoma staging process for intermediate and thick melanomas, however, the exact survival benefit is unclear. As part of this systematic review we wish to assess the literature regarding SLNB in cutaneous melanoma patients, specifically relating to survival benefit.