Incidence Patterns Research Articles

Assessing the Rise in Papillary Thyroid Cancer Incidence: A 38-Year Australian Study Investigating WHO Classification Influence

The incidence of thyroid cancer has shown marked increases globally over recent decades. This study investigated how the incidence of papillary thyroid carcinoma (PTC) subtypes and World Health Organisation (WHO) endocrine tumour classification changes have affected overall thyroid cancer incidence recorded in Australia. Using incidence data from the Australian Institute of Health and Welfare cancer registry (spanning 1982 to 2019), this descriptive epidemiological study employed joinpoint regression analysis to assess temporal trends in thyroid carcinoma incidence, focusing on PTC. Results were then compared with WHO endocrine tumour classification changes over the same period. The results showed increasing trends for the classic PTC subtype over the entire 38-year period and for thyroid microcarcinomas post-2003, while a declining trend for the follicular variant of PTC was observed commencing in 2015. Examination of PTC incidence also revealed distinct changes in trends that align with the WHO classification of papillary microcarcinoma as a subtype in 2004 and the reclassification of some encapsulated follicular variant of PTCs to non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) in 2016/17. Even when taking these WHO classification changes into account, significant increases in PTC over the last three decades are observed. These findings underscore the shifts in classification driven by improving diagnostic clarity influencing thyroid carcinoma incidence patterns. However, thyroid carcinoma cases in Australia have dramatically increased over the last three decades independent of WHO classification changes, suggesting a genuine increase rather than simply being a direct consequence of improved reporting and diagnostics.

A Descriptive Analysis of the Seasonal Patterns of Bone Stress Injury Incidence in Division I Collegiate Distance Runners.

A bone stress injury (BSI) is a common overuse injury in collegiate athletes, particularly cross-country and track and field runners. Limited work describes the seasonality of BSIs or the differences in rates and anatomic locations of BSIs in collegiate runners. To describe seasonally related trends in anatomic locations of BSIs in National Collegiate Athletic Association (NCAA) Division I male and female middle- and long-distance runners. Descriptive epidemiological study. Data from a 7-year prospective study of 2 NCAA Division I cross-country and track and field programs characterized BSIs over the years 2013 to 2020. Femoral neck, pelvic, sacral, lumbar spine, and calcaneal BSIs were considered trabecular-rich. All remaining BSIs were classified as cortical-rich. Total athlete-years of follow-up were calculated by subtracting the number of days an athlete was unable to run from the number of total study participation days. Annual incidence rates were calculated by dividing the number of BSIs by the total athlete-years of follow-up for that year, and monthly incidence rates were calculated by dividing the number of BSIs in a given month by the total athlete-years of follow-up for that month. Participants included 221 collegiate distance runners (114 female, 107 male). There were 154 BSIs across 482 total athlete-years, resulting in an incidence rate of 32 BSIs per 100 athlete-years. The female BSI rate was more than double that of the male BSI rate: 45 versus 20 BSIs per 100 athlete-years, respectively. The highest monthly BSI rates occurred during competitive months, with the lowest monthly BSI rates occurring during noncompetitive months. Tibial and femoral shaft BSI rates peaked during the early competitive phases of each season, whereas metatarsal BSI rates remained relatively constant. Cortical-rich BSI rates varied by sex and seasonal phase, whereas trabecular-rich BSI rates remained relatively consistent. BSIs were common in collegiate distance runners, especially among female athletes, with higher rates during the competitive phases of the running season. Tibial and femoral shaft BSI rates were highest during the competitive phases and lowest during the noncompetitive phases, while metatarsal BSI rates remained consistent throughout the season. Cortical-rich BSI rates varied by seasonal phase and sex, whereas trabecular-rich BSI rates were relatively constant.

Spatiotemporal dynamics and prevention strategies of cervical cancer incidence in Addis Ababa, Ethiopia: an ecological study

ObjectiveThis study analysed the spatial and temporal patterns of cervical cancer incidence in Addis Ababa from 2012 to 2021.DesignAn ecological study was conducted from 1 September to 30 November 2023...

Valley-Forecast: Forecasting Coccidioidomycosis incidence via enhanced LSTM models trained on comprehensive meteorological data.

Coccidioidomycosis (cocci), or more commonly known as Valley Fever, is a fungal infection caused by Coccidioides species that poses a significant public health challenge, particularly in the semi-arid regions of the Americas, with notable prevalence in California and Arizona. Previous epidemiological studies have established a correlation between cocci incidence and regional weather patterns, indicating that climatic factors influence the fungus's life cycle and subsequent disease transmission. This study hypothesizes that Long Short-Term Memory (LSTM) and extended Long Short-Term Memory (xLSTM) models, known for their ability to capture long-term dependencies in time-series data, can outperform traditional statistical methods in predicting cocci outbreak cases. Our research analyzed daily meteorological features from 2001 to 2022 across 48 counties in California, covering diverse microclimates and cocci incidence. The study evaluated 846 LSTM models and 176 xLSTM models with various fine-tuning metrics. To ensure the reliability of our results, these advanced neural network architectures are cross analyzed with Baseline Regression and Multi-Layer Perceptron (MLP) models, providing a comprehensive comparative framework. We found that LSTM-type architectures outperform traditional methods, with xLSTM achieving the lowest test RMSE of 282.98 (95% CI: 259.2-306.8) compared to the baseline's 468.51 (95% CI: 458.2-478.8), demonstrating a reduction of 39.60% in prediction error. While both LSTM (283.50, 95% CI: 259.7-307.3) and MLP (293.14, 95% CI: 268.3-318.0) also showed substantial improvements over the baseline, the overlapping confidence intervals suggest similar predictive capabilities among the advanced models. This improvement in predictive capability suggests a strong correlation between temporal microclimatic variations and regional cocci incidences. The increased predictive power of these models has significant public health implications, potentially informing strategies for cocci outbreak prevention and control. Moreover, this study represents the first application of the novel xLSTM architecture in epidemiological research and pioneers the evaluation of modern machine learning methods' accuracy in predicting cocci outbreaks. These findings contribute to the ongoing efforts to address cocci, offering a new approach to understanding and potentially mitigating the impact of the disease in affected regions.

Spatial Analysis of Maritime Disasters in the Philippines: Distribution Patterns and Identification of High-Risk Areas

Maritime accidents frequently occur in the Philippine archipelagic waters, often resulting in significant loss of life. These incidents highlight the urgent need for improvements in the country’s maritime safety systems. By utilising accident data from the Philippine Coast Guard and the GISIS IMO databases, spatial analytical approaches were employed to determine incident distribution patterns and resulted in an overall depiction of the likelihood component of risk across the country’s territorial waters. Kernel density and hotspot analysis revealed areas where incidents were concentrated and where statistically significant hotspots occurred. The Maxent tool was used to develop risk likelihood models for the incident locations using environmental rasters representing wind speed, significant wave height, depth, surface current, land distance and port distance. Model performance metrics including the AUC, TSS and Kappa were used to compare the two datasets and provide confidence on model robustness. Variable contribution figures showed that land distance is the most influential variable, with the majority of high-risk areas predominantly located near population centres. The resulting maps provide an intuitive and informative depiction of the characteristic patterns of maritime accidents in the country, identify areas of high risk requiring immediate attention and offer valuable insights to support strategies for improving and enhancing the country’s maritime safety.

Natural incidence pattern of cotton pink bollworm, Pectinophora gossypiella (Saunders) larval parasitoids across India

Aim: To identify natural incidence pattern of pink bollworm larval parasitoids across different cotton growing zones in India. Methodology: Green bolls of cotton were collected from farmers field across India encompassing Northern, Central and Southern regions of cotton cultivation. In total 59 locations were selected for sampling and from each cotton field, five hundred matured green bolls were collected, packed and transferred to laboratory at CICR, Nagpur. Dead/inactive larvae were placed individually in plastic tubes under controlled laboratory conditions to monitor parasitoid emergence. Percent parasitization and parasitoid emergence were calculated accordingly. Results: The pink bollworm larval recovery varied among locations, with the highest average recovery and parasitised larvae observed in the Northern zone (480.50 and 12.10 larvae). Additionally, the average parasitization rate was higher in the Northern cotton zone (2.46 %) compared to the Southern (2.16 %) and Central zones (1.70 %). In terms of parasitoids, the Southern zone exhibited the highest average number of Bracon lefroyi (9.17 ± 3.59) with a range of 3.0-17.0 parasitoids, while the Northern zone recorded the highest average number of Apanteles angaleti (9.70 ± 2.83) with a range of 6.0-15.0 parasitoids. Interpretation: The natural parasitization of pink bollworm larvae by Bracon lefroyi and Apanteles angaleti ranged from 0.43 to 4.33 per cent across various cotton-growing zones. This natural occurrence presents a hopeful strategy for controlling pink bollworm populations, potentially reducing the need for chemical interventions and minimizing crop damage. Key words: Apanteles angaleti, Bracon lefroyi, Cotton, Larval parasitoid, Pink bollworm

Tuberculosis disease burden in China: a spatio-temporal clustering and prediction study.

The primary aim of this study is to investigate and predict the prevalence and determinants of tuberculosis disease burden in China. Leveraging high-quality data sources and employing a methodologically rigorous approach, the study endeavors to enhance our understanding of tuberculosis control efforts across different regions of China. First, through nationwide spatio-temporal cluster analysis, we summarized the status of tuberculosis burden in various regions of China and explore the differences, thereby providing a basis for formulating more targeted tuberculosis prevention and control policies in different regions; Subsequently, using a time series-based forecasting model, we conducted the first-ever national tuberculosis burden trend forecast to offer scientific guidance for timely adjustments in planning and resource allocation. This research seeks to contribute significantly to China's existing tuberculosis prevention and control system. This research draws upon publicly available pulmonary tuberculosis (PTB) incidence and mortality statistics from 31 provinces and municipalities of mainland China between 2004 and 2018. We organized and classified these data according to province, month, year, and patient age group. Overall, the sample included 14,816,329 new instances of PTB and 42,465 PTB-related fatalities. We used spatiotemporal cluster analysis to record the epidemiological characteristics and incidence patterns of PTB during this period. Additionally, a time series model was constructed to forecast and analyze the incidence and mortality trends of PTB in China. This study reveals significant regional variations in PTB incidence and mortality in China. Tibet (124.24%) and Xinjiang (114.72%) in western China exhibited the largest percentage change in tuberculosis (TB) incidence, while Zhejiang Province (-50.45%) and Jiangsu Province (-51.33%) in eastern China showed the largest decreases. Regions with significant percentage increases in PTB mortality rates (>100%) included four western regions, six central regions, and five eastern regions. The regions with relatively large percentage decreases in the mortality rate of PTB include Tianjin (-52.25%) and Shanghai (-68.30%). These differences are attributed to two main factors: (1) economic imbalances leading to poor TB control in underdeveloped areas, and (2) differences in TB-related policies among provinces causing uneven distribution of disease risks. Consequently, China may still face challenges in achieving the World Health Organization's 2030 tuberculosis control goals. Nationwide, the mortality rate of PTB in China increased between 2004 and 2018 (percentage change: 105.35%, AAPC: 4.1), while the incidence of PTB showed a downward trend (percentage change: -20.59%, AAPC: -2.1). Among different age groups, the 0-19 age group has the smallest disease burden. While incidence and mortality from TB were primarily found in adults 60 years of age or older, the age group of 0-19 years has the smallest burden of TB, highlighting obvious differences in age characteristics. It is predicted that the mortality rate of TB in China will continue to increase. In summary, the TB epidemic in China has been largely controlled due to the implementation of many public health programs and policies targeting specific groups and geographical areas. Finding and supporting effective health programs will make it possible to achieve the World Health Organization's goal of controlling tuberculosis in China.

Identifying key weather factors influencing human salmonellosis: A conditional incidence analysis in England, Wales, and the Netherlands.

This study aimed to improve the understanding of seasonal incidence pattern observed in salmonellosis by identifying the most influential weather factors, characterising the nature of this association, and assessing whether it is geographically restricted or generalisable to other locations. A novel statistical model was employed to estimate the incidence of salmonellosis conditional to various combinations of three simultaneous weather factors from 14 available. The analysis utilised daily salmonellosis cases reported from 2000 to 2016 along with detailed spatial and temporal weather data from England and Wales, and the Netherlands. The incidence simulated from weather data effectively reproduced empirical incidence patterns in both countries. Key weather factors associated with increased salmonellosis cases, regardless of geographical location, included air temperature (>10⁰C), relative humidity, reduced precipitation, dewpoint temperature (7-10⁰C), and longer day lengths (12-15h). Other weather factors, such as air pressure, wind speed, temperature amplitude, and sunshine duration, showed limited or no association with the empirical data. The model was suitable for the Netherlands, despite a difference in case ascertainment. The conditional incidence is a simple and transparent method readily applicable to other countries and weather scenarios that provides a detailed description of salmonellosis cases conditional on local weather factors.

Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis

Incidence and temporal patterns of true recurrences and second primaries in women with breast cancer: A 10-year competing risk-adjusted analysis

Epidemiological perspectives of amyloidosis in Argentina: a cohort study analysing incidence and mortality patterns among a population affiliated to a medical care programme

BackgroundData on the epidemiology of amyloidosis are scarce worldwide, making it difficult to understand its true incidence and mortality.AimThe aim of this study is to estimate the incidence and mortality...

On the impact of cancer in the Kashmir valley: analyzing incidence patterns and burden

Cancer is one of the leading causes of death globally, second only to cardiovascular diseases. In India, it ranks fifth in terms of mortality rate. The incidence of cancer varies across different regions of India. This study focuses on the Kashmir region which is a valley located in the northern part of India. The aim is to analyze the dynamics of cancer incidence in this region using various models and statistical techniques. Data of 23646 patients registered for treatment of various cancers over the last five years at Regional Cancer Center (RCC) was analyzed using statistical techniques and models. Our study shows that the most prevalent types of cancer in the Kashmir region are Esophageal cancer, followed by Breast, Lung, Liver, Colorectal, Brain and Dermal cancer. The study also examines the association of various factors such as Gender, Smoking habit, Residence (Rural/Urban), and Occupation (Agricultural/Non-Agricultural) with different types of cancers in the region. The results suggest that these factors, as well as their interrelationships, are strongly linked to the development of cancer among Kashmiri population. While dermal and brain cancers were found to be associated with occupation and residence, esophageal lung liver cancers were strongly linked to smoking habit and gender. Overall, this study provides important insights into the incidence and factors associated with cancer in the Kashmir region of India.

Mapping CNS Lesions: MRI Study of Incidence, Types, and Prognostic Patterns in a Retrospective Study

Mapping CNS Lesions: MRI Study of Incidence, Types, and Prognostic Patterns in a Retrospective Study

Hepatitis C Virus Seroprevalence, Incidence, and Screening Patterns in Ontario Preexposure Prophylaxis Users.

Hepatitis C virus (HCV) has emerged as a sexually transmitted infection in gay, bisexual, and other men who have sex with men (GBM). We estimated the seroprevalence and incidence of HCV infection and examined patterns of HCV testing among GBM using human immunodeficiency virus preexposure prophylaxis (PrEP) in Ontario, Canada. We analyzed data from the Ontario PrEP Cohort Study (ON-PrEP), a prospective cohort of PrEP users from 10 Ontario clinics. Participants completed an online questionnaire and study staff collected clinical information into a study database biannually for 2 years. We estimated the baseline seroprevalence and incidence of HCV infection and examined patterns of HCV testing during follow-up. We further explored differences in sociodemographic/clinical variables between those with and without prevalent/incident HCV infection through bivariate analysis. Among 557 eligible PrEP users, 382 (68.6%) underwent baseline HCV antibody testing, of whom 5 tested HCV seropositive, giving a seroprevalence of 1.3% (95% confidence interval [CI], .43%-3.03%). Only 245 (43.9%) participants underwent HCV antibody testing after baseline, and median time to participants' first follow-up test was 245 days. During follow-up, 2 participants tested newly HCV seropositive, giving an incidence of 0.47/100 person-years (95% CI, .06-1.69) over 428.9 years of follow-up. Participants with prevalent/incident HCV infection during the study appeared more likely to report giving money, drugs, gifts, or services for sex in the 3 months preceding enrollment compared to those who never tested HCV seropositive (P = .02). HCV seroprevalence and incidence were low but not negligible among Ontario PrEP users. HCV antibody and RNA testing were suboptimal.

Susceptibility of various Gram-negative bacteria to antibacterial agents: SMART in China 2019–2020

BackgroundThe Study for Monitoring Antimicrobial Resistance Trends (SMART) is an international surveillance program longitudinally monitoring aerobic and facultative Gram-negative bacteria (GNB) involvement in infections and their antimicrobial resistance profiles. Here the incidence and resistance patterns of Chinese GNB isolates from bloodstream infections (BSI), intraabdominal infections (IAI), respiratory tract infections (RTI) and urinary tract infections (UTI) to commonly used antibacterial agents has been updated. 4,975 GNB isolates collected from 22 hospitals across 7 regions of China from 2019 to 2020 were analyzed. Antimicrobial minimum inhibitory concentrations were assessed using broth microdilution, and susceptibility interpretations followed the breakpoints of European Committee on Antimicrobial Susceptibility Testing 2022 or Clinical and Laboratory Standards Institute.ResultsThis study affirmed that Escherichia coli (Ec) was the most commonly identified GNB (32.1%) and then Klebsiella pneumoniae (Kp) (25.3%), Pseudomonas aeruginosa (Pa) (13.9%) and Acinetobacter baumannii (10.5%). The detection rates of carbapenem-resistant (CR) Enterobacterales varied across major infection sites, ranging from 10.3% in UTI to 18.9% in RTI. Specifically, the detection rates of CR-Kp and CR-Pa ranged from 16.2% in IAI to 35.8% in UTI and from 16.1% in UTI to 38.0% in RTI, respectively. Extended-spectrum β-lactamases (ESBL)-producing Ec and Kp bacteria exhibited over 91.7% susceptibility to carbapenems and at least 87.8% susceptibility to amikacin and colistin, but showed lower susceptibility to piperacillin/tazobactam (57.5–86.2%), levofloxacin (10.8–39.7%) and aztreonam (15.3–27.6%) across different infection sources. Amikacin showed higher efficacy against CR strains compared to other commonly used antibacterial drugs, with 80.0% susceptibility against CR-Ec and 82.3% susceptibility against CR-Pa, while only 36.3% susceptibility was observed against CR-Kp.ConclusionsThe study found varying incidences of CR isolates in Chinese hospitals. Treatment options remained limited due to resistance to multiple antibacterial agents. Carbapenems demonstrated effective antimicrobial in vitro activity against ESBL-producing Enterobacterales found in BSI, IAI, UTI and RTI, outperforming broad-spectrum cephalosporins and other β-lactamase inhibitors.

Recent global patterns in skin cancer incidence, mortality, and prevalence.

Skin cancer is a common skin disease whose incidence and mortality rates have been showing yearly increases. In this report, we update the most recent data on skin cancer as obtained from GLOBOCAN 2022. The incidence and mortality rates of skin cancer (melanoma of skin and non-melanoma skin cancer) in GLOBOCAN 2022 were reviewed. These data were analyzed and the characteristics of incidence and mortality across five continents and top five countries in each continent are presented. In addition, correlations between Human Development Index (HDI) and age-standardized incidence and mortality rates of these two skin cancers are described. The GLOBOCAN 2022data indicated that melanoma was the 17th most common cancer. An estimated 331,722 people were diagnosed with melanoma globally and approximately 58,667died from this disease. For non-melanoma skin cancer, it ranks as the 5th most common cancer, and estimated 1,234,533 people were diagnosed with non-melanoma skin cancer globally and approximately 69,416died from this disease. The incidence of skin cancer varies across geographic regions and countries, with a predominance observed in Oceania, North America, and Europe. Australia was ranked first in terms of incidence, while incidence rates in Africa and Asia were very low. Despite these regional differences in incidence, there was little geographic variation in mortality rates. Currently, the number of deaths from non-melanoma skin cancer exceeds that of melanoma of skin. HDI was positively associated with the incidence of both types of skin cancers, with a positive correlation obtained between HDI and mortality from melanoma of skin and a negative correlation between HDI and mortality from non-melanoma skin cancer. Skin cancer remains a major disease burden worldwide. Substantial variations are observed across countries and regions with incidence rates being greater in Caucasians, the elderly, and in groups with prolonged exposures to ultraviolet rays. Further research on skin cancer will be required to provide a rationale for more effective preventions and treatments of this condition.

Epidemiology and Management of Moderate to Severe Thyroid Eye Disease in the United States: Analysis of a Healthcare Claims Database.

To estimate the incidence, prevalence, patient characteristics and healthcare utilization patterns of moderate to severe thyroid eye disease (TED) in the United States. Retrospective review of medical and prescription claims data from the Inovalon deidentified claims database. Patients with moderate to severe TED were identified based on specific and sensitive definitions using International Classification of Diseases (ICD) codes selected by a group of TED specialists. The incident moderate to severe TED population included 3364 and 1730 patients using the sensitive and specific definitions, respectively. After adjusting for age and gender, corresponding incidence rates in the sensitive and specific populations were 8.97 (13.49 in women and 4.27 in men) and 4.37 (6.59 in women and 2.05 in men) per 100,000 person-years, respectively. The prevalent population included 16,310 and 8018 patients using the sensitive and specific definitions, respectively, corresponding to adjusted prevalence rates of 44.13 (66.00 in women and 21.39 in men) and 20.55 (31.18 in women and 9.50 in men) per 100,000 persons. A preponderance of women was observed, and comorbidity rates were high, with > 40% of prevalent patients experiencing hypertension. Steroids were the most frequently prescribed medication. The impact of teprotumumab was not captured, since this study only included claims data through 2019. The estimated incidence and prevalence rates of TED demonstrate the considerable impact of this disease in the United States, making the creation of a specific ICD code imperative for effective healthcare planning and management.

Circadian rhythm pattern of symptom onset in patients with ST-segment elevation myocardial infarction in the Chinese population

BackgroundThe peak incidence of cardiovascular diseases (CVD) usually occurs in the morning. This study aimed to investigate the exact distribution pattern of peak incidence of ST-segment elevation myocardial infarction (STEMI) in the Chinese population, and to explore whether it is associated with the prognosis.MethodsThis study included 7,805 patients with STEMI from the multicenter, prospective AMI cohort in China, for whom had a definite time of symptom onset. In the overall population and the predefined subgroup populations, the circadian rhythms of STEMI onset were statistically analyzed. Then patients were divided into four groups based on the time of onset (6 h interval) to assess the association of symptom onset time and major adverse cardiovascular and cerebrovascular events (MACCE) after discharge.ResultsThe onset of STEMI had a bimodal distribution: a well-defined primary peak at 8:38 AM [95% confidence interval (CI): 7:49 to 9:28 AM], and a less well-defined secondary peak at 12:55 PM (95% CI: 7:39 AM to 18:10 PM) (bimodal: P < 0.001). A similar bimodal circadian rhythm pattern was observed in subgroups of patients with STEMI defined with respect to day of the week, age, sex, and coronary risk factors. Notedly, the two peaks on Sunday were significantly later than other days, and the secondary peaks became clear and concentrated. In addition, no significant difference was found in MACCE among the four groups (P = 0.905).ConclusionsIn the Chinese population, the onset of STEMI exhibited a bimodal circadian rhythm pattern, with a clear primary peak and a less clear secondary peak. One-year clinical outcomes were unrelated to the timing of STEMI onset.

The global multiple myeloma incidence and mortality burden in 2022 and predictions for 2045.

Multiple myeloma (MM) is an important haematological malignancy in older adults, with a relatively poor prognosis. We aimed to present the current global patterns of incidence and mortality from MM, and predict new cases and deaths by 2045. Estimated numbers of MM cases and deaths and age-standardized (World) incidence and mortality rates per 100,000 people were obtained from the GLOBOCAN 2022 database covering 185 countries. Based on the incidence and mortality rates for 2022 and UN population estimates up to 2045, cases and deaths were predicted up to 2045. Globally, 188,000 MM cases and 121,000 deaths were estimated in 2022. Eastern Asia and Northern America accounted for one-fifth of all cases each (21% and 19% respectively), followed by South-Central Asia (11%), and Western Europe (9%). The incidence rates were higher in men than in women with similar geographical patterns. While the incidence rates were highest in Northern America and Australia/New Zealand (≥4/100,000 for both sexes combined), the highest mortality rates (1.8/100,000) were found in Australia/New Zealand, Northern Europe, and Southern Africa. In the absence of changing rates, the estimated incidence and mortality of MM will increase by 71% and 79%, respectively by 2045 relative to 2022. Our study highlights the substantial burden and variations in MM incidence and mortality reflecting global disparities in diagnosis and treatment. Improved surveillance and better disease control is needed to mitigate the global impact of MM in the presence of population aging and growth.

Geospatial analyses demonstrate variation of cutaneous T-cell lymphomas across Australia, providing insights into possible causes.

Cutaneous T-cell lymphomas (CTCL) are rare with distinct diagnostic challenges. Equitable access to cancer care is a recognised priority, internationally. To date, the geospatial distribution of CTCL has not been definitively studied. Understanding the incidence and geographical distribution of patients with CTCL are critical first steps towards the ultimate goal of equity of care. Geospatial analyses also allow the opportunity to explore environmental causative factors: for CTCL, the contribution of ultraviolet (UV) radiation on causation remains unclear. We investigate geospatial patterns of CTCL incidence across Australia, compare to all rare cancers, and consider solar UV exposure on causality and diagnosis rates. All CTCL diagnoses (1/1/2000-31/12/2019) were obtained from the nation-wide dataset. Areas of residence were collected according to nationally-approved definitions. Bayesian spatial incidence models were applied. Geospatial distributions were visually analysed. The CTCL age-standardised incidence was 7.7 [95%CI:7.4-7.9] per million people in Australia. Diagnostic disparity was seen between Australian states/territories, with lower diagnosis rates in rural/remote and socio-economically disadvantaged areas. Incidence exceeded the national average within more densely populated capital cities. Visual comparisons of the geospatial distribution of CTCL revealed marked discordances with the geospatial patterns of all rare cancers and solar UV in Australia. Geographical heterogeneity in CTCL exists across Australia. Incidence reflects population density. Geospatial patterns of CTCL substantially differ from all rare cancers, with implications for the unique diagnostic challenges and unmet needs of this patient population. The distribution of CTCL across Australia does not support a causative link with UV exposure. Further global evaluation of geospatial patterns is warranted.

Changes in psychiatric disorder incidence patterns during the COVID-19 pandemic in Korea: a study using the nationwide universal health insurance data

BackgroundFew studies have evaluated the incidence of various psychiatric disorders during the coronavirus disease (COVID-19) pandemic using hospital visit data for the entire population of a nation. We used Korea’s universal compulsory health insurance data to conduct a descriptive analysis to evaluate changes in psychiatric disorder incidence during the COVID-19 pandemic.MethodsHospital visit data related to psychiatric disorders were retrieved from the National Health Insurance Database. First-ever diagnosis for specific psychiatric disorders for each Korean was identified (from January 2015 to February 2023) and monthly age-standardized incidence rates were calculated. An interrupted time-series analysis was used to estimate counterfactual disease incidence rates and observed and counterfactual rates were compared using difference-in-difference framework.ResultsCompared to pre-pandemic period, there was a decrease in the incidence [percentage changes in monthly rate (95% confidence intervals)] of organic mental disorders [-14.6% (-18.4, -10.9)] and psychoactive substance related disorders [-12.9% (-17.5, -8.3)] during the pandemic. However, anxiety disorders [8.8% (3.1, 14.6)], behavioral syndromes associated with physiological disturbances [8.1% (4.2, 11.9)], mental retardation [8.6% (3.0, 14.2)], psychological developmental disorders [19.6% (11.5, 27.7)], childhood- and adolescent-onset behavioral and emotional disorders [45.1% (28.4, 61.8)], and unspecified mental diseases [51.8% (39.8, 63.8)] increased.ConclusionsPsychological disease incidence patterns changed substantially during the pandemic in South Korea. Various pandemic-related stressors, such as disrupted lifestyles and hospital accessibility, may have influenced these changes. The causes and public health consequences of these changes require further evaluation.