Joinpoint Regression Analysis Research Articles

The reduced mortality of malignant melanoma at the population level is mainly attributable to treatment advances for the past decade

BackgroundCutaneous malignant melanoma (CMM) causes most skin cancer deaths in the United States (US). The mortality has been decreasing in the US population. We hypothesize that this population-level reduction is mainly attributable to the treatment advances, rather than the successful primary and secondary prevention. MethodsUsing data from the Surveillance, Epidemiology, and End Results (SEER) databases, we collected the incidence, incidence-based mortality (IBM), and 5-year survival (5-YS) rates of CMM from 1994 to 2019. Trends by stage and sex were examined by joinpoint regression analyses and age-period-cohort analyses. ResultsThe overall incidence of CMM rose by 1.6% yearly from 1994 to 2006 (95% confidence interval [CI]: 0.9% to 2.2%) and then increased with a numerical trend. And we projected the incidence will continue to increase until 2029. In contrast, the IBM for all CMM has decreased yearly by 2.8% (95% CI: −3.9% to −1.8%) since 2010 after continuously increasing by 3.8% annually (95% CI: 3.2% to 4.4%) from 1996 to 2010. For early-stage (localized and regional) CMM, we found the incidence since 2005 plateaued without further increase, while the incidence for CMM at distant stage continuously increased by 1.4% per year (95% CI: 0.9% to 2.0%). Improvements in 5-YS were observed over the study period for all CMM and were most obvious in distant stage. And significant period effects were noted around the year 2010. ConclusionThis study demonstrated improved survival and reduced mortality of CMM at the US population level since 2010, which were consistent with the introduction of novel therapies. Encouraging effects of primary prevention among adolescents in the most recent cohorts were found. However, the plateaued overall incidence and early diagnosis rates indicated that advances in primary and secondary prevention are very much needed to further control the burden of CMM.

Epidemiological study of pediatric rheumatic heart disease: An analysis from the Global Burden of Disease Study 2019

BackgroundRheumatic heart disease (RHD) is the most common acquired heart disease among children in developing countries. However, there is a lack of systematic studies on the epidemiology of pediatric RHD. This study aimed to report the burden of pediatric RHD at global, regional, and national levels between 1990 and 2019, which may provide some reference for policymakers. MethodsThe numbers and age-standardized rates (ASRs) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for childhood RHD from 1990 to 2019 were analyzed based on data obtained from the Global Burden of Disease Study 2019 (GBD 2019). In addition, Joinpoint regression analysis was used to assess temporal trends in the burden of childhood RHD. ResultsGlobally, the number of incidence and prevalence cases of RHD in children increased by 41.89% and 40.88%, respectively, from 1990 to 2019. Age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) increased with an average annual percentage change (AAPC) of 0.75% and 0.66%, respectively. In contrast, the age-standardized DALY rate and age-standardized mortality rate (ASMR) decreased significantly since 1990 by an AAPC of −3.47% and − 2.65%, respectively. Girls had a significantly higher burden of RHD than boys during the study period. At the age level, the RHD burden was significantly highest in the age group of 10–14 years. Moreover, the ASRs of incidence, prevalence, mortality, and DALYs were negatively associated with sociodemographic index (SDI). Nationally, Fiji had the most significant increase in incidence and prevalence, and Philippines had the most remarkable rise in DALYs and mortality rates. ConclusionFrom 1990 to 2019, although the incidence and prevalence of childhood RHD increased globally, DALYs and mortality rates markedly reduced. Countries with lower levels of sociodemographic development shoulder a higher burden of childhood RHD. Children aged 10–14 years are critical populations for whom targeted measures are needed to reduce the RHD burden, while attention to girls cannot be neglected.

Twenty-two-year incidence trend of urological cancers in the Republic of Korea: 1999-2020.

Cancer is a disease with high social costs, and policymaking through accurate statistics is very important. This study presents the national cancer statistics on the incidence of urological cancers in the Republic of Korea over 22 years, from 1999 to 2020. Through the Korean Statistical Information Service, data on the incidence of urological cancers by sex and age in each year was obtained. For each urological cancer, the number of cases, crude incidence rate (CIR), and age-standardized incidence rate (ASR) were calculated, and the statistical trends were confirmed by joinpoint regression analysis. Urological cancers, which have increased ASR over 22 years, are as follows: prostate cancer (average annual percent change [AAPC]=6.72%, p-trend<0.05), testicular cancer (AAPC=5.26%, p-trend<0.05), ureter cancer (AAPC=4.16%, p-trend<0.05), kidney cancer (AAPC=4.14%, p-trend<0.05), renal pelvis cancer (AAPC=3.86%, p-trend<0.05), and total urological cancer (AAPC=4.37%, p-trend<0.05). Urological cancers, which has decreased ASR over 22 years, are as follows: penile cancer (AAPC=-2.93%, p-trend<0.05) and bladder cancer (AAPC=-0.31%, p-trend<0.05). It was confirmed that the ASR of all urological cancers increased for 22 years, except for bladder and penile cancer. With the aging of the population, the CIR increased for all urological cancers. This study will serve as basic data for future research and policy decisions.

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics - China, 2015-2022.

Human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) clinics play a critical role in identifying and diagnosing HIV cases. This study aimed to describe the trend of HIV positivity rate (HPR) among Chinese VCT clinics between 2015 and 2022. This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022. The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests, multiplied by 100%. To identify temporal and spatial trends in the HPR, we employed joinpoint regression analysis and the Getis-Ord hotspot analysis. From 2015 to 2022, VCT clinics in China performed a total of 22,075,386 HIV tests, leading to the identification of 260,353 HIV cases, resulting in a HPR of 1.18%. The HPR consistently declined over the study period, with an average annual percent change (AAPC) of -7.5% (95% confidence interval: -12.6%, -2.2%, P<0.05). The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022. These HPR hotspots were primarily located in Yunnan, Sichuan, Guangdong, and Guangxi provincial-level administrative divisions (PLADs). Among the 31 PLADs, 16 showed a significant decrease in HPR during the study period (AAPC<0, PAAPC<0.05). VCT clinics in China have played a significant role in identifying HIV cases. The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations. Therefore, it is crucial to further improving the utilization of VCT clinics for HIV testing.

Trends in sudden cardiac death mortality in Italy, 2013-2019.

We sought to analyse the incidence of sudden cardiac deaths (SCDs) amongst subjects aged less than 39years in Italy and its time trend between 2013 and 2019. Data regarding cause-specific mortality and population size by sex in 5-year age groups were extracted from the World Health Organization (WHO) mortality database. Decedents reporting the codes I46.1, I45.6, I47.2, I41.9, R09.2 and R96.0 of the International Classification of Disease-10 (ICD-10) coding system, were extracted. The age-adjusted mortality rates (AAMRs), with relative 95% confidence intervals (CIs) stratified by sex, were determined using the direct method. Joinpoint regression analyses were used to identify periods with statistically distinct log linear trends in SCD-related death rates. To calculate nationwide annual trends in SCD-related mortality, we assessed the annual and average annual per cent change (AAPC) and relative 95% CIs. Over the study period, 314 deaths [220 males (70.0%) and 94 females] were due to SCD corresponding to a 0.06 per 100,000 per year (0.10 per 100,000 in males and 0.04 per 100,000 in females, respectively). Proportional mortality slightly increased, without reaching the statistical significance (p = 0.82) from 3.06 to 3.56 per 100 deaths, with a similar trend in both sexes. Joinpoint regression analysis revealed a plateau in age-standardised SCD-related mortality over the period [AAPC: -4.2 (95% CI: -24.0 to 20.8, p = 0.71], which was consistent between males and females. In Italy, SCD remains a public health issue of concern in the last decade after adjusting for age.

Rural cancer disparities from Oklahoma cancer and vital records registries 2016–2020

ObjectivesCompared to Oklahoma, 33 states have higher all-cause cancer incidence rates, but only three states have higher all-cause cancer mortality rates. Given this troubling gap between Oklahoma’s cancer incidence and mortality rankings, in-depth examination of cancer incidence, staging, and mortality rates among this state’s high-risk populations is warranted. This study provides in-depth information on overall and cause-specific cancer incidence and mortality for the rural and urban Oklahoma populations classified by Rural-Urban Continuum Codes (RUCC). MethodsData were publicly available and de-identified, accessed through Oklahoma Statistics on Health Available for Everyone (OK2SHARE). Statistical analysis included calculating age-specific rates, age-adjusted rates, and percentages, as well as assessing temporal patterns using average annual percent change with 95 % confidence intervals determined by Joinpoint regression analysis. FindingsUrban areas had a higher proportion of female breast cancer cases, while large and small rural areas had higher rates of lung and bronchus cancer. Urban residents were more likely to have private insurance and less likely to have Medicare compared to rural residents. Cancer incidence rates increased with age, and men had higher mortality rates than women. Lung and bronchus cancer was the leading cause of cancer death, with lower rates in urban areas compared to rural areas. ConclusionsFindings demonstrate the need to improve the early detection of cancer among the rural populations of Oklahoma. Additionally, the high mortality rates for most types of cancer experienced by the state’s rural population underscores the need to improve cancer detection and treatment in these locations.

Global, regional, and national disease burden and attributable risk factors of HIV/AIDS in older adults aged 70years and above: a trend analysis based on the Global Burden of Disease study 2019.

We aimed to assess the burden and trend of the HIV/AIDS epidemic among older adults over the past three decades at different geographical levels, based on the data collected from the Global Burden of Diseases (GBD) study 2019. This assessment identified the average annual percentage changes (AAPCs) using Joinpoint regression analysis. Globally, the incidence of HIV/AIDS has decreased (AAPC=-3.107); however, the overall prevalence has consistently increased (AAPC=5.557). Additionally, both mortality (AAPC=2.166) and disability-adjusted life years (DALYs; AAPC=2.429) have increased. The highest increasing trends in female HIV/AIDS incidence and prevalence were observed in the Central Asia region. However, for males, these trends were observed in the Oceania region and the high-income Asia Pacific region, respectively. In recent decades, females aged 70-74years had the highest incidence and prevalence, while males aged 70-74years had highest mortality and DALYs in low social development index (SDI) regions. Unsafe sex resulted in 15381.16 deaths, accounting for 90.73% of all HIV/AIDS deaths, and 331140.56 DALYs, accounting for 91.12% of all HIV/AIDS DALYs. The HIV/AIDS disease burden differs by region, age, and sex among older adults. Sexual health education and targeted screening for older adults are recommended.

Long-term trends of infant mortality rates in post-socialist EU countries

Motives: Post-socialist European countries experienced significant political turmoil and economic and social changes in the late 1980s and the early 1990s due to regime change. These changes had a profound impact on their subsequent socioeconomic and demographic development. Since infant mortality rates (IMRs) are closely related to socio-economic changes, this study was undertaken to determine whether these changes affected IMRs in the transitional period.Aim: The aim of this study was to investigate the changes in IMRs in eleven post-socialist European countries that are currently European Union (EU) members, and to compare IMRs in these countries with the remaining EU Member States. The changes in the slope of the IMR trend line were determined by a joinpoint regression analysis. The influence of gross domestic product (GDP) per capita based on purchasing power parity (PPP) on IMRs in all EU countries was also examined.Results: It was found that the collapse of the socialist regime increased IMRs in post-socialist EU countries, and that contrary to other EU Member States, the changes in GDP per capita PPP continue to have a significant impact on IMRs in post-socialist EU countries.

Global prevalence, burden and trend in HIV and drug-susceptible tuberculosis co-infection from 1990 to 2019 and prediction to 2040

ObjectivesThe purpose of this study is to describe the current situation and forecast the trends of co-infection between the human immunodeficiency virus (HIV) and drug-susceptible tuberculosis (DS-TB) in different countries, across various age groups and genders. MethodsWe obtained data on the number of cases, age-standardized incidence rate, age-standardized prevalence rate, age-standardized rate of disability-adjusted life years (DALYs), and age-standardized death rate from the Global Burden of Disease (GBD) 2019 database. These data were used to describe the distribution and burden of co-infection between the human immunodeficiency virus (HIV) and DS-TB in different regions, genders, and age groups. We employed joinpoint regression analysis to analyze the temporal trends from 1990 to 2019. Additionally, an age-period-cohort model was established to forecast the future trends of co-infection up to 2040. ResultsThe prevalence and burden of co-infection varied across different age groups and genders. The territories with the higher disease burden were distributed in some Asian and African countries. In terms of temporal trends, the age-standardized incidence rate and age-standardized prevalence rate of HIV and DS-TB co-infection exhibited an overall increasing trend from 1990 to 2019, and the prediction indicated a slow downward trend from 2019 to 2040. ConclusionsThe co-infection of HIV and DS-TB posed a grave threat to public health and economic development. What’s more, there existed a significant disparity between the actual state of co-infection and the desired goals for prevention and control.

Changes in Commercial Insurance Claims for Contraceptive Services During the Beginning of the COVID-19 Pandemic—United States, January 2019–September 2020

ObjectiveWe describe changes in commercial insurance claims for contraceptive services during the beginning of the COVID-19 pandemic. MethodsWe analyzed commercial insurance claims using IQVIA PharMetrics Plus data from more than 9 million U.S. females aged 15–49 years, enrolled during any month, January 2019 through September 2020. We calculated monthly rates of outpatient claims for intrauterine devices (IUDs), implants, and injectable contraception and monthly rates of pharmacy claims for contraceptive pills, patches, and rings. We used Joinpoint regression analysis to identify when statistically significant changes occurred in trends of monthly claims rates for each contraceptive method. We calculated monthly percentages of claims for contraceptive counseling via telehealth. ResultsMonthly claims rates decreased for IUDs (−50%) and implants (−43%) comparing February 2020 with April 2020 but rebounded by June 2020. Monthly claims rates for injectables decreased (−19%) comparing January 2019 with September 2020, and monthly claims rates for pills, patches, and rings decreased (−22%) comparing July 2019 with September 2020. The percentage of claims for contraceptive counseling occurring via telehealth was low (<1%) in 2019, increased to 34% in April 2020, and decreased to 9–12% in June–September 2020. ConclusionsSubstantial changes in commercial insurance claims for contraceptive services occurred during the beginning of the COVID-19 pandemic, including transient decreases in IUD and implant claims and increases in telehealth contraceptive counseling claims. Contraceptive claims data can be used by decision makers to identify service gaps and evaluate use of interventions like telehealth to improve contraceptive access, including during public health emergencies.

Trends in the mortality of diabetes in Mexico from 1998 to 2022: a joinpoint regression and age-period-cohort effect analysis

ObjectiveThe purpose was to analyze age-standardized trends in diabetes mortality rates (DMR) from 1998 to 2022, stratified by sex and Mexican state, and the effects attributable to age, period, and cohort by sex. Study designJoinpoint regression and age-period-cohort effect analysis. MethodsBased on the tenth revision of the International Classification of Diseases, E11, E12, E13, and E14 codes of the death certificate, a daily record of mortality was extracted from the death certificate attributable to diabetes as the main cause. From 1998 to 2022, sexes and ages (≥20 years) were used to calculate the crude mortality rates and standardized at the national and Mexican state levels. Additionally, the age-period-cohort model was used to examine age, period, and cohort effects. ResultsFrom 1998 to 2005, the age-adjusted DMR increased by 3.6% (95% confidence interval [CI]: 2.7, 4.5) for the total population, as shown by the joinpoint regression analysis at a national level; from 2017 to 2020, it increased by 7.4% (95% CI: 0.6, 14.8). The DMR with the highest increase during the study period came mainly from states in the country's southeastern region, 2.3% to 3.7% per year. The net age and period effects showed that mortality increased with advancing age and with going time, respectively; and the net cohort effect revealed that mortality increased in more recent birth cohorts, mainly in men Rate Ratio (RR) = 2.37 (95% CI: 2.29, 2.46) vs RR = 1.13 (95% CI: 1.09, 1.17). ConclusionThe DMR increased among older age groups. The period effect showed that mortality increased over time. Furthermore, the cohort effect showed that mortality increased in more recent birth cohorts, especially among men.

Abstract B143: Temporal trends in colorectal cancer mortality in the five regions of Georgia, 1975-2018: A Joinpoint regression analyses

Abstract Background: Colorectal cancer (CRC) is the third leading cause of death in Georgia. There remain significantly higher CRC mortality rates in the five public health regions of Georgia (Clayton, West Central, East Central, Southeast, and Northeast regions) in comparison to the rates in the State of Georgia. However, studies that examined temporal trends in CRC mortality rates in small geographic regions are still limited. The aim of this study was to analyze the time trends in mortality due to CRC within five regions of Georgia, stratified by age groups to assess any changes in mortality trends for the period 1975 -2018. Methods: Surveillance, Epidemiology, and End Results (SEER) Program SEER*Stat Database: Mortality - All COD, Aggregated with County, Total U.S. were used to select 1975-2018 CRC mortality data. We conducted Joinpoint regression analyses of the trends in age-adjusted mortality rates (ADMRs) due to CRC, stratified by the five regions of Georgia. Age differences in mortality were also examined. The average annual percent change (AAPC) and annual percent change (APC) with confidence intervals of 95% were calculated. Results: A total of 12,972 deaths from CRC were reported in these five regions during the period 1975-2018. The ADMR of CRC were 24.4, 24.9, 23.4, 22.7, and 25.7 per 100,000 in Clayton, East Central, Southeast, Northeast, and West Central regions, respectively. The mortality rates for CRC decreased from 1975 to 2018 in Clayton, Northeast, and Southeast regions (AAPC: -1.7% to -3.4%, p-value&amp;lt;0.05). One Joinpoint trend found a significant reduction in mortality in the East Central (1984-2018) (APC: -4.1%, p-value&amp;lt;0.001) and West Central (1981-2018) regions (APC: -3.2%, p-value=0.003). When examining age differences, patients aged 75 years or older had a significant decrease in mortality from 1975 to 2018 except in the East Central region (AAPC: -2.4% to -4.5%, p-value&amp;lt;0.05). In the East Central region, one Joinpoint demonstrated a significant decrease in mortality during 1987-2018 for the 60-74 age group and during 1984 -2018 for 75+ age group (APC: -5.1% &amp; -6.1%, respectively; both p-value&amp;lt;0.05). Reduced mortality rates were also found from 1984 to 2018 in the 60-74 age group in the Northeast region (APC: -4.3%, p-value&amp;lt;0.001). However, Northeast Georgians aged 15-59 years demonstrated a non-significant trend for increase in mortality from 1975 to 2018 (AAPC: 2.1%, p-value=0.181). Conclusion: The regional burden of colorectal cancer varied across the five regions of Georgia with CRC mortality rates decreased significantly in the Clayton, Northeast, and Southeast regions. Although reduced mortality rates were found in older patients in most regions, younger patients living in Northeast regions demonstrated a slight increase in mortality. Increased CRC risk awareness, culturally tailored prevention strategies through timely CRC screening uptake, and improved access to cancer treatment are extremely important to reduce the CRC burden, especially in the most affected regions in Georgia. Citation Format: Meng-Han Tsai, Daramola N. Cabral, Justin X. Moore, Jorge Cortes. Temporal trends in colorectal cancer mortality in the five regions of Georgia, 1975-2018: A Joinpoint regression analyses [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B143.

Long- and Short-Term Trends in Outpatient Attendance by Speciality in Japan: A Joinpoint Regression Analysis in the Context of the COVID-19 Pandemic

The COVID-19 pandemic resulted in a decline in outpatient attendance. Therefore, this study aimed to clarify long- and short-term clinic attendance trends by speciality in Japan between 2009 and 2021. A retrospective observational study of Japan’s claims between 2009 and 2021 was conducted using the Estimated Medical Expenses Database. The number of monthly outpatient claims in clinics was used as a proxy indicator for monthly outpatient attendance, and specialities were categorised into internal medicine, paediatrics, surgery, orthopaedics, dermatology, obstetrics and gynaecology, ophthalmology, otolaryngology, and dentistry. The annually summarised age-standardised proportions and the percentage of change were calculated. Joinpoint regression analysis was used to evaluate long-term secular trends. The data set included 4,975,464,894 outpatient claims. A long-term statistically significant decrease was observed in outpatient attendance in internal medicine, paediatrics, surgery, ophthalmology, and otolaryngology during the pandemic. From March 2020 to December 2021, which includes the COVID-19 pandemic period, outpatient attendance in paediatrics, surgery, and otolaryngology decreased in all months compared with that of the corresponding months in 2019. For some specialities, the impact of the pandemic was substantial, even in the context of long-term trends. Speciality-specific preparedness is required to ensure essential outpatient services in future public health emergencies.

COVID-19 mortality trends before and after the national vaccination program in Iran: A joinpoint regression analysis

Objective: To investigate the trend of mortality by COVID-19 before and after the national vaccination program using joinpoint regression analysis from 19 February 2020 to 5 September 2022. Methods: In the present study, a joinpoint regression analysis of monthly collected data on confirmed deaths of COVID-19 in Iran from February 19, 2020 to September 5, 2022 was performed. Results: After national vaccination in Iran, the trend of new monthly deaths due to COVID-19 was decreasing. The percentage of monthly changes from the beginning of the pandemic to the 19th month was 6.62% (95% CI: 1.1, 12.4), which had an increasing trend. From the 19th month to the end of the 31st month, the mortality trend was decreasing, and the percentage of monthly changes was −20.05% (95% CI: −8.3, −30.3) (P=0.002). The average percentage of monthly changes was −5% with a 95% CI of (−10.5, 0.9). Conclusions: Along with other health measures, such as quarantine, wearing a mask, hand washing, social distancing, etc., national vaccination significantly reduces the mortality rate of COVID-19.

Ovarian cancer disease burden decreased in the United States from 1975 to 2018: A joinpoint and age-period-cohort analysis.

Ovarian cancer (OC) is the leading cause of gynecological cancer-related deaths in the United States. The purpose of this study was to evaluate long-term trends in OC incidence and incidence-based mortality rates (IBM) in the U.S. from 1975 to 2018 and to assess the effects of age, period, and cohort factors on OC incidence and mortality using an age-period-cohort model. We obtained data from the U.S. OC incidence/mortality data from the Surveillance, Epidemiology, and End Results database from 1975 to 2018. Joinpoint regression analysis was used to determine long-term trends and transitions, and an age-period-cohort model was used to quantify the effects of age, period, and cohort parameters on incidence and mortality. In addition, 1990 to 2019 U.S. OC data obtained from the Global Burden of Disease study served as a potential validation set. Between 1975 and 2018, 80,622 new cases of OC and 60,218 deaths from OC were reported in the U.S. The average annual percent change for OC incidence was -1.33 (95% CI: -1.64 to -1.02, P < .001), with a significant decrease in incidence at a rate of 7.80% (95% CI: -11.52 to -3.92) per year from to 2015-2018. IBM reached its peak for the U.S. population in 1994, with an age-standardized mortality rate of 6.38 (per 100,000 people). IBM rose first, peaked in 1986, and then declined at a rate of 0.39% (95% CI: -0.66 to -0.12) and 2.48% (95% CI: -3.09 to -1.85) per year from to 1986-2007 and 2007-2018, respectively. In addition, age-period-cohort model analysis showed the highest risk of OC incidence in 1980 to 1984 and the highest risk of OC death in 1985-1989. This study reported a significant decline in OC morbidity and mortality in the U.S. since 1986. In addition, this study analyzed the changes in trends in OC incidence and mortality by race/ethnicity in the U.S. Monitoring trends in OC incidence and mortality by race/ethnicity can help in the development of targeted prevention and treatment measures.

Abstract B117: A trend analysis of cancer incidence in Guam from 2002-2018

Abstract Pacific Islanders are one of the fastest growing population groups in the United States, and serious disparities in health outcomes exist in this group, with cancer being the leading cause of death. In Guam, the five most common cancer sites are lung and bronchus, breast, prostate, colon, and liver. While cancer appears to be less prevalent in Guam overall compared to the US (279.9 vs. 435.0), Micronesians living in Guam exhibit higher rates than the US for lung and bronchus (174.7 vs. 67.7), breast (137.5 vs. 126.8), prostate (143.1 vs. 107.0), and liver (36.2 vs. 7.8) cancer incidence, according to the 2013-2017 Guam Cancer Facts and Figures. The purpose of this study is to discern these changes in trends of cancer incidence for all cancers and the top five cancer sites in Guam. Among the 7,974 malignant cases recorded in the Guam Cancer Registry, the five most prevalent cancer sites, lung and bronchus (N = 1308), breast (N = 1195), prostate (N = 901), colon (N = 562), and liver (N = 364) were observed alongside all cancer sites. Using Guam Public Health’s 2000 population data and 2010 and 2020 Guam Census data points, quadratic regression methods were employed to estimate Guam’s population for each of the other diagnosis years between 1998-2020. Age-adjusted 5-year moving average incidence rates were calculated for all cancer sites, stratified by both sex (Male = 4155, Female = 3815) and by ethnicity (CHamoru = 3751, Filipino = 1911, Micronesian = 598). Similarly, age-adjusted 5-year moving average incidence rates were calculated for the top five cancer sites. Joinpoint regression analysis were utilized to assess the average annual percent change (AAPC) in cancer incidence rates, along with a 95% confidence interval (CI). A significant decrease in all cancer site incidence among males and females was observed from 2005 to 2016 (APC = -2.33, 95% CI: -2.9, -2.1) followed by a non-significant decrease. Among females, colon cancer incidence exhibited the highest significant increase from 2010 to 2018 (APC = 4.0, 95% CI: 2.0, 8.1), whereas lung cancer incidence exhibited the highest significant decrease from 2014 to 2018 (APC = -6.0, 95% CI: -8.5, -3.9). As for males, significant decreases were observed for all cancer sites and prostate cancer incidence from 2005 to 2018 (APC = -3.1, 95% CI: -3.6, -2.8) and 2010-2018 (APC= -5.0, 95% CI: -6.2, -0.7), respectively. Between 2009 to 2019, all cancer-site incidence exhibited increases for all three ethnic groups. Micronesians experienced the largest increase in cancer incidence for all cancer sites (AAPC = 8.1, 95% CI: 7.4, 9.4), as well as for liver cancer (AAPC = 9.8, 95% CI: 7.2, 14.5) and lung cancer (AAPC = 5.5, 95% CI: 4.3, 6.9). This study reveals discernible disparities in cancer incidence over time, particularly when examining variations based on sex and ethnicity. Notably, Micronesians consistently exhibit higher AAPC values, indicating a potentially distinct cancer burden in this particular population. Further research is needed to explore the causes of these epidemiological trends. Citation Format: Cabrini Aguon, Louis Jane Dulana, Rodney Teria, Aurienne Cruz, Su Bin Jin, Grazyna Badowski. A trend analysis of cancer incidence in Guam from 2002-2018 [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B117.

Trends in liver cancer mortality in China from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019

ObjectiveWe aimed to examine trends in overall mortality rates for liver cancer and those within subgroups according to sex, age, aetiological factors and modifiable risk factors in China from 1990...

Epidemiology, risk areas and macro determinants of gastric cancer: a study based on geospatial analysis

BackgroundBoth incidence and mortality of gastric cancer in Gansu rank first in china, this study aimed to describe the recent prevalence of gastric cancer and explore the social and environmental determinants of gastric cancer in Gansu Province.MethodsThe incidence of gastric cancer in each city of Gansu Province was calculated by utilizing clinical data from patients with gastric cancer (2013–2021) sourced from the medical big data platform of the Gansu Province Health Commission, and demographic data provided by the Gansu Province Bureau of Statistics. Subsequently, we conducted joinpoint regression analysis, spatial auto-correlation analysis, space–time scanning analysis, as well as an exploration into the correlation between social and environmental factors and GC incidence in Gansu Province with Joinpoint_5.0, ArcGIS_10.8, GeoDa, SaTScanTM_10.1.1 and GeoDetector_2018.ResultsA total of 75,522 cases of gastric cancer were included in this study. Our findings suggested a significant upward trend in the incidence of gastric cancer over the past nine years. Notably, Wuwei, Zhangye and Jinchang had the highest incidence rates while Longnan, Qingyang and Jiayuguan had the lowest. In spatial analysis, we have identified significant high-high cluster areas and delineated two high-risk regions as well as one low-risk region for gastric cancer in Gansu. Furthermore, our findings suggested that several social and environmental determinants such as medical resource allocation, regional economic development and climate conditions exerted significant influence on the incidence of gastric cancer.ConclusionsGastric cancer remains an enormous threat to people in Gansu Province, the significant risk areas, social and environmental determinants were observed in this study, which may improve our understanding of gastric cancer epidemiology and help guide public health interventions in Gansu Province.

Global burden, trends, and inequalities of ischemic heart disease among young adults from 1990 to 2019: a population-based study

BackgroundIschemic heart disease (IHD) is a major global health concern, and its burden among young adults aged 25–49 years remains underexplored. This study aims to provide a comprehensive assessment of the global burden and trends of IHD over the past 30 years (1990–2019) among this age group, as well as to analyze the health inequalities related to socioeconomic development.MethodsData from Global Burden of Disease Study 2019 (GBD 2019) were utilized to analyze the prevalence, mortality, and disability-adjusted life years (DALYs) rate of IHD among young adults globally. Joinpoint regression analysis was applied to examine the trends over the study period. Health inequality analysis was performed to investigate the disparities in IHD burden related to the Socio-Demographic Index (SDI) of countries.ResultsAccording to GBD 2019 data, in 2019, the global numbers of young adults with IHD cases, deaths, and DALYs were 18,050,671 (95% UI, 15,551,940–21,254,746), 597,137 (548,250–647,778), and 28,692,968 (26,397,448–31,178,464), respectively, accounting for 9.15%, 6.53%, and 15.7% of the total global cases. Over the past 30 years, the mortality [AAPC = −0.4%, 95% CI (−0.7% to −0.1%)] and DALYs rate [AAPC = −0.3%, 95% CI (−0.6% to −0.1%)] of IHD among young adults decreased, while the prevalence rate [AAPC = 0.4%, 95% CI (0.4%–0.4%)] and YLDs rate [AAPC = 0.4%, 95% CI (0.3%–0.4%)] increased. Furthermore, countries with lower levels of socio-demographic index (SDI) disproportionately bore a higher burden of IHD among young adults. The inequality slope index for young adult IHD shifted from −56.6 [95% CI (−480.4–370.2)] in 1990 to −583.0 [95% CI (−996.8 to −169.2)] in 2019, and the concentration index moved from −8.2 [95% CI (−8.5 to −7.9)] in 1990 to −13.2 [95% CI (−13.9 to −12.4)] in 2019.ConclusionsWhile the mortality and DALYs rate of IHD among global young adults have decreased over the past 30 years, the degree of inequality related to SDI among countries has continued to increase. Decision-makers in various countries should allocate resources wisely and implement effective strategies to improve the burden of young adults IHD globally and address the health inequalities associated with it.

Deliveries in Lebanon, the Country with the Highest Refugee Density in the World: A Descriptive Review.

The aim of this study is to analyze obstetrical and reproductive health parameters in Lebanon from 2015 until 2018 in the setting of the Syrian refugee influx in order to evaluate potential risks and provide a management plan to improve outcomes. Data from the Lebanese Ministry of Public Health (LMPH) on all obstetrical deliveries that occurred in Lebanon between 2015 and 2018 was screened and analyzed. Number and mode of delivery as well as maternal and neonatal outcomes were included. Joinpoint regression analysis was used for trends of selected parameters. Independent two-sample t-tests were used for comparisons. Women of non-Lebanese nationality residing in Lebanon had a significantly greater number of total deliveries (p-value < 0.001), vaginal deliveries (p-value = 0.002), cesarean sections (p-value = 0.02). When looking at delivery trends from 2015 to 2018, Lebanese women had a significant decrease in total number of deliveries (p-value < 0.001) and vaginal deliveries (p-value < 0.001). Total number of deliveries and cesarean sections is on the rise in Lebanon. Cesarean section practice should be audited by the LMPH and the Lebanese Order of Physicians (LOP). Local and international agencies should prioritize the implementation and management of family planning facilities in refugee hosting countries.