Male Lung Cancer Research Articles

The Effect on Nausea and Vomiting of Structured Education Given to Male Lung Cancer Patients Receiving Chemotherapy.

The objective of this study was to investigate the effect on nausea and vomiting of structured education given to male lung cancer patients receiving chemotherapy. This quasi-experimental research study had pre- and post-tests control groups. The estimated sample size was at least 20 subjects per group. Data were collected in the chest diseases clinic and outpatient chemotherapy unit of a university hospital in Turkey. An education booklet and structured education were given 30mins for each patient before chemotherapy. In post-test 1, nausea severity was significantly lower in the experimental group than in the control group (mean difference - 2.50, 95% CI - 1.46 to - 0.17, d = 0.82, p = 0.05). This was also the case in post-test 2 (mean difference - 2.10, 95% CI - 1.50 to - 0.21, d = 0.85, p = 0.01). According to this, the sizes of Cohen's d effect were large (0.82 and 0.85 for post-test 1 and post-test 2 respectively). However, vomiting frequency did not differ significantly between the experimental group and the control group in either post-test 1 or post-test 2 (p > 0.05). Structured education given by nurses had a positive effect on the severity of nausea. Nurses may be able to raise nausea management in cancer patients to a better level by education intervention.

The predictive power of tumor mutational burden in lung cancer immunotherapy response is influenced by patients' sex.

Immunotherapy, represented by immune checkpoint inhibitors (ICI), is transforming the treatment of cancer. However, only a fraction of patients show response to ICI, and there is an unmet need for biomarkers that will identify patients more likely to respond to ICI. Here we report that the ICI response prediction biomarker tumor mutational burden (TMB) shows significant sex differences. TMB's predictive power is significantly better for female than for male lung cancer patients. Receiver operating characteristic curve analysis was performed and the area under the curve (AUC) was reported to evaluate the predictive power of TMB in lung cancer ICI response. Hazard ratios (HR) of TMB-high vs. TMB-low patients were compared between male and female patients. Both AUC and HR differences between female and male are significant in all available independent lung cancer datasets. However, the AUC of programmed death ligand 1 (PD-L1) expression does not show a difference between female and male, suggesting TMB, but not PD-L1 expression has a better predictive power for female than for male lung cancer patients. Our study suggests significant sex differences in the performance of TMB in ICI response prediction. Future development of ICI biomarker should consider sex differences and special efforts should be paid to improve the performance of ICI predictive biomarkers for male lung cancer patients.

Excess risk of dying of other causes of cured cancer patients.

The proportion of patients cured of cancer is usually estimated with cure models assuming they have the same death risk as the general population. These patients, even when cured, often maintain an extra death risk compared to the overall population. Our aims were to estimate this extra risk, and to take it into account in estimating cure proportions and relative survival (RS). We used RS mixture model with an additional parameter expressing the extra noncancer death risk of patients, assumed constant with age. We applied the model to the SEER registries survival data (1990-1994 diagnosed patients) with colorectal, breast, and lung cancers, and followed up to 2013. The estimated relative risk of death for cured patients versus the general population was 1.11 for colorectal, 1.16 for breast, and 2.17 and 2.12, respectively, for female and male lung cancers. Taking this extra risk into account leads, for all cancers, to a higher estimated proportion of cured and a lower RS of uncured patients. In addition, it leads to a higher estimated RS for all patients aged >70 years, and for lung cancer patients aged >50 years, at diagnosis. Mortality of survivors not directly due to the diagnosed cancer was significantly higher than in the general population. It affected the estimates of cure proportions for all age classes and RS in the elderly.

Cancer statistics, 2019.

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2015, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2016, were collected by the National Center for Health Statistics. In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2006-2015) was stable in women and declined by approximately 2% per year in men, whereas the cancer death rate (2007-2016) declined annually by 1.4% and 1.8%, respectively. The overall cancer death rate dropped continuously from 1991 to 2016 by a total of 27%, translating into approximately 2,629,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the racial gap in cancer mortality is slowly narrowing, socioeconomic inequalities are widening, with the most notable gaps for the most preventable cancers. For example, compared with the most affluent counties, mortality rates in the poorest counties were 2-fold higher for cervical cancer and 40% higher for male lung and liver cancers during 2012-2016. Some states are home to both the wealthiest and the poorest counties, suggesting the opportunity for more equitable dissemination of effective cancer prevention, early detection, and treatment strategies. A broader application of existing cancer control knowledge with an emphasis on disadvantaged groups would undoubtedly accelerate progress against cancer.

Chest radiography surveillance for lung cancer: Results from a National Health Insurance database in South Korea

BackgroundLung cancer screening with low-dose computed tomography reduced mortality in selected high risk patients. However, the use of chest radiography for lung cancer screening in Asian populations is still controversial. We investigated the effectiveness of chest radiographic surveillance using a nationwide health service data in South Korea. MethodsData from the Korean National Health Insurance Service examinee cohort of 2004 to 2013 were examined, and 63,228 patients with lung cancer were identified, 38,494 (57%) of whom underwent chest radiography screening. The others did not undergo lung cancer screening and were considered as a control group. Clinical data including age, smoking, screening intervals, lung cancer stages, treatments, and survival were collected. Survival gain from surveillance after adjustment for lead-time bias based on the sojourn time was calculated. Cox-proportional hazard analyses were performed to evaluate the effectiveness of screening and to determine the appropriate screening interval for chest radiography surveillance. ResultsEarly lung cancer was found in 38% of patients receiving chest radiography versus 26% of those without surveillance. A patient age of more than 65 years (hazard ratio [HR], 1.53; 95% confidence limits [CL], 1.50–1.56), male (HR, 1.66; 95% CL, 1.62–1.70), and high lung cancer stages at the time of diagnosis were independent factors associated with mortality (each, P < 0.001). Chest radiography surveillance was a factor for decreasing mortality in female (HR, 0.81; 95% CL, 0.77–0.84, P < 0.001), with mortality reduction of 10% at the 3- and 5-year survival time-points. In female patients, chest radiography surveillance at intervals of less than 3 years was an independent predictor of improved survival. ConclusionsSurveillance chest radiography increased survival in a female screened population in South Korea. Chest radiography intervals of less than 3 years may help to detect lung cancer in female patients.

17α-Ethynylestradiol and 4-nonylphenol stimulate lung adenocarcinoma cell production in xenoestrogenic way

Lung cancer has been one of the major cancers leading to mortalities worldwide. In addition to smoking, estrogen is considered to play an important role in the lung cancer development because women have a higher proportion of adenocarcinoma than men. In the environment, there are many metabolites and waste products that mimic human estrogen structurally and functionally. 17α-Ethynylestradiol (EE2) which is used as an oral contraceptive is released into wastewater after being utilized. Moreover, 4-nonylphenol (NP) which is found in the petrochemical products and air pollutants reveals estrogenic activity. In the present study, 17β-estradiol (E2), EE2, and NP are administered to stimulate male lung adenocarcinoma cells (A549) and female lung adenocarcinoma cells (H1435). The results demonstrate that EE2 and NP stimulate A549 and H1435 cells proliferation in a dose- and time-dependent manner. Both estrogen receptors α and β are simultaneously activated. In response to estrogens, up-regulation of the epidermal growth factor receptor and extracellular signal-regulated kinase expression occurs. In conclusion, this is the first study to report that EE2 and NP exert a biotoxic effect to stimulate the proliferation of both male and female lung cancer cell in a dose- and time- dependent manner. The environmental hormones posing new challenges for lung cancer deserve further investigation.

A general method for evaluating the effects of air pollutants on lung cancer prevalence

ABSTRACTIt is widely accepted that some air pollutants are related to lung cancer prevalence. An effective method is proposed to quantitatively evaluate the effects of air pollutants and the interactions between them. The method consisted of three parts: data decomposition, comparable data generation and relationship inference. Firstly, very limited monitoring data published by Geographic Information System were applied to calculate the inhalable air pollution of relatively massive patient samples. Then the investigated area was partitioned into a number of districts, and the comparable data containing air pollutant concentrations and lung cancer prevalence in all districts were generated. Finally, the relationships between pollutants and lung cancer prevalence were concluded by an information fusion tool: Choquet integral. As an example, the proposed method was applied in the investigation of air pollution in Tianjin, China. Overall, SO2, O3 and PM2.5 were the top three factors for lung cancer. And there was obvious positive interaction between O3 and PM2.5 and negative interaction among SO2, O3 and PM10. The effect of SO2 on men was larger than on women. O3 and SO2 were the most important factors for the adenocarcinoma and squamous cell carcinoma, respectively. The effect of SO2 or NO2 on squamous cell carcinoma is obviously larger than that on adenocarcinoma, while the effect of O3 or PM2.5 on adenocarcinoma is obviously larger than that on squamous cell carcinoma. The results provide important suggestions for management of pollutants and improvement of environmental quality. The proposed method without any parameter is general and easily realized, and it sets the foundation for further researches in other cities/countries.Implications: For total lung cancer prevalence, male and female lung cancer prevalence, and adenocarcinoma and squamous cell carcinoma prevalence, the proposed method not only quantify the effect of single pollutant (SO2, NO2, CO, O3, PM2.5, and PM10) but also reveals the correlations between different pollutants such as positive interaction or negative interaction. The proposed method without any geographic predictor and parameter is much easier to realize, and it sets the foundation for further research in other cities/countries. The study results provide important suggestions for the targeted management of different pollutants and the improvement of human lung health.

CN4 - Economic Burden of Lung Cancer Attributable to Smoking In China in 2015

Evaluations on economic burden of cancer attributable to smoking in China were conducted ten years ago, but most recent data, particularly specific to lung cancer, is not available yet. A prevalence-based approach was used to estimate the total smoking attributable expenditure (SAE), which contained direct expenditure and indirect expenditure (premature deaths). Detailed data on one-year expenditure per patient (by age group, gender, urban/rural area and region) were re-analyzed based our recent multicenter survey across 13 provinces of China and all values discounted to year 2015. Information on smoking exposure and number of lung cancer cases and deaths were obtained from the Global Burden of Disease Study. The total SAE of lung cancer was estimated as US $9527.1 million in China in 2015 (accounting for 0.09% of the local gross domestic product), the decomposed direct and indirect SAE were estimated as $2505.0 million (accounting for 0.4% of total healthcare expenditure in local) and $7022.1 million (73.7% of total SAE), respectively. With 42.0% and 2.4% smoking prevalence among male and female in 2005, 93.5% of the total SAE occurred in male lung cancer in 2015 ($8903.3 million). Mainly due to the variation of burden of disease, age-specific total SAE peaked at 60-64 years group, urban areas’ total SAE higher than rural areas’. In 2025, the SAE of lung cancer, compared with that in 2015, would increase by 30.9% ($12471.0 million). This might be the most detailed estimation on economic burden of lung cancer attributable to smoking in China. SAE caused by lung cancer accounted at least one tenth of all-diseases-caused SAE, compared to previous study. Without main population-level smoking intervention introduced, the economic burden of lung cancer attributable to smoking will continually increase over the next ten years.

Alcohol consumption and the risk of lung cancer in males: a prospective cohort study

Objective: To investigate the association between alcohol consumption and lung cancer risk in Chinese males. Methods: Information on alcohol consumption and outcomes were collected on a biennial basis among males in Kailuan Cohort (2006-2015). In addition, electronic databases of hospitals affiliated to Kailuan Community, Insurance Systems of Kailuan Community and Tangshan were also used for supplementary information retrieval. Cox proportional hazards regression models were used to evaluate the hazard ratio (HR) and 95%CI of baseline frequency and type of alcohol consumption associated with lung cancer risk in males. Non-drinkers were used as control group. Results: A total of 101 751 males were included and 913 new lung cancer cases were identified in the Kailuan male cohort study, with a total follow-up time of 808 146.56 person-years and a median follow-up time of 8.88 years by 31 December 2015. After adjusting for potential confounding factors, the HR of former drinkers, occasional drinkers (<1/day) and drinkers (≥1/day) were 1.30 (95%CI: 0.90-1.88), 0.80 (95%CI: 0.64-1.01) and 1.04 (95%CI: 0.85-1.27), respectively, compared with non-drinkers. In addition, drinking beer/red wine (HR=0.91, 95%CI: 0.69-1.20) and white wine (HR=0.99, 95%CI: 0.83-1.19) showed no significant association with lung cancer. The results were similar when stratified analysis were conducted. Conclusion: Our study results don't support the hypothesis that alcohol consumption is significantly associated with the risk of lung cancer in males.

International trends in cancer incidence and mortality among older adults, 1983–2012

Introduction In 2012, about half of all new cancer diagnoses and deaths were estimated to occur among people age 65 years and older; these will be around two third by 2035. Assessing trends in cancer incidence and mortality in this growing population is of great importance to understand the impact of cancer on this vulnerable population and to design cancer control and management plans. We therefore described temporal trends in incidence and mortality for the most common cancers–i.e. breast, prostate, colorectal and lung cancers–in adults aged 65 years or older in 17 countries with long history of population-based cancer registration. Methods Data on incidence for cancers of the colorectum, breast, prostate and lung from 1983 to 2012 were obtained from the Cancer Incidence in Five Continents in17 countries in Asia, northern America, central and south America, northern Europe, western and southern Europe and Oceania. Cancer mortality data were obtained from the World Health Organization mortality database. Country- and sex-specific truncated age-standardized rates (65 + ) and average annual percentage changes were calculated. Results Between 1983 and 2012, incidence rates of colorectal cancer have increased between +0.4–22% on average annually in older males and between +0.0–15.7% in older females in most countries under study, while incidence rate has significantly decreased in USA (−8.3% in females and −10.6% in males). In contrast, mortality from colorectal cancer has decreased in all countries from −10.5% in Switzerland to −0.8% in Singapore but it has significantly increased in Costa Rica (+5.5% in males and 2.8% in females) and Spain (8.7% in males and +1.6% in females). The incidence of prostate and breast cancers has increased in almost all countries between 2.6% in Canada and +38.8% in Japan for prostate cancer and between +1.1% in USA and 19.4% in Japan for breast cancer. However, prostate and breast cancer mortality rates have decreased in most countries, except in Costa Rica (+4.5% and +3.3% for prostate and breast cancers respectively), Japan (+8.6% and +13.4%) and Singapore (+9.4% and +6.1%). In almost all countries, incidence and mortality rates for lung cancer have greatly increased in females over the 30-year period following the smoking epidemic pattern (from 5.2% and 0.7% respectively in Japan to 35.8% and 26.0%, respectively in Netherlands), while lung cancer in males are largely decreasing, notably in UK, Netherlands and Finland (> −10% per year on average for incidence and mortality rates). Conclusion Decreasing deaths from cancer in older adults might probably be related to earlier cancer detection and better management. Yet, the rising incidence of the most common cancer sites will increase strain in national health care resources and therefore prevention programs needs to be strengthen. The expected rise in the number of new older cancer patients must encourage the development of geriatric oncology worldwide.

Abstract 2450: The importance of a family of long noncoding RNAs from the Y chromosome in radiotherapy and chemotherapy response of male non-small cell lung cancer

Abstract Lung cancer is the number one cause of cancer-related deaths in the United States. The 5-year overall survival rate for patients with non-small cell lung cancer (NSCLC) stands at 18%, with women having a twice better overall survival rate than men. Currently, there is no solid evidence to explain the disparity between gender survival rates. The protein coding genes of the X and Y chromosomes have been relatively well characterized, and previous studies have implicated phenomena such as the dysregulation of X inactivation and the loss of the Y chromosome in a number of cancers. However, the regions of these chromosomes responsible for producing noncoding RNAs (ncRNAs) are not well understood. One such class of ncRNAs are long noncoding RNAs (lncRNAs), which are primarily classified as larger than 200 nucleotides and carry out functions in nearly every cellular process via a variety of mechanisms. In this study, we have identified a novel family of Y chromosome-linked lncRNAs that we hypothesize play a role in NSCLC cell survival. Our preliminary data show a time- and dose-dependent response in expression of the Y chromosome lncRNA family after radiation in radiosensitive NSCLC cell lines but not in radioresistant NSCLC cell lines, and we see a similar trend in response to cisplatin. Additionally, upon knockdown of this family in a sensitive cell line using two different shRNAs, we immediately observed an increase in proliferation of the knockdown cells when compared to shCtrl as well as increased cell viability and resistance to apoptosis in response to radiation, and increased resistance to cisplatin. We plan to further characterize these lncRNAs using methods such as qRT-PCR, virtual Northern blotting, traditional Northern blotting, direct RNA sequencing, cellular fractionation, and fluorescent in situ hybridization and determine their function by shRNA knockdown and subsequent assays to measure cellular processes in response to radiation and chemotherapy. The Identification of a male-specific component of lung cancer would fill a knowledge gap that could provide potential therapeutic targets and new prognostic factors, thereby improving the response rate of men with NSCLC. Citation Format: Tayvia Brownmiller, Jamie Barr, Abby Harold, Erik Bey, Ivan Martinez. The importance of a family of long noncoding RNAs from the Y chromosome in radiotherapy and chemotherapy response of male non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2450.

Is there link between occupational physical activity levels and lung cancer? A case-control study in Canadian men

Background/Aim Many studies have looked at the association between daily physical activity levels and risk of lung cancer, but very little research has been conducted where occupational physical activity (OPA) levels are isolated from recreational physical activity levels. As Canadian jobs are becoming increasingly sedentary, and Canadians spend roughly 50% of their waking day at work, this is a concern. The purpose of this study was to determine whether a link exists between occupational physical activity levels and risk of lung cancer in Canadian men. Methods This study used National Enhanced Cancer Surveillance System (NECSS) data, a questionnaire-based case-control study conducted across eight Canadian provinces between 1994 and 1997. Cases of lung cancer were identified using provincial cancer registries and controls were selected from a random sample from the same province and with a similar age and sex distribution as that of the cancer cases. Occupational physical activity levels were defined by the Canadian Classification and Dictionary of Occupations (CCDO), which includes ancillary information on occupational physical activity scores in categories of sedentary, light, moderate, heavy, and very heavy physical activity. Analysis was conducted using last job held. Basic descriptive statistics were calculated to compare cases and controls as part of a preliminary analysis. SAS software was used to fit categorical linear models to the response frequencies. Results The NECSS data includes information on 1682 male lung cancer cases and 2054 male controls. For analysis purposes very heavy OPA and heavy OPA were combined due to small sample sizes. Overall, workers fell into four categories; heavy OPA (16%), moderate OPA (35%), light OPA (31%), and sedentary OPA (17%). The remaining 1% of workers had unknown OPA and were excluded from further analysis. Further stratification for smoking status showed similar distributions across OPA categories. Of cases who never smoked, 2% worked heavy OPA jobs, 1% worked moderate OPA jobs, 3% worked light OPA jobs, and 3% worked sedentary OPA jobs. Of cases who are ex-smokers 80% worked heavy OPA jobs, 80% worked moderate OPA jobs, 80% worked light OPA jobs, and 83% worked sedentary OPA jobs. Of cases who currently smoke, 18% worked heavy OPA jobs, 19% worked moderate OPA jobs, 17% worked light OPA jobs, and 14% worked sedentary OPA jobs. A main effects model yielded statistically significant results for OPA (P Conclusion We found some evidence that occupational physical activity levels are associated with an increased risk of lung cancer among Canadian males. Further analyses should consider other covariates and modelling interactions.

Frequency, risk factors, and impact on mortality of arterial thromboembolism in patients with cancer.

In contrast to venous thromboembolism, little is known about arterial thromboembolism in patients with cancer. The aim of this study was to quantify the risk and explore clinical risk factors of arterial thromboembolism in patients with cancer, and investigate its potential impact on mortality. Patients with newly-diagnosed cancer or progression of disease after remission were included in a prospective observational cohort study and followed for two years. Between October 2003 and October 2013, 1880 patients (54.3% male; median age 61 years) were included. During a median follow up of 723 days, 48 (2.6%) patients developed arterial thromboembolism [20 (41.7%) myocardial infarction, 16 (33.3%) stroke and 12 (25.0%) peripheral arterial events], 157 (8.4%) developed venous thromboembolism, and 754 (40.1%) patients died. The cumulative 3-, 6-, 12-, and 24-month risks of arterial thromboembolism were 0.9%, 1.1%, 1.7%, and 2.6%, respectively. Male sex (subdistribution hazard ratio=2.9, 95%CI: 1.5-5.6; P=0.002), age (subdistribution hazard ratio per 10 year increase=1.5, 1.2-1.7; P<0.001), hypertension (3.1, 1.7-5.5; P<0.001), smoking (2.0, 1.1-3.7; P=0.022), lung cancer (2.3, 1.2-4.2; P=0.009), and kidney cancer (3.8, 1.4-10.5; P=0.012) were associated with a higher arterial thromboembolism risk. Furthermore, the occurrence of arterial thromboembolism was associated with a 3.2-fold increased risk of all-cause mortality (hazard ratio=3.2, 95%CI: 2.2-4.8; P<0.001). Arterial thromboembolism is a less common complication in patients with cancer than venous thromboembolism. The risk of arterial thromboembolism is high in patients with lung and kidney cancer. Patients with cancer who develop arterial thromboembolism are at a 3-fold increased risk of mortality.

Tea consumption and the risk of lung cancer in Chinese males: a prospective cohort study

Objective: To investigate the association between tea consumption and lung cancer risk in Chinese males. Methods: Tea consumption and incident lung cancer cases were collected on a biennial basis among males in Kailuan Cohort during 2006-2015. Up to 31st December 2015, a total of 103 010 male candidates from the Chinese Kailuan Male Cohort Study were enrolled in the present study. Cox proportional hazards regression model was used to evaluate the association between tea consumption and risk of lung cancer in males. Results: The age of male candidates was (51.3±13.4)years old. There were 828 810.74 person-years of follow-up and 8.91 years of median follow-up period. During the follow-up, 964 lung cancer cases were identified. In male, the rate of never cosumers, tea drinkers (<4/week) and tea drinkers (≥4/week) were 58.17%(n=59 926), 24.04%(n=24 765) and 17.78%(n=18 319), respectively. After adjustment for potential confounding factors, HR (95%CI) of lung cancer for subjects with tea drinkers (<4/week) and tea drinkers (≥4/week) were 0.80 (0.63-1.02) and 1.02 (0.80-1.30), respectively, as compared with never cosumers. The results showed no significant association with lung cancer. Stratification analysis and sensitivity analysis showed no significant changes. Conclusion: Our study has not found that tea consumption is significantly associated with the risk of male lung cancer.

Effects of an Exercise Intervention on Lung Cancer Patients Who Have Undergone a Lobectomy

Lung cancer is the second most commonly diagnosed form of cancer, and is often treated surgically via tumor resection and lobectomy. Removal of lung tissue often impairs cardiopulmonary function, reduces activities of daily living, and lowers quality of life. Exercise interventions improve cardiopulmonary health and may attenuate the negative effects of lung cancer and its treatment. PURPOSE: To evaluate the response of lung cancer patients who had previously undergone a lobectomy to a structured, supervised 12- week exercise intervention, and compare these results with all other cancer patients completing the same exercise intervention. METHODS: Nine male and female lung cancer survivors who had previously undergone a lobectomy, were recruited to participate in a 12-week exercise-based rehabilitation program. The program consisted of one hour sessions, three days per week, and included cardiovascular endurance, muscular strength and endurance, balance, and flexibility exercises. Subjects completed pre and post assessments of cardiopulmonary function, consisting of a graded exercise test, yielding peak oxygen consumption (VO2 peak), and spirometry, yielding forced vital capacity (FVC) and forced expiratory volume (FEV1). Subjects were divided into two groups: surgical resection including lobectomy (LOB, n = 9), and all other cancers (AOC, n = 205). RESULTS: There were significant improvements in VO2 peak in the LOB group (Pre: 15 ± 2 mL/kg/min, Post: 19 ± 5 mL/kg/min; +20%; p = 0.03) and no significant changes in FVC and FEV1. There were significant improvements in VO2 peak (Pre: 21 ± 0.5 mL/kg/min, Post: 24 ± 0.6 mL/kg/min; +13%; p = 0.00) and FEV1 (Pre: 95 ± 1 %-predicted, Post: 97 ± 1 %-predicted; +2.2%; p = 0.02) in the AOC group. Between group comparisons yielded no significant difference in improvement to VO2 peak for LOB vs AOC (p = 0.77). CONCLUSION: Results from this study demonstrate that lung cancer patients who have previously undergone a lobectomy can safely and effectively complete an individualized, prescriptive exercise intervention. These data also show that lung cancer survivors who have previously undergone a lobectomy are able to improve cardiopulmonary function to the same degree as all other cancer survivors completing a rehabilitative exercise intervention.

European cancer mortality predictions for the year 2018 with focus on colorectal cancer

BackgroundWe projected cancer mortality statistics for 2018 for the European Union (EU) and its six more populous countries, using the most recent available data. We focused on colorectal cancer. Materials and methodsWe obtained cancer death certification data from stomach, colorectum, pancreas, lung, breast, uterus, ovary, prostate, bladder, leukaemia, and total cancers from the World Health Organisation database and projected population data from Eurostat. We derived figures for France, Germany, Italy, Poland, Spain, the UK, and the EU in 1970–2012. We predicted death numbers by age group and age-standardized (world population) rates for 2018 through joinpoint regression models. ResultsEU total cancer mortality rates are predicted to decline by 10.3% in men between 2012 and 2018, reaching a predicted rate of 128.9/100000, and by 5.0% in women with a rate of 83.6. The predicted total number of cancer deaths is 1382000 when compared with 1333362 in 2012 (+3.6%). We confirmed a further fall in male lung cancer, but an unfavourable trend in females, with a rate of 14.7/100000 for 2018 (13.9 in 2012,+5.8%) and 94500 expected deaths, higher than the rate of 13.7 and 92700 deaths from breast cancer. Colorectal cancer predicted rates are 15.8/100000 men (−6.7%) and 9.2 in women (−7.5%); declines are expected in all age groups. Pancreatic cancer is stable in men, but in women it rose+2.8% since 2012. Ovarian, uterine and bladder cancer rates are predicted to decline further. In 2018 alone, about 392300 cancer deaths were avoided compared with peak rates in the late 1980s. ConclusionWe predicted continuing falls in mortality rates from major cancer sites in the EU and its major countries to 2018. Exceptions are pancreatic cancer and lung cancer in women. Improved treatment and—above age 50years—organized screening may account for recent favourable colorectal cancer trends.

Letter from Taiwan

Letter from Taiwan

International trends in lung cancer incidence from 1973 to 2007.

Lung cancer is the commonly diagnosed cancer and one of the most important avoidable causes of death around the world. We conducted the study to investigate the pattern of lung cancer incidence worldwide. Joinpoint analysis was used to extend international lung cancer incidence rates by the latest data from Cancer Incidence in Five Continents over the 35‐year period 1973–2007 from 24 populations from Americas, Asia, Europe, and Oceania. Age‐standardized incidence rates (ASRs) of lung cancer were from 33.3 to 66.8 per 100,000 among males and 10.5 to 37.4 per 100,000 among females in most of Americas, Europe, and Oceania populations during the period 2003–2007. In Asia, ASRs in China (Hong Kong) were the highest, up to 53.3 per 100,000 in males and 21.9 per 100,000 in females during the period 2003–2007. The international trends between 1973 and 2007 showed that ASRs of lung cancer among males were declining in 13 of 18 selected Americas, Oceania, and Europe populations, with AAPC from −0.7% to −2.9%, whereas the rates among females in 18 selected populations were increasing, with AAPC from 1.3% to 5.0%. The increasing and decreasing trends of ASRs of lung cancer in Asia have a geographic variation but no gender differences. Although the decreasing trends in ASRs of lung cancer for males were observed, the ASRs were higher than females. The declining trends in males were mainly attributed to tobacco control, whereas the increasing trends in females should be given more concern and need to be further studied in etiology factors.

Estimates of cancer burden in Italy.

This paper presents updated estimates of the incidence, prevalence and mortality of stomach, colorectal, lung, breast, uterine cervix and prostate cancer and skin melanoma in the Italian population. In particular, point estimates for 2012 and time trends from 1970 to 2015 will be provided. The presented figures were obtained by summing up the regional epidemiological indicator estimates presented in the other papers of this monographic issue, which were derived by applying the MIAMOD statistical back-calculation method to cancer registries survival data and official mortality rates. Our findings indicate that breast, colon-rectum and prostate will be the cancer sites with the highest incidence rates in the forthcoming years. The incidence rates still tend to increase for breast, male colorectal cancer and female lung cancer as well as for skin melanoma. By contrast, the incidence of stomach cancer, cervical cancer and male lung cancer, by far the most common tumor sites up to the early 1990s, will continue to decrease. The mortality estimates showed a decreasing trend for all considered cancers with the only exception of lung cancer in women. These results point to the need to reinforce prevention activities by developing more effective preventive measures for population groups at risk. There is also a need to support timely and continuous cancer surveillance in the Italian population through cancer registries in order to monitor the spread of the cancer risk and to evaluate the impact of prevention policies and therapeutic advances.

Estimates of cancer burden in Abruzzo and Molise.

Abruzzo and Molise are two regions located in the south of Italy, currently without population-based cancer registries. The aim of this paper is to provide estimates of cancer incidence, mortality and prevalence for the Abruzzo and Molise regions combined. The MIAMOD method, a back-calculation approach to estimate and project the incidence of chronic diseases from mortality and patient survival, was used for the estimation of incidence and prevalence by calendar year (from 1970 to 2015) and age (from 0 to 99). The survival estimates are based on cancer registry data of southern Italy. The most frequently diagnosed cancers were those of the colon and rectum, breast and prostate, with 1,394, 1,341 and 698 new diagnosed cases, respectively, estimated in 2012. Incidence rates were estimated to increase constantly for female breast cancer, colorectal cancer in men and melanoma in both sexes. For prostate cancer and male lung cancer, the incidence rates increased, reaching a peak, and then decreased. In women the incidence of colorectal and lung cancer stabilized after an initial increase. For stomach and cervical cancers, the incidence rates showed a constant decrease. Prevalence was increasing for all the considered cancer sites with the exception of the cervix uteri. The highest prevalence values were estimated for breast and colorectal cancer with about 12,300 and over 8,200 cases in 2012, respectively. In the 2000s the mortality rates declined for all cancers except skin melanoma and female lung cancer, for which the mortality was almost stable. This paper provides a description of the burden of the major cancers in Abruzzo and Molise until 2015. The increase in cancer survival, added to population aging, will inflate the cancer prevalence. In order to better evaluate the cancer burden in the two regions, it would be important to implement cancer registration.