Lung Cancer Rates Research Articles

DNA methylation and mRNA expression of ZNF577 as biomarkers for the detection and prognosis of lung adenocarcinoma.

Despite advances in science and technology, lung cancer remains a major public health issue. The discovery of early diagnostic and prognostic markers is still needed to reduce the mortality rate of lung cancer, which is the highest among all cancer types. Aberrations in the DNA methylation system have an important role in human cancer and are promising for the development of early diagnostic and prognostic markers. The present study focused on zinc finger protein (ZNF)577, whose encoding gene was indicated to exhibit promoter hypermethylation together with 9 other genes in lung adenocarcinoma (LADC) in a previous study by our group. ZN577 is a member of the ZNG family and its functional role has so far remained elusive. LADC tissue samples surgically resected at Tokushima University Hospital (Tokushima, Japan) between April 1999 and November 2013 were collected. A total of 73 tumors and 27 paired tumor-adjacent normal tissues were examined for DNA methylation and mRNA expression of ZNF577. A total of 149 LADC tissue samples were collected and evaluated by immunohistochemistry (IHC) for the tissue expression of ZNF577. High methylation (n=27, P<0.0001) and low mRNA expression levels (n=27, P<0.031) of ZNF577 were identified in LADC tissues, and it was demonstrated that methylation levels were inversely correlated with mRNA expression levels (P=0.0116, ρ=-0.2515). Among the LADC tissues, lepidic-patterned samples had lower methylation levels of ZNF577 than other pathological types. In addition, mRNA expression levels of ZNF577 were significantly higher in females, non-smokers and stage I samples. Overall survival [P<0.0001; area under curve (AUC)=0.8658] and disease-free survival (DFS; P<0.0004; AUC=0.7232) rates were significantly higher in the ZNF577 high mRNA expression group than in the ZNF577 low mRNA expression group. Among the 149 LADC samples examined by IHC, 105 were negative and 44 were positive for the tissue expression of ZNF577. Cox regression analysis showed poorer DFS (hazard ratio: 3.917; P=0.023) in patients with lower expression of ZNF577. In conclusion, higher methylation levels of ZNF577 were observed in LADC tissues than in normal lung tissue and low mRNA expression of ZNF577 was associated with unfavorable prognosis.

Exploring the Disparity in Indoor/Outdoor Time and Radon Exposure as Possible Factors Contributing to the Unexpected Increase in Lung Cancer Risk among Non-Smoking Women.

According to a NIH study, Lung cancer among individuals who have never smoked is more prevalent in women and occurs at an earlier age than in smokers. The rise in lung cancer rates among female non-smokers might be linked to radon inhalation and should be further investigated. Our theory is based on the differences in radon exposure between males and females, which can be attributed to the variations in time spent indoors versus outdoors. Over the past few years, the smoking rates have shown a steady decline in the United States and other developed countries. This decrease in smoking prevalence has led to a new shift in the primary risk factors associated with lung cancer. Although tobacco smoke historically served as the primary cause of lung cancer, the reduction in smoking rates has allowed other risk factors, such as radon exposure, to come to the forefront. Given that women in certain countries, on average, might spend more time indoors compared to men, they are potentially exposed to higher levels of radon. This increased exposure could explain the rising rates of lung cancer among female non-smokers. The theory is still in its nascent stages and requires further research and validation. However, if proven correct, it could significantly alter our understanding of lung cancer risk factors and lead to new prevention. It is therefore crucial to expedite the review and publication of this theory, given its potential implications for public health.

Imaging diagnostics of pulmonary ground-glass nodules: a narrative review with current status and future directions.

The incidence rate of lung cancer, which also has the highest mortality rates for both men and women worldwide, is increasing globally. Due to advancements in imaging technology and the growing inclination of individuals to undergo screening, the detection rate of ground-glass nodules (GGNs) has surged rapidly. Currently, artificial intelligence (AI) methods for data analysis and interpretation, image processing, illness diagnosis, and lesion prediction offer a novel perspective on the diagnosis of GGNs. This article aimed to examine how to detect malignant lesions as early as possible and improve clinical diagnostic and treatment decisions by identifying benign and malignant lesions using imaging data. It also aimed to describe the use of computed tomography (CT)-guided biopsies and highlight developments in AI techniques in this area. We used PubMed, Elsevier ScienceDirect, Springer Database, and Google Scholar to search for information relevant to the article's topic. We gathered, examined, and interpreted relevant imaging resources from the Second Affiliated Hospital of Nanchang University's Imaging Center. Additionally, we used Adobe Illustrator 2020 to process all the figures. We examined the common signs of GGNs, elucidated the relationship between these signs and the identification of benign and malignant lesions, and then described the application of AI in image segmentation, automatic classification, and the invasiveness prediction of GGNs over the last three years, including its limitations and outlook. We also discussed the necessity of conducting biopsies of persistent pure GGNs. A variety of imaging features can be combined to improve the diagnosis of benign and malignant GGNs. The use of CT-guided puncture biopsy to clarify the nature of lesions should be considered with caution. The development of new AI tools brings new possibilities and hope to improving the ability of imaging physicians to analyze GGN images and achieving accurate diagnosis.

Artificial intelligence software for analysing chest X-ray images to identify suspected lung cancer: an evidence synthesis early value assessment.

Lung cancer is one of the most common types of cancer in the United Kingdom. It is often diagnosed late. The 5-year survival rate for lung cancer is below 10%. Early diagnosis may improve survival. Software that has an artificial intelligence-developed algorithm might be useful in assisting with the identification of suspected lung cancer. This review sought to identify evidence on adjunct artificial intelligence software for analysing chest X-rays for suspected lung cancer, and to develop a conceptual cost-effectiveness model to inform discussion of what would be required to develop a fully executable cost-effectiveness model for future economic evaluation. The data sources were MEDLINE All, EMBASE, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, Epistemonikos, ACM Digital Library, World Health Organization International Clinical Trials Registry Platform, clinical experts, Tufts Cost-Effectiveness Analysis Registry, company submissions and clinical experts. Searches were conducted from 25 November 2022 to 18 January 2023. Rapid evidence synthesis methods were employed. Data from companies were scrutinised. The eligibility criteria were (1) primary care populations referred for chest X-ray due to symptoms suggestive of lung cancer or reasons unrelated to lung cancer; (2) study designs that compared radiology specialist assessing chest X-ray with adjunct artificial intelligence software versus radiology specialists alone and (3) outcomes relating to test accuracy, practical implications of using artificial intelligence software and patient-related outcomes. A conceptual decision-analytic model was developed to inform a potential full cost-effectiveness evaluation of adjunct artificial intelligence software for analysing chest X-ray images to identify suspected lung cancer. None of the studies identified in the searches or submitted by the companies met the inclusion criteria of the review. Contextual information from six studies that did not meet the inclusion criteria provided some evidence that sensitivity for lung cancer detection (but not nodule detection) might be higher when chest X-rays are interpreted by radiology specialists in combination with artificial intelligence software than when they are interpreted by radiology specialists alone. No significant differences were observed for specificity, positive predictive value or number of cancers detected. None of the six studies provided evidence on the clinical effectiveness of adjunct artificial intelligence software. The conceptual model highlighted a paucity of input data along the course of the diagnostic pathway and identified key assumptions required for evidence linkage. This review employed rapid evidence synthesis methods. This included only one reviewer conducting all elements of the review, and targeted searches that were conducted in English only. No eligible studies were identified. There is currently no evidence applicable to this review on the use of adjunct artificial intelligence software for the detection of suspected lung cancer on chest X-ray in either people referred from primary care with symptoms of lung cancer or people referred from primary care for other reasons. Future research is required to understand the accuracy of adjunct artificial intelligence software to detect lung nodules and cancers, as well as its impact on clinical decision-making and patient outcomes. Research generating key input parameters for the conceptual model will enable refinement of the model structure, and conversion to a full working model, to analyse the cost-effectiveness of artificial intelligence software for this indication. This study is registered as PROSPERO CRD42023384164. This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135755) and is published in full in Health Technology Assessment; Vol. 28, No. 50. See the NIHR Funding and Awards website for further award information.

COVID-19 pandemic and lung cancer rates in Kazakhstan: a comparative study of pre-pandemic and pandemic periods

Aim of the study. To assess the impact of the COVID-19 pandemic on the incidence of lung cancer by component analysis.Materials and methods. The research material was the data of the Ministry of Health of the Republic of Kazakhstan concerning LC (Form 7). To analyze the dynamics of incidence based on the number of cases from 2011 to 2020, a component method was used.Results and discussion. Analyzing 2011 and 2020, we found a tendency to decrease the incidence of lung cancer (p=0.000). However, comparing 2019 and 2020, we found a sharp decline in the incidence. The overall decrease was −2,220/0000 and depended on changes in the age structure of the population (∑ΔA=+0,340/0000), the risk of getting illness (∑ΔR=−2,520/0000) and the combined effect of the age structure and the risk of getting illness (∑ΔAR=−0,040/0000). The decrease was mainly due to the impact of the risk of getting illness. According to the calculations of the component analysis, 3,856 patients were expected in 2020, but instead the number of patients decreased to 3,375 and this is characterized by a decrease in the number of cases as a result of changes in the risk of getting illness.Conclusions. The COVID-19 pandemic has significantly reduced the incidence rate of lung cancer in Kazakhstan. Additional analysis and research are needed to understand the full impact and take appropriate measures to combat cancer in a pandemic.

Mortality risk associated to arsenic exposure after a major disaster. Results from the Manfredonia occupational cohort study 1976–2021

BackgroundOn September 1976, due to the explosion of an ammonia-washing column at the petrochemical plant in Manfredonia (Italy), 39 tonnes of arsenic were released into the atmosphere, contaminating the plants and the neighbourhoods close to it. The aim of this study is to present the results of a 45-year follow up of exposed workers with a focus on residential exposure. MethodsWe contacted Italian General Registries Offices and updated the vital status of persons involved in the clean-up activities following the disaster. The outcome of interest was the overall and cause-specific mortality. An accelerated failure time (AFT) approach was used when appropriate to model the risk of mortality. Results1772 workers contributing 67,743 person years were considered in the analysis. For overall mortality, results of the age-adjusted AFT model show an accelerator factor of 0.89 (95%CI 0.80–0.99) among contract workers, which means a shortening of survival in comparison to the reference category (plastic area workers). When accounting for latency greater than 20 years, higher mortality rates for lung cancer were observed among workers residing in Manfredonia. DiscussionAn increased risk of mortality among workers who were more exposed to arsenic during the clean-up activities has been observed. In fact, a loss of 5 years of life among more exposed workers was calculated. Furthermore, the mortality rates of residents in Manfredonia were higher than those of workers residing elsewhere.

A potential association between recent increased incidence of breast and uterine body cancers in Japanese women and changes in dietary saturated fat and folate intake: A meta-analysis

Recent increases in breast and uterine body cancers among Japanese women suggest the involvement of some modifiable factors in cancer development, including drinking and smoking habits, which are generally associated with Westernized lifestyles. Using national data on annual cancer incidence, this study examines the associations between recent changes in cancer incident rates and dietary habits. Data on age-specific incidence and mortality rates of breast, uterine body, colon, and lung cancers from 2004 to 2019, as well as annual changes in the intake of animal protein, plant protein, saturated fatty acids, and folate from 2001 to 2019 among Japanese women, were obtained from e-Stat, a portal site of Japanese Government Statistics. The analysis indicates that the incidence rates of breast and uterine body cancers among Japanese women increased from 2004 to 2019, displaying distinct distribution patterns with two peaks for breast cancer and one peak for uterine body cancer. The rising incidence rates of both cancers were positively correlated with annual changes in animal protein and saturated fat intake and inversely correlated with changes in plant protein and folate intake. Health-care professionals should be aware of the notable and characteristic increase in breast and uterine body cancer incidence among Japanese women and emphasize the importance of lifestyle modifications to counteract Westernized dietary habits.

Increased risk of subsequent primary lung cancer among female hormone-related cancer patients: A meta-analysis based on over four million cases.

The incidence rate of lung cancer in women has significantly increased over the past decade, and previous evidence has indicated a significant relationship between the elevated levels of sex hormones and the risk of lung cancer. Therefore, we hypothesized that female hormone-related cancer (FHRC) patients, including breast, endometrial, cervical, and ovarian cancer patients, may experience a higher risk of developing subsequent lung cancer. This meta-analysis aimed to identify the risk of lung cancer among FHRC patients compared to the general population. The PubMed, Web of Science, EMBASE, Cochrane Library, and CNKI databases were searched up to May 11, 2022. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were used to identify the risk of subsequent lung cancer after FHRC. Subgroup analyses based on the follow-up time and tumor type were also conducted. A total of 58 retrospective cohort studies involving 4,360,723 FHRC participants were included. The pooled results demonstrated that FHRC patients had a significantly increased risk of developing subsequent primary lung cancer (SIR=1.61, 95% CI: 1.48-1.76, P <0.001). Subgroup analysis revealed an obvious trend of increasing lung cancer risk over time (SIRs for <5years, ≥5years, ≥10years, ≥20years, and ≥30years after FHRC: 1.32, 1.59, 1.57, 1.68, and 1.95, respectively). In addition, subgroup analysis stratified by tumor type indicated an increased risk of developing subsequent lung cancer after breast (SIR=1.25, P <0.001), endometrial (SIR=1.40, P =0.019), cervical (SIR=2.56, P <0.001), and ovarian cancer (SIR=1.50, P =0.010). FHRC patients are more likely to develop lung cancer than the general population. Furthermore, the increased risk of subsequent primary lung cancer is more obvious with a longer survival time and is observed in all types of hormone-related cancer. International Platform of Registered Systematic Review and Meta-analysis Protocols: No. INPLASY202270044; https://inplasy.com/.

Evaluation of Long-Coronavirus Disease 2019 Cases Readmitted to Intensive Care Units Due to Acute Respiratory Failure: Point Prevalence Study.

Coronavirus disease 2019 (COVID-19) caused morbidity and mortality worldwide. Besides the acute effects, subacute and long-term effects are defined as long-COVID causing morbidity. The intensive care unit (ICU) data of long-COVID-19 cases were evaluated with the participation of 11 centers. Study was designed by Turkish Thoracic Society Respiratory Failure and Intensive Care Working Group to evaluate long COVID-19 patients. All patients followed up in the ICU with long-COVID diagnosis were included in point prevelance study. A total of 41 long COVID-19 patients from 11 centers were included in the study. Half of the patients were male, mean age was 66 ± 14, body mass index was 27 ± 5. Hypertension, diabetes mellitus, lung cancer, malignancy, and heart failure rates were 27%, 51%, 34%, 34%, and 27%, respectively. Eighty percent had received COVID vaccine. Patients had moderate hypoxemic respiratory failure. APACHE II, SOFA score was 18 (14-26), 6 (3-8), respectively. Forty-six percent received invasive mechanical ventilator support, 42% were sepsis, 17% were septic shock. Bilateral (67%), interstitial involvement (37%) were most common in chest x-ray. Fibrosis (27%) was detected in thorax tomography. Seventy-one percent of patients received antibiotherapy (42% carbapenem, 22% linezolid). Sixty-one percent of the patients received corticosteroid treatment. More than half of the patients had pneumonia and the majority of them used broad-spectrum antibiotics. Presence of comorbidities and malignancies, intensive care severity scores, intubation, and sepsis rates were high. Receiving corticosteroid treatment and extensive bilateral radiologic involvement due to COVID-19 might be the reasons for the high re-admission rate for the ICUs.

Survival Analysis of Lung Cancer Patients at Dr. Saiful Anwar Hospital

Background: Comprising 14% of all cancer, lung cancer is the main cause of cancer-related mortality worldwide. Previous studies showed various findings regarding the survival rate of lung cancer, and factors significantly correlated with survival rate in lung cancer patients. Aim: This research aims to identify the profile and survival rate of lung cancer patients receiving chemotherapy in Saiful Anwar General Hospital from 2018 to 2020. Methods: This cohort retrospective study used medical records of patients diagnosed with lung cancer who underwent chemotherapy from 2018 to 2020. Data analysis was done using the Mantel Cox log rank test. Survival data shown as progression free survival (PFS) and overall survival (OS) were shown using Kaplan-Meier curves. Results: Subjects were largely male (73,2%). Adenocarcinoma is the most often type of lung cancer found (59,8%) with wild type EGFR mutation being the most prevalent (20,6%). Carboplatin – Paclitaxel is the most widely used chemotherapy regimen (54,6%). Survival analysis showed a significant correlation between age, OS, and PFS (p &lt; 0,05) Conclusion: Various factors such as gender, cancer cell type, EGFR mutation, and chemotherapy regimen were not found to be related to survival rate in lung cancer patients. A significant correlation between age and survival rate showed potential in utilizing age as a predictor of survival rate in lung cancer patients.

Influence of smoking on changes in indicators of bronchitis, asthma and lung cancer - comparison on the example of Poland, Malta and other European Union countries

Introduction. Smoking is associated with respiratory diseases. Despite declining smoking rates, asthma and chronic bronchitis cases rose between 2014 and 2019. Quitting smoking is vital for managing asthma and reducing the risks of bronchitis and lung cancer. Aim. A correlational study of smoking prevalence and its association with asthma, bronchitis and lung cancer in people from Malta, Poland and the EU in 2008/2014/2019. Materials and methods. Integration and comparison of statistical data from EUROSTAT – (EHIS) 2008/2014/2019, ISAAC; ESPAD, 2014/2015, ECIS 2020. Results. Smoking habits exhibit notable gender disparities, with 24% of Polish men and 23% of Maltese men being regular smokers, compared to women (Poland – 15%, Malta – 16%). While male smoking rates have declined, especially in Poland, female rates persist. In 2019, asthma affected 5.6% of the EU adult population, with Poland at 4.1% and Malta at 6%. Chronic bronchitis is more prevalent in Poland (3%) than Malta (1%). In 2020, lung cancer rates among men varied slightly between Poland and Malta (120.0; 100.3 per 100.000). However, the incidence among women is twice as high in Poland (53.1; 23.9 per 100.000). Conclusions. Malta’s elevated asthma rate, despite comparable smoking rates, hints at additional risk factors like traffic. Poland’s increased bronchitis rate likely stems from higher historical smoking. The doubled lung cancer incidence in Polish women suggests a passive smoking connection. The burden of bronchitis intensifies due to high smoking rates in men over 50. Addressing smoking rates can potentially address respiratory disease rates, but other risk factors should also be identified and managed. Keywords: tobacco smoking, asthma, bronchitis, lung cancer.

Visual dual-mode aptasensor for non-small cell lung cancer exosome detection via HRP self-coupling enhanced oxidized iridium nanoparticle aggregation.

The main reason for the high mortality rate of non-small cell lung cancer is that patients are usually diagnosed at an advanced stage of the disease. Exosomes, small membrane vesicles secreted by normal cells or tumor cells, play a significant role in the progression of NSCLC. This study successfully optimized the preparation of artificial nanoenzymes self-coupling with horseradish peroxidase (IrO2NPs@HRP-AptCD63), without adding any ligand, demonstrating remarkable catalytic activity suitable for detecting the EGFR protein on the surface of NSCLC exosomes. When fused with the CD63 aptamer for identifying NSCLC exosomes, IrO2NPs@HRP showed enhanced catalytic activity in the 3,3',5,5'-tetramethylbenzidine-H2O2 oxidation-reduction system, thereby enhancing the colorimetric signal. This phenomenon can be distinguished by the naked eye and quantified using a UV-Vis spectrophotometer. Meanwhile, as the redox reaction occurs, the current signal of 3,3',5,5'-tetramethylbenzidine-H2O2, acting as an electrolyte, changes. The developed aptasensor generates dual-mode signal outputs, firstly, to visually assess the samples for their positive or negative status, and subsequently employ more in-depth electrochemical or colorimetric analysis methods for a detailed quantitative analysis of suspected positive samples. The detection limits of electrochemical analysis and colorimetric analysis were 0.9 × 103particles/mL and 0.14 × 103particles/mL, respectively. Compared with traditional biomarkers such as CA125, this method exhibits exceptional specificity, capable of simultaneously distinguishing serum exosomes of healthy volunteers, COPD patients, and NSCLC patients, promoting exosome detection in mouse models for tumor monitoring. Additionally, it elucidates the changes in EGFR protein expression on the surface of serum exosomes throughout the developmental trajectory.

Trends in lung cancer incidence in Spain (1990-2019): insights from Global Burden of Diseases data.

This study examines lung cancer incidence in Spain (1990-2019) through age-period-cohort (A-P-C) analysis and Global Burden of Diseases (GBD) data, unravelling the complex interplay of age, period, and birth cohort in shaping these trends. Utilizing GBD and Spanish population data, the study calculates age-standardized incidence rates (ASIRs) and employs Joinpoint analysis to identify significant trends. A-P-C analysis dissects the individual effects of age, calendar period, and birth cohort on incidence patterns. Between 1990 and 2019, almost 738,000 cases of lung cancer were diagnosed in Spain, with an average annual increase of 1.7%. The ASIR of lung cancer in Spain from 1990 to 2019 showed a sustained upward trend in women (Average Annual Per cent Change: 2.5%, P < 0.05), reaching 23.3 cases per 100,000 in 2019, whilst men experienced a significant decrease in incidence rates (AAPC: -0.6%, P < 0.05), falling to 108.9 in 2019. The male-to-female incidence ratio decreased from 12.2 in 1992 to 4.9 in 2019. Joinpoint analysis identified distinct periods for both sexes, with men showing stability, decline and then a significant decrease, whereas women showed an initial increase followed by a decrease. The longitudinal age curves showed a consistently higher incidence risk in men, peaking in the 80-84 age group. Male cohorts since the 1920s showed a decreasing relative risk, whereas women showed fluctuations in risk over time. Lung cancer rates are falling in Spain, especially amongst men, due to lower smoking rates. The gender gap is closing, but prevention targeted at women is needed. Tighter tobacco control and research into other risk factors are essential. Understanding the long-term effects of smoking and early exposure is key to better prevention and treatment in Spain.

Abstract PR004: Computational discovery of paralog dependencies drives target identification in lung cancer

Abstract Lung cancer is the leading cause of cancer-related death in the United States, and worldwide, with the 5-year survival rate of non-small cell lung cancer at 24%. Treatment options are limited, and even in cancers that harbor druggable biomarkers, resistance is near-universal. Identifying novel treatment strategies is essential to improve the outcomes of patients with lung cancer and provide secondary strategies for those who acquire resistance to first-line therapeutics. Identifying targeted therapies based on the genotype or expression pattern of cancers is an ongoing endeavor, and has been fruitful in the discovery of identifying cancer vulnerabilities. In lung cancer, treatment of patients that harbor activating mutations in EGFR with specific EGFR inhibitors has improved progression-free survival rates and extended the lifespan of patients diagnosed with this aggressive cancer, demonstrating the utility of targeted therapies based genetic-based vulnerabilities, or synthetic lethal interactions. A rich source of synthetic lethal genetic interactions are paralogous genes. Paralogs result from gene duplication events through evolutionary history, and many paralogs share both sequence homology and functional redundancy. Co-targeting of some paralogous genes induces a fitness defect that is synergistic compared to individual paralog loss alone. Nearly 70% of genes in the human genome are considered paralogs, and until recent efforts from the Berger lab and others, this buffering effect has caused them to be under-represented in lethality studies. Identifying frequently-inactivated paralog genes in lung cancer will provide a platform to identify new vulnerabilities in lung cancer and other cancer types that share mutational backgrounds. To identify patterns of mutation and expression of paralog genes in lung cancer, we have accessed publicly available data sets for both cell line and patient tumor samples. Using TCGA and CCLE data sources, and a set of 1030 paralog pairs identified previously by the Berger lab as potential drug targets, we have identified paralog genes that harbor high mutational frequencies in lung cancer. Using these early candidates, we next asked whether genetic inactivation or transcriptional repression of one paralog influences the essentiality of its paired gene using CERES scores generated by the Cancer Dependency Map. Preliminary results from this work has identified several paralog pairs with distinct dependency profiles in cell lines for which expression of one paralog is lost, including paralog pairs MAGOH/MAGOHB and TLK1/TLK2. Further work to characterize these dependencies in relevant cell line models is ongoing. Additionally, the druggability of these targets will be tested using targeted degradation using the dTAG system. This work will uncover a new set of paralog synthetic lethality targets, and further validate the utility of targeting known synthetic lethal paralogs for the treatment of highly lethal lung cancer. Citation Format: Alice H. Berger, Siobhan O'Brien. Computational discovery of paralog dependencies drives target identification in lung cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Expanding and Translating Cancer Synthetic Vulnerabilities; 2024 Jun 10-13; Montreal, Quebec, Canada. Philadelphia (PA): AACR; Mol Cancer Ther 2024;23(6 Suppl):Abstract nr PR004.

Regression–Based Diagnostic Models for Early Lung Cancer Integrating Conventional Indicators with Tumor Markers

The aim of this research was to develop a lung cancer diagnostic and predictive model that integrates traditional laboratory indicators with tumor markers. This model is intended to facilitate early screening and assist in the process of identifying or detecting lung cancer through a cost-effective, rapid, and convenient approach, ultimately enhancing the early detection rate of lung cancer. A retrospective study was conducted on 66 patients diagnosed with lung cancer and 159 patients with benign pulmonary conditions. Data including general clinical information, conventional laboratory test results, and tumor marker levels were collected. Data analysis was conducted using SPSS 26.0 (Statistical Product and Service Solutions 26.0). The lung cancer diagnosis and prediction model is created using a composite index established through binary logistic regression. The combined diagnostic prediction models, incorporating both traditional indicators and tumor markers, demonstrated a greater area under the curve (AUC) when compared to the diagnostic prediction model based solely on tumor markers and their combination testing. The values of cut-off point, AUC, accuracy, sensitivity, specificity, positive and negative detection rate and accuracy rate are 0.1805, 0.959, 86.67%, 0.955, 0.830, 95.45%, 83.02% and 89.33 respectively and it is shown that the combined diagnostic model display notable efficacy and clinical relevance in aiding the early diagnosis of lung cancer.

Demographic Disparities in Lung Cancer Mortality and Trends in the United States From 1999 Through 2020: A Population-Based CDC Database Analysis.

Lung cancer is the leading cause of cancer-related mortality in the United States and is projected to account for 127,070 deaths in 2023. Although the lung cancer mortality rate has been decreasing over the last decade, demographic disparities in mortality still exist. We sought to determine the impact of demographic factors on lung cancer mortality and trends in the United States. We queried the Centers for Disease Control and Prevention (CDC) database for mortality statistics with an underlying cause of death of lung and bronchus cancer from 1999 through 2020. Age-adjusted mortality rates (AAMR) were calculated per 100,000 people. We assessed the AAMR by demographic variables, including race, geographic density, sex, age, and US census region. Temporal trends were evaluated using Joinpoint regression software, and average annual percent change (APC) was calculated. From 1999 through 2020, lung cancer led to 3,380,830 deaths. The AAMR decreased by 55.1 to 31.8, with an associated average APC of -2.6%. In 1999, men had an AAMR almost twice as high as women, but these differences became less pronounced over time. Rural populations experienced the highest AAMR and the slowest rate of decrease compared with urban populations, who experienced the lowest AAMR and fastest decrease. Non-Hispanic Black individuals experienced the highest AAMR, with an annual decrease of -3.0%. The West experienced the fastest decrease at -3.1% annually, whereas the Midwest experienced the slowest decrease at -2.0% annually. Although the mortality rate of lung cancer has been decreasing since 1999, not all demographic groups have experienced the same rates of decrease, and disparities in outcomes are still prevalent. Vulnerable subgroups need targeted interventions, such as the incorporation of patient navigators, improved screening chest CT scan access and follow-up, and telehealth expansion, which will improve the likelihood of earlier-stage diagnoses and the potential for curative treatments.

Decreasing incidence and mortality of lung cancer in Hungary between 2011 and 2021 revealed by robust estimates reconciling multiple data sources.

Hungary has repeatedly been shown to have the highest cancer-related mortality and incidence in Europe. Despite lung cancer being the most abundant malignant diagnosis in Hungary, numerous concerns have been raised recently regarding the bias inherent to reported incidence estimates. Re-analysis of reimbursement claims has been suggested previously by our group as an alternative approach, offering revised figures of lung cancer incidence between 2011 and 2016. Leveraging on this methodology, we aimed at updating Hungarian lung cancer incidence estimates with an additional 5years (2017-2021), including years affected by the COVID-19 pandemic. Additionally, we also attempted to improve the robustness of estimates by taking additional characteristics of the patient pathway into account. Lung cancer patients between 2011 and 2021 were identified based on reimbursement-associated ICD-10 codes, histology codes and time patterns. Multiple query architectures were tested for sensitivity and compared to official estimates of the Hungarian National Cancer Registry (HNCR). Epidemiological trends were estimated by Poisson-regression, corrected for age and sex. A total of 89,948 lung cancer patients diagnosed in Hungary between 2011 and 2021 have been identified by our study. In 2019 alone, 7,887 patients were diagnosed according to our optimized query. ESP2013 standardized rate was estimated between 92.5/100,000 (2011) and 78.4/100,000 (2019). In 2019, standardized incidence was 106.8/100,000 for men and 59.7/100,000 for women. Up until the COVID-19 pandemic, lung cancer incidence was decreasing by 3.18% (2.1%-4.3%) yearly in men, while there was no significant decrease in women. Young age groups (40-49 and 50-59) featured the largest improvement, but women aged 60-79 are at an increasing risk for developing lung cancer. The COVID-19 pandemic resulted in a statistically significant decrease in lung cancer incidence, especially in the 50-59 age group (both sexes). Our results show that using an optimized approach, re-analysis of reimbursement claims yields robust estimates of lung cancer incidence. According to this approach, the incidence rate of male lung cancer is declining in Hungary, in concordance with the trend observed for lung cancer mortality. Among women aged 60-79, the incidence of lung cancer has risen, requiring more attention in the near future.

Cancer burden in South Asians in the United States: Epidemiologic report using Surveillance, Epidemiology, and End Results (SEER) program.

10574 Background: Studying racial-ethnic disparities in cancer risk can help in identifying underlying factors and developing targeted screening and education strategies. South Asian Americans (SAA), Asian Indians and Pakistanis, are a fast-growing ethnic group in the US, but there is limited research on their cancer risks. This study examines cancer prevalence patterns in the SAA population compared to Whites in the US. Methods: We analyzed cancer prevalence in 5,120,423 patients diagnosed with 23 different types of cancer between 2000 and 2018, using data from 18 SEER cancer registries. We compared cancer prevalence between SAA and Whites and examined factors such as cancer types, demographics, socioeconomic status, and urban vs. rural residency. Χ2 test was used to determine statistical significance (p&lt;0.001). Results: Our analysis revealed higher prevalence of breast (19.0% vs. 14.6%) and thyroid (5.9% vs. 2.8%) cancers among SAAs compared to Whites, but lower rates of lung (6.5% vs. 12.0%), colorectal (5.9% vs. 7.4%), and melanoma (0.8% vs. 5.4%) cancers; p&lt;0.001. Demographically, a significantly larger proportion of younger individuals (22.3% vs. 10.0%, ages 00-44) were found in the SAA cohort. The SAA survivor cohort also had a significantly higher percentage of females (50.8% vs. 48.6%) and married individuals than their White counterparts (69.3% vs 55.3%). Lastly, there were significant state-based variances in cancer prevalence. In California, SAAs had a lower cancer prevalence (23%) compared to Whites (38.5%), while in New Jersey, SAAs had a higher cancer prevalence (36.7%) than Whites (12.3%). Conclusions: Our analysis shows a disparity, highlighting the need for culturally attuned healthcare policies to enhance cancer education and screening among diverse groups. The higher prevalence of breast cancer in SAAs suggest possible effective screening, while lower rates of colorectal and lung cancers point to potential awareness gaps or cultural barriers. Addressing these, alongside researching genetic, environmental, and lifestyle influences—particularly given the younger SAA cancer population—is prudent. A focused approach, emphasizing targeted public health initiatives and further research, is necessary to enhance cancer outcomes and ensure health equity.

Sex and racial disparities in incidence and survival outcomes in adolescents and young adults (AYA) with lung cancer in the United States.

8033 Background: Limited data exists on the impact of race on the incidence and survival of lung cancer among adolescents and young adults (15 – 39 years). We examined the Surveillance, Epidemiology, and End Results Plus Data (SEER) to determine the association of race, sex and other demographic/clinicopathologic factors with incidence trends and survival in AYA. Methods: Lung cancer cases in AYA diagnosed between 2000 and 2020 were extracted from the SEER database. Age-standardized incidence rates per 100,000 persons were obtained, and the annual percentage change (APC) was used to compare incidence trends stratified by various demographics. Relative survival was calculated with the SEER Stat software. Multivariate regression analyses were performed to determine association with mortality. Results: We identified 5129 cases of lung cancer among AYA of which 50.9% (n=2610) were female, 56.6% (n=2904) were Non-Hispanic Whites (NHW), 17% (n=872) were Hispanics, 13.3% (n=684) were Non-Hispanic Blacks (NHBs), 12.5% (n=643) were Non-Hispanic Asian or Pacific Islander (NHAPI) and 0.5% (n=26) were Non-Hispanic American Indian/Alaska Native (NHAIA). Overall age-adjusted incidence rates (AAIR) of lung cancer among AYA decreased (APC, -2.01 [- 2.72 to -1.34)], slightly more in females (APC -2.05 [-2.93 to -1.26)] compared to males (APC, -2.01 [-2.74 to -1.34)]. The greatest decrease was seen in NHWs -2.4 [-3.1 to -1.8)]. There was no significant change in the AAIR among NHBs and Hispanics. NHBs showed the lowest 5-year survival rate (RSR-5: 58.8 [57.3-60.1]) with NHWs showing the highest survival (RSR-5: 77.8 [77.4-78.3]). On multivariable analysis, race was an independent predictor of mortality: Hispanics (HR: 0.78: 95% CI = 0.69 - 0.88) and NHAPI (HR: 0.79: 95% CI = 0.68 - 0.87) compared to NHW, had reduced odds of mortality. There was no association between sex and mortality. Conclusions: There is an overall decline in age-adjusted incidence rates of lung cancer, with more pronounced decline in females and specific racial groups. NHBs exhibited the lowest 5-year survival rate. Additionally, various socioeconomic and histologic factors demonstrated varying impacts on mortality. [Table: see text]

Cancer screening in sexual and gender minority populations: A systematic review and meta-analysis.

10540 Background: The sexual and gender minority (SGM) populations experience a greater cancer burden than their heterosexual or cisgender counterparts. Screening rates for cancer within this cohort are frequently suboptimal, highlighting notable deficiencies in screening recommendations. Inadequate culturally competent care and screening guidelines may contribute to delays in cancer diagnosis and treatment, ultimately impacting survival and quality of life. We sought to investigate the existing disparities in cancer screening among SGM populations. Methods: We conducted a systematic review and meta-analysis to assess the cancer screening rates in SGM. The SGM population included in this study were gays, lesbians, bisexuals, transgender men, and transgender women. Two reviewers conducted a systematic search of numerous databases, including PubMed, PsycINFO, and CINAHL, and then extracted relevant information from eligible studies. For this study, we conducted a meta-analysis using a random-effects model. Pooled estimates of the odds ratio were calculated for any combination of outcomes and population when at least two studies had relevant data. Study heterogeneity was assessed using I² statistics. Meta-regression, accounting for the study weight, year, and latitude, was performed on variables potentially associated with heterogeneity. Newcastle-Ottawa Scale was used to assess the quality of selected studies. Results: We analyzed data from a total of 60 eligible studies with 65,315 patients. Pooled analysis showed that sexual minority groups were at lower risk for cancer screening such as breast cancer screening (OR: 0.79, 95% CI, 0.75-0.82; Chi2=835.23; p&lt;0.001; I2=97%), cervical cancer screening (OR: 0.62, 95% CI, 0.56-0.72; Chi2=926.23; p&lt;0.001; I2=96%), colorectal cancer screening (OR: 0.51, 95% CI, 0.45-0.61; Chi2=3272.21; p&lt;0.001; I2=98%), and prostate cancer screening (OR: 0.71, 95% CI, 0.63-0.82; Chi2=1282.92; p&lt;0.001; I2=99%). The prevalence of lung cancer (p&lt;0.001) and anal cancer screening (p&lt;0.001) were also lower in sexual minority groups. The analysis also showed no small study effects (Egger test: 1.33; 95% CI: −5.42, −0.63; p=0.182). All the subgroups (geographical location, screening procedure, screening period) had high between-study heterogeneity. Conclusions: Our findings indicate that cancer screening rates for breast, cervical, colorectal, prostate, lung, and anal cell cancer are significantly lower in SGM populations and emphasize the urgent need for targeted interventions, culturally competent care, and inclusive screening guidelines to address these disparities. Understanding and addressing these issues are crucial for reducing delays in cancer diagnosis and improving survival and quality of life for SGM population. Further research and comprehensive strategies are warranted to bridge these gaps in cancer screening accessibility and uptake.