Male Lung Cancer Research Articles

Climatic modification effects on the association between PM1 and lung cancer incidence in China

BackgroundNationwide studies that examine climatic modification effects on the association between air pollution and health outcome are limited in developing countries. Moreover, few studies focus on PM1 pollution despite its greater health effect.ObjectivesThis study aims to determine the modification effects of climatic factors on the associations between PM1 and the incidence rates of lung cancer for males and females in China.MethodsWe conducted a nationwide analysis in 345 Chinese counties (districts) from 2014 to 2015. Mean air temperature and relative humidity over the study period were used as the proxies of climatic conditions. In terms of the multivariable linear regression model, we examined climatic modification effects in the stratified and combined datasets according to the three-category and binary divisions of climatic factors. Moreover, we performed three sensitivity analyses to test the robustness of climatic modification effects.ResultsWe found a stronger association between PM1 and the incidence rate of male lung cancer in counties with high levels of air temperature or relative humidity. If there is a 10 μg/m3 shift in PM1, then the change in male incidence rate relative to its mean was higher by 4.39% (95% CI: 2.19, 6.58%) and 8.37% (95% CI: 5.18, 11.56%) in the middle and high temperature groups than in the low temperature group, respectively. The findings of climatic modification effects were robust in the three sensitivity analyses. No significant modification effect was discovered for female incidence rate.ConclusionsMale residents in high temperature or humidity counties suffer from a larger effect of PM1 on the incidence rate of lung cancer in China. Future research on air pollution-related health impact assessment should consider the differential air pollution effects across different climatic conditions.

Clustering Trend Changes of Lung Cancer Incidence in Europe via the Growth Mixture Model during 1990–2016

Background Lung cancer accounts for half of all deaths from cancer in Europe and has the highest incidence in Southern Europe. The current study aimed to cluster trend changes of lung cancer incidence in Europe via the growth mixture model. Methods The dataset included incidence rates of female and male lung cancer per 100,000 for 42 European countries during 1990–2016 compiled from the Gapminder database. The growth mixture model was implemented to recognize different longitudinal patterns and estimate the linear trend of each pattern in Mplus 7.4 software. Results The observed overall trend of incidence for female and male lung cancer was raising and falling, respectively, and Iceland was the only country with higher incidence of female versus male lung cancer in 2016. The growth mixture model suggests 3 main patterns for the trend of lung cancer incidence both for males and females. In male lung cancer, a sharp decreasing pattern was detected for 6 countries including Belarus, Estonia, Russia, Slovenia, Ukraine, and the United Kingdom; also, a moderately decreasing pattern was observed among the other countries. In female lung cancer, a moderate increasing trend was observed for 8 countries including the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway; the other patterns were categorized into two clusters with slow increasing trends. Conclusion Given the raising patterns in the incidence of lung cancer among European females, especially in the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway, urgent effective measures are recommended to be taken.

Projections of the future burden of cancer in Australia using Bayesian age-period-cohort models

BackgroundAccurate forecasts of cancer incidence, with appropriate estimates of uncertainty, are crucial for planners and policy makers to ensure resource availability and prioritize interventions. We used Bayesian age-period-cohort (APC) models to project the future incidence of cancer in Australia. MethodsBayesian APC models were fitted to counts of cancer diagnoses in Australia from 1982 to 2016 and projected to 2031 for seven key cancer types: breast, colorectal, liver, lung, non-Hodgkin lymphoma, melanoma and stomach. Aggregate cancer data from population-based cancer registries were sourced from the Australian Institute of Health and Welfare. ResultsOver the projection period, total counts for these cancer types increased on average by 3 % annually to 100 385 diagnoses in 2031, which is a 50 % increase over 2016 numbers, although there is considerable uncertainty in this estimate. Counts for each cancer type and sex increased over the projection period, whereas decreases in the age-standardized incidence rates (ASRs) were projected for stomach, colorectal and male lung cancers. Large increases in ASRs were projected for liver and female lung cancer. Increases in the percentage of colorectal cancer diagnoses among younger age groups were projected. Retrospective one-step-ahead projections indicated both the incidence and its uncertainty were successfully forecast. ConclusionsIncreases in the projected incidence counts of key cancer types are in part attributable to the increasing and ageing population. The projected increases in ASRs for some cancer types should increase motivation to reduce sedentary behaviour, poor diet, overweight and undermanagement of infections. The Bayesian paradigm provides useful measures of the uncertainty associated with these projections.

Socio-Economic Position, Cancer Incidence and Stage at Diagnosis: A Nationwide Cohort Study in Belgium.

Simple SummarySocio-economic position is associated with cancer incidence, survival, and mortality. However, this relationship differs across cancer types and socio-economic parameters. Linking the 2001 census to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013, the aim of our study was to evaluate and characterise the associations between individual socio-economic and -demographic indicators and the risk of being diagnosed with six cancer types at the population level. With cancer stage being a major determinant for prognosis, a second aim of this study was to explore whether socio-economic position is associated with stage availability and distribution. This study, encompassing almost seven million individuals, identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium, and it contributes to building a more comprehensive picture of the complex and multifaceted nature of socio-economic position and cancer incidence in Belgium.Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.

European cancer mortality predictions for the year 2021 with focus on pancreatic and female lung cancer

We predicted cancer mortality statistics for 2021 for the European Union (EU) and its five most populous countries plus the UK. We also focused on pancreatic cancer and female lung cancer. We obtained cancer death certifications and population data from the World Health Organization and Eurostat databases for 1970-2015. We predicted numbers of deaths and age-standardised (world population) rates for 2021 for total cancers and 10 major cancer sites, using a joinpoint regression model. We calculated the number of avoided deaths over the period 1989-2021. We predicted 1267000 cancer deaths for 2021 in the EU, corresponding to age-standardised rates of 130.4/100 000 men (-6.6% since 2015) and 81.0/100 000 for women (-4.5%). We estimated further falls in male lung cancer rates, but still trending upward in women by+6.5%, reaching 14.5/100 000 in 2021. The breast cancer predicted rate in the EU was 13.3/100 000 (-7.8%). The rates for stomach and leukaemias in both sexes and for bladder in males are predicted to fall by >10%; trends for other cancer sites were also favourable, except for the pancreas, which showed stable patterns in both sexes, with predicted rates of 8.1/100 000 in men and 5.6/100000 in women. Rates for pancreatic cancer in EU men aged 25-49 and 50-64 years declined, respectively, by 10% and 1.8%, while for those aged 65+ years increased by 1.3%. Rates fell for young women only (-3.4%). Over 1989-2021, about 5 million cancer deaths were avoided in the EU27 compared with peak rates in1988. Overall cancer mortality continues to fall in both sexes. However, specific focus is needed on pancreatic cancer, which shows a sizeable decline for young men only. Tobacco control remains a priority for the prevention of pancreatic and other tobacco-related cancers, which account for one-third of the total EU cancer deaths, especially in women, who showed less favourable trends.

Causes of mortality in a large population-based cohort of psychiatric patients in Southern Europe

The World Health Organization considers excess morbidity and mortality among people with mental disorders as a high public health priority. This study aims to estimate the mortality risk and causes of death among a large population-based cohort of psychiatric patients.All residents in Veneto (Northeastern Italy) aged between 18 and 84 years with a contact with Community Mental Health Centers in 2008 and a psychiatric diagnosis (n = 54,350) were followed-up for 10 years. Standardized Mortality Ratios (SMR) and excess mortality were computed, with the general regional population as a reference.Mortality was more than doubled (males SMR = 2.4; females SMR = 2.2) and the relative increase in mortality was much larger in young and middle-aged adults (18–44 and 45–64 years) across all diagnostic groups. The most frequent causes were circulatory diseases (27%) and neoplasms (26%). Although the risk was increased by about tenfold, deaths from suicide were limited to 6% and 4% of all decedents in males and females, respectively. Patients with schizophrenia showed a very high risk for mortality for diabetes and cardiovascular disorders. A large excess was found also for respiratory diseases and a two-fold increase for lung cancer in males and breast cancer in females.Although chronic physical disorders are known to be the main causes of mortality in such patients, they receive far less attention than suicide or accidents. Our results suggest that there is still a need to plan actions to prevent excess mortality and to improve the quality of life of patients with mental disorders.

Lung Cancer Coexisting with Pulmonary Tuberculosis: A Rare Case Report

Lung cancer and tuberculosis (TB) are common causes of morbidity and mortality in the world. TB is a serious public health problem in developing countries including India, bearing the highest burden. Lung cancer is also increasing everywhere in the globe with India having the highest mortality due to lung cancer in males. Both diseases coexist producing a diagnostic dilemma. The simultaneous or sequential presentation of pulmonary TB and lung cancer within the same patient has been reported in various case series and case–control studies, but the association between them is still controversial. TB is an important risk factor for developing carcinoma lung. The dormant bacilli may activate due to disturbed defense mechanisms. Pulmonary cancer mortality was also higher in patients developing TB, simultaneously or during treatment courses, than in those without. The diagnosis may be delayed and the patient's survival may be decreased?. Pulmonary TB coexisting with lung cancer can mask the underlying disorder resulting in delay in diagnosis and management of cancer patients. Here, we present a rare and interesting case of a 52-year-old male who was diagnosed as a case of microbiologically confirmed pulmonary TB and squamous cell lung carcinoma at the same time.

The Relationship between Lymphocyte Subsets and the Prognosis and Genomic Features of Lung Cancer: A Retrospective Study.

Background: It has been shown that the prognosis of malignant tumors was closely related to the composition and function of immune system, which was associated with genomic features. However, the prognostic value of peripheral T lymphocyte subsets and its relationship with genomic features in lung cancer has not been analyzed extensively. Therefore, this study was intended to evaluate the relationship between lymphocyte subsets and the prognosis and genomic features of lung cancer.Methods: 598 lung cancer patients with complete data were included in this study between 2011 and 2018. Kaplan-Meier method and Pearson analyses were conducted to study the prognostic value of CD3+, CD4+, CD8+ T lymphocytes and the rate of CD4/CD8.Results: Patients with EGFR mutation has lower mean percentage of CD8+ lymphocytes than patients with EGFR wild-type (24.71 versus 26.62, respectively, P=0.041). Patients with high CD3 had better OS than those with low (27 versus 14 months, P=0.002). Patients with higher CD4 and CD4/CD8 rate had longer OS than with lower (27 versus 12 months, P=0.002; 25 versus 9 months, P=0.008, respectively). Patients with high CD8 had poor PFS than low group (6 versus 11 months, P=0.009). There was a negative correlation between CD3+ and CD4+ cells and OS in smoking stage Ⅱ female lung cancer patients (PCC = 0.626, P<0.05; PCC = 0.534, P<0.05, respectively). In stage Ⅰ male lung cancer patients, CD8+T cell is negatively correlated with OS and PFS (PCC = 0.295, P<0.05; PCC = 0.280, P<0.05, respectively)Conclusions: Lung cancer patients with EGFR mutation had lower percentage of CD8+ lymphocytes. Lymphocyte subsets might be potential prognostic biomarkers of lung cancer, but they are affected by gender and tumor stage.

Real-World Treatment Patterns of Lung Cancer in a Resource-Restricted Country: the Experience of Georgia

Lung cancer (LC) is the most common malignancy responsible for 1.8 million of deaths worldwide. Lung and bronchus cancer represents 13% (n = 1217) of all new cancer cases in Georgia. In 2018, in Georgian males lung cancer age-standardized incidence rate was 35.7/per 100 000, less compared to regional countries as Turkey (70.6), Russia (48.2), Ukraine (41.7), and Armenia (58.5), but higher than in neighbor Azerbaijan (25.5). Incidence is higher compared to central and eastern Europe (27.3) and near similar to North America (34.5). Georgia is an Eastern European, middleincome country with 3.7 million residents and one of the highest numbers of active smokers in the European Region. The Georgian health care system is divided into a public and a private sector, with coverage of nearly 100% of the population. There is a national healthcare system as well as private insurance and all patients, irrespective of insurance (private or governmental) can choose the hospital for treatment by themselves all over the country. The Basic Package of the Universal Health Care Program includes the treatment of oncologic patients, specifically surgery, chemotherapy, hormone therapy and radiotherapy and investigations and medications related to these procedures. The program covers all types of laboratory and instrumental investigations related to planned treatment. Georgia lacks an LC screening program for smokers and partially because of this, the majority of patients with lung cancer present at an advanced stage. The National Centre for the Disease Control (NCDC) showed that almost 90% of LC patients in the country present with advanced stages (III-IV) with 60% of patients having stage IV disease at diagnosis . Lung cancer is generally diagnosed at an advanced stage. For non-small cell lung cancer (NSCLC), the proportion with metastatic disease (TNM stage IV) ranged from 46.8% to 61.2% in developed countries. In recent years, there have been several publications addressing specifics of LC worldwide, but none concerning Georgia. In light of the rapidly changing landscape in the diagnosis, staging, and treatment of LC, we thought to define the state of practice in Georgia by convening specialists who treat LC across 13 institutions in our country with the goal to describe differences in access and approaches to LC.

OP513 Disparities In Cancer Premature Mortality In Brazil: Predictions Up To 2030 And Sustainable Development Goals

IntroductionPremature mortality affects the economy directly due to the loss of productivity of individuals who die, thus ceasing to contribute economically to the country. The one-third reduction in premature mortality (30–69 years) from chronic noncommunicable diseases is goal 3.4 of the United Nations Sustainable Development Goals (UN SDG). Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compared with the SDG 3.4 target and identify regional progress and future needs.MethodsMortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of one-third reduction of premature deaths.ResultsComparison of observed (2011–2015) and predicted (2026–2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6 percent among women nationally. Although predicted rates for 2026–2030 are lower than those observed in 2011–2015, the predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes.ConclusionsThe profile of cancer premature mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching the SDG 3.4 target, endorsing the government's long-term efforts to reduce tobacco consumption. Colorectal cancer mortality increases in most regions, reflecting the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge, especially in the North and Northeast. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in cancer patterns show the need to plan and to adapt regionally for each reality.

Abstract PO-193: Gender, women, and lung cancer: Times are changing

Abstract Objective Recent literature has indicated a shift in the pattern of incidence rates of lung cancer among men than among women in non-Hispanic whites and Hispanics born since the mid-1960’s. These changes are not fully explained by differences in smoking behaviors. The goal of our study is to determine the role, if any, of race on lung cancer in never-smokers in patients undergoing lung cancer surgery. Methods Our institutional database (Columbia University Medical Center) was queried from 2006 to 2018 for all patients undergoing lung cancer surgery. A total of 1631 cases of NSCLC were reported. We analyzed the cohort for differences in basic demographics, including sex, race, and smoking status. Results In Hispanic, Asian, and Black, but not White populations undergoing lung cancer surgery, non-smokers were significantly more likely to be women (p=0.01, 0.00001, 0.03). The proportion of never-smoking patients in men and women is dependent on race in Asian, Black, Hispanic, Non- Hispanic White, and all White populations (p=0.09). Conclusions The varying epidemiology of male and female lung cancer patients shows significant differences, by smoking status and race. This emphasizes the necessity for further research into the pathogenesis of nonsmoking related lung cancer. Our further research will utilize genomic analysis and multi-institutional statistical analyses to further investigate these differences. Citation Format: Radhika Tandon, B. Payne Stanifer, Frank D'Ovidio, Anjali Saqi, Joshua Sonett. Gender, women, and lung cancer: Times are changing [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-193.

Do socioeconomic factors modify the effects of PM1 and SO2 on lung cancer incidence in China?

BackgroundIt remains uncertain whether socioeconomic factors modify the effect of air pollution on human health. Moreover, studies investigating socioeconomic modifying roles on the effect of PM1 are quite limited, especially in developing countries. ObjectivesThe present study aims to investigate socioeconomic modification effects on the associations of the incidence rate of male lung cancer with ambient PM1 and SO2 in China. MethodsWe conducted a nationwide analysis in 345 Chinese counties (districts) between 2014 and 2015. In terms of multivariable linear regression models, we examined the modification effects of urban-rural division, education level and proportion of construction workers in the stratified and combined datasets according to the tertile and binary divisions of the three factors. Moreover, we performed three sensitivity analyses to test the robustness of socioeconomic modification effects. ResultsWe found a larger effect of PM1 on the incidence rate of male lung cancer in urban areas than in rural areas. The association between PM1 (or SO2) and the incidence rate of male lung cancer was stronger in counties with low education levels than in those with high education levels. The findings of the significant modification effects of urban-rural division and education level were robust in the three sensitivity analyses. No significant modification effect was observed for the proportion of construction workers. ConclusionsMale residents in urban areas have a high risk of lung cancer incidence associated with ambient PM1. Male residents with low education levels suffer from larger effects of PM1 and SO2 on the incidence rate of lung cancer. Area- and population-specific strategies should be developed to reduce the urban-rural and educational disparities in air pollution effects, which thereby alleviates air pollution-associated health disparities in China.

Prevalence and prognosis in cancer therapy-related cardiovascular diseases from big data of electronic health record in Japan

Abstract Background Recent advance in cancer therapy has improved the cancer prognosis, which also increased the number of elder cancer survivors. Yet the anticancer agents have some serious side effects on cardiovascular system. Although there have been previous studies regarding cancer-specific and/or therapeutic agents-specific cardiovascular side effects in the selected patients, real-world data of the epidemiology for the impact of cardiovascular diseases (CVD) in cancer survivors is still limited due to the lack of comprehensive dataset. In this regard, the electronic health record (EHR), a big data, from the National Health Insurance in Japan provides a unique opportunity to obtain the suitable dataset. Purpose The purpose of this study was to clarify the prevalence of various CVD after the use of anticancer agents and the prognosis in cancer survivors using EHR in Japan. Methods This study was a retrospective cohort study using the database of Medical Data Vision (MDV) Co., Ltd. (Tokyo, Japan). The database covered 129 hospitals of all of the Designated Cancer Hospitals in Japan. The total number of patients was 17.85 million, which covered 14% of the total Japanese population. We extracted 140,327 cancer patients who received anticancer agents between April 2008 to January 2017. We identified CVD as pulmonary thromboembolism (PTE), atrial fibrillation (AF), ischemic heart disease (IHD), ventricular arrhythmia, pericarditis patients after the use of anticancer agents, according to International Classification of Diseases, 10th revision (ICD-10) codes. Hypertension (HT) patients were also identified according to ICD-10 codes, with the use of one or more anti-HT drugs after the HT diagnosis. Results The mean follow-up period was 1.53 years and mean age (standard deviation) was 69.2 (11.6) years old. The population over 75 years old were 36.2%, while males were 59.0%. There were prostate cancer (28.3%), lung cancer (13.8%), and colon cancer (13.2%) in males, and breast cancer (43.1%), colon cancer (12.6%), and lung cancer (8.6%) in females. Among them, 3,371 patients (2.4%) were diagnosed as PTE, 2,193 patients (1.6%) as AF, 4,085 patients (2.9%) as stable coronary artery disease, 681 patients (0.5%) as acute myocardial infarction (AMI), 749 patients (0.5%) as ventricular arrhythmia, 238 patients (0.2%) as pericarditis, 7,693 patients (5.5%) as HT. The cumulative survival rate was 65.6% in all cancer patients, 50.7% in PTE, 53.4% in AF, 61.7% in stable coronary disease, 52.7% in AMI and 45.9% in HT after the use of anticancer agents. Conclusion This study indicated that the prevalence of each CVD was less than 10% after the use of anticancer agents, but that patients with cancer therapy-related CVD had worse prognosis. Funding Acknowledgement Type of funding source: None

Risk assessment and prediction for lung cancer among Hong Kong Chinese men

Objective: The discriminatory power of previous risk prediction models for all lung cancers generally ranged from 0.57 to 0.72. We constructed individual risk prediction models for all lung cancers and its specific histological subtypes among Hong Kong general male population. Methods: Epidemiological data of 1069 male lung cancer cases confirmed by histology and 1208 community controls were included in this analysis. Community controls were randomly selected from the general male population frequency-matched by age and sex. Annual concentration of ambient PM2.5 and PM10 air pollution were retrospectively reconstructed based on individual household location and the nearest monitoring station data. LASSO-model was used to select optimal risk factors for each specific prediction model. Receiver-operator characteristic curves (ROC) and the area under the curve (AUC) was used to demonstrate the model performance and the ability to differentiate cases from non-cases. Results: AUC for all lung cancers was 0.782 (95%CI: 0.762-0.801) and the discriminatory power increased to 0.824 (95%CI: 0.807-0.841) after PM10 was included into the prediction model, and this improvement was consistently shown in prediction models stratified by smoking status. When the prediction models included ambient PM10 and were further specified by histological subtypes, a notably higher AUC was demonstrated for squamous cell lung cancer (0.878, 95%CI: 0.857-0.898) than that of the adenocarcinoma (0.778, 95%CI: 0.751-0.804). Conclusion: Lung cancer risk assessment tool in Hong Kong Chinese men based on LASSO selection is promising, which shows a relatively higher discriminative accuracy than those developed in many other populations. Risk model is improved after including PM10 air pollution, indicating the importance of addressing ambient PM air pollution in risk prediction. However, external validation of this model in an independent population is recommended to be the next necessary step. [Funding source: Research Grant Council, HKSAR, Project no. CUHK4460/03M]

Antibiotic Consumption Patterns in European Countries May Be Associated with the Incidence of Major Carcinomas

The possible role of the altered intestinal microbiome in the development of malignancies has been raised recently in several publications. Among external factors, antibiotics are considered to be the most important agent capable of producing dysbiosis in the gut flora, either temporally or permanently. The human microbiome has several beneficial effects in terms of maintaining appropriate human health, but its alteration has been implicated in the development of many illnesses. Our basic aim was to explore a possible relationship between the consumption of different antibiotic classes and the incidence of the most common cancer types (male, female) in European countries. A database of the average, yearly antibiotic consumption (1997–2018) has been developed and the consumption figures were compared to the eight, most frequent cancer incidence calculated for 2018 in 30 European countries. Pearson correlation has indicated different degrees of positive (supportive) and negative (inhibitor) significant associations between antibiotic consumption figures and cancer prevalence. It has been observed that certain antibiotic classes with positive correlation probably augment the incidence of certain cancer types, while others, with negative correlation, may show some inhibitory effect. The relatively higher or lower consumption pattern of different classes of antibiotics could be related to certain cancer prevalence figures in different European countries. Our results indicated that countries with relatively high consumption of narrow-spectrum penicillin (J01CE, J01CF) and tetracycline (J01A), like certain Scandinavian countries, showed a higher incidence of female colorectal cancer, female lung cancer, melanoma, breast, prostate and uterus corpus cancer. Countries with relatively higher consumption of broad-spectrum penicillin (J01CA, J01CR) and some broad-spectrum antibiotics (J01D, J01F, J01M), like Greece, Hungary, Slovakia, France, etc. showed a higher incidence rate of male lung cancer and male bladder cancer. The higher incidence rate of different cancer types showed association with the higher consumption of antibiotics with “augmenting” properties and with less consumption of antibiotics with “inhibitory” properties.

Incidence of lung cancer in males and females in Algeria: The lung cancer registry in Algeria (LuCaReAl)

BackgroundLung cancer is a major cause of death worldwide. However, few data on incidence, histologic types and mortality rates of lung cancer were available for Algeria. MethodsLuCaReAl is an ongoing descriptive, non-interventional, national, multicenter, prospective and longitudinal study conducted in Algeria, among oncologists and pulmonologists in public community and university hospitals. Median and interquartile ranges are displayed. ResultsBetween July 2016 and July 2017, 897 patients were included. Overall incidence of lung cancer was 3.4 [3.2;3.6] cases per 100,000 inhabitants; overall incidence by sex was 5.8 [5.4;6.2] for males and 1.0 [0.8;1.1] for females. Adenocarcinoma was the most common histologic type of cancer. Most tumors were diagnosed at Stage IV. ConclusionThe first results from the LuCaReAl study in Algeria showed that most patients are diagnosed with lung cancer at an advanced stage. The ongoing follow-up will next provide data on the survival and mortality rates.

Sustainable Development Goal 3.4: Regional disparities in cancer premature mortality in Brazil

Abstract Background The Sustainable Development Goal 3.4 has a target of 1/3 reduction in premature mortality (30-69 years) from chronic noncommunicable diseases. Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compare with SDG 3.4 target and identify regional progress and future needs. Methods Mortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of 1/3 reduction of premature deaths. Results Comparison of observed (2011-2015) and predicted (2016-2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6% among women nationally. Although predicted rates for 2026-2030 are lower than those observed in 2011-2015 predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes, in all regions (except in the Southeast). Conclusions The profile of premature cancer mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching SDG 3.4 target, endorsing government's long-term efforts to reduce tobacco consumption. The increase in colorectal cancer mortality reflects the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in mortality patterns highlight the need to adapt cancer prevention policies regionally. Key messages Cancer premature mortality decrease in Brazil is expected to occur, but far from the SDG 3.4 target – including preventable cancers as cervical cancer. An increase is expected to occur in colorectal premature cancer mortality rates and strategies to face it need to be developed regionally.

Erectile Dysfunction After Surgical Treatment of Lung Cancer: Real-World Evidence.

BackgroundSexual problems are common in male lung cancer survivors. However, the development of erectile dysfunction (ED) in lung cancer patients after surgery has been rarely explored. In this study, we aimed to explore the incidence and risk factors of ED after lung cancer surgery.MethodsFrom 2000 to 2012, 6025 and 24,100 male patients were included in each matched cohort of lung cancer and non-lung cancer patients, respectively. Poisson regression analysis was used to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI).ResultsThe incidence of ED was higher in the lung cancer cohort compared to the non-lung cancer cohort (38.47 vs 28.28 per 10,000 person-years) with an adjusted IRR (aIRR) of 1.34 (95% CI: 1.06–1.70, p=0.014) after the confounders were adjusted for. An increased incidence of ED was observed in the lung cancer cohort aged 40–54 years (aIRR: 5.44, 95% CI: 2.25–13.15, p<0.001), 55–64 years (aIRR: 3.62, 95% CI: 1.61–8.17, p=0.002) years, and anxiety (aIRR: 2.99, 95% CI: 1.81–4.94, p<0.001). In addition, a higher incidence of emergency room (ER) visits (aIRR: 2.19, 95% CI: 1.98–2.42, p<0.001) was observed in lung cancer patients with ED compared to those without ED.ConclusionOur study results suggested that early surveillance and intervention of ED should be advocated in lung cancer patients after surgery.

A new trajectory approach for investigating the association between an environmental or occupational exposure over lifetime and the risk of chronic disease: Application to smoking, asbestos, and lung cancer.

Quantifying the association between lifetime exposures and the risk of developing a chronic disease is a recurrent challenge in epidemiology. Individual exposure trajectories are often heterogeneous and studying their associations with the risk of disease is not straightforward. We propose to use a latent class mixed model (LCMM) to identify profiles (latent classes) of exposure trajectories and estimate their association with the risk of disease. The methodology is applied to study the association between lifetime trajectories of smoking or occupational exposure to asbestos and the risk of lung cancer in males of the ICARE population-based case-control study. Asbestos exposure was assessed using a job exposure matrix. The classes of exposure trajectories were identified using two separate LCMM for smoking and asbestos, and the association between the identified classes and the risk of lung cancer was estimated in a second stage using weighted logistic regression and all subjects. A total of 2026/2610 cases/controls had complete information on both smoking and asbestos exposure, including 1938/1837 cases/controls ever smokers, and 1417/1520 cases/controls ever exposed to asbestos. The LCMM identified four latent classes of smoking trajectories which had different risks of lung cancer, all much stronger than never smokers. The most frequent class had moderate constant intensity over lifetime while the three others had either long-term, distant or recent high intensity. The latter had the strongest risk of lung cancer. We identified five classes of asbestos exposure trajectories which all had higher risk of lung cancer compared to men never occupationally exposed to asbestos, whatever the dose and the timing of exposure. The proposed approach opens new perspectives for the analyses of dose-time-response relationships between protracted exposures and the risk of developing a chronic disease, by providing a complete picture of exposure history in terms of intensity, duration, and timing of exposure.

Cancer Incidence Rate in Kurdistan-Iraq during 14 Years - Depend on Cancer Registry Program

The aim of this study was to identify the incident rate of different types of cancers and determine risks of cancer in Erbil Capital of Kurdistan Region Government from June 2004 to December 2017. This data was collected from registered cases in Nanakaly hospital for cancer. It included all cancer cases for different age groups during the a fore mentioned period; the results showed that the recorded number of cancer cases was 1021 with 27 types of cancer during. The highest recorded cancers are lung, breast, diffuse cancer, lymphoma, myeloid leukemia and acute lymphocytic leukemia by 9.43%, 24.40%, 10.61%, 9.10%, 8.95% and 8.78% respectively. The annual incident rate per 100,000 was 5712 and for all age groups were 67.26 in female and 4698 in women, from 53 to 376.5 cases/population/ year. Incident rate showed to be 51.72% in female and 48.28% in male. It was last noticed that the most common cancer amongst females and males were breast, lung, myeloid leukemia, Lymphoma, Acute lymphocytic leukemia, Colon, ovary, and thalassemia by 21.01%, 1.80%, 5.71%, 4.54%, 4.41%, 1.69%, 1.42%, and 0.50% with the males by 3.05%, 7.68%, 5.56%, 6.17%, 5.67%, 2.81%, 0.18%, and 0.32% respectively. Projections of cancer trends to the year 2030 indicate to expected rises in both incidence and prevalence. It seems that the cancer cases in Erbil city is higher comparing to the cases of other cities like Sulaymaniyah especially for older age groups. In this survey, breast cancer in females, lung cancers in males were ranked first with other cancer all 14 years.