Mortality In Men Research Articles

Trend of mortality rate due to drowning in Iran (2013–2018)

Background and Objectives: According to the World Health Organization, drowning is the 3rd leading cause of unintentional injury-related deaths worldwide, accounting for 360,000 annual deaths and 7% of all injury-related deaths. Low- and middle-income countries are the most affected, accounting for 90% of unintentional drowning deaths. This study aimed to calculate the rate of drowning mortality rate and to investigate its trend in Iran. Materials and Methods: Information on death due to drowning in Iran was extracted from Iranian Legal Medicine Organization. The crude mortality rate was calculated each year according to gender and province of the country. To examine the trend for different years, joinpoint regression was used. Results: From 2013 to 2018, a total of 5853 persons suffered from fatal drowning in Iran. The crude mortality rate in men was significantly higher than in women. The drowning mortality rate has decreased during the study period in both genders. The annual percent change in mortality rate was 3.2%. Conclusions: Although the death rate from drowning has declined in the country, targeted scale-up of known effective interventions such as swimmers supervision and basic survival skills are still needed for reducing mortality due to drowning, particularly in provinces with high mortality rates.

Midlife mortality in White non-Hispanic male veterans enrolled in Department of Veterans Affairs primary care, 2003–2014

BackgroundAfter years of decline in mortality rates in the United States, there have been increases in mortality rates in White non-Hispanic Americans ages 45–54, due to increases in deaths from suicide, poisoning, and alcoholic liver disease. ObjectivesTo determine whether White non-Hispanic middle age male Veterans enrolled in Department of Veterans Affairs (VA) primary care had increased mortality, as found in the general population. Research designRepeated cross-sectional analysis over 12 years to describe trends in death rates for men across 3 race/ethnicity groups (White non-Hispanic, Black non-Hispanic, Hispanic) and 2 age groups (45–54, 55–64) for the Veteran and general US male populations. Subjects60 million patient-years for Veterans enrolled in VA primary care from 2003 to 2014 and 1.8 million who died during the study period. MeasuresAll-cause and cause specific death rates for alcoholic liver disease, poisoning, and suicide. ResultsFor White non-Hispanic male Veterans ages 55–64, the increase in all-cause mortality from 2003 to 2014 (+309 deaths/100,000) was accompanied by significant changes in deaths due to poisoning (+30/100,000), alcoholic liver disease (+23/100,000), and suicide (+17/100,000). For US men ages 55–64, all-cause mortality decreased slightly from 2003-2014 (-22 deaths/100,000). However, there were increases in death rates due to poisoning (+17/100,000), alcoholic liver disease (+14/100,000) and suicide (+11/100,000). ConclusionsThese disturbing findings for White non-Hispanic Veteran men ages 55–64 suggest the critical importance of suicide prevention programs as well as the importance of high quality integrated health care for both Veteran and non-Veteran men.

Associations of changes in patient characteristics and management with decrease in mortality rates of men and women with ST-elevation myocardial infarction - a propensity score-matched analysis.

IntroductionThe aim of this study is to estimate how much of the recent decrease in mortality among patients with myocardial infarction with ST-segment elevation (STEMI) can be attributed to improved treatment strategies, and how much it is related to changes in baseline clinical characteristics, and to compare these findings for men and women.Material and methodsThis was a retrospective analysis of 32,790 patients with STEMI from the Polish Registry of Acute Coronary Syndromes PL-ACS hospitalised in 2005 and 2011. Changes in treatment strategies including pharmacotherapy were analysed. Observed in-hospital and 12-month mortality rates were compared with the outcomes in the groups matched on the propensity scores.ResultsThere was a substantial improvement in STEMI patient management between 2005 and 2011 in Poland. It included greater use of percutaneous coronary interventions and other guideline-based adjunctive therapies, and it was associated with a significant decline in in-hospital mortality. Relative 12-month mortality reduction rates were less pronounced and more related to changes in patients’ clinical characteristics. Higher mortality risk reductions were observed in women and were driven by relatively more positive changes in their baseline risk profiles when compared to men.ConclusionsThe progress in the treatment strategies has helped to achieve better survival rates in STEMI patients. However, the ongoing changes in clinical characteristics of patients also played an important role, especially in women. Clinicians should focus on modifiable risk factors and post-discharge management to possibly prolong the positive aspects of in-hospital efforts.

P142 Androgen Receptor Reduced Sensitivity is Associated with Cardiovascular Mortality in Men with Type 2 Diabetes - A 14-year Follow up Study

P142 Androgen Receptor Reduced Sensitivity is Associated with Cardiovascular Mortality in Men with Type 2 Diabetes - A 14-year Follow up Study

Analysis of National Health and Insurance Registers for All-Cause Mortality in Patients with Heart Failure with and without Diabetes Mellitus in Poland in 2012.

BackgroundThis retrospective study aimed to analyze all-cause mortality in patients with heart failure with and without diabetes mellitus in 2012 in Poland using data from the National Health Fund [Narodowy Fundusz Zdrowia] (NFZ), the Central Register of the Insured [Centralna Baza Ubezpieczonych] (CBU), and the Polish Universal Electronic System for Registration of the Population (PESEL).Material/MethodsBetween 1st January 2012 and 31st December 2012, data were analyzed from the NFZ, CBU, and PESEL to include all patients with a primary diagnosis of heart failure, with and without diabetes mellitus and all-cause mortality data. Structured Query Language (SQL) was used to retrieve and manage data from NFZ, CBU, and PESEL.ResultsIn Poland, 32.58% of 201,586 patients with a primary diagnosis of heart failure who died in 2012 also had a diagnosis of diabetes mellitus. The overall mortality rate in men with heart failure and diabetes was eight times higher than for men with heart failure without diabetes. The overall mortality rate in women with diabetes and heart failure was 5.5 times higher compared with women with heart failure without diabetes. More than 90% of deaths in female patients with heart failure, with or without diabetes, occurred in women >60 years. For male patients with heart failure with or without diabetes, 70% of deaths occurred in men >60 years.ConclusionsThese findings support the need for continued prevention programs, early diagnosis, and treatment of diabetes, and highlight the increase in mortality for patients with heart failure and diabetes.

Characteristics of Renal Cell Carcinoma Patients in RSUD Dr Soetomo Surabaya in 2014-2017

Renal Cell Carcinoma is a type of malignant renal tumour. According to GLOBOCAN 2012 data, it ranked 17th on the most common malignancy in Indonesia with an incidence rate of 1.5 per 100000 citizens. Mortality rates for men is 1.6 per 100000, while it is 0.8 per 100000 case for women. The clinical symptoms of flank pain, flank mass, and hematuria, are usually only found in patients with later stages of cancer development. This descriptive study aims to present data on characteristics of Renal Cell Carcinoma patients. Data were collected from histopathological medical records of RSUD Dr. Soetomo Surabaya. We found that 25 of 40 patients are male, with most patients aged between 50 to 59 at time of diagnosis. Majority of patients worked as a private sector worker, and had high school level education. They presented with stage 2 tumour, with Clear Cell Renal Cell Carcinoma subtype. All 40 patients were treated by Radical Nephroctomy.
 
 Keywords: renal cell carcinoma; characteristics

Cost-effectiveness analysis of PSA-based mass screening: Evidence from a randomised controlled trial combined with register data.

In contrast to earlier studies which have used modelling to perform cost-effectiveness analysis, this study links data from a randomised controlled trial with register data from nationwide registries to reveal new evidence on costs, effectiveness, and cost-effectiveness of organised mass prostate-cancer screening based on prostate-specific antigen (PSA) testing. Cost-effectiveness analyses were conducted with individual-level data on health-care costs from comprehensive registers and register data on real-world effectiveness from the two arms of the Finnish Randomised Study of Screening for Prostate Cancer (FinRSPC), following 80,149 men from 1996 through 2015. The study examines cost-effectiveness in terms of overall mortality and, in addition, in terms of diagnosed men's mortality from prostate cancer and mortality with but not from prostate cancer. Neither arm of the FinRSPC was clearly more cost-effective in analysis in terms of overall mortality. Organised screening in the FinRSPC could be considered cost-effective in terms of deaths from prostate cancer: averting just over one death per 1000 men screened. However, even with an estimated incremental cost-effectiveness ratio of below 20,000€ per death avoided, this result should not be considered in isolation. This is because mass screening in this trial also resulted in increases in death with, but not from, prostate cancer: with over five additional deaths per 1000 men screened. Analysis of real-world data from the FinRSPC reveals new evidence of the comparative effectiveness of PSA-based screening after 20 years of follow-up, suggesting the possibility of higher mortality, as well as higher healthcare costs, for screening-arm men who have been diagnosed with prostate cancer but who do not die from it. These findings should be corroborated or contradicted by similar analyses using data from other trials, in order to reveal if more diagnosed men have also died in the screening arms of other trials of mass screening for prostate cancer.

Suicide mortality and its income-based inequalities in Korea, 2005-2017

Abstract Backgrounds The suicide mortality rate in Korea has been the highest in the Organization for Economic Co-operation and Development countries between 2003 and 2016. The trends of suicide mortality and its inequalities according to socioeconomic positions provide important information in establishing suicide prevention policies. This study investigated trends in suicide mortality and its income-based inequalities in Korea between 2005 and 2017. Methods Data from 2005-2017 National Health Insurance Database individually linked with cause-of-death data of Statistics Korea were employed. A total of 164,412 suicidal deaths from 574,610,162 subjects aged 10 or over were analyzed. Age-standardized suicide mortality rates were calculated by the calendar year, sex, and income quintiles. The slope index of inequality was calculated as an absolute measure for inequality and relative index of inequality was used as a relative inequality measure. Results The suicide mortality in Korea increased from 29.3 per 100,000 in 2005 to 33.3 in 2011, then decreased to 23.1 in 2017. Suicide mortality rates in men were more than twice as high as the rates in women and the gender gap remained throughout the period. The lower income-level, the higher the suicide mortality rate, especially in men. The absolute inequality in suicide measured by the slope index of inequality has changed as the suicide mortality rate fluctuated, but the relative inequality in suicide has increased since 2012. Conclusions The suicide mortality in Korea has increased due to the global financial crisis and copycat suicide following celebrity suicides in 2008, but it has decreased since the paraquat ban in 2011-12. Despite the recent decline in suicide mortality, the gap between income quintiles did not change meaningfully during the study period. In particular, the magnitude of relative inequality has increased. Progressive national policies should be implemented to reduce suicide mortality and its income gaps. Key messages Despite the recent decline in suicide mortality in Korea, the income-based inequalities in suicide did not change meaningfully. The magnitude of relative inequalities has increased recently.

P640Sex differences in cardiovascular and all-cause mortality in middle-aged and older participants of a medically-supervised exercise program

Abstract Background Physical inactivity has been shown to be associated with all-cause mortality in both healthy and unhealthy middle-aged and older individuals. While regular exercise is equally recommended for men and women, it is virtually unknown if sex influences the long-term survival among participants of a medically-supervised exercise program (MSEP). Purpose To evaluate if cardiovascular and all-cause mortality differs between men and women who participates in a MSEP. Methods Retrospective data from an open cohort of individuals aged 36 to 85 years old (66% men) who participated in a private MSEP between March 1994 and December 2018 were analyzed. The participants were free to attend the exercise sessions anytime from 6 a.m. to 9:30 p.m. (Monday to Friday) or 7 a.m. to 4 p.m. (Saturday). In median, the participants completed 47 sessions (1 to 5992 sessions) and attended for 6 months. Exercise sessions last between 60–80 minutes on average and included aerobic, muscle power, flexibility and balance exercises for all participants. Depending on clinical condition, gross and fine motor coordination, inspiratory muscle and isometric handgrip training were also performed under direct supervision of a multiprofessional team. Before each exercise session, the participant was briefly assessed by the exercise physician amd the aerobic exercise part was individually prescribed based on pre-participation evaluation/previous session data. Kaplan-Meier survival curves were separately determined for men and women - cardiovascular and all-cause mortality - and statistically compared by log rank test. Results Men and women had identical mean ages of 62.5 years-old (p>0.99) and median follow-up was 11 years, ranging from 0.1 to 24.8 years. From a total of 2,238 participants wit different disorders (68% with coronary artery disease), 465 died (21%), with almost three times higher death rate for men (15.1%) as compared to women (5.7%) (p<0.001). Cardiovascular deaths were 27% of total and also proportionally more frequent in men than women (HR 0.63, 95% CI 0.44–0.9; p=0.012). Women had a higher long-term overall survival rate than men (83% vs. 77%, respectively, HR 0.66, 95% CI 0.55–0.80; p<0.001). Conclusion Long-term cardiovascular and all-cause mortality were much higher in men than women that participated in a MSEP and these differences could not be explained by age. Future studies are needed to explain these findings and to analyze if men and women in MSEP would need similar dose of exercise for better survival benefit. Acknowledgement/Funding CNPq/FAPERJ/Health State Secretary

Mortality pattern trends and disparities among Chinese from 2004 to 2016

BackgroundWith the changes in environmental, medical technique, population structure and national health projects, human mortality rates have undergone great changes all over the world. According to “World Health Statistics 2016: Monitoring Health for the SDGs (Sustainable Development Goals)”, we can draw a globally vision about life expectancy and cause of death; also, significant inequality still persists within and among countries. This study was designed to research into the trend of mortality pattern in China, evaluate the disparities of age-specific and disease-specific mortality rates between male and female, and provides a scientific basis for further prevention strategies and policies design.MethodsData from the Chinese Disease Surveillance Points system were used to calculate crude and age-adjusted death rates, annual percent changes (APC) for men and women during 2004 to 2016. Age-standardized mortality rates (ASMR) were performed through the direct method with the World Health Organization’s World Standard Population. APC, according to log linear model, was adopted to describe the mortality rate trend. The χ2 test was used to compare differences between age-specific and cause-specific mortality rates of men and women. Data analysis and figures were completed by R software.ResultsThe mortality rates of men and women have decreased significantly (P < 0.05) during 2004–2016, and the APC were1.98 and 2.45%, respectively. In 2016, the crude mortality rate (CMR) and ASMR in all causes of death were 658.50 and 490.28 per 100,000 per year, respectively. The 5 leading causes of death were malignant neoplasm, cerebrovascular disease, heart disease, COPD, and accidental injury. The mortality rates of men were higher than that of women in all age groups.ConclusionsThere are severe health gaps and disparities between male and female, and the chronic non-communicable diseases continue to be a serious health threat to Chinese residents.

Pathologic Upgrading and Mortality in Men with Low-Risk Prostate Cancer Treated with Radical Prostatectomy

Pathologic Upgrading and Mortality in Men with Low-Risk Prostate Cancer Treated with Radical Prostatectomy

Sex Hormone Binding Globulin: A Review of its Interactions With Testosterone and Age, and its Impact on Mortality in Men With Type 2 Diabetes.

The age-related fall in male testosterone levels can have clinical consequences. The concentration of serum-free testosterone, the putative bioactive moiety, is mediated by carrier proteins, especially SHBG. The aim of this study was to consider the nature of hormone binding to carriers with new insights into determining calculated free testosterone levels and review how SHBG and testosterone influence age-related mortality. Where possible, we focused on recent literature describing binding of testosterone to carrier proteins or, associations among age, SHBG, testosterone, and mortality. We then used logistic regression to study the impact of SHBG and total testosterone on age-related mortality in men with type 2 diabetes mellitus (T2DM). The association between mortality and age and SHBG and/or total testosterone was determined in a cohort of 364 men with T2DM leading to a graphical display of the impact of SHBG/testosterone levels on age-related mortality. Low total testosterone and high SHBG are independently associated with increased all-cause mortality. Our analyses support these findings showing that men with T2DM and a combination of total testosterone <12 nmol/L and SHBG >35nmol/L (odds ratio [OR]: 3.05; 95% CI: 1.43-6.53; P= .004) demonstrated an increased risk of mortality, independent of age (OR: 1.08; 95% CI: 1.06-1.11; P < .001). We graphically demonstrated that the risk combination altered the relationship between age and mortality. Until free testosterone is precisely, accurately, and conveniently measured, calculated values may provide useful even if somewhat inaccurate estimates. We also suggest that SHBG and testosterone assays are standardized to allow establishment of diagnostic and treatment thresholds. Although it is possible that the association in men with T2DM, among the combination of SHBG and total testosterone and age-related mortality is driven by free hormone levels, it is so far, unproven. Sudarshan Ramachandran, Geoffrey I. Hackett, Richard C. Strange, etal. Sex Hormone Binding Globulin: A Review of its Interactions With Testosterone and Age, and its Impact on Mortality in Men With Type 2 Diabetes. Sex Med Rev 2019;7:669-678.

Civilization and Sport in Colombia’s Drive to Modernization

This paper discusses the manner in which modern spectator sports developed in Colombia in the decade of the 1920s as part of the country’s efforts to modernize. An examination of the dominant theories of the diffusion of European sports to the Latin American elites and eventually to the populace as a technique for social control is undertaken. Scant immigration into the country as well as high mortality rates for men and women resulting from civil war and disease make Colombia a case of special interest. Rather than the introduction of a single sport, we embark on an analysis of leisure, scouting, gymnastics, and sports to describe the matrix from which sporting practices develop. A careful examination of the 1920s press reports allows for a careful description of the roots of these physical activities, the emergence of a new social actor, the sportsperson, and the role of state regulation in the field of sports.

Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study.

Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single-time point consumption assessments and minimal confounder adjustments. We report on 16years of follow-up from the Health and Retirement Study (HRS) cohorts born 1931 to 1941 (N=7,904, baseline mean age=61, SD=3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time-varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time-invariant confounders included baseline age, education, sex, and race. After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR=0.74, 95% CI: 0.60 to 0.91; women: HR=0.82, 95% CI: 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with ~4-fold increases in mortality rates for men and ~9-fold increases for women to change the results. There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large-scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age.

Testicular Cancer mortality in Brazil: trends and predictions until 2030

BackgroundDespite the fact that testicular cancer presents good prognosis, wide variations in mortality rates have been reported internationally. In Brazil, mortality trends and estimates have not been fully assessed. The objective of the study presented herein is to analyze the mortality trends for testicular cancer in Brazil in the period 2001–2015 and calculate mortality predictions for the period 2016–2030.MethodsThis is a population-based ecological study that utilized information of the Mortality Information System, on testicular cancer-related deaths in Brazil. Mortality trends were analyzed by Joinpoint regression, and Nordpred was utilized for the calculation of predictions.ResultsThe mortality rate for men, standardized to the world population, varied between 0.36/100,000 for the year 2001, to 0.41/100,000 for the year 2015. There was an increasing trend for Brazil (APC = 1.3% CI95% 0.6; 2.0) and the Southeast region (APC = 1.5% CI95%0.2; 2.7). When analyzing Brazilian data for the period 2016–2030, predictions indicate 2888 deaths due to testicular cancer, which corresponds to a 26.6% change when compared to the 2011–2015 period. This change is mostly explained by an increase in the risk of death (14.2%) when compared with modifications in the demographic structure (12.4%).ConclusionsTesticular cancer mortality in Brazil presents increasing trends, and until 2030 these rates continue to increase.

Mortality after osteoporotic hip fracture: incidence, trends, and associated factors

BackgroundIt is known that mortality after hip fracture increases compared to the general population; the trend in mortality is a controversial issue.The objective of this study is to examine incidence, trends, and factors associated with mortality in patients with osteoporotic hip fractures.MethodsThis is a retrospective cohort study that uses the Registry for Hospital Discharges of the National Health System of our hospital. Patients older than 45 having an osteoporotic hip fracture between 1999 and 2015 were identified. Demographic data and comorbidities were obtained. A survival analysis was performed (Cox regression and Kaplan-Meier). Incidence rate, standardized death rate (SDR), trend (Poisson regression), and risk (hazard ratio) were calculated.ResultsDuring 1999–2015, in our hospital, there were a total of 3992 patients admitted due to osteoporotic hip fracture. Out of these 3992 patients, 3109 patients (77.9%) were women with an average age of 84.47 years (SD 8.45) and 803 (22.1%) were men with an average age of 81.64 years (SD 10.08). The cumulative incidence of mortality was 69.38%. The cumulative mortality rate for 12 months was 33%. The annual mortality was 144.9/1000 patients/year. The 1-year mortality rate increased significantly by 2% per year (IRR 1.020, CI95% 1.008–1.033). The median overall survival was 886 days (CI95% 836–951). The probability of mortality density for a period of 10 years following a hip fracture was 16% for women and 25% for men (first 90 days). The SDR was 8.3 (CI95% 7.98–8.59). Variables that showed statistically significant association with mortality were aged over 75, masculine, institutionalization, mild to severe liver disease, chronic kidney disease, COPD, dementia, heart failure, diabetes, the Charlson Index > 2 , presence of vision disorders and hearing impairment, incontinence, and Downton scale.ConclusionsFor the last 17 years, an increase of mortality for patients with hip fracture and a higher mortality rate in men than in women were observed. Institutionalization combined with comorbidities is associated with a higher mortality.

Abstract 787: Aberrantly increased expression of ZIC2 is correlated with altered cellular metabolism in prostate cancer

Abstract Prostate cancer incidence and mortality rates are consistently reported to be higher in American men of recent African ancestry when compared to American men of recent European or Asian ancestry. However, actionable factors contributing to these different rates remain undefined. In order to identify common molecular events to assist in the design of interventions aimed at prevention and treatment of lethal prostate cancer, we analyzed existing public RNA-Seq data and report that Zic family member 2 (ZIC2) RNA levels are significantly higher in prostate and other cancers. ZIC2 encodes a C2H2 zinc finger domain containing protein that is expressed during embryonic development in metazoans. Altered ZIC2 expression results in holoprosencephaly in humans. The ZIC2 locus also encodes several RNA species that have been co-purified with members of the polycomb repressive complex 2 (PRC2). In prostate cancer, we found that ZIC2 levels correlated significantly with primary cancer grade, i.e., the highest ZIC2 expression was found in lethal, metastatic prostate cancer. Therefore, we hypothesize that increased ZIC2 contributes to cancer initiation and progression. To establish models for identifying functional roles for ZIC2 in cancer, we targeted the first exon in ZIC2 by CRISPR/Cas9, with the intent of abrogating ZIC2 expression. We established clonal cell lines from PC-3, E006AA-Par and 293T cells with mutant ZIC2 loci. ZIC2 mutant cells displayed significant decreases in proliferation and altered phenotypes. RNA-Seq revealed expression patterns consistent with reduced glycolysis and increased oxidative phosphorylation, as well as many altered signaling pathways, in cells with ZIC2 mutations. Metabolism was monitored by extracellular flux analysis and revealed increased oxygen consumption and significantly higher respiration rates in ZIC2 mutant cells. ZIC2 localization to mitochondria was predicted using computational methods and confirmed by sub cellular fractionation and immunoblot analysis as well as by GFP-tagged microscopy. JC-1 fluorescence indicated increased mitochondrial membrane potential in ZIC2 mutant cells. We present these results and suggest that ZIC2 promotes anabolic metabolism consistent with embryonic development and cancer cell proliferation. We found that altering ZIC2 expression in PC-3 cells increased oxidative phosphorylation and produced a 5X increase in the number of apoptotic cells. Our results suggest that ZIC2 expression contributes to the cancer phenotype, given that altered cellular energy metabolism and evasion of apoptosis are defining characteristics of nearly all cancers. We further propose that the targeted inhibition of ZIC2 in cancer cells will decrease mortality rates in men diagnosed with lethal prostate cancer. Citation Format: Nathan J. Bowen, Alira Danaher. Aberrantly increased expression of ZIC2 is correlated with altered cellular metabolism in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 787.

Abstract 625: Association between obesity and prostate cancer disease risk and mortality among African American men

Abstract Prostate cancer (PCa) is a major cause of cancer death in U.S. men. Age-adjusted mortality rates for men of African ancestry (40.8 per 100,000) are more than twice that of men of European ancestry (18.2 per 100,000). Men of African ancestry are more likely to have advanced stage cancer at diagnosis and lower prostate cancer survival rates relative to men of European ancestry of similar age and stage at diagnosis. Risk factors that may explain this survival disparity remain poorly understood. Obesity, a major risk factor for cancer development, aggressiveness and progression, disproportionately affects US men of African ancestry. Age-adjusted prevalence of obesity are higher among men of African ancestry (38.0%) compared to men of European ancestry (34.7%). While it has been previously suggested that obesity may worsen disease-related outcomes among prostate cancer patients, the relationship of obesity and prostate cancer mortality remains unclear, with studies showing mixed or null results in men of African ancestry. Less is known about the underlying biological mechanisms that may contribute to the racial differences observed in the link between obesity and prostate cancer. We previously reported an obesity paradox among African-American men in the NCI-Maryland Prostate Cancer-Case Control Study, with overweight and obese men having a lower risk of being diagnosed with the disease. Here, using Cox proportional hazard regression modeling, we estimated the risk of a PCa mortality for the 976 cases in the study. Our primary analysis suggests an obesity paradox, where obesity may protect against disease mortality among the African-American men. In subsequent analyses, we will examine the role of immune and inflammation markers in mediating or moderating the observed relationship of obesity with PCa in these men. Citation Format: Margaret Saira Pichardo, Tsion Minas, Wei Tang, Tiffany H. Dorsey, Stefan Ambs. Association between obesity and prostate cancer disease risk and mortality among African American men [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 625.

Mortality in working-age population during the Great Recession and austerity in Spain.

ObjectiveTo analyze the mortality trend in Spain before, during and after the economic crisis and austerity policies in the working-age population.MethodsFrom 2005 to 2016 we calculated the annual all-cause mortality rate and the annual mortality rate from the main causes of death in the population aged 15 to 64. We also estimated the linear trends in mortality rates during four time intervals—2005–2007 (before crisis), 2008–2010 (first part of the crisis), 2011–2013 (second part of the crisis and implementation of austerity policies) and 2014–2016 (after the crisis)- by the annual percentage change (APC).ResultsThe all-cause mortality rate in men and women showed the greatest decline in 2008–2010 and the smallest decline in 2014–2016. The decline in 2011–2013 was higher than in 2014–2016. The APCs in 2005–2007, 2008–2010, 2011–2013 and 2014–2016 were -2.8, -4.1, -3.0 and -1.5 in men and -1.0. -2.1, -1.1 and -0.6 in women, respectively, although the APC in 2014–2016 in women was not significant. In 2014–2016, cancer mortality showed the largest decrease, mortality from cardiovascular diseases (men), respiratory diseases and traffic accidents reversed and showed an upward trend, and the downward trend in mortality from infectious diseases and digestive diseases was equal to or greater than that observed before the crisis.ConclusionThe decline in all-cause mortality in the working-age population during the economic crisis and the introduction of austerity measures was greater than that observed before and after the economic crisis. The slowing of the decline after the crisis was due to the reversal of the trend in mortality from cardiovascular and respiratory diseases.

Role of RUNX2 transcription factor in epithelial mesenchymal transition in non-small cell lung cancer lung cancer: Epigenetic control of the RUNX2 P1 promoter.

Lung cancer has a high mortality rate in men and women worldwide. Approximately 15% of diagnosed patients with this type of cancer do not exceed the 5-year survival rate. Unfortunately, diagnosis is established in advanced stages, where other tissues or organs can be affected. In recent years, lineage-specific transcription factors have been associated with a variety of cancers. One such transcription factor possibly regulating cancer is RUNX2, the master gene of early and late osteogenesis. In thyroid and prostate cancer, it has been reported that RUNX2 regulates expression of genes important in tumor cell migration and invasion. In this study, we report on RUNX2/ p57 overexpression in 16 patients with primary non-small cell lung cancer and/or metastatic lung cancer associated with H3K27Ac at P1 gene promoter region. In some patients, H3K4Me3 enrichment was also detected, in addition to WDR5, MLL2, MLL4, and UTX enzyme recruitment, members of the COMPASS-LIKE complex. Moreover, transforming growth factor-β induced RUNX2/ p57 overexpression and specific RUNX2 knockdown supported a role for RUNX2 in epithelial mesenchymal transition, which was demonstrated through loss of function assays in adenocarcinoma A549 lung cancer cell line. Furthermore, RUNX2 increased expression of epithelial mesenchymal transition genes VIMENTIN, TWIST1, and SNAIL1, which reflected increased migratory capacity in lung adenocarcinoma cells.