Population-based Cancer Registry Research Articles

Trends in incidence and survival of childhood cancers in Khon Kaen, Thailand (2000–2019): a population-based Khon Kaen Cancer Registry study

BackgroundIn Thailand, the national health care system and nationwide standard treatment protocols have evolved over time, potentially influencing the trends in the incidence and survival rates of childhood cancers. However, further investigations are required to comprehensively study these trends in Khon Kaen, Thailand.MethodsChildhood cancer patients aged 0–14 years (n = 541) who were diagnosed with one of the five most common cancers between 2000 and 2019 from the population-based Khon Kaen Cancer Registry were enrolled. Descriptive statistics were used to analyse the demographic data, which are presented as numbers, percentages, means, and standard deviations. The trends in incidence between 2000 and 2019, including age-standardized incidence rates (ASRs) and annual percent changes (APCs), were analysed using the Joinpoint regression model. Survival analysis was performed for 5-year relative survival rates (RSRs) according to the Pohar Perme estimator and Kaplan–Meier survival curves.ResultsThe ASRs of the overall top 5 childhood cancer groups were 67.96 and 106.12 per million person-years in 2000 and 2019, respectively. Overall, the APC significantly increased by 2.37% each year for both sexes. The overall 5-year RSRs were 60.5% for both sexes, 58.2% for males, and 63.9% for females. The highest 5-year RSR was for germ cell tumours (84.3%), whereas the lowest 5-year RSR was for neuroblastoma (29.1%).ConclusionsThe incidence and survival rates of childhood cancers in Khon Kaen, Thailand, varied according to sex. The incidence trends increased over time, meanwhile, the relative survival rates rose to satisfactory levels and were comparable to those of other nations with similar financial status. The implementation of national health policies and adherence to national treatment guidelines have improved cancer diagnosis and treatment outcomes.

Trends in patterns of treatment and survival of colorectal cancer patients using cancer registry data in Japan: 1995-2015.

Recent advances in treating colorectal cancer (CRC) have increased the importance of multidisciplinary treatment. This study aimed to clarify trends in the treatment and survival of CRC using population-based cancer registry data in Japan. We analyzed the survival of CRC cases diagnosed from 1995 through 2015 from a population-based cancer registry of six prefectures. The year of diagnosis was classified into five periods, and the trends in the detailed categorization of treatments and survival were identified. We calculated net survival and excess hazard of death from cancer using data on 256,590 CRC patients. The use of laparoscopic surgery has been increasing since 2005 and accounts for the largest proportion of treatment types in the most recent period. Net survival of CRC patients diagnosed after 2005 remained high for laparoscopic surgery and endoscopic surgery (endoscopic mucosal resection or endoscopic submucosal dissection). There was an upward trend in treatment with chemotherapy in addition to open and laparoscopic surgery. Using the excess hazard ratio at the regional stage since 2005, there has been a significant improvement in survival in the younger age group and the rectum cancer group. By type of treatment, there was a tendency toward significant improvement in the open surgery + chemotherapy group. We clarified the trends in treating CRC and the associated trends in survival. Continuous survey based on population-based data helps monitor the impact of developments in treatment.

Breast cancer incidence, stage distribution, and treatment shifts during the 2020 COVID-19 pandemic: a nationwide population-level study

BackgroundThe first COVID-19 wave in 2020 necessitated temporary suspension of non-essential medical services including organized cancer screening programs in Belgium. This study assessed the impact of the pandemic on breast cancer (BC) incidence, stage at diagnosis, and management in Belgium in 2020.MethodsAll Belgian residents diagnosed with in situ or invasive BC in 2015–2020 in the nationwide, population-based cancer registry database were included. Incidence trends for 2015–2019 were extrapolated to predict incidence and stage distribution for 2020 and compared with the observed values. National healthcare reimbursement data were used to examine treatment strategies. Exact tumor diameter and nodal involvement, extracted from pathology reports, were analyzed for 2019 and 2020.Results74,975 tumors were selected for analysis of incidence and clinical stage. Invasive BC incidence declined by -5.0% in 2020, with a drop during the first COVID-19 wave (Mar-Jun; -23%) followed by a rebound (Jul-Dec; +7%). Predicted and observed incidence (in situ + invasive) was not different in patients < 50 years. In the 50–69 and 70 + age groups, significant declines of -4.1% and − 8.4% respectively were found. Excess declines were seen in clinical stage 0 and I in Mar-Jun, without excess increases in clinical stage II-IV tumors in Jul-Dec. There was no increase in average tumor diameter or nodal involvement in 2020. Patients diagnosed in Mar-Jun received significantly more neoadjuvant therapy, particularly neoadjuvant hormonal therapy for patients with clinical stage I-II BC.ConclusionsBC incidence decline in 2020 in Belgium was largely restricted to very early-stage BC and patients aged 50 and over. Delayed diagnosis did not result in an overall progression to higher stage at diagnosis in 2020. Observed treatment adaptations in Belgium were successful in prioritizing patients for surgery while preventing tumor progression in those with surgical delay. Continuation of monitoring BC incidence and stage in the future is crucial.

Practice patterns and survival outcomes for muscle-invasive bladder cancer: real-life experience in a general population setting.

Bladder cancer (BC) is a common malignancy in Europe and North America. Among BCs, muscle-invasive BCs (MIBCs) are distinguished, as they require aggressive treatment due to their spreading potential and poor prognosis. Despite its clinical relevance, little information on MIBC in a general population setting is available. This study aims to report practice patterns and survival outcomes for MIBC patients in a general population setting. MIBCs among BC incidence in 2011 and 2012 recorded in a French population-based cancer registry (810 000 inhabitants) were included in the study. Data were extracted from the medical files. Individual, tumour-related characteristics and initial management including diagnostic tools, multidisciplinary team meeting (MDT) assessment, and treatment delivered were described. Cystectomy, chemoradiation, radiotherapy, and chemotherapy were considered as specific treatments. Matching between MDT decision and the treatment provided was detailed. Management practices were discussed according to the guideline's recommendations. Overall survival (using the Kaplan-Meier method) and net survival (using the Pohar-Perme estimator) were calculated. Among 538 incident BC cases, 147 (27.3%) were MIBCs. Diagnostic practices displayed a relevant locoregional assessment of BC. Almost all cases (n = 136, 92.5%) were assessed during an uro-oncological MDT with a median time from diagnosis of 18 days (first quartile:12-third quartile:32). Discrepancies appeared between MDT decisions and treatments delivered: 71 out of 86 subjects received the recommended cystectomy or chemoradiation (with or without neoadjuvant chemotherapy); 6 out of 11 had the recommended radio- or chemotherapy; and 9 patients did not undergo any specific treatment despite the MDT decision. Cystectomy was the most common treatment performed; the time to surgery appeared consistent with the guideline's recommendations. Forty people only received supportive care. Still, the 5-year overall and net survival was poor, with 19% (13-26) and 22% (14-31), respectively. The 5-year net survival was 35% (23-48) for people who underwent curative-intent treatments. MIBC management remains challenging even for cases assessed during an MDT. Many people did not undergo any specific treatment. Prognosis was poor even when curative-intent therapies were delivered. Efforts to reduce exposure to risk factors such as tobacco smoking and occupational exposures must be maintained.

Abstract PS04-01: Clinical impact of timing of systemic therapy in patients with early triple negative breast cancer

Abstract Introduction TNBC is known for its aggressive nature, with early recurrence and limited treatment options beyond chemotherapy and recently immunotherapy. We aim to clarify, whether timing of systemic therapy has an impact on survival in patients with early TNBC. Methods Data from a large population-based regional cancer registry covering over 2.2 million people was used for evaluation, including women with diagnoses of TNBC between 2010 and 2018. Patients were categorized into subgroups according to the interval from TNBC pathologic diagnosis to the date of first administration of NACT (TTNC) or according to the interval from primary surgery to the date of first administration of adjuvant chemotherapy (TTAC). Univariable analyses of survival rates were conducted using the Kaplan-Meier method, the log-rank test was used for group comparisons. IBM SPSS Statistic 25 was used to perform statistical analysis, with hazard ratios, p-values, and 95% confidence intervals calculated for each model. All tests were two-sided, and significance was set at p &amp;lt; .05. Results We identified 37 382 patients with malignant neoplasms of the mammary gland. The final study cohort included 732 patients with early TNBC, of whom 43.6% were treated with NACT and 40.3% with adjuvant chemotherapy. Timing of NACT 270 patients with TNBC treated with NACT had a valid TTNC. Median follow up was 3.5 years. Patients with TTNC ≤14, ≤42, &amp;gt;42, and &amp;gt;56 days had estimated mean OS of 8.4, 6.9, 4.6, and 3.3 years, respectively. Patients with a TTNC ≤14 days were more likely to survive than patients with a TTNC ≥ 56 days (p= 0.054). Significance was barely not reached in the group of NACT. Timing of adjuvant chemotherapy 245 patients with TNBC treated with adjuvant chemotherapy had a valid TTAC. Treatment given within 22-28 days led to the best outcome with a mean OS of 10.2 years, while later treatment (29-35, 36-42 days, or &amp;gt;6 weeks) had significant reduced mean OS of 8.3, 7.8, and 6.9 years. Patients who received therapy within 22-28 days had significantly better survival than those who received therapy between 29-35 days (p=0.043) or after more than 43 days (p=0.033). Conclusion Although significance was barely not reached in the subgroup of patients treated with NACT, the results in this large population-based study indicate that there are critical time intervals for initiation of systemic therapy in patients with early TNBC, with reduced OS if NACT is applied later than 42 days after diagnosis or if adjuvant chemotherapy is applied later than 42 days after surgery. We recommend not to exceed the 6-week interval until the initiation of systemic therapy in patients with early TNBC. Citation Format: Maria Eleni Hatzipanagiotou, Miriam Pigerl, Michael Gerken, Sophie Räpple, Verena Zeltner, Madeleine Hetterich, Elisabeth C. Inwald, Monika Klinkhammer-Schalke, Olaf Ortmann, Stephan Seitz. Clinical impact of timing of systemic therapy in patients with early triple negative breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS04-01.

Abstract PO5-09-12: Unraveling the Intricacies of Racial Disparities in Breast Cancer in Brazil

Abstract Abstract Background: Over the past three decades, numerous countries have experienced a substantial decrease in breast cancer (BC) fatality, attributed to heightened consciousness, widened and earlier screening, and enhanced therapeutic interventions. However, these advancements have not eradicated the disparity in BC treatment across different racial and ethnic groups. In Brazil, the causes of these disparities are diverse and intricate, resembling health inequalities among ethnic communities observed in other countries. This study aimed to investigate the trends in BC incidence and mortality rates in Brazil, considering clinicopathological and sociodemographic variations, and placing particular emphasis on the severity of racial disparity concerning race/skin color. Patients and methods: Incidence trends for women with BC were analyzed using data from 13 Brazilian Population-Based Cancer Registries covering the period 2010-2015. Crude incidence ratios (CIRs) and the annual average percent change (AAPC) were calculated. Clinical and sociodemographic information from 348 Hospital-Based Cancer Registries spanning from 2000 to 2019 was also utilized. Meanwhile, mortality data for the years 2000-2020 were obtained from the National Mortality Information System. Racial and skin color data were collected through a self-declaration process, following the classification proposed by the Brazilian Institute of Geography and Statistics, which included categories such as white, black, and brown/mixed race. In the analysis, black and brown/mixed race categories were combined as black. Yellow and indigenous categories were excluded. Statistical significance was defined as a p-value less than 0.05. To determine clinically relevant differences, a threshold of more than 5% disparity in proportional values was used as an arbitrary criterion. Results: Between 2010 and 2015, a total of 70,896 newly diagnosed cases of BC were recorded. Mean CIRs were 83.9/100,000 for the overall population, 101.3/100,000 for white women, and 59.7/100,000 for black women. Neither the group of white women (AAPC -1.7; 95% CI: -7.9 to 4.9; p = 0.506) nor the group of black women (AAPC -0.4; 95% CI: -5.0 to 4.5; p = 0.831) exhibited any significant changes in the incidence rate. Black women predominantly originated from underdeveloped regions (56.4%, p &amp;lt; 0.001), were referred by the public healthcare system in Brazil (79.0%, p &amp;lt; 0.001), had ≤ 8 years of schooling (68.7%, p &amp;lt; 0.001), were unmarried (50.9%, p&amp;lt; 0.001), reported alcohol consumption (20.9%, p &amp;lt; 0.001), and were diagnosed with advanced stage disease (60.1%, p &amp;lt; 0.001). The escalation in mortality rates among black women exhibited a notable difference, amounting to 3.8 times the increase observed among white women (AAPC + 2.3; 95% CI: 2.1 to 2.5; p &amp;lt; 0.001) (AAPC + 0.6; 95% CI: 0.5 to 0.7; p &amp;lt; 0.001). Conclusion: Despite the lower incidence of BC in black women compared to their white counterparts, there is a concerning rise in BC-related mortality rates among black women. This group exhibits a significantly unfavorable sociodemographic and clinicopathological profile. These results highlight the pressing need to address the multifaceted factors contributing to these disparities, encompassing socioeconomic disparities and unequal healthcare access. Keywords: Breast cancer; racial disparities; incidence; mortality. Citation Format: Jesse Lopes da Silva, Andreia Cristina De Melo, Mariana Espirito Santo Rodrigues, Lucas Zanetti de Albuquerque, Luiz Claudio Santos Thuler. Unraveling the Intricacies of Racial Disparities in Breast Cancer in Brazil [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-09-12.

Abstract PO2-26-01: Prognostic Role of HER2 Expression in Patients with ER-positive/HER2-negative Breast Cancer. Results from a Population-Based Cancer Registry Study

Abstract Background: Estrogen Receptor (ER)-positive (+)/Human Epidermal Growth Factor Receptor 2 (HER2)-negative (-) breast cancers (BCs) express variable protein levels of HER2, which can influence prognosis. Materials and Methods: This cohort study was conducted using data on all consecutive patients (pts) diagnosed with BC between 2005 and 2017, which were systematically and prospectively collected by the Emilia-Romagna Cancer Registry (Provinces of Piacenza, Parma, Modena, and Ferrara), Italy. The study included 13527 pts with ER+/HER2- BC. Tumors were classified by HER2 IHC score (0 [n=7155], 1+ [n=5186], or 2+ with negative FISH [n=1186]). Comparisons of clinicopathologic characteristics and disease outcome were performed. Results: BCs with late-stage diagnosis, high histological grade, or high proliferative rate were more likely to be HER2 1+ or 2+/FISH- in comparison with earlier stage, low-grade, or low-proliferative tumors (lower bounds of 95% confidence intervals [CIs] for odds ratios [ORs] &amp;gt; 1). BCs with high expression of ER (≥ 80% [n=12383]) were more enriched with HER2 1+ (OR 1.39; 95%CI, 1.2-1.6) or 2+/FISH- tumors (OR 1.26; 95%CI, 1.0-1.6) than ER-low/moderate (1-79% [n=1144]) ones. The 5-year overall survival (OS) for HER2 1+ BCs was lower than that for HER2 0 or 2+/FISH- tumors (P = 0.0018). This finding was confirmed also after stratification by ER status (low/moderate and high expression; P = 0.07 and 0.007, respectively). By multivariate logistic regression, the following variables were significantly associated with HER2 1+, or 2+/FISH- expression compared to HER2 0 tumors: age at diagnosis &amp;lt; 50, high histological grade, ER expression ≥ 80% (lower bounds of 95% CIs for ORs &amp;gt; 1). Multivariate Cox's regression analysis showed that histological grades G2 and G3 were independently associated with poor survival vs. G1 tumors (HR 1.2; 95%CI, 1.1-1.3 and 1.3; 95%CI, 1.1-1.4, respectively). Furthermore, HER2 2+/FISH- status was significantly associated with better survival in comparison with HER2 0 tumors (HR 0.82; 95%CI, 0.7-0.9). This finding was confirmed also after stratification by ER status (ER 1-79% and ≥ 80%). No significant difference in OS was observed between HER2 1+ and 0 BCs. Conclusions: The putative worse prognostic impact of HER2 expression in pts with ER-positive/HER2-negative BCs was not confirmed. The better outcome observed in pts with HER2 2+/FISH- BCs may be related to the known FISH-negative (HER2-non-amplified) status of this subgroup. These findings may help identify optimal patient inclusion criteria for clinical trials with novel anti-HER2 therapies in ER-positive/HER2-negative disease. Citation Format: Antonino Musolino, Olga Serra, Benedetta Pellegrino, Chiara Tommasi, Daniele Zanoni, Fabio Faccini, Maria Michiara, Paolo Sgargi, Giuliano Carrozzi, Stefano Ferretti, Veruska Grossi, Alessandra Ravaioli, Federica Zamagni, Fabio Falcini. Prognostic Role of HER2 Expression in Patients with ER-positive/HER2-negative Breast Cancer. Results from a Population-Based Cancer Registry Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-26-01.

Abstract PO3-09-11: Age Group Analysis of Breast Cancer Patterns in Brazil: Findings from Population-Based Registries

Abstract Background: The rising breast cancer (BC) incidence among young women is potentially influenced by modifiable genetic and reproductive risk factors, as well as the increased incidence among older women may be associated with lifestyle-related factors and screening programs. This study examines BC incidence and mortality rates across different age groups in Brazil, focusing on clinicopathological and sociodemographic variations. Patients and methods: By using data from 13 Brazilian Population-Based Cancer Registries spanning the period 2010-2015, this study analyzed incidence trends among women with BC. Crude incidence ratios (CIRs) and the annual average percent change (AAPC) were computed. Additionally, clinical and sociodemographic information from 348 Hospital-Based Cancer Registries covering 2000-2019 was incorporated. Mortality data for the years 2000-2020 were obtained from the National Mortality Information System. Comparative analyses were conducted across three predefined age groups: &amp;lt; 40, 40-69, and ≥ 70 years. Statistical significance was defined as a p-value &amp;lt; 0.05, while a threshold of more than 5% difference in proportional values was used as a criterion to identify clinically relevant differentials. Results: Between 2010 and 2015, a total of 205,966 newly diagnosed cases of BC were documented. The CIRs were 7.1/100,000 for the age group &amp;lt; 40, 156.5/100,000 for the age group 40-69, and 247.5/100,000 for the age group ≥ 70 years. Within the scope of the analyzed age groups, it was observed that solely the age group &amp;lt; 40 years exhibited a noteworthy and persistent increase in the rate of occurrence (AAPC +1.6; 95% CI: 1.0 to 2.2; p &amp;lt; 0.001). This age group also displayed a significantly higher proportion of black women (53%, p &amp;lt; 0.001), a higher prevalence of alcohol consumption (20.5%, p &amp;lt; 0.001), and a greater likelihood of receiving multiple treatment modalities (60.7%, p &amp;lt; 0.001). In contrast, the age group ≥ 70 years experienced a more extended time delay of &amp;gt; 60 days from diagnosis to treatment onset (54%, p &amp;lt; 0.001), while exhibiting a higher utilization rate of hormone therapy (45.3%, p &amp;lt; 0.01). The mortality rates witnessed a significant increase across all age categories, with the age group &amp;lt; 40 years manifesting the most substantial escalation (AAPC +1.8%; 95% CI: 1.6 to 2.1; p &amp;lt; 0.001). This rise was comparatively more than double the rate observed in the 40-69 age group (AAPC +0.7%; 95% CI: 0.5 to 0.8; p &amp;lt; 0.001) and exactly twice as high as the rate recorded in the age group &amp;gt; 70 years (AAPC +0.9%; 95% CI: 0.7 to 1.1 ; p &amp;lt; 0.001). Conclusion: This study reveals substantial disparities in BC incidence and mortality rates, as well as significant differences in clinicopathological and sociodemographic features, among women aged &amp;lt; 40 compared to those in the 40-69 and ≥ 70 years in Brazil. Keywords: Breast cancer; age groups; incidence; mortality. Citation Format: Jesse Lopes da Silva, Andreia Cristina De Melo, Lucas Zanetti de Albuquerque, Mariana Espirito Santo Rodrigues, Luiz Claudio Santos Thuler. Age Group Analysis of Breast Cancer Patterns in Brazil: Findings from Population-Based Registries [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-09-11.

Global Incidence of Ovarian Cancer According to Histologic Subtype: A Population-Based Cancer Registry Study.

Ovarian cancer can be categorized into distinct histologic subtypes with varying identifiable risk factors, molecular composition, clinical features, and treatment. The global incidence of ovarian cancer subtypes remains limited, especially in low- and middle-income countries (LMICs) without high-quality cancer registry systems. We used data from population-based cancer registries of the Cancer Incidence in Five Continents project to calculate the proportions of serous, mucinous, endometrioid, clear cell, and other histologic subtypes of ovarian cancer. Proportions were applied to the estimated numbers of patients with ovarian cancer from Global Cancer Observatory 2020. Age-standardized incidence rates were calculated. Globally, an estimated 133,818 new patients of serous cancer, 35,712 new patients of mucinous cancer, 29,319 new patients of endometrioid cancer, and 17,894 new patients of clear cell cancer were identified in 2020. The distribution of ovarian cancer histologic subtypes exhibited regional variation. Eastern Europe had the highest rate of serous and mucinous carcinomas, whereas Northern Africa and Eastern Asia had the highest burden of endometrioid and clear cell carcinomas, respectively. This study provides a global incidence landscape of histologic subtypes of ovarian cancer, particularly in LMICs lacking comprehensive registry systems. Our analysis offers valuable insights into disease burden and guidance for tailored strategies for prevention of ovarian cancer.

Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019

Population-based survival studies of adult acute myeloid leukemia (AML) have not simultaneously evaluated age at diagnosis, race and ethnicity, sex, calendar period or AML subtypes/subgroups among chemotherapy-treated patients. For 28,473 chemotherapy-treated AML patients diagnosed at ages ≥20 years in population-based cancer registry areas of the Surveillance, Epidemiology, and End Results Program (2001-2018, followed through 2019), we evaluated 1-month through 5-year relative survival (RS) and 95% confidence intervals (95% CI) using the actuarial method in the SEER∗Stat Survival Session and overall survival (OS) using multivariable Cox regression to estimate proportional hazard ratios (HR) and 95% CI. RS decreased with increasing age (20-39, 40-59, 60-74, 75-84, ≥85 years) at AML diagnosis. RS declined substantially within the first month and, except for acute promyelocytic leukemia, decreasing patterns continued thereafter for core binding factor AML, AML with antecedent condition/therapy, and all other AML. For all ages, acute promyelocytic leukemia RS stabilized after the first year. For total AML the hazard of death was significantly increased for non-Hispanic (NH)-Black (HR=1.18, 95% CI=1.12-1.24) and NH-Pacific Islander patients (HR=1.31, 95% CI=1.11-1.55) compared with NH-White patients. In contrast, NH-Asian and Hispanic patients had similar OS to NH-White patients across all ages and most AML subgroups. Males had significantly inferior survival to females with some exceptions. Compared to 2001-2006, in 2013-2018 OS improved for all age and AML subgroups. Chemotherapy-treated U.S. adults with AML have notable differences in survival by age, race and ethnicity, sex, calendar-year period, and AML subgroup. Despite survival gains over time, our findings highlight the need for improving early outcomes across all AML subgroups, older ages, and Black and Pacific Islander patients and long-term outcomes among most treated groups. Intramural Research Program of the U.S. National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics, and the U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology.

Stage at diagnosis and survival by stage for the leading childhood cancers in Rwanda.

The lack of accurate population-based information on childhood cancer stage and survival in low-income countries is a barrier to improving childhood cancer outcomes. In this study, data from the Rwanda National Cancer Registry (RNCR) were examined for children aged 0-14 diagnosed in 2013-2017 for the eight most commonly occurring childhood cancers: acute lymphoblastic leukaemia, Hodgkin lymphoma (HL), Burkitt lymphoma (BL), non-Hodgkin lymphoma excluding BL, retinoblastoma, Wilms tumour, osteosarcoma and rhabdomyosarcoma. Utilising the Toronto Childhood Cancer Stage Guidelines Tier 1, the study assigned stage at diagnosis to all, except HL, and conducted active follow-ups to calculate 1-, 3- and 5-year observed and relative survival by cancer type and stage at diagnosis. The cohort comprised 412 children, of whom 49% (n=202) died within 5years of diagnosis. Five-year survival ranged from 28% (95% confidence interval [CI]: 12.5%-45.6%) for BL to 68% (CI: 55%-78%) for retinoblastoma. For the cancers for which staging was carried out, it was assigned for 83% patients (n=301 of 362), with over half (58%) having limited or localised stage at diagnosis. Stage was a strong predictor of survival; for example, 3-year survival was 70% (95% CI: 45.1%-85.3%) and 11.8% (2.0%-31.2%) for limited and advanced non-HL, respectively (p<.001). This study is only the second to report on stage distribution and stage-specific survival for childhood cancers in sub-Saharan Africa. It demonstrates the feasibility of the Toronto Stage Guidelines in a low-resource setting, and highlights the value of population-based cancer registries in aiding our understanding of the poor outcomes experienced by this population.

The State of Oncology Care in Russia: Localization Structure Features, Quality of Recording, and Survival of Cancer Patients in the Major Age Groups of the Population (population study). Part 6

Malignant neoplasms are considered among the most serious and prevalent diseases in many countries worldwide. In the course of our research, we conducted a review where we synthesized findings from five scientific articles providing detailed descriptions of age-related patterns of prevalence, structure, and survival among oncology patients. The final population-based study presents a culmination of all identified characteristics of this process, particularly regarding the role of age in the characteristics of prevalence and survival of cancer patients, which holds significant importance. The study utilized data from the International Agency for Research on Cancer (IARC), handbooks from the P. A. Herzen MNIOI and the N. N. Petrov National Medical Research Center of Oncology, as well as data from population-based cancer registries databases from the Saint Petersburg and Northwestern Federal District of Russia. Data processing was conducted using licensed software MS Excel 2013–2016 and STATISTICA 6.1. Modified Eurocare software, alongside mathematical, bibliographic, and statistical methods, was employed for survival calculations. The population-based study allowed for a detailed examination of the dynamics of age-specific indicators of morbidity, mortality, quality of initial patient management for MN, and survival rates of MN patients, consolidating vast datasets from across Russia and the Northwestern Federal District of Russia. All gathered and analyzed data indicate an enhancement in the quality of initial patient management for MN, a reduction in mortality rates, and an increase in survival rates.

Ethnic disparities in breast cancer patterns in Brazil: examining findings from population-based registries.

To investigate breast cancer (BC) incidence and mortality rates among specific racial groups in Brazil. BC incidence was evaluated from 2010 to 2015, using Brazilian Population-Based Cancer Registries, incorporating crude ratios and annual average percentage change (AAPC). Clinical and sociodemographic data from 2000 to 2019 were obtained from Hospital-Based Cancer Registries. Mortality data from 2000 to 2020 were sourced from the National Mortality Information System, comparing White women and Black women. Across 13 Brazilian registries, 70,896 new BC cases were reported from 2010 to 2015. The median BC incidence rate was notably higher for White women (101.3 per 100,000) compared to Black women (59.7 per 100,000). In the general population, non-significant decrease in annual BC incidence was observed (AAPC = - 1.2; p = 0.474). Black women were more likely to live in underdeveloped areas, have lower education levels, live without a partner, and have higher alcohol consumption as compared to White women. A higher proportion of Black women received advanced-stage diagnoses (60.1% versus 50.6%, p < 0.001). BC-related mortality analysis showed 271,002 recorded deaths, with significant increase in BC-specific mortality rates in both racial groups. Black women displayed an AAPC of 2.3% (p < 0.001), while White women demonstrated a moderately elevated AAPC of 0.6% (p < 0.001). This study underscores the need for targeted policies to address disparities in access to early detection and proper treatment, particularly for Black women in underprivileged regions, aiming to improve the survival rates of Brazilian women grappling with BC.

Travel burdens to access care among children with cancer between 2016 and 2019: Analysis of a national population-based cancer registry in Japan.

Centralization of cancer care increases survival but increases the travel burden (i.e., travel durations, distances, and expenditures) in visiting hospitals. This study investigated the travel burdens to access cancer care for children aged 18 years and younger in Japan. The study population comprised 10,709 patients diagnosed between 2016 and 2019 obtained from a national population-based cancer registry in Japan. Their residences were classified as urban or rural. We counted the number of patients treated at specialized hospitals and investigated the treatment centralization across diagnostic groups by Pareto plot. Travel burdens to access care were estimated using a route-planner web service and summarized using median values. A multivariable logistic model was performed to investigate factors associated with the events of car travel duration exceeding 1 h. Of the patients, 76.7% lived in urban areas, and 82.5% received treatment in designated hospitals for childhood cancer. The Pareto plot suggested that the top five hospitals treated 63.5% of patients with retinoblastoma. The estimated travel burdens for all patients were 0.62 h (0.57 h in urban areas and 1.00 h in rural areas), 16.9 km, and 0.0 dollars of toll charges. Regarding travel duration, 21.7% of patients had travel exceeding 1 h, and rural areas, retinoblastoma, malignant bone tumors, and childhood cancer-hub hospitals were associated with travel duration exceeding 1 h (adjusted odds ratios of 6.93, 3.59, 1.94, and 1.91, respectively). Most patients were treated in specialized hospitals and the treatments for specific diseases were centralized. However, most patients were estimated to travel less than 1 h, and the travel burden tended to increase for patients in rural areas, those with specific diseases, and those going to specialized hospitals. Cancer control measures in Japan have steadily improved centralized treatment while keeping the travel burden relatively manageable.

Time trend analysis of rare cancer incidence 2011-2018: Nationwide population-based cancer registries in Japan.

Rare cancers collectively account for a significant proportion of the overall cancer burden in Japan. We aimed to describe and examine the incidence of each rare cancer and the temporal changes using the internationally agreed rare cancer classification. Cancer cases registered in regional population-based cancer registries from 2011 to 2015 and the National Cancer Registry (NCR) from 2016 to 2018 were classified into 18 families, 68 Tier-1 cancer groupings, and 216 single cancer entities based on the RARECAREnet list. Crude incidence rates and age-standardized incidence rates (ASR) were calculated for Tier-1 and Tier-2 cancers. The annual percent change and the 95% and 99% confidence limits for annual ASR for each of the 68 Tier-1 cancers were estimated using the log-linear regression of the weighted least squares method. The differences in ASRs between 2011 and 2018 were evaluated as an absolute change. A total of 5,640,879 cases were classified into Tier-1 and Tier-2 cancers. The ASRs of 18 out of 52 Tier-1 cancers in the rare cancer families increased, whereas the ASR for epithelial tumors of gallbladder decreased. The ASRs of 6 out of the 16 Tier-1 cancers in the common cancer families increased, whereas those of epithelial tumors of stomach and liver decreased. There was no significant change in the incidence of the other 40 Tier-1 cancers. The incidence of several cancers increased due to the dissemination of diagnostic concepts, improved diagnostic techniques, changes in coding practice, and the initiation of the NCR.

Prevalence of survivors of childhood cancer based on a population-based cancer registry in Osaka, Japan.

Although the survival rate of patients with childhood cancer has greatly improved, long-term survivors face specific problems such as the late effects of cancer treatment. In this study, we estimated the number of people who had experienced childhood cancer to predict their needs for medical care and social resources. Using data from the population-based Osaka Cancer Registry, we identified children aged 0-14 years who were diagnosed with cancer between 1975 and 2019. We estimated the prevalence on December 31, 2019, and the 5- and 10-year prevalence (i.e., the number of survivors living up to 5 or 10 years after the diagnosis of cancer) over time. The prevalence proportion was age-standardized using a direct standardization method. The prevalence estimates for Osaka were applied to the national population to determine the national prevalence in Japan. Among 8186 patients diagnosed with childhood cancer in Osaka, 5252 (987 per million) survived until December 31, 2019. The 5-year prevalence per million increased from 194 in 1979 to 417 in 2019 (+116%), while the 10-year prevalence increased from 391 in 1984 to 715 in 2019 (+83%). Based on the long-term registry data, an estimated 73,182 childhood cancer survivors were living in Japan by the end of 2019. The increasing 5-year and 10-year prevalence proportions indicate the continued need for cancer survivorship support for children, adolescents, and young adults. These estimates of the prevalence of childhood cancer survivors, including long-term survivors, may be useful for policymakers and clinicians to plan and evaluate survivorship care.

Trends in the incidence of colorectal cancer in sub-Saharan Africa: A population-based registry study.

In sub-Saharan Africa, colorectal cancer (CRC) has historically been considered a rare disease, although some previous studies have suggested that the incidence is increasing. We examine time trends in the incidence of CRC using data from 12 population-based cancer registries in 11 countries of sub-Saharan Africa that were able to provide time series data for periods of 12 or more years, or with earlier data with which recent rates may be compared. Age-standardized incidence rates were highest in the higher-income countries, and were increasing in all of the populations studied, and these increases were statistically significant in all but three. Current evidence has suggested a link between the increased adoption of western lifestyle habits with colorectal cancer, and along with increasing urbanization of African populations, there is an increase in body weight, as well as evidence of increasing consumption of meat, sugars, and alcohol.

Epidemiology of Uterine Cancer in Sarawak, Borneo, A 20-Year Review.

This study aimed to determine the epidemiology of uterine cancer in Sarawak, Malaysia, using data from a population-based cancer registry. The study population included all women diagnosed with uterine cancer in Sarawak, Malaysia between January 1996 and December 2015. Data on demographic and clinical characteristics were obtained from the Sarawak Cancer Registry. The crude incidence rate, age-standardized incidence rate (ASR), and incidence risk ratios (IRR) were calculated. Joinpoint regression analyses were performed to assess trends in incidence rates. A total of 811 women were diagnosed with primary uterine cancer during the study period. The overall crude incidence rate for uterine cancer in Sarawak for the period 1996-2015 was 3.7 per 100,000. The ASR was 4.4 per 100,000 with a 95% CI (4.1-4.8). The ASR in 2011-2015 is 1.6 times higher than the ASR of uterine cancer in 1996-2000. Higher incidence rates were observed in women aged 40-59 years and those aged 60 years and above. Chinese women had the highest ASR, followed by Malay and Iban women. Joinpoint regression analyses showed a significant increase in cases of uterine cancer among all ethnic groups and age groups. The incidence of primary uterine cancer in Sarawak, Malaysia, has increased over the past 20 years, with higher incidence rates observed in older age groups and among Chinese women. The findings suggest the need for continued efforts to improve the prevention, early detection, and treatment of uterine cancer in Sarawak.

Demographical and Epidemiological Contribution to Cancer Incidence in Delhi and Its Trends from 1991-2015.

Cancer incidences are rising worldwide, and India ranked third globally in cancer incidence as of 2020, according to estimates from GLOBOCAN. The three components that contributed to changes in cancer incidence include cancer-related risk factors, population size, and population structure. The present study aim is to derive the contribution of these factors to cancer incidence and to evaluate their trend from 1991 to 2015. The Data were extracted from the Delhi population-based cancer registry published reports. This longstanding registry covers nearly 100% of the Delhi population. The secular trends of cancer incidence from 1991-2015 were assessed for all sites combined as well as top-five cancer sites among males and females. Joinpoint regression and Riskdiff software were performed to assess the trend among the components of cancer incidence change. Both males and females exhibited nearly equal age-standardised incidence rates over 25 years. Albeit, an overall trend in age-standardised rate was not significant for both sexes (0.68% for males and -0.16% for females) when considering all cancer sites combined. Lung, prostate, oral, and gallbladder cancer exhibits a significant rising trend in the age-standardised rates in males while in females only breast and endometrial cancer showed a rising trend. The cancer counts surged by 252% in males and 208.5% in females from 1991 to 2015. The population size component contributed a 180% increase in males and a 170% increase in females, respectively. The site-specific risk changes were more than 100% for the prostate, oral, and gallbladder cancers in males and endometrial cancer in females. The population structure (aging) contributed to rising cancer incidence varying from 35% to 60% in both genders. A significant contribution to new cancer cases was observed due to a demographical shift in both population size and structure, in addition to plausible cancer-specific risk factors. This transformation could surge a potential burden on the Delhi healthcare system. Persistent endeavours are essential to expand and enhance the existing cancer care infrastructure to meet the rising demand driven by aging and population growth. Implementing a stringent population policy can help to mitigate the impact of population growth on cancer incidence.

Disparities in incidence and survival for patients with Ewing sarcoma in Florida.

Ewing sarcoma (ES) is a malignant bone tumor most commonly affecting non-Hispanic White (NHW) adolescent males, though recognition among Hispanic individuals is rising. Prior population-based studies in the United States (US), utilizing Surveillance, Epidemiology, and End Results (SEER) have shown higher all-cause mortality among White Hispanics, Blacks, and those of low socioeconomic status (SES). Florida is not part of SEER but is home to unique Hispanic populations including Cubans, Puerto Ricans, South Americans that contrasts with the Mexican Hispanic majority in other US states. This study aimed to assess racial/ethnic disparities on incidence and survival outcomes among this diverse Florida patient population. Our study examined all patients diagnosed with osseous ES (2005-2018) in Florida (n = 411) based on the state's population-based cancer registry dataset. Florida Age-adjusted Incidence Rates (AAIRs) were computed by sex and race-ethnicity and compared to the equivalent populations in SEER. Cause-specific survival disparities among Florida patients were examined using Kaplan-Meier analysis. Univariable and multivariable analyses using Cox regression were performed for race/ethnicity, with adjustment for age, sex, year of diagnosis, site of disease, staging, SES, and insurance type. There was a significantly higher incidence of osseous ES in Florida Hispanic males (AAIR 2.6/1,000,000); (95% CI: 2.0-3.2 per 1,000,000; n = 84) compared to the SEER Hispanic males (AAIR 1.2/1,000,000;1.1-1.4 per 1,000,000; n = 382). Older age, distant metastasis, lack of chemotherapy or surgical resection were statistically significant determinants of poor survival while SES, insurance status and race-ethnicity were not. However, among nonmetastatic ES, Florida Hispanics had an increased risk of death compared to Florida NHW (adjusted Hazard Ratio 2.32; 95%CI: 1.20-4.46; p = 0.012). Florida Hispanic males have a higher-than-expected incidence of osseous ES compared to the US. Hispanics of both sexes show remarkably worse survival for nonmetastatic disease compared to NHW. This disparity is likely multifactorial and requires further in-depth studies.