Population-based Cancer Registry Study 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.

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] > 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 < 50, high histological grade, ER expression ≥ 80% (lower bounds of 95% CIs for ORs > 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.

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.

Stage at diagnosis of colorectal cancer in the Middle East and Northern Africa: A population-based cancer registry study.

Colorectal cancer (CRC) is the 2nd most common cancer and 3rd most common cause of death in the Middle East and Northern Africa (MENA) region. We aimed to explore CRC stage at diagnosis data from population-based cancer registries in MENA countries. In 2021, we launched a Global Initiative for Cancer Registry Development (GICR) survey on staging practices and breast and CRC stage distributions in MENA. According to the survey results, population-based data on TNM stage for CRC were available from six registries in five countries (Kuwait, Morocco, Oman, Türkiye, UAE). The proportion of cases with unknown TNM stage ranged from 14% in Oman to 47% in Casablanca, Morocco. The distribution of CRC cases with known stage showed TNM stage IV proportions of 26-45%, while the proportions of stage I cancers were lowest in Morocco (≤7%), and highest (19%) in Izmir, Türkiye. Summary extent of disease data was available from six additional registries and four additional countries (Algeria, Bahrain, Iraq, Qatar). In summary, the proportions of CRC diagnosed with distant metastases in Oman, Bahrain and UAE were lower than other MENA countries in our study, but higher than in European and the US populations. Harmonising the use of staging systems and focusing stage data collection efforts on major cancers, such as CRC, is needed to monitor and evaluate progress in CRC control in the region.

286P Prognostic role of HER2 expression in patients with ER-positive/HER2-negative breast cancer: Results from a population-based cancer registry study

286P Prognostic role of HER2 expression in patients with ER-positive/HER2-negative breast cancer: Results from a population-based cancer registry study

1744P Socioeconomic inequalities in the diagnosis and treatment of colon cancer: A population-based English cancer registry study

1744P Socioeconomic inequalities in the diagnosis and treatment of colon cancer: A population-based English cancer registry study

Prognostic role of HER2 expression in patients with ER-positive/HER2-negative breast cancer: Results from a population-based cancer registry study.

547 Background: Estrogen Receptor (ER)-positive (+)/Human Epidermal Growth Factor Receptor 2 (HER2)-negative (-) breast cancers (BCs) express variable protein levels of both ER and HER2, which can influence prognosis. Methods: We evaluated all invasive ER+/HER2- BCs (n = 3633) that were diagnosed and systematically collected by the Parma Province Cancer Registry, Italy, from 2004 to 2018. Tumors were classified by HER2 (IHC score of 0, 1+ or 2+ with negative FISH) and ER status (ER-low [1-9%], ER-moderate [10-79%] or ER-high [80-100%]). Comparisons of clinicopathologic characteristics and disease outcome were performed. Results: BCs with late-stage diagnosis ( P = 0.04), high histologic grade ( P < 0.0001), or high proliferative rate ( P < 0.0001) were more likely HER2 2+/FISH-. The rate of ER-high BCs did not change from 2675 of 2938 (91%) HER2 0 tumors to 508 of 560 (90.7%) HER2 1+, and 124 of 135 (91.9%) HER2 2+/FISH- tumors. Correspondingly, ER-low BCs were not enriched among HER2 0 tumors compared to the other tumors with different HER2 expression ( P = 0.6). The 5-year overall survival (OS) for HER2 2+/FISH- BCs was lower than that for HER2 0 or 1+ tumors ( P = 0.03). ER-low/moderate tumors were associated with poorer OS in comparison with ER-high BCs ( P < 0.0001). HER2 2+/FISH- status was detrimental to OS among patients (pts) with ER-high tumors ( P = 0.04), while this finding was not observed among ER-low/moderate BCs ( P = 0.21). An interaction between HER2 2+/FISH- expression and ER-high status was found for poorer OS after adjusting for prognostic variables (HR = 1.7; 95% CI: 1.1-2.9). Conclusions: The prognostic role of HER2 expression in pts with ER-positive/HER2-negative BCs seems to be restricted to ER-high tumors, while the worse prognosis of tumors with lower ER expression is not associated with HER2 status. These findings may help identify optimal patient inclusion criteria for clinical trials with novel anti-HER2 therapies in ER-positive/HER2-negative disease.

Epidemiology of Oral Cancer in Taiwan: A Population-Based Cancer Registry Study.

Oral cancer (OC) is one of the most common cancers worldwide, and its incidence has regional differences. In this study, the cancer registry database obtained from 1980 to 2019 was used to analyze the characteristic of incidence of OC by average annual percentage change (AAPC) and an age-period-cohort model. Spearman's correlation was used to analyze the relationship between the age-standard incidence rates (ASR) of OC and related risk factors. Our results showed that the ASR of OC increased from 4.19 to 27.19 per 100,000 population with an AAPC of 5.1% (95% CI = 3.9-6.3, p value < 0.001) in men and from 1.16 to 2.8 per 100,000 population with an AAPC of 3.1% (95% CI = 2.6-3.6, p value < 0.001) in women between 1980-1984 and 2015-2019. The age-period-cohort model reported a trend of rising then declining for the rate ratio in men, with peaks occurring in the 1975 cohort, with a rate ratio of 6.80. The trend of incidence of oral cancer was related to changes in the consumption of cigarettes and alcohol and production of betel quid, with r values of 0.952, 0.979 and 0.963, respectively (all p values < 0.001). We strongly suggest avoiding these risk factors in order to prevent OC.

Incidence trends of oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers among males in Taiwan, 1980–2019: a population-based cancer registry study

In a country with a high prevalence of cigarette smoking, betel chewing, and alcohol drinking, cancers of the oral cavity, nasopharynx, and larynx were the fourth, twelfth and seventeenth leading causes of cancer death, respectively, for men in 2020. We analyzed patients with head and neck cancer from 1980 to 2019 from the Taiwan Cancer Registration Database and discussed the annual average percent change, average percent change, age period, and birth cohort. Obvious period effects and birth effects are seen in oral, oropharyngeal, and hypopharyngeal cancer; however, the most significant period effect was seen between 1990 and 2009, which mainly reflects the consumption of betel nuts per capita. In addition, the period effect lessens after 2010 in oral cancer and hypopharyngeal cancers, while oropharyngeal cancers remain an obvious period effect, which results from the rising prevalence of HPV. Due to the high prevalence rate of betel quid chewing and cigarette smoking in the 1990s, the government executed several acts. As a result, the age-adjusted incidence rates of oral, oropharyngeal, and hypopharyngeal cancers have flattened since 2010, which can be explained by the declining cigarette smoking rate. The strict policy indeed shows an obvious effect on the head and neck cancer incidence rates, and we expect to see a further decline in the future.

Increased incidence of rare cancers and varied age distributions by cancer group: A population-based cancer registry study in Hiroshima Prefecture, Japan

BackgroundEpidemiological characteristics of many types of rare cancers are limited especially in Asia. Therefore, this study aimed to describe the burden and changing time trends of rare cancers in Hiroshima, Japan. MethodsThe internationally agreed RARECAREnet list of rare cancers was used to identify patients diagnosed with cancers from 2005 to 2015 who were registered in the Hiroshima Prefecture Cancer Registry. Quality indicators specific to rare cancers were assessed by cancer grouping. Crude incidence rates (IRs) and age-standardized rates (ASRs) were calculated for 216 single cancers (rare and common) included in the list. A joinpoint regression was used to analyze age distribution and time trends in the ASRs for 12 internationally agreed rare cancer families. Quality indicators, ASRs, and IRs in Japan were identified to examine IR differences and the effects on data accuracy. ResultsThe 231,328 cases were used to calculate the IRs of each cancer. Epithelial tumors in rare families increased with age, but nonepithelial tumors occurred at any age. The proportion of rare cancer families to total cancers was stable. The time trend for families of head and neck cancers (annual percent change and 95 % confidence interval: 2.4 %; 1.2–3.7 %), neuroendocrine tumors (6.6 %; 5.1–8.1 %), and hematological cancers (4.3 %; 3.2–5.5 %) markedly increased. ConclusionThe ASRs of several rare cancers increased because of increased knowledge of these diseases, improved diagnostic techniques, and aggressive diagnoses.

Linearity of Age at Cancer Onset Worldwide: 25-Year Population-Based Cancer Registry Study.

Simple SummaryThe age at cancer onset varies worldwide and is intuitively linked to the age structure of the population originating the cases. The exact amount by which age explains this pattern has been estimated for breast cancer to give clues about the 10-year difference in age at cancer onset between low/middle and high income countries. The age contribution for 20 selected cancer types was calculated, using cancer incidence data from all worldwide cancer registries, through linear regression models. For all cancers but skin, age explained 56% of the pattern in men and 65% in women. The percentages varied by cancer types. Since age at cancer onset is embedded with the age structure of the underlying population, it is possible to avoid misinterpretations of a high frequency of cancer onset in specific age groups by inspecting the age pyramid of the population to check for the plausibility of the excess.Background The linear association between median age at cancer onset and median age of the underlying population has been described only for breast cancer. We quantified the shape and strength of such association for 20 cancer types using data from all population-based cancer registries (CRs) worldwide. Methods The patients’ median age at cancer onset and of the underlying population were extracted from all CRs listed in volumes VI (1983–1987 years) and XI (2008–2012 years) of Cancer Incidence in Five Continents. The association was assessed at cross-sectional level by linear regression models and longitudinally considering only the long-standing CRs active throughout the study period (i.e., 25-year span). Results During 2008–2012, each one-year increase in median population ageing was associated in men with a nearly half year increase of median age at onset of all cancers, but skin; and a 2/3 year increase in women. Variance explained by linear model was around 60%. In long-standing CRs a decrease in median age at cancer onset was observed for prostate and cervical cancers throughout the 25-year span. Conclusions Population ageing reflected 60% of the median age at cancer onset. Misinterpretation of peaks of cancer incidence in specific age groups may be avoided by examining population pyramids.

Secular decreasing trends in gastric cancer incidence in Taiwan: A population-based cancer registry study.

BACKGROUNDGastric cancer remains a leading cause of cancer death worldwide. In Taiwan, gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIMTo evaluate secular trends in gastric cancer incidence according to age, sex, and Helicobacter pylori (H. pylori) treatment in Taiwan.METHODSIn this population-based study, we used the national Taiwan Cancer Registry database. Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan. Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H. pylori infection.RESULTSThe annual percent changes showed continuously decreasing rates of gastric cancer among both males and females. However, the decreasing trends differed by sex, with an annual percent change of -2.58% in males and -2.14% in females. The age-specific incidence rates increased with age. Within the same age group, more recent time periods showed lower incidence rates than greater time periods. Similarly, the sex ratio was lower in later birth cohorts than in earlier birth cohorts. Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H. pylori infection during 2005 to 2016 (r = 0.72).CONCLUSIONWe observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan. These results support H. pylori eradication programs in Taiwan.

Impact of misclassification of Klatskin tumor on incidence of intra- and extrahepatic bile duct cancer: A population-based national cancer registry study

Misclassification of Klatskin tumor as intrahepatic rather than extrahepatic bile duct cancer (eBDC) may overestimate the incidence of intrahepatic BDC (iBDC). However, the effect was insignificant in countries with lower incidence of BDC. Therefore, the impact of misclassified Klatskin tumor on iBDC and eBDC incidences was analyzed in a high endemic country of BDC. The incidence and topography classification of morphology code "Klatskin tumor (8162/3)" from 1999 to 2017 were investigated based on data of the Korea Central Cancer Registry, which covers the entire 51.6 million Korean population. For misclassification analysis, all Klatskin tumor was reclassified as eBDC as proposed in ICD-O-3.2. Klatskin tumor accounted for 13.5% of all 81,414 BDC cases. In the registry, a mean of 59.7% of Klatskin tumor was classified as iBDC, gradually decreasing from 95.5% to 16.9%. Misclassification led to a 17.3% mean overestimation of iBDC cases and a mean underestimation of 15.0% eBDC cases. After reclassification, iBDC and eBDC constituted 46.4% and 53.6% of all BDC, respectively. Age standardized rate (ASR) of incidence per 100,000 population decreased in iBDC from 3.4 to 2.9 and increased in eBDC from 2.8 to 3.2 after reclassification. Average annual percent change of iBDC and eBDC incidences were 2.0% and 1.2%, respectively, but the ASR of iBDC significantly decreased since 2012 (p < 0.0001). Misclassification of Klatskin tumor has remarkable impact on the incidence of iBDC and eBDC in a highly endemic country. The incidence of iBDC and eBDC increased over time but not linearly.

Incidence Patterns of Patients with Two or More Lymphoid Malignancies in a Patient with a Prior History of Lymphoid Malignancy: A Population-Based Cancer Registry Study in Nagasaki, Japan

Background: The occurrence of second or more lymphoid malignancies in a patient with a prior history of lymphoid malignancy or a combination of two different subtypes of lymphoid malignancies at the same time in a patient have been sporadically reported. However, the incidence pattern of such cases in a large number setting has been rarely reported. Therefore, we investigated patients with two or more lymphoid malignancies in a population-based cancer registry.Methods: After approval of the institutional review board, we obtained a dataset of cases with lymphoid malignancies during the periods of 1985-2012 from the Nagasaki Prefectural Cancer Registry (NPCR), which was established in 1974, covers a population of approximately 1.56 million people in Nagasaki, Japan, and is known to be one of the highest data quality of the registry (the death certification only 9% and the proportion of morphological verification 79%). The overall age-adjusted incidence rate of lymphoid malignancies during 1985-2012 was already reported to be 20.5 for men and 12.9 for women (per 100,000 population). In the dataset, the lymphoid malignancies were coded according to the ICD-O-1, -2 and -3 systems. In case those were coded according to the ICD-O-1 and -2 systems, we substituted the corresponding ICD-O-3 code. For cases with undetermined codes, we reviewed the cancer registry sheets or pathological reports as much as possible. Finally, we confirmed all the lymphoid malignancies by ICD-O-3 histology codes 9650-9667, 9670-9699, 9700-9719, 9724-9729, 9731-9734, and 9760-9769. We then extracted cases having two or more histopathologically distinct lymphoid malignancies. We eliminated cases that were apparently considered to be recurrence cases of the first lymphoma. We analyzed the age- and sex-specific frequencies of multiple lymphomas among whole lymphoid malignancies, and characterized the combination pattern.Results: A total of 11,124 cases (male 5,981 cases and female 5,143 cases) of lymphoid malignancies were registered in the NPCR during 1985-2012. Among those, we identified 45 cases (male 27 and female 18) who had two or more different subtypes of lymphoid malignancies at same diagnosed date or at different diagnosed date. The median age at diagnosis of the first lymphoma of the 45 cases was 65.2 years (ranges from 26.6 years to 91.5 years). The overall prevalence of patients having multiple lymphoma among all patients with lymphoid malignancies during the periods of 1985-2012 was 0.40% (95%CI, 0.30-0.54%) for all, 0.45% (95%CI, 0.31-0.65%) for male, and 0.35% (95%CI, 0.21-0.55%) for female. There was no statistically significant difference in the prevalence by sex (Odds ratio, 1.29, P=0.40). Among the 45 cases, a patient was diagnosed as having two subtypes at same date, follicular lymphoma on spleen and Waldenstrom's macroglobulinemia. Another patient had three subtypes of lymphomas at different year; MALT on spleen in 2006, DLBCL on nasal in 2009, and Multiple Myeloma on bone marrow. The rest of the 43 patients developed two subtypes of lymphomas at different date. Median duration between date of the first lymphoid malignancy and date of the second one was 4.0 years (ranges from 0.1 years to 22 years). Among 45 cases, 23 (51.1%) had different cell lineage lymphomas between first and second lymphoma. The frequencies of the major combination pattern of first/second subtypes were as follows; MALT/DLBCL (n=4), MALT/mature T-lymphoma (n=4), DLBCL/ATL (n=3), DLBCL/ mature T-lymphoma (n=3), AILD/mature B-cell lymphoma (n=2), and others. From four patients with first Hodgkin's lymphoma, DLBCL (n=2), MALT (n=1), and ATL (n=1) developed as the second lymphoid malignancies.Conclusion: In the era of improved survival of patients with lymphoid malignancies, hematologists should be aware of the potential development of secondary or more lymphoid malignancies after treatment for first lymphoid malignancies. DisclosuresNo relevant conflicts of interest to declare.

Incidence of Hematopoietic Sarcoma in Iranian Population.

The heterogeneous nature of hematopoietic sarcoma has restricted the diagnosis and treatment of this disease to the extent that annually, several patients lose their lives. Given the lack of comprehensive epidemiologic information on the incidence of hematopoietic sarcoma in the Iranian population, we designed the present study to evaluate the distribution pattern of this disease. In this national population-based cancer registry study, we collected data from patients diagnosed with hematopoietic sarcoma who were registered in the Iran National Cancer Registry (INCR) between 2009 and 2013. For each patient, the variables of age, sex, province, year of diagnosis, site of involvement and morphology were collected. In 45 cases from 18 provinces of Iran, we found that the incidence rate of the disease was 0.60 (95% CI: 0.44-0.80) per million persons. Among all provinces, Ilam had the highest incidence of hematopoietic sarcoma with a rate of 2 (95% CI: 0.05- 11.14) per million persons, while Isfahan had the lowest incidence with a rate of 0.21 (95% CI: 0.01-1.16) per million persons. The incidence rate of the disease increased with age and the disease was slightly more common in men (0.63 [95% CI: 0.41-0.94] vs. 0.56 [95% CI: 0.35-0.86] per million persons). The frequency of hematopoietic sarcoma in connective and soft tissues was higher than other anatomical sites and we found that myeloid morphology was the most prevalent morphology. The resulting data provided a valuable perspective on the distribution pattern of hematopoietic sarcoma in Iran; however, further studies are required to confirm these results.

Impact of changes in the topographic classification of Klatskin tumor on incidence of intra- and extrahepatic bile duct cancer: A population-based national cancer registry study.

Misclassification of Klatskin tumor as intrahepatic rather than extrahepatic bile duct cancer (eBDC) may overestimate the incidence of intrahepatic BDC (iBDC). This study aimed to investigate the impact of misclassified Klatskin tumor on iBDC and eBDC incidences in Korea, where BDC is highly endemic. The data of incidence, topography and morphology code of BDC from 1999 to 2017 were obtained from the Korea Central Cancer Registry, which covers the entire 51.6 million Korean population. For misclassification analysis, all Klatskin tumors were reclassified as eBDC. Klatskin tumors accounted for 13.5% of all 81 414 BDC cases. In the registry, an average of 59.7% of Klatskin tumors were classified as iBDC, gradually decreasing from 95.5% to 16.9%. Misclassification led to a 17.3% overestimation of iBDC cases and a 15.0% underestimation of eBDC cases on average. After reclassification, age standardized rate (ASR) of incidence per 100 000 population decreased in iBDC from 3.4 to 2.9 and increased in eBDC from 2.8 to 3.2. Average annual percentage change of iBDC and eBDC incidences were 2.0% and 1.2%, respectively, but ASR of iBDC significantly decreased since 2012 (P<0.0001). Misclassification of Klatskin tumors has remarkable impact on the incidence of iBDC and eBDC in a highly endemic country.

Incidence Patterns of Sequential or Composite Lymphoma: A Population-Based Cancer Registry Study.

The development of multiple histologic types of lymphoma in a single patient has been sporadically reported as sequential or composite lymphoma. However, the incidence pattern of such patients has been rarely evaluated in a large population-based setting. We investigated the incidence of sequential or composite lymphoma based on 11,174 lymphoma records from a population-based cancer registry between 1985-2012 in Nagasaki Prefecture, Japan. We identified 99 lymphoma records were of 49 independent patients other than relapse. The prevalence of the sequential or composite lymphomas in a single patient was 0.44% (95% confidence interval [95% CI], 0.32-0.56%) without sex difference. Among the 49 patients, five (10.2%) were composite/discordant lymphoma. The most frequent "composite lymphoma" was a combination of diffuse large B-cell lymphomas (DLBCL) and adult T-cell leukemia (n = 3). A case of "discordant lymphoma" was a combination of follicular lymphoma on spleen and Waldenström macroglobulinemia on bone marrow. The rest of the patients (n = 44, 89.8% of all composite lymphoma) were "sequential lymphoma" with various combination of lymphoma subtypes on different dates. The major combination of the sequential lymphoma was DLBCL after marginal zone lymphomas (n = 4). In the era of improved survival of lymphoma patients, hematologists should be aware of the development of additional lymphomas.

Survival of cancer patients in Fujian, Southeast China: a population-based cancer registry study.

Survival rates are usually used to evaluate the effect of cancer treatment and prevention. No study has focused on the characteristic of population-based cancer survival in Fujian, which is regarded as one of the high-risk areas of cancer in China. This study aims to analyze the 5-year relative survival of patients in Fujian Province using population-based cancer registry data. A total of 8 population-based registries in Fujian Province reported cancer cases diagnosed in 2012-2014. Relative survival was calculated as the ratio between observed survival and expected survival. The 5-year relative survival for all cancers combined was 36.19% and the age-standardized 5-year relative survival for all patients was 31.80%. Females had higher relative survival than males (38.90% and 27.00%). The patients in urban areas had higher relative survival than those in rural areas (32.34% and 31.29%). Lung, gastric, liver, colorectal, and esophageal cancers were the five most common cancers, with 5-year relative survival below 50%. This is the first study that evaluated the population-based cancer relative survival in Fujian, China. Our study suggests that the overall survival of cancer patients in Fujian Province is poor. Furthermore, the results of this study can be used as a baseline for further research in Fujian, and provide important evidence for cancer etiology research.

The Survival and Incidence Rate of Ewing Sarcoma; a National Population-based Study in Iran (2008-2015).

The effect of race and ethnicity on some kind of malignant bone tumors including Ewing sarcoma has been proven in different studies. In order to evaluate the latter, national cancer registries may help to increase understanding about potential cancer causes, prevention and control strategies, and apply these findings to control health problems among populations with similar characteristics. A national population-based cancer registry study based on all patients affected by Ewing Sarcoma was registered in the Iran National Cancer Registry (INCR) between 2008 and 2015 was designed. Demographic data of microscopically confirmed cases of bone Ewing sarcoma were registered. Patients with Ewing sarcoma were divided in groups to describe the primary site of the tumor (including axial or appendicular bones) and analyzed. In order to analyze the survival rate, randomized selection of the patient through the INCR data-base was performed. A total of 678 cases of malignant Ewing sarcoma of the bone were identified through the INCR. The mean age of Ewing sarcoma in Iran was 21.53 years. Nearly half of patients were observed at the age group of 15-24. The total crude incidence rate of Ewing sarcoma was 1.29 in 1 million. The mean 5 year survival rate was 47%. The Mean survival rate for study population was 5.53. The crude incidence rate of Ewing sarcoma in Iran is relatively lower with respect to other registries. The majority of patients are in 15-25 years group and shows affection by Ewing sarcoma in an older age. Socioeconomic factors had direct influence on survival rate.

Cholangiocarcinoma Trends, Incidence, and Relative Survival in Khon Kaen, Thailand From 1989 Through 2013: A Population-Based Cancer Registry Study [J Epidemiol 29 (5) (2019) 197-204

Cholangiocarcinoma Trends, Incidence, and Relative Survival in Khon Kaen, Thailand From 1989 Through 2013: A Population-Based Cancer Registry Study [J Epidemiol 29 (5) (2019) 197-204