Prevalence Of Cancer Risk Factors Research Articles

Establishing a cancer registry and baseline data for Nyandarua County, Kenya: A step towards establishing a central cancer registry

Cancer is a major global public health issue, causing a significant number of premature deaths worldwide. In 2020, the World Health Organization reported that more than 19 million individuals were diagnosed with cancer, and over 10 million lost their lives to the disease. Predictions indicate that cancer-related deaths will exceed 30 million by 2030, with around 75 % occurring in low- and middle-income countries (LMICs) like Kenya. Various factors contribute to this concerning trend, including aging populations, a high prevalence of cancer risk factors, socioeconomic disparities resulting in limited healthcare access, and deficiencies in healthcare systems within LMICs. This study focused on Nyandarua County, Kenya, which lacks a dedicated cancer registry. Without comprehensive incidence data, the county faces challenges in developing targeted programs for cancer prevention, management, and control. The main objective of this investigation was to establish a cancer registry specific to Nyandarua County, capable of continuously gathering accurate cancer data, patient treatment follow-ups and disease outcomes. A demographic survey was conducted to determine the frequency of all-cause and specific cancers among patients who attended selected health facilities between 2013 and 2020. Data were collected from existing hospital records in three main hospitals in the county. A total of 1373 cases were recorded, with 54.9 % of patients being female. North Kinangop Catholic Hospital accounted for the largest number of patients (62 %), followed by JM Kariuki County Memorial Hospital (35 %), while Engineer Hospital contributed the remaining 3 %. The top five cancer sites observed in Nyandarua County were esophagus (16.8 %), cervix uteri (13.4 %), stomach (10.6 %), breast (8.8 %), and prostate (8.6 %). Our findings provide valuable insights into the prevalence and distribution of different types of cancer in the region. With the establishment of this cancer registry, Nyandarua County is now among the pioneering counties in Kenya. It is crucial for the county government to undertake the responsibility of continuously updating the registry to draw inferences regarding cancer prevalence in the region to enhance patients follow up and survival.

Mapping the prevalence of cancer risk factors at the small area level in Australia

BackgroundCancer is a significant health issue globally and it is well known that cancer risk varies geographically. However in many countries there are no small area-level data on cancer risk factors with high resolution and complete reach, which hinders the development of targeted prevention strategies.MethodsUsing Australia as a case study, the 2017–2018 National Health Survey was used to generate prevalence estimates for 2221 small areas across Australia for eight cancer risk factor measures covering smoking, alcohol, physical activity, diet and weight. Utilising a recently developed Bayesian two-stage small area estimation methodology, the model incorporated survey-only covariates, spatial smoothing and hierarchical modelling techniques, along with a vast array of small area-level auxiliary data, including census, remoteness, and socioeconomic data. The models borrowed strength from previously published cancer risk estimates provided by the Social Health Atlases of Australia. Estimates were internally and externally validated.ResultsWe illustrated that in 2017–2018 health behaviours across Australia exhibited more spatial disparities than previously realised by improving the reach and resolution of formerly published cancer risk factors. The derived estimates revealed higher prevalence of unhealthy behaviours in more remote areas, and areas of lower socioeconomic status; a trend that aligned well with previous work.ConclusionsOur study addresses the gaps in small area level cancer risk factor estimates in Australia. The new estimates provide improved spatial resolution and reach and will enable more targeted cancer prevention strategies at the small area level. Furthermore, by including the results in the next release of the Australian Cancer Atlas, which currently provides small area level estimates of cancer incidence and relative survival, this work will help to provide a more comprehensive picture of cancer in Australia by supporting policy makers, researchers, and the general public in understanding the spatial distribution of cancer risk factors. The methodology applied in this work is generalisable to other small area estimation applications and has been shown to perform well when the survey data are sparse.

Abstract B053: Rural-urban disparities in cancer risk factors and screening by United States census region

Abstract We examined rural-urban differences in the prevalence of cancer risk factors and screening behaviors across U.S. census regions to better understand variations within and between geographic regions and inform strategies to address rural cancer inequities. Using an ecological cross-sectional design, we examined rural-urban differences in the self-reported prevalence of county-level cancer risk factors (i.e., obesity, physical inactivity, alcohol consumption) and cancer screening behaviors (i.e., breast, colorectal and cervical) ascertained from the Behavioral Risk Factor Surveillance System and National Health Interview Survey (2008-2013) across four U.S. census regions (Northeast, Midwest, South, and West). County-level rurality was defined using 2013 U.S. Office of Management and Budget rural-urban classification codes, and the U.S. Department of Agriculture, Economic Research Service’s rural-urban continuum codes. Chi-square tests assessed differences in the mean prevalence of county-level cancer risk factors and cancer screening behaviors in each geographic region. Analysis of variance (ANOVA) models estimated the p-values for trends in cancer risk factors and screening prevalence across the rural-urban continuum. Within each geographic region, rural counties had a higher prevalence of smoking, obesity and physical inactivity. Yet, rural-urban differences in cancer risk factors were not statistically significant in all geographic regions (e.g., prevalence of obesity for Western rural vs. urban counties was 26.5% vs. 25.7% [p=0.08] and physical inactivity for Northeastern rural vs. urban counties was 23.2% vs. 22.5% [p=0.15]). Moreover, the mean prevalence of obesity was higher in urban areas of the Midwest (31%) and South (31.3%) compared to rural areas in the West (26.5%) and Northeast (29.5%). Binge alcohol use was higher in rural vs. urban counties in the West (19.8% vs. 17.7%; p<0.001) and Midwest (22.3% vs. 21.5%; p=0.006), but lower in the South (13.5% vs. 15.2%; p<0.001). Obesity and smoking prevalence increased with increasing rurality across all regions (ptrend<0.045). Breast, cervical and colorectal cancer screening prevalence were lower in rural vs. urban counties in each geographic region (all p-values<0.04). However, the overall prevalence of screening across all cancer sites was higher in rural Northeast counties compared to both rural and urban counties in the South and West regions. Across all regions, cervical and breast cancer screening decreased with increasing rurality (all ptrend<0.001). A significant inverse trend in prevalence of colorectal cancer screening with increasing rurality was observed in all regions except the Northeast (ptrend=0.17). Our findings suggest notable variations in rural-urban cancer risk factors and screening disparities across U.S. geographic regions. Further exploration of the source of this geographic variation is warranted to ensure the development and implementation of relevant cancer control interventions targeting rural populations most in need. Citation Format: Kelly A. Hirko, Huiwen Xu, Laura Q. Rogers, Michelle Y. Martin, Siddhartha Roy, Kimberly M. Kelly, Shannon M. Christy, Kimlin Tam Ashing, Jean C. Yi, Marquita W. Lewis-Thames, Cathy D. Meade, Qian Lu, Clement K. Gwede, Rachel M. Ceballos, Usha Menon, Katie Cueva, Karen Yeary, Lisa Klesges, Monica L. Baskin, Kassandra I. Alcaraz, Sabrina Ford. Rural-urban disparities in cancer risk factors and screening by United States census region [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B053.

Prevalence of oncopatology risk factors among residents of the Omsk region

Aim. To assessment the prevalence of cancer risk factors in various population groups of the Omsk region.Materials and Methods. The descriptive, cross-sectional epidemiological study included residents of the Omsk region (n = 542) aged 18 to 83 years. To obtain the data, we performed a survey which included questionnaires on the daily patterns and frequency of food consumption, eating habits, and health status. In addition, we assessed the prevalence of smoking, alcohol consumption, physical activity, family history of cancer, overweight.Results. At least one of the studied risk factors was present in 80.1 ± 1.7% of the adult population, including 84.9% of men and 76.3% of women (p = 0.030). The most common factors were: excessive consumption (> 500 g/week) of red and processed meat (55.8 ± 2.1%), overweight (53.6 ± 2.1%), excessive consumption of dietary salt (44.2 ± 2.1%), frequent alcohol consumption (39.3 ± 2.1%), and low physical activity (29.8 ± 2.1%). The smoking was more prevalent in the male population (37.0 ± 3.13%). Although overall alcohol consumption was below the Russian average, excessive alcohol consumption was still found in 21.9% of men and 12.8% of women. The combination of smoking and excessive consumption of alcohol was also more frequent in male population (26.8 ± 2.1%). The proportion of people with consumption of fresh vegetables and fruits < 500 g/day (including potatoes) was 42.6 ± 2.12%. The content of dietary fiber in the diet in an amount < 20 g/day was noted in 57.8 ± 2.1% of the study participants. In men, the average daily salt intake was significantly higher compared to women (6.24 g and 5.20 g, respectively; p = 0.001).Conclusion. The prevalence of cancer risk factors among the residents of the Omsk region was assessed as high and generally does not tend to decrease.

Prevalence of cancer risk factors among transgender and gender diverse individuals: a cross-sectional analysis using UK primary care data.

Transgender and gender diverse (TGD) individuals experience an incongruence between their assigned birth sex and gender identity. They may have a higher prevalence of health conditions associated with cancer risk than cisgender people. To examine the prevalence of several cancer risk factors among TGD individuals compared with cisgender individuals. A cross-sectional analysis was conducted using data from the UK's Clinical Practice Research Datalink to identify TGD individuals between 1988-2020, matched to 20 cisgender men and 20 cisgender women on index date (date of diagnosis with gender incongruence), practice, and index age (age at index date). Assigned birth sex was determined from gender-affirming hormone use and procedures, and sex-specific diagnoses documented in the medical record. The prevalence of each cancer risk factor was calculated and the prevalence ratio by gender identity was estimated using log binomial or Poisson regression models adjusted for age and year at study entry, and obesity where appropriate. There were 3474 transfeminine (assigned male at birth) individuals, 3591 transmasculine (assigned female at birth) individuals, 131 747 cisgender men, and 131 827 cisgender women. Transmasculine people had the highest prevalence of obesity (27.5%) and 'ever smoking' (60.2%). Transfeminine people had the highest prevalence of dyslipidaemia (15.1%), diabetes (5.4%), hepatitis C infection (0.7%), hepatitis B infection (0.4%), and HIV infection (0.8%). These prevalence estimates remained elevated in the TGD populations compared with cisgender persons in the multivariable models. Multiple cancer risk factors are more prevalent among TGD individuals compared with cisgender individuals. Future research should examine how minority stress contributes to the increased prevalence of cancer risk factors in this population.

Breast, Prostate, Colorectal, and Lung Cancer Incidence and Risk Factors in Women Who Have Sex with Women and Men Who Have Sex with Men: A Cross-Sectional and Longitudinal Analysis Using UK Biobank.

There is limited evidence about cancer incidence for lesbian, gay and bisexual women and men, although the prevalence of cancer risk factors may be higher. To describe cancer incidence for four common cancers (breast, lung, colorectal and prostate). This project used UK Biobank participant data. We explored risk factor prevalence (age, deprivation, ethnicity, smoking, alcohol intake, obesity, parity, and sexual history), and calculated cancer risk, for six groups defined based on sexual history; women who have sex exclusively with men (WSEM), or women (WSEW), women who have sex with men and women (WSWM); men who have sex exclusively with women (MSEW), or men (MSEM), and men who have sex with women and men (MSWM). WSEW, WSWM, MSEM, and MSMW were younger, more likely to smoke, and to live in more deprived neighbourhoods. We found no evidence of an association between sexual history and breast, colorectal, or prostate cancer in age-adjusted models. Lung cancer incidence was higher for WSWM compared with WSEM, HR (95%CI) 1.78 (1.28-2.48), p = 0.0005, and MSWM compared with MSEW, 1.43 (1.03-1.99), p = 0.031; after adjustment for smoking, this difference was no longer significant. Sexual minority groups have a higher risk for lung cancer, due to greater exposure to smoking.

Cancer burden and status of cancer control measures in fragile states: a comparative analysis of 31 countries

Information on cancer statistics and cancer control policies is limited in fragile states. This paper describes the cancer burden and status of cancer control measures in these countries. In this comparative analysis, fragile states presenting with a Fragile States Index (FSI) score of 90·0 or more (alert for fragility) for at least 10 years during the 2006-20 period were selected. States with fewer than 10 years of data were selected if they were in alert for fragility during all years. Information on cancer burden, prevalence of cancer risk factors, population-attributable fraction, and on political commitment, health financing, and health system capacity was collected. Cancer incidence and mortality was calculated on the basis of data from population-based cancer registries, estimated with modelling that used mortality-to-incidence ratios and incidence-to-mortality ratios derived from cancer registries in neighbouring countries, or average of rates in selected neighbouring countries. For statistical comparison, fragile states were grouped according to the annual percent change (APC) of the FSI, with group 1 showing an increasing fragility trend (APC 0·2% or higher), group 2 a relatively stable fragility trend (APC between 0·2% and -0·2%), and group 3 a decreasing fragility trend (APC of -0·2% or lower). Overall, the estimated cancer burden in the 31 selected fragile states was lower than worldwide rates, except for cervical and prostate cancer. Cancer cases were attributed to infections (22·40% in group 1, 21·20% in group 2, and 18·80% in group 3) at a higher proportion in fragile states than globally (13·0%). Group 1 and 2 showed a significantly higher exposure to household air pollution (97·70% in group 1 and 94·90% in group 2), whereas current tobacco use in men increased from group 1 to group 3, with lung cancer incidence and mortality being higher in group 3. However, 25 countries had implemented only one or no MPOWER measures for tobacco control. Countries showed an out-of-pocket expenditure of 48·72% in group 1, 42·68% in group 2, and 51·07% in group 3, and only half of the countries had an updated cancer control plan or cancer management guidelines. Fragile states have started the epidemiological transition but are still not implementing enough cancer control measures. There is a need to develop reliable cancer control plans and guidelines, and to create financial mechanisms for implementation. None. For the Arabic and French translations of the abstract see Supplementary Materials section.

Cancer disparities in the context of rurality: risk factors and screening across various U.S. rural classification codes.

Prior cancer research is limited by inconsistencies in defining rurality. The purpose of this study was to describe the prevalence of cancer risk factors and cancer screening behaviors across various county-based rural classification codes, including measures reflecting a continuum, to inform our understanding of cancer disparities according to the extent of rurality. Using an ecological cross-sectional design, we examined differences in cancer risk factors and cancer screening behaviors from the Behavioral Risk Factor Surveillance System and National Health Interview Survey (2008-2013) across rural counties and between rural and urban counties using four rural-urban classification codes for counties and county-equivalents in 2013: U.S. Office of Management and Budget, National Center for Health Statistics, USDA Economic Research Service's rural-urban continuum codes, and Urban Influence Codes. Although a rural-to-urban gradient was not consistently evident across all classification codes, the prevalence of smoking, obesity, physical inactivity, and binge alcohol use increased (all ptrend < 0.03), while colorectal, cervical and breast cancer screening decreased (all ptrend < 0.001) with increasing rurality. Differences in the prevalence of risk factors and screening behaviors across rural areas were greater than differences between rural and urban counties for obesity (2.4% vs. 1.5%), physical activity (2.9% vs. 2.5%), binge alcohol use (3.4% vs. 0.4%), cervical cancer screening (6.8% vs. 4.0%), and colorectal cancer screening (4.4% vs. 3.8%). Rural cancer disparities persist across multiple rural-urban classification codes, with marked variation in cancer risk factors and screening evident within rural regions. Focusing only on a rural-urban dichotomy may not sufficiently capture subpopulations of rural residents at greater risk for cancer and cancer-related mortality.

Cancer Prevention Behaviors in Workers of a Referral Cancer Center in Mexico City: A Pilot Study on Early Detection Awareness for Cancer.

BackgroundPrevention strategies for cancer are necessary. Health workers who often serve as role models bear responsibility for prevention counseling and programs. However, whether their habits and behaviors reflect prevention goals are unknown. We describe the prevalence of cancer risk factors and prevention behaviors in health workers of a referral cancer center in Mexico City.MethodsCross-sectional study in which workers of the National Cancer Institute were invited to participate in a prevention program, risk factor survey, and nutrition, psychological, and genetic counseling were included. The likelihood of cancer was calculated based on the presence of risk factors. Factors associated with prevention behaviors were identified by logistic regression.ResultsWe recruited 301 workers; 77% were women. The median self-reported BMI was 26.4 kg/m2, 9.97% smoked, 78% drank alcohol, and 89% did not get at least 150 min/week of physical activity. In women, age (OR = 1.3 95%CI 1.01-1.06) and physical activity of 150 min/week (OR = 2.52 95% CI 1.28-4.96) were associated with cancer prevention behaviors. No risk factors were associated with healthy behaviors among men.ConclusionHealth workers may have unhealthy lifestyles and behaviors, is essential to create supportive environments to promote cancer prevention counseling and programs effectively.

Examining prevalence of cancer risk factors across Ontario for the Ontario Cancer Profiles tool

The Ontario Cancer Profiles is an interactive dashboard for the public containing population-level cancerstatistics created by Ontario Health (Cancer Care Ontario). The tool contains data on cancer burden, cancerscreening measures, and cancer risk factors by Local Health Integration Network (LHIN) and Public Health Unit (PHU). It can be used for health system planning, measuring health systems performance, monitoring the impact of interventions, and to help identify new areas of research. There were 9 new modifiable cancer risk factors proposed to be included in future updates of the dashboard. The proposed risk factors include: access to care, active transportation, binge drinking, alcohol abstinence, inadequate fruit consumption, inadequate vegetable consumption, sedentary behaviour, second-hand smoke exposure, and sun safety. My practicum consisted of two main objectives: to conduct a literature review on the association between the proposed risk factors and cancer and to determine the prevalence of exposure of the identified risk factors in Ontario using 2015 to 2017 CCHS data. I performed a literature review to examine current evidence linking each proposed risk factor with cancer risk to determine the inclusion or exclusion of the indicator in the analysis. An analysis was performed with the selected variables in CCHS. Each indicator was age-standardized, and both standardized and crude ratios of individuals engaging in selected indicator activities were calculated. The results were examined for reliability using the produced coefficient of variation values. The estimates for each risk indicators allowed for the identification of target population that may be at higher risk of developing cancer due to greater exposure to the risk factors. They also serve as useful predictors for areas of improvement in regions with a high prevalence, such as healthy living within the community, and a guide to implementing preventative measures, screening, or treatment plans that may have been lacking.

Enhancing the Awareness of Modifiable Risk Factors for Cancer Prevention in the Alabama Black Belt Region: A Follow-up Study.

We determined the profile of participants in the multi-level annual marathons held in Alabama Black Belt counties in terms of lifestyle characteristics and considered how these characteristics relate to a family history of cancer. Data on socioeconomic, health, and lifestyle characteristics of respondents were collected during the Annual Healthy Lifestyle Marathons of 2013-2019. These events were five miles in length and allowed participants to walk, bike, or run. Characteristics of respondents were compared using frequencies, percentages, and cross-tabulations. Most of the respondents with a family history of cancer were within the 18 to 24-year age category; had an annual income in the range of under U.S. $10,000; had received some college training; reported their overall health as good; and were African American. Although low consumption of fruits and vegetables has a demonstrated association with being diagnosed with cancer, in 2019 only 43% of respondents reported frequent intake of fruits and vegetables. Community-based health programs are critically needed to improve health in rural Black Belt communities.

Abstract PO-258: Cancer risk factors and screening across various U.S. rural classification codes: Cancer disparities in the context of rurality

Abstract Incidence and mortality of many preventable cancers are higher in rural compared to urban U.S. regions. However, prior research is limited by methodological inconsistencies in defining rurality, and has largely focused on a rural-urban dichotomy which ignores potential variability of cancer risk factors and outcomes within rural and urban settings. These limitations hamper data interpretation and may lead to inequitable distribution of resources to address disparities. In this study, we describe cancer risk factors and screening across various U.S. rural-urban classification codes to inform our understanding of cancer disparities across the rural to urban continuum. We examined the prevalence and trends in cancer risk factors and screening across the following rural-urban classification codes for counties and county-equivalents in 2013; U.S. Office of Management and Budget (OMB), National Center for Health Statistics (NCHS), U.S. Department of Agriculture, Economic Research Service’s rural-urban continuum codes (RUCC), and Urban Influence Codes (UIC). County-level data on demographics (age, race, education, income, poverty level, insurance status), and cancer risk factors (obesity, physical inactivity, alcohol consumption), including cancer screening (colorectal, cervical and breast) were obtained from the U.S. Census Bureau, Behavioral Risk Factor Surveillance System, and National Health Interview Survey from 2008-2013. Overall, rural counties’ populations were more likely to be older, white, and uninsured with lower educational attainment and household income than urban counties (all ptrend&amp;lt;0.001). Across all classification codes, the prevalence of smoking, obesity, physical inactivity, and binge alcohol use increased (all ptrend&amp;lt;0.03), while colorectal, cervical and breast cancer screening decreased (all ptrend&amp;lt;0.001) with increasing rurality. Variation in the prevalence of cancer risk factors and screening was also evident within rural regions. For example, cervical cancer screening ranged from 67.6% to 74.7%, breast cancer screening from 65.4% to 68.2%, and colorectal cancer screening from 52.8% to 57.2% across rural counties. Our findings suggest that rural cancer disparities persist across multiple rural-urban classification codes, with marked variation in cancer risk factors and screening apparent within rural regions. Thus, focusing on a rural-urban dichotomy may fail to identify subpopulations of rural residents at greater risk for cancer and cancer-related mortality. As such, the variation in cancer disparities within rural regions, including persistent racial/ethnic and socioeconomic differences, should be considered in future cancer control research to inform the development of targeted policies and strategies to address rural cancer disparities. Citation Format: Kelly A. Hirko, Huiwen Xu, Laura Q. Rogers, Michelle Y. Martin, Siddhartha Roy, Kimberly M. Kelly, Shannon M. Christy, Kimlin T. Ashing, Jean C. Yi, Marquita W. Lewis-Thames, Cathy D. Meade, Qian Lu, Clement K. Gwede, Julianna Nemeth, Rachel M. Ceballos, Usha Menon, Katie Cueva, Karen Yeary, Lisa Klesges, Monica L. Baskin, Kassandra I. Alcaraz, Sabrina Ford. Cancer risk factors and screening across various U.S. rural classification codes: Cancer disparities in the context of rurality [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-258.

Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort

Excessive sugar intake is now recognized as a key risk factor for obesity, type 2 diabetes, and cardiovascular diseases. In contrast, evidence on the sugar-cancer link is less consistent. Experimental data suggest that sugars could play a role in cancer etiology through obesity but also through inflammatory and oxidative mechanisms and insulin resistance, even in the absence of weight gain. The objective was to study the associations between total and added sugar intake and cancer risk (overall, breast, and prostate), taking into account sugar types and sources. In total, 101,279 participants aged >18 y (median age, 40.8 y) from the French NutriNet-Santé prospective cohort study (2009-2019) were included (median follow-up time, 5.9 y). Sugar intake was assessed using repeated and validated 24-h dietary records, designed to register participants' usual consumption for >3500 food and beverage items. Associations between sugar intake and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Total sugar intake was associated with higher overall cancer risk (n=2503 cases; HR for quartile 4 compared with quartile 1: 1.17; 95% CI: 1.00, 1.37; Ptrend=0.02). Breast cancer risks were increased (n=783 cases; HRQ4vs.Q1=1.51; 95% CI: 1.14, 2.00; Ptrend=0.0007). Results remained significant when weight gain during follow-up was adjusted for. In addition, significant associations with cancer risk were also observed for added sugars, free sugars, sucrose,sugars from milk-based desserts, dairy products, and sugary drinks (Ptrend≤0.01). These results suggest that sugars may represent a modifiable risk factor for cancer prevention (breast in particular), contributing to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. This trial was registered at clinicaltrials.gov as NCT03335644.

Total and added sugar intakes, sugar types and cancer risk: results from the NutriNet-Santé cohort

Abstract Background Excessive sugar is now recognized as a key risk factor for several cardiometabolic diseases. In contrast, the associations between sugars and cancer risk in cohort studies have been less investigated, and data is lacking regarding differential effect of sugar types and sources. Experimental data suggest that sugars could play a role in cancer etiology, through obesity but also through inflammatory and oxidative mechanisms and insulin resistance. Our objective was to study the associations between total and added sugar intake and cancer risk, accounting for sugar types and sources. Methods 101,279 French adults from the NutriNet-Santé prospective cohort study (2009-2019) were included. Sugar intake was assessed using repeated 24h-dietary records, designed to register participants' usual consumption for more than 3,500 food and beverage items. Associations with cancer risk were assessed by multi-adjusted Cox proportional hazard models. Results Sugar intake was associated with increased cancer risk (2,503 cases, Hazard Ratio Quartile 4 vs 1=1.17, 95% Confidence Interval 1.00-2.37, P trend=0.02). This association was mainly driven by breast cancer (783 cases, HR Q4 vs Q1=1.51 (1.14-2.00); P trend=0.0007) and remained significant even when weight-gain during follow-up was accounted for. Associations were more specifically observed for added sugars (P trend=0.02), free sugars (P trend=0.007), sucrose (P trend=0.01), and sugars from milk-based desserts (P trend=0.02), from sugary drinks (P trend=0.002), and from dairy products (P trend=0.01). Conclusions These results suggest that sugar (especially added sugar), of which intake is increasing in Western countries, may represent a modifiable risk factor for cancer prevention, adding to its well-established effect on dental and cardiometabolic health. These findings provide important and novel insights to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. Key messages In this large-scale prospective cohort of French adults, sugar intake (especially added sugar) was associated with higher cancer risk. These results suggest that (added) sugar may represent a modifiable risk factor for cancer prevention, adding novel insights to current debates on implementing sugar-related public health policies.

Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda.

Background:Research into aetiologies and prevention of the commonest cancers and implementation of primary and secondary prevention can reduce cancer risk and improve quality of life. Moreover, monitoring the prevalence of cancer risk factors in a specific population helps guide cancer prevention and early detection efforts and national cancer control programming.Objective:This article aims to provide the scope and findings of cancer risk studies conducted in Uganda to guide researchers, health-care professionals, and policymakers.Methods:Between November 2019 to January 2020, we searched peer-reviewed published articles in Pubmed, EMBASE and Cochrane Library (Cochrane central register of controlled trials-CENTRAL). We followed the recommendation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – the PRISMA. The primary focus was to identify cancer risk and prevention studies conducted in Uganda and published in peer-reviewed journals from January 2000 and January 2020. We used key Boolean search terms with their associated database strings.Results:We identified 416 articles, screened 269 non-duplicate articles and obtained 77 full-text articles for review. Out of the 77 studies, we identified one (1%) randomized trial, two (2.5%) retrospective cohort studies and 14 (18%) case-control studies, 46 (60%) cross-sectional studies, five (6.4%) ecological studies, three panel studies (4%) and six (8%) qualitative studies. Cervical cancer was the most studied type of cancer in Uganda (23.4%, n = 18 studies), followed by lymphomas – both Hodgkin and Non-Hodgkin sub-types (20.7%), n = 16 studies) and breast cancer (15.6%, n = 12 studies). In lymphoma studies, Burkitt lymphoma was the most studied type of lymphoma (76%, n = 13 studies). The studies concentrated on specific cancer risk awareness, risk perceptions, attitudes, uptake of screening, uptake of human papillomavirus vaccination, the prevalence of some of the known cancer risk factors and obstacles to accessing screening services.Conclusion:The unmet need for comprehensive cancer risk and prevention studies is enormous in Uganda. Future studies need to comprehensively investigate the known and putative cancer risk factors and prioritize the application of the higher-hierarchy evidence-generating epidemiological studies to guide planning of the national cancer control program.

Prevalence of Various Cancer-Related Risk Factors among the Forcibly Displaced Myanmar National Community, the Rohingya, in Bangladesh: A Preliminary Assessment

Background: Large numbers of Forcibly Displaced Myanmar Nationals (FDMN), also called the Rohingya community, in Bangladesh face chronic life-threatening illnesses. Symptoms concerning for a cancer diagnosis are not easily evaluated and treated by healthcare systems available to this population. We conducted a rapid needs assessment of cancer screening and pain and palliative care with the goal of identifying the prevalence of cancer risk factors among the Rohingya who attended local health facilities. Methods: A cross-sectional study was conducted in the Kutupalong camp of Ukhiya, Cox’s Bazar among the Rohingya community. Data were collected through purposive sampling. Face-to-face interviews were done using a structured questionnaire. Statistics were analyzed by using IBM SPSS 23. Results: Out of 85 participants, 75 were female and 10 were male. 70 (82.4%) were uneducated (defined as lacking any formal institutional education), 10 (11.8%) people completed the primary level education and only 5 (5.9%) people received secondary level education. There were many participants with pulmonary disease with 35 (41.2%) people endorsing a history of asthma, bronchitis, and/or tuberculosis. There was a lack of female menstrual sanitation and hygiene with only 25 (29.4%) patients using sanitary napkins, that were donated by Non Government Organizations. Only 5.9% of the women had received any form of cervical cancer screening. Conclusion: This study identifies risk factors associated with cancers and life-limiting diseases among the FDMN Rohingya refugees in Bangladesh. It is necessary to develop targeted education, cancer screening and cancer awareness programs for this population.

Sugary drink consumption and cancer risk: results from NutriNet-Santé prospective cohort

Abstract Background The objective was to assess the associations between the consumption of sugary drinks (sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages and cancer risk. Methods Overall, 101,257 participants aged ≥18y (mean age: 42.2) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed using repeated 24h-dietary records, designed to register participants’ usual consumption for 3,300 different food and beverage items. Associations between beverage consumption and the risk of overall, breast, prostate and colorectal cancer were assessed by multi-adjusted Fine&amp;Gray Hazard models, accounting for competing risks. Results The consumption of sugary drinks was significantly associated with overall cancer risk (n = 2,193 cases, sHRfor a 100mL/d increase=1.18, 95% confidence interval 1.10 to 1.27, P&amp;lt;.0001) and breast cancer risk (n = 693 cases, sHRfor a 100mL/d increase=1.22, 95% confidence interval 1.07 to 1.39, P = 0.004). The consumption of artificially sweetened beverages was not associated with cancer risk. In specific sub-analyses, the consumption of 100% fruit juice was significantly associated with overall cancer risk (n = 2,193 cases, sHRfor a 100mL/d increase =1.12, 95% confidence interval 1.03 to 1.23, P = 0.007). Conclusions In this large prospective study, the consumption of sugary drinks was positively associated with overall and breast cancer risks. Of note, 100% fruit juices were also positively associated with overall cancer risk. These results need replication in other large-scale prospective studies. They suggest that sugary drinks, which are massively consumed in Western countries, may potentially represent a modifiable risk factor for cancer prevention. Key messages In this large prospective study (n = 101,257), the consumption of sugary drinks (including 100% fruit juice) was associated with an increase in overall and breast cancer risk. In specific sub-analyses, 100% fruit juices were also associated with an increased risk of overall cancers. The consumption of artificially sweetened beverages was not associated with cancer risk.

Abstract P6-10-01: Consumption of sugar-containing beverages and cancer risk: Results from the NutriNet-Santé prospective cohort

Abstract OBJECTIVE To assess the associations between the consumption of sugar-containing and artificially sweetened beverages and cancer risk. DESIGN Population based prospective cohort study. SETTING AND PARTICIPANTS Overall, 101 257 participants aged ≥18y (mean age: 42.2±14.4y) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugar-containing and artificially sweetened beverages were assessed using repeated 24h-dietary records, designed to register participants' usual consumption for 3300 different food and beverage items. MAIN OUTCOME MEASURES Associations between beverage consumption and overall, breast, prostate and colorectal cancer risk were assessed by multivariable Cox Proportional Hazard models adjusted for known risk factors. RESULTS A 100mL increase in the consumption of sugar-containing beverages was significantly associated with an increased risk of overall cancer (HR=1.08, 95% confidence interval 1.04 to 1.12, P&amp;lt;.0001) and breast cancer (HR=1.11, 95% confidence interval 1.04 to 1.19, P&amp;lt;0.002). The consumption of artificially sweetened beverages was not associated with cancer risk. In sub-analyses, a 100 mL increase in the consumption of 100% fruit juice was significantly associated with an increased risk of overall cancers (HR=1.08, 95% confidence interval 1.02 to 1.15, P=0.01). These associations were strongly mediated by the sugar contained in these beverages. In contrast, weight gain during follow-up did not appear as a strong mediator. Besides, results were similar in overweight and non-overweight participants. CONCLUSIONS In this large prospective study, a 100mL increase in the consumption of sugar-containing beverages in the diet was associated with an 8% significant increase in overall cancer risk and an 11% significant increase in breast cancer risk. 100% fruit juices were also associated with an 8% increased risk of overall cancers. Given the massive consumption of sugar-containing beverages in Western countries, these results suggest that they may represent a key modifiable risk factor for cancer prevention. Citation Format: Chazelas E, Srour B, Desmetz E, Kesse-Guyot E, Julia C, Druesne-Pecollo N, Galan P, Zelek L, Hercberg S, Latino-Martel P, Deschasaux M, Touvier M. Consumption of sugar-containing beverages and cancer risk: Results from the NutriNet-Santé prospective cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-10-01.

Cancer Statistics for Hispanics/Latinos, 2018.

Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.8% (57.5 million) of the total population in the continental United States and Hawaii in 2016. In addition, more than 3 million Hispanic Americans live in the US territory of Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanics in the United States based on data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the Centers for Disease Control and Prevention. For the first time, contemporary incidence and mortality rates for Puerto Rico, which has a 99% Hispanic population, are also presented. An estimated 149,100 new cancer cases and 42,700 cancer deaths will occur among Hispanics in the continental United States and Hawaii in 2018. For all cancers combined, Hispanics have 25% lower incidence and 30% lower mortality compared with non-Hispanic whites, although rates of infection-related cancers, such as liver, are up to twice as high in Hispanics. However, these aggregated data mask substantial heterogeneity within the Hispanic population because of variable cancer risk, as exemplified by the substantial differences in the cancer burden between island Puerto Ricans and other US Hispanics. For example, during 2011 to 2015, prostate cancer incidence rates in Puerto Rico (146.6 per 100,000) were 60% higher than those in other US Hispanics combined (91.6 per 100,000) and 44% higher than those in non-Hispanic whites (101.7 per 100,000). Prostate cancer is also the leading cause of cancer death among men in Puerto Rico, accounting for nearly 1 in 6 cancer deaths during 2011-2015, whereas lung cancer is the leading cause of cancer death among other US Hispanic men combined. Variations in cancer risk are driven by differences in exposure to cancer-causing infectious agents and behavioral risk factors as well as the prevalence of screening. Strategies for reducing cancer risk in Hispanic populations include targeted, culturally appropriate interventions for increasing the uptake of preventive services and reducing cancer risk factor prevalence, as well as additional funding for Puerto Rico-specific and subgroup-specific cancer research and surveillance.

Use of age-period-cohort analysis in cancer epidemiology research.

Age-period-cohort (APC) models simultaneously estimate the effects of age - biological process of aging; time period - secular trends that occur in all ages simultaneously; and birth cohort - variation among those born around the same year or from one generation to the next. APC models inform understanding of cancer etiology, natural history, and disparities. We reviewed findings from recent studies (published 2008-2018) examining age, period, and cohort effects and summarized trends in age-standardized rates and age-specific rates by birth cohort. We also described prevalence of cancer risk factors by time period and birth cohort, including obesity, current smoking, human papilloma virus (HPV), and hepatitis C virus (HCV). Studies (n=29) used a variety of descriptive analyses and statistical models to document age, period, and cohort trends in cancer-related outcomes. Cohort effects predominated, particularly in breast, bladder, and colorectal cancers, whereas period effects were more variable. No effect of time period was observed in studies of breast, bladder, and oral cavity cancers. Age-specific prevalence of obesity, current smoking, HPV, and HCV also varied by birth cohort, which generally paralleled cancer incidence and mortality rates. We observed strong cohort effects across multiple cancer types and less consistent evidence supporting the effect of time period. Birth cohort effects point to exposures early in life - or accumulated across the life course - that increase risk of cancer. Birth cohort effects also illustrate the importance of reconsidering the timing and duration of well-established risk factors to identify periods of exposure conferring the greatest risk.